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Immunology > HYPERSENSITIVITIES:TYPE I HYPERSENSITIVITY > Flashcards

HYPERSENSITIVITIES:TYPE I HYPERSENSITIVITY Flashcards

1
Q

Immune mediated hypersensitivity is

A

An inflammatory response to an antigen that is inappropriate (unwanted)
Antigen is not part of a pathogen.
For example, allergies to pollen
Inflammation is excessive and damages the host more than the pathogens.
Allergies to bee stings

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2
Q

Allergen is

A

Often called allergies.
An inciting antigen is called an allergen.

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3
Q

Allergies and sites

A

May be limited to a specific site.
May involve the whole body.
If this is severe → anaphylactic shock

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4
Q

Anaphylactic shock is

A

Generalized poor tissue perfusion as the result of allergic vasodilation.

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5
Q

Define an alergen

A

an adverse reaction to a substance or material

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6
Q

Define an allergen

A

antigen, the thing causing the allergic reaction

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7
Q

Type 1 hypersensitivity is provoked by

A

IgE

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8
Q

Type 2 hypersensitivity is caused by

A

IgG or IgM binding to normal tissue

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9
Q

Type 3 hypersensitivity is caused by

A

Antibody-antigen complexes activate immune response.

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10
Q

Type 4 is caused by

A

T cells and Macrophages directly cause inflammation.

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11
Q

Type 1 is also called

A

IgE mediated hypersensitivity
Immediate hypersensitivity

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12
Q

What is the most common cause of allergy

A

Exaggerated type I responses are the most common cause of allergy.

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13
Q

Why is type 1 called IgE mediated

A

Because IgE is pre-bound to mast cells
Rapid response to allergen (minutes)

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14
Q

Why does type 1 hyper happen

A

Some animals genetically produce more IgE
Some dogs
Some antigens naturally produce very strong IgE responses.
Wasp and bee stings

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15
Q

How does mast cells work in type 1 hyper

A

Some IgE responses are appropriate.
Mast cells are sentinel cells and use bound IgE as a method to detect invaders.
Internal parasites (worms)
Mast cells can release chitinase. (kayh-tin-aze)
Destroys parasite outer covering.
Attract eosinophils which also help to destroy the worm

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16
Q

Steps after an allergen binds to IgE in type 1 hyper

A

The mast cell degranulators
Release IL-31
Stimulates pruritus
Release histamine and heparin
Vasodilation and increased capillary permeability
Attract eosinophils

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17
Q

IgE bounds to

A

Remember that most IgE is bound to mast cells (some on basophils, eosinophils)

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18
Q

Signs of type 1 hyper

A

Redness, swelling (edema) and itchiness.

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19
Q

Three types of allergic dermatitis

A

Three types: atopy, food allergy, parasite allergy

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20
Q

Atopy defintiion

A

The genetic disposition to allergic disease
An increased production of IgE
Become sensitized to common environmental antigens
Terriers, Dalmations, and Retrievers are particularly susceptible.
Mixed breed dogs are less susceptible

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21
Q

Causes of atopic dermatitis

A

Contact with environmental allergen
Skin keratin defect?
Seen in some people with allergic skin disease.
Microbial colonization
Immune dysregulation

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22
Q

Causes of food allergies

A

Ingested
From gut
A small amount of dietary protein is absorbed intact.
May/may not be GI signs (increased defecation, vomiting, diarrhea)
Absorbed allergen binds to skin mast cells

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23
Q

Signs of allergic dermatitis

A

Often seen in younger adults
Characterized by pruritus
Itching can be intense
Often the first sign

24
Q

Skin lesions caused by allergic dermatitis look like

A

Hives /urticaria
Raised lumps, small or large
Warm, edematous, pruritic
Erythema
“Hot Spots”

25
Q

Signs of atopic skin disesae

A

Skin lesions
Face, feet, axillas, ventral abdomen and groin are common areas affected
Scratching/licking/rubbing leads to secondary damage to skin
Erythema
Hair loss
Thickening
Pigmentation
Secondary infections

26
Q

Food allergies that cause allergic dermatitis c/s

A

Recurrent ear infections
Recurrent anal gland problems
Pruritus – feet, ears,eyes, axilla, perianal region

27
Q

Exclusion diet is and used for

A

Food Allergy
Time consuming – pruritus should improve within 4 weeks; full trail is 8-12 weeks in duration

28
Q

Skin testing is and used for

A

Atopic Dermatitis
Inject potential allergens into skin (ID) and see if there is a reaction.
Largely limited to veterinary dermatologists

29
Q

Serum testing is and used for

A

Atopic Dermatitis
Better at ruling out allergens.

30
Q

Prevention and treatment of allergic dermatitis

A

Washing and bathing
Reduce inflammation
Remove source
Desensitization
Changing to less inflammatory diet
Dietary exclusion

31
Q

How to bath a dog with allergic dermatitis

A

Especially useful for contact dermatitis
tepid/cool water
Emollient (moisturizing) shampoos
Oatmeal is anti-pruritic
Lots of shampoos and topical products available

32
Q

What medications are used for allergic dermatitis

A

Antihistamines – not particularly effective
Corticosteroids – immunosuppressant (high dose) and anti-inflammatory
Atopica (cyclosporin) – immunosuppressant
Oclacitinib (Apoquel)
Janus kinase (JAK) inhibitor
Inhibits IL-31 and other cytokines
Monoclonal antibody against IL-31 (cytopoint)
Reduces pruritus

33
Q

Removing allergen source in allergic dermatitis

A

Look for and remove environmental allergens
Kill fleas and prevent reinfestation.
House/stable horses to avoid culicoides midges
House dust allergies?
Can be very challenging with certain environmental allergens

34
Q

Desensitization fo allergic dermatitis

A

Allergen specific immunotherapy- injectable vs sublingual
Aim is to switch from synthesis of IgE to IgG
Gradually increasing doses of allergens

35
Q

Changing diet for allergic dermatitis

A

Changing to a less inflammatory diet – Atopic Dermatitis
Increase omega-3 fatty acids
Fish
Supports skin barrier

36
Q

Dietary exclusion for allergens

A

Basis of treatment for food allergies
Feed a simple diet
Feed novel proteins
Lamb, duck, venison
Can add back protein sources to identify problem

37
Q

Anaphylaxis caused by parasites

A

Rupture of warble pupae in cattle
Rupture of hydatid (tapeworm) cysts

38
Q

Allergic dermatitis caused by parasites

A

Flea saliva (flea bite hypersensitivity)
Culicoides (midge) bites in horses
Sweet itch – urticaria and intense pruritus
Mosquitos

39
Q

Hay fever and asthma is and caused by

A

Hay fever (allergic rhinitis) and asthma are both IgE mediated hypersensitivities - the difference depends on where the antigen gets trapped.
Large particles get trapped in the upper airways and cause hay fever
Small particles are carried down into the lungs and cause asthma
Mainly a people problem

40
Q

Signs of hay fever and asthma

A

Nose: Sneezing, watery nasal discharge, blocked nasal passages, itchy nose
Eyes: Itchy, red, swollen, may feel gritty, in people blueness below skin
Throat: Soreness, itchy
Sleep – mouth breathing and fatigue

41
Q

Asthma is most common in signs and treatment

A

Cats, basenjis, people and horses
Signs:
Wheezing and dyspnea
Can be acute and severe.
Diagnose by giving bronchodilator

42
Q

Hay fever and asthma in techs

A

Less likely if you have a lot of siblings and were raised on a farm.
More likely if there is a family history.
Can be seasonal.
Often an allergy to pollens from any type of plant or spores from fungi
Can occur year round
Often an allergy to dust mites, roaches, animal dander, fungi, and molds
Dander allergies are more of a concern if you work indoors.
Fine dander (cats and rabbits) is more likely to cause asthma and/or hay fever.
In cats, the main allergen is a salivary protein that gets stuck to hair during grooming
A feline diet containing antibodies against cat allergens reduces allergic burden and helps people with allergies.
Purina Pro Plan LiveClear

43
Q

Anaphylactic shock occurs due to

A

Generalized mast cell degranualtion

44
Q

Anaphylactic is a concern when

A

Giving any biological product
e.g. Vaccines, Penicillin

45
Q

How long does anaphylactics take to develop

A

Typically 15-30 minutes

46
Q

What to have on hand for anaphylaxis

A

Should always have epinephrine, antihistamines, and corticosteroids on hand
Fatal if not recognized and treated promptly.

47
Q

Which organ predominates depends on the species in anaphylaxis

A

Lungs and the GI tract are the major shock organs
Which organ predominates depends on the species
Lungs and GI – horses, cats
Lungs only – cattle, sheep
Liver – dogs

48
Q

Why are the kidneys and skeletal muscles NOT affected by anaphylaxis?

A

Few sentinel cells

49
Q

Resp signs of anaphylaxis

A

Increased RR
Dyspnea
Cough

50
Q

GI signs of anaphylaxis

A

Vomiting (not in horses or rabbits)
Increased defecation/diarrhea (may be bloody)

51
Q

Signs not involving resp or GI in anaphylaxis

A

Cats - irritation and scratching around the head.
Urination
Weakness (lethargic)
Lack of coordination (ataxia)
Collapse
Death

52
Q

Antihistamines are given by and used for

A

Diphenhydramine (Benadryl)
2-4 mg/kg IM, PO, SQ every 8-12 hours
Injectable to treat an allergic reaction or anaphylaxis
Oral if given prophylactically or after initial injection.

53
Q

Epinephrine works by

A

Stabilizes mast cells
Reverses vasodilation
Dilates smooth muscle (helps breathing)
Rapidly absorb if given IM or SQ
Dose for cats and dogs is 0.1 to 0.5 mL of 1:1000 epinephrine.

54
Q

Which Corticosteroids are used for anaphylaxis

A

Prednisolone sodium succinate (Solu-Delta-Cortef)
Dexamethasone in water
-Not the propylene glycol preparation
-Not absorbed properly if in the propylene glycol

55
Q
A

Immunology (21 decks)

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