Author Topic: What type of hypersensitivity-autoimmunity is Sjogren?  (Read 19071 times)

inga

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Re: What type of hypersensitivity-autoimmunity is Sjogren?
« Reply #30 on: December 15, 2010, 10:55:21 AM »
I see there is a type V, 'autoimmune disease'.

For myself, obviously, I have a T helper problem.  My B cells appear normal, hence my reluctance to 'clobber' them.  Mybe that doesn't make sense but, in my head it does.

navydad

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Re: What type of hypersensitivity-autoimmunity is Sjogren?
« Reply #31 on: December 15, 2010, 11:08:20 AM »
Inga,, your pretty sharp, so if in your head it makes sense,, it probably does,, I dont know if they ever did a test on my T cells,,, only thing I recall is C-4,, which I think were a bit low normal,, only thing that ever shows up odd is eosonophils,,8% and ABS esonophils .60

inga

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Re: What type of hypersensitivity-autoimmunity is Sjogren?
« Reply #32 on: December 15, 2010, 11:37:57 AM »
I don't normally use Wikipedia as a source, but I am going to use it as a resource here....it is pretty clear and instructive.

http://en.wikipedia.org/wiki/Epithelium

So, if one makes it thru this site, one is struck by a few facts....One that struck me is, neural tissue and it's connection to epithelium.  Could it be that the PN of SjS could be due to a problem with the epithelium?  Let's say that auto-antibodies are attacking the epithelium (all types? or glandular and that which lines lumens?) 

It seems to me more on a continuum with Scleroderma, without the keritanized epithelium being affected?  I dunno, it is my feeling that most AI disease is on a continuum....or on a spectrum.


Nathan

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Re: What type of hypersensitivity-autoimmunity is Sjogren?
« Reply #33 on: December 15, 2010, 12:43:26 PM »
inga: Don't feel bad about using wikipedia as a resource. It is considerably higher quality than it was initially, and it is pretty much a requirement to site sources (and especially the medical and biological areas, the articles are often reviewed by professionals).

inga/anita: Knowing the levels of just alpha 1-globulin itself isn't especially helpful in people like us, it is often used as a comparasin against other globulin values--for example, alpha 1-globulin is compared to alpha 2-globulin, and if 2 is higher than 1, it is often a sign of chronic inflammation (as in anita's case), but this probably isn't especially worthwhile information, unless your doctor is worried about COPD or malignancies or other blood-related diseases (this test is great for detecting hemolysis).

anita: I think rnathans sort of answered your question. The parameters of reading the test are based on lots of data. They picked a number they felt right to minimize the sensitivity and specificity of the test--that is, keep the amount of false positives and negatives as low as possible. I believe this is why there are multiple grading scales--one population might find one optimal number, whereas another might be completely different.

Baklavas: I believe SS is Ab-mediated from the start, as the lymphocytic infiltration that we see is a result of auto-antigens already in circulation. There should be no self-reactive cells that bind to the MHC II site on the glandular cells that are targeted.
Seronegativity may be due to low test sensitivity. Here's a good article about SS-A testing (http://rheumatology.oxfordjournals.org/content/32/6/449.abstract). It may be due to insufficient leucocytes (many with Autoimmune diseases are actually immune deficient). It may also be due to co-morbid conditions, and whether or not a patient has primary or secondary Sjogren's. Those with secondary sjogren's are much less likely to show seronegativity. I believe it's a complicated issue, and has much more to it than just the surface.

inga

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Re: What type of hypersensitivity-autoimmunity is Sjogren?
« Reply #34 on: December 15, 2010, 12:51:49 PM »
BTW navydad, I know enough to know I don't know squat, about this.

navydad

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Re: What type of hypersensitivity-autoimmunity is Sjogren?
« Reply #35 on: December 15, 2010, 01:01:05 PM »
DOnt sell yourself short Inga,, your holding your own from what I see,, then again I might not own a weiner dog,, it might jsut be a long little pony thats red,, but no,, your sharp, you do research.. and you try to find out what exactly is going on with this nonsense

Patze

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Re: What type of hypersensitivity-autoimmunity is Sjogren?
« Reply #36 on: December 15, 2010, 04:57:00 PM »
A short pony Navydad?!?!  Too cute of a description of a doxie! :D


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irish

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Re: What type of hypersensitivity-autoimmunity is Sjogren?
« Reply #37 on: December 15, 2010, 08:17:56 PM »
Inga, It is interesting reading all these numbers. I have had an issue since the early 1980's that continues to stay in the back of my mind---especially since I have the positive FANA both speckled and nucluolar(sp). Never spell it the same way twice!!!! Also, I feel the same way you do about your B cells. I am rather attached to them and I don't think that killing them off to see if I would improve is something I care to do. There comes a time when to do nothing is the best treatment there is. Like you, IVIG is it for me. If I get cancer my goose is cooked the way I see it. Sometimes one lives longer and better with no treatment for cancer and good pain control. I won't get to make a choice.

ANyway, back then I started to have hard tissue show up on my chest. It is between my breasts and under them. You can see the little knobs of hard tissue and feel them when you run your fingers over my skin. It is the only place on my body that I have the tissue changes, but scleroderma has always been nagging me. Sort of like, if I live long enough I will probably add about 5 more AI diseases to the platter.

Also, with your CD and t-cells issues do you have a lot of little skin tags. I have many and that also started in the early 80's. I would go to the dermatologist and he would zap them and do 100 at a time. I felt like a cooked goose when he was done.

My immunologist told me that these are caused by a virus. I believe him cause I have had times when after my IVIG they seem to become less. Sort of like the fall off and no more grow for a week or two. Really a weird thing. I no longer look good in anything other than a t-shirt for sure. Irish ;D
« Last Edit: December 15, 2010, 08:25:31 PM by irish »

Baklavas

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Re: What type of hypersensitivity-autoimmunity is Sjogren?
« Reply #38 on: December 16, 2010, 07:14:56 AM »
The majority of infiltrating lymphocytes in SS is CD4+.
This demands MHC II antigen-presentation.
MHC-II antigen-presents exogenous antigen-parts.
i) this can account for molecular mimicry from Coxsackie,
ii) it seems the route can do without the B cells for starters.
..
One can say the Abs appear secondarily after the damage established
by CD8+.
If anyone is aware whether there is an established chronologically series (in terms of T and B cells), kindly
share.

Baklavas

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Re: What type of hypersensitivity-autoimmunity is Sjogren?
« Reply #39 on: December 16, 2010, 07:18:56 AM »
..and, and I thank 4 the oxford journal notation upon seronegativity.

inga

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Re: What type of hypersensitivity-autoimmunity is Sjogren?
« Reply #40 on: December 16, 2010, 09:48:15 AM »
Does it have to be Coxsackie virus only?

I am fairly certain I had Coxsackie, and I remember when, however I was also infected with 'Lyme'....or Borrelia Burgdorferi, which is spirochetal, not viral....however, I am also seropositive for Human Granulocytic Erhlichiosis.  (Europe has a different strain of Borrelia).  I am just wondering if the activation of the CD4+ in the manner you describe is attributable solely to Coxsackie?

I live rurally and have had a lot of contact with animals both domestic and wild.  I am also an RN, and had exposure to many organisms, of which the common ones have been ruled out as causitive.

Lastly, if this is molecular mimicry, there is little that can be done other than managing the response?


inga

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Re: What type of hypersensitivity-autoimmunity is Sjogren?
« Reply #41 on: December 16, 2010, 10:29:21 AM »
Well, the autoimmune epithelitis theory makes sense even down to the periodic attacks of vertigo....the labyrinth is lined with epithelium too.

Baklavas

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Re: What type of hypersensitivity-autoimmunity is Sjogren?
« Reply #42 on: December 20, 2010, 06:04:29 AM »
Who' s in  4 some mini survey??!..

Let 's see:

               Any Sjogren patient who has contracted Coxsackie virus in his knowledge is welcomed
to state it along i) antibody titres, ii) therapy she received, iii) whether any resolution was observed upon therapy, or any experience with the virus...

               - A specialist would call this "retrospective" study if I m not much mistakening.. -

inga

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Re: What type of hypersensitivity-autoimmunity is Sjogren?
« Reply #43 on: December 20, 2010, 06:38:41 AM »
I only had a clinical diagnosis.....we had a Coxsackie B outbreak in the early 1980's.   I had the severe headache and red sclera that came with the infection, but they did not do bloodwork, nor treat.  It lasted 7-10 days, and was quite severe, but did not require hospitalization.  All 4 of my kids got it, then my husband, then myself, last.  We lost the entire month of August.  All of us had the headache and the bright red sclera, which were striking, and a feature of the disease.

Sorry, can't help you with data, as there is no proof.  I suspect very few would have titers, since I don't think many are done for Coxsackie.



Baklavas

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Re: What type of hypersensitivity-autoimmunity is Sjogren?
« Reply #44 on: December 20, 2010, 06:44:56 AM »
   I confirm that Coxsackie antibodies is not a routine test - even nowadays.