Stem cell technology and immune applications MCQs With Answer

Introduction: This quiz collection on Stem Cell Technology and Immune Applications is tailored for M.Pharm students preparing for advanced coursework and exams in Immunotechnology. It focuses on practical and mechanistic aspects of stem cell biology, immune interactions, clinical translation, safety, and regulatory considerations. Questions cover pluripotency, mesenchymal and hematopoietic stem cells, iPSC reprogramming, immunomodulation, graft-vs-host and graft-versus-leukemia effects, cell therapy manufacturing, potency testing, and emerging tools such as CAR-T and CRISPR. Use these MCQs to test conceptual understanding, reinforce protocols and assays, and sharpen reasoning required for designing and evaluating stem cell–based immunotherapies.

Q1. Which term describes stem cells that can differentiate into cells of all three embryonic germ layers but not extraembryonic tissues?

• Totipotent
• Pluripotent
• Multipotent
• Unipotent

Correct Answer: Pluripotent

Q2. Which combination of transcription factors constitutes the classical Yamanaka factors used to generate induced pluripotent stem cells (iPSCs)?

• Oct4, Sox2, Klf4, c-Myc
• Nanog, Lin28, Oct4, Sox2
• GATA4, Mef2c, Tbx5, Hand2
• STAT3, Klf4, TET1, c-Myc

Correct Answer: Oct4, Sox2, Klf4, c-Myc

Q3. What is a primary mechanism by which mesenchymal stem/stromal cells (MSCs) exert immunomodulatory effects?

• Direct differentiation into regulatory T cells
• Secretion of anti-inflammatory cytokines and indoleamine 2,3-dioxygenase (IDO)
• Upregulation of MHC class II to induce tolerance
• Activation of complement-mediated cytotoxicity

Correct Answer: Secretion of anti-inflammatory cytokines and indoleamine 2,3-dioxygenase (IDO)

Q4. Which hematopoietic stem cell graft source is most commonly associated with a higher risk of chronic graft-versus-host disease (GVHD)?

• Umbilical cord blood
• Bone marrow
• Peripheral blood stem cells
• Mesenchymal stem cell co-infused graft

Correct Answer: Peripheral blood stem cells

Q5. CD8+ cytotoxic T lymphocytes primarily recognize antigenic peptides presented by which molecules?

• MHC class II molecules
• MHC class I molecules
• CD1 family molecules
• Fc receptors on antigen-presenting cells

Correct Answer: MHC class I molecules

Q6. According to the ISCT minimal criteria, which phenotype correctly describes human MSCs?

• Positive for CD73, CD90, CD105 and negative for CD45, CD34
• Positive for CD45 and CD34 and negative for CD73
• Positive for HLA-DR and CD14 and negative for CD90
• Express high levels of CD3 and CD19

Correct Answer: Positive for CD73, CD90, CD105 and negative for CD45, CD34

Q7. Embryonic stem cells (ESCs) typically display which pattern of major histocompatibility complex (MHC) expression relevant to immunogenicity?

• High MHC class I and high MHC class II expression
• Low MHC class I and negligible MHC class II expression
• High MHC class II and no MHC class I expression
• No MHC expression at all

Correct Answer: Low MHC class I and negligible MHC class II expression

Q8. Why are allogeneic MSCs often considered less likely to induce immediate immune rejection compared with other cell types?

• They constitutively express high levels of co-stimulatory molecules
• They are depleted of all surface proteins during culture
• They have low MHC class II expression and secrete immunosuppressive factors
• They are rapidly cleared before immune recognition

Correct Answer: They have low MHC class II expression and secrete immunosuppressive factors

Q9. Which antigen is the most common target for CAR-T cell therapy in B-cell malignancies?

• CD3
• CD19
• PD-1
• HER2

Correct Answer: CD19

Q10. What is the main rationale for using feeder-free and xeno-free culture systems when expanding clinical-grade pluripotent stem cells?

• To rapidly increase mutation rates for selection
• To eliminate animal-derived components and reduce immunogenicity and pathogen risk
• To force differentiation toward hematopoietic lineages
• To enhance expression of MHC class II molecules

Correct Answer: To eliminate animal-derived components and reduce immunogenicity and pathogen risk

Q11. Which panel of markers is commonly used to confirm human pluripotency by flow cytometry or immunostaining?

• SSEA-3, SSEA-4, TRA-1-60, TRA-1-81
• CD34, CD45, CD14, CD11b
• CD73, CD90, CD105, CD146
• HLA-DR, CD80, CD86, CD40

Correct Answer: SSEA-3, SSEA-4, TRA-1-60, TRA-1-81

Q12. How is CRISPR/Cas9 most usefully applied in the context of iPSC-based regenerative medicine?

• As a non-specific mutagen to increase diversity
• For precise correction of disease-causing mutations in patient-derived iPSCs
• To permanently activate MHC class II expression
• To convert iPSCs into terminally differentiated fibroblasts without differentiation cues

Correct Answer: For precise correction of disease-causing mutations in patient-derived iPSCs

Q13. What is a major safety concern when transplanting cells derived from pluripotent stem cells?

• Teratoma formation due to residual undifferentiated cells
• Immediate complement-mediated lysis in all autologous settings
• Guaranteed immune tolerance without conditioning
• Inability to engraft any tissue types

Correct Answer: Teratoma formation due to residual undifferentiated cells

Q14. MSC-derived extracellular vesicles (exosomes) contribute to immunomodulation primarily through what cargo?

• Viral DNA that stimulates innate immunity
• MicroRNAs and regulatory proteins that alter recipient cell signaling
• Large intact mitochondria that replace host organelles
• Cell wall components that activate macrophages

Correct Answer: MicroRNAs and regulatory proteins that alter recipient cell signaling

Q15. Regulatory guidelines require potency assays for cell-based products. What best describes an appropriate potency assay?

• A purely descriptive identity test with no functional readout
• An assay that measures a biological function relevant to the product’s intended mechanism of action
• Any assay that is easiest to perform in QC labs regardless of relevance
• Only genomic sequencing of donor cells

Correct Answer: An assay that measures a biological function relevant to the product’s intended mechanism of action

Q16. What is the primary purpose of conditioning regimens prior to allogeneic hematopoietic stem cell transplantation?

• To expand host hematopoietic stem cells
• To ablate recipient marrow and immunosuppress to allow donor engraftment
• To increase peripheral blood counts transiently
• To induce tolerance by donor lymphocyte infusion before transplant

Correct Answer: To ablate recipient marrow and immunosuppress to allow donor engraftment

Q17. Which cytokines are commonly included to support ex vivo expansion of early hematopoietic progenitors?

• GM-CSF and IL-2 only
• Stem cell factor (SCF) and thrombopoietin (TPO)
• IFN-gamma and IL-6 only
• IL-4 and IL-13 only

Correct Answer: Stem cell factor (SCF) and thrombopoietin (TPO)

Q18. What factor can unexpectedly increase immunogenicity of autologous iPSC-derived grafts despite being patient-specific?

• Incomplete reprogramming leading to aberrant antigen expression or neoantigens
• Perfect HLA match with the host
• Absence of somatic mutations during culture
• Use of xeno-free reagents during expansion

Correct Answer: Incomplete reprogramming leading to aberrant antigen expression or neoantigens

Q19. The graft-versus-leukemia (GvL) effect following allogeneic transplant is mainly mediated by which cell population?

• Donor B cells producing alloantibodies
• Donor T cells recognizing residual leukemia-associated antigens
• Recipient NK cells rapidly eliminating donor cells
• Platelets transferring antigens to host APCs

Correct Answer: Donor T cells recognizing residual leukemia-associated antigens

Q20. What is a major advantage of umbilical cord blood banking for hematopoietic transplantation?

• Higher risk of chronic GVHD compared to peripheral blood grafts
• Readily available source with lower incidence of severe GVHD and tolerance for HLA mismatch
• Unlimited cell dose in each unit for adult transplantation
• Guaranteed long-term engraftment without conditioning

Correct Answer: Readily available source with lower incidence of severe GVHD and tolerance for HLA mismatch

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