Immunology Review Corner

Prepared by Thao N. Tran, M.D., Stony Brook University Hospital- SUNY; Karla Lowe, M.D., Walter Reed Medical Center; John Norvell, M.D., Vanderbilt University; and Todd Levin, M.D., Medical College of Georgia.

Chapter 41: Structural and Functional Cutaneous Immunology

1. Which of the following statements regarding epidermal cells is true?
a. Intradermal T cells make up 1% of the epidermal cell population and are typically CD8+/CD45RA+
b. Langerhans cells make up 5% of the epidermal cell population and have MHC II on the surface
c. Keratinocytes make up 70% of the epidermal cell population and can prime naïve-T cells
d. B cells make up 15% of the epidermal cells in normal skin

2. Which of the following layers of the dermal-epidermal junction is the most easily disrupted?
a. Lamina lucida
b. Lamina densa
c. Anchoring fibril layer
d. Stratum germinativum

3. Which of the following statements is correct?
a. Mast cells of the skin have granules containing tryptase vs. mast cells of the lung have granules containing chymase.
b. Intestinal mast cells have granules containing tryptase vs. mast cells of the lung have granules containing chymase.
c. Mast cells of the skin and the intestinal mucosa have granules containing both chymase and tryptase.
d. Mast cells of the skin have granules containing chymase.

4. Which of the following distinguishes dermal macrophages within the skin?
a. CD68
b. CD34
c. CD14
d. CD24

5. Which of the following molecules, stored in the cytoplasm of keratinocytes, is a key initiator of cutaneous inducible innate immunity?
a. IL-1-alpha
b. IL-1-beta
c. IL-8
d. Nitric oxide synthase

6. Constitutive innate immunity of the skin consists of:
a. Microorganisms such as Streptococcus pyogenes and Pseudomonas aeruginosa
b. Polypeptides such as beta-defensin-1, iron-binding proteins, and natural IgM
c. High pH
d. Skin temperature cooler than normal core body temperature, as a consequence of evaporation

7. Pathogen associated molecular patterns (PAMPs) are important in innate immunity. Which is a true statement regarding PAMPs?
a. PAMPs are actual parts of pathogens
b. PAMPs are found on the surface of dendritic cells and are involved in the endocytosis of pathogens
c. PAMPs are host molecules that recognize pathogens
d. PAMPs are cell surface molecules that can be secreted under proper circumstances

8. Which of the following is correct about pattern-recognition receptors (PRRs)?
a. Mannose is recognized by CD1a
b. CD14 is expressed by neutrophils and macrophages and mediate lipopolysaccharide-sensitive killing
c. Unmethylated CpGs are examples of PRR
d. Macrophage scavenger receptor is an example of a secreted PRR

9. Which of the following represents the earliest infiltrating leukocyte in a typical cutaneous immune response?
a. Monocyte
b. Eosinophil
c. B lymphocyte
d. Neutrophil

10. Which of the following contributes to the down-regulation of the cutaneous inflammatory response?
a. IL-1ra
b. TNF-alpha
c. IFN-alpha
d. IL-8

11. For which of the following immunobullous skin diseases is desmocollin-1 the antibody-targeted protein?
a. Pemphigus foliaceous
b. Paraneoplastic pemphigus
c. IgA pemphigus
d. Pemphigus vulgaris

12. In drug-induced lupus erythematosus, autoantibodies are directed to which of the following nuclear antigens?
a. SS-A/Ro
b. Double-stranded DNA
c. Jo-1
d. Histones

Answers:
1. b, pages 671-673
2. a, page 673
3. c, page 674
4. a, page 674
5. a, page 676
6. b, page 676
7. a, page 677
8. b, page 677
9. d, page 677
10. a, page 679
11. c, page 681
12. d, page 682