Allergy Flashcards
What is hypersensitivity?
Undesirable, damaging, discomfort-producing and sometimes fatal reactions produced by the normal immune system (directed against innocuous antigens) in a pre-sensitized (immune) host.
What is the immunopathogenesis of type II (cytotoxic) hypersensitivity?
IgG/IgM Ab response against combined self/foreign antigen at the cell surface- complement activation/phagocytosis/ADCC.
What are the clinical features of type II hypersensitivity?
- Onset minutes to hours
- Cell lysis and necrosis
What is a common antigen that stimulates type II reactions?
Penicillin.
What diseases are associated with type II hypersensitivity?
- Erythroblastosis fetalis,
- Goodpasture’s nephritis
What is the immunopathogenesis of type III (immune complex) hypersensitivity?
IgG/IgM Ab against soluble antigen- immune complex deposition.
What are the clinical features of type III hypersensitivity?
- Onset 3-8h
- Vasculitis
What is type III hypersensitivity traditionally associated with?
Serum sickness
What is the immunopathology of type IV (delayed) hypersensitivity?
Antigen specific T-cell mediated cytotoxicity
What are the clinical features of type IV hypersensitivity?
- Delayed onset 48-72h
- Erythema induration
Which antigens are commonly associated with type IV hypersensitivity?
- Metals-e.g nickel
- (tuberculin reaction)
- Poison ivy
What disease is commonly associated with type IV hypersensitivity?
Contact dermatitis
What is the hygiene hypothesis?
- Stimulation by microbes is protective
- Epidemiological data – Increase in Allergy
- Animal Models – T1DM, EAE, Asthma
- Increased atopy (Asthma) after anti-parasitic Rx
- Prevention of autoimmunity (Crohn’s) by infections
- Pro-biotics in pregnant women
- Mechanism – Th1 Th2 deviation
What are the genetic influences on the immune response?
- Polygenic diseases
- Cytokine gene cluster IL3,5,9,13
- IL12R; IL4R
- FceRI
- IFNg; TNF
- NOT sufficient for disease
- ONLY susceptibility
What are allergens?
- Antigens that initiate an IgE-mediated response
- First encounter results in innate & IgM response