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GI - Year 2 > GI Mucosal Immunology - Treatment of IBD > Flashcards

GI Mucosal Immunology - Treatment of IBD Flashcards

1
Q

What is the role of the colonic mucosa in immunology?

A

Detects luminal contents

Recognises commensal microbiome from pathogens that require robust immune response

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2
Q

What are the challenges of antigen processing in the GI tract?

A

Develop self-tolerance
Develop exogenous tolerance - non-response to newly encountered environmental antigens (food + microbes)
Develop effective immune response - elimination/control of infections, allergic and noxious agents

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3
Q

What is the role of the epithelial layer of the colon in immunology?

A

Specialised tight junctions that regulate permeability

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4
Q

What is the role of the mucus layer of the colon in immunology?

A

Physical barrier keeping microbes from host cells

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5
Q

What are the innate immune responses in the colon?

A

sensing of bacteria and anti-microbial peptides and IgA

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6
Q

What are the antigen presenting cells?

A

Dendritic cells and macrophage

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7
Q

What are the soluble mediators of immunity?

A

Chemokines

Cytokines

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8
Q

What is the most important role of T cells?

A

Maintaining immune homeostasis

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9
Q

What are Peyer’s patches?

A

Organised lymphoid structure in gut containing large numbers of immune cells

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10
Q

Why are peyer’s patches so important?

A

Important for immune responses to commensal bacteria and pathogens

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11
Q

What are macrophages?

A

Phagocytic - ingest and kill foreign micro-organisms

1st line defence in gut

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12
Q

Where are dendritic cells found? + function

A

Lamina propria and peyer’s patches
Important for mucosal immune responses
Important for directing function of T cells

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13
Q

What 3 signals determine T cell response?

A

MHC/peptide-TCR
CD80-CD28
Cytokine

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14
Q

What is the innate immune system induced by?

A

Induced upon infection with microbes

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15
Q

What is the adaptive immune system induced by?

A

Upon infection by specialised pathogens

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16
Q

What is the pathogenesis of IBD?

A

Triggering factor unknown

17
Q

What are the treatment strategies for IBD?

A

Target lymphocytes directly
Target single cytokines
Target migration of immune cells to GI mucosa
Target multiple cytokines
Target cytokine intracellular signalling pathways
Modulation of microbiota

18
Q

What does anti-TNF do?

A

Neutralises cytokine by binding to it - can cause cell death/apoptosis of immune cells

19
Q

What does Vedolizumab (Entyvio) do?

A

Blocks migration of leucocytes to intestinal mucosa

20
Q

What is dysbiosis of microbiota?

A

Faecal microbial transplant - works in c. diff patients where antibiotics don’t work

21
Q

What does celiac disease do?

A

Loss of villi - loss of absorptive capacity

Increase in intra-epithelial lymphocytes

22
Q

What is the treatment for celiac disease?

A

Gluten-free diet

GI - Year 2 (39 decks)

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