Allergy and asthma

Question 1

Immune response to asthma

Answer 1

• Protein presented to dendritic cells
• Presented to T cell on MHC ii
• Dendritic cells release IL-4
• Differentiation into Th2 cells + clonal expansion
• Class switching to IgE
• Memory B cell made

Question 2

Th2 and IL-4

Answer 2

Induces B cell switching to IgE production

Opposes Th1 activity

Question 3

TH2 and Il5

Answer 3

Eosinophil growth factor

Question 4

TH2 and IL13

Answer 4

Acts on epithelial cell and smooth muscle

Question 5

TH17 and IL17

Answer 5

Enhancement of eosinophil recruitment

Question 6

Th1 and IFN-y

Answer 6

IFN-y inhibits switch to IgE

Question 7

Sx of IgE mediated response

Answer 7

• Hives
• Angioedema
• Palatal itching

Question 8

Sx of non-IgE mediated response

Answer 8

• Eczema flare up
• Food aversion
• Spitting up
• Colicky children
• Pallor due to anaemia
• Faltering growth

Question 9

Diagnosing allergy

Answer 9

IgE mediated - skin prick testing

Question 10

Anaphylaxis tx

Answer 10

Antihistamines and salbutamol steroids

Question 11

What is anaphylaxis?

Answer 11

• Potentially life threatening systemic hypersensitivity reaction
• Rapid in onset, airway/breathing/circulatory problems, mucosal/skin changes

Question 12

Anaphylaxis sx

Answer 12

Hives, swelling, coughing, nausea, dizziness, anxiety etc

Question 13

Anaphylaxis tx

Answer 13

Adrenaline injection

Call 999

Question 14

Allergen immunotherapy

Answer 14

• Sublingually under the tongue or subcutaneously into skin or orally via food
• You want to decrease IgE
• You want to increase IgG4 and IgA (blocking antibodies)
• You want to increase Il-10 (decreasing TH2 cytokines)
• Decreases allergen proliferation and decreases tissue damage