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7/31/2019 Hypersensitive Reactions 2-060806 (REPORT)
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Type II
Antibody-mediated
cytotoxic hypersensitivity
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The four types of hypersensitive responses
Kuby J et al., Immunology 2003
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Type II hypersensitivity reactions (1)
- Caused by antibody to cell surface antigens
and components of the extracellular matrix.
- These antibodies can sensitize the cells for
antibody-dependent cytotoxic attackby K cells
or for complement-mediated lysis.
- Type II hypersensitivity is seen in the destruction
of red cells in transfusion reactions and inhaemolytic disease of the newborn.
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Type II hypersensitivity reactions (2)
- Innocuous antigens can cause Type II
hypersensitivity reactions insusceptible individuals by binding
to the surfaces of circulating blood cells.
- IgG antibodies against cell-surface receptors
that disrupt the normal functions of the
receptor, either by causing uncontrollable
activation or by blocking receptor function.
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Antibody-Dependent Cell-mediated Cytotoxicity (ADCC)
Kuby J et al., Immunology 2003
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ABO blood group
Kuby J et al., Immunology 2003
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Development of erythroblastosis fetalis (hemolytic disease of the newborn) caused when an
RH- mother carries an RH+ fetus, and effect of treatment with anti-Rh antibody, or Rhogam
Kuby J et al., Immunology 2003
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Graves disease: Hyperthyroidism Myasthenia gravis
: Muscle weakness
(hormones) (neurotransmitter)
Effector mechanisms of antibody-mediated disease
C
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Type III
Immune complex-mediated
hypersensitivity
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The four types of hypersensitive responses
Kuby J et al., Immunology 2003
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Type III hypersensitivity reactions (1)
- Directed against soluble antigens
- Caused by the deposition of antigen/antibodycomplexes in tissue and blood vessels.
- The complexes activate complement and attractploymorphs and macrophages to the site.
- These cells may exocytose their granule contentsand release reactive oxygen and nitrogen
intermediates to cause local tissue damage.
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Type III hypersensitivity reactions (2)
- The deposition of immune complexes in
tissues causes a local inflammatory
response known as an Arthus reaction.
- Serum sickness is a classic example of a
transient immune complex-mediated syndrome.
- In situations in which antigen persists
subacute bacterial endocarditischronic viral hepatitis
systemic lupus erythematosus (SLE)
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Development of a localized Arthus reaction
Immunology (Fig. 16-15), 5th edn 2003 Kuby J
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The multiple activities of the complement system.
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Immune complex disease
- The immune complexes produced may bind to vascular
endothelium and kidney glomeruli and activate complement
(MAC generation).
- It initiates the acute inflammatory responses that destroy the
vessel walls or glomeruli and lead to thrombosis, ischemicdamage to tissues, and scarring.
- Some of the late complement proteins may activate
prothrombinases in the circulation that initiate thrombosis.
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Figure 12-23
Serum sickness is a classic example of a transient
immune complex-mediated syndrome
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Type IV
Delayed-type hypersensitivity (DTH)
(Cell-mediated hypersensitivity)
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The four types of hypersensitive responses
Kuby J et al., Immunology 2003
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Type IV hypersensitivity reactions
- T-cell mediated
- 1st group: Tissue damage is caused by the activationofmacrophages by TH1 cells, which results
in an inflammatory response.
- 2nd group: Damage is caused by the activation by TH2
cells ofinflammatory responses in which
eosinophils predominate.
- 3rd group: Damage is caused directly by cytotoxic T
cells (CTL).
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Figure 12-24
Type IV hypersensitivity responses
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Overview of the DTH response
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Figure 12-26 part 1 of 2
The delayed-type (type IV) hypersensitivity response is directed by
chemokines and cytokines released by TH1 cells stimulated by antigen (1)
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Figure 12-26 part 2 of 2The delayed-type (type IV) hypersensitivity response is directed bychemokines and cytokines released by TH1 cells stimulated by antigen (2)
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A prolonged DTH response can lead to formation of a granuloma
Lytic enzymes released from
activated macrophages in a
granuloma can cause extensivetissue damage.
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A Second Exposure to Poison Oak May Result in Delayed-Type Hypersensitivity
Kuby J et al., Immunology 2003
D l t f d l d t h it it ti ft
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Immunology (Fig. 16-20), 5th edn 2003 Kuby J
Development of delayed-type hypersensitvity reaction after
a second exposure to poison oak
Secrete INF- and other cytokines
Activated macrophages
Secrete mediatorsof inflammation
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Bli t i ki l i h d f ti t ith
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Figure 12-28
Blistering skin lesions on hand of patient with
poison ivy contact dermatitis
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There are four types of hypersensitivity reaction mediated
by immunological mechanisms that cause tissue damage
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Kuby J et al., Immunology 2003
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