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Immunology -- Jones > Final- Hypersensitivities > Flashcards

Final- Hypersensitivities Flashcards

1
Q

What is the definition of a Hypersensitivity?

A

response to an Ag that is beyond normal

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2
Q

What are the four types of Hypersensitivity Reactions?

A
  1. Type I (immediate/allergies)
  2. Type II (antibody/cytokines)
  3. Type III (immune complex)
  4. Type IV (cell mediated/delayed)

“ACID”

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3
Q

T/F. Only some forms of Hypersensitivity require prior exposure to the antigen.

A

False– ALL forms require prior exposure

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4
Q

What type of antibodies or cells are involved in each one of the Four hypersensitivites?

A
  1. Type I –> IgE
  2. Type II –> IgM and/or IgG
  3. Type III –> IgM and/or IgG
  4. Type IV–> T cells
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5
Q

How much time does it take before clinical signs show up for the each one of the 4 types of hypersensitivities?

A
  1. Type I –> less than 30 mins
  2. Type II –> 5-12 hrs
  3. Type III –> 3-8 hrs
  4. Type IV –> 24-48 hours
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6
Q

What type of Hypersensitivity is rapid and always involves IgE and the degranulation of basophils or mast cells?

A

Type I (anaphylactic/ allergies)

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7
Q

What type of Hypersensitivity involes IgM or IgG antibodies binding ot cell membranes or ECM and the Ag may be you or exogenous molecules?

A

Type II (cytokine)

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8
Q

What type of Hypersensitivity involves IgM or IgG antibodies binding to soluble Ag’s and forming an anitbody complex and inflammation takes place at sites of deposition of the complexes?

A

Type III (immune complexes)

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9
Q

What type of Hypersensitivity involves direct attack of WBCs w/o using antibodies and T cells initiate the inflammation?

A

Type IV (delayed type)

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10
Q

What type of hypersensitivity is anaphylactic shock from drug injection and insect venom an example of?

A

Type I

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11
Q

What type of hypersensitivity is arthus reactions or serum sickness an example of?

A

Type III

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12
Q

What type of hypersensitivity is transfusion reactions and Rh incompatibility an example of?

A

Type II

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13
Q

What type of hypersensitivity is a rejection of transplanted tissues, contact dermatitis,– like poison ivy, or certain chronic diseases such as Tb examples of?

A

Type IV

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14
Q

What occurs on the initial exposure for a Type I hypersensitivity?

A
  1. allergen enters body
  2. APC eats it
  3. APC presents peptides from allergen on MHC II’s
  4. Helper T cells are activated –> differentiate into the Th-2 subtype (GI system and parasites)
  5. Th-2 cells activate B cells that are specific for allergen
  6. B cells (plasma cells) make IgE specific to allergen (Ag)
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15
Q

When an individual is first exposed to an allergen, do they have a reaction?

A

may not have initial allergic reaction; it takes time for IgE antibodies to accumulate and load onto mast cells

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16
Q

For a Type I Hypersensitivity describe what is occurring during Sensitization. What will a second exposure cause?

A
  • IgE antibodies’ Fc regions bind w/ high affinity to mast cells (which are everywhere in body)
  • Second exposure will ACTIVATE mast cells and degranulation will occur
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17
Q

What occurs during Re-Exposure for a Type I Hypersensitivity?

A

allergen will bind to IgE antibodies which are attached to Mast Cells via there Fc region —-> this will cause degranulation of mast cells and release of chemistry

18
Q

What does the chemistry released by mast cells during the allergic reaction of a Type I hypersensitivity include?

A
  1. vasocative amines (histamine)
  2. prostaglandins
  3. leukotrienes
  4. recruitment of other WBCs (neutrophils and eosinophils)
  5. leaky vessles, edema, smooth muscle spasms, increased mucus secretion, drop in BP
19
Q

What “type” of a Type I hypersensitivity involves being injected via insect sting and may result in shock which could be deadly?

A

Systemic Anaphylaxis

20
Q

What “type” of a Type I hypersensitivity involves generally ingested or inhaled, but could be systemic?

A

Localized Anaphylaxis

21
Q

What are examples of upper respiratory Type I Reactions? How are they Tx?

A

(hay fever)

  • itchy eyes, congestion, sneezing
  • pollen, pet dander, dust mite feces

Tx: antihistamine

22
Q

What is an example of a lower respiratory Type I reactions? How is it Tx?

A
  • asthma

Tx: epinephrine, albuterol

23
Q

What are some common causes and symptoms of a Gastrointestinal Type I reaction?

A

NOT food intolerance!!!!

Causes: Eggs, peanuts, tree grown nuts, milk, soy, fish, wheat, peas

Symptoms: hives

24
Q

How can one prevent a Type I reaction? What is short term Tx for it? What is long term Tx?

A

avoid contact and get a skin test to Dx

Short term–> antihistamine and epinephrine

Long term–> desensitize and convert IgE and IgG

25
Q

How are Type II hypersensitivities mediated?

A

antibody mediated by IgM or IgG (NOT IgE)

26
Q

What do the antibodies bind to that are involved in a Type II reaction?

A

surface of cells (cell membrane) or the ECM

27
Q

What are the two means of destruction for Type II reaction?

A
  1. Antibody-dependent cell -mediated cytotoxicity (ADCC)

2. Complement system

28
Q

Which hypersensitivity is the ADCC involved in? What is it? What occurs?

A

Type II

Antibody-dependent cell-mediated cytotoxicity

WBCs w/ Fc receptors (monocytes, neutrophils, eosinophils, and NK cells) bibind to cells with IgG or IgG antibodies

29
Q

What type of hypersensitivity involves the Complement system? What

A

Type II and Type III b/c IgM and IgG are good at fixing complement

30
Q

What does activating the Complement system for Type II and Type III reactions result in? What Ab are involved?

A

IgM and IgG are good at fixing complement

  • complement proteins may destroy the cells (MACs)
  • Products of the complement proteins activate macrophages and neutrophils
31
Q

What type of hypersensitivity is Hemolytic Disease of the Newborn? When does this occur?

A

Type II reaction

Rh+ father and Rh- mother make Rh+ baby–> 1st child = no issue; 2nd child she has developed Ab’s against Rh now = issues

Mother must take RhoGAM in order to prevent her Ab.s from attacking fetus RBCs

32
Q

What is occurring in a Type III reaction?

A

Antibody-Antigen Complexes accumulate and are deposited in tissues and cause inflammation

(normally they would be cleared, but here they attempt to be, but can’t be = inflammation)

Complement System

33
Q

Where are the deposition of antibodies and antigen complexes that occur in a Type III reaction typically?

A
  • vascular walls –> vasculitis
  • other tissues–> arthritis
  • common in kidneys and joints
34
Q

What type of hypersensitivity is vasculitis an example of? How does this occur?

A

Type III

phagocytes get attracted due to deposition of antibody-antigen complexes–> and cause inflammation by releasing cytokines

35
Q

What hypersensitivity is Rheumatoid Arthritis an example of?

A

Type III–> caused by Ab complex deposition into joints

36
Q

What type of hypersensitivity is an excessive or inappropriate immune response from T cells? What is another name for this reaction?

A

Type IV

DTH = Delayed Type Hypersensitivity

37
Q

What mediates a Type IV reaction?

A

T cell mediated w. help from:

  • CD4 helper T cells
  • CD8 killer T cells
  • macrophages
  • neutorophils
38
Q

T/F. Type IV hypersensitivity involves antibodies.

A

False– it does NOT; it involves T cell mediated response

39
Q

What are Type IV reactions directed against, self or exogenous antigens?

A

BOTH

40
Q

What type of hypersensitivity is Poison Ivy an example of?

A

Type IV

41
Q

T/F. All four types of hypersensitivity occur upon second exposure.

A

True

Immunology -- Jones (14 decks)

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