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GI II > IBD Immunology > Flashcards

IBD Immunology Flashcards

1
Q

what factors are highly associated with IBD?

A

increased permeability of the epithelial barrier
mucosal inflammation
bacterial dysbiosis

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2
Q

what does ASCA-positive serology indicate?

A

CD

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3
Q

what does pANCA-positive serology indicate?

A

UC

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4
Q

what phyla of bacteria predominate in a healthy colon?

A
  1. Bacteroidetes

2. Firmicutes

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5
Q

what phyla of bacteria predominate in a UC colon?

A

Proteobacteria

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6
Q

what microbiota changes occur in high fiber diet?

A

increased bacteroidetes, firmicutes and actinobacteria

decreased proteobacteria

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7
Q

what microbiota changes occur in high protein diet?

A

increased bacteriodetes, firmicutes and proteobacteria

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8
Q

what microbiota changes occur in high fat diet?

A

decrease bacteroidetes, firmicutes and proteobacteria

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9
Q

what microbiota changes occur with high carb diet?

A

increased bacteroidetes, firmicutes, and actinobacteria

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10
Q

what infective agents may contribute to development of IBD?

A 
M. paratuberculosis
measles
listeria monocytogenes
salmonella 
campylobacter
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11
Q

what infective agents decrease the risk of developing IBD?

A

helmenth colonization

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12
Q

what populations have the lowest risk of developing IBD?

A

Asian and African descent

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13
Q

which gene mutation puts you at increased risk of developing CD?

A

IBD-1 locus on chromosome 16

CARD15/NOD2 genes

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14
Q

where is CARD15 primarily expressed?

A

macrophages

dentritic cells

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15
Q

what is the role of CARD15?

A

recognizes MDP - peptidoglycan constituent of gram + and gram - bacteria

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16
Q

what is the downstream effect of CARD15?

A

activation of NF-kB

17
Q

what is the downstream effect of a NOD2 mutation?

A

defective function of macrophages
defective epithelial cell responses
defective conditioning of APCs

18
Q

how does the gut microbiota maintain homeostasis?

A

induces development of GALT
maintains basal level of Th17 and Th1
directly and indirectly suppresses pathogenic bacteria via Tregs and IL-10

19
Q

how does commensal bacteria contribute anti-inflammatory properties in the gut?

A

they ferment indigestible polysaccharides (cellulose) to produce short chain fatty acids (SCFAs)

SCFAs have anti-inflammatory properties in macrophages, DCs, CD4 cells an epithelial cells

SCFA also induce IgA and mucus secretion into the lumen

20
Q

what is the role of segmented filamentous bacteria (SFB) in gut tolerance?

A

induce Tregs

maintaince of Th17 cells within the epithelial barrier

21
Q

what occurs in the absence of commensal bacteria?

A

Salmonella flagellin binds to TLR5 which activates NF-kB and promotes inflammation

22
Q

what occurs in the presence of commensal bacteria?

A

salmonella response is attenuated by commensal bacteria

induction of PPAR occurs to export the activated NF-kB from the nucelus (no inflammatory response)

23
Q

what is primarily activated in CD that results in inflammation?

A

Th1 and Th17 cells driven by IL-12, IL-6 and IL-23 produced by macrophages and DCs

24
Q

what cytokines are produced in CD?

A

IL-2
IFN-y
TNF
IL17

25
Q

what is primarily activated in UC that results in inflammation?

A

Th2 cells and NK T cells by IL-4 produced by macrophages and DCs

26
Q

what cytokines are produced in UC?

A

IL-4
IL-5
IL-13

27
Q

what cytokines are produced in a healthy gut to maintain tolerance?

A

IL-10

TGF-B

28
Q

what is the primary role of Treg cells in suppression of IBD?

A

suppress effector T cells via cell-to-cell interactions and IL-2 deprivation

29
Q

what are the current treatment options for IBD?

A

TNF blockers

fecal microbiota transplantation (FMT)

30
Q

loss of function SNP to IL-10 and TGF-B genes would result in…

A

predisposition to IBD

31
Q

gain of function SNP to IL-10 and TGF-B genes would result in…

A

protection from IBD

32
Q

loss of function SNP to TNF-a, IFN-y, IL-1, IL-6, IL-2, IL-17 and IL-22 genes would result in…

A

protection from IBD

33
Q

gain of function SNP to TNF-a, IFN-y, IL-1, IL-6, IL-2, IL-17 and IL-22 genes would result in…

A

predisposition to IBD

34
Q

loss of function SNP in IL-4, IL-5 and IL-13 genes would result in…

A

protection from IBD

35
Q

gain of function SNP in IL-4, IL-5 and IL-13 genes would result in…

A

predisposition to IBD

36
Q

what phyla of bacteria predominate in CD?

A

Firmicutes

Actinobacteria

GI II (16 decks)

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