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Functional Medicine University > GI > Flashcards

GI Flashcards

1
Q

elevated monocytes think what

A

allergies/inflammation

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2
Q

Zonulin increase leads to what

A

increased gut permeability. it is a well documented marker of intestinal tight junctions. (increased, means leaky junctions)

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3
Q

Gliadins affect on zonulin and the outcome

A

Gliadin induces Zonulin release and increases intestinal permeability and onset of autoimmunity

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4
Q

diseases/CAs associated with increased zonulin

A

AS, Celiac disease, IBS, Crohns, RA, SLE, T1D, Brain CA, Breast CA, Lung CA, Ovarian and Pancreatic CA

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5
Q

considerations for healing zonulin mediated intestinal permiability

A

Oral Immunoglobulins and Probiotics HN019

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6
Q

what are the markers for leaky gut

A

LPS (lipopolysaccharia Bacterial Endotoxin)
DAO (Diamine Oxidase)

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7
Q

What is LPS

A

lipopolysaccharide bacterial endotoxin–an endotoxin produced by gram negative bacteria. a marker of transcellular leaky gut.
Can go through the middle of the cell

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8
Q

what does high LPS antibodies mean

A

leaky gut

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9
Q

What is linked with LPS (disease)

A

heart disease and systemic inflammatory problems

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10
Q

what marker is linked with heart disease and systemic inflammatory problems

A

LPS (therefore leaky gut issues)

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11
Q

what are some remedies for LPS

A

Bernerines (anti-microbial)
Probiotics
CoQ10

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12
Q

What is DAO

A

Diamine Oxidase (a marker for leaky gut)

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13
Q

Where is DAO produced and what does it do

A

enzyme made in the microvilli. When Microvilli are damaged, they atrophy and produce less DO. DO is an enzyme that degrades histamine. When decreased, it cannot break down histamine and causes reactions.

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14
Q

high or low DAO leads to leaky gut

A

low

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15
Q

high or low zonulin leads to leaky gut

A

high

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16
Q

high or low LPS leads to diseases

A

high

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17
Q

high or low DAO before period may lead to what?

A

low, headaches

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18
Q

what factor may contribute to histamine excess

A

DAO deficiency (diamine oxiidase)

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19
Q

top histamine releasing foods

A

fish, mackerel, herring, sardine, tuna, gouda, camembert, cheddar, emmental, swiss, parmesean, fermented sausage, salami, sauerkraut, spinach, eggplant, ketchup, champagne

if give patients fermented foods for probiotics and they react strongly to them, consider DAO an issue not the probiotics.

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20
Q

what lab company tests DAO, LPS and histamine

A

dunwoody labs

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21
Q

what is included in the gut brain axis

A

CNS, neuroendocrine, neuroimmune, sympathetic, parasympathetic, enteric nervous system and intestinal microbiota

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22
Q

what influences can the bidrectional relationship from the gut to the brain influence

A

-regulation of the mucosal immune system
-GI motility
-epithelial barrier function
-digestive and host metabolism support
-prevention of colonization by pathogens

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23
Q

LPS definition

A

molecules present on the surface of gram-negative bacteria that elicit a strong immune respose

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24
Q

cytokine definition

A

messengers used by the immune system to communicate with itself and other parts of the body including the CNS. they can be inflammatory, non-inflammatory and regulatory.

-they should stay in the gut–if they get out that’s when they can be inflammatory.

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25
Q

how large is the intestinal epithelium?

A

2,000,000 cm^2 (thats over 2100 square feet)

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26
Q

function of tight junctions

A

regulatory role in regulating what is absorbed and what is excreted. control flow of particles between the cells. “paracellular flow”

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27
Q

what are the three categories of triggers for gut dysbiosis and what do they lead to

A

stress, environment and dietary. lead to breakdown of gut barrier, change in microbial balance, translocation of endotoxins and or inflammatory cytokine production.

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28
Q

functional evidence shows that the ____ nerve regulates the intestinal immune system

A

vagus nerve

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29
Q

stimulation of the ___ ____ has been shown to prevent endotoxin-induced shock by reducing pro0inflammatory cytokine production.

A

vagus nerve

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30
Q

what is SIgA

A

antibody produced in mucosal linings and plays a role in host immunity

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31
Q

what is SIgA

A

antibody produced in mucosal linings and plays a role in host immunity.
-prevents antigens in the gut from being able to stick to the walls of the intestines.
-promotes the clearance of antigens and pathogenic microorganisms from the intestinal lumen by blocking access to epithelial receptors, trapping them in mucus and facilitating removal by peristalsis.

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32
Q

what is the function of SIgA

A

-prevents antigens in the gut from being able to stick to the walls of the intestines.
-promotes the clearance of antigens and pathogenic microorganisms from the intestinal lumen by blocking access to epithelial receptors, trapping them in mucus and facilitating removal by peristalsis.

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33
Q

what prevents antigens in the gut from being able to stick to the walls of the intestines, promotes the clearance of antigens and pathogenic microorganisms from the intestinal lumen by blocking access to epithelial receptors, trapping them in mucus and facilitating removal by peristalsis.

A

SIgA

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34
Q

together with microflora _____ contributes to maintaining intestinal inflammatory reponse

A

SIgA

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35
Q

stress and SIgA

A

stress downregulates SIgA.
increased adhesions of pathogens, increasing inflammatory rxn, increase intestinal permiability.

36
Q

acute vs chronic stress and SIgA

A

acute: increased SIgA
chronic: decreased SIgA

37
Q

what food sugar can cause gut inflammation and how

A

fructose.
1. consume fructose
2. increased LPS translocation (outside gut barrier)
3. LPS binds immune cells via toll-like receptor
4. immune cells generate inflammatory cytokines in response to LPS
5. inflammatory cytokines alter systemic inflammatory load
induce liver damage directly through increasing intestinal LPS translocation and endotoxemia.

38
Q

fructose implicated in what four diseases

A

insulin resistance
fatty liver
metabolic syndrome
depression

39
Q

diets higher in calories are associated with higher levels of plasma ____

A

LPS

40
Q

Western diets and diets higher in omega 6 linked to reduction of bacteria: ________ and increase in: ______

A

decrease in bacteroides
increase in firmicutes

41
Q

what nutrients are important in maintaining tight junctions

A

Vitamin A, D, zinc, mg, Ca

42
Q

_____ deficiency has been shown to directly break down tight junctions/sensitize barrier cells to external stress

A

zinc

43
Q

vitamin D and tight junctions

A

preserves junctional complexes and stimulates epithelial cell renewal

44
Q

Systemic inflammatory cytokines can induce the production of inflammatory cytokines in the CNS via _____ _____

A

microglial activation

45
Q

function of microglia and location

A

brain
accessory cells int eh brain that clean dev=bris and if infection attack the cells. must be activated.

46
Q

effects of chronic systemic cytokine production in the brain

A

potentially brought on by LPS which activate the microglial cells in the brain. causes abnormal intra and extracellular communication, abnormal function and potentially neurodegeneration

47
Q

LPS and affect on tryptophan and outcome

A

LPS stimulates and draws the pathway of tryptophan to serotonin away so less serotonin produced. depression/mood disorders.

48
Q

altered cytokine levels due to western diet, LPS stimulation, fructose and stress lead to

A

altered neurochemistry

49
Q

best treatments for those with altered neurochemistry

A

exercise: 30-60 minutes 4x/wk

50
Q

oregano benefits on the GI & dosage

A

anti-microbial
-destroy/inhibit growth of E. coli, staph aureus, listeria innocua, saccharomyces cerevisiae, aspergillus niger
-eliminate parasites

600mg 1x/d 6 wks (ADP biotics)

51
Q

sources of antimicrobials

A

thyme, clove, anise, buchu, dill, brucea javanica, acacia catechu

52
Q

dysbiocide use

A

parasites and SIBO–adjunct if ADP isn’t working

53
Q

supplement for H pylori

A

Bio-HPF
3 caps, 3x/day for 20-40 days with meals. Biotics

54
Q

dosage of probiotics after taking care of dysbyosis

A

40-80 billion (Biotics BioDoph 7: 2-4 caps)

55
Q

supplement for gut permiability per lecture (CNS)

A

IPS. stimulate growth and repair of mucosa plus gut deox. Biotics. 2; 2x/day empty stomach

56
Q

SOD what is it and the benefits

A

superoxide dismutase: antioxidant. SOD reduces T-cell activation and immune dysfunction. Biotics: Dismutase Plus 5000

57
Q

omega 3 and T-cells

A

increased omega 3: decrease T-cell activation (good) and boost immune system
-stabilize BBB (anti-inflammatory properties)

-Biotics: Biomega-3 Liquid: 1Tbsp= 2220mg EPA, 1380 DHA

58
Q

Lipoic Acid and the Blood Brain Barrier

A

reduces monocyte infilatration into the CNS and increases stability of the BBB
(biotics Lipoic acid 2 capsules 2x/day)

59
Q

bacteria most dominant in premature infants that is an issue

A

C. Difficile

60
Q

infants born vaginally were colonized mostly by bacterial communities similar to their mothers vaginal microbiotia consisted of

A

Lactobacillus, Prevotella, Sneathia spp.

61
Q

infants born caesarean were colonized mostly by bacterial communities similar to their mothers vaginal microbiotia consisted of

A

staphylococcus, corynebacterium, propionibacterium

62
Q

what should you test with vague symptoms of: fatigue, low-grade CYCLICAL fever, muscle and joint pain and malaise.

A

test auto-antibodies

63
Q

what is the #1 trigger of zonulin increased permeability and increased zonulin levels

A

gluten

64
Q

what does zonulin do

A

opens spaces between the cells of the intestinal lining

65
Q

zonulin cascade

A

zonulin opens spaces btween the cells of the intestinal lining
-spaces between cells allow larger protein molecules to get into the bloodstream
-body is primed to react to those proteins when they appear….leading to immune response, inflammation and LPS activation.

66
Q

common causes of intestinal permeability

A

IBS, NSAIDS, SIBO, Celiac, Protozoal infections, Food allergy, C. Alcoholism, Diarrhea, Strenuous exercise, increasing age, nutrient deficiencies, low stomach acid

67
Q

triad of autoimmune disease

A

-environment
-genetics
-gut dysbiosis (food sensitivity, microbe infections, permeability)

68
Q

what percent of autoimmune diseases does genetics account for?

A

30% (rest are due to environment, toxins, diet, gut and infections)

69
Q

Glyphosate is linked to causing what

A

gluten related issues/diseases

70
Q

what heavy metal is heavily linked to autoimmune issues

A

mercury

71
Q

lipid perioxides is a marker for what

A

marker for membrane damage and oxidative stress. (DNA damage) (think heavy metals if elevated)

72
Q

often patient with dysbiosis is the small intestine have dysbiosis in the

A

mouth

73
Q

porferious gingivalis associated with

A

RA and auto-immunity

74
Q

prevotella copri in the gut found higher in patients with what disease

A

RA

75
Q

symptoms associated with mold/mycotoxin illness

A

red eyes, blurred vision, sweats, mood swings, sharp pains, static shocks, chronic cough, metallic taste in the mouth

76
Q

serotonin and Enterochromaffic cells

A

Enterochromaffin cells shoot seotonin into the gut wall and receptors. They then communicate with nerve cells to get things moving in the intestines
-also sends signals to the brain/keeps it in the loop

77
Q

what is the number one source of immunologic function in the GI

A

MALT (mucosal associated lymphoid tissue)

78
Q

what is the first line of defense against foreign invaders (antigens) in the gut

A

GALT (gut-associated lymphoid tissue)
-the immune system is then activated by the GALT

79
Q

Peyer’s Patches where and what

A

part of the GALT (gut associated lymphoid tissue)
-house plasma cells that manufacture antibodies.
-survey and then initiate immune response

80
Q

what are the two levels of defense the GALT has against pathogens

A

local: SIgA
systemic: IgG, IgE

81
Q

where is SIgA MC found?

A

mucosal secretions, saliva, intestinal juices, colostrum, vaginal fluids, respiratory system

82
Q

is SIgA inflammatory

A

no.
but it signals for other immune cells like IgM and IgG that are inflammatory.

83
Q

parasites antibody profile and meaning:
IgM
IgG

A

IgM: early stages
IgG: long term response to chronic infection

84
Q

parasite test: if only IgM and asymptomatic what is course of action

A

may want to wait to treat could be body is currently fighting or just fought it. re-test in 2-3 moths

85
Q

IgE

A

immediate food allergy

86
Q

IgG

A

delayed food allergy

Functional Medicine University (2 decks)

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