Lec 09: Prevention Immunotherapy and Immunomodulators Flashcards
T/F
Allergies are curable and preventable through immunotherapy and immunomodulation.
F
Allergies are not curable as of now.
Allergy results from the interplay of what three general factors?
genetic factors
environmental factors
age-related factors
This is the process or condition wherein environmental factors affect the expression of genes.
epigenetics / epigenetic changes
True of immune regulation EXCEPT
A. Th2 is protective in utero and essential for fetal integrity
B. Excessive Th2 activation leads to autoimmunity.
C. Th1 sends regulatory signals to prevent the action of Th2.
D. Treg cells regulate both Th1 and Th2 responses.
E. NOTA
B
excess Th1 - autoimmunity
excess Th2 - allergy / hypersensitivity
These cytokines are secreted by Treg cells to regulate Th1 and Th2 activation.
IL-10 and TGF-B
IL-10 and TGF-B are also known as what type of cytokines?
tolerogenic cytokines
They allow for the development of immune tolerance (e.g. oral tolerance for food).
Non-atopics produce this type of immunoglobulin in response to allergens or environmental stimuli.
IgG
If both of your parents have no history of atopy, what is the probability of you being atopic?
A. O% B. <1% C. 1-10% D. 5-15% E. 10-20%
D
5-15%
Epigenetics (i.e. environmental effects) play a role in the development of atopy.
T/F
Increase in cases of allegy is likely due to genetic drift.
F
It is more likely due to environmental changes.
The following are included in a pro-allergic lifestyle EXCEPT
A. hygiene B. infections C. caloric restriction D. sedentary living E. NOTA
C
Obesity rather than caloric restriction is pro-allergic.
Other factors include
climate change
pollution and tobacco smoke
early feeding
stress
The following cytokines are predominantly secreted by Th1 cells EXCEPT
A. IL-2 B. IL-5 C. IL-12 D. IFN-y E. NOTA
B
IL-5 is secreted by Th2 together with IL-4, and IL-13
Th1 secretes IL-2, IL-12, and IFN-y
T/F
Immune regulation is affected pre- and postnatally.
T
IgE can be produced as early as how many weeks in utero?
16 weeks
A balanced Th1/Th2 immunity should be developed by what age?
5 years
Which T line matures slower in atopic individuals?
A. Th1 B. Th2 C. Treg D. Tcyt E. B & C only
A. Th1
Th1 maturation is late, therefore there is excess Th2 activity predisposing the individual to atopic diseases.
At what level must the immune response cascade be blocked for it to be the most ideal primary prevention strategy?
blocking the antigen from binding to the antigen-presenting cells
Theoretically, how do you achieve the solution in the previous question?
by putting the child in a sterile plastic bubble :D
Interrupting the allergic march falls to what level of prevention?
A. primary B. secondary C. tertiary D. active management E. B or C
B
Tertiary is more of preventing serious complications such as COPD in the case of asthma.
This is immunologic unresponsiveness to antigen induced by prior exposure to the same antigen.
immune tolerance
Promotion of oral tolerance falls to what level of prevention.
A. primary B. secondary C. tertiary D. active management E. NOTA
A
Treatment with antihistamine for 18 months of an infant with atopic dermatitis to prevent asthma later in life falls under what level of prevention?
A. primary B. secondary C. tertiary D. active management E. NOTA
B
This interrupts the atopic march.
Enumerate the three mechanisms by which immunologic tolerance develops.
T cell anergy
T cell apoptosis
anti-inflammatory cytokine production
This is the best time to manipulate the diet of an infant since the gut is pliable and the immune system is neither too young nor too mature.
4-6 months (window of tolerance)
T/F
Bigger antigens elicit greater immune response.
T
That’s why milk products for infants are extensively hydrolyzed.
Why is the window of tolerance only up to 6 months?
The child might have been exposed already (through non-oral routes) to allerges, therefore the patients is already sensitized and pro-allergic. It is too late already.
