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604 Immuno/Microbio - Exam 3 > 3.2.12 - Hypersensitivity > Flashcards

3.2.12 - Hypersensitivity Flashcards

1
Q

What are the 4 types of hypersensitivity reactions?

A

Anaphylactic (type I)
Cytotoxic (type II)
Immune complex disease (type III)
Cell-mediated delayed hypersensitivity (type IV)

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2
Q

Antibody class involved w/ anaphylactic reaction

A

IgE

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3
Q

IgE half life

A

2-3 days

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4
Q

IL-___ is important for class switching to IgE and IL-___ plays a role

A

IL-4
IL-13

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5
Q

Where there’s less parasitic infections, there’s an increase/decrease of atopic allergic reactions

A

Increase

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6
Q

Antigens are also referred to as

A

allergens

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7
Q

3 common sources of allergens

A

Inhaled, injected, ingested

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8
Q

Steps for IgE attaching to mast cells and basophils

A
  • Allergen enters across mucosal membrane
  • Cytotropic antibody (IgE) attaches to mast
    cell by Fc receptor
    Fab (antigen binding site)part’s ready
    to interact w/ allergen
  • IgE remained attached for months on surface
    of mast cell, basophil, and activated
    eosinophils
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9
Q

3 features of inhaled allergens that promote priming of the Th2 cells that drive the IgE response

A

Molecular type
low dose
high solubility

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10
Q

IgE only remains isolated in blood for ___, but can remain attached to leukocytes for ___

A

few days

months

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11
Q

Primary sensitization steps for anaphylactic reaction

A
  1. exposure to pollen
  2. extraction of antigen goes to mucosal surface
  3. activation of Th2 cells
  4. production of IgE and binding to mast cells
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12
Q

IgE receptor

A

FcER1

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13
Q

what else can interact w/ mast cells and cause release of mediators?

A

Anaphylatoxins (mainly C3a and C5a)

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14
Q

What happens during the 2nd exposure to an allergen?

A

Mast cell coated in IgE antibody and allergen interacts w/ it and causes mediator release

Results in

Immediate hypersensitivity rxn within minutes (found in granules) AND late phase rxn within 2-8 hours (produced by mast cell in membrane)

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15
Q

3 important mediators released by mast cells. What do each of them do?

A

Histamine
- capillary dilation
- increase vascular permeability
- Increase in mucous secretions

ECF-A

Leukotrienes
- similar properties to histamine

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16
Q

The peak expiratory phase in response to inhaled allergen lasts for ___ min. The immediate response is due to ___ and the late response is due to ___

A

less than 30 min

Histamine
Leukotrine

17
Q

What are the 2 types of mast cells? Describe

A

Connective tissue - associated w/ blood
Mucosal - mucosal mast cells

18
Q

Mast cell’s release granules into what 3 locations? What is the effect in each of these?

A

GI tract
- diarrhea and vomiting

Airways
- expulsion of airway contents

Blood vessels
- Increased lymph flow

19
Q

What are the 2 types of allergic manifestations? What are examples of each? Which one has a genetic predisposition?

A

Atopic or local anaphylaxis
-ex: allergic rhinitis (hay fever)
- genetic predisposition

Systemic anaphylaxis
- ex: anaphylactic shock

20
Q

Acute vs. chronic response steps in asthma

A

acute
- Mucosal mast cell captures antigen → antibody response by producing IgE → inflammation causes SM to contract, increase in mucus secretion, increase in blood vessel permeability
- Cytokines produced bring in eosinophils
—Eosinophils can release their toxic substances

chronic
- Mediated by cytokines and eosinophil products

21
Q

systemic anaphylaxis results from ___. What is the local and systemic treatment?

A

systemic release of histamine and leukotrienes
- occurs in minutes

local = antihistamine
systemic = epinephrine

22
Q

Describe skin testing. Immediate response is due to ___ and response ~30 min is due to ___

A

Use to test allergies
Look for wheel (swelling) and flare (reddening around swelling)

leukotrienes
Histamine

23
Q

Describe hypo-sensitive treatment. You can also use a ___ antibody

A
  • If you already know what you’re allergic to
  • Treatment plan that gives you small amount of what you’re allergic to, but not enough to cause a response, only a small immune response
  • IgE antibody starts to decrease over time
  • IgG (blocking antibody) is produced over time in tissue fluid that has a chance to interact w/ allergen causing a problem before it can interact w/ IgE on mast cell

anti-IgE monoclonal antibody

24
Q

4 types of IgE mediated allergic reactions

A

Systemic anaphylaxis
Wheal and flare
allergic rhinitis
bronchial asthma

25
Q

Describe cytotoxic (type II) reaction

A

Antibody is directed against antigen on surface of cell

End result = cell lysis through complement activation

26
Q

Examples of cytotoxic reaction

A

blood transfusion reaction
drug reactions
autoimmune hemolytic anemia
antibody-dependent cell cytotoxicity (ADCC)

27
Q

Describe autoimmune hemolytic anemia

A
  • occurs in cytotoxic reactions
  • Penicillin can either bind to bacterial transpeptidase and inactivate it OR can modify proteins on human RBC to create foreign epitopes (develops antibody against penicillin)
    —End result can be hemolytic anemia
28
Q

Some drugs are ___ that can interact w/ surface proteins of cells and induce an antibody response

A

Haptens
- don’t initiate immune response by themselves but if they react w/ decreased surface proteins they can trigger response

29
Q

Example of antibody-dependent cell cytotoxicity (ADCC)

A

Patient response to therapy directed against B cells employing an anti-CD20 antibody Rituximab → CD20 found on B cells as is CD19
- NK cell has receptor that binds to IgG antibody which causes NK to release (perforin and granzymes)
- Retuximab is front line therapy in treating patients w/ B cell lymphomas

30
Q

Immune complex disease (type III) reaction is initiated by ___. Which can activate ___

A

antigen-antibody complexes which can induce an inflammatory response

Complement system

31
Q

Example of a local response in immune complex disease. It’s ___ induced. It results from and what causes it? Site of reaction?

A

Arthus reaction

Locally

previous exposure to antigen
vaccine

skin

32
Q

What are the 2 responses in immune complex disease?

A

Local and systemic response

33
Q

time of reaction for arthus reaction

A

5-6 hours after injection of antigen

34
Q

Describe systemic reaction in immune complex disease

A

Antigen-antibody complexes circulate throughout bloodstream and settling in organs, like the kidney, and initiation inflammatory response

35
Q

What do neutrophils try to do in the systemic reaction in the immune complex disease?

A

Neutrophils try to remove antigen-antibody complexes and destroy filtration system of kidney → renal failure if it goes on for too long

36
Q

If you have a large dose of drug that’s not cleared right away, you have the ability to make ___, that then over time form ___

A

antibody

antigen:antibody complexes

37
Q

autoimmune disease has continued production of

A

antigen:antibody complex

604 Immuno/Microbio - Exam 3 (5 decks)

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