BSMT-3 IMMUNOSEROLOGY Aug.

24, 2020
HYPERSENSITIVITY Dr. Andrea Villaruel, MD, DPSP

OUTLINE
I. Hypersensitivity
II. Classification of Hypersensitivity
a. Type 1 (Immediate) Hypersensitivity
- Preformed mediators
- Responsibilities of preformed
mediators
- Newly synthesized mediators
- Clinical Manifestation
- Testing for immediate hypersensitivity
b. Type 2 (Cytotoxic) Hypersensitivity
- Clinical manifestation
- Testing for Cytotoxic Hypersensitivity
c. Type 3 (Immune Complex)
Hypersensitivity
- Clinical Manifestation
d. Type 4 (Delayed Type) Hypersensitivity
- Clinical Manifestation
- Testing for Delayed-Type
Hypersensitivity Preformed mediators:
- Comparison of Hypersensitivity
Reactions
 Histamine
- Comparison of Different types of  Eosinophil chemotactic factor
Hypersensitivity of anaphylaxis
HYPERSENSITIVITY  Neutrophil chemotactic factor
 Heightened state of immune  Proteolytic enzyme such as
responsiveness. trypsin
 Exaggerated response to a harmless Responsibilities of the preformed
antigen resulting to tissue injury, mediators:
disease, or even death.
a) Contraction of the smooth muscle in
the bronchioles, blood vessels, and
CLASSIFICATION OF intestines;
HYPERSENSITIVITY
1. Type 1 (Immediate) Hypersensitivity b) Increased capillary mediators;
2. Type 2 (Cytotoxic) Hypersensitivity c) Increased concentration of
3. Type 3 (Immune Complex) eosinophils and neutrophils in the area;
Hypersensitivity and
4. Type 4 (Delayed Type)
Hypersensitivity d) Decreased coagulability of blood.
Newly synthesized mediators:
Type 1 (Immediate)
a) Prostaglandins (PG);
Hypersensitivity
 Is manifested within minutes of b) Leukotrienes (LT); and
exposure to antigen.
 IgE- is the immune reactant. c) Platelet-activating factor (PAF)
 Mast cells- principle effector cells of -potentiate the effects of the
immediate hypersensitivity. preformed mediators.
 Degranulation of basophils/mast
cells releases mediators that
enhance the inflammatory
response.

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 BSMT-3 IMMUNOSEROLOGY Aug. 24, 2020
HYPERSENSITIVITY Dr. Andrea Villaruel, MD, DPSP

bronchopulmonary aspergillosis and

hyper-IgE syndrome.
 It is also serve as screening tool to
determine if more specific allergy
testing is indicated.

b) Radioallergosorbent Test (RAST)

- Noncompetitive method
- Measures antigen-specific IgE by
using solid phase antigen to capture
patient antibody.
RAST
 Useful in detecting allergies to common
triggers such as ragweed, trees,
grasses, mold spores, animal dander,
milk and egg albumin.
Clinical Manifestations:
 Useful also in determining common
1. Wheal and flare skin reactions food allergies and sensitivity to the
venom of stinging insects such as
2. Rhinitis honey bees, wasps, and hornets.
3. Systemic anaphylactic responses
(life-threatening)
4. Asthma
5. Food allergies
Testing for Immediate
Hypersensitivity:
1. In vivo tests
 cutaneous and intradermal tests
- Direct skin tests
- Wheal and flare formation (positive
reaction)
Type 2 (Cytotoxic)
2. In vitro tests
Hypersensitivity
a) Radioimmunosorbent Test (RIST) IgG and IgM
- Noncompetitive method - Are the principle reactants
- React with antigens located on cellular
- Measures total IgE by capturing the surfaces and trigger activation of the
antibody with solid-phase anti-IgE. complement cascade resulting to
RIST damaged target cells.

 It is used to clinically to aid in the

diagnosis of allergic rhinitis, asthma,
parasitic infections,

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 BSMT-3 IMMUNOSEROLOGY Aug. 24, 2020
HYPERSENSITIVITY Dr. Andrea Villaruel, MD, DPSP

1. Contact dermatitis

Testing for Cytotoxic Hypersensitivity:

Direct Antiglobulin (DAT) technique
2. Farmer’s lung disease
- Also known as direct Coombs’ test
3. Pigeon breeder’s disease
- Used to detect in vivo coating of red
4. Humidifier lung disease
blood cells with antibody (IgG) or
complement components (C3d or 5. Tuberculin-type hypersensitivity
C3b).
6. Hypersensitivity pneumonitis
- After washed patient rbcs are
combined with antihuman globulin Testing for Delayed-Type
(AHG), observed for agglutination. Hypersensitivity:

Type 3 (Immune Complex) 1. Patch test

Hypersensitivity 2. Mantoux method
 IgG, IgM and complement
components 3. Tuberculin test
-Are the principal reactancts, BUT
reaction is directed against soluble
rather than cellular antigens.
-Antigen-antibody complexes deposited
in the tissues+ complement
components= tissue damage.
Clinical Manifestation:
1. Arthus reaction (localized type 3
reaction)
2. Serum Sickness (generalized type 3
reaction)
3. Autoimmune disease (e.g. SLE and
RA)

Type 4 (Delayed Type)

Hypersensitivity
Clinical Manifestation:

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 BSMT-3 IMMUNOSEROLOGY Aug. 24, 2020
HYPERSENSITIVITY Dr. Andrea Villaruel, MD, DPSP

REFERENCE

 Dr. Andrea Villaruel’s Powerpoint

Presentation
(Don’t study with a fear of failing.
Study with the hope of succeeding.
– Dr.K)

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