Type I hypersensitivity (or immediate hypersensitivity) is an allergic reaction

provoked by reexposure to a specific type of antigen referred to as an allergen.[1] Type

I is not to be confused with Type II, Type III, or Type IV hypersensitivities.
Exposure may be by ingestion, inhalation, injection, or direct contact.
Pathophysiology
In type 1 hypersensitivity, an antigen is presented to CD4+ Th2 cells specific to the
antigen that stimulate B cell production of IgE antibodies also specific to the antigen.
The difference between a normal infectious immune response and a type 1
hypersensitivity response is that in type 1 hypersensitivity the antibody is IgE instead
of IgA, IgG, or IgM. During sensitization, the IgE antibodies bind to Fc receptors on
the surface of tissue mast cells and blood basophils. [2] Mast cells and basophils coated
by IgE antibodies are "sensitized." Later exposure to the same allergen cross-links the
bound IgE on sensitized cells, resulting in degranulation and the secretion of
pharmacologically active mediators such as histamine, leukotriene (LTC4 and LTD4),
and prostaglandin that act on the surrounding tissues. The principal effects of these
products are vasodilation and smooth-muscle contraction.
Type 1 hypersensitivity can be further classified into an immediate and late-phase
reaction. The immediate hypersensitivity reaction occurs minutes after exposure and
includes release of vasoactive amines and lipid mediators, whereas the late-phase
reaction occurs 2-4 hours after exposure and includes the release of cytokines. [3]
Treatment and prognosis
Treatment usually involves epinephrine, antihistamines, and corticosteroids. If the
entire body gets involved, then anaphylaxis can take place, which is an acute,
systemic reaction that can prove fatal.
In type II hypersensitivity (or cytotoxic hypersensitivity)[1] the antibodies produced
by the immune response bind to antigens on the patient's own cell surfaces. The
antigens recognized in this way may either be intrinsic ("self" antigen, innately part
of the patient's cells) or extrinsic (adsorbed onto the cells during exposure to some
foreign antigen, possibly as part of infection with a pathogen). These cells are
recognized by macrophages or dendritic cells, which act as antigen-presenting cells.
This causes a B cell response, wherein antibodies are produced against the foreign
antigen.
An example of type II hypersensitivity is the reaction to penicillin wherein the drug
can bind to red blood cells, causing them to be recognized as different; B cell
proliferation will take place and antibodies to the drug are produced. IgG and IgM
antibodies bind to these antigens to form complexes that activate the classical
pathway of complement activation to eliminate cells presenting foreign antigens
(which are usually, but not in this case, pathogens). That is, mediators of acute
inflammation are generated at the site and membrane attack complexes cause cell
lysis and death. The reaction takes hours to a day.
Another form of type II hypersensitivity is called antibody-dependent cell-mediated
cytotoxicity (ADCC). Here, cells exhibiting the foreign antigen are tagged with
antibodies (IgG or IgM). These tagged cells are then recognised by natural killer
(NK) cells and macrophages (recognised via IgG bound (via the Fc region) to the
effector cell surface receptor, CD16 (FcRIII)), which in turn kill these tagged cells

Type III hypersensitivity occurs when antigens and antibodies (IgG or IgM)[1] are
present in roughly equal amounts, causing extensive cross-linking.
Type IV hypersensitivity is often called delayed type hypersensitivity as the
reaction takes two to three days to develop. Unlike the other types, it is not antibody
mediated but rather is a type of cell-mediated response.
CD4+ helper T cells recognize antigen in a complex with either type 1 or 2 major
histocompatibility complex. The antigen-presenting cells in this case are macrophages
that secrete IL-12, which stimulates the proliferation of further CD4+ T cells. CD4+ T
cells secrete IL-2 and interferon gamma, further inducing the release of other Type 1
cytokines, thus mediating the immune response. Activated CD8+ T cells destroy
target cells on contact, whereas activated macrophages produce hydrolytic enzymes
and, on presentation with certain intracellular pathogens, transform into
multinucleated giant cells.