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GIGU and Repro > Gut Immunology > Flashcards

Gut Immunology Flashcards

1
Q

Gut Associated Lymphoid Tissue or GALT, is the body’s largest immune organ and consists of 2 things. What 2 things does GALT consist of?

A

Peyer’s Patches

Isolated Lymphoid Follicles

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2
Q

What are 3 main food culprits that cause Food dependent exercise induced anaphylaxis?

A

Seafood

Celery

Wheat

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3
Q

Which of the following are only part of underdeveloped GALT?

A. Isolated Lymphoid Follicles

B. Peyer’s Patches

C. Cryptopatches

D. None of the above

A

Cryptopatches

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4
Q

T/F: Cryptopatches develop into mature ILFs after B and T cell recruitment

A

True

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5
Q

All of the following sense microbiota and induce production of AMPs (antimicrobial peptides). Which of them is found in rgw crypts of the small intestines?

A. Enterocytes

B. Colonocytes

C. Paneth cells

D. None of the above

A

Paneth cells

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6
Q

What 3 reasons allow secretory IgAs (sIgAs) to be able to maintain a peaceful bacteria-host interaction?

A
  • Does not activate complement
  • Does not activate phagocytes in Fc dependent amnner
  • It is resistant to proteolysis
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7
Q

Defensins are diverse members of a large family og AMPs. Which of the following is true of the definsins contributions?

A. Antimicrobial action

B. Mucosal host defense in GI

C. A and B

D. None of the above

A

A and B

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8
Q

What characteristics of the inner mucous layer make it largely impervious to bacterial colonization or penetration?

A. High density and low concetration of bactericidal definsins

B. Low density and high concentration of bactericidal defensins

C. High density and high concentration of bactericidal definsins

D. Low density and low concentration of bactericidal defensins

A

C. High density and high concentration of bactericidal definsins

These characteristics are why the innate immune system provides protection on 98% of pathogens that enter the body

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9
Q

What characteristics allow definsins to interact with microbial membrans that results in formation of pores in the membranes?

A. Positively charged AA side chains

B. Negatively charged AA side chains

C. Hydrophilic AA side chains

D. Hydrophobic AA side chains

E. A and C

F. A and D

A

A and D

Positively charged AA side chains

Hydrophobic AA side chains

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10
Q

Commesnsal bacteria and Pathogenic bacteria that penetrate the enterocyte epithelial layer are rapidly killed by:

A. Macrophages in the lamina propria

B. Neutrophils in the submucosa

C. Macrophages in the submucosa

D. Neutrophils in the lamina propria

A

Macrophages in the lamina propria

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11
Q

Some bacteria can penetrate specialized epithelium contains M cells that overlie Peyer’s PAtches. This bacteraia can be rapidly killed by macrophages or picked up by DCs. DCs that contain the bacteria can do all of the following EXCEPT?

A. Induce IgA producing plasma cells for more effective killing

B. Migrate to draining Mesenteric LNs to allow B and T cells to leave though efferent lymphatics

C. Enter systemic circulation

D. Activate T cell differentiation in the Peyer’s Patches

A

Enter systemic circulation

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12
Q

Where are B and T cells leaving the Mesenteric LNs efferent lymph able to enter the blood stream, where they can then home back to the intestinal mucosa?

A. Cystern Chyli

B. Thoracic Duct

C. Axillary LN

D. Inferior Vena Cava

A

Thoracic Duct

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13
Q

Which of the following is found in the GALT due to limited expression of pro-inflammatory cytokines and excess TGF-Beta released from stromal cells?

A. Th17

B. Th2

C. Treg

D. Th1

A

Treg cells

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14
Q

Short chain fatty acids like _____, ____, and _____ are produced in the colon via microbial fermentation of undigested fibers, and have broad effects on host immune system development.

A

Butyric acid

Propionic acid

Acetic acid

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15
Q

T/F: Malnutrition is associated with defects in innate and adaptive immunity because diet shapes gut microbiota and gut microbiota co-evolves with the immune system

A

True

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16
Q

SCFA’s promote which of the following?

A. Treg differentiation

B. sIgA production

C. stimulate mucous production

D. All of the above

A

All of the above

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17
Q

Which of the following SCFA’s stimulates recruitment of IL-10 producing colonic Treg cells?

A. Acetate

B. Butyrate

C. Propionate

D. None of the above

A

Acetate

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18
Q

Which of the following SCFA’s directly acts on Treg cells or enhances Treg inducibilaty of DCs by modulating DCs?

A. Acetate

B. Butyrate

C. Propionate

D. None of the above

A

Butyrate

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19
Q

What TLR do capsilar polysachrides (derived from B. Fragilis) bind to that leads to enhanced expression of IL-10 and TGF-B to promote Treg function?

A. TLR1

B. TLR2

C. TLR4

D. TLR6

A

TLR2

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20
Q

Both central tolerance of T cells and nTreg cell differentiation require initiation of which of the following and where?

A. BCR with cognate Ag in bone marrow

B. TCR with cognate Ag in periphery

C. BCR with cognate Ag in periphery

D. TCR with cognate Ag in thymus

A

TCR with cognate Ag in thymus

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21
Q

Depletion of which of the following can destroy development of oral tolerance?

A. CD25+ cells

B. CD4+ cells

C. CD8+ cells

D. All of the above

A

CD25+ cells

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22
Q

What 3 groups of immune cells have been shown to play a big role in oral tolerance induction?

What is the mechanism for developing oral tolerance?

A

Macrophages, DCs, Treg

  1. Macrophages send out their processes into the lumen and take up Ags
  2. Macrophages transfer Ags to DCs in the lamina propria (goblet cells can do this occasionally too)
  3. Ag-DCs leave the lamina propria to the mLNs via chemokine signalling
  4. Ag-DCs stimulate naive CD4+Tcells to CD4+CD25+Treg cells
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23
Q

Ag-DCs are able to stimulate naive CD4 T cells into Treg cells via the work of RA, TGF-B, and IDO(indoleamine-2,3-dioxygenase). What are the actions of those three substances?

A

RA: directly induces Treg cell differentiation

TGF-B: mediates FoxP3 upreglation

IDO: immunosupression–> anergy of effector T cells and induce Treg proliferation

24
Q

Local acute GI responses like diarrhea occur via what substances acting on the GI epithelium?

A. Leukotriens, PGD2

B. PAF and serotonin

C. Histamine and PAF

D. None of the above

A

PAF and serotonin

25
Q

T/F: Food allergy and celiac disease arise from a specific immune response that occurs reproducibly on exposure to a given food

A

True

26
Q

In the mechanism of IgE mediated food allergy, primary exposure involves an adaptive immune response where B cells mature into IgE producing plasma cells, then IgE enters circulation. What happens when IgE enters circulation?

A. IgE binds to mast cells triggering mastocytosis

B. IgE binds to FcRe (CD23) on mast cells

C. IgE binds to FcyR on mast cells

D. IgE activates mast cells, basophils, and eosinophils

A

B. IgE binds to FcRe (CD23) on mast cells

NOTE: in secondary exposure, the crosslinking of Ag-IgE causes the mast cell it’s bound to to degranulate and release stuff

27
Q

Factors that affect which of the following are important for primary sensitization and boosting of secondary immune responses?

A. Integrity of epithelial barrier only

B. Extent of allergens digested only

C. Both integrity of epithelial barrier and extent of allergens digested

D. None of the above

A

Both integrity of epithelial barrier and extent of allergens digested

28
Q

Which of the following are preformed mediators of mast cells that show in early allergic reaction?

A. Histamine and TNF-a

B. Tryptase, Chymase, Peroxidase

C. Bradykinin

D. PAF, prostaglandins (PGE2), Leukotriens, LTC4, D4, E4

A

A. Histamine and TNF-a

B. Tryptase, Chymase, Peroxidase - Early but Granule associated

C. Bradykinin - Early, but formed during degranulation

D. PAF, prostaglandins (PGE2), Leukotriens, LTC4, D4, E4 - Late and formed during degranulation

NOTE: TNF-a also shows uo in late allergic reaction generated after transcription

29
Q

All of the following cause vascular permeability and SM contraction, BUT which one instead causes vascular permeability and pain?

A. Histamine

B. PGD2 and LTC4, D4, E4

C. Prostaglandin (PGE2)

D. Leukotriens

A

C. Prostaglandin (PGE2)

30
Q

What cell type is central to both systemic and local manifestations of food allergy?

A. Eosinophils

B. Plasma B cells

C. Mast Cells

D. Basophils

A

Mast Cells

31
Q

Ag disseminated systemically can trigger distal reactions like urticaria or bronchospasm through mechanisms dependent on…

A. Th2 derived cytokines (IL-4, 9, 13)

B. Mastocytosis

C. PAF and Serotonin

D. Histamine and PAF

A

Histamine and PAF

32
Q

GI manifestations of food allergy are dependent on which of the following that act on mast cells?

A. Th2 derived cytokines (IL-4, 9, 13)

B. Mastocytosis

C. PAF and Serotonin

D. Histamine and PAF

A

Th2 derived cytokines (IL-4, 9, 13)

33
Q

Which of the following mediate local acute GI response like diarrhea to allergen exposure?

A. Th2 derived cytokines (IL-4, 9, 13)

B. Mastocytosis

C. PAF and Serotonin

D. Histamine and PAF

A

PAF and Serotonin

NOTE: Mastocytosis is necessary for local symptoms

34
Q

What 4 things can Treg cells do via IL-10 and TGF-B that allows control of food allergy?

A
  1. Suppress Th2 immunity
  2. Inhibit mast cell reactivity (decrease FCeR1 on surface and thus reduce IgE’s binding ability)
  3. Reduce sIgE synthesis
  4. Increase IgG and IgA synthesis
    * In a regional lymph nodes Ag-DC MHC-II interaction with TGF-B induces Treg cells, which leads to supress mast cells and altered Ab production by B cells*
35
Q

All of the following supress inflammatory response, EXCEPT which of the following that does the opposite and promotes inflammation?

A. Vitamin D

B. Vitamin A

C. Folate

D. High fat diet

A

High fat diet

36
Q

Gut microbiota can suppress allergic immune response via which of the following methods?

A. Induction of Treg cells

B. Supression of Basophils

C. Supression of Mast cells

D. All of the above

E. A and C only

A

All of the above

37
Q

Which of the following routine clinical tests is used to understand the relationship between IgE sensitization and the cell-mediated response that characterizes atopic eczema?

A. Skin prick test

B. Serum-specific IgE test

C. Atopy patch

D. Basophil activation test (BAT)

A

Atopy patch

38
Q

Which of the following is absolutely required to make a diagnosis of an allergy?

A. Blood test only

B. Blood test and skin prick test

C. Double-blinded, placebo controlled oral food challenge

D. Patient history

A

Patient history

39
Q

T/F: Blood tests are less sensitive than a skin prick test, but neither are conclusive for predicating the patient’s degree of sensitivity for the allergens

A

True

40
Q

In sensitization phase of a peanut allergy, Th2 releases what 3 cytokines to promote B cells to produce peanut specific IgEs?

A

IL-4

IL-5

IL-13

41
Q

Production of which of the following can contribute to shock from peanuts, in a non-IgE mediated pathway? Bonus: What is the mechanism?

A. C3b-C3bR on mast cells, basophils, and macrophages

B. C3a-C3aR on mast cells, basophils, and macrophages

C. C5a-C5aR on mast cells, basophils, and macrophages

D. A and C

E. B and C

A

B and C

C3a-C3aR on mast cells, basophils, and macrophages

C5a-C5aR on mast cells, basophils, and macrophages

42
Q

The mucosa contains everything needed to generate plasma B cells that produce which of the following Ig’s that contributes to non-IgE mediated allergic reaction to peanuts?

A. IgG1

B. IgA

C. IgG2

D. IgG2a

A

IgG1

43
Q

What 3 things (Ig’s or pathways) induce anaphylacis in nut allergy?

A

IgG1, IgE, complement activation

44
Q

Which of the following are important allergens associated with wheat allergy?

A. Alpha-amylase inhibitors

B. Germ agglutinin

C. Peroxidase

D. All of the above

A

All of the above

45
Q

What foods have been implicated in Food-Dependent Exercise Induced Anaphylaxis?

A

Seafood

Celery

Wheat

Cheese

NOTE: Aspirin and NSAIDs have been most frequent implicated medicines

  • reactions usually occurs within 2 hours of eating the allergic food
46
Q

T/F: Non-IgE mediated reactions are delayed and take up to 48 hours to develop but still involve the immune system

A

True

47
Q

Read about milk allergy

A
48
Q

Which of the following molecules are the main genetic predisposing factor>

A. Type I HLAs

B. HLA-DQ2 and DQ4

C. HLA DQ2 and DQ8

D. HLA D2 and D8

A

HLA-DQ2 and DQ8

49
Q

Serum antibodies against what ubiquitous enzyme are specifically associated with Celiac’s Disease?

A. Tissue Transglutaminase 1

B. Tissue Transglutaminase 2

C. Tissue Transglutaminase 3

D. Tissue Transglutaminase 4

A

Tissue Transglutaminase 2

(TG2)

50
Q

Gluten is a proline rich protein and rich in glutamine residues. Gluten is poorly digested in the small intestines due to lack of what?

A. Glutamine

B. Prolyl Endopeptidases

C. Prolyl Enteropeptides

D. All of the above

A

Prolyl Endopeptidases

51
Q

Peptides with a specific spacing of proline and glutamic acid bind to HLA Class II on APCs. What APC is expressed on the majority of CD patients?

A. HLA DQ 2.0

B. HLA DQ 2.3

C. HLA DQ 2.4

D. HLA DQ 2.5

A

HLA DQ2.5

52
Q

Responses in CD cause tissue damage that occurs via self reactive CD4 and CD8 T cells, making this what type of hypersensitivty reaction?

A. Type I

B. Type II

C. Type III

D. Type IV

A

Type IV

53
Q

T/F: In patients with CD, gluten causes a T cell mediated inflammatory respons in the proximal small bowel that damages the mucosa and leads to malabsorption

A

True

  • Dx: is through a duodenal biopsy where we see flattening of villi
  • Dx is also a tTG-IgA test
54
Q

Pathogenesis of CD

A

Cool

55
Q

All of the following cytokines plat a role in polarizing and maintaining the Th1 response, EXCEPT for which of the following thatlinks the adaptive and innate immune response serving as a growth factor for T cells?

A. IL-18

B. IFN-y

C. IL-21

D. IL-15

A

IL-15

56
Q

How do you test for CD?

A

initial testing: IgA against tTG

  • high sensitivity (low false negative) and specificity

GIGU and Repro (35 decks)

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