Professional Documents
Culture Documents
Nanang Sukmana
Divisi Alergi - Imunologi Klinik
Departemen Ilmu Penyakit Dalam FKUI / RSCM - Jakarta
Defining Autoimmune Disease
An autoimmune disease is a condition in
which tissue injury is caused by T-cell or
antibody reactivity to self
self.. The immune
activation may be initiated by infection, but
must persist in the absence of any detectable
microbial antigen
antigen..
(Davidson and Diamond, 2001
2001)).
CD4+25+
Treg cells
Doan T, Melvold
R, Viselli S,
Waltenbaugh .
Immunology.
Lippincotts
Illustrated
Reviews. 2008
Female: Male ratios in Autoimmune Diseases
Scleroderma Th2 92
Polymyositis/dermatomyositis Unknown 67
Vitiligo Unknown 52
Diseases Classification:
Six major Rheumatic diseases
Systemic Lupus Erythematosus(SLE)
Scleroderma(Scl)
Polymyositis(PM)
Dermatomyositis(DM)
Rheumatoid Arthritis(RA)
Primary Sjogrens syndrome
Infections in S L E
Infections related to the
development of autoantibodies
Hepatitis A Measles Chickenpox
Mumps Influenza
virus
IFN
IFN
TLR cytokines blockade
inhibitors DC
TLR9
TLR
IFN
IFN
blockade
B B7.1/2 B7.1/2
CTLA4-Ig
CTLA4-
TLR2
TLR4
TLR6
inhibitors
TLR7
CD28
Abatacept TLR8
CD40
IFN
IFN IL-2, 4
IL-10 CXCL13
TNF CD40L CXCR4
pDC
IFN
IL-12p40 T IP-10
S1P M TNF
blockade
TNF
Cytokine IFN- IL-1
Lymphocyte inhibitors
IL-12 IL-6
signaling
IL-23
TNF
Chemokine -
inhibitors Lymphocyte IL-6
IL-
trafficking blockade
Adapted from Martin & Chan, 2006. modulators
Annu. Rev. Immunol. 24:467-96
Gilliam classification
Disease Mechanism
Take Home Points
1. Remission
2. Organ Survival
3. Patient Survival
4. Complication/
Comorbid
5. Quality of Life
(Cost)
Ann Rheum Dis 2010;69:1603-1611 doi:10.1136/ard.2010.135186
Review 2010
Therapeutic opportunities in systemic lupus erythematosus: state of the art and prospects for the new decade
1.George K Bertsias1, Jane E Salmon2, Dimitrios T Boumpas1
Therapy
Induction
Maintenance
Prednison Cyclo MM
Prednison AZT MM
Thank You