Lecture 7: Immunological disorders, antimicrobial drugs Flashcards
(88 cards)
What is immunological hypersensitivity?
Antigenic response beyond normal such as allergy. Occurs when sensitized by previous exposure to an antigen.
What are the types of hypersensitivity?
Types of hypersensitivity: Type I Anaphylactic Type II Cytotoxic Type III. Immune complex Type IV. Delayed cell-mediated Limited exposure to pathogens may lower immune tolerance and the ability to cope with harmless antigens
Type 1 (Anaphylactic) Reaction
Occurs minutes after a person sensitized to an antigen and reexposed to that antigen
- Antigens combine with IgE antibodies
- IgE attaches to mast cells and basophils
- Mast cells and basophils release mediators:
What are the mediators released by mast cells and basophils?
- Histamine: increases the permeability of blood capillaries
- Leukotrienes: cause prolonged contraction of smooth muscles
- Prostaglandins: affect smooth muscle and increase mucus secretion
What is systemic anaphylaxis?
This is anaphylactic shock where a individual is sensitized to an antigen and then re-exposed to it. It may result in circulatory collapse and death. it is treated with epinephrine.
What is localized anaphylaxis?
Usually associated with ingested or inhaled antigens. Symptoms depend on the route of entry. Hives, hay fever and asthma are examples.
How can anaphylactic reactions be prevented?
- Antigens are inoculated beneath the epidermis to test for rapid inflammatory reaction (wheal)
- Desensitization: increasing dosages of antigen injected beneath the skin. Produces IgG, which act as blocking antibodies to intercept and neutralize antigens
What are Type II (Cytotoxic) Reactions?
This involves activation of complement by the combination of IgG or IgM antibodies with an antigenic cell. Causes cell lysis or damage by macrophages.
How can the ABO blood types create Type II reactions?
- Antibodies in the blood form against certain carbohydrate antigens on red blood cells. A, B or both. Type O do not have any carbohydrate antigens attached.
How can Rh factor create a type II reaction?
Rh factor is found on the RBC’s of 85% of the population. Rh+ blood given to an Rh- recipient will stimulate anti-Rh antibodies.
What is hemolytic disease of the newborn?
An Rh- mother with an Rh+ fetus causes the mother to produce anti-Rh antibodies during birth. The second Rh+ fetus may be damaged by the anti-Rh antibodies because these can cross the placental barrier. This can cause hemolysis, jaundice, edema, and death. The cure is to give antibodies (Rhogam) to attach to the mother’s antibodies to bind them. Give this during the third trimester of the first birth.
What are three types of drug-induced
- Thrombocytopenic purpura
- Agranulocytosis
- Hemolytic anemia
Thrombocytopenic purpura
Platelets combine with drugs , forming a complex that is antigenic. Antibody and complement destroy platelets.
Agranulocytosis
Drug-induced immune destruction of granulocytes
Hemolytic anemia
Drug-induced immune destruction of RBC’s
What is a Type III (Immune Complex) reaction?
Antibodies form against soluble antigens in the serum. These form immune complexes that lodge in the basement membranes under the cells. They activate complement and attract neutrophils. These release enzymes that damage the endothelial cells of the basement membrane. This causes damage and inflammation.
What is glomerulonephritis?
Inflammatory damage to the kidney glomeruli due to immune complexes as a result of infection.
Type IV (Delayed Cell-Mediated) reactions
- These are cell mediated immune responses caused by T cells that do not appear for days.
- It takes time for T cells and macrophages to migrate and to accumulate near the foreign antigen.
- Antigens are phagocytized and presented to receptors on T cells, causing T cells to proliferate into mature differentiated T cells and memory cells.
- Reexposure to antigen causes memory cells to release destructive cytokines
What is different about Type IV from all of the other types of hypersensitivity reactions?
Type IV involves T cells while all of the others involve antibodies immediately.
Give an example of a type IV reaction.
Allergic contact dermatitis
- Haptens combine with proteins in the skin, producing an immune response
- Allergic response to poison ivy, cosmetics, metals, latex etc.
What is autoimmunity?
Autoimmunity is a loss of self-tolerance where the immune system does not discriminate self from non self. Type II, III or IV
What are some examples of autoimmune disorders?
- Graves disease
- Myasthenia gravis
- Systemic lupus erythematosus
- Rheumatoid arthritis
- Multiple Sclerosis
- Insulin dependent diabetes mellitus
- Psoriasis
Graves’ disease
Antibodies react with cell-surface antigens. Abnormal antibodies are produced that mimic TSH, produce excessive amounts of hormones. Increase heart rate, metabolism, cause bulging of eyes.
Myasthenia gravis
Antibodies coat acetylcholine receptors; muscles fail to receive nerve signals. Action potentials cannot be produced. If it affects respiratory muscles death may result.