0b]ectives

After working through this modu|e, you shou|d be ab|e to:

\|ain the immuno|ogica| mechanisms under|ying ty\e
II and ty\e III hy\ersensitivity reactions.
Oescribe the \rinci\a| causes and sym\toms associated
with each ty\e of ty\e II and ty\e III hy\ersensitivity
reactions.
Oiscuss current a\\roaches to the \revention or re|ieve
of ty\e II and ty\e III hy\ersensitivity res\onses.
\e 11 H\ersensitivit
y\e II hy\ersensitivity is a|so known as
cytotoic hy\ersensitivity, is caused by the
antibody-mediated cytotoicity towards antigen
\ositive ce||s.
Antibody invo|ved is IgG or IgM \roduced in
res\onse to a ce|| surface antigen
he common ty\e II hy\ersensitivity in humans
inc|ude res\onses towards:
i. ABO antigen
ii. Rhesus (Rh) antigen
iii. Orugs
echanisms o1 \e 11 H\ersensitivit
CompIements
Antibodies
K ceII
Fc receptor
Antigen
Target ceII
\e 11 H\ersensitivit
# common c|inica| conditions of hy\ersensitivity
ty\e II inc|ude
i. ABO incom\atibi|ity
ii. Rhesus (Rh) incom\atibi|ity
iii. Orug a||ergy
rug-induced immune hemolsis
rug-induced immune hemolsis
rug allerg
y\e II hy\ersensitivity is a common cause of
drug a||ergy
Anti-drug antibodies recognize drug mo|ecu|es
bound to surface of erythrocytes
5uch antibody-ha\ten interaction wi|| trigger
either com\|ement-mediated cyto|ysis (CMC) or
AOCC
Phenacetin, ch|or\romazine
\e 111 H\ersensitivit
y\e III hy\ersensitivity is a|so known as immune com\|e
hy\ersensitivity.
he a||ergic res\onse is simi|ar to ty\e II hy\ersensitivity
ece\t antibody invo|ved is most|y IgG directed against
so|ub|e antigens
Patho|ogica| seque|ae resu|ts from antigen-antibody
com\|e formation and de\osition
he common c|inica| conditions inc|ude:
i. 5erum sickness
ii. Arthus reaction
echanisms o1 \e 111 h\ersensitivit
Antigen
Antibody
Antibodies
EndotheIium of bIood vesseI
CompIement
K ceII
echanisms o1 \e 111 H\ersensitivit
nIy Ag-Ab compIex of a certain size can trigger
type 3 Hx
- very smaII Ag-Ab compIex phagocytes cannot
recognize
SIowing of bIood fIow resuIts in deposition of smaII
(soIubIe) Ag-Ab compIex on endotheIiaI ceII
activates the compIement system + ADCC
tissue damage
eg. kidney-smaII tube (GIomeruIonephritis)
\e 111 H\ersensitivit
Immune com\|ees can form |oca||y when antigens
contact the body at sites other than in the b|ood
z c|inica| conditions
i. 5erum sickness
ii. Arthus reaction
\e 111 H\ersensitivit
i. Serum sickness
- immune compIex-systemic manifestation
- systemic injury initiated by ag-ab
compIexes that circuIate in the bIood and
settIe into membranes at various sites
- presence of ag in excess
eg. injection of horse serum containing
specific ab for treatment of snake bite
\e 111 H\ersensitivit
ii. Arthus reaction
- immune compIex-IocaIized manifestation
- initiated by antigen forming compIex with
ab in IocaI area.
- presence of ab in excess
eg. InhaIed antigen from fungaI spores
in hay, pigeon dropping immune
compIex pneumonitis.
e1erences
Roderick Nairn and Matthew He|bert. Immuno|ogy for Medica|
5tudents. |sevier Mosby. z#.
5tites OP, err A| and Pars|ow G. Medica| Immuno|ogy.
th
dition,
A\\|eton 8 Lange, Prentice-ha|| Internationa| Inc. z.
Roitt I, Brostoff 1 and Ma|e O. Immuno|ogy. 6
th
dition, Gower
Medica| Pub|ishing, London. z
Cedric Mims, Haze| M. Oockre||, Richard V.Goering, Ivan Roitt, Oerek
Wake|in and Mark Zuckerman. Medica| Microbio|ogy. #
rd
dition,
|sevier Mosby. zq.
Mar|orie ke||y Cowan and kath|een Park a|aro. Microbio|ogy A
5ystems A\\roach. McGraw-Hi||. z6.