Reviews and feature articles
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.: mai00114 Contact hours: 1.5 Expiration date: March 31, 2009 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 Texas Medical Branch at Galveston Allergy/Immunology training program for developing this CME examination. The individuals who contributed to its preparation were Rana Bonds, MD, Yoshiko Ogawa, MD, David Redding, MD, Michael Saavedra, MD, Paul Scibielski, MD, and J. Andrew Grant, MD.
Learning objectives: ‘‘Mechanisms of allergen-specific immunotherapy’’ 1. 2. 3. 4.
To identify the features of early allergen desensitization. To discuss the role of T regulatory cells and induction of peripheral tolerance during immunotherapy. To define the modulation of immunoglobulin classes during immunotherapy. To characterize the current position of sublingual immunotherapy.
CME items Question 1. Acute desensitization of a penicillin allergic patient is due to which of the following? A. reduction in allergen-specific IgE B. increase in T regulatory (Treg) cells C. allergen-specific desensitization of mast cells D. rise in allergen-specific IgG4 Question 2. Changes in which of the following molecules correlate best with early improvement due to specific immunotherapy (SIT)? A. IgG4 B. IgE C. IL-10 D. IL-13 Question 3. With initiation of specific allergen immunotherapy, there may be a rise in IgG4. Changes in this isotype — A. indicate adequacy of immunization dosing. B. are closely linked to changes in IgE. C. correlate with clinical improvement. D. facilitate allergen clearance by complement binding.
Question 4. Peptide immunotherapy studies have been performed with which of the following allergens? A. dog Can f 1 B. timothy grass Phl p 4 C. dust mite Der p 1 D. cat Fel d 1 Question 5. Peripheral T-cell tolerance induced by allergen SIT is due to which of the following? A. CD41CD252 T cells B. CD81 T cells C. IL-10 D. IFN-g Question 6. IL-10 plays a role in — A. the increase of allergen-specific IgG4. B. the decrease of allergen-specific IgA. C. enhancing total and allergen-specific IgE production. D. increasing proinflammatory cytokine release from mast cells.
J ALLERGY CLIN IMMUNOL
Question 7. Regarding the status of sublingual immunotherapy (SLIT), which of the following is correct? A. Dosing is standard. B. Immunologic mechanisms are established. C. The benefit is twice that achieved with subcutaneous SIT. D. Safety and efficacy are documented. Question 8. Which of the following is a surface marker for Tregs induced by SIT? A. CD8 B. CD20 C. CD25 D. CD59
Akdis and Akdis 791
Question 9. Native allergen utilizes which of the following mechanisms to activate T cells? A. phagocytic antigen uptake by dendritic cells B. pinocytic antigen uptake by macrophages C. IgE-facilitated antigen presentation by dendritic cells D. IgG-facilitated antigen presentation by B cells Question 10. The anti-inflammatory effects of IgG4 antibodies include which of the following? A. complement binding B. induction of IgA C. blocking of mast cell activation D. stimulation of TH2 cells
Reviews and feature articles
J ALLERGY CLIN IMMUNOL VOLUME 119, NUMBER 4