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CNM Nut2 S2 Exam revision > Immune Health > Flashcards

Immune Health Flashcards

1
Q

What are the key elements that contribute to effective immunity in the body?

A

Healthy barrier tissue integrity, antimicrobial secretions, probiotic bacteria, innate immune response, inflammation, and antigen presentation by APCs.

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2
Q

How do T-helper cells contribute to immune response, and what are the consequences of their over-activation?

A

T-helper cells can differentiate into Th1, Th2, Th17, or T-reg cells. Over-activation can lead to Th1 or Th2 dominance, causing chronic inflammation/autoimmunity or allergies/asthma.

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3
Q

What are the clinical indications and tests for low immunity, and how is low immunity assessed in a case history?

A

susceptibility to infections, fatigue, weight loss, and specific symptoms.

Tests: low WBC count, low sIgA, and positive pathogen/antibody tests. Case history assesses infection history and symptoms.

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4
Q

Explain the “Hygiene Hypothesis” and its association with immune programming.

A

The Hygiene Hypothesis suggests that pathogen exposure in neonates is crucial for immune development. Inadequate exposure is linked to increased atopic diseases and autoimmunity.

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5
Q

What factors contribute to compromised gut and microbiome health, impacting immune protection?

A

c-section, formula feeding, antibiotics, hygienic upbringing, dysbiosis, low sIgA, PPIs, NSAIDs, steroids, and impaired barrier defenses like tonsillectomy.

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6
Q

How does cortisol, influenced by emotional and physical stress, impact immune activity?

A

Elevated cortisol inhibits phagocytes, NK cells, and lymphocyte activity, compromising the immune response under emotional and physical stress.

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7
Q

What role does sleep play in immune function, and how does it influence cytokine production?

A

Sleep influences immune memory, anti-viral cytokines (IL-12/IFNγ), and inflammatory cytokines (e.g., IL-6), impacting lymphocyte blastogenesis.

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8
Q

How can heavy metal toxicity affect immune function?

A

Heavy metal toxicity can inhibit lymphocyte proliferation, contributing to immune dysfunction.

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9
Q

What are the genetic factors (polymorphisms/SNPs) associated with low vitamin D status, and how can individuals with these factors be supported?

A

VDBP and VDR can impact vitamin D status.

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10
Q

Explain the principles of supporting immunity

A

reducing sugar, alcohol, caffeine, maintaining a healthy weight, regular activity, and supporting digestion with a high prebiotic diet.

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11
Q

How can fresh woodland or sea air contribute to supporting immunity, and what compounds play a role in this?

A

Fresh woodland or sea air contains phytoncides (plant antimicrobial compounds) and minerals, contributing to immune support.

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12
Q

What lifestyle modifications are recommended for supporting immunity?

A

supporting sleep, reducing stress, minimizing toxic exposure, and considering bed rest for energy conservation.

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13
Q

How does digestion and GI health play a vital role in supporting immunity, and what dietary recommendations are made?

A

Digestion and GI health support a healthy microbiome. Dietary recommendations include a high prebiotic diet, chewing well, and taking time to digest when relaxed.

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14
Q

How do T-helper cells exhibit crosstalk, and why is it important in maintaining a balanced immune response?

A

T-helper cells exhibit crosstalk, where Th1 downregulates Th2 and vice versa. Balanced crosstalk is crucial for maintaining a well-regulated immune response.

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15
Q

What is the role of antigen presentation in the immune system, and how does it bridge the innate and adaptive immune responses?

A

Antigen presentation by innate immune cells (APCs) bridges the innate and adaptive immune responses, allowing for a tailored immune reaction to specific threats.

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16
Q

Supplements for Immune support & dosages?

A

Vit A (2500-5000): lymphatic tissue and immune cells, maintain lung barrier function.

Vit C (buffered 1-5g): support innate/adaptive immune system + ↓ suceptibility to infection.

Zinc chelated(10-15): ↓ viral replication, permeability of barriers

Vit D3 (1000-2000iu): innate immune, T reg, ↓ IgG, self tolerence

Probiotics (1-30bn): boost sigA. Lacto, Sacc boulardii. Low level challenge to immune.

Reishi (immune cell, T cells, NK)/Chaga (anti-viral)/Shiitake (↑ phagocyte T cell NK cells interferons)/Maitake (↑Th1, macrophages, NK, anti-cancer)

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17
Q

Supplements to consider during infection to support immune?

A

Vit A (5000): anti-viral

Vit C (buffered 1g/hour up to 6 hours): inhibis viral multiplication

Zinc (15-30): anti-viral

Vit D (5000iu): antimicrobial peptide prod

Elderberry (3-8g): prevent viral cell entry. Phytochemicals

Echinaea (4000mg) Immune enhancing/ modulating, NK cells

Lysine (1-3g); ↓ viral replication esp herpes simplex.

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18
Q

What is a Cytokine Storm?

A

Cytokine Storm is an immune hyperresponsiveness characterized by an excess of pro-inflammatory cytokines. It can be triggered by various factors, including infections and viral illnesses.

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19
Q

How does Elderberry contribute to immune health during a viral infection?

A

Elderberry is antiviral, reduces viral load, lowers overall inflammation, and acts as a powerful antioxidant, potentially minimizing damage during infections.

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20
Q

What are the risk factors associated with more severe cases of COVID-19?

A

Risk factors for severe COVID-19 include obesity, diabetes mellitus, cardiovascular diseases, non-alcoholic fatty liver disease, and nutritional deficiencies (e.g., vitamin D, vitamins C, B6, selenium, zinc, DHA, and EPA).

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21
Q

How does dysbiosis relate to COVID-19, and what are the consequences of dysbiosis in this context?

A

Dysbiosis in COVID-19 is linked to the depletion of immunomodulatory gut bacteria, potentially leading to infection. It may result in metabolic endotoxaemia, aggravating inflammation.

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22
Q

Outline the Naturopathic approach for COVID-19, emphasizing lifestyle and dietary recommendations.

A

plant-based diet focus, adequate rest, stress reduction, immune support through probiotics and vitamins, and additional support for severe cases, targeting specific affected areas.

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23
Q

How does chronic inflammation manifest in the body, and what are the cardinal signs of inflammation?

A

pain, swelling, joint stiffness, redness, and heat. The cardinal signs of inflammation include redness, heat, edema, pain, and loss of function.

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24
Q

What are the causes and risk factors of chronic inflammation related to diet and lifestyle?

A

a Western diet (high refined sugar, high omega-6/low omega-3), genetic polymorphisms (FADS1/2), chronic stress, poor sleep, excess exercise, oxidative stress, high toxic load, metabolic endotoxaemia, sex hormone imbalance, persistent infections, and myeloid-derived suppressor cells.

25
Q

What are some common mediators of inflammation, and how do they contribute to the inflammatory process?

A

Mediators include cytokines (TNF⍺, IL-6, IL-1), histamine, kinins (bradykinin), and Nuclear Factor-Kappa B (NF-kB). They upregulate inflammation, promoting vasodilation, increased permeability, and other inflammatory processes.

26
Q

How does the resolution of inflammation occur in the body, and what factors contribute to this process?

A

the production of receptor antagonists, T-reg cells producing inhibitory cytokines, and the production of less inflammatory eicosanoids from omega-3 fatty acids.

Lipoxins downregulate NFkB and immune response.

27
Q

What are the medical management options for chronic inflammation, and what are their potential side effects?

A

NSAIDs (ibuprofen, naproxen), corticosteroids (prednisolone), and DMARDS (methotrexate, azathioprine). Side effects range from gastrointestinal issues to immune suppression.

28
Q

What is the Naturopathic approach to addressing chronic inflammation, and how does it differ from medical management?

A

Dietary support for blood glucose stability, gut health improvement, oxidative stress reduction, stress and sleep support, immune function enhancement, and background support for methylation.

29
Q

Why is supporting lung health essential in a Naturopathic approach during a respiratory infection like COVID-19?

A

Lungs are susceptible to oxidative stress and damage during respiratory infections. Supporting lung health includes avoiding smoking, using N-acetyl cysteine (NAC), ensuring adequate vitamin D levels, and employing anti-microbial herbs.

30
Q

Name chronic inflammation supplements and dosages

A

Turmeric (500-2000): NFkb block. ↓ inflam cytokines IL-1B/IL-6.

Curcumin (1000) - cytokine regulator. ↓ TNFa, PGE-2, reduce joint inflammation

Ginger (500-1000): ↓ TNFa/PGE-2

Boswelia (250-500): ↓ 5LOX

EFAs (1g): ↓ PGE-2, TNFa, IL-6.
Vit D (2000-10000): ↓ eosinophils, T reg, TH1-TH2. ↓IL-6/TNFa.

Quercetin (250-1500): ↓ LOX/COX NFkb

Probiotics ↓ TNFa/IL6

Reishi (3-9g): triterpenes are anti-inflammatory ↓ NF-kB

31
Q

What is the definition of Autoimmune (AI) disease, and what happens when there is a breakdown in self-tolerance?

A

Autoimmune disease involves the immune system mistakenly attacking the body’s own cells, leading to ill-health. Breakdown in self-tolerance occurs when the immune system fails to distinguish between self and non-self, resulting in an attack on the body’s own tissues.

32
Q

Describe the role of ‘Central Tolerance’ in preventing autoimmune reactions.

A

Central tolerance ensures self-reactive lymphocytes are deleted in the thymus. It involves the elimination of mature self-reactive T-cells, preventing their release into circulation without proper training. Dysregulation in this process can contribute to a loss of self-tolerance.

33
Q

Explain the significance of Th1, Th2, and Th17 cells in the pathophysiology of autoimmune diseases.

A

Th1 and Th17 cells are crucial drivers of inflammation in tissue-specific autoimmunity. Th1 increases macrophages, while Th17 promotes inflammatory cells. Systemic AI conditions, such as SLE and Sjögren’s, are characterized by Th2-dominant cytokine production.

34
Q

How does cross-reactivity contribute to autoimmune diseases, and what are the mechanisms involved?

A

Cross-reactivity occurs when an autoantigen or mimic triggers a reaction against specific self-tissues. This can involve mimicry, where an antigen resembles a self-antigen, or tissue damage from infections releasing self-antigens. Dysfunction in the Major Histocompatibility Complex (MHC) may also play a role in autoimmune diseases.

35
Q

Discuss the role of foods, especially gluten, in molecular mimicry and autoimmune diseases.

A

Peptide sequences in foods, like dairy and wheat, can mimic human tissues, leading to molecular mimicry and the induction or exacerbation of autoimmune diseases. Gliadin, found in gluten, mimics transglutaminase, contributing to conditions such as Hashimoto’s.

36
Q

What are some proposed mechanisms for autoimmunity, including epitope spreading and bystander activation?

A

Epitope spreading involves the extension of an antibody or cellular response to different epitopes on an antigen, increasing damage. Bystander activation occurs when infections activate antigen-presenting cells (APCs), leading to the activation of autoreactive T-cells.

37
Q

Explore the causes and risk factors of autoimmunity, including genetic and environmental factors.

A

Genetic factors: HLA SNPs HLA-DRB1 (RA)/HLA-DQ8 (Coeliac), TNFa, IL2/12. VDR Emotional trauma, infections, gluten, environmental toxins, and vitamin Deficiency , intestinal permeability, thinning mucosal barrier, high oestrogen (xenoestrogens)

38
Q

Describe the clinical presentation and diagnostic methods for autoimmune diseases.

A

GP tests for inflammatory markers (CRP, ESR) and autoantibodies, as well as functional tests for gut profiling and genetic testing for SNPs.

39
Q

Outline the Naturopathic approach to autoimmunity, emphasizing gut health, diet, and lifestyle.

A

focusing on gut health, addressing food sensitivities, maintaining a blood glucose-balancing diet, eliminating gluten, supporting optimal vitamin D levels, promoting methylation, and providing stress and sleep support.

40
Q

Explain the ‘autoimmune protocol’ (AIP) and its emphasis on nutrient-dense foods and lifestyle factors.

A

AIP focuses on nutrient-dense foods and eliminates potential immune-stimulating or harmful foods. It emphasizes factors that modulate immune function, gut health, and hormone health, including sleep, stress management, and adequate activity. Excludes alcohol, dairy, grains legumes, refined sugars/oils, nuts, seeds, nightshades, sweeteners

41
Q

Nutrients for Autoimmunity?

A

Vit D (2000-1000) - T reg and ↓ Th17

EFAs (1g): ↓ PGE2 pathway

Curcumin (1000)

Resveratrol (200): ↓ TH17/nf-KB, cox-2

Alpha Lipoic Acid (200): ↑ cellular glutathione, anti-inflam IL6/TNFa

Cordyceps: IB-1b induced MMP expression in RA snovial

42
Q

How can probiotics contribute to the Naturopathic approach for autoimmune conditions related to the gastrointestinal (GI) system?

A

Probiotics -RA, UC and MS.

A combination of Lactobacillus and Bifidobacterium to↓ disease severity and C-reactive protein (CRP) levels in RA.

43
Q

what probiotic intervention has shown promise between dysbiosis and MS

A

L. reuteri

44
Q

Which probiotic strains have demonstrated a reduction in inflammatory cytokines in inflammatory bowel disease (IBD)?

A

L. salivarius and L. rhamnosus GG

45
Q

How can gut permeability be supported in the Naturopathic approach, and what nutrients are involved in this process?

A

vitamin A, vitamin C, zinc, glutamine, N-acetyl glucosamine (NAG), and collagen.

46
Q

In cases of persistent pathogens, what might be considered as part of a Naturopathic approach for managing dysbiosis?

A

A dysbiosis protocol may be considered- include natural antimicrobial agents oregano, garlic, and berberine to address imbalances.

47
Q

What characterizes Systemic Lupus Erythematosus (SLE), and how is it diagnosed?

A

A chronic inflammatory disease marked by autoantibody response to nuclear and cytoplasmic antigens, leading to multi-system dysfunction. Diagnosis involves the presence of anti-nuclear (ANA) and double-stranded DNA (dsDNA) antibodies.

48
Q

Explain the pathophysiology of SLE and its impact on cellular metabolism.

A

widespread cellular apoptosis and defective clearance, leading to the persistence of antigens and immune complex production.

This deposits in microvasculature, skin, and kidneys.

This process impairs energy production, increases oxidative stress, inflammation, and alters lipid metabolism.

49
Q

Define allergy and describe the key mechanisms involved in allergic diseases.

A

an immune hypersensitivity reaction to normally harmless substances.

Key mechanisms involve a heightened Th2 response, leading to the release of cytokines (IL-4, IL-5, IL-6, IL-13), IgE antibody production, mast cell activation, and histamine release.

Mast Cell Activation Syndrome (MCAS) can result in excessive chemical mediator release.

50
Q

Risk factors for SLE

A

HLA-DR-3/2
Sex hormone imbalance (women in reprod years)
Not breastfed
Infectious trigger (EBV, periodontal)
Toxins
Stress (low DHEA)
Low vit D

51
Q

How does the microbiome influence the development of allergies, and what is the ‘hygiene hypothesis’?

A

The microbiome plays a vital role in immune response modulation through ‘bystander suppression.’

The ‘hygiene hypothesis’ suggests that a lack of early exposure to sufficient antigens increases the risk of atopic dermatitis and autoimmune diseases.

Vaginal birth and microbial exposure contribute to a balanced immune response.

52
Q

What are the genetic factors and SNPs associated with increased susceptibility to allergies?

A

SNPs in FLG (linked to atopic dermatitis), VDR (associated with asthma), HLA (implicated in allergy), TNF-α, IL-13 (increasing asthma risk), and glutathione-related SNPs (GSTP1, GSTM1) that raise oxidative stress susceptibility.

53
Q

Explain the causes and risk factors for allergies related to birthing and feeding practices in infants.

A

C-section-born babies have lower microbial diversity and increased IgA, IgG, and IgM levels, leading to a higher risk of sensitization.

Formula-fed infants show lower bacterial diversity, increasing the risk of eczema and asthma.

Maternal atopy, vaccinations, early antibiotic use, and disruptions in gut flora also contribute.

54
Q

What is the Naturopathic approach to managing allergies, and how can histamine levels be reduced?

A

↓ exposure to triggers, focusing on gut health, balancing blood glucose, and supporting optimal vitamin D levels.

To reduce histamine levels, -avoid histamine-rich foods, support detoxification pathways (methylation, DAO, acetylation, MAO-B), and ↓ overall toxin exposure.

55
Q

Describe the metabolism of histamine and its role in allergic dermatitis.

A

Histamine metabolism involves enzymes like Diamine oxidase (DAO), histamine-N-methyltransferase (HNMT), monoamine oxidase B (MAO-B), alcohol dehydrogenase (ADH), and N-acetyltransferase 2 (NAT2).

Poor detoxification or ‘high histamine loading’.

High histamine levels can exacerbate inflammation, increase oxidative stress, and induce pruritus in allergic dermatitis.

56
Q

What are the clinical presentations and symptoms associated with Systemic Lupus Erythematosus (SLE)?

A

fatigue, joint inflammation, seizures, renal damage, photosensitivity, pulmonary and cardiac issues, cytopenia, and digestive problems.

distinctive butterfly skin rash, malaise, fever, and a relapsing and remitting pattern characterize SLE.

It primarily affects females, and diagnosis involves the presence of ANA and dsDNA antibodies.

57
Q

strategies for reducing histamine levels in individuals experiencing histamine intolerance.

A

Avoiding/minimizing histamine-rich foods and drinks: fermented products, dairy (especially cheese), alcohol, dried fruits, avocados, aubergine, spinach, and processed meats.

Support histamine detoxification pathways, including methylation (with folate and B12), DAO function (with copper, vit C, and B6), acetylation (vit B5), and MAO-B activity (vit B2).

58
Q

Supplements in high histamine

A

Quercetin (250-750): LOX/NFkb/IL4

Nettle leaf (500)
EFAs (1g)
Probiotics
Vit D (2000-10000)
Mg (200-400) - improve bronchial reactivity
Vit C (2g+): histamine detox - DAO cofactor (degrades histamine in the gut.

CNM Nut2 S2 Exam revision (9 decks)

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