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Host and Defense > Hypersensitivity, Allergy, and Chronic Inflammation > Flashcards

Hypersensitivity, Allergy, and Chronic Inflammation Flashcards

1
Q

what is anaphylaxis

A

a severe, immediate and system-wide harmful immune response to a non-pathogenic antigen

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2
Q

what is a hypersensitivity reaction

A

an immediate or delayed immune response to innocuous antigens(often, but not always) resulting in healthy tissue damage.
-the antigen should not be harmful normally

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3
Q

how many types of hypersensitivity reactions are there?

A

4

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4
Q

what types are humorally mediated?

A

type 1-3

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5
Q

what types are cellular mediated?

A

type 4

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6
Q

what is type 1 hypersensitivity?

A

mast cell degranulation

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7
Q

what is type 2 hypersensitivity?

A

due to IgG and IgM that initiate a complement response or a ADCC

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8
Q

what is type 3 hypersensitivity?

A

anti body complex deposistion

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9
Q

what is type 4 hypersensitivity?

A

T cell sensitization

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10
Q

Allergy: A type I hypersensitivity reaction

A 
Allergen-IgE activation of granulocytes
-Mast cells
-basophils
-eosinophils
immediate hypersensitivity 
localized
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11
Q

what is an allergen?

A

a non-pathogenic antigen that illicit hypersensitivity reactions

  • proteins or glycoproteins
  • enzymatic activity
  • interact with PRR
  • low, persistent concentrations at mucosal surfaces
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12
Q

what is the mechanism of a type I allergy?

A

Ag induces cross linking of IgE bound to mast cells and basophils with release of vasoactive mediators

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13
Q

typical manifestations of type I allergy

A 
systemic anaphylaxis 
localized anaphylaxis
-hay fever
-asthma
-hives
-food
-eczema
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14
Q

what cells is the Th2 effector cell in parasite immunity?

A

Granulocytes

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15
Q

how does the body deal with parasitic diseases, 3 ways?

A

degranulation
sequestration
excretion (proteolytic enzymes)

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16
Q

How does mast cell degranulation drive inflammation?

A
  • histamine/heparin-increase vascular permeability, SM contraction
  • TNF alpha- promotes inflammation
  • Tryptase, chymase, cathepsin G, carboxypeptidase remodel CT matrix
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17
Q

mast cell deregulation effect on the GI, Airways and blood vessels

A

GI- increased fluid excretion
Airway- decreases diameter, increased mucous secretion
Blood vessels- increases blood flow, increased permeabil

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18
Q

Eosinophil degranulation is?

A

toxic

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19
Q

what causes eosinophil degranulation?

A

mast cell and Th2 cytokines

-express Fc receptors upon activation

20
Q

what do the granules of the eosinophils do?

A

they are highly toxic and promote further inflammation

21
Q

what is the hygiene hypothesis?

A

reduced early developmental immune pressure causes poor immune education and an inappropriate pathogen identification, leading to allergy and autoimmune disorders
-basically lack of parasites leads to allergies and autoimmune disease

22
Q

Development of type I hypersensitivity causes immediate what?

A

mast cell degranulation of histamine, heparin, TNF alpha, and proteases
-also recruit eosinophils

23
Q

allergic reactions occur in two phases what are they?

A
  • immediate-mast cells are activated leading to localized swelling. Looks like a hive
  • late- the inflammatory process leading to a typical response with leukocytes and such
24
Q

anaphylactic shock:

A

rapid, systemic and deadly allergic reactions

  • basically a hyper immediate response
  • systemic mast cell degranulation
25
Q

what halts anaphylactic shock?

A

epinephrine- due to a sympathetic response, which basically reverses the allergic response
epi-pens

26
Q

what are some therapeutic interventions that can resolve type I allergies?

A 
allergy shots
antihistamines
leukotriene antagonists
corticosteroids
immunotherapeutics
27
Q

what is hyposensitization?

A

repeated exposure to escalating dosage of allergens to reduce a type I response

28
Q

what are the two possible models of how hyposensitization work?

A
  1. tolerance is built up by the production of T reg cells

2. Desensitization- IgG4 inhibit inflammatory response by binding up Fc receptors on macs

29
Q

Type II hyper sensitization: Antibody-mediated reactions

A
  • IgG response to small molecules bound to cell surfaces
  • *-complement or Ab-directed cellular cytotoxicity
  • Abs against self antigen
  • drug allergies
  • graft rejection
  • autoimmunity
30
Q

what is Newborn hemolytic disease?

A

Type II hypersensitivity reaction

  • Rh- mother caries an Rh+ fetus leads to anti-Rh IgG in 1st pregnancy
  • future Rh+ fetuses are targeted by maternal IgG
31
Q

what prevents newborn hemolytic disease?

A

Rhogam- binds the Rh+ on the fetus

32
Q

Type III hypersensitivity: immune complex reactions

A

inefficient immune complex clearance
-Ag-Ab lattices
-Ags with high affinity for tissue surfaces
-highly charged antigens
-compromised phagocytosis
complexes deposited in blood vessels and tissues
-Innate inflammatory response

33
Q

what are some manifestations of type III hypersensitivity?

A 
clot formation
fever
skin rash
Rheumatoid arthritis 
lupus
34
Q

mechanism for type III hypersensitivity?

A

Ag-Ab complexes deposited in various tissues induce complement activation and an ensuing inflammatory response mediated by massive infiltration of neutrophils

35
Q

Type IV hypersensitivity: cell-mediated delayed type hypersensitivity

A

contacted materials function as adjuvants

  • chemically modify human antigens
  • complex initiates an immune response
  • *cell mediated NOT humoral
36
Q

what are the two cells responsible for type IV hypersensitivity?

A

CD4 and macrophage mediated

37
Q

what are the two phases of type IV hypersensitivity?

A
  • sensitization-priming step usually no reaction

- effector-the reaction that happens days later

38
Q

type IV hypersensitivity mechanism?

A

sensitized CD4 T cells release cytokines that activate macs which mediate direct cellular damage

39
Q

how is poison ivy a type IV delayed hypersensitivity?

A

the pentadecacatechol oil of the ivy combines with skin protein as an adjuvant.

  • this is no antigenic to the human
  • next exposure leads to a effector response
40
Q

chronic inflammation cytokines

A

IL-6
TNF alpha
IL-1 beta
IL-18

41
Q

non-infectious causes of chronic inflammation?

A

obesity
tissue damage
heart disease and atherosclerosis

42
Q

infectious causes of chronic inflammation

A

unresolved infection

intestinal microbes

43
Q

chronic inflammation can lead to what two changes?

A

metabolic
tissue
*both of which can lead to systemic diseases

44
Q

Periodontitis is a result of what?

A

polymicrobial dysbiosis (pathogenic bacteria present rather than commensals) which causes chronic inflammation

45
Q

T/F periodontitis may be linked to systemic inflammation and disease?

A

True

-has been shown to aid in hypertension, DM, cardiovascular diseases

46
Q

Chronic inflammation produces IL-6, which means what?

A

acute phase proteins released from liver

-can lead to atherosclerosis, gut diseases, pregnancy complications

Host and Defense (26 decks)

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