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L:22 Hypersensitivity disorders Flashcards

1
Q

What is hypersensitivity

A

Exaggerated immune response harmful to organism itself

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2
Q

Classifications of the 4 types of hypersensitivity reactions

A

Antibody-mediated

Cell-mediated

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3
Q

Antibody mediated effector mechanisms

A

Type I, II, and III

Correspond to defenses against extracellular pathogens

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4
Q

Cell-mediated effector mechanisms

A

Type IV- corresponds to defense against intracellular pathogens

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5
Q

Clinical manifestation of Type I hypersensitivity caused by?

A

Mediators secreted by Mast cells

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6
Q

What type of hypersensitivity takes place when antibodies specific for the cell and tissue Ags cause injury or disease to the tissue?

A

Type II

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7
Q

What is it called when Abs bind to circulating Ags to form immune complexes, which deposit in vessels, leading to inflammation in the vessel walls (vasculitis)

A

Immune Complex diseases (type III hypersensitivity)

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8
Q

What is the cause of type IV hypersensitivity?

A

T cell mediated disease caused by inflammation caused by cytokines produced by CD4 Th1 and Th17, or killing of host by CD8 CTLs

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9
Q

Individuals with a strong propensity to develop allergic reaction is said to be what?

A

Atopic

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10
Q

Type I hypersensitivity rxn is controlled by the binding of what?

A

IgE Abs to FcĘR1 located on the membrane of MAST CELLS, BASOPHILS and EOSINOPHILS

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11
Q

Most IgE produced following initial contact with Ag becomes?

A

Fixed on the surface of mast cell and basophils..

Second contact with Ag, the Ag-Ab rxn occurs predominantly on mast cell and basophil membrane

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12
Q

Hallmarks of Immediate hypersensitivity

A

Acute vascular, smooth muscle reactions, and inflammation

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13
Q

What causes vascular dilation

A

Prostaglandins

Histamines

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14
Q

What causes prolonged smooth muscle contractions?

A

Leukotrienes

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15
Q

What induces local inflammation (the late phase rxn)

A

Cytokines

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16
Q

Time frame of immediate and late phase rxn

A

Immediate vascular and smooth muscle develops within minutes.
The late-phase rxn develops 2-4 hrs. later characterized by inflammation

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17
Q

reversible airway obstruction often caused by inflammatory mediators from mast cells

A

Asthma

*spasmatic contraction of smooth muscle surrounding bronchi decreasing lumen size and causing SOB

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18
Q

Anaphylaxis

A

Rapid release of vaso active amines from mast cells and basophils as well as cytokines. Results in smooth muscle contraction in vasculature and vasodilation of capillary epithelium. **BP decreases leading to vascular shock* contraction of smooth muscles in bronchi cause difficulty breathing

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19
Q

In type II hypersensitivity IgG and IgM activate what pathways?

A

Complement system by classical pathway. results in byproducts that recruit leukocytes to induce inflammation

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20
Q

Type II

What activates leukocytes resulting in pro-inflammatory response?

A

IgG antibodies binding to neutrophil and macrophage Fc receptors.

Reactive oxygen and lysosomal enzymes are released and damage adjacent tissue because Ab-Ag complexes are formed on target cell

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21
Q

Type III

Ab-Ag complexes deposit where?

A

blood vessels and other sites resulting in vascular inflammation, and subsequent ischemic damage to tissue

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22
Q

Type III

Major mechanism triggering tissue damage

A

Classical activation of complement

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23
Q

Type III

Tissue damage is mediated by?

A
  • Complement activation
  • Mast cell degranulation
  • Neutrophil chemotaxis
  • Inflammation caused by immune cells
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24
Q

Type IV (delayed type hypersensitivity DTH) is caused by?

A

Activation of Th1 cells

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25
Unlike Type I, II, III passive transfer of type IV requires the transfer of ?
Antigen- specific TH1 clones
26
What type of hypersensitivity is T cell mediated?
Type IV
27
Tissue injury is caused by what in type IV
Inflammation induced by cytokines that are produced by CD4 Th1 cells and Th17 ****Inflammation associated with T-cell mediated disease is typically chronic****
28
The classical T cell mediated inflammatory reaction is called?
**Delayed-type hypersensitivity | TB test is type of delayed reaction
29
Types Of type IV disease
``` MS, rheumatoid, type 1 diabetes, Crohns, contact dermatitis (poison ivy) Chronic Infections (tb) ```
30
Types of type I syndromes
Food alergy, asthma, allergic rhinitis
31
SLE systemic lupus erythematosus is what type of hypersensitivity?
Type III
32
Type 1: | Pathologic immune mechanism
TH2 cells, IgE antibodies, mast cells, eosinophils
33
Type 1: | Mechanism of tissue injury and disease
Mass cell derived mediators (vasoactive amines, lipid mediators, cytokines) Cytokine-mediated inflammation (eosinophils, neutrophils)
34
Immediate type 1 hypersensitivity is a type of pathologic reaction that is caused by what?
Release of mediators from mast cells
35
Type 1 hypersensitivity is most often triggered by what?
Production of IgE Ab against environmental Ags and the binding of IgE to Mast cells
36
IgE-Fc∑R1 binding has high affinity for ?
IgE
37
What are the sequence of events in the development of immediate hypersensitivity?
1. production of IgE after activation of Th2 cells by 1˚ exposure to allergen 2. Binding of IgE to Fc receptors of mast cells 3. Release of mediators by mast cells after 2˚ exposure to Ag and cross-linking of the membrane-bound IgE by Ags
38
The activation of TH2 cells causes what to happen to start production of IgE
Stimulation of IgE class switching in B cells
39
What mediators case Imediate HS reaction within minutes
Mast cells releasing Vasoactive amines, lipid mediators
40
What mediator cause late-phase reaction within 6-24 hrs.after repeat exposure?
Mast cells releasing Cytokines
41
Examples of type 1 hypersensitivity
``` Anaphylaxis Acute urticaria Allergic rhinitis Asthma Food allergy ```
42
Type 2 hypersensitivity: | Pathological immune mechanism
IgM, IgG, antibodies against cell surface of extracellular matrix antigens
43
Type 2 hypersensitivity | mechanism of tissue injury and disease
Complement and Fc receptor mediated recruitment and activation of leukocytes (Neutrophils, macrophages) Opsonization and phagocytosis of cells Abnormalities in cellular function, e.g. hormone receptor signaling
44
Examples of type 2 hypersensitivity
``` Hemolytic anemia Thrombocytopenic purpura Goodpasture syndrome Graves disease Myasthenia gravis Pemphigus vulgaris Blood Transfusion rxn Rheumatic fever ```
45
Type 3 hypersensitivity: | Pathological mechanism:
Immune complexes of circulating antigens and IgM or IgG antibodies deposited in vascular basement membrane of blood vessel
46
Type 3 hypersensitivity mechanism of tissue injury or disease
Complement and Fc receptor mediated recruitment and activation of leukocytes
47
Type 3 is mediated by the deposition of what in BV
Soluble Ab-Ag complexes formed in circulation
48
The complexes initiate the complement to release what anaphylatoxin products
C3a and C5a
49
Examples of type 3 hypersensitivity
``` Systemic lupus polyarteritis nodosa post-strep glomerulonephritis serum sickness arthus reaction ```
50
Type 4 hypersensitivity | pathological mechanism
``` CD4 Tcells (cytokine-mediated inflammation) CD8 CTLs (T-cell mediated cytolysis) ```
51
Type 4 hypersensitivity | mechanism of tissue injury or disease
1. Macrophage activation, cytokine-mediated inflammation | 2. Direct target cell lysis, cytokine-mediated inflammation
52
The major causes of T-cell mediated (type 4) hypersensitivity is?
Autoimmunity and exaggerated or persistent response to environmental Ag
53
****Type 4 tissue injury may also accompany a T-cell response to microbes such as
M. tuberculosis
54
Type 4 killing of host cells is caused by?
CD8 CTLs
55
Type 4 cytokine mediated inflammation and tissue injury is primarily caused by
Cytokines produced by CD4 Th1 and Th17 cells
56
What are Th1 cells
Th1 cells protect against intracellular organisms and secrete IFN¥ and TFNå. They help activate B-cells stimulation to secrete IgG, macrophages, and assist in activation of CD8. **ˆIFN-¥ inhibits IgE production reducing allergic responses
57
What are Th2 cells
Protect against Extracellular organisms and secrete IL-4,5,10, and 13. release mediators that cause sneezing, coughing, and diarrhea to expel extracellular microbes
58
HS type systemic lupus erythematous
Type 3
59
HS type rheumatoid arthritis
Type 2 and 4 | diagnostic test for rheumatoid factor
60
HS type MS
Type 4
61
HS type Diabetes mellitus type 1
TYPE 4
62
HS type Inflammatory bowel
Type 4

immunology (6 decks)

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