resp hypersensitivity Flashcards

1
Q

what is type I hypersensitivity

A

immediate

IgE mediated antibody response to external antigen

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2
Q

what are some examples of T1H

A

allergy
asthma
parasite e.g. schistosomiasis

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3
Q

what cells of the adaptive immune system are involved in T1H

A

Th2 - (CD4, HLA class II)
B cells
IgE

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4
Q

what cells of the innate immune system are involved in T1H

A

eosinophils

mast cells

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5
Q

what is the management of T1H

A
mast cell stabilisers
antihistamines
leukotriene antagonists
corticosteroids
immunotherapy
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6
Q

how is T1H diagnosed

A

skin prick test
quantitative specific IgE to positive allergen
challenge test

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7
Q

what IL produced by Th2 cells activates

1) eosinophils
2) mast cells
3) IgE plasma cells

A

1) IL5
2) IL4 and IL13
3) IL4, IL5 and IL13

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8
Q

what happens in 1st encounter with allergen in T1H

A

B cells produce antigen specific IgE antibody and allergen is cleared
remaining IgE bind to Fc receptors on mast cells

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9
Q

what happens in 2nd encounter with allergen in T1H

A

allergen binds to IgE coating mast cells and disrupts membrane causing release of inflammatory molecules —> degranulation

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10
Q

what does T2H involve

A

direct cell killing - bound antigen on surface

localised

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11
Q

what cells of the adaptive immune system does T2H involve

A

IgM , IgG

B cells

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12
Q

what cells of the innate immune system does T2H involve

A

complement

phagocytes

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13
Q

give examples of T2H

A

immune haemolytic anaemias

  • ABO blood transfusion reactions
  • drug induced haemolysis

acute vascular rejection
Good pasteurs syndrome

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14
Q

what is the treatment of T2H

A

immunosuppression

plasmapheresis

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15
Q

what happens in T2H

A

antibody binds to cell surface antigen

  • activation of complement
  • mediated by B cells/IgG/IgM —> NK cells and eosinophils activated —> antibody acts as opsonin for phagocytes —> phagocytosis of antigen +ve cells

“antibody mediated phagocytosis”

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16
Q

what is T3H

A

immune Complex mediated
antibody to soluble antigens
systemic

17
Q

what are some examples of T3H

A

acute hypersensitivity pneumonitis
SLE
rheumatoid arthritis

18
Q

what cells of the adaptive immune system are involved in T3H

A

B cells

IgG

19
Q

what cells of the innate immune system are involved in T3H

A

complement

neutrophils

20
Q

what happens in T3H

A

excess antigen present - antibody binds and forms small immune complexes

  • deposit in BV wall
  • activates complement
  • infiltration of macrophages and neutrophils
  • enzymes released from neutrophils cause damage to endothelial cells of basement membrane
21
Q

what is the management of T3H

A

avoidance
corticosteroid
immunosuppression

22
Q

what is T4H

A

Delayed type

23
Q

what cells are involved in T4H

A
Th1 cells (Adaptive)
macrophages (innate)
24
Q

what are some examples of T4H

A
sarcoidosis
leprosy
Hep B
contact dermatitis
TB
T1 diabetes
Psoriasis
cellular rejection of organ transplant
25
what forms in T4H
granuloma
26
what happens initially in T4H
initial sensitisation to antigen generates primed Th1 cells and memory cells
27
what does subsequent exposure in T4H cause
activates previously primed Th1 cells - recruitment of macrophages, lymphocytes, neutrophils - release of proteolytic enzymes
28
what is the role of IFN- Y in T4H
activates macrophages increasing the release of inflammatory markers
29
what is the role of IFN-a in T4H
local tissue destruction
30
what is the treatment of acute sarcoidosis
NSAIDs
31
what is the management of sarcoidosis
corticosteroids
32
what kind of hypersensitivity is graves
type 2