Hypersensitivity 2 Flashcards
What immunoglobulins mediate type II hypersensitivity?
Mediated by IgG or IgM reacting with antigen present on surface of cell:
- Bound IgG then interacts with complement or with Fc receptor on macrophages
- Causing opsonisation of target cells (more susceptible to phagocytosis)
- Take several hours
What are the different effects that type II hypersensitivity can cause?
- Damage to red cells
- Haemolysis
- Damage to solid tissues
- Functional effects

What are examples of type II hypersensitivity?
- Immune mediated haemolysis, such as autoimmune haemolytic anaemia
- Destruction of solid tissues, such as Goodpasture syndrome
- Affects function, such as Graves disease
What are the different variations of blood type?
- Rhesus positive or negative
- I positive or negative
- Group A, B or O
What is a consequence of A and B blood group antigens being oligosaccharides which are similar to molecule exposed by bacteria?
- So have naturally occurring antibodies that recognise them unless we are same blood group
- People who are group O have antibodies against both A and B
- People who are AB have antigens against neither
- Anti-A and Anti-B are IgM antibodies
People who are group O have antibodies against what groups?
A and B
People who are group AB have antibodies against what groups?
None
What type of antibodies are anti-A and anti-B?
IgM antibodies
What is unique about IgM?
IgM antibodies are multivariant (can combine to multiple antigens)
What is a complication of IgM being multivariant?
IgM antibodies are multivariant (can combine to multiple antigens):
- Causes agglutinate of red blood cells
- IgM activates complement and the membrane attack complex destroying RBC

How does IgG lead to destruction of red cells?
IgG does not damage circulating red cells:
- Fc receptors on splenic macrophages bind IgG coated red cells, which are then destroyed

What can autoimmune haemolysis occur due to?
- Rhesus antigen (IgG develops during pregnancy and crosses the placenta and causes haemolytic disease
- Incompatibility in the ABO system during blood transfusion

What can autoimmune haemolytic anaemia be caused by?
- Induced by infections or drugs
- Part of systematic autoimmune disease (SLE)
- Autoantibodies produced by malignant B cells
Describe the pathophysiology of Goodpasture syndrome?
- IgG autoantibodies bind a glycoprotein in basement membrane of lung and glomeruli
- Anti-basement membrane antibody activates complement, triggering inflammatory response
Describe the genetics of Graves disease?
- Family history
- HLA allele DR3