Chapter 19

Disorders
Associated
with the Immune
System

Copyright © 2010 Pearson Education, Inc.

Lectures prepared by Christine L. Case
Q&A

 How can microscopic

pollen from plants
cause acute
discomfort to many
people?

Copyright © 2010 Pearson Education, Inc.

Hypersensitivity Reactions

Type of Reaction Time After Exposure for

Symptoms
Type I (anaphylaxis) or
<30 min
IgE-mediated
Type II (cytotoxic) 5–12 hours

Type III (immune complex) 3–8 hours

Type IV (cell-mediated, or
24–48 hours
delayed hypersensitivity)

Copyright © 2010 Pearson Education, Inc.

 Type I (Anaphylaxis)

 Local anaphylaxis
 Hives, hay fever, asthma
 Systemic anaphylaxis
 May result in circulatory collapse and death
Copyright © 2010 Pearson Education, Inc.
 Preventing Anaphylaxis
• Skin Testing
• RAST

 Desensitizing
injections of Ag
 Cause IgG,
blocking Ab

• Medications to relieve
symptoms
Copyright © 2010 Pearson Education, Inc. Figure 19.3
Type II (Cytotoxic) Reactions
 IgG or IgM and complement + cellular Ag
 Complement activation causes cell lysis or
damage by macrophages

Copyright © 2010 Pearson Education, Inc.

Hemolytic Disease of the Newborn

Copyright © 2010 Pearson Education, Inc. Figure 19.4

 Type III (Immune Complex) Reactions
 IgG or IgM and soluble Ag form immune complexes: AGN

Copyright © 2010 Pearson Education, Inc.

 Type IV (Cell-Mediated) Reactions
 Delayed hypersensitivities - sensitized T cells
 Cytokines attract macrophages and TC - allergic
contact dermatitis

Copyright © 2010 Pearson Education, Inc.

Allergic Contact Dermatitis

 A nurse develops
this rash 3 days
after using latex
gloves.

 Was this her first

exposure?

 What is the
delayed reaction?

Copyright © 2010 Pearson Education, Inc. Clinical Focus, p. 531

Autoimmune Diseases

 Clonal deletion during fetal development ensures self-

tolerance
 Autoimmunity
 loss of self-tolerance

http://www.bio.davidson.edu

 Cytotoxic—Ab + cellular Ag; Graves’ disease

 Immune complex—IgM or IgG, soluble Ag deposit in
tissues; SLE, Rheumatoid Arthritis
 Cell-mediated— T cells; Hashimoto’s thyroiditis, MS

Copyright © 2010 Pearson Education, Inc.

 Grafts or Transplants
 Privileged sites
 May be attacked by T cells, mac rophages, NK cells and complement-fixing antibodies.

 Autograft
 Isograft
 Allograft
 Xenotransplantation

 Graft-versus-host disease

 transplanted bone marrow that contains immunocompetent cells

http://blog.taragana.com

Copyright © 2010 Pearson Education, Inc.

 Stem Cells
 May allow therapeutic cloning to avoid rejection
 Embryonic stem cells are pluripotent
 Adult stem cells have differentiated to form specific cells

Copyright © 2010 Pearson Education, Inc. Figure 19.10

Immunodeficiencies – Lack of Function
Disease Cells Affected
AIDS TH (CD4+) cells
Selective IgA immunodeficiency B, T cells
Common variable
B, T cells (decreased Igs)
hypogammaglobulinemia
Reticular dysgenesis B, T, and stem cells
Severe combined immunodeficiency B, T, and stem cells
Thymic aplasia (DiGeorge syndrome) T cells (defective thymus)

Wiskott-Aldrich syndrome B, T cells

X-linked infantile (Bruton’s)

agammaglobulinemia B cells (decreased Igs)
Copyright © 2010 Pearson Education, Inc.