L20: Hypersensitivity Flashcards

1
Q

what are hypersensitivity diseases

A

diseases caused by the immune response

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2
Q

when responses are not adequately controlled or
targeting to ____ then the immune response
becomes ____

A

the wrong tissue, the cause of the disease

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3
Q

Type 1 mediated

A

IgE - allergy

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4
Q

Type II mediated

A

IgG - antibody mediated (cytotoxic)

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5
Q

Type III mediated

A

IgG - immune complex

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6
Q

Type IV mediated

A

TH cells

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7
Q

Why do we have IgE responses?

A

crucial in defence against parasite infection

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8
Q

Why IgE and not IgG/FcR mediated for T1HS

A
  • Normal IgG/FcR-mediated activity not very effective in mobilising fast response
  • The mast cell receptor affinity for IgE is high and the IgE/FcR response is immediate in the presence of pathogen
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9
Q

What is the action of IgE

A

causes mast cell degranulation by binding to FcER receptor and antigen crosslinking IgE

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10
Q

what happens when mast cells degranulate?

A

release of mediators
1. chemoattractants
2. activators (blood flow/dilation)
3. spasmogens (smooth muscle contraction, mucous secretions)

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11
Q

Mast cell mediators that are synthesised after activation

A

lipid mediatiors, cytokines

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12
Q

mast cell mediators pre-formed, what does this mean?

A
  • biogenic amines (histamines), enzymes (tryptases)
  • immediate release upon activation
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13
Q

action of histamines

A

vasodilation and vascular leak

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14
Q

action of enzymes

A

tissue damage

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15
Q

action of lipid mediators

A

bronchoconstriction, intestinal hypermotility, inflammation

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16
Q

action of cytokines

A

inflammation

17
Q

common causes of allergies

A

rhinitis (hay fever), insect stings, food allergies, small molecules (morphine)

18
Q

What is mast cell sensitization

A

The binding of IgE to its high-affinity IgE receptor on mast cell surfaces upon first exposure to allergen

19
Q

What happens upon re-exposure when a mast cell has been sensitized?

A

mast cell preloaded with IgE - triggering a HS reaction

20
Q

allergies treatment

A
  1. avoidance
  2. antihistamines (bind histamine receptor so histamine cant trigger symptoms)
  3. coritcosteroids
  4. epinephrine
  5. desensitisation (gradually increasing dose of allergen to insude high affinity IgG - competes with IgE = stops allergic reaction)
21
Q

allergy testing

A

immunoassay (test for AB to allergen), skin prick

22
Q

Explain the hygiene hypothesis in terms of T helper cells

A

Immune response to common allergens get polarised away from having a Treg/Th1 response to a Th2 IgE response

23
Q

Explain what happens in T2 HS

A
  • Antibodies (IgG/IgM) bind directly to antigens on the surface of cells and cause lysis
  • can attack mobile cells (in blood stream), or antibodies bind fixed/solid tissue
24
Q

what is hemolytic anemia

A

Individual makes
antibodies to their own red
blood cells (RBC)

25
Explain how hemolytic anemia occurs
- IgG coated RBC are cleared from circulation via uptake by Fc receptor bearing macrophages - IgM coated RBC are fixed by complement and directly lysed (MAC complex formation)
26
What happens when AB bind to self antigen on tissue (T2 HS)
1. ADCC - antibody dependent cellular cytotoxicity 2. complement activation 3. frustrated phagocytosis
27
what is an example of Anti-tissue antibodies
goodpastueres syndrome
28
explain how goodpastures syndrome occurs
- Antibodies against type IV collagen in glomerular basement membrane - Affects the kidney glomeruli and the alveoli in the lungs - Antibodies trigger complement activation that damages epithelial cells - Patients present with transient kidney dysfunction and bleeding in the lungs
29
explain what happenscin T III HS
- Antibody complex is not cleared * Complex becomes large, insoluble * Complexes lodge in sites and provoke an immune response
30
give examples of T III HS
serum sickness, rheumatoid arthritis
31
What is Txpe IV HS
delayed-type hypersensitvity
32
Type IV HS is mediated by?
antigen specific T-cells
33
Explain how TIV HS is established
Antigen injected, process by local APC, Th1 effector response, recruitment of phagocytes, inflammation at site
34
What are examples of T IV HS
contact sensitivity eg jewellery
35
explain the process of contact sensitivity
- normal proteins act as carrier for small molecule - transport to lymph