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Immunology > Lecture 27; Hypersensitivities I > Flashcards

Lecture 27; Hypersensitivities I Flashcards

1
Q

what is a hypersensitivity

A

Exaggerated, inappropriate or prolonged immune response to antigen

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2
Q

What are two phases of hypersensitivity reactions

A
  1. Sensitization
  2. Effector
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3
Q

Hypersensitivity reactions are recognized based on

A
  1. Type of immune response causing tissue injury
  2. Location of the target antigen
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4
Q

Type I hypersensitivity rxn

A

Immediate hypersensitivity (IgE)

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5
Q

Type II hypersensitivity rxn

A

Cytotoxic hypersensitivity IgM or IgG

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6
Q

Type III hypersensitivity reaction

A

Immune complex mediated cytotoxicity (IgM or IgG)

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7
Q

Type IV hypersensitivity reaction

A

Delayed type, T cell mediated

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8
Q

Type I immediate hypersensitivity is an inappropriate secretion of

A

IgE

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9
Q

Which hypersensitivity type is often genetic

A

Type I

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10
Q

What is the hygiene hypothesis

A

Prevalence of atopic disorders increases as the environment becomes more hygienic due to lack of microbial diversity

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11
Q

During type I sensitization phase first exposure to antigen activates what Th cells

A

Th2

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12
Q

What does activation of Th2 cells stimulate

A

Class switching to IgE via IL-4 and IL-13

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13
Q

When are mast cells considered sensitized

A

IgE binds FCeRs on surface of mast cells

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14
Q

Where do matura mast cells reside

A

Connective tissue throughout body

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15
Q

The effector phase occurs during repeat exposure to same allergen that causes cross linking of what

A

IgE bound FcERs on mast cells

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16
Q

Mast cell activation in effector phase results in

A

Release of granular contents and synthesis and release of lipid mediators and cytokines

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17
Q

What do mast cell granules contain

A

Preformed histamine and proteases

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18
Q

What is the major mediated in granule contents

A

Preformed histamine

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19
Q

Is histamine an early or late phase reaction

A

Early

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20
Q

What are the biologic effects of histamine

A

Vasodilation, increased vascular permeability, non-vascular smooth muscle contraction and increased mucus production

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21
Q

What lipid mediators do mast cells release

A

prostaglandins and leukotrienes

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22
Q

Are lipid mediators part of early or late phase reaction

A

Early

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23
Q

What are the biologic effects of prostaglandins and leukotrienes

A

PG’s- amplify pain
LT’s- vasodilate (redness) and increased vascular permeability

24
Q

What cytokines released from mast cells cause inflammation

A

TNF and IL-6

25
Q

What cytokines promote Th2 and IgE

A

IL-4 and IL-13

26
Q

What cytokine recruits eosinophils

A

IL-5

27
Q

Are cytokines part of late or early phase reaction

A

Late

28
Q

What are the biologic effects of eosinophils

A

Release cytotoxic granules, release lipid mediates and cytokine secretion

29
Q

What cytokines do eosinophils secrete

A

IL-12, IL-31 and TNF

30
Q

Inflammatory responses produce by cytokines recruit what two cell types

A

Eosinophils and neutrophils

31
Q

Recruitment of eosinophils and neutrophils can result in damage to what

A

Tissue

32
Q

Corticosteroids are used to prevent ____

A

Damaging inflammation

33
Q

What is anaphylaxis

A

Acute, hypersensitive allergic reactions to an antigen

34
Q

Anaphylactic reactions manifest in different ways depending on ___

A

Location

35
Q

Localized anaphylaxis

A

Local release of mediators, specific clinical manifestations are dependent on site of allergen exposure and location of mast cell activation

36
Q

What is systemic anaphylaxis

A

Systemic release of mediators, result from allergen in/spread through bloodstream

37
Q

Allergic rhinitis and allergic conjunctivitis activate mast cells where

A

URT and eyes

38
Q

What are clinical signs of allergic rhinitis and allergic conjunctivitis

A

Itchy, watery eyes, sneezing, runny nose

39
Q

What are some treatment options for allergic rhinitis and allergic conjunctivitis

A

Antihistamines, corticosteroids and antimicrobials if infectious

40
Q

Allergic asthma activates mast cells where

A

Lower respiratory tract

41
Q

What does allergic asthma cause

A

Bronchoconstriction and increased mucus secretion

42
Q

What are some symptoms of allergic asthma

A

Coughing, wheezing, open mouth breathing, and or gasping for breath

43
Q

What are some treatments for allergic asthma

A

Bronchodilators (fast acting) and corticosteroids (prevent late phase response)

44
Q

Atopic dermatitis and urticaria activate mast cells where

A

Skin

45
Q

What are some clinical signs of atopic dermatitis and urticaria

A

Red, dry, itchy, inflamed skin lesions

46
Q

Treatments for atopic dermatitis

A

Corticosteroids, antihistamines, cyclosporine A, lokivetmab, and olacitinib

47
Q

Food allergies cause activation of mast cells where

A

GI tract

48
Q

Clinical signs of food allergies

A

Vomiting, diarrhea, gas

49
Q

Which allergens often become systemic and can manifest in skin and respiratory tract

A

Food allergies

50
Q

What are some common systemic allergens

A

Drugs, vaccines, food venoms

51
Q

Systemic anaphylaxis is a medical emergency and the following should be done

A

Remove inciting substance, stabilize, treat with epinephrine, add adjunctive tx- antihistamines, IV fluids, bronchodilators, corticosteroids

52
Q

What does epinephrine cause

A

Vasoconstriction, relax bronchial smooth muscle, increase HR and BP, inhibit mast cell degranulation

53
Q

How can you test for allergies

A

Intradermal allergies or immunoassays to measure IgE

54
Q

How doe allergic immunotherapy work

A

Administration of low dose of antigen to alter the immune response

55
Q

AIT results in induction of Tregs to suppress

A

Mast cells, basophils, eosinophils, Th2 cells, IgE production, tissue inflammation and mucous production, inflammatory Dc’s (make DC’s tolerogenic

Immunology (22 decks)

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