Medical Microbiology

orgranulocyticdigestiveenzymes.Themostimportantdiseasesresulting

fromcytotoxichumoralimmuneresponsesarelistedinTable2. 11.

AutoantibodyResponses..............................

Someclinicallyimportantautoantibodiesaredirectedagainsthormonere-

ceptors,forexamplethyrotoxicosisinBasedow’sdiseaseiscausedbyauto-

antibodiesthatstimulatetheTSHreceptor,andmyastheniagravisiscaused

byblockageoftheacetylcholinereceptorbyspecificautoantibodies.Other

antibody-induceddiseasesmediatedbyantibodies,directedagainsthor-

monesandothercellularselfantigens,includeHashimotothyroiditis(in-

ducedbyanti-thyroglobulinandanti-mitochondrialautoantibodies),perni-

ciousanemia(anti-intrinsicfactor),pemphigusvulgaris(anti-desmosome)

Guillain-Barre ́syndrome(ascendingparalysiscausedbyspecificmyelinauto-

antibodies),andscleroderma(involvinganti-collagenantibodies).Other

immunopathologiesinvolvingautoantibodiesincludetransplantrejection

asaresultofendothelialdamage(especiallyinxenogeneictransplants),

andtumorrejectioncausedbyantibodiesagainsttumor-associatedantigens

presentonneoplasticcells(especiallyrelevantforlymphohematopoietic

110 2 BasicPrinciplesofImmunology

Table2. 11 ExamplesofAntibody–RelatedTypeIIImmunopathologies

Antibody Autoimmunepathologyorimmunopathology

Anti-cellmembrane –Rhesusincompatibility

• Bloodtransfusioncomplications


• Autoimmunehemolyticanemia


• Immuneneutropenia,idiopathicthrombocytopenia
  Anti-basementmembrane –Goodpasturesyndrome
  Anti-collagen –Sclerodermia


• Pemphigoid(anti-epidermalbasalmembrane)
  Anti-desmosome –Pemphigusvulgaris
  Anti-receptor –Anti-acetylcholinereceptors:myastheniagravis


• Anti-TSHreceptors:Basedowdisease
  Anti-hormone –Anti-thyroidhormone(Hashimotothyroiditis)


• Anti-intrinsicfactor(perniciousanemia)
  Anti-medication –Chemicalgroups(haptens)boundtocellsurface
  (cytolysis,agranulocytosis)
  Anti-cellcomponent –Anti-DNA(lupuserythematosus,LE)


• Anti-mitochondrial(LE,Hashimotothyroiditis)

2

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Kayser, Medical Microbiology © 2005 Thieme

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