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Finals > Celiac Disease > Flashcards

Celiac Disease Flashcards

1
Q

What are the two forms of Gluten?

A
  • Glutenin
  • Gliadin
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2
Q

a chronic inflammatory disorder of the small intestine as a result of the ingestion of gluten products by susceptible individuals

A

Celiac Disease

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3
Q

Other term for Celiac Disease

A

Celiac Sprue

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4
Q

one of the primary causes of developing celiac disease

A

Genetics

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5
Q

the risk of developing celiac disease is around

A

35%

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6
Q

the risk of developing celiac disease is around _ being accounted to ___ ___ and is usually based on the presence of the genes encoding for ___ ___ ___ the serving platter for antibodies for gluten these protein are known as ____ and ____

A

35%
genetic disposition
MHC Class II proteins
HLA-DQ8 and HLA-DQ2

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7
Q

Both HLA-DQ2 and HLA-DQ8 present gluten peptides to ________ in the intestinal mucosa, inducing their proliferation as well as triggering the release of _______

A

antigen-specific T-lymphocytes

inflammatory cytokines (IL-15)

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8
Q

Environmental factors of Celiac Disease

A

Feeding patterns during the first year of life
Potential viral infections

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9
Q

children who had frequent infection with ___ has a predicted increased risk of celiac disease autoimmunity in children

A

rotavirus

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10
Q

It has also been noted that ____ and ______ may increase the risk for the disease with the reduced abundance of the ________ may constitute an early predictive biomarker of celiac disease

A

premature maturation
early exposure to complex microbiota
Bifidobacterium (Actinobacteria phylum)

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11
Q

Considered as the culprit for initiating immune response in individuals with celiac disease

A

Gluten

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12
Q

Where are gluten found?

A

Barley
Rye
Wheat

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13
Q

Two forms of gluten

A

Glutenin
Gliadin

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14
Q

Which one of the two protein components of gluten that is considered as the real instigator of this inflammatory response.

A

Gliadin

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15
Q

Gliadin is high in?

A

Glutamine
Proline

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16
Q

What makes gliadin partially resistant to the degradation of intestinal peptidases

A

high proline content

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17
Q

The resistance of gliadin to degradation results to?

A

production of toxic or immunologic peptides

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18
Q

Where in gluten absorbed?

A

Lamina Propia

19
Q

Gluten is absorb in lamina propia via?

A

retrotranscytosis

20
Q

what mediates this retrotrancytosis of intact gliadin peptides

A

Secretory IgA (immunoglobulin A)

21
Q

what mediates this retrotrancytosis of intact gliadin peptides via the transferrin receptor (CD71)?

A

Secretory IgA (Immunoglobulin A)

22
Q

tends to be overly expressed in the intestinal epithelium of individuals with celiac disease and is colocalized with Immunoglobulin A (IgA).

A

Transferrin Receptor or CD71

23
Q

For the gliadin to be absorbed in the lamina propia, where does it binds?

A

SIgA

24
Q

The intestinal transport of intact gliadin peptides is blocked by?

A

IgA
CD71

25
Q

As the gliadin binds to a receptor, it forms?

A

SIgA-gliadin complex

26
Q

what deamidates gliadin in the lamina propia?

A

Tissue Transglutaminases

27
Q

What happens when the gliadin is deamidated?

A

amide group is removed

28
Q

The interaction of gliadin and TG results in protein modification of gliadin thus having a stronger affinity towards what molecules?

A

HLA-DQ2 and HLA-DQ8 molecules

29
Q

One of the immune cells that responds to the presence of SIgA-deamidated gliadin-complex in the lamina propia

A

Macrophages

30
Q

Two types of macrophages that appear with the presence of gliadin in lamina propia

A

M1
M2

31
Q

this type of macrophages predominantly appears during the early stages of inflammation

A

M1

32
Q

M1 releases what?

A

tumor necrosis
interferon-gamma
interleukin 8

33
Q

This particular pro inflammatory cytokine induces cell death especially to those cells that are inflamed (

A

Tumor necrosis factor

34
Q

With the increasing number of gliadin in the lamina propia and inflammatory cytokines, it activates ?

A

CD4+ T-lymphocytes (Helper T cells )

35
Q

The high levels of inflammatory cytokines trigger the clonal expansion of ?

A

B-lymphocytes (B-cells)

36
Q

B cells secretes?

A

anti-gliadin
anti-tissue-transglutaminase antibodies

37
Q

There are some gliadin peptides that are not recognized by the T-lymphocytes leading to the recruitment of?

A

CD8+ T-lymphocytes

38
Q

these immune cells tend to attack cells that are undergoing inflammation causing further damage and entry of gliadin peptides into the lamina propia

A

CD8+ T-lymphocytes

39
Q

Symptoms of Celiac Diseases (Gastrointestinal)

A

PNEUMONICS: DDABCCHARS

Diarrhea
Delayed puberty
Abdominal pain
Bloating
Constipation
Coagulopathy
Hypocalcemia
Anemia
Rickets
Short stature

40
Q

Extraintestinal Manifestation of Celiac Disease

A

PNEUMONICS: A4D2E2ORI
Arthritis
Aphthous stomatitis
Ataxia
Anxiety
Dermatitis Herepetiformis
Depression
Elevations in transaminases
Epilepsy
Osteoporosis/Osteopenia
Recurrent abortions
Infertility

41
Q

Dietary Management for Celiac Disease

A

Gluten-free diet

42
Q

What is the gold standard in diagnosing celiac disease,

A

duodenal biopsy

43
Q

tissue samples from subjects with celiac disease are characterized by?

A

Decreased height of enterocytes
crypt hyperplasia
Villous atrophy
Increased intraepithelial T-lymphocytes.

Finals (4 decks)

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