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It is mediated by soluble immune complexes. They are mostly of the IgG class,
although IgM may also be involved.
This form of hypersensitivity has a lot in common with type I except that the
antibody involved is IgG and therefore not prebound to mast cells, so that only
preformed complexes can bind to the low affinity Fcgamma RIII.
The antigen is soluble and not attached to the organ involved.
The primary components are soluble immune complexes and complement (C3a,
4a. And C5a)
The Antigen may be exogenous (chronic bacterial, viral parasitic infections). Or
endogenous (non-organ specific autoimmunity).The damage is caused by platelets
and neutrophils. The reaction is Initiated within 2 – 8 hours of exposure.
A. Formation of soluble Ag-Ab complexes ( IgG- IgM) (which are able to fix
complement)
B. These soluble Immune complexes escape pagocytosis
C. Tissue damage then occurs due to:
i. Complement fixation
ii. Attraction of neutrophils by C3a & C5a
iii. Platelets aggregation
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Dr. Fadwa Alghalib Hypersensitivity 3rd Year 2009
iii. pneumonitis
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Dr. Fadwa Alghalib Hypersensitivity 3rd Year 2009
a- Persistent Infections:
continued infection and continual production of antigen & plasma cells
continue producing Abs.
Immune complexes continually generated
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Dr. Fadwa Alghalib Hypersensitivity 3rd Year 2009
b- Autoimmune diseases
A. Continued production of Autoantibody to a self-antigen
B. Leads to prolonged immune complex formation
E.g:
1. Rheumatoid arthritis (RA is an autoimmune disorder that causes
joint inflammation).
2. SLE: Accumulation of DNA complexed with anti-DNA Ab in
synovial membranes or kidney basement membranes yielding arthritic
symptoms or kidney damage.
3. hyperthyroidism is occasionally caused by long acting thyroid
stimulators (LATS) as a result of an autoimmune reaction.
Diagnosis :
Detection of immune Complexes:
1) In Tissues
Tissue biopsies for deposits of Ig and complement by immunofluorescence
2) In Serum
A- Measurement of serum level of C3 and C4 ( usually decreased)
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Dr. Fadwa Alghalib Hypersensitivity 3rd Year 2009