Immuno: Hypersensitivity Flashcards
What is the primary mediator of Type 1 Hypersensitivity?
IgE dependent Mast cells
What is the primary mediator of Type II Hypersensitivity?
IgG Abs that react with cell-surface or matrix antigens
What is the primary mediator of Type III Hypersensitivity?
Immune complexes
What is the primary mediator of Type IV Hypersensitivity?
T-cells
Why is Type IV also called delayed-type?
Because it takes a little while for effector T cells to proliferate.
Arthus reaction happens during what type of hypersensitivity reaction?
Type III - immune complex
Most human allergic responses are elicited by what route?
Inhalation of PROTEIN allergens
Name some properties common to most antigens
- Protein
2. HIghly soluble
How do soluble inhaled allergens get onto our system?
Inhale their carriers - most allergens are carried on desiccated particles (pollen, mite feces)
Upon contact with the mucosa of airways, soluble antigens elute from the delivery particles and diffuse into the mucosa.
What kind of T cell response do soluble inhaled antigens elicit?
Th2 cell response.
Soluble inhaled antigens are presented to the immune system at very low doses. Remember: Low doses of antigen cause Th0 –> Th2.
How do Th2 cells promote B-cells to class switch their antibodies to IgE?
Once Th2 cell binds its antigen via MHC-II, it secretes Il-4,5, and 13. These upregulate the T cell’s expression of CD40L and CD23 (low affinity IgE receptor)
CD40L and CD23 molecules bind to their match on B cells: CD40 and CD2 (respectively)
This combo of signals induces class switching to IgE by that B cell.
T/F : All people exposed to allergens will have an immune response.
False.
May be first exposure (allergic response occurs only after 2nd exposure) or an individual may not have innate reaction to that particular antigen.
Parasites produce many _____________, which elicit what kind of immune response? What kind of hypersensitivity?
proteolytic enzymes (proteases) are strong inducers of Th2 responses, therefore IgE response.
Type 1 Hypersensitivity
What 3 types of cells express the high affinity IgE receptor? What is the receptor called?
Mast cells, basophils, and eosinophils all express FceR1.
What causes degranulaton of mast cells, eosinophils, and basophils?
Antigen binding to and cross-linking IgE bound to the cells. (serving as a hijacked receptor since granulocytes don’t have specific receptors of their own)
During Type 1 hypersensitivity, mast cells degranulate, and what is the result?
The chemicals released are inflammatory mediators. They recruit eosinophils and basophils to the area, and contribute to the inflammatory response.
What demographic is most likely to have IgE responses to common environmental agents? What is this predisposed state called?
White people of N. America and Europe.
Atopy is the term for a predisposition to type 1 hypersensitivity evoked by common allergens.
What do Atopic individuals have that others don’t, that makes them more susceptible to IgE mediated hypersensitivity?
Higher levels of soluble IgE and more circulating eosinophils than normal people
How do you tell an individual’s sensitivity to a particular antigen?
There is a 2 step response if a person has an allergy to an injected allergen.
1st step of response: Wheal and flare caused by immediate mast cell degranulation. Histamine from the mast cell granules causes the wheal (increases vascular permeability in the area) and flare (redness caused by increased blood flow).
2nd step of response: 6-8 hours post-injection (late phase reaction) More widespread inflammatory response mediated by granule contents (chemokines, leukotrienes…etc..)
Airborne allergens will cause mast cell degranulation where?
In the bronchial mucosa.
Food-borne allergens will cause mast cell degranulation where?
GI tract.
Mast cell degranulation in the gut causes what to happen?
Increased mucosal secretion and increased peristalsis. Vomiting, diarrhea possibly
Mast cell degranulation in the airway causes what to happen?
Decreased diameter of bronchi (bronchioconstriction)
Increased mucus production
Violent cough, sneezing, wheezing.
Mast cell degranulation in the bloodstream causes what immediate effects?
Edema, inflammation, increased blood flow, vascular permeability, increased lymph flow and carriage of antigens to lymph nodes, creating more of a memory response.
What causes systemic anaphylaxis?
Wide-spread activation of mast cells. Degranulation causes INCREASED VASCULAR PERMEABILITY and widespread CONTRACTION OF SMOOTH MUSCLE.
Describe the effects of systemic anaphylaxis.
- blood fluid depletion leading to ANAPHYLACTIC SHOCK
- Connective tissue swelling
- Constriction of airways and epiglottis swelling = ASPHYXIATION
What does anaphylaxis mean, literally?
“Anti-protection”
Makes sense. Prophylactic means “protective.”
What are some methods by which allergens can be introduced directly into the bloodstream?
- Insect sting
- Drug injection/ingestion
- Food intake - if GI absorption into the blood is rapid (peanuts)
What is the most common cause of anaphylaxis in the USA?
Drug injection/ingestion. Primarily IgE mediated allergy to PENICILLIN.
What is a reaction that resembles anaphylaxis, but doesn’t involve interaction between allergen and IgE called?
Anaphylactoid reaction.
“Anaphylaxis-like”