Hyper Sensitivity
Transcript of Hyper Sensitivity
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H YPERSEN SITIVITY
NUR FADZLINA BINTI ZABRI
082013100006SERIAL NO 4
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Introduction
A state of altered reactivity in which thebody reacts with an exaggerated
immune response to a foreign agent
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Five types of hypersensitivity raections :
Type I (Anaphylactic) Reactions
Type II (ytotoxic) Reactions Type III (Immune omplex) Reactions
Type I!(ell"#ediated) Reactions
Type ! ($timulatory Type)
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Type III / Im m une Com plex Disease Antigen and antibodies form complex and
escape phagocytosis%
The immune complexes deposited onbasement membrane of blood vessel%
Activate complements and inducein&ammation%
'g : $ystemic upus 'rythematosus ($')Rheumatoid Arthritis (RA)
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Type IV / Cell M ediated Reaction or DelayedHypersensitivity
#ediated by macrophages that are activatedby T ells
Allergens are ta*en up by A+s and
presented to T cell% +roliferation of T cell some migrate to the
allergen entry into the body%
$ecreted cyto*ines that activate
macrophages induce in&ammatory reactions% 'g : s*in test for tuberculosis%
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Type V / Stim ulatory type
A modi,cation of Type IIhypersensitivity reaction
Antibodies interact with antigens oncell surface
ell proliferation and di-erentiation
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TYPE III / IM M !E C"M P#E$ RE%CTI"!
Deposition of antien!anti"o#$ %o&p'e( intiss)es * +as%)'a, en#ot-e'ia' s),fa%es.
A%ti+ation of %o&p'e&ent an# in/'t,ationof po'$&o,p-on)%'ea, 'e)%o%$tes
Tiss)e #a&ae
I&&)ne %o&p'e( ,ea%tion
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ocali.ed /ue to
antibodyexcess
Arthus
reaction
0enerali.ed /ue to antigen
excess
$erumsic*ne
ss
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i& %rt'us reaction
1ith in2ection intense local edema andhemorrhagic necrosis develop
Tissue damage due to antigen"antibodycomplex formed at e3uivalence or slightantibody excess
These complex activates complement
Attract neutrophils at the local site
eucocyte"platelet thrombi formed which reduceblood supply% Tissue necrosis occur
A,t-), ,ea%tion%an "e passi+e'$t,ansfe,,e# it-se,a %ontainin
-i- tit,e ofanti"o#ies *I
I.
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#echanism(pictures)
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linical types4
a) 5ypersensitivity pneumonitis
Inhalation of exogenous antigen may leadto allergic alveolitis such as farmers lung
aused by inhalation of spores ofthermophilic actinomycetes
6agassosis due to allergy of sugar caneproducers to the product
heese"washers disease by inhaling ofpenicillium casei spores
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b) 5ypersensitivity due to internal antigens
iving ,larial worms are harmless but thedead one may cause ,lariasis
6y initiating in&ammatory reaction
/apsone therapy in leprematous leprosy
may also release bacterial antibody eads to high level of antibody production
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ii& Serum sic(ness
$ingle in2ection of high concentration of foreignserum
Antibodies to foreign serum reach high enoughbut still excess antigen remains in the circulatingblood
Immune complexes get deposited on the
endothelial lining of blood vessel
#assive complement activation leads to fall incomplement concentration
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haracteri.ed by :
Fever
7rticariaArthralgia
ymphadenopathy
$plenomegaly
Immune complex disease :+oststreptococcal glomerulonephritis
'ndocarditis
5epatitits 6
/engue hemorrhagic fever
#alaria$ystemic upus 'rythematosus ($')
Rheumatoid Arthritis (RA)
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TYPE IV / DE#%YED "R CE## M EDI%TEDRE%CTI"!
Reaction is mediated by sensiti.ed T"lymphocytes which on contact withspeci,c antigen
/elayed hypersensitivity occurs within89"; hours of antigen challenge
It is not antibody mediated hence it
cannot be passively transferred byserum
an be transferred by lymphocytes ortransfer factor
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Types :Tuberculin infection type
ontact dermatitis type
0ranulomatous type
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i& Tu)erculin in*ection type
$mall dose of tuberculin is in2ectedintradermally in a person sensiti.ed totuberculoprotein
An erythema and induration occurs at thesite of in2ection
In2ection site is in,ltrated by large numbersof lymphocytes and
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7seful indicator for delayed hypersensitivity
to bacillus /evelops in many infections with bacteria
fungi and parasite
!arious s*in test are done to detect delayedtype of hypersensitivity examples :
epromin test ? positive in tuberculoid leprosy
Frei test ? positive in lymphogranuloma venereum(+!)
#antoux test ? for Tuberculosis
5istoplasmin test ? +ositive in histoplasmosis
+atch test ? poison ivy
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ii& Contact derm atitis type
@ic*elchromium
picryl chloridecosmetics
soapsantibiotics$*in intact with a range of sensiti.ingmaterials
These substance acts as hapten
ell mediated is induced in s*in whenchemical is applied on an in&ammed area%
angerhans cells carry these antigens toregional lymph node
T"lymphocytes are sensiti.ed
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$ensiti.ed lymphocytes releaselympho*ines
ause super,cial in&ammation of thes*in
haracteri.ed by redness induration
vesiculation within ;8"89 hours
The dermis is in,ltrated predominantlyby lymphocytes and few macrophages
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Hapten + tissue protein ,com plete anti-en sensiti.ed T lym p'ocytes
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/etection by patch test
$uspected allergen is applied on a smallarea of s*in under the adherent dressing
$ensitised individual develops itching in 8"Bhours
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ii& ranulom atous type
Results from persistence ofmicroorganisms or other particleswithin the macrophages which cell isunable to destroy
$hows granuloma containingepitheloid cells giant cells and
macrophages 'g : #itsuda reaction to leprosy
antigens
Cther example : rohns disease
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DT t$pe Rea%tion
ti&e
5'ini%a'
appea,an%e
Antien
ontact 89"9hours
'c.ema 'pidermaleg : nic*el
rubberpoison ivy
Tuberculin 89";hours
ocalhardeningand
swelling
Intradermal useddiagnostica
lly
0ranulomatous
8 wee*s 5ardening eg: in s*inor lung
+ersistentAg or Ag"Ab
complexes
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TYPE V / STIM #%T"RY TYPE
#odi,cation of Type ll hypersensitivityreaction
Antibodies interact with antigens on
cell surface ead to cell proliferation and
di-erentiation
Antigen"antibody reaction enhancesthe activity of a-ected cell
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'xample :
0raves disease
thyroid hormone are produced in excess
ong acting thyroid stimulating (AT$)antibody is an autoantibody to thyroidmembrane antigen
AT$ D T$5 receptor on thyroid cell
surface and produce the same e-ect asT$5
5ence excessive secretion of thyroidhormone
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SH0 %RT1M %! RE%CTI"!
@ot an immune response
It has super,cial resemblance of
hypersensitivity reaction ls a rare reaction of a body to
particular types of toxins calledendotoxins which cause thrombosis
in the a-ected tissue%
http://en.wikipedia.org/wiki/Endotoxinshttp://en.wikipedia.org/wiki/Thrombosishttp://en.wikipedia.org/wiki/Biological_tissuehttp://en.wikipedia.org/wiki/Biological_tissuehttp://en.wikipedia.org/wiki/Thrombosishttp://en.wikipedia.org/wiki/Endotoxins -
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1 S t$p-i isin7e%te#
int,a#e,&a''$
5emorrhagicnecrotic lesion is
developed
Initial intradermal(preparatory)
in2ection causeaccumulation of
leucocyte
Release oflysosomal en.ymedamage capillary
wall
2 Sa&e /'t,ateis in7e%te#
int,a+eno)s'$afte, 24 -o),s
Intravenous(provocative)
in2ection thereoccurs intravascular
clotting
The thrombileading to necrosis
of vessel walls andhemorrhage
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6oth preparatory andprovocative doses are given
intravenously
Animal dies within
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ontact with large3uantities oflipopolysaccharide
endotoxin
'xcessive releaseof cyto*ine (T@Fand I
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This mechanism operate in certainclinical conditions such as Fulminating meningococcal septicemia
Acute hemorrhagic adrenal necrosisfound in overwhelming infections(1aterhouse"Friederichsen $yndrome)
@eisseria meningitidis endotoxin
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RE2ERE!CES
Textboo* of #icrobiology 9th'ditionby Ananthanarayan and +ani*ers
Textboo* of #icrobiology by +rof% +6ave2a
Immunology International 'dition th'dition by /avid #ale Gonathan
6rosto- Text 6oo* of #icrobiology by +%
ha*raborty
I@T'R@'T