Continuing Medical Education examination
Mechanisms of allergen-specific immunotherapy Instructions for category 1 Continuing Medical Education credit The American Academy of Allergy, Asthma & Immunology is accredited as a provider of Continuing Medical Education (CME) by the Accreditation Council for Continuing Medical Education. Test ID no.: mai00212 Contact hours: 1.0 Expiration date: December 31, 2012 Category 1 credit can be earned by reading the text material and taking this CME examination online. For complete instructions, visit the Journal’s Web site at www.jacionline.org.
The Editors thank the University of South Florida Allergy/Immunology training program for developing this CME examination. The individuals who contributed to its preparation were Robbie Pesek, MD, Michel Alkhalil, MD, David Fitzhugh, MD, Jim Parkerson, DO, Salman Aljubran, MD, Ahmed Butt, MD, Roger Fox, MD, and Richard Lockey, MD.
Learning objectives: ‘‘Mechanisms of allergen-specific immunotherapy’’ 1. 2. 3. 4.
To To To To
understand understand understand understand
the early cellular changes after initiation of specific immunotherapy (SIT). mechanisms by which regulatory T cells induce tolerance against the TH2 immune response. the role of IL-10. the changes that take place in allergen-specific IgE and IgG subclasses.
CME items Question 1. Levels of which allergen-specific IgG subclass increase the most during SIT? A. 1 B. 2 C. 3 D. 4 Question 2. Which cell is responsible for presentation of allergen to T cells during sublingual immunotherapy (SLIT)? A. Langerhans cells B. stratified squamous epithelium C. mast cells D. IgA-secreting B cells Question 3. Which cytokine secreted by CD41CD251 regulatory T cells plays a role in the induction of peripheral tolerance? A. IL-4 B. IL-10 C. IL-13 D. IL-2 Question 4. Which of the following transcription factors is important for development of CD41CD251 regulatory T cells? A. GATA-3 B. signal transducer and activator of transcription (STAT) 6 C. STAT1 D. runt-related transcription factor (RUNX) 1
Question 5. Which cytokine is critical for IgE antibody class switching? A. IL-5 B. IL-12 C. IL-13 D. IL-17 Question 6. Neutralization of which CD41 T-cell response attenuates the severity of autoimmune arthritis in experimental models? A. TH1 B. TH2 C. TH17 D. regulatory T cells Question 7. Which of the following statements is true regarding IL-10? A. It is a potent suppressor of allergen-specific IgE. B. It increases IgG4 production. C. It regulates specific isotype formation toward a noninflammatory phenotype. D. all of the above Question 8. Which alteration of the immune response occurs during the early phase of SIT? A. decrease in IgE level B. decrease in mast cell activity C. increase in the number of TH2 cells D. decrease in production of IL-10 J ALLERGY CLIN IMMUNOL
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Question 9. Which receptor is most important for determining the type of immune response that occurs after allergen challenge? A. T-cell receptor B. B-cell receptor C. histamine receptor D. Toll-like receptor
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Question 10. Which of the following cell types is suppressed by regulatory T cells? A. antigen-presenting cells B. TH1 cells C. TH2 cells D. all of the above