ALLERGY AND

HYPERSENSITIVITIES

RUBINA SHOUKAT
 HYPERSENSITIVITY

• Hypersensitivity is a condition in which an exaggerated or

augmented immune response occurs that is harmful to the host.
• Hypersensitivity requires a presensitized state.
• For example, in a given individual, such reactions typically occur
after the second encounter with that specific antigen (allergen)
• Types: I, II, III, IV.
TYPE I: IMMEDIATE HYPERSENSITIVITY (ALLERGY)

• Associated Antibody: IgE antibody

• Symptoms may manifest as a systemic anaphylaxis or local reaction
• First (binding of IgE on mast cell, ) and second exposure cross-
linking of the cell-bound IgE molecules and the release of
pharmacologically active mediators
• Histamine (Vasodilation, Increased capillary permeability and smooth muscle
contraction bronchospasm)
• Prostaglandin (Edema, Bronchoconstriction) and leukotriene B4, C4, D4
• These mediators, along with TNF-α and IL-4, are referred to as secondary
mediators of type 1 reaction .
 ATOPY AND TREATMENT

• A strong familial predisposition and are associated with elevated

IgE levels.
• Common clinical manifestations include hay fever, asthma,
eczema, and urticaria.
• Treatment:
• Anaphylactic shock: Reverse the mediators
• Artificial ventilation
• Supporting cardiac activity
• Drugs (Epinephrine, antihistamines, and corticosteroids)
 TYPE II: HYPERSENSITIVITY

• IgG
• binding of IgG antibodies to cell surface antigens or extracellular
matrix molecules
• Complement activation Example (Hemolytic anemia, ABO and
Rh transfusion reactions)
• Drugs such as penicillin can attach to surface proteins on red
blood cells and initiate antibody formation. Such autoimmune
antibodies may then combine with the cell surface and cause
hemolysis.
• Autoimmune reactions
 TYPE III: IMMUNE COMPLEX HYPERSENSITIVITY

• Immune complex formation and deposition (kidney, joints etcs)

• Causing complement to activate
• There are two major forms of immune complex-mediated
hypersensitivity.
• Arthus reaction (Local and at low does), neutrophil and mast cell
activated reaction in 12 hours
• Acute poststreptococcal glomerulonephritis (group A β-
hemolytic streptococcal infection)
 TYPE IV: CELL-MEDIATED (DELAYED)
HYPERSENSITIVITY

• Cell-mediated hypersensitivity is a T cell-mediated response.

• begins 2 or 3 days after contact with the antigen and typically lasts
for several days.
• Types
• Contact Hypersensitivity (Small Molecules acting as haptens), erythema,
itching, vesication, eczema, or necrosis of skin within 12–48 hours.
Langerhans cells in the epidermis, which interact with CD4 Th1 cells,
• Tuberculin-Type Hypersensitivity
• The tuberculin reaction is a good example of a delayed-type
hypersensitivity (DTH) response.