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GI > Mucosal Immunity > Flashcards

Mucosal Immunity Flashcards

1
Q

Why is the mucosa vulnerable?

A

Fragility and permebaility

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2
Q

Physiological functions of mucosal tissue?

A

Gas exchange
Food absorption
Sensory activities
Reproduction

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3
Q

Examples of mucosal tissues?

A 
Mammary gland
Salivary gland
Kidnye
Uterus/bladder/vagina 
Conjunctiva
Trachea
Lungs 
Intestine
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4
Q

Anatomical features of gut mucosal system?

A

Organised lymphoid structures unique to mucosal sites

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5
Q

Effector mechanisms of gut lymphocytes?

A

Activated/Memory T cells predominate

Natural effector/regulatory T cells- in organised tissues

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6
Q

Where is the Peyer’s patch?

A

Only in small intestine

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7
Q

What are Peyer’s atches covered in?

A
  • Covered by an epithelial layer containing M cells which have membrane ruffles
  • Takes up antigens by endocytosis/phagocytosis and transported across M cells in vesicles
  • To dendritic cells which activate T cells
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8
Q

Special skill of dendritic cells?

A

Can reach through epithelial layer to capture antigen from lumen of gut

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9
Q

How many compartments is mucosal immune system?

A

2
Epithelium
Lamina propria

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10
Q

Immune cells of lamina propria?

A
  • CCR9
  • Plasma cell
  • Dendritic cells
  • Mat cells
  • Macrophages
  • C4 T cell
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11
Q

Immune cells of epithelial layer?

A
  • CD8 T cell expressing alpha E:B7 integrin and CCR9

- Dendritic cells

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12
Q

What happens to T cells when they are activated by dendritic cells after they’ve encountered antigens?

A

Enter Peyer’s patch from blood vessels

Drain through lymph nodes to thoracic duct ad return to gut via bloodstream

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13
Q

Most common Ig in GI tract?

A

IgA (80%) the IgM the IgG

Dimeric

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14
Q

What can IgA do?

A

Neutralize pathogens and toxins also while internalized in endosomes
-Can also export toxins and pathogens from lamina propria while being secreted

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15
Q

Special T cells in Gut?

A

Intra-epithelial lymphocytes (IELs) 90% are T cells

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16
Q

What happens after virus infects mucosal epithelium cell?

A 
Infected cell displays viral peptide to CD8 IEL via MHC class 1 
-Activated IEL kills epithelial cell by Fas-dependant pathway
17
Q

What happens when mucosal immunity is dysregulated in infections?

A

Infection crosses mucosa and fuses to dendritic cells which shuttle viruse to regional lymph nodes, infection spreads to CD4+ lymphocytes, these viral infected cells go into blood stream and disseminate across body

18
Q

What is selective IgA deficiency?

A

Asymptomatic

Recurrent sino-pulmonary infection (coeliac disease x10)

19
Q

What does CVID stand for?

A

Common variable Immuno-deficiency

20
Q

What is CVID?

A

Recurrent Sino-pulmonary and GI infections (low IgA, M, G & E)

21
Q

What does XLA stand for?

A

X linked agammaglobulinaemia

22
Q

What is XLA?

A

Sinopulmonary and GI infection + devastating enteroviral infections (No B cells)

23
Q

What is chronic granulomatous disease?

A

Staph aureus/ inflammatory granulomas
Pneumonia
Abcesses

24
Q

Severe combined Immunodeficiency acronym?

A

SCID

25
Q

What is SCID?

A

Defect in T & B cell immunity

26
Q

What happens with IgE in allergies?

A

Secreted by plasma cells binds to mast cells which secrete signals to B cells to stimulate further IgE production.
During ingestion antigen diffuses into blood diseminating causing urticaria and anaphylaxis

27
Q

Coeliac disease profile?

A

Genetically linked
Not an allergy
Loss of villi
Biopsy for gold standard diagnosis

28
Q

2 examples of inflammatory bowel disease?

A

Crohn’s disease

Ulcerative colitis

29
Q

What is Crohn’s disease?

A

Can affect any part from mouth to anus

  • Focal and discontinuous inflammation with deep fissures +- granulomas
  • Mediated by Th1 CD4+ T cells
30
Q

What is ulcerative colitis?

A

Rectum and colon - starts in rectum and moves proximally

31
Q

What do ulcerative colitis and Crohn’s disease both produce in large amounts?

A

Inflammatory cytokines IL-1, IL-6 and TNF alpha

32
Q

Treatment of inflammatory bowel disease?

A

-NSAIDS (Non- specific anti-inflammatory and immunosuppressive drugs)

Steroids, azathioprine, methotrexate

GI (15 decks)

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