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    Hypersensitivity 1 4

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    Wahyudi Yusman
    Hypersensitivity reactions are abnormal immune responses to antigens that cause damage to host tissues. There are four main types of hypersensitivity reactions: Type I reactions are immediate and anaphylactic, mediated by IgE antibodies binding mast cells and basophils. Type II reactions are cytotoxic, where IgG or IgM antibodies activate complement and lyse antigen-bearing cells. Type III reactions involve immune complex deposition activating complement and causing tissue damage. Type IV reactions are delayed cell-mediated responses involving T cells.

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    Hypersensitivity 1 4

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    Wahyudi Yusman
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    Hypersensitivity reactions are abnormal immune responses to antigens that cause damage to host tissues. There are four main types of hypersensitivity reactions: Type I reactions are immediate and anaphylactic, mediated by IgE antibodies binding mast cells and basophils. Type II reactions are cytotoxic, where IgG or IgM antibodies activate complement and lyse antigen-bearing cells. Type III reactions involve immune complex deposition activating complement and causing tissue damage. Type IV reactions are delayed cell-mediated responses involving T cells.

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    Hypersensitivity reactions are abnormal immune responses to antigens that cause damage to host tissues. There are four main types of hypersensitivity reactions: Type I reactions are immediate and anaphylactic, mediated by IgE antibodies binding mast cells and basophils. Type II reactions are cytotoxic, where IgG or IgM antibodies activate complement and lyse antigen-bearing cells. Type III reactions involve immune complex deposition activating complement and causing tissue damage. Type IV reactions are delayed cell-mediated responses involving T cells.

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    124 views62 pages

    Hypersensitivity 1 4

    Uploaded by

    Wahyudi Yusman
    Hypersensitivity reactions are abnormal immune responses to antigens that cause damage to host tissues. There are four main types of hypersensitivity reactions: Type I reactions are immediate and anaphylactic, mediated by IgE antibodies binding mast cells and basophils. Type II reactions are cytotoxic, where IgG or IgM antibodies activate complement and lyse antigen-bearing cells. Type III reactions involve immune complex deposition activating complement and causing tissue damage. Type IV reactions are delayed cell-mediated responses involving T cells.

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    HYPERSENSITIVITY

    dr R. Lia K. Iswara, MS, SpMK (K)

    HYPERSENSITIVITY
    A damage to host mediated by preexisting an abnormal immune response to self or foreign antigen

    Reaksi Hypersensitivitas Tipe I-II-III-IV

    Hypersensitivity (Allergy): Four Types of Hypersensitivity Reactions:


    Type I: Anaphylactic/Immediate Reactions Type II: Cytotoxic Reactions Type III: Immune Complex Reactions Type IV: Cell-Mediated/delayed Reactions

    Type I (Anaphylactic) Reactions


    Occur

    within minutes of exposure to antigen Antigens combine with IgE antibodies IgE binds to mast cells and basophils, causing them to undergo degranulation and release several mediators:

    Type I (Anaphylactic) Reactions


    Histamine:

    Dilates and increases permeability of blood vessels (swelling and redness), increases mucus secretion (runny nose), smooth muscle contraction (bronchi). Prostaglandins: Contraction of smooth muscle of respiratory system and increased mucus secretion. Leukotrienes: Bronchial spasms.
    Anaphylactic

    shock: Massive drop in blood pressure. Can be fatal in minutes.

    Mast Cells and the Allergic Response

    Role of Mast Cells & Basophils


    Mast cells located in the connective tissue of all organs (in lungs, skin, GI and genital tract) Basophils circulate in blood into tissues Each cell can bind 10,000-40,000 IgE Cytoplasmic granules contain active cytokines, histamine, etc Cells degranulate when stimulated by allergen

    Chemical mediators

    Mast Cells and the Allergic Response

    Mechanism of Type I

    Sensitizing dose first contact with allergen (specific B cells form IgE which attaches to mast cells and basophils) Provocative dose - subsequent exposure with the same allergen (binds to the IgE-mast cell complex) Degranulation : releases mediators with physiological effects (vasodilation and bronchoconstriction) Symptoms : rash, itching, redness, increased mucous discharge, pain, swelling, and difficulty breathing

    Systemic Anaphylaxis
    Sudden

    respiratory and circulatory disruption that can be fatal in a few minutes Allergen and route are variable Bee stings, antibiotics or serum injection

    Strategies for circumventing allergic attacks

    Blocking Ab

    Type II (Cytotoxic) Reactions


    Involve

    activation of complement by IgG or IgM binding to an antigenic cell. Antigenic cell is lysed. Transfusion reactions:
    ABO

    Blood group system: Type O is universal donor. Incompatible donor cells are lysed as they enter bloodstream.

    Type II (Cytotoxic) Reactions


    Rh

    Blood Group System: 85% of population is Rh positive. Those who are Rh negative can be sensitized to destroy Rh positive blood cells.
    Hemolytic disease of newborn: Fetal cells are destroyed by maternal anti-Rh antibodies that cross the placenta.

    Immunopathology Definition - Type II reaction


    Cytotoxic antibodies of IgM or IgG subtype formed against an antigen on a cell surface, or more rarely, against a component of the extracellular matrix. Usually, the binding of the antibody to the cellular antigen causes complement fixation (activation). The membrane attack complex (MAC) of complement then kills the cell.

    Type III (Immune Complex) Reactions


    Involve

    reactions against soluble antigens circulating in serum. Antibody-Antigen immune complexes are deposited in organs, activate complement, and cause inflammatory damage.
    Glomerulonephritis:

    Inflammatory kidney

    damage.
    Occurs

    with slightly high antigen-antibody ratio is present.

    Immunopathology Definition - Type III reaction


    Type III reactions involve immune complexes of antibody and antigen. Antibodies are of IgM or IgG type, but the antigen is usually a soluble antigen. Antibodies form immune complexes with these antigens, and the complexes are deposited in tissue activate complement. Kidney and skin are most often affected.

    Immunopathology Type III hypersensitivity reaction


    Immune complexes of ideal size are usually formed with slight antigen excess. Larger complexes removed by the mononuclear phagocyte system. Complexes likely induce disease by attaching to the Fc or C3b receptors on polymorphs, and trigger release of cytokines, attracting more PMNs, and initiating more complement fixation.

    Immune Complex Mediated Hypersensitivity

    SYSTEMIC LUPUS ERYTHEMATOSUS

    Detection of immune complexes in serum

    Type IV (Cell-Mediated) Reactions


    Involve
    First

    reactions by TD memory cells.

    contact sensitizes person. Subsequent contacts elicit a reaction.


    Reactions
    Delay

    are delayed by one or more days (delayed type hypersensitivity).


    is due to migration of macrophages and T cells to site of foreign antigens.

    Type IV (Cell-Mediated) Reactions


    Reactions

    are frequently displayed on the skin: itching, redness, swelling, pain.


    Tuberculosis skin test Poison ivy Metals Latex in gloves and condoms (3% of health care workers)

    Anaphylactic

    shock may occur.

    Type IV Hypersensitivity
    Cell-mediated A delayed response to Ag involving activation of and damage by T cells Delayed allergic response skin response to allergens tuberculin skin test, contact dermititis from plants, metals, cosmetics Graft rejection reaction of cytotoxic T cells directed against foreign cells of a grafted tissue; involves recognition of foreign HLA

    Immunopathology
    Transplant rejection
    Mechanisms

    involved in transplant

    rejection
    T

    cell mediated delayed type hypersensitivity

    Direct

    pathway via recipient CD4+ and CD8+ recognition of MHC Class I antigens on donor APCs Indirect pathway whereby processing of antigen by the recipients APCs is required
    Antibody

    mediated immediate hypersensitivity

    Allergic Contact Dermatitis Response to Poison Ivy Hapten

    Contact dermatitis reaction to leather

    Granuloma in a leprosy

    Delayed hypersensitivity

    Mechanism of damage in contact hypersensitivity

    Comparison of hypersensitivity

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