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Year 2 Medicine > Allergy > Flashcards

Allergy Flashcards

1
Q

The early phase allergic reaction

  • In allergic individuals, exposure to allergens (substance to which IgE antibodies may be produced) leads to the rapid development of symptoms
  • This reaction develops within … or … of exposure and results from the binding of allergens to pre-formed IgE antibodies on the surface of … cells and …
A
  • In allergic individuals, exposure to allergens (substance to which IgE antibodies may be produced) leads to the rapid development of symptoms
  • This reaction develops within seconds or minutes of exposure and results from the binding of allergens to pre-formed IgE antibodies on the surface of mast cells and basophils
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2
Q

Allergen=substance to which … antibodies may be produced

A

Allergen=substance to which IgE antibodies may be produced

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3
Q

In allergic individuals, exposure to … leads to the rapid development of symptoms

A

In allergic individuals, exposure to allergens leads to the rapid development of symptoms

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4
Q

Basic mechanism of the early phase allergic reaction

A

*

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5
Q

Events the follow mast cell IgE ligation

  • IgE binds its specific allergen
  • …-… of IgE antibodies by allergen leads to clustering of FcεR1 receptors
  • The intracellular portion of the receptor becomes …
  • The resulting intracellular cascade leads to cellular …
  • Mast cell ‘…’ releasing histamine, tryptase and other pre-formed mediators
A
  • IgE binds its specific allergen
  • Cross-linking of IgE antibodies by allergen leads to clustering of FcεR1 receptors
  • The intracellular portion of the receptor becomes phosphorylated
  • The resulting intracellular cascade leads to cellular activation
  • Mast cell ‘degranulates’ releasing histamine, tryptase and other pre-formed mediators
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6
Q

Events the follow mast cell IgE ligation

  • IgE binds its specific allergen
  • Cross-linking of IgE antibodies by allergen leads to … of FcεR1 receptors
  • The … portion of the receptor becomes phosphorylated
  • The resulting … cascade leads to cellular activation
  • … cell ‘degranulates’ releasing …, tryptase and other pre-formed mediators
A
  • IgE binds its specific allergen
  • Cross-linking of IgE antibodies by allergen leads to clustering of FcεR1 receptors
  • The intracellular portion of the receptor becomes phosphorylated
  • The resulting intracellular cascade leads to cellular activation
  • Mast cell ‘degranulates’ releasing histamine, tryptase and other pre-formed mediators
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7
Q

Delayed mediators – leukotrienes (allergy)

A
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8
Q

Pharmacological effects of mast cell mediators and leukotrienes

  • Histamine effects (mast cell activation and granule release):
    • GI - Increased … secretion, increased … - … of GI tract contents (diarrhea, vomiting)
    • Airway - Decreased diameter, increased mucus … - congestion and blockage of airways (wheezing, …, …) - swelling and mucus secretion in nasal passages
    • Blood Vessels - Increased blood flow, increased … - increased fluid in tissues causing increased flow of … to … nodes, increased cells and proteins in tissues, increased … response in tissues
A
  • Histamine effects:
    • GI - Increased fluid secretion, increased peristalsis - expulsion of GI tract contents (diarrhea, vomiting)
    • Airway - Decreased diameter, increased mucus secretion - congestion and blockage of airways (wheezing, coughing, phlegm) - swelling and mucus secretion in nasal passages
    • Blood Vessels - Increased blood flow, increased permeability - increased fluid in tissues causing increased flow of lymph to lymph nodes, increased cells and proteins in tissues, increased effector response in tissues
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9
Q

Pharmacological effects of mast cell mediators and leukotrienes

  • Histamine effects (… cell … and … release):
    • GI - Increased fluid secretion, increased peristalsis - expulsion of GI tract contents (…,…)
    • Airway - Decreased diameter, increased mucus secretion - congestion and blockage of airways (…, …, …) - swelling and mucus secretion in nasal passages
    • Blood Vessels - Increased blood flow, increased permeability - increased fluid in tissues causing increased flow of lymph to lymph nodes, increased cells and proteins in tissues, increased effector response in tissues
A
  • Histamine effects (mast cell activation and granule release):
    • GI - Increased fluid secretion, increased peristalsis - expulsion of GI tract contents (diarrhea, vomiting)
    • Airway - Decreased diameter, increased mucus secretion - congestion and blockage of airways (wheezing, coughing, phlegm) - swelling and mucus secretion in nasal passages
    • Blood Vessels - Increased blood flow, increased permeability - increased fluid in tissues causing increased flow of lymph to lymph nodes, increased cells and proteins in tissues, increased effector response in tissues
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10
Q

Examples of allergen sources

  • Allergens are almost always otherwise … environmental …
  • Of the thousands of environmental proteins that we meet, only a few hundred are recognised as allergens
A
  • Allergens are almost always otherwise innocuous environmental proteins
  • Of the thousands of environmental proteins that we meet, only a few hundred are recognised as allergens
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11
Q

Give some examples of allergen sources

A
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12
Q

General characteristics of allergens

A
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13
Q

General characteristics of allergens

  • … (there are a few minor exceptions)
  • Physical properties that favour transition across … membranes
  • Biologically active, often …
  • Have moderate … with self-proteins
A
  • Proteins (there are a few minor exceptions)
  • Physical properties that favour transition across mucus membranes
  • Biologically active, often enzymes
  • Have moderate homology with self-proteins
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14
Q

Clinical allergy syndromes: anaphylaxis

  • ‘… …’ reaction
  • Systemic release of … causes generalised vasodilatation & fluid loss from circulation to tissues
    • Cutaneous: hives, angioedema
    • Gut … release: vomiting, diarrhoea
    • Mucosal … release: laryngeal oedema, bronchoconstriction
    • Circulation: vasodilatation, hypotension
  • Food, drugs and insect … commonest triggers in UK
  • Cardinal features: typical symptoms, multi-system and dramatic, … follows exposure to allergen and tends to improve fairly … thereafter
A
  • ‘Generalised allergic’ reaction
  • Systemic release of histamine causes generalised vasodilatation & fluid loss from circulation to tissues
    • Cutaneous: hives, angioedema
    • Gut histamine release: vomiting, diarrhoea
    • Mucosal histamine release: laryngeal oedema, bronchoconstriction
    • Circulation: vasodilatation, hypotension
  • Food, drugs and insect venom commonest triggers in UK
  • Cardinal features: typical symptoms, multi-system and dramatic, rapidly follows exposure to allergen and tends to improve fairly quickly thereafter
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15
Q

Clinical allergy syndromes: anaphylaxis

  • ‘Generalised allergic’ reaction
  • Systemic release of histamine causes generalised … & fluid … from circulation to tissues
    • Cutaneous: h.., angioedema
    • Gut histamine release: V, …
    • Mucosal histamine release: … oedema, broncho…
    • Circulation: vaso…, …tension
  • …, drugs and insect venom commonest triggers in UK
  • Cardinal features: typical symptoms, multi-system and dramatic, rapidly follows exposure to allergen and tends to improve fairly quickly thereafter
A
  • ‘Generalised allergic’ reaction
  • Systemic release of histamine causes generalised vasodilatation & fluid loss from circulation to tissues
    • Cutaneous: hives, angioedema
    • Gut histamine release: vomiting, diarrhoea
    • Mucosal histamine release: laryngeal oedema, bronchoconstriction
    • Circulation: vasodilatation, hypotension
  • Food, drugs and insect venom commonest triggers in UK
  • Cardinal features: typical symptoms, multi-system and dramatic, rapidly follows exposure to allergen and tends to improve fairly quickly thereafter
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16
Q

Clinical allergy syndromes: oral allergy syndrome

  • Most … type of food allergy amongst UK adults
  • Ig… directed against pollen proteins …-reacts with homologous proteins in plant-derived foods
  • Oral itching upon exposure to raw fruit, nuts and vegetables
  • In UK:
    • Pollen = mainly …
    • Food = mainly … fruits
A
  • Most common type of food allergy amongst UK adults
  • IgE directed against pollen proteins cross-reacts with homologous proteins in plant-derived foods
  • Oral itching upon exposure to raw fruit, nuts and vegetables
  • In UK:
    • Pollen = mainly birch
    • Food = mainly Rosaceae fruits (such as apples, pears, quinces, apricots)
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17
Q

Clinical allergy syndromes: oral allergy syndrome

  • Most common type of food allergy amongst UK adults
  • IgE directed against pollen proteins cross-reacts with homologous proteins in plant-derived foods
  • Oral … upon exposure to .. fruit, nuts and vegetables
  • In UK:
    • … = mainly birch
    • … = mainly Rosaceae fruits
A
  • Most common type of food allergy amongst UK adults
  • IgE directed against pollen proteins cross-reacts with homologous proteins in plant-derived foods
  • Oral itching upon exposure to raw fruit, nuts and vegetables
  • In UK:
    • Pollen = mainly birch
    • Food = mainly Rosaceae fruits
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18
Q

Clinical allergy syndromes: airway disease

  • R…
    • Sneezing, rhinorhoea, blockage due to a type … allergy
  • … airway obstruction
    • Wheeze due to type … allergy
  • Allergens/ symptoms may be:
    • Seasonal: pollens, m…
    • Episodic: o.., animal dander
  • When symptoms are chronic, the inflammation becomes established and cannot be explained simply in terms of mast cell …
A
  • Rhinitis
    • Sneezing, rhinorhoea, blockage due to a type 1 allergy
  • Lower airway obstruction
    • Wheeze due to type 1 allergy
  • Allergens/ symptoms may be:
    • Seasonal: pollens, moulds
    • Episodic: occupational, animal dander
  • When symptoms are chronic, the inflammation becomes established and cannot be explained simply in terms of mast cell degranulation
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19
Q

Clinical allergy syndromes: airway disease

  • Rhinitis
    • S.., rhinorhoea, blockage due to a type 1 allergy
  • Lower airway obstruction
    • … due to type … allergy
  • Allergens/ symptoms may be:
    • Seasonal: P.., moulds
    • Episodic: occupational, A.. dander
  • When symptoms are chronic, the inflammation becomes established and cannot be explained simply in terms of … cell degranulation
A
  • Rhinitis
    • Sneezing, rhinorhoea, blockage due to a type 1 allergy
  • Lower airway obstruction
    • Wheeze due to type 1 allergy
  • Allergens/ symptoms may be:
    • Seasonal: pollens, moulds
    • Episodic: occupational, animal dander
  • When symptoms are chronic, the inflammation becomes established and cannot be explained simply in terms of mast cell degranulation
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20
Q

The immunological tightrope

  • The immune system is constantly challenged with antigens&must somehow decide how to respond
    • … antigens vs non-…
    • Dangerous infections vs … organisms
    • … allergens such as foods and pollens
A
  • The immune system is constantly challenged with antigens&must somehow decide how to respond
    • Self antigens vs non-self
    • Dangerous infections vs commensal organisms
    • Environmental allergens such as foods and pollens
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21
Q

The immunological tightrope

  • The immune system is constantly challenged with antigens&must somehow decide how to respond
    • Self antigens vs non-self
    • … infections vs commensal organisms
    • Environmental allergens such as … and …
A
  • The immune system is constantly challenged with antigens&must somehow decide how to respond
    • Self antigens vs non-self
    • Dangerous infections vs commensal organisms
    • Environmental allergens such as foods and pollens
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22
Q

Allergy - over the years:

A
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23
Q

Chronic allergic inflammation: asthma

  • Patients with chronic asthma have on-going symptoms
  • Most patients are … to a variety of …. allergens
  • Biopsy shows inflammatory … and airway changes known as ‘re-modelling’ – thickened basement membrane and smooth muscle hyper..
  • The ‘early allergic reaction’ model does not provide a good explanation by itself
A
  • Patients with chronic asthma have on-going symptoms
  • Most patients are sensitised to a variety of airborne allergens
  • Biopsy shows inflammatory infiltrate and airway changes known as ‘re-modelling’ – thickened basement membrane and smooth muscle hyperplasia
  • The ‘early allergic reaction’ model does not provide a good explanation by itself
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24
Q

Chronic allergic inflammation: asthma

  • Patients with chronic asthma have on-going symptoms
  • Most patients are sensitised to a variety of airborne allergens
  • Biopsy shows inflammatory infiltrate and airway changes known as ‘re-…’ – thickened … membrane and smooth muscle …
  • The ‘… allergic reaction’ model does not provide a good explanation by itself
A
  • Patients with chronic asthma have on-going symptoms
  • Most patients are sensitised to a variety of airborne allergens
  • Biopsy shows inflammatory infiltrate and airway changes known as ‘re-modelling’ – thickened basement membrane and smooth muscle hyperplasia
  • The ‘early allergic reaction’ model does not provide a good explanation by itself
25
Q

The late phase allergic reaction

  • The … … reaction to allergen is followed some hours later by a second ‘late phase reaction’
  • Biopsy of the late phase shows infiltration with inflammatory cells – particularly … T cells, eosinophils and … cells; provides some insight into chronic allergic inflammation, and often used as an experimental model
A
  • The early phase reaction to allergen is followed some hours later by a second ‘late phase reaction’
  • Biopsy of the late phase shows infiltration with inflammatory cells – particularly CD4 T cells, eosinophils and mast cells; provides some insight into chronic allergic inflammation, and often used as an experimental model
26
Q

T cell subsets

A
27
Q

T cell subsets

A
28
Q

Th2-biased infiltrate in asthmatic lung

A
29
Q

Alder allergy associated with Th2-biased responses to alder

A
30
Q

T cell subsets and the Th2 hypothesis

  • Th2 responses to allergens have been … associated with allergic disease
    • … of allergic inflammation are rich in T cells expressing Th2 cytokines
    • T cells from allergic patients stimulated with … in the laboratory produce Th2 cytokines
  • Plenty of reasons to believe that Th2 responses may be important in allergy:
    • IL-… is required for B cell class switching to IgE
    • IL-.. and IL-… promote mucus hypersecretion
    • IL-5 is required for … survival
    • IL-9 recruits … cells
A
  • Th2 responses to allergens have been consistently associated with allergic disease
    • Biopsies of allergic inflammation are rich in T cells expressing Th2 cytokines
    • T cells from allergic patients stimulated with allergen in the laboratory produce Th2 cytokines
  • Plenty of reasons to believe that Th2 responses may be important in allergy:
    • IL-4 is required for B cell class switching to IgE
    • IL-4 and IL-13 promote mucus hypersecretion
    • IL-5 is required for eosinophil survival
    • IL-9 recruits mast cells
31
Q

T cell subsets and the Th2 hypothesis

  • Th2 responses to allergens have been consistently associated with allergic disease
    • Biopsies of allergic inflammation are rich in T cells expressing Th2 cytokines
    • T cells from allergic patients stimulated with allergen in the laboratory produce Th2 cytokines
  • Plenty of reasons to believe that Th2 responses may be important in allergy:
    • IL-4 is required for B cell class switching to …
    • IL-4 and IL-13 promote mucus …
    • IL-… is required for eosinophil survival
    • IL-.. recruits mast cells
A
  • Th2 responses to allergens have been consistently associated with allergic disease
    • Biopsies of allergic inflammation are rich in T cells expressing Th2 cytokines
    • T cells from allergic patients stimulated with allergen in the laboratory produce Th2 cytokines
  • Plenty of reasons to believe that Th2 responses may be important in allergy:
    • IL-4 is required for B cell class switching to IgE
    • IL-4 and IL-13 promote mucus hypersecretion
    • IL-5 is required for eosinophil survival
    • IL-9 recruits mast cells
32
Q
  • Biopsies of allergic inflammation are rich in T cells expressing Th… cytokines
  • T cells from allergic patients stimulated with allergen in the laboratory produce Th… cytokines
A
  • Biopsies of allergic inflammation are rich in T cells expressing Th2 cytokines
  • T cells from allergic patients stimulated with allergen in the laboratory produce Th2 cytokines
33
Q

Chronic allergic disease: asthma (ACUTE responses)

  • Inflammatory mediators cause increased mucus … and … muscle contraction leading to airway …
  • … of cells from the circulation
A
  • Inflammatory mediators cause increased mucus secretion and smooth muscle contraction leading to airway obstruction
  • Recruitment of cells from the circulation
34
Q

Chronic allergic disease: asthma (CHRONIC responses)

  • Chronic response caused by … and … products
  • Activated Th… cells and other inflammatory cells accumulate
  • Th… products lead to chronic disease
    • IL4: mucus hypersecretion
    • IL-13: bronchial hyper-responsiveness
    • IL-5: eosinophil recruitment
    • IL-9: mast cell recruitment
  • This model suggests a true role for T cells in chronic inflammation rather than just in causing IgE production
A
  • Chronic response caused by cytokines and eosinophil products
  • Activated Th2 cells and other inflammatory cells accumulate
  • Th2 products lead to chronic disease
    • IL4: mucus hypersecretion
    • IL-13: bronchial hyper-responsiveness
    • IL-5: eosinophil recruitment
    • IL-9: mast cell recruitment
  • This model suggests a true role for T cells in chronic inflammation rather than just in causing IgE production
35
Q

Chronic allergic disease: asthma (CHRONIC responses)

  • Chronic response caused by cytokine and eosinophil products
  • Activated Th2 cells and other inflammatory cells accumulate
  • Th2 products lead to chronic disease
    • IL4: mucus …
    • IL-13: bronchial …-r…
    • IL-5: … recruitment
    • IL-9: … cell recruitment
  • This model suggests a true role for T cells in chronic inflammation rather than just in causing … production
A
  • Chronic response caused by cytokines and eosinophil products
  • Activated Th2 cells and other inflammatory cells accumulate
  • Th2 products lead to chronic disease
    • IL4: mucus hypersecretion
    • IL-13: bronchial hyper-responsiveness
    • IL-5: eosinophil recruitment
    • IL-9: mast cell recruitment
  • This model suggests a true role for T cells in chronic inflammation rather than just in causing IgE production
36
Q

Potential factors in the aetiology of allergy: genetics

  • Childhood allergy is … predicted by presence of allergy in parents, but difficult to unpick relative contribution of …
  • Numerous genetic risk factors identified, but none particularly compelling
  • Notable that the allergy epidemic has occurred too … to be explained entirely by genetics
A
  • Childhood allergy is strongly predicted by presence of allergy in parents, but difficult to unpick relative contribution of environment
  • Numerous genetic risk factors identified, but none particularly compelling
  • Notable that the allergy epidemic has occurred too quickly to be explained entirely by genetics
37
Q

Hygiene hypothesis: Strachan 1989

  • … hygiene levels, … pathogen load, helminth infection proposed to:
    • Skew immunity from Th… to Th…
    • Induce regulatory T cells
  • … hygiene levels, … pathogen load, absence of helminth infection proposed to:
    • Skew immunity towards Th…
    • Reduce production of regulatory T cells
  • Has proved resilient as a theory, but remains somewhat theoretical
A
  • Low hygiene levels, high pathogen load, helminth infection proposed to:
    • Skew immunity from Th2 to Th1
    • Induce regulatory T cells
  • High hygiene levels, low pathogen load, absence of helminth infection proposed to:
    • Skew immunity towards Th2
    • Reduce production of regulatory T cells
  • Has proved resilient as a theory, but remains somewhat theoretical
38
Q

Hygiene hypothesis: Strachan 1989

  • Low hygiene levels, high pathogen load, … infection proposed to:
    • Skew immunity from Th2 to Th1
    • … regulatory T cells
  • High hygiene levels, low pathogen load, absence of … infection proposed to:
    • Skew immunity towards Th2
    • … production of regulatory T cells
  • Has proved resilient as a theory, but remains somewhat theoretical
A
  • Low hygiene levels, high pathogen load, helminth infection proposed to:
    • Skew immunity from Th2 to Th1
    • Induce regulatory T cells
  • High hygiene levels, low pathogen load, absence of helminth infection proposed to:
    • Skew immunity towards Th2
    • Reduce production of regulatory T cells
  • Has proved resilient as a theory, but remains somewhat theoretical
39
Q

Detection of allergen-specific IgE in vivo: skin testing

  • Skin … testing
    • Allergen extract applied as …
    • … layers of epidermis punctured with lancet
    • A wheal with … response after 15 minutes is positive
    • Result needs interpretation in clinical context
A
  • Skin prick testing
    • Allergen extract applied as drops
    • Top layers of epidermis punctured with lancet
    • A wheal with flare response after 15 minutes is positive
    • Result needs interpretation in clinical context
40
Q

In skin prick testing (allergy) a … with flare response after … minutes is positive

A

In skin prick testing (allergy) a wheal with flare response after 15 minutes is positive

41
Q

Detection of allergen-specific IgE in vitro

  • Performed by radioallergosorbant (RAST) assay a very long time ago
  • Now usually by …, but term ‘RAST’ still widely used clinically
A
  • Performed by radioallergosorbant (RAST) assay a very long time ago
  • Now usually by ELISA, but term ‘RAST’ still widely used clinically
42
Q

Treatment of allergy: Pure symptom relievers (don’t act on mediators, but act on other pathways that oppose actions of mediators)

A
43
Q

Treatment of allergy: Pure symptom relievers (don’t act on mediators, but act on other pathways that oppose actions of mediators)

  • Nasal decongestants
    • eg oxymetazoline
    • Act on … adrenoreceptors to cause vasoconstriction
    • Only for short-term use
    • … and systemic
  • B2 …
    • Eg salbutamol
    • Act on lung B2 adrenoreceptors, cause smooth muscle …
  • Epinephrine/Adrenaline
    • Systemic adrenergic effects oppose vasodilatation and bronchoconstriction
A
  • Nasal decongestants
    • eg oxymetazoline
    • Act on α1 adrenoreceptors to cause vasoconstriction
    • Only for short-term use
    • Topical and systemic
  • B2 agonists
    • Eg salbutamol
    • Act on lung B2 adrenoreceptors, cause smooth muscle relaxation
  • Epinephrine/Adrenaline
    • Systemic adrenergic effects oppose vasodilatation and bronchoconstriction
44
Q

Treatment of allergy: Pure symptom relievers (don’t act on mediators, but act on other pathways that oppose actions of mediators)

  • Nasal decongestants
    • eg oxymetazoline
    • Act on α1 adrenoreceptors to cause …
    • Only for short-term use
    • Topical and systemic
  • B2 agonists
    • Eg …
    • Act on lung B2 adrenoreceptors, cause smooth muscle relaxation
  • Epinephrine/Adrenaline
    • Systemic adrenergic effects oppose … and …
A
  • Nasal decongestants
    • eg oxymetazoline
    • Act on α1 adrenoreceptors to cause vasoconstriction
    • Only for short-term use
    • Topical and systemic
  • B2 agonists
    • Eg salbutamol
    • Act on lung B2 adrenoreceptors, cause smooth muscle relaxation
  • Epinephrine/Adrenaline
    • Systemic adrenergic effects oppose vasodilatation and bronchoconstriction
45
Q

Treatment of allergy: drugs acting on early-phase mediators

A
46
Q

Mast cell stabilisers

  • Eg sodium cromoglycate
  • Reduce mast cell … by unknown mechanism
  • Not … absorbed – … use only
  • Short …-… requires frequent dosing
  • Main benefit is …-free, but efficacy …
A
  • Eg sodium cromoglycate
  • Reduce mast cell degranulation by unknown mechanism
  • Not orally absorbed – topical use only
  • Short half-life requires frequent dosing
  • Main benefit is steroid-free, but efficacy very poor
47
Q

H1 Antihistamines

  • Inverse … at H1 histamine receptor
  • Best used before … to allergen
  • 1st generation eg chlorpheniramine
    • Considerable …, drug interactions
  • 2nd generation eg cerizine, loratidine, desloratidine, fexofenadine
  • No/ minimal …, once-daily
A
  • Inverse agonists at H1 histamine receptor
  • Best used before exposure to allergen
  • 1st generation eg chlorpheniramine
    • Considerable sedation, drug interactions
  • 2nd generation eg cerizine, loratidine, desloratidine, fexofenadine
  • No/ minimal sedation, once-daily
48
Q

Leukotriene receptor antagonists

  • Only UK drug is …
  • Effective in reducing … allergic responses, but … to H1 antihistamines
  • Unlike anti-histamines, beneficial in … asthma, which is the main indication for their use
A
  • Only UK drug is montelukast
  • Effective in reducing early allergic responses, but inferior to H1 antihistamines
  • Unlike anti-histamines, beneficial in chronic asthma, which is the main indication for their use
49
Q

Treatment of allergic disease: corticosteroids

  • Steroids reduce immune activation by altering gene … in numerous cell types, including T cells, B cells and cells of the … immune system. Their onset of action is … and they must be taken …
A
  • Steroids reduce immune activation by altering gene expression in numerous cell types, including T cells, B cells and cells of the innate immune system. Their onset of action is delayed and they must be taken regularly
50
Q

Corticosteroids - Types

  • Inhaled - eg b…, fluticasone
  • Nasal - eg b…, mometasone, fluticasone
  • Skin - h… and opthalmic drops
  • Topical prep may cause local and even .. side effects
  • Oral, … and depot prep available
A
  • Inhaled - eg beclamathosome, fluticasone
  • Nasal - eg beclamathasone, mometasone, fluticasone
  • Skin - hydrocortisone and opthalmic drops
  • Topical prep may cause local and even systemic side effects
  • Oral, IV and depot prep available
51
Q

Treatment of allergic disease: Omalizumab

  • Omalizumab is a … … directed against …, used for atopic asthma (amongst other things)
A
  • Omalizumab is a monoclonal antibody directed against IgE, used for atopic asthma (amongst other things)
52
Q

…lizumab is a monoclonal antibody directed against IgE, used for atopic … (amongst other things)

A

Omalizumab is a monoclonal antibody directed against IgE, used for atopic asthma (amongst other things)

53
Q

Omalizumab is a monoclonal antibody directed against …., used for … asthma (amongst other things)

A

Omalizumab is a monoclonal antibody directed against IgE, used for atopic asthma (amongst other things)

54
Q

Treatment of allergic disease: allergen-specific immunotherapy

  • Allergen doses administered by … injection or sub…
  • Provide …-term protection
  • Mainly … allergy and rhinitis
  • Multiple immunological effects:
    • Induce regulatory T cell responses to allergens
    • Reduce Th… responses
    • Induce allergen-specific … antibodies
    • Reduction in mast cell responsiveness
    • Reduce allergen-specific IgE levels
A
  • Allergen doses administered by subcutaneous injection or sublingually
  • Provide long-term protection
  • Mainly venom allergy and rhinitis
  • Multiple immunological effects:
    • Induce regulatory T cell responses to allergens
    • Reduce Th2 responses
    • Induce allergen-specific IgG antibodies
    • Reduction in mast cell responsiveness
    • Reduce allergen-specific IgE levels
55
Q

Treatment of allergic disease: allergen-specific immunotherapy

  • Allergen doses administered by subcutaneous injection or sublingually
  • Provide long-term protection
  • Mainly venom allergy and …
  • Multiple immunological effects:
    • Induce … T cell responses to allergens
    • Reduce Th2 responses
    • Induce allergen-specific IgG antibodies
    • Reduction in … cell responsiveness
    • Reduce allergen-specific … levels
A
  • Allergen doses administered by subcutaneous injection or sublingually
  • Provide long-term protection
  • Mainly venom allergy and rhinitis
  • Multiple immunological effects:
    • Induce regulatory T cell responses to allergens
    • Reduce Th2 responses
    • Induce allergen-specific IgG antibodies
    • Reduction in mast cell responsiveness
    • Reduce allergen-specific IgE levels
56
Q

Contact dermatitis vs type 1 allergy​

A
57
Q

Contact dermatitis vs type 1 allergy​

A
58
Q

Skin prick testing vs patch testing

A

Year 2 Medicine (162 decks)

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