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year 1 > GI - immunology > Flashcards

GI - immunology Flashcards

1
Q

what is the name of the lymph nodes found in the gut

A

peyer’s patches

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2
Q

what is the function of the ruffled membranes of M cells of payer’s patches

A

antigen sampling and absorption - endocytosis and phagocytosis

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3
Q

true/false

dendritic cells project themselves across epithelial membrane of gut to sample antigen in gut lumen

A

true

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4
Q

where are cytotoxic T cells (CD8) found in gut

A

epithelium (intraepithelial lymphocytes)

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5
Q

where are helper T cells (CD4) found in gut

A

lamina propria of gut cells

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6
Q

how are T cells in lamina propria activated

A

dendritic cells capture antigen at membrane, migrate to lymph nodes and present to T cells

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7
Q

what is MA

A

molecular address signal - binds to effector T cells which need to return to that area in the gut

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8
Q

what is chemokines role in gut immunity

A

direct migration of T cells through gut epithelium

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9
Q

why do HIV patients have mucosal immune dysfunction

A

loss of 70% of CD4+ T cells (helper/memory) in gut

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10
Q

where are IgA cells found in gut

A

lamina propria

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11
Q

how does IgA enter the epithelium from lamina propria

how does it enter gut lumen

A

endocytosis

exocytosis - while doing so can transport pathogens back to gut lumen

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12
Q

what is the purpose of the secretory component

A

allows IgA to persist in gut lumen for a awhile without being digested by proteolytic enzymes

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13
Q

how does IgA neutralise antigens

A

internalising them within a vesicle

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14
Q

what is the function of IgA

A

stops toxins and pathogens binding to gut epithelium

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15
Q

give 4 examples of when the mucosal immune system is dysregulated

A

primary immunodeficiency
allergy
coeliac disease
IBD

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16
Q

where do intraepithelial cells kill infected epithelial cells

A

basolateral side

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17
Q

what kind of immunodeficiency is HIV

A

acquired

18
Q

what is XLA

A 
X linked agammaglobulinaemia
no B cells
no IgG
recurrent infection
tx: immunoglobulin injections
19
Q

what is a phagocyte respiratory burst

A

phagocytes produce reaction oxygen species (superoxide) to kill pathogens

20
Q

what is chronic granulomatous disease

A

primary immunodeficiency

failure of phagocytes to produce superoxides for respiratory bursts

21
Q

what is SCID

A

no B or T cells

constant pulmonary and GI infection

22
Q

how is an allergy self-perpetuating

A

activated mast cells produce IL4 which stimulates B cells to produce more IgE

23
Q

what genes trigger coeliac

A

HLA-DQ2
HLA-DQ8
(responsible for protein that activates T cell response)

24
Q

what immune cells mediate coeliac

A

T cells

25
Q

what occurs in coeliac

A

gluten specific T cells produce interferon gamma which triggers intraepithelial lymphocytes (CD8) to kill epithelial cells

26
Q

what is the presentation of coeliac

A 
abdominal pain
bloating
diarrhoea / steatorrhoea
weight loss
anaemia
27
Q

what is seen in coeliac

A

flattened epithelium

villi atrophy

28
Q

what is the gold standard Dx for coeliac

A

duodenal biopsy after positive tTG-IgA test

biopsy not in children

29
Q

what is tTG

A

tissue transglutaminase
enzyme that modulates gluten by forming a complex with it when it enters the gut
the more gluten you eat the more tTG presented to B cells - more epithelial damage done

30
Q

does the large intestine have villi

A

no just crypts

31
Q

does the small intestine have villi

A

yes

villi and crypts

32
Q

do both the small and large intestine have goblet cells

A

yes

33
Q

where are paneth cells found

what do they do

A

small intestine

secrete defensives - antimicrobial peptide

34
Q

where are peyer’s patches found

A

small intestine

35
Q

where does antigen capture and activation occur in gut

A

mediated by dendritic cells

takes place in payer’s patches and across epithelium

36
Q

what are M cells

A

part of epithelium covering Peyer’s patches

37
Q

what are CCR7 and L-selectin

A

homing receptors which mediate T cell transport into payer’s patches

38
Q

how do T cells become activated and reach the thoracic duct

A

activated by antigen bound dendritic cells
lose CCR7 so can no longer circulate
drain via mesenteric lymph nodes into thoracic duct

39
Q

what is the function of a4-B7 integrin on T cell and MAdCAM-1 on endothelium

A

receptors aiding transport of effector immune cell out of gut

40
Q

what Ig is most involved in humoral intestinal immune response

A

IgA

year 1 (45 decks)

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