Section 2 Hypersensitivity Reactions. 1.Type I hypersensitivity (Anaphylactic type) Immediate...
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Transcript of Section 2 Hypersensitivity Reactions. 1.Type I hypersensitivity (Anaphylactic type) Immediate...
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Section 2 Section 2 Hypersensitivity Hypersensitivity
ReactionsReactions
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1.1. Type I hypersensitivity Type I hypersensitivity (Anaphylactic type)(Anaphylactic type)
Immediate hypersensitivity reaction, resulting from release of pharmacologically active mediators.
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Slide 7.9
Activation of mast cells in type I hypersensitivity and release of their mediators. ECF, eosinophil chemotactic factor; NCF, neutrophil chemotactic factor; PAF, platelet-activating factor. (From Robbins Basic Pathology ,2003 )
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(2) (2) Tissue reactions: variable in severityTissue reactions: variable in severity
Mildest may be only edema. Reaction is triggered by mast cells, basophils. If inflammatory cells are present, many are eosinophils.
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(3) Diseases
① Urticaria and angioneurotic edema
② Asthma
③ Hay fever
④Insect allergy: serious or fatal anaphylaxis may follow. Edema of larynx, with airway obstruction may occur.
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2. Type II Hypersensitivity
Cytolytic or cytotoxic reactions
(1) Mechanism:(1) Mechanism: ① Complement-dependent reactions
Transfusion reactionsErythroblastosis fetal Autoimmune hemolytic anemiaCertain drug reactions
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②Antibody-dependent cell-mediated cytotoxicit
(ADCC).
May be relevant to:
Graft rejection
The destruction of targets too large to be
phagocytosed, such as parasites or tumor cells.
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③Antibody-mediated cellular dysfunction
Myasthenia gravis: muscle weakness
Graves’ disease:Graves’ disease: hyperthyroidism
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Slide 7.10
Schematic illustration of three different mechanisms of antibody-mediated injury in type hypersensitivity. A, Complement-dependent reactions that Ⅱlead to lysis of cells or render them susceptible to phagocytosis.
(From Robbins Basic Pathology ,2003 )
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Slide 7.11
Antibody-dependent cell-mediated cytotoxicity (ADCC). IgG-coated target cells are killed by cells that bear Fc receptors for IgG (e.g., NK cells,
macrophages). . (From Robbins Basic Pathology ,2003 )
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Slide 7.12
Antireceptor antibodies disturb the normal function of receptors. In this example, acetylcholine receptor antibodies impair neuromuscular transmission
in myasthenia gravis. (From Robbins Basic Pathology ,2003 )
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3. 3. Type Hypersensitivity ⅢType Hypersensitivity Ⅲ(Immune complex-mediated)(Immune complex-mediated)
(1) Reaction types(1) Reaction types
① Arthus reaction
② serum sickness
③ Collagen diseases
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(2) (2) Toxic complex diseases:Toxic complex diseases:
① Acute glomerulonephritis
② Systemic lupus erythematosus
③ Necrotizing angiitides
④ Rheumatoid arthritis
⑤ Progressive systemic sclerosis
⑥ Dermatomyositis etc.
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Slide 7.13
Schematic illustration of the three sequential phases in the induction of systemic type (immune complex) hypersensitivity. Ⅲ(From Robbins Basic Pathology ,2003 )
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Slide 7.14
Schematic representation of the pathogenesis of immune complex-mediated tissue injury. The morphologic consequences are depicted as boxed areas. . (From Robbins Basic Pathology ,2003 )
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Slide 7.15
Immune complex vasculitis. The necrotic vessel wall is replaced by smudgy, pink “fibrinoid” (Dr. Trace Worrell)
(From Robbins Basic Pathology ,2003 )
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4. Type HypersensitivityⅣ
(Cell-Mediated )
Delayed hypersensitivity reaction
(1) TissueTissue reactionreaction: Consist of parenchymal destruction associated with perivascular lymphocytic and macrophage reaction.
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(2) (2) Diseases:Diseases:
① ① Chronic active hepatitisChronic active hepatitis
② ② Viral exanthem(Viral exanthem( 皮疹)皮疹) ③ ③ Contact dermatitisContact dermatitis
④ ④ Graft rejectionGraft rejection
⑤ ⑤ Inflammatory bowel disease. Inflammatory bowel disease.
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Slide 7.16
Delayed hypersensitivity in the skin. Immunoperoxidase staining reveals a predominantly perivascular cellular infiltrate that marks positively with anti-CD4 antibodies. ( Dr. Louis Picker) .
(From Robbins Basic Pathology ,2003 )
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Slide 7.17
A section of a lymph node shows several granulomas, each made up of an aggregate of epithelioid cells and surrounded by lymphocytes. The granuloma in the center shows several multinucleate giant cells. ( Dr. Trace Worrell) (From Robbins Basic Pathology ,2003 )
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Slide 7.18
Schematic illustration of the events that give rise to the formation of granuloma in type Ⅳhypersensitivity reactions. Note the role played by T cell-derived cytokines. . (From Robbins Basic Pathology ,2003 )