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HYPERSENSITIVITIES:TYPE I HYPERSENSITIVITY Flashcards

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1
Q

Immune mediated hypersensitivity is

A

An inflammatory response to an antigen that is inappropriate (unwanted)
Antigen is not part of a pathogen.
For example, allergies to pollen
Inflammation is excessive and damages the host more than the pathogens.
Allergies to bee stings

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2
Q

Allergen is

A

Often called allergies.
An inciting antigen is called an allergen.

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3
Q

Allergies and sites

A

May be limited to a specific site.
May involve the whole body.
If this is severe → anaphylactic shock

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4
Q

Anaphylactic shock is

A

Generalized poor tissue perfusion as the result of allergic vasodilation.

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5
Q

Define an alergen

A

an adverse reaction to a substance or material

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6
Q

Define an allergen

A

antigen, the thing causing the allergic reaction

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7
Q

Type 1 hypersensitivity is provoked by

A

IgE

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8
Q

Type 2 hypersensitivity is caused by

A

IgG or IgM binding to normal tissue

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9
Q

Type 3 hypersensitivity is caused by

A

Antibody-antigen complexes activate immune response.

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10
Q

Type 4 is caused by

A

T cells and Macrophages directly cause inflammation.

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11
Q

Type 1 is also called

A

IgE mediated hypersensitivity
Immediate hypersensitivity

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12
Q

What is the most common cause of allergy

A

Exaggerated type I responses are the most common cause of allergy.

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13
Q

Why is type 1 called IgE mediated

A

Because IgE is pre-bound to mast cells
Rapid response to allergen (minutes)

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14
Q

Why does type 1 hyper happen

A

Some animals genetically produce more IgE
Some dogs
Some antigens naturally produce very strong IgE responses.
Wasp and bee stings

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15
Q

How does mast cells work in type 1 hyper

A

Some IgE responses are appropriate.
Mast cells are sentinel cells and use bound IgE as a method to detect invaders.
Internal parasites (worms)
Mast cells can release chitinase. (kayh-tin-aze)
Destroys parasite outer covering.
Attract eosinophils which also help to destroy the worm

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16
Q

Steps after an allergen binds to IgE in type 1 hyper

A

The mast cell degranulators
Release IL-31
Stimulates pruritus
Release histamine and heparin
Vasodilation and increased capillary permeability
Attract eosinophils

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17
Q

IgE bounds to

A

Remember that most IgE is bound to mast cells (some on basophils, eosinophils)

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18
Q

Signs of type 1 hyper

A

Redness, swelling (edema) and itchiness.

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19
Q

Three types of allergic dermatitis

A

Three types: atopy, food allergy, parasite allergy

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20
Q

Atopy defintiion

A

The genetic disposition to allergic disease
An increased production of IgE
Become sensitized to common environmental antigens
Terriers, Dalmations, and Retrievers are particularly susceptible.
Mixed breed dogs are less susceptible

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21
Q

Causes of atopic dermatitis

A

Contact with environmental allergen
Skin keratin defect?
Seen in some people with allergic skin disease.
Microbial colonization
Immune dysregulation

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22
Q

Causes of food allergies

A

Ingested
From gut
A small amount of dietary protein is absorbed intact.
May/may not be GI signs (increased defecation, vomiting, diarrhea)
Absorbed allergen binds to skin mast cells

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23
Q

Signs of allergic dermatitis

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A

Often seen in younger adults
Characterized by pruritus
Itching can be intense
Often the first sign

24
Q

Skin lesions caused by allergic dermatitis look like

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A

Hives /urticaria
Raised lumps, small or large
Warm, edematous, pruritic
Erythema
“Hot Spots”

25
Signs of atopic skin disesae
Skin lesions Face, feet, axillas, ventral abdomen and groin are common areas affected Scratching/licking/rubbing leads to secondary damage to skin Erythema Hair loss Thickening Pigmentation Secondary infections
26
Food allergies that cause allergic dermatitis c/s
Recurrent ear infections Recurrent anal gland problems Pruritus – feet, ears,eyes, axilla, perianal region
27
Exclusion diet is and used for
Food Allergy Time consuming – pruritus should improve within 4 weeks; full trail is 8-12 weeks in duration
28
Skin testing is and used for
Atopic Dermatitis Inject potential allergens into skin (ID) and see if there is a reaction. Largely limited to veterinary dermatologists
29
Serum testing is and used for
Atopic Dermatitis Better at ruling out allergens.
30
Prevention and treatment of allergic dermatitis
Washing and bathing Reduce inflammation Remove source Desensitization Changing to less inflammatory diet Dietary exclusion
31
How to bath a dog with allergic dermatitis
Especially useful for contact dermatitis tepid/cool water Emollient (moisturizing) shampoos Oatmeal is anti-pruritic Lots of shampoos and topical products available
32
What medications are used for allergic dermatitis
Antihistamines – not particularly effective Corticosteroids – immunosuppressant (high dose) and anti-inflammatory Atopica (cyclosporin) – immunosuppressant Oclacitinib (Apoquel) Janus kinase (JAK) inhibitor Inhibits IL-31 and other cytokines Monoclonal antibody against IL-31 (cytopoint) Reduces pruritus
33
Removing allergen source in allergic dermatitis
Look for and remove environmental allergens Kill fleas and prevent reinfestation. House/stable horses to avoid culicoides midges House dust allergies? Can be very challenging with certain environmental allergens
34
Desensitization fo allergic dermatitis
Allergen specific immunotherapy- injectable vs sublingual Aim is to switch from synthesis of IgE to IgG Gradually increasing doses of allergens
35
Changing diet for allergic dermatitis
Changing to a less inflammatory diet – Atopic Dermatitis Increase omega-3 fatty acids Fish Supports skin barrier
36
Dietary exclusion for allergens
Basis of treatment for food allergies Feed a simple diet Feed novel proteins Lamb, duck, venison Can add back protein sources to identify problem
37
Anaphylaxis caused by parasites
Rupture of warble pupae in cattle Rupture of hydatid (tapeworm) cysts
38
Allergic dermatitis caused by parasites
Flea saliva (flea bite hypersensitivity) Culicoides (midge) bites in horses Sweet itch – urticaria and intense pruritus Mosquitos
39
Hay fever and asthma is and caused by
Hay fever (allergic rhinitis) and asthma are both IgE mediated hypersensitivities - the difference depends on where the antigen gets trapped. Large particles get trapped in the upper airways and cause hay fever Small particles are carried down into the lungs and cause asthma Mainly a people problem
40
Signs of hay fever and asthma
Nose: Sneezing, watery nasal discharge, blocked nasal passages, itchy nose Eyes: Itchy, red, swollen, may feel gritty, in people blueness below skin Throat: Soreness, itchy Sleep – mouth breathing and fatigue
41
Asthma is most common in signs and treatment
Cats, basenjis, people and horses Signs: Wheezing and dyspnea Can be acute and severe. Diagnose by giving bronchodilator
42
Hay fever and asthma in techs
Less likely if you have a lot of siblings and were raised on a farm. More likely if there is a family history. Can be seasonal. Often an allergy to pollens from any type of plant or spores from fungi Can occur year round Often an allergy to dust mites, roaches, animal dander, fungi, and molds Dander allergies are more of a concern if you work indoors. Fine dander (cats and rabbits) is more likely to cause asthma and/or hay fever. In cats, the main allergen is a salivary protein that gets stuck to hair during grooming A feline diet containing antibodies against cat allergens reduces allergic burden and helps people with allergies. Purina Pro Plan LiveClear
43
Anaphylactic shock occurs due to
Generalized mast cell degranualtion
44
Anaphylactic is a concern when
Giving any biological product e.g. Vaccines, Penicillin
45
How long does anaphylactics take to develop
Typically 15-30 minutes
46
What to have on hand for anaphylaxis
Should always have epinephrine, antihistamines, and corticosteroids on hand Fatal if not recognized and treated promptly.
47
Which organ predominates depends on the species in anaphylaxis
Lungs and the GI tract are the major shock organs Which organ predominates depends on the species Lungs and GI – horses, cats Lungs only – cattle, sheep Liver – dogs
48
Why are the kidneys and skeletal muscles NOT affected by anaphylaxis?
Few sentinel cells
49
Resp signs of anaphylaxis
Increased RR Dyspnea Cough
50
GI signs of anaphylaxis
Vomiting (not in horses or rabbits) Increased defecation/diarrhea (may be bloody)
51
Signs not involving resp or GI in anaphylaxis
Cats - irritation and scratching around the head. Urination Weakness (lethargic) Lack of coordination (ataxia) Collapse Death
52
Antihistamines are given by and used for
Diphenhydramine (Benadryl) 2-4 mg/kg IM, PO, SQ every 8-12 hours Injectable to treat an allergic reaction or anaphylaxis Oral if given prophylactically or after initial injection.
53
Epinephrine works by
Stabilizes mast cells Reverses vasodilation Dilates smooth muscle (helps breathing) Rapidly absorb if given IM or SQ Dose for cats and dogs is 0.1 to 0.5 mL of 1:1000 epinephrine.
54
Which Corticosteroids are used for anaphylaxis
Prednisolone sodium succinate (Solu-Delta-Cortef) Dexamethasone in water -Not the propylene glycol preparation -Not absorbed properly if in the propylene glycol
55

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