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12.hypersensitivity 2013
12.hypersensitivity 2013
Li Li ( )
[email protected]
2013.12.13
Main contents
Definition and classification
IgE-mediated(type) hypersensitivity
IgG/IgM-mediated(type ) hypersensitivity
Immune complex-mediated(type )
hypersensitivity
Delayed (type ) hypersensitivity
Definition of Hypersensitivity
The mechanisms
phagocytizes and processes
antigen.
of a type I
hypersensitivity
APC presents
epitope to Th2 cell.
reaction:
Th2 cell
IL-4 from Th2
IL-4
cell stimulates selected
B cell clone.
B cell
Mast cell
IgE
Sensitization Basophil Eosinophil
The mechanisms of a type I
hypersensitivity reaction:
degranulation
Subsequent exposure
to allergen
Histamines, kinins,
proteases, leukotrienes,
prostaglandins, and other
inflammatory molecules
Degranulation
Roles of degranulating cells in an allergic
reaction
Degranulation occurs after cells are sensitized
Mast cells
Basophils
Eosinophils
Degranulation releases histamine, kinins, proteases,
leukotrienes, and prostaglandins
Preformed
Vasoactive amines: histamine
Neutral proteases: tryptase, chymase
Acid hydrolases: b-hexoseaminidase
Proteoglycans: heparin, chondroitin sulfate
Newly formed
Eicosanoids: PGD2, LTC4
Cytokines: TNFa, IL-4, IL-5, IL-6
Acute Phase Allergic Reaction:
Usually mild
Site of reaction depends on portal of entry
Small inhaled allergens may reach lungs and cause
asthma
Some foods contain allergens
May cause diarrhea and other gastrointestinal signs
and symptoms
Local skin inflammation may produce hives or urticaria
Complement-mediated cytolysis
Antibody-dependent cell-mediated
cytotoxicity (ADCC)
Type II (Cytotoxic) Hypersensitivity
Transfusion
Complement
Hemoglobin
Recipient:
TypeA
Agglutination and
complement binding
Hemolysis
Type II (Cytotoxic) Hypersensitivity
Drug-induced cytotoxic reactions
Some drug molecules bind larger molecules
Stimulate the production of antibodies
Can produce various diseases
Immune thrombocytopenic purpura
Agranulocytosis
Hemolytic anemia
thrombocytopenic Platelet
purpura
Drug molecules bind to platelets,
forming drug-platelet complex.
Drug-platelet
complex Complexes are antigenic,
triggering a humoral
immune response.
Complement
Membrane attack
complexes of complement
lyse platelet, which leaks
cytoplasm.
Type II (Cytotoxic) Hypersensitivity
The Rh system and hemolytic disease of the
newborn(HDN, )
Rh antigen
Common to red blood cells of humans and rhesus monkeys
About 85% of humans are Rh positive (Rh+)
Rh woman carrying an Rh+ fetus may be at risk for
hemolytic disease
RhoGAM administered to prevent hemolytic disease
of the newborn