Self-assessment questions: The hepato-enteric immune axis in health and disease
The liver is able to generate a vigorous immune response to pathogenic organisms entering through the portal circulation while simultaneously being tolerogenic to harmless food-borne antigens. Which of the following statements regarding the hepatic immune response are true?
A vigorous intrahepatic immune response depends on activation of T-cells by hepatic-resident antigen- presenting cells
A vigorous intrahepatic immune response depends on activation of DCs by liver-resident T-cells
Direct activation of T-cells within the liver by hepatic- resident antigen-presenting cells usually results in tolerance
Direct activation of DCs within the liver by hepatic-resident T-cells usually results in tolerance
IL10 promotes the development of effector T-cells over Tregs
Primary sclerosing cholangitis (PSC) is strongly associated with inflammatory bowel disease (IBD). Which of the following questions regarding PSC and IBD are correct?
The majority of patients with IBD have PSC
Patients with PSC and IBD are have a lower lifetime risk of developing colonic carcinoma than patients with IBD alone
Colectomy for ulcerative colitis prevents the development of PSC
Patients with PSC and IBD have a greater lifetime risk of developing colonic carcinoma than patients with IBD alone
Crohn's disease is more common than ulcerative colitis in patients with PSC
Regarding enterohepatic lymphocyte homing, which of the following statements are false?
CCL25 and α4β7 are constitutively expressed on the sinusoidal endothelium in normal human liver
CCL25 and MAdCAM-1 are upregulated in the human liver in PSC
Mucosal VAP-1 expression is upregulated in ulcerative colitis
MAdCAM-1 is constitutively expressed on the lamina propria of the small bowel
VAP-1 is constitutively expressed on the human liver sinusoidal endothelium
Which of the following statements is correct?
Enzymatic action of MAdCAM-1 leads to the upregulation of VAP-1 expression
Neutralising antibodies against MAdCAM-1 are efficacious in treating PSC
MAdCAM-1 possesses amine oxidase activity and also functions as an adhesion molecule
Patients who develop PSC after being diagnosed with IBD have a better outcome than those who are diagnosed with PSC before being diagnosed with IBD
Colectomy for ulcerative colitis before liver transplant is more protective against PSC recurrence in the liver allograft than colectomy performed 10 years after transplant
Answers to these self-assessment questions can be found on page s92.
- © 2012 Royal College of Physicians
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