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GEM > 1.07 Mucosal Immunology > Flashcards

1.07 Mucosal Immunology Flashcards

1
Q

What kind of cells produce antimicrobial peptides in the intestinal lumen?

A

Paneth cells

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2
Q

Where is secretory IgA produced at the intestinal mucosa?

A

Lamina propria (plasma cells)

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3
Q

How are intestinal epithelial cells held together to maintain a first line of defense/physical barrier?

A

Tight junctions

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4
Q

What are some immune stimuli that can increase mucin production?

A

IL1, IL4, IL6, TNFa, Interferons (Type 1)

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5
Q

Intestinal epithelial cells produce what two anti microbial substances?

A

Paneth cells + defensins

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6
Q

Why do IECs express TLR 2,4, 5, 6, 7, 9, and engage in signaling?

A

Increase tight junction strength, motility and replication, & defensin secretion

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7
Q

Do IECs also have Nod like Receptors?

A

Yup to recognize pathogens

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8
Q

When are TLR and NLR activated at IECs (why not all the time)?

A

TLR only activated past basolateral surface (past epi) and NLR only activated at cytosol

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9
Q

What is included in the adaptive immune defense at the mucosa?

A

GALT, Peyer’s patches, mesenteric lymph node

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10
Q

What’s in a Peyer patch?

A

B, T, DC cells and Macrophages

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11
Q

What delivers antigens from lumen to GALT to be recognized by adaptive immune system?

A

M cells (with short irregular micro ills)

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12
Q

Where does antigen presentation to the T cells happen?

A

Lymph nodes (GALT, Peyer, mesenteric)

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13
Q

How are effector T cells distributed in the mucosa?

A

CD8 = epithelium (kill)
CD4 = peyers patches + nodes (orchestrate)

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14
Q

Where do al the Th responses happen at mucosa?

A

Lamina propria

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15
Q

What helps enhance fluid and mucus secretion, smooth muscle contraction, and bowel motility?

A

IL-4, IL-13

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16
Q

What immune response against intestinal helminth infections?

A

Th2 (IL4, IL13, IgA)

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17
Q

What immune response maintains mucosal epithelial barrier function?

A

Th17 (IL17, IL22, IgA)

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18
Q

What process allows activated T cells to go from the mucosal Lamina propria to lymph nodes?

A

Imprinting

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19
Q

What is essential to allow the expressions of integrins and chemokine receptors for imprinting process?

A

Retinoic acid (via DCs)

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20
Q

What immune responses is typically found in the gut?

A

Th2 (immunosuppressive)

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21
Q

What kind of cells are found in the gut almost 2 fold?

A

Tregs

22
Q

Peripheral Tregs are reliant on what two factors?

A

Retinoic acid and TGFb

23
Q

TGFb is also necessary factor for what other immune component in the gut?

A

IgA (isotype switching)

24
Q

What autoimmune disorder is associated with Treg dysfunction?

A

IPEX (immune dysfunction, polyendocrinopathy, enteropathy, X linked)

25
Q

A mutation where leads to a loss of Tregs?

A

Foxp3

26
Q

Where are B cells activated in the gut?

A

GALT

27
Q

What’s the most abundant antibody in the human body?

A

IgA

28
Q

What is the GALT ration of B:T cells versus normal lymph nodes?

A

5:1

29
Q

What antibody is most abundant in the blood?

A

IgG

30
Q

IgA is able to get to the mucosal layer via transcytosis because of what?

A

Poly-Ig receptor (on IECs)
It also gets cleaves and joins IgA afterwards to protect it a bit

31
Q

How to infants get IgA?

A

Breastfeeding

32
Q

Most common immunoglobulin deficiency that leads to decreased levels of IgA and normal IgM and IgG?

A

Selective IgA deficiency

33
Q

Clinical presentation of selective IgA deficiency?

A

Increases respiratory, gastrointestinal and GU infections + giardiasis risk (most asymptomatic)

34
Q

Short chain fatty acids produced by commensal gut bacteria have what role in immunity?

A

Stimulate Treg production + inhibit neutrophil activation

35
Q

When an immune response is elicited in the gut, what do IECs produce?

A

IL1, TNFa, IFNy

36
Q

What live attenuated vaccine is delivered orally to stimulate musical IgA response?

A

Polio live (Sabin)

37
Q

What is activated and where in an allergic food response that causes nausea, vomiting, diarrhea, and abdominal pain?

A

Mast cells in Lamina propria

38
Q

Why does an allergic food response also led to anaphylactic/systemic symptoms too?

A

Antigens activate mast cells in different tissues too

39
Q

What are the antibodies in a pernicious anemia directed against?

A

Intrinsic factor (via parietal cells of stomach needed for B12 absorption at intestine)

40
Q

What is the leading theory on what causes IBDx?

A

Inadequate Treg mediated suppression to commensal invasion — Th1 — Inflammation

41
Q

Crohn’s disease illicit what kind of reaction in the gut that is thought to cause defect in inflammasome mediated intracellular signaling to bacterial products?

A

Granulomatous reaction

42
Q

Can affect any part of GI tract, NOD2 loss of function mutation, and Th1 mediated (IFNy + IL12) granulomatous inflammation?

A

Crohn’s Dx

43
Q

Colon only, IL-10 suspectibility mutation, Th2 mediated (IL5)?

A

Ulcerative colitis

44
Q

What is triggering the immune responses in celiacs disease?

A

Deamidated gliadin (presented to DC and activate T cells that are intolerant)

45
Q

What CD4 T cells are implicated in celiacs?

A

HLA DQ2
HLA DQ8

46
Q

What antibodies are associated in celiacs?

A

Anti-tTG, antiendomysial, antigiladin

47
Q

What kind of antibodies should you look for if patient suspected with celiacs tests negative for IgA?

A

anti tTG-IgG

48
Q

Celiacs and Crohn’s are what kind of hypersensitivity reaction?

A

IV

49
Q

Chronic gastritis associated with H. Pylori infections can lead to what?

A

MALT lymphomas

50
Q

Painful swollen tongue, hyper segmented neutrophils in blood smear, macrocytic anemia, neurological symptoms, and hashimoto thyroiditis hint at a deficiency of what?

A

Intrinsic factor

51
Q

What will differentiate/hint a folate versus a B12 deficiency in a clinical stem?

A

Autoimmune disease (B12 autoantibody hint)

GEM (28 decks)

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