10 hypersensitivity
DESCRIPTION
HipersensitivitasTRANSCRIPT
HYPERSENSITIVITY
1. Allergic Response2. Allergic Response Type
Type I –III: Immediate Hypersensitivity
Type– IV: Delayed Type Hypersensitivity
Allergic Responses
• Reexposed to antigen that has encountered previously
• Allergic symptoms are caused by immune reponses (Immune product).• Immediate Hypersensivity :
antibody (B) and cytokines (T)
Allergic Response Type
Type (Group) I (Anaphylactic)
B
MastCell
MastCellIgE
degranulasi
histamine release
pollen (first) pollen (second)
Type (Group) II (Cytotoxic)
Allergic Response Type
REDCELLS
C
Direct Cell LYSIS orC5a reqruitment of Neutrophylto phagocytose cell
IgG
Surface Antigen
Allergic Response Type• Type (Group) III (Immunocomplex)
CIgGIgM
Neut Neut
IntegrinICAM-1VCAM-1
CIgGIgM
VASCULITIS
complement
Immunocomplex DiseasesAllergic Diseases
• Arthur Reaction (vaccine,drug,insect bite)• SerumSickness (Protein & nonprotein drugs)
Nonalleric Diseases• Lupus erythematosus
• Vasculitis• Glomerulonephritis
• Rheumatoid arthritis• Acute allograft rejection.
Allergic Response TypeType (Group) IV
(Delayed Type Hipersensitivity or T cell mediated monocyte/ macrophage activation
or Cell Mediated Hypersensitivity)Exp:
Allergic Contact Dermatitis.Hypersensitivity Pneumonitis
Photoallergic Contact Dermatitis.
Allergic Response TypeType IV (Abbas)
Delayed type hypersensitivity
Th1/Tc M
Activated macrophage inflammation
IL-2INFγTNFß
Tissue injury
Tc Tc
Cell killing & tissue injury
Targetcells
T cell mediated cytolysis.
Th0M
IL-12
Th2Th1
IL-2TNFß
INFγIL-10
IL-4 TGFß IL-5
DTH B Cell IH EosinophilIgE
promote
inhibit
antigen
CLASS SPECIFIC IMMUNE MEDIATORS DISEASES REACTANT
I Ig E Mast Cell and Atopy basophil-derived Anaphylaxis Uricaria/angioedema
II IgG,*Ig M Complement Immune hemolytic anemia, Neutropenia
III IgG,IgM Complement Serum Sickness (Immunocomplex)
IV T lymphocyes T cell cytokines Allegic contact dermaitis
DRUG ALLERGY
DRUGANTIGEN
CARRIER PROTEIN(TISSUE)
CONYUGATE SPECIFICANTIBODY
1. Native molecule
2. Hydrolisis/biotransformation products
3. Interaction of the drug/drug metabolite and the protein
4. Conformational change in the tissue protein
DRUG ALLERGY
drug
drug ordrug metabolite
drug ordrug metabolite
drug metabolite
IMMUNOLOGIC IN VIVO IN VITRO REACTION TYPE I Immediate skin prick RAST. ELISA and intradermal
TYPE II None Coombs
TYPE III Intradermal Arthus Test Precipitin Test RAST,ELISA
TYPE IV Patch Test Lymphocyte Proliferation.
DRUG ALLERGY TESTING METHODS