1. Compare the major classes of immunoglobulins as to its: a. characteristics b.

if it fixes
complement or not; and its function/s.

IGG

Molecular weight: 150,000

H-chain type (MW): gamma (53,000)

Serum concentration: 10 to 16 mg/mL

Percent of total immunoglobulin: 75%

Glycosylation (by weight): 3%

Distribution: intra- and extravascular

Function: secondary response

Fixes Complement: Yes

The predominant Ig type of human serum is IgG, a monomer. This immunoglobulin class, generated as
part of the secondary immune response to an antigen, accounts for around 75% of total serum Ig. IgG is
the single Ig class that can cross the placenta on humans, and the protection of newborns during their
first months of life is primarily responsible. IgG is the principle antibody used in immunology and clinical
diagnostics due to its relative abundance and excellent antigen-specificity.

IgM Class

Molecular weight: 900,000

H-chain type (MW): mu (65,000)

Serum concentration: 0.5 to 2 mg/mL

Percent of total immunoglobulin: 10%

Glycosylation (by weight): 12%

Distribution: mostly intravascular

Function: primary response

Fixes Complement: Yes

Serum IgM occurs in mammals as a pentamer and constitutes about 10% of the usual human serum Ig
content. It is the most effecient complement immunoglobulin in primary immune responses to most
antigens. The plasma membrane of B lymphocytes is also expressed as a monomer. This is a B-cell
antigen receptor, with each hydrophobic domain for anchors in the membrane having an additional H-
chains. Serum IgM monomers have disulfide bonds and a connection (J) chain linked together.
Two light chains (either kappa or lambda) and two heavy chains compose one of the five monomers in
the pentamer structure. In contrast to IgG, IgM monomers have one variable and four constant
domains, with the additional constant domain replacing the hinge region. Cell agglutination occurs as
IgM recognizes epitopes on invading microorganisms. Complement fixation or receptor-mediated
endocytosis by macrophages destroy the antibody-antigen immune complex. IgM is the first
immunoglobulin class produced by a newborn and is involved in the pathogenesis of certain
autoimmune diseases.

IgA Class

Molecular weight: 320,000 (secretory)

H-chain type (MW): alpha (55,000)

Serum concentration: 1 to 4 mg/mL

Percent of total immunoglobulin: 15%

Glycosylation (by weight): 10%

Distribution: intravascular and secretions

Function: protect mucus membranes

Fixes Complement: No

IgA is mostly monomeric in serum, but it is present as a dimer in secretions such as saliva, tears,
colostrums, mucus, sweat, and gastric fluid. The majority of IgA is secreted. This is thought to be due to
its ability to bind to and penetrate epithelial surfaces, blocking bacteria from entering. Since IgA is a
weak complement-activating antibody, it does not cause bacterial cell lysis via the complement system.
Secretory IgA, on the other hand, collaborates with lysozymes (also used in many secreted fluids) to
hydrolyze carbohydrates in bacterial cell walls, allowing the immune system to clear the infection.

IgE Class

Molecular weight: 200,000

H-chain type (MW): epsilon (73,000)

Serum concentration: 10 to 400 ng/mL

Percent of total immunoglobulin: 0.002%

Glycosylation (by weight): 12%

Distribution: basophils and mast cells in saliva and nasal secretions

Function: protect against parasites

Fixes Complement: No
IgE's heavy chain contains an extra domain that binds to Fc epsilon Receptor I (FcRI), which is present
mainly on eosinophils, mast cells, and basophils. Pollen, venoms, fungus, spores, dust mites, or pet
dander bind to the Fab part of the IgE attached to the cells, causing the cells to degranulate and release
factors such as heparin, histamine, proteolytic enzymes, leukotrienes, and cytokines. As a result of
vasodilation and increased small vessel permeability, fluid escapes from capillaries and into the tissues,
resulting in the effects of an allergic reaction. Most of these typical allergic reactions like mucus
secretion, sneezing, coughing or tear production are considered beneficial to expel remaining allergens
from the body.

IgD Class

Molecular weight: 180,000

H-chain type (MW): delta (70,000)

Serum concentration: 0 to 0.4 mg/mL

Percent of total immunoglobulin: 0.2%

Glycosylation (by weight): 13%

Distribution: lymphocyte surface

Function: unknown

Fixes Complement: No

Many but not all B cells have IgD molecules on their surfaces early in their growth, but very little IgD is
ever released into the bloodstream. IgD hasn't been identified as having a specific function, but it may
be involved in deciding whether antigens cause B cells.

2. Discuss the type of hypersensitive responses in the following conditions/situations are

manifested and how it affects the individual: a. Anaphylactic Shock b.) Graves’s Disease c.)
Acute Serum Sickness d.) Administration of a purified protein derivative (PPD). Discuss how the
above conditions/situations are managed.

Anaphylactic Shock

Anaphylaxis is a severe allergic reaction that can be fatal. Food, insect stings, medications, and latex are
the most frequent causes of anaphylactic reactions. Food, insect stings, medications, and latex are the
most frequent causes of anaphylactic reactions. The immune system overreacts to an allergen by
releasing toxins that cause allergy symptoms if a person is allergic to it. These bothersome signs usually
manifest in only one part of the body. Some individuals, though, are more vulnerable to a life-
threatening anaphylactic response. Usually, this response involves many parts of the body at the same
time. Anaphylaxis necessitates urgent medical attention, including an epinephrine injection and a visit to
a hospital emergency department.

Anaphylaxis is more likely to happen in many people. The chance of anaphylaxis is increased if a

person have allergies or asthma and a family history of anaphylaxis. If a person had anaphylaxis before,
the chances of getting another anaphylactic reaction are higher. Allergies require accurate diagnosis and
effective treatment. An allergist, also known as an immunologist, has advanced training and expertise to
identify the disease and assist you in developing a plan to protect oneself in the future.

Graves’s Disease

Graves' disease is a group of symptoms brought on by the butterfly-shaped thyroid gland in the lower
body, which affects 3% of individuals in the United States. Thyroid hormones assist the body in
regulating a variety of essential functions, including growth and development, body temperature, heart
rate, weight, fertility, mental wellbeing, and sleep.

Graves' disease occurs when the thyroid produces more thyroid hormone than the body requires,
resulting in hyperthyroidism, which causes the metabolism to speed up. It normally manifests itself in
mid-adulthood, but it can manifest itself at any age.

The immune system produces antibodies that allow the thyroid to rise and release too much thyroid
hormone in Graves' disease. Thyroid-stimulating immunoglobulins are the name for these antibodies
(TSIs). Thyroid cell receptors, which serve as “docking stations” for thyroid-stimulating hormone, bind to
the TSIs (TSH). Invading TSIs then cause hyperthyroidism by causing the thyroid to rise and release too
much thyroid hormone.

There are a variety of treatments available for Graves’ disease. The majority are aimed at inhibiting the
overproduction of thyroid hormones by targeting the thyroid gland; others aim to reduce the symptoms.
Anti-thyroid medication. The most commonly utilized treatment for Graves’ disease anti-thyroid
medication. Three common drugs that target the thyroid are propylthiouracil,methimazole, and
carbimazole (which is converted to methimazole and is not available in the United States but is used in
Europe); methimazole is most common in the United States. Anti-thyroid medication helps prevent the
thyroid gland from producing excess amounts of hormones by blocking the oxidation of iodine in the
thyroid gland.

Radioactive iodine therapy has been used to treat Graves’ disease since the 1940s. It is still popular
because it is non-invasive and highly effective. Radioactive iodine is taken orally and directly targets the
thyroid gland. Iodine is used by the thyroid gland to make thyroid hormones. When medication is taken,
the radioactive iodine soon builds up in the thyroid gland and slowly destroys any overactive thyroid
cells. Because other treatments for Graves’ have steadily improved, surgery is now less common.
However, it is still used if other treatments are unsuccessful. Thyroidectomy is the removal of all or part
of the thyroid gland on how much depends on the severity of the symptoms.
Acute Serum Sickness

Serum sickness is a similar immune response to an allergic reaction. When antigens (substances that
induce an immune response) in some drugs and antiserums cause the immune system to respond, this is
what happens.

Proteins from nonhuman origin normally animals are involved in serum sickness antigens. These
proteins are misinterpreted by the body as toxic, causing an immune response to eliminate them.
Immune complexes (antigen and antibody combinations) form as the immune system interacts with
these proteins. These complexes may form clumps and lodge in small blood vessels, resulting in
symptoms.

There are no evidence-based protocols or high-quality controlled trials to use as a foundation for
treatment. The following is the general approach: Stop taking the medication that is triggering the
reaction,  Antihistamines may be used to relieve pruritu, for joint pain control, take nonsteroidal anti-
inflammatory medications. Short courses of systemic glucocorticoids can be used in patients with severe
arthritis, high fever, or a severe generalized rash. Oral prednisone 0.5 to 1 mg/kg once everyday, with
dosage tapering to discontinuation during 1 to 2 weeks, is a popular method.

Purified protein derivative (PPD)

A purified protein derivative (PPD) skin test is a test that determines if you have tuberculosis (TB). TB is a
dangerous infection, generally of the lungs, caused by the bacteria Mycobacterium tuberculosis. When a
person breathe in the air exhaled by someone who has tuberculosis, the infection spreads. Bacteria will
stay dormant in your body for years. TB may become activated when the immune system is
compromised, causing symptoms such as: fever, weight loss, coughing, night sweats.

Drug-resistant tuberculosis is described as tuberculosis that does not react to antibiotics. In many parts
of the world, including Southeast Asia and Africa, this is a major public health problem. As tuberculosis
infects the body, it becomes hypersensitive to certain bacteria components, such as distilled protein
derivatives. A PPD test determines the current level of sensitivity. This will say doctors whether a
person have tuberculosis or not.

Tuberculosis (TB) is a highly infectious illness. According to the World Health Organization (WHO)Trusted
Source, tuberculosis is the second-leading cause of death worldwide, behind only HIV and AIDS. In the
United States, though, the condition is comparatively uncommon. The majority of patients afflicted with
tuberculosis in the United States have no signs or symptoms.

If a person work in the medical industry, they can get a PPD skin test. Both healthcare staff must be
tested for tuberculosis on a regular basis. A PPD skin test is also needed if: A person  come into contact
with someone who has tuberculosis. Certain drugs, such as hormones, or illnesses, such as cancer, HIV,
or AIDS, have compromised the immune system.
 Oxford- Sinovac/ Pfizer-BioNTech Sputnik-V
AstraZeneca Sinopharm

classification Adenovirus- Inactivated mRNA Adenovirus-

as a vaccine based SARS-CoV-2 based
based on virus
how it works
storage about 36-46 35.6 and 46.4 -94 degrees F 35.6 and
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administered
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healthcare
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effectivity Currently 50.38% to About 95%. 91.4%
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overall depending on 100% at
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and death.
reported Pain or increase in Chills, short-term
problems tenderness at blood headache, pain, effects
with its the injection pressure, tiredness, including
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cost $25-$37 per $60 per dose $19.50 per dose $10 per
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 If I were to choose a vaccine by the table given above, I would then choose Pfizer-BioNTech, not
just because of what it says in the table but because of the videos and articles that I have found
in the internet. It is the most widely used vaccine in US and the effectivity rate is high based on
the clinical trials. I would choose last the Sinovac for no important reasons, I just do not feel like
using any kind of vaccines that comes from them.

4. Brian goes to the hospital after not feeling well for a week. He has a fever of 38 °C (100.4 °F)
and complains of nausea and a constant migraine. Distinguish between the signs and
symptoms of disease in Brian’s case

A sign is a health problem that can be used in the medical community. While everyone can recognize the
signs, they should be clinically examined by physicians who have the expertise and expertise to
determine the cause. Doctors can evaluate a number of symptoms, which is a vital aspect of the
diagnosis. In this case, the signs in Brian’s case is a fever of 38°C (100.4 °F). This is observable and can be
identified by a nurse or doctor.

A symptom is a person's own experience of a possible health condition that can't be seen by a doctor.
Stomach cramps caused by undercooked beef, a throbbing headache caused by tension, or an intense
sense of exhaustion are all examples. These problems are symptoms, not signs, so the practitioner
cannot see, sense, sound, or scent them. You are the only one who can explain the symptoms while you
are feeling them. In Brian’s case the symptoms are nausea and constant migraine that can only be felt by
the patient.

Two periods of acute disease are the periods of illness and period of decline.

5.1.In what way are both of these periods similar?

The prodromal duration is brief and quickly leads to stop disease, the period of illness. This is the stage
in the progression of a disease where a person begins to experience the disease's normal signs and
symptoms. At a nutshell, this is when you're sick.

When a person reach the acme phase, they enter the time of regression, which is the stage of disease
progression where the immune system starts to keep microbial replication under control, resulting in a
decrease of disease-related clinical signs and symptoms.

5.2.In terms of quantity of pathogen, in what way are these periods different?

The prodromal period happens after the incubation period. During this process, the pathogen continues
to multiply, and the host starts to exhibit signs and symptoms of sickness, which are normally triggered
by the immune system being activated. The period of infection is accompanied by a period of decline,
during which the number of pathogen particles reduces and the signs and symptoms of illness decrease.
Patients may be more vulnerable to secondary infections during the decline phase when their immune
systems have been compromised by the main infection.

5.3. What initiates the period of decline?

The number of pathogen particles began to decline, during which the number of pathogen particles
begins to decrease, and the signs and symptoms of illness begin to decline.

Reference:

Anaphylaxis: AAAAI. The American Academy of Allergy, Asthma & Immunology.

https://www.aaaai.org/conditions-and-treatments/allergies/anaphylaxis.

Classes of immunoglobulins. https://www.britannica.com/science/immune-system/Classes-of-

immunoglobulins.

Immunoglobulin IgE Class. Thermo Fisher Scientific - US.

https://www.thermofisher.com/ph/en/home/life-science/antibodies/antibodies-learning-
center/antibodies-resource-library/antibody-methods/immunoglobulin-ige-class.html.

Leo, L. (2021, March 1). Pfizer-BioNTech, Moderna and Sinovac: A look at three key COVID-19
vaccines. CNA. https://www.channelnewsasia.com/news/world/covid-19-vaccines-
comparison-pfizer-sinovac-moderna-13784890.

Libretexts. (2021, March 5). 12.2: Characteristics and Steps of Infectious Diseases. Biology
LibreTexts. https://bio.libretexts.org/Courses/Manchester_Community_College_(MCC)/
Remix_of_Openstax%3AMicrobiology_by_Parker_Schneegurt_et_al/
12%3A_Microbial_Interactions_Flora_Pathogenicity_and_Epidemiology/
12.02%3A_How_Pathogens_Cause_Disease.

MediLexicon International. Graves' disease: Symptoms, treatment, and causes. Medical News
Today. https://www.medicalnewstoday.com/articles/170005#treatment.

Posted on August 20, 2020 by S. A.- L. (2020, August 20). What's The Difference Between Signs
And Symptoms? Medical Centre.
https://www.brisbanebulkbillingdoctor.com.au/news/whats-the-difference-between-signs-
and-symptoms/.

Serum Sickness. Allergy and Immunology - Diseases - McMaster Textbook of Internal Medicine.
https://empendium.com/mcmtextbook/chapter/B31.II.17.2.

Terry, M. (2021, February 8). UPDATED Comparing COVID-19 Vaccines: Timelines, Types
and Prices. BioSpace. https://www.biospace.com/article/comparing-covid-19-vaccines-
pfizer-biontech-moderna-astrazeneca-oxford-j-and-j-russia-s-sputnik-v/.
What Is Graves' Disease? EndocrineWeb. https://www.endocrineweb.com/conditions/graves-
disease/graves-disease-overview.