Hypersensitivities Flashcards
Which type of immune response is immediate and associated with allergies?
Type I
Which type of immune response is immune complex mediated?
Type III
Which type of immune response is T cell-mediated (example = poison ivy)?
Type IV
Which type of immune response is antibody mediated?
Technically Types I-III, but specifically Type II
Which antibody is associated with Type I hypersensitivity?
IgE
Which antibody is associated with Type II hypersensitivity?
IgM and/or IgG
Which antibody is associated with Type III hypersensitivity?
Usually IgM and/or IgG
Which antibody is associated with Type IV hypersensitivity?
NONE :)
What cells are associated with Type IV hypersensitivity?
T cells
What thing do all forms of hypersensitivity require?
Prior exposure to the antigen
What is the result of prolonged or repeated exposure to an antigen?
Tissue damage
How is the immune response to the antigen unique in hypersensitivity reactions?
Excessive or inappropriate
What kinds of antigens can be targeted by hypersensitivity reactions?
Both self antigens or foreign antigens
What results from a hypersensitivity reaction targeting self antigens?
Autoimmune disease
Type I hypersensitivites occur within what kind of time frame after antigen exposure?
Within minutes or hours
What is usually the term for the antigens involved in Type I hypersensitivities?
Allergens
About what percentage of the population suffers from Type I hypersensitivity reactions?
54%
What are the chain of events of an allergic reaction?
1 allergen enters body 2 APC eats it 3 APC presents peptides on MHC II 4 helper T cells are activated 5 helper T cells activate B cells (plasma cells) specific to antigen 6 B cells make IgE
The activated helper T cells in an allergic response differentiate into which bias subtype?
Th2 (strong response)
What cytokines cause the antibody class switching to IgE?
IL-4 and IL-13
How long do IgE antibodies live in the blood?
About a day
In what circumstance do IgE antibodies have a half life of several weeks?
When attached to mast cells
Why is it common for a person to not have an initial allergic reaction to the first exposure of an antigen?
Takes a while for IgE antibodies to accumulate and load onto mast cells
What specific part of the IgE antibodies have a high binding affinity to mast cells?
Fc regions
Where are mast cells found in the body?
Everywhere
Which exposure to an allergen will activate mast cells?
Second
What is the result of multiple allergens binding to IgE antibodies on mast cells (clustering)?
Mast cell degranulation and release of “chemistry”
What is included in the immediate early phase of chemistry released by mast cells during an allergic reaction?
Vasoactive amines (ex. = histamine), proteases, prostaglandins
What is included in the late phase of chemistry released by mast cells (6-24 hours)?
IL-4 and TNF pull in other WBCs like neutrophils and eosinophils
What is the order in which these cells respond to an allergic reaction: basophils, mast cells, eosinophils?
1 mast cells (immediate response) 2 basophils (rapid response) 3 eosinophils (delayed response)
Where do basophils come from during an allergic response?
Brought into tissue from blood by signals sent by mast cells
Where do eosinophils come from during an allergic response?
Recruited from bone marrow (T helper secreting IL-5)
Which cell type plays a prominent player in chronic allergic reactions: mast cells, basophils, eosinophils?
Eosinophils
Which cells involved in an allergic response exhibit degranulation?
Mast cells and basophils
Which cells involved in an allergic response have receptors for IgE?
Mast cells and basophils
What is the term for allergic people?
Atopic individuals
What antibodies are mainly produced by non-atopic individuals (non-allergic people)?
IgG
What kind of people produce large quantities of IgE antibodies?
Atopic (IgE blood levels can be 1000 to 10,000X greater)
What respiratory condition is coupled with allergies a lot of the time?
Asthma
The placenta makes a lot of which cytokine?
IL-4
What is the function of IL-4?
Makes helper T cells become Th2 cells
Why do atopic individuals produce IgE antibodies?
Because their allergen-specific helper T cells tend to be of theTh2 type
What is the hygiene hypothesis?
Theory that the increase of allergies in society is due to the reduction in exposure to microbes in the first years of life
When exposed to allergens or microbial infections early in life, the immune system is suspected to bias toward what type of helper T cells?
Th1 (aka less allergy potential)
In Type II hypersensitivity reactions, to where do antibodies (IgM or IgG) bind?
Surface of cells (cell membrane) or ECM
What are the means of destruction with Type II hypersensitivity reactions?
Antibody-mediated cell-mediated cytotoxicity (ADCC)
Complement system
Functional derangements
Which WBCs bind to cells with IgG or IgM antibodies?
Monocytes, neutrophils, eosinophils, and NK cells
Which form of destruction of Type II hypersensitivity reactions is complement-independent?
ADCC
Which antibody types are good at fixing complement?
IgM and IgG
What is the function of the products of the complement proteins?
Activate macrophages and neutrophils
Can antibodies act as agonists or antagonists to cell receptors?
Both :)
Myasthenia gravis and pernicious anemia are examples of what type of hypersensitivity?
Type II
What is the mechanism of destruction for Myasthenia gravis?
Antibodies act as competitive antagonists to acetylcholine within the neuromuscular junction
What is the mechanism of destruction for pernicious anemia?
Antibodies react with intrinsic factor not permitting absorption of cobalamin (B12)
Is inflammation always present with Type II hypersensitivities?
May occur with or without inflammation
What occurs with hemolytic anemias?
1 antibodies bind to CHO or proteins on RBCs
2 RBCs are phagocytized
3 RBCs quickly lysed
A blood transfusion mismatch is an example of what condition and what type of hypersensitivity reaction?
Hemolytic anemia; Type II hypersensitivity
What occurs with molecular mimicry?
Lymphocytes are activated by non-self that look similar to “self”, then lymphocytes attack both self and non-self
Do BCRs and TCRs usually recognize just one antigen?
Rarely; usually multiple with different affinities
What two guards prevent self-reactive lymphocytes from becoming active and dangerous?
1 receptor affinity too low to trigger activation
2 restricted traffic patterns prevent them from encountering self-antigen
In Rheumatic Heart Disease, the helper T cells from a strep throat infect cross-react with what?
Protein present on mitral valve of heart
What is the result from the cross-reaction between helper T cells from strep throat at the proteins present on the mitral valve?
Inflammatory attack on heart
What is the term for the result of deposition of antibodies and antigens complexes into vascular walls? Other tissues?
Vasculitis; arthritis
What kind of structures accumulate more antibody-antigen complexes leading to more inflammation due to a Type III hypersensitivity reaction?
Small blood vessels under higher pressures (kidneys, joints)
What is the term for localized Type III hypersensitivity reactions?
Arthus reactions
What gender is primarily affected by SLE (lupus)?
Women (90%)
What parts of the body are targeted by lupus?
Lungs, joints, kidneys
Lupus is associated with intolerance of which cells?
B and T cells
Lupus is an example of what kind of hypersensitivity reaction?
Type III (complex formed by antibodies)
What are the two types of Type IV hypersensitivity reactions?
Delayed type hypersensitivity (DTH)
Cell mediated cytotoxicity
What type of helper T cells are associated with delayed type hypersensitivity (Type IV)?
Mediated by CD4 helper T cells (Th1 and Th17 cells)
What type of helper T cells are associated with cell-mediated cytotoxicity (Type IV)?
Mediated by CD8 killer T cells
Which type of hypersensitivity reaction does NOT involved antibodies?
Type IV
What kinds of things can trigger Type IV hypersensitivity reactions?
Bacteria, fungi, viruses
Contact dermatitis, poison ivy, Crohn’s disease, type I diabetes, and MS are all examples of which type of specific hypersensitivity reactions?
Delayed Type Hypersensitivity (Type IV)
What cytokine is associated with Delayed Type Hypersensitivity?
INF-gamma secreted by Th1 cells
What cells are responsible for the majority of the damage caused by DTH (Type IV hypersensitivity) reactions/
Macrophages (stimulated by INF-gamma)
What causes fibrosis seen in DTH?
Stimulation of fibroblasts by macrophages thus leading to fibrosis
What type of cells attack the pancreatic beta cells in Type I diabetes?
CTLs
What is the target of MS?
Myelin basic protein
T cells isolated from MS patients can also recognize peptides derived from proteins encoded by what two viruses?
Herpes simplex and Epstein-Barr
What is the strong genetic protein associated with MS?
MHC II gene
What substances are used by killer T cells to kill cells displaying foreign antigens?
Perforin or granzyme B
What is the major reason why organ transplants are rejected?
Killer T cells release INF-gamma to activate macrophages to induce fibrosis (Cell-mediated cytotoxicity)
Viral hepatitis is an example of what specific hypersensitivity reaction?
Cell-mediated Cytotoxicity (Type IV)
Where does inflammation take place with a Type III hypersensitivity reaction?
At sites of deposition of immune complexes
Rheumatoid arthritis is an example of which type of hypersensitivity reaction?
Type III
Chronic transplant rejection is an example of which type of hypersensitivity reaction?
DTH (Type IV)
What does Human Immunodeficiency Virus Number 1 infect?
Helper T cells beneath rectal or vaginal mucosa
The HIV number 1 docks on what proteins?
CD4
What happens to the immune system with an HIV infection?
Immunosuppression, susceptibility to infections that normally aren’t an issue