German - Hypersensitivity, Allergy, And Chronic Inflammation

Question 1

What does “ana” mean?

What does “phylaxis” mean?

Answer 1

Ana - Against

Phylaxis - Protection

Question 2

What is anaphylaxis?

Answer 2

Severe, immediate, and system-wide harmful immune response to a non-pathogenic antigen
-First identified hypersensitivity rxn

Question 3

What is a hypersensitivity rxn?

Answer 3

Immediate or delayed immune response to innocuous antigens which often results in healthy tissue damage

Question 4

What are the 4 types of hypersensitivity rxns?

Answer 4

Types I, II, III, and IV

Question 5

Which types are humorally-mediated?

Answer 5

Types I, II, and III

-Mediated by antibody

Question 6

Which type is cell-mediated?

Answer 6

Type IV

Question 7

Type I leads to what?

Answer 7

Degranulation

Question 8

Type II leads to what?

Answer 8

Complement

ADCC

Question 9

Type III leads to what?

Answer 9

Antibody complex deposition

Question 10

Type IV leads to what?

Answer 10

T cell sensitization

Question 11

Type I mostly deal with what Ig?

Answer 11

IgE

Question 12

Type II mostly deals with what Ig?

Answer 12

IgG

*Cell-directed

Question 13

Type III deals with what Ig?

Answer 13

IgG, IgM

Question 14

What is an allergen?

Answer 14

Non-pathogenic antigens that illicit hypersensitivity rxns

Question 15

What are allergens?

Answer 15

Proteins or glycoproteins

Enzymatic activity, often proteases

Interact with PRRs

• Pollen
• Dust mite feces
• Venom
• Drugs
• Peanuts
• Shellfish

Question 16

Allergen-IgE activation activates what granulocytes?

Answer 16

Mast cells

Basophils

Eosinophils

Question 17

Localized hypersensitivity is presented how?

Answer 17

Allergic rhinitis (Hayfever)

Allergic asthma

Eczema

Food allergies

Systemic: anaphylactic shock

Question 18

__________ are Th2 effectors in parasite immunity.

Answer 18

Granulocytes

Question 19

T/F - Mast cell degranulation drives inflammation.

Answer 19

TRUE

*This is the first cell that responds in an allergic rxn

Question 20

Mast cell activation in the GI tract?

Answer 20

Increased fluid secretion and peristalsis

-Expulsion of GI tract contents by diarrhea and/or vomiting

Question 21

Mast cell activation in airways leads to what?

Answer 21

Decreased diameter, increased mucus secretion

Expulsion of airway contents thru coughing, sneezing, and expulsion of phlegm

Question 22

Mast cell activation in the blood vessels results in what?

Answer 22

Increased blood flow, increased permeability

Edema and inflammation, increased flow of antigens in lymph to lymph nodes

Question 23

Enzyme products and effects?

Answer 23

Tryptase, Chumash, cathepsin G, carboxypeptidase

Remodel CT matrix

Question 24

Toxic mediator products and biological effects?

Answer 24

Histamine, heparin

Poison parasites
Increase vascular permeability
Cause smooth muscle contraction

Question 25

T/F - Eosinophil degranulation is toxic.

Answer 25

TRUE

Question 26

What are eosinophils activated by?

Answer 26

Mast cells Th2 cytokines *They express Fcepsilon receptors upon activation

Question 27

What is the hygiene hypothesis?

Answer 27

Reduced early developmental immune pressure causes poor immune education and an inappropriate pathogen ID, leading to allergy, and autoimmune disorders

Question 28

T/F - Where parasites are more prevalent, allergies are less prevalent, and vice versa.

Answer 28

TRUE

Question 29

1st exposure: what? 2nd exposure: what?

Answer 29

1st: Antibodies created 2nd: Sensitized mast cells come into contact and degranulate

Question 30

What are the 2 phases of allergic rxns?

Answer 30

Immediate -Mast cell activation —Small bubble Late -Vascular permeability increased and leads to localized swelling —Large mass

Question 31

What halts anaphylactic shock?

Answer 31

Epinephrine

Question 32

Is anaphylactic shock immediate or late?

Answer 32

Immediate | -0-5 minutes

Question 33

What happens in anaphylactic shock?

Answer 33

Antigen in bloodstream enters tissues and activates CT mast cells throughout the body

Question 34

What does anaphylactic shock do to the heart and vascular system?

Answer 34

Increased capillary permeability and entry of fluid into tissues Swelling of tissues including tongue Loss of blood pressure Reduced O2 to tissues Irregular heartbeat Loss of consciousness

Question 35

What does anaphylactic shock do to the respiratory tract?

Answer 35

Contraction of smooth muscle and constriction of throat and airways Difficulty in swallowing Difficulty in breathing Wheezing

Question 36

What does anaphylactic shock do to the GI tract?

Answer 36

Contraction of smooth muscle Stomach cramps Vomiting Fluid outflow into gut Diarrhea

Question 37

How can allergies be gotten rid of?

Answer 37

Hyposensitization (Immunotherapy): Repeated exposure to escalating dosages of allergens to reduce type I responses - Allergy shots - Most effective allergy tx * T cell can desensitize * Inhibitory signals overwhelm activating signals and the macrophage does NOT secrete inflammatory cytokines

Question 38

Other type I treatments?

Answer 38

Antihistamines Leukotriene antagonists Corticosteroids Immunotherapeutics -Anti-IgE prevents mast cell from acquiring cell-surface IgE. Mast cell can’t be activated thru FcepsilonRI and downregs its cell-surface expression

Question 39

What is hyposensitization?

Answer 39

Repeated exposure to escalating dosages of allergens to reduce Type I responses

Question 40

Tell me about Type II hypersensitization.

Answer 40

Antibody-mediated rxns IgG response to small molcules bound to cell surfaces Complement or ADCC Antibodies against self antigen Drug allergies Graft rejection Autoimmunity

Question 41

Type ____ hypersensitivity causes newborn hemolytic disease?

Answer 41

II *Rh- mother carries an Rh+ fetus **Anti-Rh IgG developed during the 1st pregnancy **Future Rh+ fetuses are targeted by maternal IgG -This results in erythroblastosis fetalis (attacking of the fetal RBCs) —Rhogam prevents erythroblastosis fetalis

Question 42

Type III hypersensitivities are mediated by what Igs?

Answer 42

IgG *Immune complex rxns*

Question 43

Tell me more about type III.

Answer 43

Complexes deposited in blood vessels and tissues Innate inflammatory response Inflammatory lesions - Clots - Fever - Skin rash - Rheumatoid arthritis

Question 44

Tell me about Type IV Hypersensitivity.

Answer 44

Cell-Mediated Delayed-Type Hypersensitivity * Minutes to hours after contact* * Recruitment of macrophages and CD4 T cells to site of contact* - Contacted material fx as adjuvants - Cell mediated, not humoral

Question 45

What are the 2 phases of Type IV Hypersensitivity?

Answer 45

Sensitization Effector

Question 46

Give me an example of an adjuvant.

Answer 46

Poison ivy -Pentadecacatechol is the adjuvant —Skin proteins are targets —Dermatitis only develops on the second contact

Question 47

Sensitization phase of Type IV?

Answer 47

Macrophages and CD4 cells

Question 48

Effector phase of Type IV?

Answer 48

Cytokines

Question 49

What cytokines are associated with chronic inflammation?

Answer 49

IL-1beta IL-6 IL-18 TNFalpha

Question 50

What are three key pathogens in periodontitis?

Answer 50

P gingivalis Tannerella forsythia Treponema denticola *PG Too Few TD*

Question 51

T/F - Periodontitis may be linked to systemic inflammation and disease.

Answer 51

TRUE

Question 52

In chronic inflammation, what does the liver release?

Answer 52

CRP Fibrinogen Serum amyloid A

Question 53

Which granulocytes are involved in Type I?

Answer 53

Mast cells Eosinophils

Question 54

T/F - Periodontitis is related to whole body inflammation.

Answer 54

TRUE