Type 1 Hypersensitivity Flashcards

1
Q

What type of antigen mediates type 1 hypersensitivity reactions?

A

IgE

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2
Q

What are allergens?

A

Environmental, non infectious antigens (proteins) that we should not normally react to

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3
Q

What is a type 1 hypersensitivity reaction?

A

Allergy

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4
Q

Give examples of seasonal allergens

A

Tree and grass pollens

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5
Q

Give examples of allergens that have perennial exposure (present throughout the year)

A
  • House dust mite
  • Animal dander (cats and dogs)
  • Fungal spores
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6
Q

Give examples of allergens that have accidental exposure?

A
  • Insect venom
  • Medicines e.g. penicillin (any medicine can cause allergy)
  • Chemicals e.g. latex
  • Foods; milk, nuts, peanuts etc
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7
Q

Explain the mechanism behind type 1 hypersensitivity reactions

A
  • Exposure to antigen- should normally develop TH1 response → IgG that won’t cause allergy
  • In hypersensitivity… TH2 mounts a response
    • IL-4, IL-5, IL-13
  • Produces IgE → drives allergy in subsequent encounter
  • Second exposureIgE drives reaction and mast cell degranulation
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8
Q

How do allergies vary between developing and westerised countries?

A

Developing country - less likely to develop allergy

Westernised country - more likely to develop allergy.

Hygeine hypothesis → less infectious burden = more likely to have allergy

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9
Q

What is the hygeine hypothesis?

A

Children exposed to animals, pets and microbes in the early postnatal period appear to be preotected against certain allergic disease

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10
Q

What is microbial dysbiosis seen in western lifestyles?

A

Western lifestles induce an alteration of the symbiotic relationships with parasites and bacteria leading to a dysbiosis of the microbiome at mucosal surfaces (gut)

Dysbiosis= compositional and functional alterations of microbiome

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11
Q

What happens when mast cells are activated?

A

Degranulation releasing inflammatory mediators

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12
Q

Where are mast cells strategically located within the body?

A

Mature mast cells line most mucosal and epithelial tissues - GI tract, skin, respiratory epithelium

In connective tissue surround blood cells

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13
Q

Give an example of an enzyme mast cell mediator

A

Tryptase

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14
Q

Give an example of a toxic mediator released by mast cells

A

Histamine

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15
Q

Give examples of lipid mediators released by mast cells

A

Leukotrienes C4, D4, E4

Platelet activating factor

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16
Q

What are the effects of mast cell degranulation?

A

Release of histamine and chemiokines, leukotrienes and prostaglandins causes:

  • increased vascular permability
  • vasodilation
  • bronchial constriction
17
Q

How do allergic reactions manifest on the skin?

A

Mast cell activation within the epidermis causes urticaria

If exposure is prolonged → atopic dermatitis and eczema

18
Q

What is angiodema?

A

Mast cell degranulation in the deep dermis

Mediated by histamine and bradykinin

19
Q

What are the risks of angiodema?

A

Angiodema of the lip, tongue and upper respiratory airways can cause life threatening airways obstruction

20
Q

What are some of systemic manifestations of allergic reaction that lead to anaphylaxis?

A
  • Hypotension
  • Cardiovascular collapse
  • Generalise urticaria
  • Angioedema
  • Breathing problems
21
Q

How do you treat anaphylactic shock?

A

Adrenaline (epinephrine) IM

22
Q

How does adrenaline help with anaphylactic shock?

A
  • Reverse peripheral vasodilation and reduced oedema and alleviates hypotension
  • Reverses airway obstruction/ bronchospasm
  • Increased force of Mycoardial contraction
  • Inhibits mast cell activation
23
Q

What therapies can you give to deal with mast cell activation in allergy?

A
  • anti-histamine
  • leukotriene receptor antagonist
  • corticosteroids
24
Q

What therapy can be given to stop the abnormal adaptive immune response against allergens?

A
  • Allergen desensitization (oral immunotherapy)
  • IgE mediated- give anti-IgE monoclonal antibodies
25
Q

What is allergen desensitisation immunotherapy?

A

The administration of increasing doses of allergen extracts over a period of years

Given to patients by injection, drops, tablets