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- 1. Pharmacy-Immunology 17 – 18 Hypersensitivity Saber Hussein
- 9. Fig 11-1: Immune effector mechanisms of the four types of hypersensitivity
- 10. Fig 11-1
- 12. Fig 11-2: The sequence of events in immediate hypersensitivity
- 13. Fig 11-2: The sequence of events in immediate hypersensitivity Fig 11-2: The sequence of events in immediate hypersensitivity
- 18. Clinical manifestations of immediate hypersensitivity Fig 11-5
- 19. Treatment of immediate hypersensitivity reactions Various drugs & their principal mechanisms of action cAMP ↑ Fig 11-6
- 38. Human antibody-mediated diseases Itching blisters Fig 11-9
- 39. Human antibody-mediated diseases Fig 11-9
- 47. T-cell mediated diseases Fig 11-12
Notas del editor
- Allergy: Disease with immune response to an Ag Clinical symptoms are independent of physical & chemical characteristics of Ag
- 5. Type V: Stimulatory Hypersensitivity
- ITAM = IMMUNORECEPTOR TYROSINE-BASED ACTIVATION MOTIF ITIM = IMMUNORECEPTOR TYROSINE-BASED INHIBITION MOTIF
- anaphylaxis an c^ -f U -lak c sis An induced systemic or generalized sensitivity; at times the term anaphylaxis is used for anaphylactic shock. The term is commonly used to denote the immediate, transient kind of immunologic (allergic) reaction characterized by contraction of smooth muscle and dilation of capillaries due to release of pharmacologically active substances (histamine, bradykinin, serotonin, and slow-reacting substance), classically initiated by the combination of antigen (allergen) with mast-cell–fixed, cytophilic antibody (chiefly IgE); the reaction can be initiated, also, by relatively large quantities of serum aggregates (antigen-antibody complexes, and others) that seemingly activate complement leading to production of anaphylatoxins. Syn: anaphylactic reaction. Origin [G. ana, away from, back from, + phylaxis, protection Forms of Type I disease: Urticaria , hives Eczema Conjunctivitis Rhinitis, hay fever Asthma Anaphylaxis : Bronchioconstriction & hypotension can be life threatening
- epinephrine A catecholamine that is the chief neurohormone of the adrenal medulla of most species; also secreted by neurons. The L-isomer is the most potent stimulant (sympathomimetic) of adrenergic - and -receptors, resulting in increased heart rate and force of contraction, vasoconstriction or vasodilation, relaxation of bronchiolar and intestinal smooth muscle, glycogenolysis, lipolysis, and other metabolic effects; used in the treatment of bronchial asthma, acute allergic disorders, open-angle glaucoma, cardiac arrest, and heart block, and as a topical and local vasoconstrictor. Generally used salts are epinephrine hydrochloride and epinephrine bitartrate, the latter most frequently used in topical preparations. Syn: adrenaline cromolyn sodium Used for the prevention of asthmatic attack. Stabilizes mast cell membranes to prevent the release of leukotrienes and other bronchospasm-inducing substances. Syn: sodium cromoglycate. Corticosteroid A steroid mad by adrenal cortex
- urticaria er c ti-kar c i- ^ An eruption of itching wheals, usually of systemic origin; it may be due to a state of hypersensitivity to foods or drugs, foci of infection, physical agents (heat, cold, light, friction), or psychic stimuli. Syn: hives (1), urtication (2). Syn: hives, urtication L. a nettle Urtica dioica , fr. uro, pp. ustus, to burn
- Bathmotropic state refers to the irritability of the myocardium Chronotropic state refers to the cardiac frequency Dromotropic state refers to the conduction velocity of the myocardial conduction system
- Leukotrienes are the main mediators of bronchoconstriction of asthma and are not treatable by antihistamines
- Serotonin ( 5-hydroxytryptamine , or 5-HT ) is a monoamine neurotransmitter synthesised in serotonergic neurons in the central nervous system and enterochromaffin cells in the gastrointestinal tract . In the central nervous system, serotonin is believed to play an important role in the regulation of mood , sleep , emesis (vomiting), sexuality and appetite . Serotonin has been thought to play a part in many disorders, notably as part of the biochemistry of depression , migraine , bipolar disorder and anxiety . The name "serotonin" is something of a misnomer and reflects the circumstances of the compound's discovery. It was initially identified as a vasoconstrictor substance in blood serum - hence serotonin , a serum agent affecting vascular tone. This agent was later chemically identified as 5-hydroxytryptamine (5-HT), and, as the broad range of physiological roles were elucidated, 5-HT became the preferred name in the pharmacological field Serotonin was first isolated from blood in 1948 by Page and coworkers and was later identified in the central nervous system. As is the case for most neurotransmitters, it has a relatively simple chemical structure but displays complex pharmacological properties. Based on the similarity of this structure to the structures of norepinephrine and dopamine, it is not surprising that serotonin, like its catecholamine counterparts, possesses a diversity of pharmacological effects, both centrally and peripherally. It is found in three main areas of the body: the intestinal wall (where it causes increased gastrointestinal motility); blood vessels (where large vessels are constricted); and the central nervous system (CNS).
- Prausnitz-Kustner Reaction This test was used in the past to determine the cutaneous anaphylaxis In this test serum from atopic patient was taken and injected into the skin of a normal person A few hours later the test antigen was injected into the sensitized site Positive test gave an immediate type of wheal-and-flare reaction Not used; danger of transmitting viral infections
- a·top·ic ( ³ -t ¼ p “¹ k) adj. Of, relating to, or caused by a hereditary predisposition toward the development of certain hypersensitivity reactions, such as hay fever, asthma, or chronic urticaria, upon exposure to specific antigens: atopic dermatitis. [From Greek atopia , unusualness, from atopos , out of the way : a- , not; see A- 1 + topos , place.] --at “ o·py ( ² t “… -p ¶ ) n.
- Graves disease 1. toxic goiter characterized by diffuse hyperplasia of the thyroid gland, a form of hyperthyroidism; exophthalmos is a common, but not invariable, concomitant; 2. thyroid dysfunction and all or any of its clinical associations; 3. an organ-specific autoimmune disease of the thyroid gland. See: goiter, myxedema, Hashimoto thyroiditis, thyrotoxicosis. Syn: Basedow disease, Parry disease, ophthalmic hyperthyroidism Hashimoto thyroiditis diffuse infiltration of the thyroid gland with lymphocytes, resulting in diffuse goiter, progressive destruction of the parenchyma and hypothyroidism. Syn: Hashimoto disease, Hashimoto struma, struma lymphomatosa, autoimmune thyroiditis, chronic lymphadenoid thyroiditis, chronic lymphocytic thyroiditis, lymphocytic thyroiditi All three mechanisms are seen with antibodies that bind directly to their target antigens
- IgG and IgE antibodies in subjects allergic to penicillins recognize different parts of the penicillin molecule. Torres MJ , Gonzalez FJ , Mayorga C , Fernandez M , Juarez C , Romano A , Blanca M . Department of Internal Medicine, Carlos Haya Hospital, Malaga, Spain. BACKGROUND: IgE and IgG antibodies to penicillins can have different specificities. However, this response, including the recognition of the different parts of penicillin, has never been studied in the same subject. OBJECTIVE: Study of the specificity of IgE and IgG antibodies and the relevant parts of the penicillin molecule that contribute to the hapten binding site in sera from human. METHODS: Specific IgE antibodies were determined by RAST and specific IgG antibodies by ELISA. The recognition of the different molecules was studied by inhibition studies. RESULTS: Seven sera with IgG and IgE antibodies to amoxicillin and benzyl penicillin were analyzed. IgE antibodies recognized mainly two different epitopes: in one, the side chain was a relevant part of the epitope, in the other, it was the nuclear portion. IgG antibodies recognized the nuclear portion in all instances. In the same subject, antibodies of different isotype and specificity were found. CONCLUSIONS: Subjects who develop simultaneously IgE and IgG antibodies to penicillins show different specificities. This proves that different populations of antibodies recognize different epitopes.
- pemphigus (p µ m “ f ¹ -g … s, p µ m-f º“ g … s) n. Any of several acute or chronic skin diseases characterized by groups of itching blisters. [New Latin, from Greek pemphix , pemphig-, pustule.] --pem “ phi·gous adj.
- hyperthyroidism hU-per-thUcroyd-izm An abnormality of the thyroid gland in which secretion of thyroid hormone is usually increased and is no longer under regulatory control of hypothalamic-pituitary centers; characterized by a hypermetabolic state, usually with weight loss, tremulousness, elevated plasma levels of thyroxin and/or triiodothyronine, and sometimes exophthalmos; may progress to severe weakness, wasting, hyperpyrexia, and other manifestations of thyroid storm; often associated with exophthalmos (Graves disease). See Also: thyrotoxicosis. Syn: hyperthyrea, thyroidism (1), thyrointoxication. hereditary hyperthyroidism iodine-induced hyperthyroidism masked hyperthyroidism ophthalmic hyperthyroidism primary hyperthyroidism secondary hyperthyroidism
- Fig 11-10: Human immune complex diseases
- Although it takes several days for the symptoms to develop, serum sickness is classified as immediate reaction due to the fact symptoms develop promptly after immune-complexes are formed. The symptoms gradually subside as the antigen is excreted from the body. Serum sickness is rare because foreign serum is rarely used. Now a day’s serum sickness is due to drugs
- The reaction consists of mononuclear cell infiltration, e.g., macrophages and CD4 cells and induration. Examples of delayed type hypersensitivity include contact hypersensitivity and tuberculin type hypersensitivity
- Infected person does not always give a positive skin test. Overwhelming infections, use of immunosuppressive drugs and disorders suppress cell-mediated immunity ( anergy ). Cell-mediated immunity also develops in many viral infections. However, serologic tests are more specific than skin tests for the assessment of immunity Infected person does not always give a positive skin test. Overwhelming infections, use of immunosuppressive drugs and disorders suppress cell-mediated immunity ( anergy ). Cell-mediated hypersensitivity also develops in many viral infections . However, serologic tests are more specific than skin tests for the assessment of immunity
- urushiol oocroo-shT-bl A mixture of nonvolatile hydrocarbons, derivatives of catechol with unsaturated C15 or C17 side chains, constituting the active allergen of the irritant oil of poison ivy, Toxicodendron radicans , poison oak, T. diversilobum , and the Asiatic laquer tree, T. verniciferum . Origin [Jap. urushi, lac, + L. oleum, oil] urushiol oxidase