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Nutrition 2 (Semester II) > 12f. Immune Health - Autoimmunity > Flashcards

12f. Immune Health - Autoimmunity Flashcards

1
Q

What is autoimmunity?

A

Immune system mistakenly attacking the body’s own cells

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2
Q

Why is AI present in healthy individuals?

A

To eliminate degraded self antigens

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3
Q

When does the elimination of degraded self antigens become pathological?

A

If there is a breakdown in self tolerance

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4
Q

What are the pathophysiological reasons for AI?

A

Tolerance
T-helper cells
Cross-reactivity
MHC dysfunction

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5
Q

What happens in AI with self tolerance?

A

Usually self-reactive lymphocytes and T-cells are deleted
However, some T-cells may be released early into circulation before being fully exposed to self-antigens
Also may be too few T-reg cells to manage autoreactive T-cells

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6
Q

What role do Th1, Th2 and Th17 cells have in AI?

A

Th1 increases macrophages in Crohn’s
Th17 increases inflammatory cells
Th2 cells are dominant in systemic conditions (SLE, Sjogren’s)

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7
Q

What is involved in cross-reactivity?

A

Mimicry - an antigen looking like a self-antigen
Tissue damage from a previous infection which releases self-antigens

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8
Q

What is the role of the Major Histocompatibility Complex?

A

Encodes cell surface proteins (HLAs)
Antigen presentation
Prevention of immune system targeting own cells
(Dysfunction is associated with AI)

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9
Q

Why are bacteria implicated in AI?

A

May have a similar structure that can fit on an epitope of an antigen

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10
Q

Which bacteria is implicated in RA, MS, SLE?

A

EBV

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11
Q

How can we get cross-reactivity in foods?

A

Peptide sequences in foods may be similar to human tissues
Molecular mimicry can induce or exacerbate AI diseases

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12
Q

Examples of foods where peptide sequences can mimic certain molecules

A

Wheat
Dairy

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13
Q

How can food toxins become more reactive?

A

May be modified by toxins

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14
Q

What is epitope spreading?

A

Antibody and cellular response to a given antigen may extend from one epitope to others

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15
Q

What is bystander activation?

A

Infections activate APCs such as dendritic cells which activate autoreactive T-cells

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16
Q

What are cryptic epitopes?

A

Some self-epitopes are hidden from immune recognition
If produced in large quantities, AI T-cell reactions may occur

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17
Q

Causes and risk factors for AI

A

Genetics
Emotional trauma
Infection
Gluten
Environmental toxins
Vit D deficiency
Dysbiosis
Intestinal permeability
Gender
Hormonal imbalances

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18
Q

Examples of SNPs that disrupt antigen recognition/self tolerance

A

HLA-DRB1
HLA-DQA1
HLA-DQ8

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19
Q

Examples of SNPs predisposing to inflammation increase

A

TNF
IL-2
IL-12

20
Q

Examples of SNPs that affect vit D conversion

A

VDR
CYP24A1
CYP27B1

21
Q

Why is gluten a cause/risk factor for AI?

A

Key food source of molecular mimicry
Inducer of intestinal permeability

22
Q

Why are environmental toxins a cause/risk factor for AI?

A

Induce OS
Contributes to immune intolerance

23
Q

Why is a vit D deficiency a risk factor for AI?

A

Vit D increases T-reg cells
Maintains self-tolerance

24
Q

Why is dysbiosis a risk factor for AI?

A

Creates too much cross-talk between GI microbes and wider immune system

25
Q

Why is intestinal permeability a risk factor for AI?

A

Intestinal epithelial barrier controls the equilibrium between tolerance and immunity to non-self antigens

26
Q

Are men or women more predisposed to AI?

A

Women

27
Q

How are hormonal imbalances a risk factor for AI?

A

Immune system of females tends to lead towards Th2 dominance
High oestrogen has pro-inflammatory properties

28
Q

How can women be exposed to higher oestrogen?

A

OCP
HRT
Xenoestrogens

29
Q

What is the AI triad?

A

Genetics
Environment
Immune regulation

30
Q

What constitutes environment in the AI triad?

A

Poor nutrition
Nutritional deficiencies
Gluten
Toxins - smoking, alcohol
Drugs

31
Q

What constitutes immune regulation in the AI triad?

A

Vit D def
Hormonal imbalances
Intestinal permeability
Dysbiosis

32
Q

How does AI present clinically?

A

Expressing symptoms of an AI condition
History of pathogen exposure, gut issues, FH
GP tests - CRP, ESR, RF, low vit D
Functional tests - Cyrex, gut profiling
SNPs

33
Q

Naturopathic approach to AI

A

Reduce inflammation
Support gut/food sensitivity - microbiome balance/mucosal barrier
Balance blood sugars
Eliminate gluten
Test vit D
Support methylation/detoxification/elimination
Reduce stress
Anti-virals

34
Q

Examples of anti-virals to support AI

A

L-lysine
Olive leaf
St John’s Wort

35
Q

Diets specific to supporting AI

A

Paleo
Autoimmune Protocol (AIP)
Wahl’s

36
Q

What is the autoimmune protocol diet?

A

Nutrient dense foods
Eliminates foods that may stimulate the immune system, cause hormone dysregulation or harm GI environment
Adequate sleep
Reducing stress

37
Q

Can eliminated foods on the AIP diet be reintroduced?

A

Yes, if the disease is in remission (or not progressing)
If GIT is working effectively
If person can manage without medication

38
Q

Foods included on the AIP diet

A

Vegetables - 8/day
Grass fed organic meat
Fish/shellfish
Healthy fats
Pre/probiotic foods
Glycine rich foods - bone broth
Herbs/spices

39
Q

Foods excluded on the AIP diet

A

Alcohol
Dairy
Grains
Legumes
Eggs
Nuts/seeds
Nightshades
Sweeteners
Emulsifiers

40
Q

Supplements recommended for AI

A

Vit D
EFAs
Curcumin
Resveratrol
Alpha lipoic acid
Medicinal mushrooms

41
Q

Why is resveratrol recommended for AI?

A

Reduces Th17
Downregulates NF-kB/COX-2

42
Q

Dosage of resveratrol for AI

A

200mg/day

43
Q

Why is alpha lipoic acid recommended for AI?

A

AO
Anti-inflammatory
Increases glutathione levels

44
Q

Dosage of alpha lipoic acid for AI

A

200mg/day

45
Q

Why are medicinal mushrooms recommended for AI?

A

Immune-modulating

46
Q

Example of medicinal mushrooms recommended for AI

A

Cordyceps

47
Q

Examples of probiotics to support AI

A

Lactobacillus
Bifidobacterium
L. rhamnosus GG

Nutrition 2 (Semester II) (55 decks)

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