Term
MHC restriction is generated in which organ? |
|
Definition
|
|
Term
T cells from animal A will only recognize MHC from what animal? |
|
Definition
|
|
Term
Foreign peptide + foreign MHC or self peptide + foreign MHC generate what response? |
|
Definition
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|
Term
Analysis of lysed target cells (MHC experiments) was performed with what compound? |
|
Definition
|
|
Term
If AxB BM cells are injected into an irradiated mouse with thymus of type A, what will the T cells recognize? How about with thymus type AxB? |
|
Definition
|
|
Term
How was activation of Th cells analyzed? |
|
Definition
Pulsing mac's with Ag and mixing them with Ag-primed Th cells; Activation was measure by Th cell proliferation (Same strain and hybrids containing the original strain = activation) |
|
|
Term
|
Definition
Response to self-Ag in foreign MHC molecule (problem in transplants) |
|
|
Term
CD4 T cells recognize what type of Ag? |
|
Definition
|
|
Term
CD8 T cells recognize what type of Ag? |
|
Definition
|
|
Term
If a self-peptide cannot be inserted into the MHCI molecule, what will happen? |
|
Definition
The MHC molecule won't make it to the surface |
|
|
Term
Ubiquitin does what with proteins in the cytoplasm? |
|
Definition
Targets them to a proteasome |
|
|
Term
What are sources of cytosolic Ag's? |
|
Definition
Viruses, escaped microbes, tumors |
|
|
Term
|
Definition
A multiprotein enzyme complex with proteolytic activity in cytoplasm (degrade damaged/misfolded proteins) |
|
|
Term
|
Definition
Large cylinder (four rings of proteins with central channel); channel is degradation site |
|
|
Term
Three subunits of proteasome (activity) |
|
Definition
Chymotrypsin, trypsin, caspase |
|
|
Term
Three subunits of proteasome (Names) |
|
Definition
LMP-2/7/10, change predominant activity to chymotrypsin |
|
|
Term
What mediates peptide transport from proteasome to ER? |
|
Definition
|
|
Term
What kind of transporters are TAP1/2? |
|
Definition
ATP-binding complex (ABC) |
|
|
Term
|
Definition
Assists folding of alpha chain of MHC I and association with beta2M |
|
|
Term
What does calreticulin do? |
|
Definition
Stabilized newly formed EMPTY CI molecule |
|
|
Term
|
Definition
Tethers new CI molecules to TAP on lumenal side of ER, waiting for peptide |
|
|
Term
Which receptors are higher in immature DC's? |
|
Definition
|
|
Term
How are Ag's internalized? |
|
Definition
Receptor mediated phago and endocytosis |
|
|
Term
At what pH are proteases optimally active? |
|
Definition
|
|
Term
What are the most abundant endocytic proteases? |
|
Definition
Cathepsins (Cys/Asp proteases with broad specificities) |
|
|
Term
Most Ag processing and CII loading occurs where? |
|
Definition
In MHC II containing compartments |
|
|
Term
After synthesis in the ER, what happens to CII alpha/beta chains? |
|
Definition
They associate to form a heterodimer and then 3 of these a/b complexes assoc. with a homotrimer of the invariant chain |
|
|
Term
What does the invariant chain do? |
|
Definition
Promote assembly/proper folding of a/b CII dimer, prevents CII molecules from binding peptides in ER, targets the full structure to endocytic compartments |
|
|
Term
How is the invariant chain removed from CII molecules? |
|
Definition
Degradation through the endocytic pathway, the RLS of this is cleavage of Iip10 into CLIP |
|
|
Term
What cathepsins cleave Iip10 to form CLIP? |
|
Definition
|
|
Term
CII peptide loading is mediated by what? |
|
Definition
DM (targeted to endo. pathway by itself, kicks CLIP out of cleft and waits for peptide with higher affinity to kick it out again; then recycles to load another CII molecule) |
|
|
Term
Where are CD1 molecules loaded? |
|
Definition
|
|
Term
What do CD1 molecules present? |
|
Definition
|
|
Term
|
Definition
Immunologically sterile environs (CSF, eyes, urine) |
|
|
Term
|
Definition
|
|
Term
|
Definition
Relative concentration of Ab (1/dilution) |
|
|
Term
|
Definition
A molecule that won't generate an immune response by itself, but coupled with a carrier protein will generate Ab's for the protein, the hapten and the complex of carrier/hapten |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
3 phases of humoral immune response |
|
Definition
Recognition, activation, effector |
|
|
Term
Changing a proline to a serine causes what in Ig? |
|
Definition
Loss of rigidity through loss of S-S binding and gain of intrachain S-S binding |
|
|
Term
Alternative splicing causes what? |
|
Definition
Change from membrane bound to soluble form of Ab; dual expression of IgM/IgD |
|
|
Term
|
Definition
Above S-S bonds in Ig molecule (generates Fc and 2x Fab) |
|
|
Term
|
Definition
Below S-S bonds in Ig molecule (generates Fab2 and chewed-up Fc) |
|
|
Term
Ig domains are composed of what? |
|
Definition
|
|
Term
Ig domains (Variable domain, constant domains) are what size? |
|
Definition
|
|
Term
What angle does a beta strand have? |
|
Definition
|
|
Term
|
Definition
2 beta sheets (3+4 constant, 4+5 variable antiparallel) |
|
|
Term
How large are complementarity determining regions in Ig's? |
|
Definition
|
|
Term
What shape do CRD's have in Ig's? |
|
Definition
Loop outside of overall structure, allows variability to be concentrated in specific locations |
|
|
Term
What is the dissociation constant? |
|
Definition
The concentration of Ag required to bind 1/2 of Ab binding sites at equil |
|
|
Term
|
Definition
Difference in a few amino acids in the same isotype (Small difference in IgM Fc portion from one person to the next) |
|
|
Term
|
Definition
The sum of the Ag-binding sequences on an Ig molecule |
|
|
Term
Lack of S-S bonds holding the two chains together in some IgG molecules causes what? |
|
Definition
Hybrid (and quite often less effective) IgG molecules |
|
|
Term
|
Definition
The sum of a humoral immune response, based on multiple B cells involved, multiple specificites, affinities, etc. |
|
|
Term
|
Definition
A single Ab type from a single B cell, with specific affinity, binding site, etc. |
|
|
Term
|
Definition
Neutralization of infectious agents/toxins and Ag entry into blood |
|
|
Term
Functions of Fc (Aggregated) |
|
Definition
Removal of Ag, Killing of infectious agents/abnormal cells, driving inflammation |
|
|
Term
|
Definition
|
|
Term
Antibody mediated neutralization does... |
|
Definition
Interferes with microbial infectivity by blocking recognition sites/adhesion sites, inducing conf. changes; interferes with toxin activity, interferes with Ag transport across mucosal tissue |
|
|
Term
Ig Opsonization occurs through what receptor? |
|
Definition
|
|
Term
How is activation signal sent into phago? |
|
Definition
Through ITAM (immunoreceptor tyr-based activation motif) located on cyto. tail |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
What happens when mac's are activated through FcR's? |
|
Definition
Release of RO's, degradative enzymes, prostaglandins |
|
|
Term
What happens when NK cells are activated through FcR's? |
|
Definition
Release of IFNgamma, perforin, granzymes |
|
|
Term
What happens when allergic/parasitic defense cells are activated through FcR's? |
|
Definition
Release of histamine, proteases, toxic proteins, etc. |
|
|
Term
What happens when platelets are activated through FcR's? |
|
Definition
Release of histamine, thrombi (clotting) |
|
|
Term
Ab-dependent cell mediated cytotoxicity means what? |
|
Definition
NK cells recognize Ig-coated cells through FcR's; Parasitic defense recognizes IgE coated parasites through FcR's |
|
|
Term
|
Definition
Present without overt immunization, limited specificity (based on polysacc's), innate-like immunity |
|
|
Term
What do natural Ab's block? |
|
Definition
Xenografts (complement can be suppressed, but not natural Ab's) |
|
|
Term
How does complement enhance B cell signaling? |
|
Definition
Through interaction with CR2 receptor (while bound to BCR) |
|
|
Term
Besides the B cell receptor, where does an Ag-Ab complex bind a B cell? |
|
Definition
|
|
Term
What is the major Ig produced daily? |
|
Definition
|
|
Term
What is the major immunity function of IgA? |
|
Definition
|
|
Term
How is IgA transported across the epithelium? |
|
Definition
It is secreted with a J chain, bound to a poly-Ig receptor on the endo cells, endocytosed into endo cells, transported to opposite membrane where it is cleaved before release as active secreted IgA |
|
|
Term
What does the secretory component of IgA do? |
|
Definition
Protects it from breakdown in the lumen |
|
|
Term
What Ab is responsible for neonatal immunity? |
|
Definition
|
|
Term
What Ab is present in breast milk? |
|
Definition
|
|
Term
What receptor allows IgG transport across placenta? |
|
Definition
|
|
Term
What is type II hypersensitivity? |
|
Definition
Tissue injury caused by anti-tissue Ab |
|
|
Term
What is type III hypersensitivity? |
|
Definition
Immune complex mediated tissue injury (Mainly vasculitis/deposition) |
|
|
Term
|
Definition
Multisystem disease caused by IC deposition (both Ab/complement types) on various tissues |
|
|
Term
|
Definition
Inability to regulate production of auto-Ab, Dysfunctional clearance of Ag-debris/IC, Polymorphic complement proteins/Fc receptors protect against diseased tissue while mediating healthy tissue damage, defective complement/Fc receptors responsible for this situation |
|
|
Term
Differences between mouse/human Ig's? |
|
Definition
Mouse IgG2alpha/beta fix complement, IgG1/3 don't; Human IgG1/3 fix complement, 2/4 don't |
|
|
Term
What are the four major classes of Ag? |
|
Definition
Carbos, Lipids, NA's, Proteins (Only Carbos/usually and proteins/always are immunogens, the other two are rare... lupus is characterized by anti-DNA Ab) |
|
|
Term
A greater degree of protein complexity causes what? |
|
Definition
A more vigorous immune response |
|
|
Term
What structural features of a protein can an Ab recognize? |
|
Definition
All 4 (Primary, secondary, etc.) |
|
|
Term
Are all antigens immunogenic? |
|
Definition
|
|
Term
|
Definition
A particle/sequence which has the ability to combine specifically with Ab/cell surface BCR/TCR |
|
|
Term
|
Definition
A specific site on a macromolecule where an immune cell will recognize and initiate a reaction |
|
|
Term
What type of amino acids are typically part of a B cell epitope? |
|
Definition
Hydrophilic (outside of protein complex) |
|
|
Term
What type of aa are typically part of a T cell epitope? |
|
Definition
Hydrophobic (inside protein complex, linear, etc.) |
|
|
Term
What regions have B cell epitopes? |
|
Definition
|
|
Term
What type of B cell epitopes do complex proteins have? |
|
Definition
Overlapping, some are immunodominant (larger response) |
|
|
Term
Hen egg-white lysozyme makes how many nonsequential epitopes? |
|
Definition
|
|
Term
If an S-S bond is reduced, will the same Ab bind this epitope? |
|
Definition
|
|
Term
What are the four types of Ab-Ag interactions? |
|
Definition
Ionic, H-bonds, hydrophobic, van der Waals |
|
|
Term
|
Definition
The part of an Ag-peptide that binds to the MHC molecule |
|
|
Term
A given MHC molecules has what type of specificity? |
|
Definition
|
|
Term
What are the factors in determining immunogenicity? |
|
Definition
Foreignness, high MW, chemical complexity, degradability, dosage/route of administration, genetic composition, adjuvants (coupled with Ag simply increase immune response, not same as haptens) |
|
|
Term
Which would generate an immune response in the same animal, sperm or collagen? |
|
Definition
|
|
Term
Which molecule would not generate an immune response in very distant animals, cytochrome C or corneal tissue? |
|
Definition
|
|
Term
What is the cutoff for usual non-immunogenic MW? |
|
Definition
|
|
Term
If a homopolymer of aa is injected into a mouse, will there be a response? |
|
Definition
Not likely, not complex enough |
|
|
Term
If a peptide is composed of D-aa, will it be degraded? |
|
Definition
|
|
Term
Too high of a dosage of an Ag causes what? |
|
Definition
Tolerance (also caused by numerous low doses) |
|
|
Term
What is the only human adjuvant currently in use? |
|
Definition
Alum (causes precipitation of Ag = higher response) |
|
|
Term
|
Definition
Prolong Ag persistence, Enhance co-stim signals, Induce granuloma formation (large mass of granulocytes), Stim lymphocyte proliferation |
|
|
Term
Adjuvants used in animals? |
|
Definition
Freund's complete (M. tb), BCG (Mycobact, C. parvum, B. pertussis) = slow continuous release of Ag, Bacterial endotoxins (LPS, MDP) |
|
|
Term
What is the mechanism of alum? |
|
Definition
Delayed release of Ag = enhanced uptake by APC |
|
|
Term
How are epitopes determined? |
|
Definition
Protein sequence analysis (compare with databases, check for HLA-binding peptides, look for coils, transmembrane segments, etc.) |
|
|
Term
What do consensus predicted epitopes show? |
|
Definition
High values for antigenicity, flexibility, surface location |
|
|
Term
Heavy chain = how many domains? |
|
Definition
1 variable and 3-4 constant |
|
|
Term
Light chain = how many domains? |
|
Definition
1 variable and 1 constant |
|
|
Term
Structure of variable domains |
|
Definition
3 hypervariable regions (HV1/2/3) flanked by four framework regions (FR1/2/3/4) with less variable sequences |
|
|
Term
|
Definition
Provide mucosal immunity and defense against microbes |
|
|
Term
|
Definition
By plasma cells in mucosal lymphoid tissues |
|
|
Term
|
Definition
Perform effector functions (Ab-mediated cytotoxicity); IgG bind to infected cells and Fc receptors on NK cells; IgE bind to parasites (worms) and FcE receptors on eosinophils |
|
|
Term
Ig expressed during B cell development |
|
Definition
Stem cell = no Ig, pre-B = IgH only (surrogate IgL), immature B = IgM only, Mature B = IgM/D |
|
|
Term
|
Definition
VDJ recombination/somatic hypermutation, secreted vs. membrane-bound, isotype switching |
|
|
Term
On what chromosomes are the Ig genes located? |
|
Definition
H = 14, kappa = 2, lambda = 22 |
|
|
Term
How many V/J/C segments does lambda have? |
|
Definition
|
|
Term
How many V/J/C segments does kappa have? |
|
Definition
|
|
Term
How many V/D/J/C segments does IgH have? |
|
Definition
45V, 23D, 6J, numerous C's |
|
|
Term
How is membrane/soluble form determined? |
|
Definition
Polyadenylation of specific sites in the mRNA (upstream = secreted, downstream = membrane-bound), same as IgM/D |
|
|
Term
How is class switching mediated? |
|
Definition
Switch regions cross and intervening DNA is cut out (5'-3') = only remaining DNA transcribed, intervening = lost |
|
|
Term
Somatic hypermutation selects for what? |
|
Definition
Higher affinity Ig (after Ag stimulation) |
|
|
Term
Mutations increase or decrease with multiple exposures? |
|
Definition
Increase, attempting to better match the Ag and create stronger response |
|
|
Term
Where does somatic hypermutation occur? |
|
Definition
|
|
Term
What are the 2 differences between BCR/TCR? |
|
Definition
TCR is monovalent/BCR is bivalent, TCR has no secreted component |
|
|
Term
What is the structure of a TCR? |
|
Definition
Variable region, constant region, Transmembrane region, Tail piece |
|
|
Term
TCR is similar to what of the Ig? |
|
Definition
|
|
Term
Can the TCR class switch? |
|
Definition
|
|
Term
How was TCR cDNA isolated? |
|
Definition
Obtaining fragments from Tcells and subtracting B cell DNA to isolate unique sequences |
|
|
Term
How was TCR cDNA analyzed? |
|
Definition
|
|
Term
On what chromosomes are TCR genes located? |
|
Definition
beta=7, alpha/delta=14, gamma=7 |
|
|
Term
Which TCR genes are located adjacent to each other? |
|
Definition
alpha and delta (delta is within alpha) |
|
|
Term
How many VDJ segments does alpha have? |
|
Definition
|
|
Term
How many VDJ segments does delta have? |
|
Definition
|
|
Term
How many VDJ segments does beta have? |
|
Definition
50V, 2D, 12 J, 2C (DJC are repeated, so only 1D/6J/1C per repeat) |
|
|
Term
How many VDJ segments does gamma have? |
|
Definition
|
|
Term
What is the structure of the surrogate light chain? |
|
Definition
|
|
Term
|
Definition
|
|
Term
When are RAG1/2 turned on? |
|
Definition
During H-chain rearrangement and kappa/lambda rearrangement |
|
|
Term
|
Definition
During H-chain rearrangement |
|
|
Term
What is allelic exclusion? |
|
Definition
Expression of a single allele (kappa only or lambda only), also called light chain isotype exclusion |
|
|
Term
Which chains are rearr first in T cells? |
|
Definition
delta then gamma; beta then alpha |
|
|
Term
Which chains are rearr first in B cells? |
|
Definition
|
|
Term
What are recombination signal sequences? |
|
Definition
Conserved sequences which mediate joining between variable region segments |
|
|
Term
What is the structure of RSS's? |
|
Definition
Palindromic heptamer and AT rich nonamer separated by 12 or 23 bp |
|
|
Term
What is the 12/23 bp rule? |
|
Definition
RSS's with same spacing cannot combine |
|
|
Term
|
Definition
RSS with 12 bp combines with RSS of 23 bp, etc. |
|
|
Term
What does 12/23 bp rule prevent? |
|
Definition
Direct combination of VH-JH (causes VDJ) |
|
|
Term
Which VDJ recombination proteins are resistant to ionizing radiation? |
|
Definition
|
|
Term
Where is Artemis involved in VDJ recombination? |
|
Definition
Nicks DNA at hairpins and allows insertion of palindromic P nucleotides (template dependent) |
|
|
Term
What type of nucleotides does TdT add? |
|
Definition
N nucleotides (template independent) (at the same time, exonucleases can cut away nt's) |
|
|
Term
What aa's are present in the transmembrane region of the TCR to give positive charge? |
|
Definition
|
|
Term
What function do the transmembrane proteins of the TCR serve? |
|
Definition
|
|
Term
When cDNA was added to T cells which coded for a portion of the TCR, did it allow for recognition of peptides previously recognized by that cell? |
|
Definition
No, only the specific combination of original chains codes for that peptide recognition |
|
|
Term
How many CDR's are present on TCR's? |
|
Definition
3 on each (alpha/beta) chain, a 4th on the outside of the beta chain (used by super-Ag's) |
|
|
Term
Which CDR's interact with what molecules (TCR)? |
|
Definition
III with Ag, I/II with MHC |
|
|
Term
What molecule do TCR's need for signal transduction? |
|
Definition
|
|
Term
What chains compose the CD3 molecule? |
|
Definition
epsilon/gamma (44-81aa), epsilon/delta (44-81aa), zeta/zeta or zeta/eta (113aa) |
|
|
Term
How are zeta/zeta CD3 chains linked? |
|
Definition
|
|
Term
What are ITAMs composed of? |
|
Definition
Tyr-XX-Leu (Tyr is substrate for Tyr kinases) |
|
|
Term
If CD3 is not expressed, what is prevented? |
|
Definition
Expression of the TCR at the cell surface |
|
|
Term
What is the structure of CD4 molecules? |
|
Definition
4 domains, top two bind to beta2 domain of CII molecule |
|
|
Term
What is the structure of CD8 molecules? |
|
Definition
Heterodimer of single domains, either domain binds to alpha3 of CI molecule |
|
|
Term
What is a common accessory molecule interaction bet. T cells and target cells/APC's? |
|
Definition
|
|
Term
What molecules bind B cells to Th cells? |
|
Definition
|
|
Term
What is the signaling dimer needed by BCR's? |
|
Definition
|
|
Term
|
Definition
beta chain with preTalpha |
|
|
Term
|
Definition
Soluble proteins produced by leukocytes that regulate the intensity/duration of an immune response and bind to specific receptors/trigger signal transduction |
|
|
Term
What effects do the signals from IL's have? |
|
Definition
Growth/differentiation of lymphocytes, activation of effector cells, devel. of stem cells |
|
|
Term
Some things about cytokine secretion? |
|
Definition
Brief timing, not pre-formed, synth'd in response to cell activation, transient transcriptional activation, highly unstable mRNA, posttranslationally modified, rapid secretion after synthesis |
|
|
Term
|
Definition
autocrine (self), paracrine (neighboring cells), endocrine (systemic) |
|
|
Term
|
Definition
Affect multiple cell populations (cytokines) |
|
|
Term
|
Definition
Multiple cytokines with same effects |
|
|
Term
|
Definition
Multiple cytokines work together for specific response |
|
|
Term
|
Definition
Cytokines inhibit each other |
|
|
Term
|
Definition
Cytokines affect a large number of cells in a cycle |
|
|
Term
|
Definition
Mediate innate (from mac's), mediate adaptive (from T cells), stim hemato (from stromal cells, leukos) |
|
|
Term
What are actions of TNFalpha? |
|
Definition
Mediate acute inflammatory response (block O2 and nutrients to tumor area), systemic complications of severe infections |
|
|
Term
What stimulates TNFalpha? |
|
Definition
LPS/TLR4/CD14, enhanced by IFNgamma |
|
|
Term
|
Definition
Intracell N terminus, large extracell C terminus |
|
|
Term
How is TNFalpha expressed in the membrane? |
|
Definition
Homotrimer, cleaved to release polypeptides which trimerize and bind receptors at the base of the pyramid |
|
|
Term
|
Definition
Stimulate recruitment of PMN's and monocytes to sites of infection (Induce adhesion cascade, chemotaxis, etc.) and Activate cells to eradicate microbes (stimulate PMN's/mac's to kill more efficiently) |
|
|
Term
|
Definition
Adhesion, activation, fever, microbicidal proteins, more PMN's |
|
|
Term
|
Definition
Septic shock, low cardiac efficiency, vessel clotting, liver problems, lack of glucose replenishment, loss of weight from low appetite |
|
|
Term
What other cytokines work with TNFalpha to generate septic shock? |
|
Definition
IL-1/12, IFNgamma (prevent lowering of shock by blocking TNFalpha) |
|
|
Term
|
Definition
|
|
Term
What are the actions of IL-1? |
|
Definition
Mediate local inflammation (low), systemic responses like fever, BM production up, etc. (high), no septic shock |
|
|
Term
Monocytes produce a natural agonist of IL-1 that does... |
|
Definition
Binds receptor in competitive fashion |
|
|
Term
|
Definition
Mediator of early innate immune response to intracellular microbes/induction of cell-mediated immunity, stim IFNgamma production (T/NK cells), diff. of CD4 T cells to TH1, enhance active NK cells/CD8 T cells |
|
|
Term
|
Definition
p40/p35 = activates or p40/p40 = inhibits |
|
|
Term
|
Definition
|
|
Term
|
Definition
Mac's produce during infection, contributes to autoimmune diseases, causes diff/maintenance of Th17 cells |
|
|
Term
Th1 cells work with what kind of pathogens? |
|
Definition
|
|
Term
Th2 cells work with what kind of pathogens? |
|
Definition
|
|
Term
IL-12 deficiencies caused what in all 3 patients? |
|
Definition
Recurrent opportunistic infections, some from immunizations |
|
|
Term
IL-12 receptor deficiency led to what in patients? |
|
Definition
Lack of IFNgamma (treated with IFNgamma injections) |
|
|
Term
IL-12 component deficiency led to what in patients? |
|
Definition
Lack of IFNgamma (treated with IL-12 injections) |
|
|
Term
|
Definition
Mediates early innate immune responses to viral infections/intracellular microbes (up MHCI regulation, devel Th1 cells, sequester lymphos in LN) |
|
|
Term
What stimulates IFN-1 family? |
|
Definition
Viral NA that bind receptors/sensors and stimulate IRF transcription factors |
|
|
Term
What is the range of IFN-1 family? |
|
Definition
|
|
Term
What does IFN-1 do to target cells? |
|
Definition
Tell infected ones to die, tell uninfected to secrete enzymes which block viral replication |
|
|
Term
TNFalpha/IL-1 control what pathogens? |
|
Definition
|
|
Term
IL-12 controls what pathogens? |
|
Definition
Intracellular bact/fungal |
|
|
Term
IFN-1 controls what pathogens? |
|
Definition
|
|
Term
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Definition
Inhibits mac's/DC's (from mac's = negative feedback/reg T cells) |
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Term
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Definition
Inhibits IL-12 from mac's/DC's, inhibits costim molecules/MHC II molecules in mac's/DC's |
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Term
IL-10 KO mice develop inflammatory bowel syndrome from what? |
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Definition
Inability to turn off inflammation from intestinal microbes |
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