Module 5 Flashcards

Allergies

1
Q

microorganisms that co-evolved with mammals and inhabit our body

A

commensal microbes

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2
Q

What tissues comprise MALT?

A

respiratory tract, GI tract, urogenital tract, salivary glands, mammary glands, lacrimal glands, conjunctiva, and pancreas

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3
Q

What does mucus contain that protects epithelium from damage and invasion by microbes?

A

secretory IgA and IgM, proteoglycans, glycoproteins, peptides, and enzymes

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4
Q

Tonsils and adenoids make up what?

A

Waldeyer’s ring (secondary lymphoid tissues in upper GALT)

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5
Q

What secondary lymphoid tissues are found in the lower GALT?

A

small intestine villi, lamina propria, isolated lymphoid follicles, peyer’s patches

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6
Q

What transports microbes and antigens from gut lument to GALT?

A

M cells (microfold cells)

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7
Q

Secondary lymphoid organ that underlies the gut epithelium in small intestine and have lots of T cells, B cells, and have dendritic cells and germinal centers

A

Peyer’s patches

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8
Q

What makes mucosal lymphocytes unique?

A

they can travel to other mucosal tissues

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9
Q

Mucosal B cells give rise to plasma cells that secrete what two antibodies?

A

IgM and dimeric IgA

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10
Q

Largest lymph nodes in the body and are found in the gut

A

Mesenteric lymph nodes

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11
Q

After isotype switching, what antibody acts as the B cell receptor

A

IgA monomer

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12
Q

Phenomenon where the gut is constantly exposed to foreign antigens in food and bacteria but stays totally fine

A

oral tolerance

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13
Q

Do gut macrophages produce an inflammatory response?

A

no

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14
Q

This antibody protects mucosal surfaces (namely lamina propria) form microbial invasion

A

secretory IgA

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15
Q

how do IgM and IgA in the lamina propria get secreted to the intestinal lumen?

A

transcytosis

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16
Q

Main difference between inflammation in mucosal tissues and non-mucosal tissues

A

non-mucosal tissues will have significant tissue damage due to inflammatory macrophages

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17
Q

Overreaction of the immune system to “safe” antigens

A

hypersensitivity

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18
Q

Reactions to environmental antigens are this type:

A

Type II-IV

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19
Q

Allergic disease is this type:

A

Type II-I

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20
Q

Localized ability to develop immediate hypersensitivity reactions to a variety of allergens

A

Atopy

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21
Q

What 3 things are higher in atopic patients?

A

Serum IgE, Th2 responses, and IL-4 production

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22
Q

Summarize the hygiene hypothesis

A

individuals raised with little to no antigen exposure show stunted immune capacity

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23
Q

Type of reaction caused by interaction of soluble allergens with specific IgE that cause the degranulation of mast cells

A

Type I

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24
Q

Type of reaction caused by IgG antibodies reacting to new epitopes from chemical modifications

A

Type II

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25
Q

Type of reaction caused by IgG against soluble antigens that form immune complexes, deposit in tissue, and become subject to complement fixation and phagocyte attack

A

Type III

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26
Q

Type of reaction caused by CD4 T cells responding to either epitopes of foreign proteins or to chemically modified self-proteins

A

Type IV

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27
Q

Antigens that provoke a Type I hypersensitivity response

A

allergens!

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28
Q

4 main cells involved in Type I reactions

A

IgE, mast cells, basophils, and eosinophils

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29
Q

Major effector cell during Type I reactions

A

mast cells

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30
Q

What action recruits eosinophils and basophils to tissues?

A

Degranulation of mast cells

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31
Q

2 steps of allergic reactions

A

sensitization and mast cell activation

32
Q

What kind of cells activate B cells to secrete cytokines during allergic sensitization?

A

Th2 cells

33
Q

Allergen specific IgE binds to which receptors on mast cells?

A

Fc e RI

34
Q

Steps of sensitization

A

Th2 cells activate B cells. B cells secrete cytokines to differentiate the B cells into plasma or memory cells. The plasma cells secrete high affinity allergen-specific IgE. The memory cells will produce a strong reaction to subsequent exposures. IgE binds to FceRI receptors on mast cells. mast cells are now sensitized to the allergen

35
Q

Steps of mast cell activation/reaction

A

Sensitized mast cells degranulate and release pre-formed mediators that initiate the allergic reaction

36
Q

How long can mast cell activation take?

A

up to two weeks for a new allergen and a few minutes-hours for recurrent ones

37
Q

What phase of allergic reaction do pre-formed mediators get released from degranulation?

A

immediate (early) phase

38
Q

What granules are released from mast cells?

A

vasoactive amines (like histamine), enzymes (like proteases), and proteoglycans (like heparin)

39
Q

What allergic mediator packages and stores histamine in granules?

A

proteoglycans

40
Q

What allergic mediator causes tissue damage and activates complement?

A

enzymes like proteases

41
Q

What allergic mediator causes mucous secretion, increases vascular permeability, and stimulates smooth muscle contraction?

A

vasoactive amines like histamine!

42
Q

What phase of allergic reaction do newly formed mediators get released?

A

Late phase reaction

43
Q

What are some late phase mediator molecules?

A

membrane phospholipids, leukotrienes, prostaglandins, platelet activating factor (PAF), and cytokines

44
Q

Which allergic mediator is vasoactive, spasmodic, and a chemoattractant for neutrophils, eosinophils, and monocytes?

A

leukotrienes

45
Q

Which allergic mediator causes bronchospasm and mucous secretion?

A

prostaglandin

46
Q

Which allergic mediator causes platelet aggregation, histamine release, bronchospasm, increased vascular permeability and vasodilation, and attract neutrophils and eosinophils?

A

platelet activating factor (PAF)

47
Q

Which cytokines promote leukocyte recruitment in allergic reaction?

A

TNF and IL-1

48
Q

Which cytokine amplifies the Th2 response in allergic reaction?

A

IL-4

49
Q

What response results from mast cell activation in the GI tract?

A

increased fluid secretion and peristalsis resulting in GI upset

50
Q

What response results from mast cell activation in the airways?

A

bronchoconstriction and increased mucus secretion

51
Q

What response results from mast cell activation in the vessels?

A

increased blood flow and permeability resulting in swelling and inflammation, and lymph movement. Systemic anaphylaxis and hives can occur with this mode as well

52
Q

this reaction occurs when a stimulus other than IgE sensitization causes mast cell degranulation

A

anaphylactoid reactions

53
Q

Which phase of allergic reaction is usually more intense?

A

Late phase reaction

54
Q

Hemolytic anemia is an example of which type of hypersensitivity reaction?

A

Type II

55
Q

What can induce Type II inflammatory pathways?

A

complement and IgG

56
Q

self or foreign antigens bound to antibodies that can activate the classical complement pathway

A

immune complexes

57
Q

Complement-recognizing receptor found on rbc’s

A

CR1

58
Q

fever, utricaria, arthralgia, lymphadenopathy, malaise, and proteinuria are symptoms of what?

A

serum sickness

59
Q

What happens in serum sickness?

A

soluble proteins are injected into the bloodstream and form immune complexes which lodge in vascular beds leading to arthritis, vasculitis, nephritis, and fever

60
Q

What two situations can cause serum sickness?

A

passive immunization with preformed animal or non-human antibodies or transfusion with human blood products

61
Q

arthus reaction is also known as

A

vaccine reaction

62
Q

Difference between serum sickness and vaccine reaction

A

vaccine reaction occurs localized to the injection site whereas serum sickness is more systemic

63
Q

injected soluble protein causing immune complex formation in the tissue resulting in inflammation

A

arthus reaction/vaccine reaction

64
Q

This type of hypersensitivity is mediated by T cells

A

Type IV

65
Q

Nickel allergy is what type of hypersensitivity reaction?

A

Type IV

66
Q

What two T cells are recruited for Type IV reactions?

A

Cytotoxic T cells and T helper cells

67
Q

Celiac disease (gluten-sensitive enteropathy) is what type of hypersensitivity reaction?

A

Type IV

68
Q

Example of Type IV delayed hypersensitivity reaction?

A

insect bites, PPD TST

69
Q

Gliadin is the antigen associated with what disease?

A

Celiac disaese

70
Q

Contact hypersensitivity/dermatitis occurs when an antigen is exposed to what?

A

skin

71
Q

Gluten-sensitive enteropathy occurs when antigen is exposed to what?

A

intestinal lumen

72
Q

Delayed type hypersensitivity occurs when an antigen is what?

A

injected into the skin

73
Q

Celiac inflammation in the small intestine is primarily mediated by what cells?

A

CD4 T cells and macrophages

74
Q

what does tissue transaminase do?

A

deaminates gluten fragments

75
Q

what type of cell responds to deaminated peptides presented by HLA-DQ?

A

naive CD4 T cells