Mucosal Immunity

Question 1

IgA

Answer 1

mucosal surface immunity

Question 2

innate immunity of GI

Answer 2

goblet cells - mucous
epithelial cells - barrier
paneth cells - antibacterial
M cells - antigen sampling

Question 3

adaptive immunity of GI

Answer 3

IgA - anti-inflammatory
Th17 - IL-17 and IL-22
suppression of cell-mediated immunity - T regs

Question 4

FoxP3

Answer 4

T reg cell

-inhibit immune responses

Question 5

CD103

Answer 5

dendritic cells

Question 6

cytokines of adaptive immunity

Answer 6

TGF-beta
IL-10
IL-2

Question 7

celiac disease

Answer 7

deficient fox-p3 cells

-no T regs to inhibit response

Question 8

stratification

Answer 8

minimize contact between bacteria and epithelium

mucous

Question 9

compartmentalization

Answer 9

confine bacteria to intestinal sites and limiting systemic exposure

• phagocytes in lamina propria
• homing lymphocytes to mucosal surfaces

Question 10

abnormalities in inflammatory bowel disease

Answer 10

dysregulated innate immunity

abnormal cell mediated immunity - overactive Th17

defect T regs

defective autophagy

Question 11

NLR

Answer 11

PAMP recognition

-in cytoplasm*

Question 12

crohns disease susceptibility gene

Answer 12

NOD2

is an NLR

Question 13

food allergies

Answer 13

IgE mediated

• food specific IgE - mast cells
• young children

non IgE mediated

• Th2 response - skin/GI sx
• eosinophilic disorders

Question 14

induction of tolerance in gut

Answer 14

CD103 dendritic cells

TGF-beta

retinoic acid

all 3 to stimulate foxp3 T reg cells

Question 15

events in immediate hypersensitivity

Answer 15

allergen exposure

• Th2 activation and IgE class switch
• B cells make IgE
• IgE activate mast cells

repeat exposure
-IgE activate mast cells

release of vasoactive amines and cytokines occurs**

Question 16

immediate hypersensitivty rxns

Answer 16

vasoactive amines

lipid mediators

Question 17

late phase rxn

Answer 17

cytokines - hours after exposure

Question 18

why food allergies

Answer 18

inappropriate digestion hypothesis

• di and tri peptides don’t cause immune response
• longer peptides result in immune response**

Question 19

celiac disease

Answer 19

T cell mediated
-with other autoimmune disease

sx-abdominal pain, growth failure, anemia, osteoporosis

Question 20

Abs to tissue transglutaminase

Answer 20

celiac disease

Abs are IgA

useful for diagnosis

Question 21

celiac genetics

Answer 21

HLA-DQ2 or DQ8

necessary, but not sufficient to develop disease

Question 22

celiac path

Answer 22

tissue response is to de-aminated gluten

damage is due to the T cells

antibodies - useful for diagnosis

Question 23

gliadin

Answer 23

breakdown of gluten

resistant to protelytic digestion by GI proteases

Question 24

celiac disease antibodies

Answer 24

tissue transglutaminase

endomysium

gliadin

deamidated gliadin

Question 25

marsh score

Answer 25

villous atrophy in celiac with increase TG levels - see more villous atrophy

Question 26

diagnosis of celiac

Answer 26

biopsy and Abs for TG

Question 27

TG autoantibodies

Answer 27

takes years for this to decrease even after a gluten free diet with celiac disease

Question 28

enzyme therapy for celiac

Answer 28

digest gliaden

Question 29

zonulin antagonist

Answer 29

celiac tx protein increasing intestine permeability

Question 30

IPEX

Answer 30

immune dysregulation, polyendocrinpathy, enteropathy X-linked disease mutation in Foxp3 loss of T reg cells** widespread autoimmunity sx - watery diarrhea, failure to thrive, diarrhea, autoimmune diabetes elevated IgE

Question 31

foxp3 mutation

Answer 31

IPEX

Question 32

autoimmune disease with elevated IgE

Answer 32

think IPEX

Question 33

IL-10

Answer 33

suppreses IgE production

Question 34

TGF-beta

Answer 34

inhibits IgE production

Question 35

T reg cell activity

Answer 35

suppress Th1 and Th2 cells suppress IgE - by inducing IL-10 and TGF-beta