Hypersensitivity Flashcards

1
Q

What is an antigen

A

Any molecule or molecular structure that can be recognised by an antibody or the adaptive immune system

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2
Q

Differen structures of antibodies

A
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3
Q

How do T cells differentiate

A
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4
Q

What is type 1 hypersensitivity known as

A

Immediate or anaphylactic hypersensitivity

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5
Q

What are types of Type 1 hypersensitivity

A

Asthma

Allergic rhinitis

Atopic dermatitis

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6
Q

What is Type 1 hypersensitivity provoked by

A

Re-exposure to a specific type of antigen

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7
Q

What are Type 1 hypersensitivity mediated by

A

IgE

Non allergic individuals only make IgE in response to parastic infections or potent venoms

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8
Q

What are some different types of allergens

A

Food

plants

Due to multiple sites on antigen that antibody can stick onto

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9
Q

How do you diagnose the allergy

A

Skin prick test

Wheal and flare

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10
Q

End result of sensitization of the immune response to allergens

A

Type 2 help CD4 T cells

B cell helper follicular CD4 T cells

They both produce type 2 cytokines IL-4 and IL-13

These act on B cells

B cells therefore produce IgE

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11
Q

Why are IgE rarely found in circulation

A

Normally bound to surface of innate immune cells, espeically mast cells and basophils

These granuloytic cells express high affinity IgE receptor (Fc epsilon receptor 1)

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12
Q

What happens when an allergen is encountered by cell bound IgE

A

Rapid crosslinking and degradulation of mast cell or basophil

Happens much faster and across a much broader site

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13
Q

Diagram of Hypersensitivity 1

A
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14
Q

What is the end product of all hypersensitivity reactiosn

A

Release of histamine

Host of cytokines

Further Th2 differentiation

Highly active smooth muscle contracting

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15
Q

What are the different phases of type 1 hpyersensitivity

A

Early phase: occurs within minutes

Later response: Recuitment of early inflammatory cells

Late response: Peaks 3-4 days after exposure where high frequencies of eosinophils are recruited

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16
Q

What is Type 2 hypersensitivity referred to as

A

Antibody-mediated cytotoxic hypersensitivity

17
Q

Which antibodies are invovled

A

IgG and IgM

18
Q

Examples of Type 2 hyeprsensitivity

A

Mismatched blood transfuction

Haemolytic disease of newborns by transfer of antibodies across placenta

Immune thrombocytopenia (antibodies develop against platelet surface proteins)

Graves disease (thyroid stimulating antibodies (thyroid stimulating antibodies that bind to thyrotropin receptor)

19
Q

How does type 2 hypersentivity happen

A

Exposure to foreign antigen

Aberrant response to a self antigen

20
Q

What are the 3 mechanisms of Type 2 Hypersensitivity

A
  1. Anti-receptor activity
  2. Antibody dependent cell-mediated cytotoxicity
  3. Classical activation of the complement cascade
21
Q

What is the complement cascade

A

Leads to MAC formation as well as inflammation opsonisation and recruimtment and activation of immune cells

22
Q

What happens in ADCC

A

In antibody-dependent cell mediated cytotoxicity antibody-antigen complexes on the surface of cells are bound by Fc receptors expressed by granulocytes and NK cells resulting in directed lysis

This releases inflammatory mediators, chemokines and cytokines

23
Q

Type 3 hypersensitivity is sometimes known as

A

Immune complex driven disease

24
Q

What are immune complexes

A

Non-cell bound antigen-antibody complexes which are normally cleared through the activity of the immune system

25
What happens in Type 3 hypersensitivity
Immune complexes cannot be efficiently cleared e.g. antibodies reacting against self-antigens Immuen complexes deposited in the blood vessel walls Causes fever, rashes, joint pain or arthritis, glomerulonephritis
26
What are some diseases of type 3 hypersensitivity
Rheumatoid arthritis Multiple clerosis Systemic lupus erythematosus (develop IgGs against DNA or proteins present in the nucleus of cells)
27
How does serum sickness work
Anti-serum is given for snake venom (antibodies) Body will react to produce antibodies against venom antibodies Doesn't cause a problem until person is bit again
28
What is Type 4 hypersensitivity known as
Delayed-type or T cell mediated hypersensitivity
29
Why is type 4 hypersensitivity slower
It is initiated by T cells Antigen is presented to naive T cells by dendritic cell Results in T memory cells Subsequent exposure means they promot inflammation Memory T cell response is slower than antibodies
30
Examples of type 4 hypersensitivity (contact dermatits)
urushiol acts as a hapten drives a T helper 1 response Reexposure means that cytokines such as IFN-gamma are released This promotoes pro-inflammatory activation of macrophages resulting in swelling and oedema
31
What are examples of type 4 hypersensitivity
Nickel salt and hair dyes Measles and mycobacerium tuberculosis
32
How to test for TB
Injection of small amuonts of M.tb into skin (type 4 reaction)
33
What Type 4 hypersensitivity can be related to others
Asthma ( T helper cells produce soluble mediators that promote bronchoconstriction) Tissue graft rejection (CD8 T cells)
34
Diagram of summary of hypersensitivity