Classically one attempts to identify the allergic reaction (if it exists) by moving first to a minimal, elemental diet (proven, over time, to be acceptable even to those with intolerance to multiple foods) which the patient can tolerate. You then gradually add in those choices you think are likely most responsible for the initiating problem and observe symptoms.


Use a modified diet. Starch (complex carbohydrates) are important dietary foods, but there are number of nongliadin natural starchy foods (rice and other legumes).

Test Yourself

Multiple Choice Questions

1. Which one of the following associates with class II MHC molecules to prevent the peptide binding in the "groove" formed by the two polypeptide chains?

a. |32-microglobulin b. adapter protein c. invariant chain (Ii)

d. clathrin

2. The multipeptide unit that degrades cytosolic viral proteins is called a. calnexin b. TAP

c. proteasome d. NADPH oxidase

3. Class I MHC presents antigen to which one of the following?

a. CD4+ Th1 cells b. CD4+ Th2 cells c. Natural killer cells d. CD8+ T cells

4. Which one of the following cells is not an antigen presenting cell?

a. Neutrophil b. B cell c. Macrophage d. Dendritic cell

5. A 12-year-old boy has a one month history of increased urination, appetite and thirst. Tests reveal a very high (8-fold elevation) blood sugar, with high levels of sugar in the urine. Which of the following HLA molecules would you anticipate on his father's and/or mother's white blood cells?

a. HLA-DR3

b. HLA-B27

d. HLA-DQ5

Answers: 1c; 2c; 3d; 4a; 5a Short Answer Questions

1. What is meant by polymorphism? Of what advantage is MHC polymorphism to a species?

2. What is meant by codominant expression? Why is it advantageous to the individual?

3. Describe how some viruses prevent the display of antigenic peptide/class I MHC on the infected cell surface.

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