14. B cell receptors (BCRs) are antigen receptors of B cells. Which statement regarding BCRs is NOT CORRECT?
(A) BCRs are surface immunoglobulin composed of 2 heavy and 2 light chains
(B) BCR gene segments are rearranged beginning from the light chain gene during B cell development
(C) Each B cells express BCRs of different specificity
(D) The Fab structure of BCRs is able to bind antigens

15. Macrophages and neutrophils are phagocytes and a front-line defense system in the body. Which statement regarding macrophages and neutrophils is NOT CORRECT? (A) The phagocytic mechanisms of macrophages and neutrophils are similar (B) After phagocytosis, the phagosomes inside the cells will increase pH to digest bacteria (C) Both macrophages and neutrophils produce antimicrobial peptides to facilitate the killing of pathogens (D) Neutrophils, but not macrophages, can undergo a special way of apoptosis, called NETosis, to trap and kill bacteria

16. Which statement concerning complement activation is NOT CORRECT? (A) Only antigen-bound antibodies and not free circulating antibodies can initiate the classical pathway (B) IgG has better complement fixation ability than IgM (C) Patients with deficiencies in C3 are more severe than those with deficiencies in membrane attack complex (D) C6-C9 are structurally related proteins without enzymatic activity

17. Regarding ITAM and ITIM, which statement is NOT CORRECT? (A) NK cells express different NK receptors that either contain ITAM or ITIM (B) Tyrosine residue(s) in ITAM or ITIM are phosphorylated in response to stimulation (C) ITAMS are found in the intracellular domain of BCR, i.e. surface immunoglobulin (D) Once activated, ITIM recruits protein phosphatases to negatively regulate downstream signal pathways

18. Monoclonal antibody (mAb) is a powerful research tool and a drug for treating diseases. Regarding mAb, which statement is NOT CORRECT? (A) mAb can be used to kill tumor cells or to block the binding of viruses or bacteria to host cells (B) Hybridoma technology is one way to generate mAbs (C) mAbs for immune checkpoint blockade are successfully used for treating cancer patients (D) mAbs can be used to target molecules located on the cell surface and inside the cells

19. Antimicrobial peptides (AMPs) belong to one component of the innate immune system. Which statement concerning AMPs is NOT CORRECT? (A) AMPs can be produced by non-immune cells in the skin, lung, and gut where the host is exposed directly to the outside environment (B) AMPs are produced in an inactive form and become active when cleaved (C) AMPs are peptides that have a hydrophilic end and a hydrophobic end, which will help degrade bacterial membrane (D) AMPs have a selective killing activity toward bacteria but not host cells

20. CAR-T and Immune checkpoint blockade (ICB) are two breakthroughs in recent years for tumor immunotherapy. Which statement concerning these two approaches is NOT CORRECT? (A) CAR-T approach bypasses the requirement of recognition of MHC-peptide and 2 signals to activate antigen-specific T cells (B) The ICB approved for treating cancer patients is to block molecules that transduce inhibitory signals in T cells, not in antigen-presenting cells (C) CAR-T and ICB both work for solid tumors and leukemia efficiently (D) The mechanisms for anti-CLT4 and anti-PD-1 ICBs are different; therefore, there is increased therapeutic activity when combining both treatments

21. After activation, naive B cells differentiate into antibody-secreting plasma cells and secrete different isotypes of immunoglobulin or antibodies. Regarding the functions of different isotypes of antibodies, which statement is NOT CORRECT? (A) IgM antibodies usually form pentamer and are produced first in a humoral immune response (B) IgA is the predominant antibody in mucosal sites, such as the intestinal and respiratory tracts (C) IgG efficiently opsonizes pathogens for engulfment by phagocytes and activates the complement system (D) IgE antibody is present in high levels in the blood or extracellular fluid and has a high affinity to bind and active mast cells

22. Antibodies are the effector molecules of the humoral immune response. Regarding the functions of antibodies, which statement is NOT CORRECT? (A) Antibodies inhibit the toxic effects by binding to pathogens products, a process called neutralization (B) Antibodies can bind viruses and directly kill them, a key effector function for humoral immunity (C) When bound to pathogens, the Fab of antibodies will facilitate the recruitment of other immune cells, such as macrophages, to mediate phagocytosis, a process called opsonization (D) Antibodies can trigger complement by activating C1, the first step in the classical pathway

23. Cytotoxic T cells eliminate infected or cancerous cells through a tightly controlled process. Which of the following mechanisms are involved in this process? Select all that apply (Select all that apply) (A) Activate Fas/FasL Signaling in the target cell (B) Inducing apoptosis (programmed cell death) in the cytotoxic T cell (C) Release of granzyme, perforin, and granulysin by the cytotoxic T cell (D) Lower antigen presentation (E) Inducing the target cell to undergo senescence

24. T cell activation is a tightly regulated process. Which of the following mechanisms contribute to the downregulation or suppression of T cell signaling? (Select all that apply) (A) CTLA-4 binding to B7 molecules on antigen-presenting cells (B) PD-1 binding to PD-L1 or PD-L2 on antigen-presenting (C) Recruitment of the Cbl family of ubiquitin ligases (D) Production of immunosuppressive cytokines like IL-10 and TGF-B (E) Increased expression of co-stimulatory molecules like CD28

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