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Immunology > allergy and hypersensitivity > Flashcards

allergy and hypersensitivity Flashcards

1
Q

Give examples of clinical indications of allergy

A 
epithelial - eczema, itching, reddening
XS mucus production
airway constriction
abdominal bloating, vomiting, diarrhoea
anaphylaxis
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2
Q

Define allergy

A

abnormal response to harmless foreign material

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3
Q

What is atopy?

A

a hereditary predisposition to the development of immediate hypersensitivity reactions against common environmental antigens

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4
Q

Give examples of allergic diseases/ causes of allergy

A

Rhinitis, anaphylaxis, asthma, dermatitis, eczema, insect venom, food allergies, medication

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5
Q

Give examples of allergens

A

Pollen, house dust mites, animal fur, nickel, foods

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6
Q

Which cells are involved in allergy?

A

mast, eosinophil, basophil, lymphocytes (Th2), dendritic cells (APC), smooth muscle, fibroblasts, epithelial, neurones (coughing and sneezing)

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7
Q

IgE has a short half life. T or F

A

True as it is only 2.5 days

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8
Q

IgE fixes complement. T or F

A

F

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9
Q

What needs to happen to the IgE receptors before a cellular response occurs

A

cross-linking

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10
Q

What is the low affinity IgE receptor called?

A

FceRII

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11
Q

Which cells express low-affinity IgE receptors?

A

B cells, T cells, monocytes, eosinophils, platelets and neutrophils

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12
Q

What is the function of the low-affinity IgE receptor?

A
  1. regulates IgE synthesis
  2. triggering of cytokine release by monocytes
  3. antigen presentation by cells
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13
Q

What are the three major cell types that express high affintiy IgE receptor?

A
  1. eosinophils
  2. mast cells
  3. basophils
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14
Q

What protein do mast cells require?

A

c-kit

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15
Q

What preformed compounds to mast cells contain?

A
  1. histamine
  2. chemotactic factors
  3. proteases
  4. proteoglycans
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16
Q

What lipid derived mediators do mast cells contain?

A

leukotrienes
prostaglandin D2
platelet activating factor

17
Q

What type of cell do mast cells activate with their chemokines?

A

eosinophils (macrophages nd neutrophils)

18
Q

What factors activate mast cells?

A 
allergens 
bacterial/viral antigens 
phagocytosis of enterobacteria
cold/mechanical defomation
aspirin, latex, proteases
19
Q

Which T cells response is activated by mast cells?

A

Th2 (IL-4,5,10)

20
Q

What are the characterisitics of an allergen?

A

weak PAMPs
nasal/skin delivery
low dose

21
Q

Can you get allergic responses without IgE bind initially?

A

Yes, some allergens can stimulate the production of IL-4 from mast cells. IL-4 leads to isotype switching in B cells to IgE production. The IgE then activates mast cells - cycle

22
Q

Give cardiovascular changes in anaphylaxis

A

vasodilation
increased vascular permeability
lower BP

23
Q

Give respiratory changes in anaphylaxis

A

bronchial smooth muscle contraction

mucus

24
Q

Give dermatological changes in anaphylaxis

A

rash

swelling

25
Q

Give GI symptoms in anaphylaxis

A

pain

vomiting

26
Q

Name the 6 treatment strategies for allergic disease

A
  1. avoid the allergen
  2. desensitise to allergen
  3. prevent IgE production
  4. prevent IgE interaction with receptor
  5. prevent mast cell activation
  6. inhibit mast cell products
27
Q

Give two routes of desensitisation

A

sublingual

subcutaneous

28
Q

Give ways to prevent IgE production

A
  1. suppression of Th2 responses - allergens fused to the cholera toxin
  2. suppressive cytokines eg IL12 that reduces eosinophilia and IL-18 that reduces IgE production
  3. blocking cytokines - IL-4 antagonist
  4. targeting CD23 associated with low affinity IgE receptors to reduce IgE levels
29
Q

Give a drug to block binding of IgE to its high affinity receptor

A

Omalizumab

30
Q

Give disadvantages of Omalizumab

A

very high cost
increase in cancer incidence
anaphylaxis
not recommended where intestinal parasites are present

31
Q

Give examples of two anti-cytokine antibodies permitted by NICE

A

IL-5 antibodies

IL-2 antibodies

32
Q

Give methods to prevent mast cell activation

A
  1. membrane stabilisers
  2. beta-2-agonists (increase camp leading do bronchodilation)
  3. channel blockers
  4. signalling inhibitors
  5. glucocorticoid - inhibit gene transcription
33
Q

Name some mast cell product inhibitors

A
  1. histamine receptor antagonists
  2. leukotriene and prostaglandin antagonists
  3. tryptase inhibitors
  4. protease-activated receptor antagonists

Immunology (4 decks)

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