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Eosinophil trafficking in allergy and asthma
Reviews and feature articles
Continuing Medical Education examination
Eosinophil trafficking in allergy and asthma 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.: mai00118 Contact hours: 1.5 Expiration date: May 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 Cincinnati College of Medicine: Cincinnati Children’s Hospital Medical Center/ University Hospital Allergy/Immunology training program for developing this CME examination. The individuals who contributed to its preparation were Kelly Brauer, MD, Christopher Codispoti, MD, Ann Collier, MD, Luqman Seidu, MD, Li Zuo, MD, Amal Assa’ad, MD, and Nives Zimmermann, MD.
Learning objectives: ‘‘Eosinophil trafficking in allergy and asthma’’ 1. To list crucial differences between human and mouse eosinophils. 2. To identify the cytokines that affect eosinophil development and trafficking. 3. To become familiar with potential therapeutic targets for eosinophil-associated clinical disorders.
CME items Question 1. Which of the following is a unique feature of eosinophils in comparison to neutrophils? A. They are granulocytic leukocytes. B. Their growth and development occur in the bone marrow. C. They respond to chemoattractant cytokines. D. They are primarily tissue-dwelling leukocytes under homeostatic conditions. Question 2. It is important to know the difference between human and mouse eosinophils. As compared to mouse eosinophils, human eosinophils — A. do not degranulate. B. do not contain Charcot-Leyden crystal protein. C. express FceRI. D. do not express Siglec 8. Question 3. Which of the following cytokines interact with eosinophils uniquely? A. RANTES B. eotaxin C. IL-13 D. macrophage inflammatory protein (MIP)-1a
J ALLERGY CLIN IMMUNOL
Question 4. In vitro studies suggest that which of the following cytokines promote the survival of eosinophils? A. IL-3 and IL-4 B. IL-4 and IL-13 C. IL-5 and GM-CSF D. IL-5 and TGF-b Question 5. Which of the following statements is true regarding the role of IL-5 in eosinophils? A. The IL-5 receptor (IL-5R) is uniquely expressed on eosinophils in mice. B. The IL-5R signals through the b chain that it shares with IL-3 and GM-CSF. C. IL-5 gene–deleted mice lack eosinophils. D. In studies using monoclonal antibodies against IL-5 in patients with asthma, tissue eosinophils were diminished along with changes in clinical symptoms.
June 2007
1311
1312 Rosenberg, Phipps, and Foster
Reviews and feature articles
Question 6. Which of the following statements is true? A. IL-4 is a critical inducer of eosinophil differentiation from CD341IL-5R1 progenitors in the bone marrow. B. Under homeostatic conditions, IL-5 is required for eosinophil growth and differentiation. C. Eosinophil progenitors in the bone marrow can be identified as CD341IL-4R1 cells. D. GATA-1 is thought to act as a transcription factor for eosinophil differentiation in the bone marrow. Question 7. The chemokine receptor CCR3 is crucial for — A. chemotaxis of eosinophils in response to eotaxins 1, 2, and 3. B. homeostatic levels of eosinophils in the gastrointestinal tract. C. migration of eosinophils into the lung tissue in response to allergic stimuli. D. (all of the above) Question 8. Potential therapeutic agents designed to have a unique impact on eosinophil trafficking to the lung may target which of the following? A. CCR3 B. CCR4 C. L-selectin D. IL-8
J ALLERGY CLIN IMMUNOL JUNE 2007
Question 9. Eosinophil expansion occurs via various mechanisms in response to allergic airway inflammation. Which of the following statements is therefore true? A. Eotaxin-2 production by airway epithelial cells promotes direct eosinophil growth. B. Airway CD341IL-5R1 eosinophil progenitors are the primary source of the eosinophils in allergic lung inflammation. C. Autocrine production of IL-5 by eosinophils is the primary means of eosinophil proliferation and differentiation. D. IL-13 promotes eosinophilia indirectly through eotaxin production. Question 10. Clinical trials with humanized anti–IL-5 monoclonal antibodies have shown — A. reduced peripheral eosinophilia. B. persistence of eosinophils in airways and lung tissue. C. no improvement in clinical asthma symptoms. D. (all of the above)
Continuing Medical Education examination
Eosinophil trafficking in allergy and asthma 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.: mai00118 Contact hours: 1.5 Expiration date: May 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 Cincinnati College of Medicine: Cincinnati Children’s Hospital Medical Center/ University Hospital Allergy/Immunology training program for developing this CME examination. The individuals who contributed to its preparation were Kelly Brauer, MD, Christopher Codispoti, MD, Ann Collier, MD, Luqman Seidu, MD, Li Zuo, MD, Amal Assa’ad, MD, and Nives Zimmermann, MD.
Learning objectives: ‘‘Eosinophil trafficking in allergy and asthma’’ 1. To list crucial differences between human and mouse eosinophils. 2. To identify the cytokines that affect eosinophil development and trafficking. 3. To become familiar with potential therapeutic targets for eosinophil-associated clinical disorders.
CME items Question 1. Which of the following is a unique feature of eosinophils in comparison to neutrophils? A. They are granulocytic leukocytes. B. Their growth and development occur in the bone marrow. C. They respond to chemoattractant cytokines. D. They are primarily tissue-dwelling leukocytes under homeostatic conditions. Question 2. It is important to know the difference between human and mouse eosinophils. As compared to mouse eosinophils, human eosinophils — A. do not degranulate. B. do not contain Charcot-Leyden crystal protein. C. express FceRI. D. do not express Siglec 8. Question 3. Which of the following cytokines interact with eosinophils uniquely? A. RANTES B. eotaxin C. IL-13 D. macrophage inflammatory protein (MIP)-1a
J ALLERGY CLIN IMMUNOL
Question 4. In vitro studies suggest that which of the following cytokines promote the survival of eosinophils? A. IL-3 and IL-4 B. IL-4 and IL-13 C. IL-5 and GM-CSF D. IL-5 and TGF-b Question 5. Which of the following statements is true regarding the role of IL-5 in eosinophils? A. The IL-5 receptor (IL-5R) is uniquely expressed on eosinophils in mice. B. The IL-5R signals through the b chain that it shares with IL-3 and GM-CSF. C. IL-5 gene–deleted mice lack eosinophils. D. In studies using monoclonal antibodies against IL-5 in patients with asthma, tissue eosinophils were diminished along with changes in clinical symptoms.
June 2007
1311
1312 Rosenberg, Phipps, and Foster
Reviews and feature articles
Question 6. Which of the following statements is true? A. IL-4 is a critical inducer of eosinophil differentiation from CD341IL-5R1 progenitors in the bone marrow. B. Under homeostatic conditions, IL-5 is required for eosinophil growth and differentiation. C. Eosinophil progenitors in the bone marrow can be identified as CD341IL-4R1 cells. D. GATA-1 is thought to act as a transcription factor for eosinophil differentiation in the bone marrow. Question 7. The chemokine receptor CCR3 is crucial for — A. chemotaxis of eosinophils in response to eotaxins 1, 2, and 3. B. homeostatic levels of eosinophils in the gastrointestinal tract. C. migration of eosinophils into the lung tissue in response to allergic stimuli. D. (all of the above) Question 8. Potential therapeutic agents designed to have a unique impact on eosinophil trafficking to the lung may target which of the following? A. CCR3 B. CCR4 C. L-selectin D. IL-8
J ALLERGY CLIN IMMUNOL JUNE 2007
Question 9. Eosinophil expansion occurs via various mechanisms in response to allergic airway inflammation. Which of the following statements is therefore true? A. Eotaxin-2 production by airway epithelial cells promotes direct eosinophil growth. B. Airway CD341IL-5R1 eosinophil progenitors are the primary source of the eosinophils in allergic lung inflammation. C. Autocrine production of IL-5 by eosinophils is the primary means of eosinophil proliferation and differentiation. D. IL-13 promotes eosinophilia indirectly through eotaxin production. Question 10. Clinical trials with humanized anti–IL-5 monoclonal antibodies have shown — A. reduced peripheral eosinophilia. B. persistence of eosinophils in airways and lung tissue. C. no improvement in clinical asthma symptoms. D. (all of the above)