Hypersensitivity types 2,3 & 4

Description

Mind Map on Hypersensitivity types 2,3 & 4, created by tanitia.dooley on 05/13/2013.
tanitia.dooley
Mind Map by tanitia.dooley, updated more than 1 year ago
tanitia.dooley
Created by tanitia.dooley almost 12 years ago
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Resource summary

Hypersensitivity types 2,3 & 4
  1. Type II
    1. Caused by IgM/IgG Abs to cell surface and extracellular matrix proteins: Abs interact with complement components and effector cells such as macrophages and neutrophils=results in tissue damage via mechs nor malls active against foreign Ags
      1. Eg. Reactions against incompatible blood transfusions, autoimmune haemolytic anaemia (sensitised to patients own RBS, often drug induced), good pastures syndrome (Ab against basement mem proteins produce nephritis)
        1. Haemolytic disease of the newborn
          1. Occurs when mother has become sensitised to Ag on the infants erythrocytes. Rhesus D commonly. 1. Sensitiation of the mother during the birth of the first rhesus +ve baby 2. Subsequent children have an increased risk of being affected-Ab crosses placenta and goes to babies RBCs
            1. Child shows high bilirubin levels from haemoglobin breakdown, lower erythrocyte counts (because RBCs lysed), enlarged spleen and liver (tried to make more RBC to make up for ones removed) & potentially lower growth (lack of O2)
              1. Prophylaxis: rhesus -ve mothers given anti rhesus D Abs immediately after birth- thought it works by removing infact Rh +ve erythrocytes (Ag) from mothers circa preventing sensitisation
      2. Myasthenia gravis
        1. Extreme muscle weakness-Abs to the Ach receptors present on muscle mem=reduced signal transmission
      3. Type III
        1. Caused by IgM/IgG Abs against soluble Ags. Ab/Ag complexes normally removed efficiently. In these reactions complexes that persist are deposited in circ or tissues and cause inflammation. Frequent complication in autoimmune disease.
          1. A lot of Ag little Ab
          2. 3 categories: Persistent infection-Ag is microbial and infects kidney and infection organs/ autoimmunity against self Ag in kidney joints and skin/inhaled Ag from mould plant or animal Ag affects the lung
            1. Complexes interact with basophils and platelets to induce amino release eg histamine=inflammation. Macriohage stimulation results in cytokine release (TNF, IL-1), complement activation and inflammation
              1. Extrinsic allergic alveolitis
                1. Farmers lung caused by Abs to actinomycete fungi present in moudly hay or pidgeon fanciers lung with Abs to pidgeon Ags. Ag is inhaled and immune complexes form in alveoli=complement activation, inflammation ad fibrosis follows
                2. Arthurs reaction
                  1. Hyper-immunise animal to get high Ab levels-give Ag usually to skin or give suspected Ag to a patient by intradermal injection and look for inflammation. Local immune complexes activate complement and mast cell degranulation=local inflammation, movement of fluid and proteins into tissues and blood vessel occlusion (raised area of skin)
                3. Type IV
                  1. Delayed type hypersensitivity
                    1. Mediated by TH1 cells which produce cytokines (TNFa, IFNy, IL-12, IL-15=inflammation)
                      1. Can be shown experimentally by transferring T cells between animals (from sensitised animal to non-sensitised=animal becomes sensitised even in absence of Ag)
                    2. 3 types
                      1. Contact hypersensitivity (48-72 hrs)
                        1. Characterised by inflammatory reaction in the skin following contact with allergen (Nickel, chromate & small organic chemicals for example DNCB). Small molecules to generate a response this must act as haptens (small group of chemical bound to carrier)
                          1. Allergen enters skin and binds protein carrier-now big enough to be recognised- langerhans cell migrate to lymph node: Ag is presented to CD4 generating memory cells and effector cells- these cells can migrate to the skin where reaction can be set off if person in contact with Ag again
                            1. Elicitation phase- subsequent time- Ag presentation to primed T cells in the tissue- T cells respond by making cytokines (TNFa & IFNy) which promotes tissue swelling or oedema of the tissue and cell adhesion molecule expression on the vasculature. Causes cytokine release from kerratinocytes including IL1, IL6 & chemoattractant cytokines resulting in inflammatory cell recruitment
                        2. Granulomatous hypersensitivity (21 days)
                          1. Seen in many T cell mediated disease. Macrophages are activated but are unable to destroy an Ag which persists. Activation persists and the macrophage form large epitheloid cells which can fuse into giant multinuclear cells (granuloma)=Form large collections of cells and the products from these activated cells can damage tissues
                            1. Diseases which can show granulomatous type IV reactions: -Leprosy-borderline skin reactions -Tuberculosis: mycobacterium tuberculosis -Crohns disease: granulomatous reaction in the gut, nature of any infectious agent is unknown
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