Type 1 HSRs

Question 1

What is a type I HSR?

Answer 1

Immune reaction to innocuous/environmental antigen mediated by IgE induced degranulation

Question 2

What are the 3 phases of type I HSRs?

Answer 2

1. sensitization
2. early phase
3. late phase

Question 3

What happens during the early phase of type I HSRs?

Answer 3

mast cell degranulation
IgE–FCERI
release of primary/secondary mediators

Question 4

What happens during the late phase of type I HSRs?

Answer 4

cytokine production (IL-4, 5,13)
cellular recruitment (granulocytes and TH2)

Question 5

What are 4 granulocytes?

Answer 5

1. mast cells
2. eosinophils
3. neutrophils
4. basophils

Question 6

What receptor does IgE bind to with high affinity?

Answer 6

FCERI

Question 7

What cytokine induces IgE class switching?

Answer 7

IL-4

Question 8

What cytokine induces eosinophil recruitment?

Answer 8

IL-5

Question 9

What cytokines signal to goblet cells?

Answer 9

IL-13

Question 10

Where are mast cells located?

Answer 10

tissue

Question 11

What is primary mediator?

Answer 11

histamine

Question 12

What are 3 secondary mediators?

Answer 12

1. prostaglandins
2. leukotrienes
3. TNF-a (anaphylaxis)

Question 13

Degranulation induces PLA to produce ________ which makes __________ and _________

Answer 13

arachidonic acid
prostaglandins and leukotrienes

Question 14

What pathway does leukotrienes use?

Answer 14

lipoxygenase

Question 15

What pathway does prostaglandins use?

Answer 15

COX 2

Question 16

What is the product of leukotriene synthesis?

Answer 16

cys LTR1

Question 17

What is the product of prostaglandin synthesis?

Answer 17

DP1 and CRTH2

Question 18

How does Singulair (Montelukast) reduce asthma symptoms?

Answer 18

cys-LTR1 antagonist (prevents leukotriene synthesis)

Question 19

What does degranulation induce?

Answer 19

vasodilation
vascular permeability
smooth muscle contractions
mucus production
ROS/RNS

Question 20

At high concentrations of NO its combined with ROS to form ____________

Answer 20

peroxynitrite

Question 21

What 3 ways does peroxynitrite damage cells?

Answer 21

protein oxidation
apoptosis
necrosis

Question 22

What cytokine induces the transition to the late phase response and why?

Answer 22

TNF-a
induces vascular permeability and adhesion molecules

Question 23

What are some way the severity of the type I HSR can be affect?

Answer 23

1. prior exposure
2. concentration
3. route of entry
4. predisposition

Question 24

What cytokine is important for anaphylaxis and why?

Answer 24

TNF-a
induces vascular permeability and adhesion molecules = now systemic

Question 25

How does epinephrine inhibit anaphylaxis?

Answer 25

binds to alpha/beta adrenergic receptor which counter acts primary/secondary mediators ** improves cardiac output

Question 26

How do steroids inhibit inflammation?

Answer 26

blocks pro-inflammatory NFkB signaling

Question 27

What is the goal of SCITs?

Answer 27

divert the TH2 response

Question 28

What 2 mechanisms do SCITs use to reduce allergies?

Answer 28

1. induce Tregs (IL-10) and reduce TH2 (IL-4) 2. switch IgE to IgG (FCGRIIB)

Question 29

What is the inhibitory receptor on granulocytes used by IgG to prevent degranulation?

Answer 29

FCGRIIB

Question 30

What does SHIP Phosphatase do in SCITs?

Answer 30

prevents IgE--Lyn phosphorylation --> degranulation

Question 31

Beta-2 agonists target the same receptor as __________

Answer 31

epinephrine

Question 32

How do anticholinergics reduce asthma symptoms?

Answer 32

allows acetylcholine to bind to M2 inhibitory receptor preventing ACs normal function of airway hyper-reactivity

Question 33

What happens when eosinophils degranulate in the lungs in regards to M2 receptors?

Answer 33

MBP will bind to M2 so now acetylcholine cannot = no longer inhibitory = hyper-reactivity and bronchial spasms

Question 34

Where are type I IL-4/13 receptors found?

Answer 34

lymphocytes

Question 35

Where are type II IL-4/13 receptors found?

Answer 35

epithelial cells, goblet cells, smooth muscle cells, endothelial cells

Question 36

What's the difference between type I and II IL-4/13 receptors besides where they are located?

Answer 36

type I only binds IL-4 type II binds IL4- and IL-13

Question 37

Atopic dermatitis is a IL-___ dominant disease

Answer 37

IL-13

Question 38

Atopic dermatitis is a TH___ mediated response

Answer 38

TH2

Question 39

What does atopic mean?

Answer 39

predisposition to allergic responses involving IgE

Question 40

What is the atopic march?

Answer 40

AD development early in life commonly leads to food allergies --> asthma ---> rhinitis

Question 41

Asthma is IL-_____ dominant

Answer 41

IL-4

Question 42

What is the genetic mutation in AD?

Answer 42

FLG gene

Question 43

What does the FLG gene do?

Answer 43

crosslinks epidermal layer so its strong

Question 44

FLG mutation is common in what race?

Answer 44

europeans and asians

Question 45

What race has higher IL-17/TH17 levels in AD?

Answer 45

asians

Question 46

FLG mutation is less common in _____________ but their AD is just as severe

Answer 46

african americans

Question 47

What race has the highest IgE/Th2 response and a very low Th17/22 response?

Answer 47

african americans

Question 48

Why is it important that AD is mediated differently in different races?

Answer 48

AD is not just mediated by TH2 but also TH17 due to polymorphisms

Question 49

What is the polymorphism in AD regarding races?

Answer 49

(Q576R) IL-4 Ra gene mutatio

Question 50

What are the 3 distinct features of AD?

Answer 50

epithelial barrier dysfunction susceptibility to infections atopic features (rhinitis and asthma)

Question 51

What are 3 type I HSRs?

Answer 51

atopic dermatitis asthma allergies