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Hypersensitivity Reactions
Dr Anantha Chaitanya J
Intern
BGS GIMS
1
Hypersensitivity Reaction III
 Immune Complex Mediated.
 Formation of immune complexes in circulation → deposit in various tissues →
trigger classical pathway of complement activation.
 Produce damage as they localize within blood vessel walls or when trapped in
filtering structures (e.g. renal glomeruli)
2
Hypersensitivity Reaction III3
Hypersensitivity Reaction III4
Hypersensitivity Reaction III
5
ANTIGEN CLINICAL MANIFESTATION
A] EXOGENOUS:
Arthritis
GN, Infective endocarditis
Glomerulonephritis
1) BACTERIA:
Y. enterocolitica
Streptococci
T. pallidum
2) Viruses:
Hepatitis B, CMV Polyarteritis nodosa
3) Parasites:
Plasmodium
Schistosoma
Glomerulonephritis
4) Fungi:
Actinomycetes Farmer’s lung
B] ENDOGENOUS:
SLE1) Nuclear Antigens
2) Immunoglobulins Rheumatoid Arthritis
3) Tumor Antigens Glomerulonephritis
Hypersensitivity Reaction III
1. SERUM SICKNESS:
 Systemic inflammatory response to deposited immune complexes at many areas of body.
 Few days to 2 weeks after injection of foreign serum or drug it results in : Fever, Urticaria,
Arthralgia, Eosinophilia, Splenomegaly, and Lymphadenopathy.
2. ARTHUS REACTION:
 It is named after Dr. Arthus.
 Inflammation caused by the deposition of immune complexes at a localized site.
 Clinical Manifestation is : Hypersensitivity Pneumonitis.
6
Hypersensitivity Reaction IV
 Cell-mediated hypersensitivity.
 Initiated by sensitized T lymphocytes.
 Principal pattern of immunologic response to intracellular microbiologic agents
(particularly Mycobacterium tuberculosis) as well as viruses, fungi, protozoa &
parasites.
7
Hypersensitivity Reaction IV
1. Delayed-type hypersensitivity:
 Mediated by CD4 T cells.
 1st exposure to Ag → CD4 T cells + class II MHC → differentiation of naïve CD4 T cells to TH1
cells → release of IL-12, IFN-γ, IL-2, TNFα & lymphotoxin.
 Tuberculin skin test, contact dermatitis, granulomatous inflammation.
2. T Cell-Mediated Cytotoxicity:
 Mediated by CD8+ T cells.
 Sensitized CD8+ T cells kill antigen-bearing target cells.
 Perforin-granzyme-dependent killing → cause perforation of plasma membrane.
 Fas-FasL-dependent killing → activation of apoptosis.
 Graft rejection, virus infections, tumor immunity.
8
Hypersensitivity Reaction IV9
Treatment
 Symptomatic treatment: Anti-histamines, corticosteroids, vasoconstrictors,
smooth muscle relaxants.
 Exposure prevention: Ideal. Not Practical.
 Barriers: Clothes, creams, filters.
 Specific hyposensitization: Test → Identify → Controlled Exposure.
 Nonspecific desensitization: Obsolete.
 Immunoregulation.
 Molecular medicine.
10
Bibliography
Textbook of Microbiology, Ananthnarayan, 9th
Edition.
IADVL Textbook Of Dermatology, 4th Edition.
Pathologic Basis Of Disease, Robbins and Cotran, 9th
Edition.
11
Thank You
12

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Hypersensitivity Reactions

  • 1. Hypersensitivity Reactions Dr Anantha Chaitanya J Intern BGS GIMS 1
  • 2. Hypersensitivity Reaction III  Immune Complex Mediated.  Formation of immune complexes in circulation → deposit in various tissues → trigger classical pathway of complement activation.  Produce damage as they localize within blood vessel walls or when trapped in filtering structures (e.g. renal glomeruli) 2
  • 5. Hypersensitivity Reaction III 5 ANTIGEN CLINICAL MANIFESTATION A] EXOGENOUS: Arthritis GN, Infective endocarditis Glomerulonephritis 1) BACTERIA: Y. enterocolitica Streptococci T. pallidum 2) Viruses: Hepatitis B, CMV Polyarteritis nodosa 3) Parasites: Plasmodium Schistosoma Glomerulonephritis 4) Fungi: Actinomycetes Farmer’s lung B] ENDOGENOUS: SLE1) Nuclear Antigens 2) Immunoglobulins Rheumatoid Arthritis 3) Tumor Antigens Glomerulonephritis
  • 6. Hypersensitivity Reaction III 1. SERUM SICKNESS:  Systemic inflammatory response to deposited immune complexes at many areas of body.  Few days to 2 weeks after injection of foreign serum or drug it results in : Fever, Urticaria, Arthralgia, Eosinophilia, Splenomegaly, and Lymphadenopathy. 2. ARTHUS REACTION:  It is named after Dr. Arthus.  Inflammation caused by the deposition of immune complexes at a localized site.  Clinical Manifestation is : Hypersensitivity Pneumonitis. 6
  • 7. Hypersensitivity Reaction IV  Cell-mediated hypersensitivity.  Initiated by sensitized T lymphocytes.  Principal pattern of immunologic response to intracellular microbiologic agents (particularly Mycobacterium tuberculosis) as well as viruses, fungi, protozoa & parasites. 7
  • 8. Hypersensitivity Reaction IV 1. Delayed-type hypersensitivity:  Mediated by CD4 T cells.  1st exposure to Ag → CD4 T cells + class II MHC → differentiation of naïve CD4 T cells to TH1 cells → release of IL-12, IFN-γ, IL-2, TNFα & lymphotoxin.  Tuberculin skin test, contact dermatitis, granulomatous inflammation. 2. T Cell-Mediated Cytotoxicity:  Mediated by CD8+ T cells.  Sensitized CD8+ T cells kill antigen-bearing target cells.  Perforin-granzyme-dependent killing → cause perforation of plasma membrane.  Fas-FasL-dependent killing → activation of apoptosis.  Graft rejection, virus infections, tumor immunity. 8
  • 10. Treatment  Symptomatic treatment: Anti-histamines, corticosteroids, vasoconstrictors, smooth muscle relaxants.  Exposure prevention: Ideal. Not Practical.  Barriers: Clothes, creams, filters.  Specific hyposensitization: Test → Identify → Controlled Exposure.  Nonspecific desensitization: Obsolete.  Immunoregulation.  Molecular medicine. 10
  • 11. Bibliography Textbook of Microbiology, Ananthnarayan, 9th Edition. IADVL Textbook Of Dermatology, 4th Edition. Pathologic Basis Of Disease, Robbins and Cotran, 9th Edition. 11