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KMMS > MSI Allergy > Flashcards

MSI Allergy Flashcards

1
Q

Type 1 HS reaction (aka immediate reaction) involves ___- mediated release of antibodies against the soluble antigen. This results in MAST CELL DEGRANULATION and release of ________ and other inflammatory mediators.

A

IgE, histamine

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2
Q

What type of hypersensitivity reaction causes allergic rhinitis, ocular allergic conjunctivitis, eczema, asthma, and anaphylaxis?

A

Type 1 hypersensitivity reaction (IgE mediated)

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3
Q

Which type of allergic reaction has SYSTEMIC EFFECTS and is a life-threatening emergency?

A

Anaphylaxis- Type 1 HS reaction- IgE mediated

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4
Q

Hygiene hypothesis: Early exposure to a diverse range of microorganisms and antigens may lead to overall ________ rates of allergies, asthma, and other immune disorders.

A

decreased

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5
Q

Delayed mediators in the process of allergic reactions

A

Leukotrienes

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6
Q

Leukotrienes are produced from arachidonic acid (via enzymes 5-Lipoxygenase and phospholipase A2) and have similar effects to…

A

histamine

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7
Q

Mast cell activation converts membrane phospholipids into arachadonic acid via which enzyme?

A

phospholipase A2

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8
Q

What substance, released from mast cells, stimulates bronchoconstriction, vascular permeability, eosinophil recruitment, and neutrophil recruitment?

A

Leukotrienes

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9
Q

What substance, released from mast cells, plays a role in tissue remodeling, cellular recruitment, vascular permeability, and acute allergic disease?

A

proteases

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10
Q

A clinical test for Type 1 (IgE) HS reactions to a variety of antigens injected or placed into small cuts in the skin produces what type of reaction?

A

“Wheal and flare”

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11
Q

Activated T cell release of IL-5, IL-3, and GM-CSF promotes which type of allergic reaction? (Immediate or late?)

A

Late reaction- eosinophils migrate through the bloodstream to target tissue.

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12
Q

Activated T cell release of IL-4 and IL-13 leads to which type of allergic reaction? (Immediate or late?)

A

Immediate- Membrane binding IgE activates B cells, which then activate mast cells. The activation of mast cells causes degranulation and the release of histamine and leukotrienes.

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13
Q

People with ______ ________ are four times more likely to suffer from asthma, eczema, and food allergies

A

allergic rhinitis

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14
Q

Biopsy of airways of patient with chronic asthma shows inflammatory infiltrate and airway changes known as __________ (thickened basement membrane and smooth muscle hyperplasia).

A

re-modelling

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15
Q

Most patients with chronic asthma are sensitised to a variety of ________ allergens.

A

airborne

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16
Q

Early phase of allergic reaction are based on the activation of _____ cells, which release mediators and cytokines

A

mast

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17
Q

What type of cells take up allergen for processing and presentation to MHC class II molecules in the late phase allergic reaction?

A

neutrophils

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18
Q

In the late phase allergic reaction, there is tissue redness and swelling d/t the arrival of cells to the area such as neutrophils, eosinophils, and lymphocytes (particularly ____ and ____ cells)

A

CD4 T cell, mast

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19
Q

Late phase allergic reactions develop within _______ hours of exposure to the allergen

A

6-12

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20
Q

CD4 subset ___

Cytokine: IFN-gamma, IL-12

Transcription factor: T-bet

Cytokines: IFN- gamma, lymphotoxin

Major functions: Anti-viral and mycobacterial effects, activation of macrophages to kill intracellular pathogens

A

Th1

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21
Q

** CD4 subset ____ **

Cytokine: IL-4
Transcription factor: GATA-3
Cytokines: IL-4, IL-5, IL-13
Major functions: Antiparasitic responses. Stimulation of IgE and other Ab production, increases mucous production, promotes eosinophilia

A

Th2

22
Q

CD4 subset ____

Cytokine: IL-6, TGF-Beta1, IL-1 Beta
Transcription factor: ROR gamma t
Cytokines & mediators produced: IL-17A, IL-17F, IL-22
Major functions: Antibacterial and anti-fungal effects, recruitment and activation of PMNs

A

Th17

23
Q

CD4 subset ______

Cytokine: TGF-Beta 1, IL-10
Transcription factor: FOXp3
Cytokines: TGF-Beta 1, IL-10
Major functions: Suppression of T cell activation, inhibition of APC function

A

Treg

24
Q

___ cells are central players in immunity to helminths and are implicated in mediating the inflammatory pathology associated with allergies

A

Th2

25
Q

Biopsies of allergic inflammation are rich in T cells expressing ___ cytokines

A

Th2

26
Q

This Th2 mediator recruits mast cells

A

IL-9

27
Q

This Th2 mediator is required for eosinophil survival

A

IL-5

28
Q

These Th2 mediators promote mucus hypersecretion

A

IL-4 and IL-13

29
Q

This Th2 mediator is required for B cell class switching to IgE

A

IL-4

30
Q

The ___ hypothesis/model suggests a true role for T cells in chronic inflammation rather than just in causing IgE production- activated Th2 cells and other inflammatory cell accumulate, produce products that lead to disease

A

Th2

31
Q

The World Allergy Organisation estimates of allergy prevalence of the whole population by country ranges between __-__%

A

10-40%

32
Q

What is the most common chronic disease in Europe?

A

Allergies

33
Q

Up to __% of patients with allergies live with a severely debilitating form of their condition, and struggle daily with the fear of a possible asthma attack, anaphylactic shock, or even death from an allergic reaction

A

20

34
Q

__% of British adults now suffer from at least one allergy. Almost half of sufferers have more than one allergy.

A

44

35
Q

The % of children diagnosed with allergic _____ and ________ have both trebled over the last 30 years.

A

rhinitis, eczema

36
Q

Childhood allergy is strongly predicted by the presence of allergy in _________

A

parents

37
Q

Low hygiene levels, high pathogen load, helminth infection proposed to skew immunity from ___ to ___ and induce regulatory T cells

A

Th2 to Th1

38
Q

High hygiene levels, low pathogen load, and absence of helminth infection is proposed to skew immunity towards ___ cells and reduce production of regulatory T cells

A

Th2

39
Q

Detection of allergen-specific IgE can be tested in vivo by using what type of testing?

What is a positive response?

A

Skin prick testing

A wheal and flare response after 15 minutes is positive

40
Q

Laboratory diagnosis of allergies uses ________ testing- Detection of allergen-specific IgE in vitro (immobilised IgE Abs detected with polyclonal anti-IgE detection Ab).

A

ELISA

NB: ELISA testing has replaced RAST testing

41
Q

Symptom relief in the treatment of allergies are nasal decongestants (act on alpha 1 adrenoreceptors to cause vasoconstriction), _________ (Beta 2 agonists promote smooth muscle relaxation), and epinephrine to oppose vasodilation and bronchoconstriction

A

salbutamol

42
Q

The two easiest and most helpful allergy drugs for early-phase mediators are antihistamines (H1 receptor) and ___________ receptor antagonists

A

Leukotriene

43
Q

First line medication to reduce the signs & sx of allergies is H1 antihistamines (MOA: _________ agonists at H1 histamine receptor). Best used before exposure to allergen.

A

inverse

44
Q

Hydroxyzine onset of action? ______ hours

A

20

45
Q

Leukotriene receptor antagonists (Montelukast) is effective in reducing early allergic responses, but inferior to H1 anti-histamines. Montelukast is beneficial in treating chronic ______ which is the main indication for its use.

A

asthma

46
Q

______ reduce immune activation by altering gene expression in numerous cell types, including T cells, B cells, and cells of the innate immune system. Their onset of action is delayed and they must be taken regularly.

A

Steroids

47
Q

Route of administration for beclametasone (for use in allergies)

A

Inhaled, nasal spray

48
Q

Route of administration for hydrocortisone (for use in allergies)

A

Topical - skin

49
Q

MOA of ___________:
Binds to glucocorticoid receptor leading to downstream effects such as:
Inhibition of phospholipase A2
Inhibition of Nuclear Factor-kappa B
Inhibition of other inflammatory transcription factors
Promotion of anti-inflammatory genes

A

hydrocortisone

50
Q

____________ is a recombinant, fully human IgG1 monoclonal Ab subcutaneously administered biological disease modifier which targets Tumour Necrosis Factor (TNF).

Produced by recombinant DNA technology in a mammalian cell expression system and is purified by a process that includes specific viral inactivation and removal steps.

A

Adalimumab

51
Q

MOA of _____________ is primarily linked to the neutralization of TNF-alpha bioactivity by preventing the interaction of TNF alpha with the cell surface of TNF receptors.
It inhibits several TNF-alpha induced events (eg the release of serum cytokines [IL-6], acute phase reactants of inflammation, matrix metalloproteases, and other markers of cartilage and synovium turnover, and the expression of adhesion molecules responsible for leukocyte migration.
Also, it lyses TNF-expressing cells in the presence of complement.

A

Adalimumab

52
Q

Allergen-specific immunotherapy:
Allergen doses administered subcut or sublingually
Mainly used for venom allergy and rhinitis

Multiple immunological effects:
	Induce regulatory T cell responses to allergens
	Reduce \_\_\_ responses
	Induce allergen-specific IgG Abs
	Reduction in mast cell responsiveness
	Reduce allergen-specific IgE levels
A

Th2

KMMS (58 decks)

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