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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
how large is the intestinal epithelium?
2,000,000 cm^2 (thats over 2100 square feet)
26
function of tight junctions
regulatory role in regulating what is absorbed and what is excreted. control flow of particles between the cells. "paracellular flow"
27
what are the three categories of triggers for gut dysbiosis and what do they lead to
stress, environment and dietary. lead to breakdown of gut barrier, change in microbial balance, translocation of endotoxins and or inflammatory cytokine production.
28
functional evidence shows that the ____ nerve regulates the intestinal immune system
vagus nerve
29
stimulation of the ___ ____ has been shown to prevent endotoxin-induced shock by reducing pro0inflammatory cytokine production.
vagus nerve
30
what is SIgA
antibody produced in mucosal linings and plays a role in host immunity
31
what is SIgA
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.
32
what is the function of SIgA
-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.
33
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.
SIgA
34
together with microflora _____ contributes to maintaining intestinal inflammatory reponse
SIgA
35
stress and SIgA
stress downregulates SIgA. increased adhesions of pathogens, increasing inflammatory rxn, increase intestinal permiability.
36
acute vs chronic stress and SIgA
acute: increased SIgA chronic: decreased SIgA
37
what food sugar can cause gut inflammation and how
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
fructose implicated in what four diseases
insulin resistance fatty liver metabolic syndrome depression
39
diets higher in calories are associated with higher levels of plasma ____
LPS
40
Western diets and diets higher in omega 6 linked to reduction of bacteria: ________ and increase in: ______
decrease in bacteroides increase in firmicutes
41
what nutrients are important in maintaining tight junctions
Vitamin A, D, zinc, mg, Ca
42
_____ deficiency has been shown to directly break down tight junctions/sensitize barrier cells to external stress
zinc
43
vitamin D and tight junctions
preserves junctional complexes and stimulates epithelial cell renewal
44
Systemic inflammatory cytokines can induce the production of inflammatory cytokines in the CNS via _____ _____
microglial activation
45
function of microglia and location
brain accessory cells int eh brain that clean dev=bris and if infection attack the cells. must be activated.
46
effects of chronic systemic cytokine production in the brain
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
LPS and affect on tryptophan and outcome
LPS stimulates and draws the pathway of tryptophan to serotonin away so less serotonin produced. depression/mood disorders.
48
altered cytokine levels due to western diet, LPS stimulation, fructose and stress lead to
altered neurochemistry
49
best treatments for those with altered neurochemistry
exercise: 30-60 minutes 4x/wk
50
oregano benefits on the GI & dosage
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
sources of antimicrobials
thyme, clove, anise, buchu, dill, brucea javanica, acacia catechu
52
dysbiocide use
parasites and SIBO--adjunct if ADP isn't working
53
supplement for H pylori
Bio-HPF 3 caps, 3x/day for 20-40 days with meals. Biotics
54
dosage of probiotics after taking care of dysbyosis
40-80 billion (Biotics BioDoph 7: 2-4 caps)
55
supplement for gut permiability per lecture (CNS)
IPS. stimulate growth and repair of mucosa plus gut deox. Biotics. 2; 2x/day empty stomach
56
SOD what is it and the benefits
superoxide dismutase: antioxidant. SOD reduces T-cell activation and immune dysfunction. Biotics: Dismutase Plus 5000
57
omega 3 and T-cells
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
Lipoic Acid and the Blood Brain Barrier
reduces monocyte infilatration into the CNS and increases stability of the BBB (biotics Lipoic acid 2 capsules 2x/day)
59
bacteria most dominant in premature infants that is an issue
C. Difficile
60
infants born vaginally were colonized mostly by bacterial communities similar to their mothers vaginal microbiotia consisted of
Lactobacillus, Prevotella, Sneathia spp.
61
infants born caesarean were colonized mostly by bacterial communities similar to their mothers vaginal microbiotia consisted of
staphylococcus, corynebacterium, propionibacterium
62
what should you test with vague symptoms of: fatigue, low-grade CYCLICAL fever, muscle and joint pain and malaise.
test auto-antibodies
63
what is the #1 trigger of zonulin increased permeability and increased zonulin levels
gluten
64
what does zonulin do
opens spaces between the cells of the intestinal lining
65
zonulin cascade
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
common causes of intestinal permeability
IBS, NSAIDS, SIBO, Celiac, Protozoal infections, Food allergy, C. Alcoholism, Diarrhea, Strenuous exercise, increasing age, nutrient deficiencies, low stomach acid
67
triad of autoimmune disease
-environment -genetics -gut dysbiosis (food sensitivity, microbe infections, permeability)
68
what percent of autoimmune diseases does genetics account for?
30% (rest are due to environment, toxins, diet, gut and infections)
69
Glyphosate is linked to causing what
gluten related issues/diseases
70
what heavy metal is heavily linked to autoimmune issues
mercury
71
lipid perioxides is a marker for what
marker for membrane damage and oxidative stress. (DNA damage) (think heavy metals if elevated)
72
often patient with dysbiosis is the small intestine have dysbiosis in the
mouth
73
porferious gingivalis associated with
RA and auto-immunity
74
prevotella copri in the gut found higher in patients with what disease
RA
75
symptoms associated with mold/mycotoxin illness
red eyes, blurred vision, sweats, mood swings, sharp pains, static shocks, chronic cough, metallic taste in the mouth
76
serotonin and Enterochromaffic cells
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
what is the number one source of immunologic function in the GI
MALT (mucosal associated lymphoid tissue)
78
what is the first line of defense against foreign invaders (antigens) in the gut
GALT (gut-associated lymphoid tissue) -the immune system is then activated by the GALT
79
Peyer's Patches where and what
part of the GALT (gut associated lymphoid tissue) -house plasma cells that manufacture antibodies. -survey and then initiate immune response
80
what are the two levels of defense the GALT has against pathogens
local: SIgA systemic: IgG, IgE
81
where is SIgA MC found?
mucosal secretions, saliva, intestinal juices, colostrum, vaginal fluids, respiratory system
82
is SIgA inflammatory
no. but it signals for other immune cells like IgM and IgG that are inflammatory.
83
parasites antibody profile and meaning: IgM IgG
IgM: early stages IgG: long term response to chronic infection
84
parasite test: if only IgM and asymptomatic what is course of action
may want to wait to treat could be body is currently fighting or just fought it. re-test in 2-3 moths
85
IgE
immediate food allergy
86
IgG
delayed food allergy

Functional Medicine University (2 decks)

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