34-35/21-12-15

1.

2.

CD4 ,
MHC TCR

( )

, .


,

5-7%


, MHC.


.


( IgE).



6

.

,
/
.
:
1)
Hashimoto

Goodpasture (
)

2)
Graves
(myasthenia gravis)


1)

Hashimoto
1

, ,

.

,
.

,

10

1)
Hashimoto CD4
CD8 .




.

TCR/MHC-,

11

Hashimoto # Graves
2)

Grave
s


.
,
,

(Longacting thyroidstimulating, LATS)
12

2)

Graves (Graves' disease)
TSH
,
,

13

2)
H gravis (myasthenia gravis)
,
. myasthenia,

,

14


1)

CTL

() ,


(
IFN-,
TNF- IL-1)

DTH

2:1000 , -

15



CD8
-.

-,
MHC .
,
CD4
:



IFN-
. IFN-
MHC
o ,
( ,
IL-1),

16

:=9:
1

.





17

,
,
.

(rheumatoid factors)
Fc IgG.
gM
.
IgG ,
IgM-IgG, .

,

.
18

TNF

: infliximab (Remicade),
etanercept (Enbrel), adalimumab (Humira), certolizumab (Cimzia)
golimumab (Simponi).

,

.
anti-TNF

.
IL-1 [anakinra, (Kineret)],
IL-6 [tocilizumab, (Roactemra)],
[CTLA4-Ig,
abatacept, (Orencia)] [rituximab, (Mabthera)]
19

 (Multiple Sclerosis, MS)

,
.

MS ,

, .
,


.

20

(-4), -

-4
-.
-
,

T-

(), -23 (IL-23),
IFN-
(TNF).

1


(APLs),
. -



.
21

 (MS)
-

22

 CD4 , MHC
TCR

1/2 .
1 ,
, 2
,
MHC
.

HLA
( HLA-B27 90
HLA-B
)

, V V
-.


.
-
23

 CD4 , MHC
TCR

, .
, CD4 CD8,
.
1.


.
2
.
CD4
. -CD4
,
.
24

)
MHC
)

)

-.

()

(), ()

25

26

(

)



( , ).

MHC
,
.

IL-2
,

27

MHC
.
Graves
MHC-II. IFN
,
.

.
-

- ( s-Treg)

28

29

Mo

30

,

, ,
Rous,
Abelson, ,
Epstain-Barr .

,
60%
.


MHC ,
MHC ,
31

32

,


,

-.
.

:
-.
.
-

.
33

MHC .


MHC
.
. -
. ,

. ,

2,

34

 ( )

Fingolimod ( )

, ,

35

36

37

: :

38

,
,
,

,
,

,

,

39

 Goodpasture

.
gG C3b



,

.


40