IAH AC Gastrointestinal Disease

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• Antigen presenting cells • Intraepithelial cells • Dendritic cells • Neutrophils • Macrophages recognition Antigen is presented mostly via the MCH II. In some patients this is aberrant and leads to IBD activation T cell response, non-specific local immune response, with mast cell as transducer response © <strong>IAH</strong> 2007 6 Determination of which immune reaction will be induced, will depend on the antigen presenting cell taking up the antigen. In the gut a special class of APC’s (antigen presenting cells) namely certain dendritic cells will respond differently to different antigens. This will start the differentiation into a tolerant reaction or an inflammatory reaction. Dendritic cells will respond to the antigens presented by a special class of cells, the M cells in the epithelium, or directly to antigens getting through the tight junction. Some patients will be genetically predisposed to generate an inflammatory response, rather than the normal tolerant response in the gut. This will predispose then to diseases like Crohn’s disease. A large body of research is now available in these individual differences in the immune response in the gut. 6
The function of the mucosal lining as an immune organ • Permeability • MHC secretion • Antigen presentation • Secretory component • Adhesion molecule • Presentation • Immunocyte chemo • Attractants • Antimicrobial activity © <strong>IAH</strong> 2007 7 The epithelium itself plays a very important role in immunity. Through the integrity of the Tight Junction, the size of antigens is controlled, so that under normal physiological conditions, only small amounts of antigen is processed by the GALT. This leads to natural tolerance. The gut further secretes Major Histocompatibilty proteins, especially Type II which play a role in antigen presentation. The M cells interspersed between the epithelial cells are specialized Antigen Presenting cells. IgA is the major antibody active in the gut, but needs a secretory component to function. This is provided by the mucosal cells. The mucosa will also secrete chemokines which under special conditions will attract immune cells to the gut by virtue of chemotaxis. Lastly the gut lining will secrete several antimicrobial peptides, which plays a role in host defense. 7
Page 1 and 2: Gastrointestinal Disease IAH AC Gas
Page 3 and 4: The intestinal mucosa • Has the p
Page 5: The mucosal barrier • From the ga
Page 9 and 10: Breast is best!! Photos: WHO Ethiop
Page 11 and 12: Environment © IAH 2007 11 The gut
Page 13 and 14: Mucosal distress (2) • Examples,
Page 15 and 16: Vicious cycles of changed permeabil
Page 17 and 18: Lactose intolerance, not immune-reg
Page 19 and 20: Food allergies Positive skin test P
Page 21 and 22: II. Liver overload • All the bloo
Page 23 and 24: Gut milieu luminal contents and pH
Page 25 and 26: IV. Low grade pancreatitis liver To
Page 27 and 28: Homotoxicology approach © IAH 2007
Page 29 and 30: Oral tolerance and immunological by
Page 31 and 32: Oral tolerance and immunological by
Page 33 and 34: Systemic Gastroenterology Antihomot
Page 35 and 36: Aphthous ulceration • Painful ulc
Page 37 and 38: Gastroesophageal reflux disease (GE
Page 39 and 40: Treatment of gastroesophageal reflu
Page 41 and 42: The composition of Gastricumeel 4.
Page 43 and 44: Peptic ulcer disease • Gastric ul
Page 45 and 46: Treatment • Often an adjuvant tre
Page 47 and 48: Peptic ulceration Symptomatic Basic
Page 49 and 50: Cholecystitis and gall stones • I
Page 51 and 52: Spascupreel tablets - injection sol
Page 53 and 54: Viral hepatitis • Hepatitis virus
Page 55 and 56: Hepatitis Symptomatic Basic medicat
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Functional disturbances of motility
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Diarrhea • Increase secretion of
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Actions of Diarrheel Mucosal action
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IAH AC Gastrointestinal Disease

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