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Immunology > Lecture 27; Hypersensitivities I > Flashcards

Lecture 27; Hypersensitivities I Flashcards

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1
Q

what is a hypersensitivity

A

Exaggerated, inappropriate or prolonged immune response to antigen

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2
Q

What are two phases of hypersensitivity reactions

A
  1. Sensitization
  2. Effector
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3
Q

Hypersensitivity reactions are recognized based on

A
  1. Type of immune response causing tissue injury
  2. Location of the target antigen
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4
Q

Type I hypersensitivity rxn

A

Immediate hypersensitivity (IgE)

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5
Q

Type II hypersensitivity rxn

A

Cytotoxic hypersensitivity IgM or IgG

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6
Q

Type III hypersensitivity reaction

A

Immune complex mediated cytotoxicity (IgM or IgG)

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7
Q

Type IV hypersensitivity reaction

A

Delayed type, T cell mediated

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8
Q

Type I immediate hypersensitivity is an inappropriate secretion of

A

IgE

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9
Q

Which hypersensitivity type is often genetic

A

Type I

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10
Q

What is the hygiene hypothesis

A

Prevalence of atopic disorders increases as the environment becomes more hygienic due to lack of microbial diversity

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11
Q

During type I sensitization phase first exposure to antigen activates what Th cells

A

Th2

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12
Q

What does activation of Th2 cells stimulate

A

Class switching to IgE via IL-4 and IL-13

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13
Q

When are mast cells considered sensitized

A

IgE binds FCeRs on surface of mast cells

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14
Q

Where do matura mast cells reside

A

Connective tissue throughout body

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15
Q

The effector phase occurs during repeat exposure to same allergen that causes cross linking of what

A

IgE bound FcERs on mast cells

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16
Q

Mast cell activation in effector phase results in

A

Release of granular contents and synthesis and release of lipid mediators and cytokines

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17
Q

What do mast cell granules contain

A

Preformed histamine and proteases

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18
Q

What is the major mediated in granule contents

A

Preformed histamine

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19
Q

Is histamine an early or late phase reaction

A

Early

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20
Q

What are the biologic effects of histamine

A

Vasodilation, increased vascular permeability, non-vascular smooth muscle contraction and increased mucus production

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21
Q

What lipid mediators do mast cells release

A

prostaglandins and leukotrienes

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22
Q

Are lipid mediators part of early or late phase reaction

A

Early

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23
Q

What are the biologic effects of prostaglandins and leukotrienes

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A

PG’s- amplify pain
LT’s- vasodilate (redness) and increased vascular permeability

24
Q

What cytokines released from mast cells cause inflammation

25
What cytokines promote Th2 and IgE
IL-4 and IL-13
26
What cytokine recruits eosinophils
IL-5
27
Are cytokines part of late or early phase reaction
Late
28
What are the biologic effects of eosinophils
Release cytotoxic granules, release lipid mediates and cytokine secretion
29
What cytokines do eosinophils secrete
IL-12, IL-31 and TNF
30
Inflammatory responses produce by cytokines recruit what two cell types
Eosinophils and neutrophils
31
Recruitment of eosinophils and neutrophils can result in damage to what
Tissue
32
Corticosteroids are used to prevent ____
Damaging inflammation
33
What is anaphylaxis
Acute, hypersensitive allergic reactions to an antigen
34
Anaphylactic reactions manifest in different ways depending on ___
Location
35
Localized anaphylaxis
Local release of mediators, specific clinical manifestations are dependent on site of allergen exposure and location of mast cell activation
36
What is systemic anaphylaxis
Systemic release of mediators, result from allergen in/spread through bloodstream
37
Allergic rhinitis and allergic conjunctivitis activate mast cells where
URT and eyes
38
What are clinical signs of allergic rhinitis and allergic conjunctivitis
Itchy, watery eyes, sneezing, runny nose
39
What are some treatment options for allergic rhinitis and allergic conjunctivitis
Antihistamines, corticosteroids and antimicrobials if infectious
40
Allergic asthma activates mast cells where
Lower respiratory tract
41
What does allergic asthma cause
Bronchoconstriction and increased mucus secretion
42
What are some symptoms of allergic asthma
Coughing, wheezing, open mouth breathing, and or gasping for breath
43
What are some treatments for allergic asthma
Bronchodilators (fast acting) and corticosteroids (prevent late phase response)
44
Atopic dermatitis and urticaria activate mast cells where
Skin
45
What are some clinical signs of atopic dermatitis and urticaria
Red, dry, itchy, inflamed skin lesions
46
Treatments for atopic dermatitis
Corticosteroids, antihistamines, cyclosporine A, lokivetmab, and olacitinib
47
Food allergies cause activation of mast cells where
GI tract
48
Clinical signs of food allergies
Vomiting, diarrhea, gas
49
Which allergens often become systemic and can manifest in skin and respiratory tract
Food allergies
50
What are some common systemic allergens
Drugs, vaccines, food venoms
51
Systemic anaphylaxis is a medical emergency and the following should be done
Remove inciting substance, stabilize, treat with epinephrine, add adjunctive tx- antihistamines, IV fluids, bronchodilators, corticosteroids
52
What does epinephrine cause
Vasoconstriction, relax bronchial smooth muscle, increase HR and BP, inhibit mast cell degranulation
53
How can you test for allergies
Intradermal allergies or immunoassays to measure IgE
54
How doe allergic immunotherapy work
Administration of low dose of antigen to alter the immune response
55
AIT results in induction of Tregs to suppress
Mast cells, basophils, eosinophils, Th2 cells, IgE production, tissue inflammation and mucous production, inflammatory Dc’s (make DC’s tolerogenic

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