IMMUNOLOGY AND SEROLOGY

LECTURE / WEEK NO.9 / MACARUBBO L.

HYPERSENSITIVITY COMMON ALLERGENS

I. What is Hypersensitivity 

÷
Pollen
II. Type I Hypersensitivity  Mold spores
III. Type II Hypersensitivity  Animal dander
IV. Type III Hypersensitivity  Dust mites
V. Type IV Hypersensitivity  Insect venom
 Certain foods (peanuts, shellfish, dairy products) -
WHAT IS HYPERSENSITIVITY?
 Certain drugs (penicillin) -

 Exaggerated immune response to a typically harmless  Latex .

antigen
CLINICAL MANIFESTATIONS OF TYPE I HYPERSENSITIVITY
 Results in tissue injury and disease

÷
 Four categories of hypersensitivity  Rhinitis (“hay fever”)

E-
o Type I  Asthma
o Type II  Food allergies
o Type III  Urticaria (“hives”)
o Type IV o Wheal and flare (welts)
 Immediate reactions  Eczema

÷
o Develop minutes to hours after antigen  Systemic anaphylaxis
exposure o A potentially fatal reaction
o Type I, type II, type III 
TESTING FOR TYPE I HYPERSENSITIVITY: IN VIVO SKIN
 Delayed reactions TESTS
o Develop 24 to 48 hours after antigen  Percutaneous or intradermal
exposure  Process
o Type IV
o Apply a panel of allergens to separate sites
on the skin
TYPE I - HYPERSENSITIVITY
o Wait 15 to 20 minutes
 Also known as anaphylactic hypersensitivity  Positive test = wheal and flare at the site of application
 Typically thought of as “allergies”
 Commonly occur within minutes after exposure to an TYPE II - HYPERSENSITIVITY
allergen
 Also known as antibody-mediated cytotoxic
 Key components
hypersensitivity
o IgE
 Key components = IgG and IgM directed against a cell
o Mast cells
surface antigen
o Basophils
 Effects of the antibodies:
o Eosinophils
o Cell destruction
 Allergens can be inhaled, ingested, or enter through the
skin or genitourinary tract. Avoidance of the allergen is
the first line of defense against allergies.
o
o =
Inhibition of cell function
Increase in cell function

IMMUNOLOGY AND SEROLOGY: HYPERSENSITIVITY 1

 IMMUNOLOGY AND SEROLOGY
LECTURE / WEEK NO.9 / MACARUBBO L.

CLINICAL EXAMPLES OF TYPE II HYPERSENSITIVITY EXAMPLES OF TYPE III HYPERSENSITIVITY

 Transfusion reactions  Autoimmune disease

 Hemolytic disease of the newborn (HDN)  Hypersensitivity pneumonia
 Autoimmune hemolytic anemia  Infection
o Warm reactive antibodies – attack RBCs at  Drug reactions
37°C  Arthus Reaction
o Cold agglutinins –Ab that attack self o Skin reaction caused by type III
antigens (RBCs) if below 37°C hypersensitivity
o Paroxysmal cold hemoglobinuria – cold o Localized inflammation characterized by
reacting Abs redness and edema
 Goodpasture’s syndrome o Peaks at 3 to 8 hours
 Hashimoto’s disease
 Hemolytic Disease of the Newborn (HDN)
o Caused by development of antibodies by a
pregnant woman to red blood group
antigens, usually Rh D, on the RBCs of the
fetus.

TYPE III - HYPERSENSITIVITY

 Complex-mediated hypersensitivity
 Key components are IgG and IgM directed against a  Serum Sickness
soluble antigen o Generalized type III hypersensitivity reaction
 Small antigen–antibody complexes precipitate out and o Caused by passive immunization of humans
deposit in tissues with animal serum
 C’ binds; vasodilation and vasopermeability increase. o Produces antibodies against the foreign animal
Can develop edema, wheal and flare. proteins in patients
 Macrophages and neutrophils migrate to the affected o Causes immune complexes to form and deposit
areas and release their lysosomal enzymes, resulting in in tissues
tissue damage o Symptoms: headache, fever, nausea, joint pain,
rashes, and lymphadenopathy
 Other Conditions Associated with Type III
Hypersensitivity
o Some autoimmune diseases (e.g., systemic
lupus erythematosus and rheumatoid arthritis)
o Reactions to bee stings
o Drug reactions (e.g., penicillin)
o Sequelae to infections (e.g., post-streptococcal
glomerulonephritis)

IMMUNOLOGY AND SEROLOGY: HYPERSENSITIVITY 2

 IMMUNOLOGY AND SEROLOGY
LECTURE / WEEK NO.9 / MACARUBBO L.

TYPE IV- HYPERSENSITIVITY  Contact Dermatitis

 Cell-mediated hypersensitivity o Low-molecular-weight compounds contact
 Th1 cells and macrophages are involved the skin and act as haptens to sensitize Th1

 APCs present antigen to naïve T helper cells, which cells

o Examples:
differentiate into Th1 cells
 Poison ivy, poison oak, nickel salts,
 Th1 cells release cytokines that attract and activate
materials in cosmetics and hair
macrophages
dyes, and latex
 Macrophages induce inflammation
o Skin eruptions with erythema, swelling, and
 Cytotoxic T lymphocytes are recruited and destroy
papules are produced
target cells
 Hypersensitivity peaks 48 to 72 hours after antigen
exposure SUMMARY

 Type I – IgE mediated immediate reaction

 Type II – Antibody – mediated reaction (IgG or IgM)
 Type III – Immune complex mediated reaction
 Type IV – cytotoxic cell mediated, delayed
hypersensitivity.

CLINICAL EXAMPLES OF TYPE III HYPERSENSITIVITY

 Infections with intracellular pathogens

o Myobacterium tuberculosis, Myobacterium
leprae, Pneumocystis carinii, Leishmania
species, herpes simplex virus
 Contact dermatitis
 Hypersensitivity pneumonitis
o Allergic diseases of the lungs
o Caused by inhalation of bacterial and fungal
spores
o Examples: Farmer’s lung disease (allergy to
mold in crops) , bird breeder’s lung disease,
humidifier lung disease

IMMUNOLOGY AND SEROLOGY: HYPERSENSITIVITY 3