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Final_exam_review_slides - Gel and Coombs classification...

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1 Type I IgE Mediated Classic Allergy Type II IgG/IgM Mediated rbc lysis Type III IgG Mediated Immune complex Disease Type IV T cell Delayed Type Hypersensitivity Gel and Coombs classification of hypersensitivities. TYPE I Hypersensitivity Classic allergy Mediated by IgE attached to Mast cells. The symptoms resulting from allergic responses are known as anaphylaxis . • Includes: Hay fever, asthma, eczema, bee stings, food allergies. Characteristics of allergens Small 15-40,000 MW proteins Only specific protein components of larger complex foreign antigen. Low dose mucosal exposure Promote a Th2 immune Genetic Predisposition Type I hypersensitivity Candidate genes include: – IL-4 Receptor or IL-4 cytokine – Fc receptor for IgE – Class II MHC – Inflammation genes
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2 Mechanisms of allergic response Sensitization Repeated exposure to allergens initiates immune response that generates IgE isotype. Th2 cells required to provide the IL-4 required to get isotype switching to IgE. Mechanisms of allergic response Sensitization Th2/B cell interaction IL-4 IL-4R CD40 Drive B cell Activation and IgE isotype switch. Busse and Lemanske NEJM Feb 2001. 344:350 Mechanisms of allergic response Effector Stage of Hypersensitivity Secondary exposure to allergen Mast cells are primed with IgE on surface. Allergen binds IgE and cross-links to activate signal degranulation and release of mediators. Mediators of Type I Hypersensitivity Primary Mediators Histamine Cytokines TNF- α , IL-1, IL-6. Attractants for Neutrophils and Eosinophils. Enzymes = connective tissue breakdown.
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3 Type I Hypersensitivity Secondary mediators formed after activation Leukotrienes and Prostaglandins Th2 cytokines- IL-4, IL-5, IL-10 Continuation of sensitization cycle Mast cells control the immediate response. – Eosinophils and neutrophils drive late or chronic response. More IgE production further driven by activated Mast cells, basophils, eosinophils. Treatment for Type I Drugs OR Immunotherapy Skin Testing to identify allergens Desensitization (allergy shots) repeated injections of allergen to reduce the IgE on Mast cells and produce more IgG against allergen.
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