医学课件 生物主題報告自體免疫疾病

生物主題報告,Chap43 Multiple sclerosis Myasthenia gravis,B9902072馮敏 B9902098謝慈芸,自體免疫疾病,一般在人類的免疫系統中，由B淋巴球製造許多的抗體來對付外來的疾菌，病毒，而在某些異常的情況之下， B淋巴球製造出來的抗體 對於身體的器官或組織會有作用，進而破壞自己的器官或組織造成疾病 Multiple Sclerosis成因：確切成因未知；已知是身體攻擊體內髓鞘質的自體免疫疾病 Myasthenia Gravis成因：體內產生抗乙醯胺受體的抗體，影響神經肌肉交接處,Multiple Sclerosis(多發性硬化症) MECHANISM,+,自體免疫疾病 （autoimmune disease）：身體會產生一些特殊抗體，來攻擊自體的神經組織,The name multiple sclerosis refers to scars (sclerosesbetter known as plaques斑塊 or lesions損害) particularly in the white matter of the brain and spinal cord, mainly composed of myelin Its possible for the damaged myelin to be recoveredremyelination(髓鞘質再生現象),CAUSE,Changes inHLA (human leukocyte antigen class II gene人類白細胞抗原基因) region of Chromosome 6 increase the probability of suffering MS.,SYMPTOMS,Almost any neurological symptom can appear with the disease, and often progresses to physical and cognitive disability. 一般的症狀：體感覺(觸覺)發生問題、失去肌肉的強度或是靈敏度、走路，平衡，或協調出現問題 、因為神經發炎所引起的視覺問題 其他可能的症狀：膀胱以及腸子方面的問題 、疼痛、 疲勞、認知方面的問題(例如：思考，記憶) 憂鬱 說話含糊不清 患者多在二十至四十歲時發病，特別是三十一至三十三歲最為常見，女性的發生率約為男性的兩倍,DIAGNOSIS &TREATMENT,不同神經系統部位的疾病證據 至少有兩個急性疾病爆發的證據 無法開刀治療，沒有藥物可以治療，只能夠控制病情及緩解疾病所帶來的併發症 皮質類固醇、干擾素、人工合成髓蛋白,Myasthenia Gravis(MG)重症肌無力症,an autoimmune neuromuscular disease leading to fluctuating muscle weakness and fatiguability The disease incidence is 330 cases per million and rising as a result of increased awareness not directly inherited nor is contagious may occur in more than one member of the same family(目前已知與11種基因有關),CAUSE,體內產生了一種乙醯膽素接受體的抗體，進而導致接受體的破壞與數目的減少，使神經與肌肉間的傳導功能受損。,1. Axon 2. Sarcolemma 3. Synaptic vesicle 4. Nicotinic acetylcholine receptor 5. Mitochondrion,SYMPTOMS,A drooping eyelid 眼瞼下垂 Blurred or double vision 視力模糊或複視 Slurred speech 言語不清 Difficulty chewing and swallowing 吞嚥困難 Weakness in the arms and legs 四肢無力 Chronic muscle fatigue 慢性肌肉疲勞 Difficulty breathing 呼吸困難 分類方式：依肌肉軟弱程度區分為五類,DIAGNOSIS,臨床檢查：測試多種肌肉 血液檢查：檢查血液中特定抗體 (1) against the acetylcholine receptor (2)against the MuSK protein(Muscle Specific Kinase) (3)其他症狀(如:Lambert-Eaton syndrome)相關之抗體 (如:against a voltage-gated calcium channel) Neurophysiology： electromyography Edrophonium test Imaging Pulmonary function test,TREATMENT,Medication： (1)Acetylcholinesterase inhibitors (2)Immunosuppressive drugs Plasmapheresis and IVIG Surgery ：thymectomy 胸腺切除術,REFERENCES,Multiple sclerosis-Wikipedia (/wiki/Multiple_sclerosis#Historical_cases) 小小神經科學：多發性硬化症(.tw/neuroscience/ms_c.html) 多發性硬化症-維基百科(/zh-tw/%E5%A4%9A%E5%8F%91%E6%80%A7%E7%A1%AC%E5%8C%96%E7%97%87 Elements4Health (/inheritance-of-multiple-sclerosis-gene-mutation-more-complex-than-previously-thought.html) 免疫真討厭 (/2009/07/12/%E5%A4%9A%E7%99%BC%E6%80%A7%E7%A1%AC%E5%8C%96%E7%97%87/) 多發性硬化症 三叉神經痛 誤為牙痛(/jw!TTOiL4.GGBiXpIotx_vblg-/article?mid=144) 關於多發性硬化症 (.hk/your-health/multiple-sclerosis/index.htm),REFERENCES,小小神經科學：突觸 (.tw/neuroscience/synapse_c.html) Myasthenia Gravis-Wikipedia (/wiki/Myasthenia_gravis) (/wiki/%E9%87%8D%E7%97%87%E8%82%8C%E7%