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Respiratory system > Lung Immunology > Flashcards

Lung Immunology Flashcards

1
Q

What is an allergy?

A

is an exaggerated immunological response to a foreign substance (allergen) which is either inhaled, swallowed, injected, or comes in contact with the skin or eye
Mechanism not disease

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2
Q

What is an atopy?

A

hereditary predisposition to produce specific IgE antibodies to common aeroallergens
- Allergic rhinitis, asthma, atopic eczema

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3
Q

What is an intolerance?

A

presence of symptoms following environmental exposure and/or food ingestion where an immunological mechanism cannot be established.

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4
Q

What is a hypersensitivity?

A

umbrella term to describe an exaggerated sensitivity to any agent irrespective of the mechanism.

  • May be immunological (IgE atopic or non IgE allergic mediated)
  • Or non immunological (pharmological, intolerance, enzyme deficiency)
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5
Q

How do atopic allergic conditions arise?

A
  • Individuals produce increased IgE

- Binds to specific FcεR1 and FcεR2 recpetors found on mast cells, blood basophils and dendritic cells

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6
Q

What is the pathophysiology of seasonal allergic rhinitis?

A
  1. Sensitization

2. Exposure results in allergic response

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7
Q

What cytokines are released proinflammatory?

A

Il-4, IL-5

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8
Q

What cells characterize allergic tissue reaction in atopic subjects?

A

Th2 and eosinophils

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9
Q

What occurs during a Type 1 response?

A

against viruses, bacteria, fungi and protozoa

recruitment of T helper type 1 (Th1), Th17 cells, cytotoxic T cells, IgM, IgA and IgG subclasses

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10
Q

What occurs during a Type 2 response?

A

Against Helminth and ectoparasites
Th2 cells, IgE and IgG1 antibodies
Innate immune system: epithelial barriers, innate lymphoid cells, eosinophils, mast cells, basophils and activated macrophages.

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11
Q

What are the 3 types of allergic airway disease?

A
  1. Allergic rhinitis (upper airway) - affects 25% of population
  2. Asthma (lower airway)
  3. Around alveolar spaces (extrinsic allergic alveolitis)
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12
Q

What are triggers for asthma?

A
  • Allergy e.g house mites, pollen
    • Viral infections
    • Exercise
    • Exposure to fumes or other irritants
    • Aspirin
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13
Q

What is the mechanism of asthma?

A
  1. Small allergenic particles penetrate to distal airways in alveoli
  2. Causes release/activation
    • Antigen/antibody complexes
    • Complement
    • Chemotactic factors
    • Neutrophils
    • Macrophages
    • Fibroblasts
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14
Q

What is the principles of treatment of allergic diseases?

A
  1. Allergen avoidance
  2. Anti-allergic medication
  3. Immunotherapy (desensitization)
    ○ Subcutaneous
    ○ Sublingual
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15
Q

How are allergic airway diseases treated depending on severity?

A
  1. Avoid allergen
  2. Antiallergic medication e.g antihistamines for allergic rhinitis and topical corticosteroids for allergic inflammation
    • Oral/local non sedative H1 blocker
  3. Intra nasal steroid
  4. Specific allergen immunotherapy (hypo/desensitization)
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16
Q

What is the process of specific immunotherapy?

A
  • administering increasing concentrations of allergenic extracts over long periods of time
  • Risk for anaphylaxis
17
Q

What are the pros and cons of allergen injection immunotherapy?

A

PROS:
Effective
Long lasting immunity

CONS:
Occasional severe allergic reactions
Time consuming
Standardization problems

18
Q

What is the model of action of specific immunotherapy?

A
  1. IgG “blocking antibodies “compete with IgE for allergen
    - Prevent aggregation of FcεRI IgE complexes on mast cells through steric hindrance
    - Also interfere with antigen trapping by IgE bound to antigen-presenting cells
  2. Inhibit the release of pharmacological mediators from mast cells and basophils
    - prevents infiltration of allergic lesions by inflammatory cells and decreases the number of tissue mast cells.
  3. Induce s a shift from a Th2 to a Th1 cytokine profile
    - IL-4 and IL5 decreases and the output of IFN-γ and IL-12 increases
    - Inhibition of late phase allergic reaction
  4. Induce IL-10 secreting T regulatory cells
  5. Induction of long-term anergy in allergens specific CD4+ cells
    - decreases the number of mast cells + inhibition of eosinophilopoiesis
    - May induce non responsiveness

Respiratory system (20 decks)

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