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GI Final > 6 Gut Immunity, Nutrition, and Adverse Food Reactions > Flashcards

6 Gut Immunity, Nutrition, and Adverse Food Reactions Flashcards

1
Q

What antibody is mainly used in the gut

A

IgA

It resists proteolysis in the GI

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2
Q

Defects in the epithelial barrier can result in what

A

Allergen sensitization

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3
Q

What is the main cell type responsible for oral tolerance

A

Treg and TGFβ

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4
Q

What cytokine functions to suppress the immune system

A

IL10

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5
Q

What does TGFβ do in the gut

A

Facilitates class switching from IgM to IgA

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6
Q

Th1 heavy reactions in the gut lead to

A

Inflammation and Crohns

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7
Q

Th2 heavy reactions lead to q

A

Allergies and adverse food reactions

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8
Q

What role does retinoic acid play in oral tolerance

A

Helps form the dendritic cells which are responsible for sampling

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9
Q

What does IDO do

A

Helps induce Treg

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10
Q

Where are Ags captured

A

Lamina propria and peyers patches

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11
Q

DCs stimulate Treg through what signals

A

TGFβ, retinoic acid, and IDO

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12
Q

What do macrophages express to expand Tregs

A

IL10

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13
Q

What molecules suppress inflammation

A

Vitamin D, A, and folate

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14
Q

How does the microbiota suppress allergic reactions

A

Inducing Tregs

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15
Q

What ab is involved in allergies

A

IgE

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16
Q

What cell type does the microbiota suppress

A

Basophils and mast cells

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17
Q

What other T cell type do Tregs downregulated

A

Th2 which is essential for generating IgE

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18
Q

What nutritional factors promote the development of allergies

A

High fat diet and MCT

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19
Q

What nutritional factors suppress allergies

A

Vitamin D, A, and LCT

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20
Q

How does the gut microbiota function to suppress allergy

A

Decreasing IgE

Increasing Tregs

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21
Q

What factors can help create a good symbiotic relationship for gut bacteria

A

Short chain FA
Polysaccharide A
Peptidoglycan

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22
Q

What factors can disrupt the gut microbiota

A

Malnutrition
Decreased immune function
Impaired absorption
Infections

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23
Q

What are the types of food reactions

A

Immune mediated (food allergy and celiac dx)

Nonimmune mediated (food intolerances)(lactose)

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24
Q

IgE mediated reactions are Type __ hypersensitivity and non-IgE mediated reaction are Type ____ and ______

A

1; 3; 4

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25
Q

IgE mediated reactions have what phases

A

Immediate (mast cells)

Late-phase

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26
Q

What are non-IgE mediated reactions believed to be caused by

A

T cells typically 4-28 hours

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27
Q

Food allergies can have reactions in what systems

A

Skin, gastrointestinal, and respiratory

28
Q

The most common food allergy is what

A

Milk

29
Q

Within the first 3 to 5 years what allergies are normally lost

A

Milk, eggs, wheat, soy

30
Q

What allergies are likely to continue into adulthood

A

Peanuts, tree nuts, fish, shellfish

31
Q

What induces Th2

A

IL4

32
Q

What cell types react during initiation of a reaction

A

DC go to LN —> Naive T cells —> Th2 —> Th2 —> B cells —> basophil, eosinophil, mast cell

33
Q

What event constitutes sensitization

A

IgE binding to Fcε on basophils and mast cells

34
Q

What reaction is seen during sensitization

A

Nothing

35
Q

What is released from mast cells during allergies

A

Tryptase (tight junction rearrangement)

Histamine

De novo synthesis of cytokines

36
Q

What cell type is central to local and systemic manifestation of food allergies

A

Mast cells

37
Q

What is responsible for the local acute GI response (diarrhea) to allergen exposure

A

PAF and serotonin

38
Q

Disseminated Ags can trigger what symptoms

A

Urticaria and brochospasm

39
Q

Distal reactions of allergies involve what mediators

A

histamine and PAF

40
Q

Many children with allergies to cow milk show no reaction with

A

IgE, they have Type IV delayed type hypersensitivity which is Th1 mediated

41
Q

What foods are most often associated with anaphylaxis

A

Peanuts, tree nuts, seeds, seafood, spices, celery, eggs, milk, and some friuts

42
Q

What are the systemic reactions of anaphylaxis

A

GI

  • increased fluid secretion
  • increased peristalsis

Airways

  • decreased diameter
  • increased mucus

Blood veseels

  • increased flow
  • increased permeability
43
Q

What causes the airway constriction in the airways

A

Bradykinin

44
Q

Nut induced allergies are also mediated by

A

IgG

45
Q

What causes increased vascular permeability and SM contractility

A

PAF and histamine

46
Q

What converts C3 and C5 in complement mediated reaction

A

Tryptase

47
Q

Wheat allergies are mediated by what

A

IgE

48
Q

What is the most common variant of wheat allergies in adults

A

WDEIA (wheat-dependent exercise-induced anaphylaxis)

49
Q

People with what are more likely to develop autoimmune diseases

A

Celiac

50
Q

What Ab test is positive in those with CD

A

Anti-tTG2

51
Q

What are the main HLA genotypes that predispose someone to CD

A

HLA-DQ2 and DQ8

52
Q

What do HLA-DQ2 and 8 form a response to

A

Gluten peptides

53
Q

Macrophages participate in ______ which DC and B cells participate in

A

Phagocytosis; endocytosis

54
Q

Gluten is rich in what AA

A

Glutamine and proline

55
Q

What is gluten structure similar to

A

Collagen

56
Q

Why is gluten left partially undigested

A

Lack of prolyl endopeptidases

57
Q

What causes gluten to become an Ag

A

Glutamines are deamidated by tissue TG2

58
Q

The majority of CD patients express what heterodimer

A

HLADQ2.5

59
Q

What is responsible for tissue remodeling in CD

A

MMP1,2,12

60
Q

Th2 cytokines, in CD, drive the production of auto-Ab to

A

Gluten and TG2

61
Q

What cytokines links the adaptive and innate immune response

A

IL15

62
Q

Who should be tested for CD

A
  • failure to thrive and persistent diarrhea
  • GI symptoms including recurrent abdominal pain, constipation, vomiting
  • Non-GI symptoms such as dermatitis herpertiformis
63
Q

How should you test CD

A

IgA ab to tTG

64
Q

If the results from IgA tTG comes back odd, what should you do

A

Measure total IgA to rule out IgA deficiency

65
Q

What is recommended to confirm CD in all cases

A

Intestinal biopsy

66
Q

If these are missing you can rule out CD

A

HLA DQ2 or 8

GI Final (12 decks)

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