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Final year semester 2 exam > Immune system > Flashcards

Immune system Flashcards

1
Q

What is the innate immune system?

A

The immune system we are born with. Includes:
- phagocytes and other immune cells
- inflammatory response
- external barriers
- chemical barriers

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2
Q

What is the adaptive immune system?

A

The innate immune cells will show the adaptive immune cells the invading pathogen, and the innate cell will help up-regulate or down-regulate over-all immune response.

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3
Q

What is effective immunity dependant on?

A
  • barrier tissue integrity
  • presence of secretions
  • probiotic bacteria
  • MALT/GALT
  • Inflammation
  • ## effective adaptive and innate immunity
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4
Q

what is lactoferrin?

A

A protein that binds to iron stopping infectious cells obtaining the iron wall

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5
Q

what is the function of Th1

A

Defence against intracellular pathogens

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6
Q

what is the function of Th2

A

Defence against external threats

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7
Q

what are CD4 cells

A

naive T-helper cells

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8
Q

which IL promotes differentiation of the naive Th into Th1

A

IL-12

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9
Q

which IL promotes differentiation of the naive Th into Th2

A

IL-2, IL-4 and IL-5

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10
Q

What does the production of Th1 cells trigger?

A

cytotoxic T cells, macrophages, IFN-y and TNF-a/b

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11
Q

What does the production of Th2 cells trigger?

A

IL-4, -5, -10 and -13, increase B-cell antibody production (especially IgE), and induces eosinophils.

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12
Q

What is the function of Th17

A

defence against extracellular pathogens

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13
Q

What is the function of T-reg cells

A

modulate and deactivate immune response.

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14
Q

which IL promotes differentiation of the naive Th into Th17

A

IL-1, IL-6, and TGF-b.

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15
Q

What does the production of Th17 cells trigger?

A

Pro-inflammatory cytokines such as IL-17, -6, -22 and TNF-a.

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16
Q

Which cytokines to T-reg cells activate?

A

IL-10 and TGF-b

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17
Q

Where are T-reg cells produced?

A

GALT

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18
Q

What does Th1 dominance drive?

A

Chronic inflammation and autoimmunity.

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19
Q

What does Th2 drive?

A

Allergies (asthma and atopic triad)

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20
Q

Which test results can show low immunity

A
  • low WBC
  • low secretory IgA (stool and salivary)
  • positive antibody or pathogen
  • pathogens in stool
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20
Q

what are some signs someone has low immunity?

A
  • frequent infections
  • prolonged illness
  • fatigue
  • loss of appetite
  • aches and pains
  • large lymph nodes
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21
Q

What signs in case taking can you look out for that can cause low immunity?

A
  • early lack of exposure
  • c-section
  • breastfed
  • antibiotic use
  • poor nutrition
  • immunosuppressants
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22
Q

Name some causes of lowered immunity

A
  • impaired barrier defence
  • emotional
  • chemical
  • physical stress
  • poor sleep
  • heavy metal toxicity
  • leaky gut
  • no tonsils/appendix
  • bloody glucose regulation
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23
Q

How can we support the immune system?

A
  • reduce super, starchy carbs, sugar, caffeine
  • regular exercise (not over exercising)
  • good sleep
  • reduce stress
  • reduce toxic exposure
  • digestion/GI health
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23
Q

How does bloody glucose regulation cause low immunity?

A

high glucose activates Protein Kinase C (PKC) which inhibits phagocytosis and superoxide production which significantly alters innate immune response. low glucose can cause release in cortisol which inhibits inflammation.

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24
Q

How does vitamin A support immunity, and what does deficiency look like? Recommended dose?

A
  • supports lymphatic tissue and immune cells
  • maintains lung barrier function

D: severe respiratory infections

RD: 2500-5000 iu/day

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25
Q

How does vitamin C support immunity, and what does deficiency look like? Recommended dose?

A
  • supports innate and adaptive immune system
  • supports epithelial barrier, vital for collagen synthesis
  • supports energy levels
  • major antioxidant

D: more susceptible to infection

RD: 1-2g / day

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26
Q

How does zinc support immunity? Recommended dose?

A
  • boosts WBC activity
  • boosts immunity in children
  • supports barrier integrity

RD: 10-15mg / day

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27
Q

How do probiotics support immunity? Recommended dose?

A
  • Increase IgA
  • reduce frequency and severity of infection in children

RD: 1-3 billion / day

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28
Q

How does vitamin D support immunity, and what does deficiency look like? Recommended dose?

A
  • increase innate immune system
  • increases T-reg cells
  • ‘immune balancer’
  • reduces flu risk in children

D: higher susceptibility, complications and mortality.

RD: 1000-2000 IU/day
5000-20000 IU/day for 3 months when low levels

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29
Q

How do betaglucens support immunity? Recommended dose?

A
  • these polysaccharides are seen as ‘foreign’ to the immune system, and it up-regulates immune activity.

RD: 900mg/day

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30
Q

Which medicinal mushrooms support immunity?

A
  • reshi
  • shittake
  • chaga
  • miatake
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31
Q

If someone was unwell or deficient in vitamin A, what is the dose you would suggest?

A

5000 IU/day

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32
Q

If someone was unwell or deficient in vitamin C, what is the dose you would suggest?

A

2g/day or 1g an hour for several hours (5/6)

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33
Q

If someone was unwell or deficient zinc , what is the dose you would suggest?

A

30mg/day

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34
Q

If someone was unwell or deficient in vitamin D, what is the dose you would suggest?

A

5000 IU/day

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35
Q

Which herbs can be used for immunity during infection?

A
  • elderberry
  • betaglucans
  • echinacea
  • Lysine
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36
Q

What is a cytokine storm?

A

an excess of pro-inflammatory cytokines which cause lung tissue damage, resp damage, pneumonia and even death

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37
Q

Which nutritional deficiencies make a person more susceptible to Covid-19

A

vitamin D, vitamin C, B6, Selenium, Zinc, DHA and EPA

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38
Q

List some naturopathic ways we can support someone with COVID-19

A

Reducing stress, improving sleep, reducing oxidative stress, lowering blood glucose, weight management, pro-biotics, microbiome support.

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39
Q

How does Quercitin help with COVID-19? RD?

A

Impairs spike binding to ACE-2 and inhibits viral replication

RD: 500-1000mg x2 daily

40
Q

How does reservatrol help with COVID-19? RD?

A

Inhibits SARS Cov-2 in vitro, and antioxidant.

41
Q

How does turmeric help with COVID-19? RD?

A
  • cytoprotective effects on type II alveolar cells
  • decreases inflammatory macrophages
  • ACE-2 blocking

RD: 1.5g daily

42
Q

How does berberine help with COVID-19? RD?

A
  • interferes with viral replication
  • helps with insulin sensitivity

RD: 400mg x2 daily

43
Q

what happens internally when inflammation occurs?

A
  • vasodilation
  • increased tissue permeability
  • blood clotting
  • accumulation of cells
  • recruitment of immune cells
44
Q

what are the external signs of inflammation?

A

redness, heat, pain, swelling, loss of function

45
Q

what are some clinical presentations of chronic inflammation?

A
  • typical inflammatory signs and symptoms
  • inflammatory diagnosis (endo, IBD)
  • high stress, overtraining
  • steroid and analgesic use
46
Q

what GP tests would be done for chronic inflammation

A
  • CRP
  • vitamin D
  • WBC
  • fibrinogen
  • ESR
  • MRI, ultrasound
47
Q

what functional tests would be done for chronic inflammation

A
  • hsCRP
  • omega 6:3 ratio
  • low omega 3
48
Q

name some genetic SNPs that might make someone predisposed to chronic inflammation

A
  • IL-6
    -FADS1/2
  • IL-13
  • TNF-a
  • HLA
    -VDR
49
Q

If TH1 is high in a test, what does this suggest?

A

chronic inflammation

50
Q

which cytokines up-regulate inflammation?

A
  • TNF-a
  • IL-1
  • IL-6
51
Q

How does histamine upregulate chronic inflammation?

A

promotes vasodilation and vascular permeability

52
Q

How does NF-kB up-regulate the inflammatory process?

A

activates gene transcription (translates the genetic codes into real actions)

53
Q

What activates NF-kB?

A
  • high homocysteine
  • cytokines
  • LPS
  • heavy metals
54
Q

What are Ecosanoids?

A

locally-acting, hormone like messengers made from the oxidation of omega-3 and 6 fat cells in the membranes. Depending on the precursor used (3 or 6), they can exert different degrees of inflammation.

55
Q

What doe prostaglandin-E2 (PGE-2) do?

A
  • ## increases vasodilation, platelet aggrigation, histamine and kinins.
56
Q

How is PGE-2 activated?

A

certain cytokines such as TNF and IL-1 activate COX which then converts arachidonic acid to PGE-2. NF-kB facilitates this.

57
Q

what is inflammation resolution?

A

we produce receptor antagonist that block the receptors, stopping the inflammatory components exerting their effect, blocking their actions.

58
Q

how do T-reg cells help with inflammation resolution?

A

produce inhibitory cytokines like IL-10 and TGFb which inhibit pro-inflammatory cytokines such as Th1

59
Q

name some ‘less inflammatory’ cytokines

A
  • lipoxins
  • PGE-1
  • PGE-3
  • protectins
  • resolvins
60
Q

how does the western diet cause chronic inflammation?

A
  • high refined sugar increases free radicals and AGE
  • High omega-6 and low omega-3 increases PGE-2
61
Q

how can chronic high cortisol lead to chronic inflammation?

A

it can lead to glucocorticoid receptor resistance, which leads to failing to down-regulate inflammatory response

62
Q

list some causes or risk factors for chronic inflammation

A
  • sex hormone imbalance
  • metabolic endotoxaemia
    -excess exercise
  • poor quality sleep
  • excessive exercise
63
Q

explain the mode of action of NSAIDs, and side effects

A

inhibits COX-1 and COX-2, down-regulating prostaglandin synthesis.

SE: no COX-1 causes low mucosal secretions in the stomach, potentially leading to ulceration

64
Q

explain the mode of action of corticosteroids, and side effects

A

inhibits inflammatory proteins blocking NF-Kb, induces expression of anti-inflammatory proteins, inhibits 5-LOX and COX-2.

SE: weight gain, diabetes, hypertension, blurred vision, osteoporosis

65
Q

name some naturopathic approaches to chronic inflammation

A
  • blood glucose regulation
  • gut health
  • oxidative stress
  • stress, sleep, recovery support
  • immune function
  • methylation
66
Q

How can turmeric help with chronic inflammation, and what’s the RD?

A

blocks NF-Kb activation and inhibits pro-inflammatory cytokines IL-1 and IL-6. antioxidant.

RD: 500-2000 mg/day

67
Q

How can curcumin help with chronic inflammation, and what’s the RD?

A

Reduces PGE-2 and LOX-5. Regulates cytokines such as IL-1, -6, -12, TNFa. Reduces joint inflammation and arthritic pain. Antioxidant.

RD: 200-400mg /day

68
Q

How can ginger help with chronic inflammation, and what’s the RD?

A

Inhibits TNFa and PGE-2 through COX-2. Reduces inflammatory joint pain

RD: 500-1000mg/day

69
Q

How can Boswellia help with chronic inflammation, and what’s the RD?

A

Reduces 5-LOX activity

RD: 250-500mg/day

70
Q

How can EFA’s especially EPA (purified fish oil) help with chronic inflammation, and what’s the RD?

A

Inhibits PGE-2 pathway. Inhibits NF-Kb, TNF and IL-6.

RD: 1g /day

71
Q

How can vitamin D help with chronic inflammation, and what’s the RD?

A

Inhibits eosinophils. Improves T-cell function

RD: 2000-10000 IU/day

72
Q

How can Rheshi help with chronic inflammation, and what’s the RD?

A

Reduces activity of NF-Kb

RD: 3-9g /day

73
Q

Explain ‘central tolerance’

A

Self reactive lymphocytes are deleted in the thymus, and mature self reactive T cells are deleted in peripheral tissues, all via apoptosis.

74
Q

Which Th cells are more likely to cause autoimmunity?

A

Th-1 and Th-17

75
Q

What does the Major Histocompatability Complex (MHC) do?

A

encodes cell surface proteins acting as an identifier. helps the body differentiate between self and non-self antigens. dysfunction is associated with AI.

76
Q

Which genetic SNP is closely linked to AI?

A

HLA

77
Q

List some potential triggers for AI

A
  • emotional trauma / infection (80% of AI)
  • gluten
  • environmental toxins
  • vitamin D deficiency
78
Q

Which AI diseases is low vitamin D linked to, and why?

A
  • T1DM due to attacking pancreatic beta cells
  • MS due to attacking oligodendrocytes
79
Q

What % of AI sufferers are female?

A

78%

80
Q

List 1 possible reason women are more likely to suffer from AI disease

A

high oestrogen from xenoestrogen consumption, contraception and HRT.

81
Q

What are the clinical presentations of AI

A
  • diagnosis
  • history of pathogen exposure, gut issues, family history or stress
  • Predisposing SNPs to inflammation
82
Q

What blood markers would you look for in AI disease

A
  • inflammatory markers
  • specific antibodies such as RA (rheumatoid factor)
  • low VD
83
Q

What is the naturopathic approach to autoimmunity?

A
  • blood glucose balancing/low GL
  • gut/food sensitivity
  • gut permeability
  • eliminate gluten and other allogenic foods
  • support methylation
  • vitamin D support
  • stress support
84
Q

what foods are eliminated in the auto immune protocol?

A

alcohol, dairy, grains, refined sugar, oils, eggs, nuts, seeds, sweeteners.

85
Q

How does vitamin D help with autoimmunity? RD?

A
  • interacts with VDR which modulates gene expression
  • inhibits CD4 T1 cells and their production of cytokines
  • Increases T-reg activity and suppresses Th-17

RD: 2000-10000 IU/day

86
Q

How do EFA’s help with autoimmunity? RD?

A

-high potency omega-3 fish oil can reduce inflammation by inhibiting the PGE-2 pathway

RD: 1g of EPA

87
Q

How does vitamin D help with autoimmunity? RD?

A
88
Q

which 2 gut bacteria has been linked to lowering IBD symtpoms?

A

L. salivarius and L-rhamnosus GG

89
Q

What are some symptoms of SLE?

A
  • fatigue
  • joint inflammation
  • seizures
  • renal damage
  • photosensitivity
  • butterfly rash
90
Q

what are some causes or risk factors for SLE?

A
  • female
  • genetics
  • sex hormone imbalance
  • viral trigger
  • high toxic load
  • stress
  • low vitamin D
  • non-breastfed/bottle fed
91
Q

What is the key mechanism in an allergic response?

A

High Th2 response

92
Q

What happens when Th2 cells initiate an allergic response?

A

Th2 secretes IL-4, -5, -6, -13 to regulate IgE antibody producing B cells, mast cells and eosinophils.

93
Q

What is IgE’s main function?

A

Immunity to parasites

94
Q

How does IgE activate it’s actions?

A

binds to mast cells triggering degranulation and histamine release

95
Q

What is mast cell activation syndrome? (MCAS)

A

mast cells inappropriately and excessively release chemical mediators resulting in a range of chronic symptoms, and sometime anaphlaxys.

96
Q

What does histamine do?

A
  • induces IL-31
  • upregulates inflammation
  • increases oxidative stress
  • triggers pruritus
97
Q

How can histamine be exasperated?

A
  • poor detoxification
  • high histamine loading
  • SNP: DAO, HNMT, MAO-B, ADH and NAT-2
98
Q

How does quercetin help with allergies?

A
  • Inhibits LOX
  • stabilises mast cells
  • downregulates NF-Kb and IL-4
99
Q

How does nettle leaf help with allergies?

A
  • reduces effect of histamine
  • Inhibits COX-1 and COX-2
100
Q

How to help histamine loading?

A
  • reduce foods such as fermented foods like cheese, alcohol, dried fruits, spinach, aubergine, avocado.
  • support detoxification oh histamine via methylation with floate and B12. Also copper, B6 and vitamin C via DAO enzyme which breaks down histamine in the gut

Final year semester 2 exam (9 decks)

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