IMMUNOLOGY CASE STUDY

Immunology Case Study



Immunology Case Study

Case of Mr. Z

Mrs. Z is a 52 years old women having GP. The term "autoimmune disease" refers to a varied group of illnesses that involve almost every human organ system. It includes diseases of the nervous, gastrointestinal, and endocrine systems, as well as skin and other connective tissues, eyes, blood and blood vessels. In all of these diseases, the underlying problem is similar - the body's immune system becomes misdirected and attacks the very organs it was designed to protect. The fact that women have enhanced immune systems compared to men increases women's resistance to many types of infection, but also makes them more susceptible to autoimmune diseases (Lowin & Hahne, 1994: 650).

Taken together, autoimmune diseases strike women three times more than men. Some diseases have an even higher incidence in women. In fact, of the 50 million Americans living with autoimmunity, 30 million people are women, some estimates say. Autoimmune diseases have been cited in the top ten leading causes of all deaths among U.S. women age 65 and younger. Moreover, these diseases represent the fourth largest cause of disability among women in the United States. (Vanderpump, 2002: 839)

At present, the CTLA-4 (chromosome 2q33), thyroglobulin (or ZFAT) (8q24) and likely HLA genes (6p21.3) are the only susceptibility loci for HT and thyroid autoimmunity to be mapped. Two HT-specific susceptibility loci that have been detected in mixed Caucasian families from USA and Europe, HT-1 (13q) near marker D13S173 and HT-2 on chromosome 12q in the vicinity of marker D12S351, are still not defined. HT-2 locus has been subsequently replicated in the extended dataset, with a peak linkage close to marker D12S346, which HT-1 does not have. Possible candidate genes for susceptibility to HT positioned within the HT-2 locus may include the BTG1 and CRADD genes. The BTG1 gene encodes B-cell translocation protein-1, which play an immune regulatory role as a negative regulator of the proliferation of B cells.

Study of the Disease

In recent years, many new immunosuppressive drugs have been discovered and developed for clinical use in transplantation. The wide array of new drugs offers the opportunity to use combinations that block different pathways of immune activation while at the same time selecting drug combinations with nonoverlapping toxicity profiles so that doses of each single drug can be reduced below toxicity levels. The immunosuppressive therapy for patients can be tailored according to their individual needs. (Niederwieser 2003 672-675)

Leflunomide and the malononitriloamides (MNA) are a new class of immunomodulating drugs that are currently under investigation for use in transplantation. In 1985, the anti-inflammatory and immunomodulating properties of leflunomide were recognized, which differ from classical anti-inflammatory and immunosuppressive drugs. The immunosuppressive effects of leflunomide have been investigated extensively in animal models of transplantation. Because of its long half-life (11 to 16 d) in humans, the clinical development of leflunomide has been restricted to use in patients with autoimmune diseases such as rheumatoid arthritis. A large preclinical program has been started to evaluate the potential ...