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Gastrointestinal pathology > Immunology of the gut > Flashcards

Immunology of the gut Flashcards

1
Q

Examples of PRRs:

A

Toll-like receptors (TLR4, TLR5)

NODs (NOD2)

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2
Q

What arm of the immune system are PPRs involved in?

A

Innate

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3
Q

CD4+ cells can form 2 main arms:

A

Effector cells

Regulator cells

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4
Q

Effects CD4+ cells

A

Th1
Th2
Th17

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5
Q

Th1 cells -

A

Release INF-y

Involved in intracellular pathogens, chronic inflammation, autoimmunity

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6
Q

Th2 cells -

A

IL-4
IL-5
Involved in allergy and asthma

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7
Q

Th17 cells

A

Il17

Extracellular pathogens, chronic inflammation and autoimmunity

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8
Q

What released TNF-a

A

Activated macrophages

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9
Q

What amount of the body’s lymphocytes are in mucosal surfaces?

A

3/4ths

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10
Q

Defences of the intestinal epithelial cell barrier:

A

Tight junctions between cells
Goblet cells - mucins
Paneth cells - anti-microbial peptides

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11
Q

What secretes anti-microbial peptides?

A

Paneth cells

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12
Q

MALT =

A

Mucosal-associated lyphoid tissue

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13
Q

Types/subsets of MALT:

A

NALT
BALT
GALT

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14
Q

Where are most commensals in the gut found?

A

Colon

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15
Q

Important tasks of GALT:

A

Ignore harmless antigens, food, commensals

Mount an immune response to pathogens

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16
Q

GALT can be arranged in:

A

Organised tissues

Scattered lymphoid tissue

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17
Q

Organised tissues in GALT:

A

Peyers patch
Isolated lymphoid follicles
Mesenteric lymph node

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18
Q

Peyer’s patch is found in

A

Small intestine

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19
Q

Isolated lymphoid follicles are found in

A

Small and large intestine

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20
Q

Mesenteric lymph node drains

A

Entire intestinal tract

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21
Q

Scatter lymphoid cells in GALT:

A

Lamina propria leukocytes

Intra-epithelial lymphocytes

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22
Q

2 ways antigens at mucosal surface can be transported across epithelial barrier:

A
  1. M cells

2. Capture by macrophages/APCs

23
Q

M cells =

A

Microfold cells

24
Q

M cells are found on

A

Peyers patch

Isolated lymphoid follicles

25
Q

Ex of pathogens which use M cells to gain access:

A

Polio
Reavirus
Salmonella
Shingella

26
Q

How can antigens be captures from the intestinal lumen?

A

Macrophages have porcesses which extend to capture - hand over to DCs - drain to MLN

27
Q

To happens to dendritic cells to regulate immune function

A

Conditioning

28
Q

What can condition DCs

A 
Diet 
Epithelial cells
Flora
Vitamins
Cytokines
29
Q

What is conditioning?

A

Makes DCs favour a Tref response

30
Q

T reg cells

A

Treg1
Treg3
CD25+

31
Q

Treg1 released

A

IL-10

32
Q

Treg3 releases

A

TGF-b

33
Q

CD25+ released

A

IL-10, TGF-b

34
Q

How can microbial metabolites control the gut inflammatory response.

A

Short chain fatty acids - make DCs favour regulatory response - make macrophages less responsive to TLRs/LPS entering the gut.

35
Q

What can interrupt intestinal homeostasis?

A

Too many effects

Regulatory cell defect

36
Q

Dominant antibody of mucosal system =

A

IgA

37
Q

Difference between blood and GALT IgA

A 
Blood = monometric
GALT = dimetric
38
Q

Dimetric IgA is joined by

A

J chain

39
Q

why is J chain important?

A

Binds to poly-IgA receptor
Most is cleaved, some is left to make secretory component
Secretory component binds to mucus layer

40
Q

Functions of sIgA

A
  • Prevents adherence of microorganisms

- Neutralises toxins

41
Q

Why is IgA better than IgG?

A

IgA has little capacity to opsonise or start classical pathway of complement

42
Q

What can replace sIgA in those deficient?

A

sIgM

43
Q

What normal is generated when food antigens are consumed:

A

Oral tolerance

44
Q

Oral tolerance:

A

Antigen specific T effector cells turned off or deleted

Antigen specific T regulatory cells generated

45
Q

What happens when commensals are in gut?

A

Treg response

Ignored by systemic immune response

46
Q

What happens when pathogens present in gut?

A

DCs activated through PRRs and induce effector cells.

47
Q

How does the body tell the difference between commensals and pathogens?

A
  1. Localisation of PPRs
  2. Virulence factors in pathogens
  3. Commensals avoid PRR activation
48
Q

TLR4 is found

A

Crypt base

49
Q

TLR5 is found

A

Basolateral side

50
Q

Genetic predisposition associated with Crohn’s =

A

NOD2

51
Q

Example of aminosalicylates

A

Sulphasalazine

52
Q

Examples of immune suppressants used in IBD

A

Azathiprine

Methotrexate

53
Q

Examples of biologicals used in IBD:

A

Infliximab

Adalimumab

Gastrointestinal pathology (6 decks)

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