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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
IgE mediated reactions have what phases
Immediate (mast cells) Late-phase
26
What are non-IgE mediated reactions believed to be caused by
T cells typically 4-28 hours
27
Food allergies can have reactions in what systems
Skin, gastrointestinal, and respiratory
28
The most common food allergy is what
Milk
29
Within the first 3 to 5 years what allergies are normally lost
Milk, eggs, wheat, soy
30
What allergies are likely to continue into adulthood
Peanuts, tree nuts, fish, shellfish
31
What induces Th2
IL4
32
What cell types react during initiation of a reaction
DC go to LN —> Naive T cells —> Th2 —> Th2 —> B cells —> basophil, eosinophil, mast cell
33
What event constitutes sensitization
IgE binding to Fcε on basophils and mast cells
34
What reaction is seen during sensitization
Nothing
35
What is released from mast cells during allergies
Tryptase (tight junction rearrangement) Histamine De novo synthesis of cytokines
36
What cell type is central to local and systemic manifestation of food allergies
Mast cells
37
What is responsible for the local acute GI response (diarrhea) to allergen exposure
PAF and serotonin
38
Disseminated Ags can trigger what symptoms
Urticaria and brochospasm
39
Distal reactions of allergies involve what mediators
histamine and PAF
40
Many children with allergies to cow milk show no reaction with
IgE, they have Type IV delayed type hypersensitivity which is Th1 mediated
41
What foods are most often associated with anaphylaxis
Peanuts, tree nuts, seeds, seafood, spices, celery, eggs, milk, and some friuts
42
What are the systemic reactions of anaphylaxis
GI - increased fluid secretion - increased peristalsis Airways - decreased diameter - increased mucus Blood veseels - increased flow - increased permeability
43
What causes the airway constriction in the airways
Bradykinin
44
Nut induced allergies are also mediated by
IgG
45
What causes increased vascular permeability and SM contractility
PAF and histamine
46
What converts C3 and C5 in complement mediated reaction
Tryptase
47
Wheat allergies are mediated by what
IgE
48
What is the most common variant of wheat allergies in adults
WDEIA (wheat-dependent exercise-induced anaphylaxis)
49
People with what are more likely to develop autoimmune diseases
Celiac
50
What Ab test is positive in those with CD
Anti-tTG2
51
What are the main HLA genotypes that predispose someone to CD
HLA-DQ2 and DQ8
52
What do HLA-DQ2 and 8 form a response to
Gluten peptides
53
Macrophages participate in ______ which DC and B cells participate in
Phagocytosis; endocytosis
54
Gluten is rich in what AA
Glutamine and proline
55
What is gluten structure similar to
Collagen
56
Why is gluten left partially undigested
Lack of prolyl endopeptidases
57
What causes gluten to become an Ag
Glutamines are deamidated by tissue TG2
58
The majority of CD patients express what heterodimer
HLADQ2.5
59
What is responsible for tissue remodeling in CD
MMP1,2,12
60
Th2 cytokines, in CD, drive the production of auto-Ab to
Gluten and TG2
61
What cytokines links the adaptive and innate immune response
IL15
62
Who should be tested for CD
- failure to thrive and persistent diarrhea - GI symptoms including recurrent abdominal pain, constipation, vomiting - Non-GI symptoms such as dermatitis herpertiformis
63
How should you test CD
IgA ab to tTG
64
If the results from IgA tTG comes back odd, what should you do
Measure total IgA to rule out IgA deficiency
65
What is recommended to confirm CD in all cases
Intestinal biopsy
66
If these are missing you can rule out CD
HLA DQ2 or 8

GI Final (12 decks)

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