hypersensitive reactions 2-060806 (report)

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    Type II

    Antibody-mediated

    cytotoxic hypersensitivity

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    The four types of hypersensitive responses

    Kuby J et al., Immunology 2003

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    Type II hypersensitivity reactions (1)

    - Caused by antibody to cell surface antigens

    and components of the extracellular matrix.

    - These antibodies can sensitize the cells for

    antibody-dependent cytotoxic attackby K cells

    or for complement-mediated lysis.

    - Type II hypersensitivity is seen in the destruction

    of red cells in transfusion reactions and inhaemolytic disease of the newborn.

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    Type II hypersensitivity reactions (2)

    - Innocuous antigens can cause Type II

    hypersensitivity reactions insusceptible individuals by binding

    to the surfaces of circulating blood cells.

    - IgG antibodies against cell-surface receptors

    that disrupt the normal functions of the

    receptor, either by causing uncontrollable

    activation or by blocking receptor function.

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    Antibody-Dependent Cell-mediated Cytotoxicity (ADCC)

    Kuby J et al., Immunology 2003

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    ABO blood group

    Kuby J et al., Immunology 2003

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    Development of erythroblastosis fetalis (hemolytic disease of the newborn) caused when an

    RH- mother carries an RH+ fetus, and effect of treatment with anti-Rh antibody, or Rhogam

    Kuby J et al., Immunology 2003

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    Graves disease: Hyperthyroidism Myasthenia gravis

    : Muscle weakness

    (hormones) (neurotransmitter)

    Effector mechanisms of antibody-mediated disease

    C

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    Type III

    Immune complex-mediated

    hypersensitivity

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    The four types of hypersensitive responses

    Kuby J et al., Immunology 2003

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    Type III hypersensitivity reactions (1)

    - Directed against soluble antigens

    - Caused by the deposition of antigen/antibodycomplexes in tissue and blood vessels.

    - The complexes activate complement and attractploymorphs and macrophages to the site.

    - These cells may exocytose their granule contentsand release reactive oxygen and nitrogen

    intermediates to cause local tissue damage.

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    Type III hypersensitivity reactions (2)

    - The deposition of immune complexes in

    tissues causes a local inflammatory

    response known as an Arthus reaction.

    - Serum sickness is a classic example of a

    transient immune complex-mediated syndrome.

    - In situations in which antigen persists

    subacute bacterial endocarditischronic viral hepatitis

    systemic lupus erythematosus (SLE)

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    Development of a localized Arthus reaction

    Immunology (Fig. 16-15), 5th edn 2003 Kuby J

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    The multiple activities of the complement system.

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    Immune complex disease

    - The immune complexes produced may bind to vascular

    endothelium and kidney glomeruli and activate complement

    (MAC generation).

    - It initiates the acute inflammatory responses that destroy the

    vessel walls or glomeruli and lead to thrombosis, ischemicdamage to tissues, and scarring.

    - Some of the late complement proteins may activate

    prothrombinases in the circulation that initiate thrombosis.

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    Figure 12-23

    Serum sickness is a classic example of a transient

    immune complex-mediated syndrome

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    Type IV

    Delayed-type hypersensitivity (DTH)

    (Cell-mediated hypersensitivity)

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    The four types of hypersensitive responses

    Kuby J et al., Immunology 2003

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    Type IV hypersensitivity reactions

    - T-cell mediated

    - 1st group: Tissue damage is caused by the activationofmacrophages by TH1 cells, which results

    in an inflammatory response.

    - 2nd group: Damage is caused by the activation by TH2

    cells ofinflammatory responses in which

    eosinophils predominate.

    - 3rd group: Damage is caused directly by cytotoxic T

    cells (CTL).

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    Figure 12-24

    Type IV hypersensitivity responses

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    Overview of the DTH response

    Kuby J et al., Immunology 2003

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    Figure 12-26 part 1 of 2

    The delayed-type (type IV) hypersensitivity response is directed by

    chemokines and cytokines released by TH1 cells stimulated by antigen (1)

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    Figure 12-26 part 2 of 2The delayed-type (type IV) hypersensitivity response is directed bychemokines and cytokines released by TH1 cells stimulated by antigen (2)

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    A prolonged DTH response can lead to formation of a granuloma

    Lytic enzymes released from

    activated macrophages in a

    granuloma can cause extensivetissue damage.

    Kuby J et al., Immunology 2003

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    A Second Exposure to Poison Oak May Result in Delayed-Type Hypersensitivity

    Kuby J et al., Immunology 2003

    D l t f d l d t h it it ti ft

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    Immunology (Fig. 16-20), 5th edn 2003 Kuby J

    Development of delayed-type hypersensitvity reaction after

    a second exposure to poison oak

    Secrete INF- and other cytokines

    Activated macrophages

    Secrete mediatorsof inflammation

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    Bli t i ki l i h d f ti t ith

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    Figure 12-28

    Blistering skin lesions on hand of patient with

    poison ivy contact dermatitis

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    There are four types of hypersensitivity reaction mediated

    by immunological mechanisms that cause tissue damage

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    Kuby J et al., Immunology 2003

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