Celiac Disease

Question 1

What are the two forms of Gluten?

Answer 1

• Glutenin
• Gliadin

Question 2

a chronic inflammatory disorder of the small intestine as a result of the ingestion of gluten products by susceptible individuals

Answer 2

Celiac Disease

Question 3

Other term for Celiac Disease

Answer 3

Celiac Sprue

Question 4

one of the primary causes of developing celiac disease

Answer 4

Genetics

Question 5

the risk of developing celiac disease is around

Answer 5

35%

Question 6

the risk of developing celiac disease is around _ being accounted to ___ ___ and is usually based on the presence of the genes encoding for ___ ___ ___ the serving platter for antibodies for gluten these protein are known as ____ and ____

Answer 6

35%
genetic disposition
MHC Class II proteins
HLA-DQ8 and HLA-DQ2

Question 7

Both HLA-DQ2 and HLA-DQ8 present gluten peptides to ________ in the intestinal mucosa, inducing their proliferation as well as triggering the release of _______

Answer 7

antigen-specific T-lymphocytes

inflammatory cytokines (IL-15)

Question 8

Environmental factors of Celiac Disease

Answer 8

Feeding patterns during the first year of life
Potential viral infections

Question 9

children who had frequent infection with ___ has a predicted increased risk of celiac disease autoimmunity in children

Answer 9

rotavirus

Question 10

It has also been noted that ____ and ______ may increase the risk for the disease with the reduced abundance of the ________ may constitute an early predictive biomarker of celiac disease

Answer 10

premature maturation
early exposure to complex microbiota
Bifidobacterium (Actinobacteria phylum)

Question 11

Considered as the culprit for initiating immune response in individuals with celiac disease

Answer 11

Gluten

Question 12

Where are gluten found?

Answer 12

Barley
Rye
Wheat

Question 13

Two forms of gluten

Answer 13

Glutenin
Gliadin

Question 14

Which one of the two protein components of gluten that is considered as the real instigator of this inflammatory response.

Answer 14

Gliadin

Question 15

Gliadin is high in?

Answer 15

Glutamine
Proline

Question 16

What makes gliadin partially resistant to the degradation of intestinal peptidases

Answer 16

high proline content

Question 17

The resistance of gliadin to degradation results to?

Answer 17

production of toxic or immunologic peptides

Question 18

Where in gluten absorbed?

Answer 18

Lamina Propia

Question 19

Gluten is absorb in lamina propia via?

Answer 19

retrotranscytosis

Question 20

what mediates this retrotrancytosis of intact gliadin peptides

Answer 20

Secretory IgA (immunoglobulin A)

Question 21

what mediates this retrotrancytosis of intact gliadin peptides via the transferrin receptor (CD71)?

Answer 21

Secretory IgA (Immunoglobulin A)

Question 22

tends to be overly expressed in the intestinal epithelium of individuals with celiac disease and is colocalized with Immunoglobulin A (IgA).

Answer 22

Transferrin Receptor or CD71

Question 23

For the gliadin to be absorbed in the lamina propia, where does it binds?

Answer 23

SIgA

Question 24

The intestinal transport of intact gliadin peptides is blocked by?

Answer 24

IgA
CD71

Question 25

As the gliadin binds to a receptor, it forms?

Answer 25

SIgA-gliadin complex

Question 26

what deamidates gliadin in the lamina propia?

Answer 26

Tissue Transglutaminases

Question 27

What happens when the gliadin is deamidated?

Answer 27

amide group is removed

Question 28

The interaction of gliadin and TG results in protein modification of gliadin thus having a stronger affinity towards what molecules?

Answer 28

HLA-DQ2 and HLA-DQ8 molecules

Question 29

One of the immune cells that responds to the presence of SIgA-deamidated gliadin-complex in the lamina propia

Answer 29

Macrophages

Question 30

Two types of macrophages that appear with the presence of gliadin in lamina propia

Answer 30

M1 M2

Question 31

this type of macrophages predominantly appears during the early stages of inflammation

Answer 31

M1

Question 32

M1 releases what?

Answer 32

tumor necrosis interferon-gamma interleukin 8

Question 33

This particular pro inflammatory cytokine induces cell death especially to those cells that are inflamed (

Answer 33

Tumor necrosis factor

Question 34

With the increasing number of gliadin in the lamina propia and inflammatory cytokines, it activates ?

Answer 34

CD4+ T-lymphocytes (Helper T cells )

Question 35

The high levels of inflammatory cytokines trigger the clonal expansion of ?

Answer 35

B-lymphocytes (B-cells)

Question 36

B cells secretes?

Answer 36

anti-gliadin anti-tissue-transglutaminase antibodies

Question 37

There are some gliadin peptides that are not recognized by the T-lymphocytes leading to the recruitment of?

Answer 37

CD8+ T-lymphocytes

Question 38

these immune cells tend to attack cells that are undergoing inflammation causing further damage and entry of gliadin peptides into the lamina propia

Answer 38

CD8+ T-lymphocytes

Question 39

Symptoms of Celiac Diseases (Gastrointestinal)

Answer 39

PNEUMONICS: DDABCCHARS Diarrhea Delayed puberty Abdominal pain Bloating Constipation Coagulopathy Hypocalcemia Anemia Rickets Short stature

Question 40

Extraintestinal Manifestation of Celiac Disease

Answer 40

PNEUMONICS: A4D2E2ORI Arthritis Aphthous stomatitis Ataxia Anxiety Dermatitis Herepetiformis Depression Elevations in transaminases Epilepsy Osteoporosis/Osteopenia Recurrent abortions Infertility

Question 41

Dietary Management for Celiac Disease

Answer 41

Gluten-free diet

Question 42

What is the gold standard in diagnosing celiac disease,

Answer 42

duodenal biopsy

Question 43

tissue samples from subjects with celiac disease are characterized by?

Answer 43

Decreased height of enterocytes crypt hyperplasia Villous atrophy Increased intraepithelial T-lymphocytes.