2. Hypersensitivities
• Immune responses to innocent antigens or
self antigens that lead to symptoms or tissue
damage
• Term “hypersensitivity” originally used to
denote acquired immune response, as was
“allergy”
• “Hypersensitivity” and Allergy” most
commonly refer to responses to innocent
antigens
• But autoimmune diseases are sometimes
subset of hypersensitivity
• Atopy is term used to describe condition of
general likelihood of responding with allergic
reaction
3. Classified by mechanism (Gel and Coombs 1963)
• Type I, Immediate: IgE antibody
triggering mast cells and eosinophils
• Type II, Antibody Mediated: IgG
antibody reacting with cell surface or
matrix antigens
• Type III, Immune Complex
Mediated: antigen-antibody
complexes
• Type IV: T cell mediated
15. Eosinophils & Basophiles contribute to the
chronic allergic reaction releasing similar
chemicals mediators to IgE binding to
FceeRI (which is induced in eosinophils by
inflammation)
17. • Helper T cells (TH2) that secrete IL-4, IL-5, and
IL-13 are
responsible for inducing allergen specific IgE
production
• Non-atopic individuals also have T cells that
recognize
allergens after sensitization, but in normal
individuals the
T cells are kept in check by Tregs (IL-10 and TGFb)
• Normal people activate TH1 helper T cells and
make IgG
antibodies to same antigens
19. • Four distinct susceptibility genes
identified so far
– G-protein coupled receptor expressed in
inflamed tissue
20. 8% of children under 3, 4% of US
adults Leading cause of
anaphylaxis outside of hospitals,
30,K ER cases per year
May lead to IgE or cell mediated
responses, and be expressed any
of atopic sites (gut, skin, bronchi,
systemic)
Gut largest immunologic organ
for Food allergy
25. • Desensitization with protein or peptide
antigens, with or without adjuvant
• Anti-IgE antibody
• – Xolair approved in 03 for asthma, but not yet
tested for peanut allergy (Genentech)
• – TNX-901 very effective in clinical trials but
removed
from testing by biotech squabbling
(Tanox/Genentech
legal battle)
26. • – Peanut allergy treated with
treated with peptide plusHeat
Killed Listeria, to induce TH1
response (in dogs, Frick 05)
• E.g., Ara
h 1,2, and 3
are peanut
proteins
• – Peptide epitopes recognized by
CD4 TCRs have been determined
• – Therapy with Fel d 1 peptides
increases TH1 T cellsrather then T
reg T cells (Alexander 05)
Fel d 1 is
component
of cat
dander
28. Hygiene hypothesis
• Asthma and allergies increasing
dramatically in recent years in
developed countries
• Exposure to pathogens (larger
families, day care, farms) lowers
incidence of allergies
• Suggested that TH1 responses limit
TH2responses, but TH1 and TH2
are not solely antagonistic, and basis
of hygiene effects are notyet clear