Immunology Review Corner

Immunology Review Corner: Chapter 76 of the 6th edition of Middleton’s Allergy Principles and Practice, edited by N. Franklin Adkinson, et al.

Prepared by Drs. Karla R. Davis, Landstuhl Regional Medical Center, Germany, and Soo Kim-Delio, Walter Reed Army Medical Center.

Chapter 76 Questions: Allergic and Nonallergic Rhinitis

1. At which of the following ages does peak prevalence for allergic rhinitis occur in the United States?
A. 10 years
B. 19 years
C. 24 years
D. 35 years

2. Which of the following neurotransmitters has vasodilatory properties and has been shown to stimulate serous cell secretion in human nasal mucosal explants?
A. Acetylcholine
B. Peptide histidine isoleucine
C. Substance P
D. Vasoactive intestinal peptide

3. What is the dominant determinant of exudation of extravasated plasma in the nasal mucosa?
A. Gaps in endothelial cells at postcapillary venules
B. Endothelial cell behavior
C. Arteriolar tone
D. Decreased capillary vascular pressure

4. Which of the following chemokines is a chemoattractant for T cells, basophils, mast cells, and eosinophils?
A. IL-8
B. IL-8 sIgA
C. MIP-1 alpha
D. RANTES

5. Which of the following constitutes approximately 55 percent of the granular protein content of eosinophils?
A. Eosinophil cationic protein
B. Eosinophil derived neurotoxin
C. Eosinophil peroxidase
D. Major basic protein

6. Studies of nasal allergen challenge reveal an early increase in eosinophils 30 to 60 minutes after challenge in recovered nasal lavage fluid and a second increase 6 to 10 hours after challenge, which is sustained for up to 24 hours. This change in eosinophils is paralleled by changes in nasal lavage levels of which of the following?
A. Eosinophil cationic protein
B. Eosinophil derived neurotoxin
C. Eosinophil peroxidase
D. Major basic protein

7. The development of basophil-specific antibodies has allowed a detailed evaluation of the localization of basophils within the nasal mucosa. Which of the following is a basophil-specific antibody?
A. BB1
B. BB2
C. BB7
D. 2D1

8. Basophils and mast cells generate comparable amounts of which of the following after immunologic activation?
A. Chondroitin sulfate A
B. LTC4
C. PGD2
D. Tryptase

9. In patients with aspirin-sensitive rhinitis, which of the following is increased in the nasal mucosa?
A. IL-2
B. IFN-gamma
C. IL-4 mRNA-positive cells
D. IL-5 mRNA-positive cells

10. Which of the following is an excitatory stimulus that influences substance P release and its ability to act on different neurokinin receptors within the nose?
A. Cannabinoid agonists
B. Opiates
C. Purines
D. Theophylline

11. What is the predominant nasal effect of PGD2, LTC4, and LTD4?
A. Rhinorrhea
B. Nasal blockage
C. Nasal itch
D. Sneezing

Answers:
1. C, page 1394
2. D, page 1397
3. C, page 1396
4. D, page 1401
5. D, page 1402
6. C, page 1402
7. A, page 1403
8. B, page 1403
9. D, page 1405
10. C, page 1406
11. B, page 1404