2 Allergic Diseases

Allergic Diseases and Medicines
Dr. apt. Nunuk Aries Nurulta, M.Si.

Faculty of Pharmacy
Universitas Muhammadiyah Purwokerto
Fakultas Farmasi Fakultas Farmasi Fakultas Farmasi Fakultas Farmasi

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Hypersensitivity
• Immune response are themselves capable of causing tissue
injury and disease.
• Disorder that are caused by immune responses are called
hypersensitivity diseases.
• Hypersensitivity is reflection of excesive or aberrant immune
responses.
• Immune responses of hypersensitivity:
1. Responses to foreign antigens may be regulated or
u n c o n t r o l l e d , r e s u l t i n g i n t i s s u e i n j u r y.
2. The immune responses may be directed against self
(autoimmunity caused autoimmune diseases).

Types of Hypersensitivity
• Type I: Immediate hypersentivity
Pathologic reaction that is cused by the release of mediators from mast cells,
triggered by the production of IgE antibody.
• Type II: Antibody mediated diseases
Antibodies directed against cell or tissue antigen can damage these cells or tissues or
impair their functions.
• Type III: Immune complex diseases
Antibodies against soluble antigens mau form complexes with the antigens, and the
immune complexes may deposit in blood vessels in various tissues and cause
inflamation and tissue injury.
• Type IV: T-cell-mediated diseases
The reactions of T lymphocytes, often against self antigens in tissues.

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Immediate Hypersensitivity
 Immediate hypersensitivity
diseases are initiated by the
introduction of an allergen, which
stimulates TH2 reactions and
IgEreaction.
 IgE binding to Fc receptors (FceRI)
on mast cells, and subsequent
exposure to the allergen activates
the mast cells.
 Mast cells secrete the mediators
that are responsible for the
pathologic reactions og
immediate hypersensitivity.
Biochemical Events
in mast cells activation
 The signalling pathways stimulate:

- The release of mast cell
granule contents (amines ,
proteases),
- The synthesis of arachidonic
acid metabolites
(prostaglandins,
leucotrienes),
- The synthesis of various
cytokines.
 These mast cell mediators stimulate
the various reactions of immediate
hypersensitivity.
Clinicals Manifestations
Some mild reactions:
• Allergic rhinitis and sinusitis, which are commonly seen in hay fever, are reactions to inhaled allergens, such as the
ragweed protein of pollen. Mast cells in the nasal mucosa produce histamine, which causes increased secretion of
mucus. Late phase reactions may lead to more prolonged inflamation.
• In food allergic, ingested allergens trigger mast cell degranulation, and the reW histamine causes increased
peristalsis.
• Bronchial asthma is a form of respiratory allergy in which inhaled allergens (often undefined) stimulate bronchial
mast cells to release mediators, including leukotrienes, which cause repeated bouts of bronchial constriction and
airway obstruction. In chronic asthma, there are large numbers of eosinophils in the bronchial mucosa and
excessive secretion of mucus in the airways, and the hronchial smooth muscle becomes hyperreactive to various
stimuli. Some cases of asthma are not associated with IgE production, although all are caused by mast cell
activation. In some individuals, asthma may be triggered by cold or exercise; how these cause mast cell activation
is unknown.
The most severe form of immediate hypersensitivity:
• Anaphylaxis, a systemic reaction characterized by edema in many tissues, including the larynx, accompanied by a
fall in blood pressure. This reaction is caused by widespread mast cell degcanulation in response to a systemic
antigen, and it is threatening because of the sudden fall in blood pressure and airway obstruction.
Clinical Manifestations of
Immediate Hypersensitivity Reactions
Immediate hypersensitivity may be manifested in many other ways, such as urticaria and eczema
in the skin.

Therapy of Immediate Hypersensitivity
The therapy for immediate hypersensitivity reactions:
• Inhibiting mast cell degranulation
• Antagonizing the effects of mast cell mediators,
• Reducing inflammation
 Many patients benefit from repeated administration of srnall doses of

allergens, called desensitization.
 This treatment may work by changing the T cell response away from TH2
dominance or by inducing tolerance (anergy) in allergen-specific T cells.

Treatment of Immediate Hypersensitivity Reactions

Shock Anaphylaxis

Anaphylaxis Pathogenesis

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Simons FE. Anaphylaxis. J Allergy Clin Immunol 2010;125:S162.
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Anaphylaxis Treatment
ABC: Airway, Breathing, Circulation

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NS/RL: Normal saline/Ringer laktate UMP UMP farmasi.ump.ac.id
Epinephrine

Antihistamine

Corticosteroids and Beta 2 Receptor Agonists

Histamine Receptor

Phosphodiesterase Inhibitors

PAF = Palatelet activating factor
Methylene Blue

Glucagon-Like Protein Receptor Agonist

Anti-IgE

Terima Kasih

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Allergic Diseases and Medicines

Dr. apt. Nunuk Aries Nurulta, M.Si.

Fakultas Farmasi Fakultas Farmasi Fakultas Farmasi Fakultas Farmasi

Fakultas Farmasi Fakultas Farmasi Fakultas Farmasi Fakultas Farmasi

Fakultas Farmasi Fakultas Farmasi Fakultas Farmasi Fakultas Farmasi

 The signalling pathways stimulate:

Fakultas Farmasi Fakultas Farmasi Fakultas Farmasi Fakultas Farmasi

 Many patients benefit from repeated administration of srnall doses of

Fakultas Farmasi Fakultas Farmasi Fakultas Farmasi Fakultas Farmasi

Fakultas Farmasi Fakultas Farmasi Fakultas Farmasi Fakultas Farmasi

Fakultas Farmasi Fakultas Farmasi Fakultas Farmasi Fakultas Farmasi

Fakultas Farmasi Fakultas Farmasi Fakultas Farmasi Fakultas Farmasi

ABC: Airway, Breathing, Circulation

Fakultas Farmasi Fakultas Farmasi Fakultas Farmasi Fakultas Farmasi

Fakultas Farmasi Fakultas Farmasi Fakultas Farmasi Fakultas Farmasi

Fakultas Farmasi Fakultas Farmasi Fakultas Farmasi Fakultas Farmasi

Fakultas Farmasi Fakultas Farmasi Fakultas Farmasi Fakultas Farmasi

Fakultas Farmasi Fakultas Farmasi Fakultas Farmasi Fakultas Farmasi

Fakultas Farmasi Fakultas Farmasi Fakultas Farmasi Fakultas Farmasi

Fakultas Farmasi Fakultas Farmasi Fakultas Farmasi Fakultas Farmasi

Fakultas Farmasi Fakultas Farmasi Fakultas Farmasi Fakultas Farmasi

Fakultas Farmasi Fakultas Farmasi Fakultas Farmasi Fakultas Farmasi

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