Hypersensitivity

Dr. Wai Mar Linn

M.B.,B.S, MSc , DTM&H
Type I Anaphylactic (Immediate)
Hypersensitivity
Type I: Immediate Hypersensitivity (Allergy)

• Antigen: Allergen

• Antibody : IgE

• Tissue reaction occur within minutes after the antigen

combines with the specific antibody.

• Its symptoms may manifest as a systemic anaphylaxis or as a

local reaction
Type I: Immediate Hypersensitivity (Allergy)

• Allergens are antigens that induce production of specific IgE

in humans.

• Examples : plant pollens , bird feathers, animal hairs , faecal

pallets of house dust mite, certain food(peanuts , milk, eggs),

insect venoms, certain drugs and chemicals.

Mechanism of Type I: Immediate Hypersensitivity
(Allergy)
• An antigen (allergen) induces the formation of IgE antibody.

• IgE binds firmly by its Fc portion to high-affinity IgE

receptors (FcԐR) on mast cells, basophils, and possibly
eosinophils.
Type I: Immediate Hypersensitivity (Allergy)

• A second exposure of the individual with the same antigen

results in the antigen's binding to cell-bound IgE.

• Cross-linking of IgE molecules, and inducing the release of

pharmacologically active mediators from cells within seconds
to minutes.
Type I: Immediate Hypersensitivity (Allergy)
• Degranulation occurs with the release of preformed mediators.
• Some important mediators of type I hypersensitivity and their
main effects are
Histamine
• Histamine exists in a preformed state in platelets and in
granules of mast cells, basophils, and eosinophils.
• Its release causes vasodilation, increased capillary
permeability, and smooth muscle contraction (eg,
bronchospasm).
• Antihistamine drugs can block histamine receptor sites and are
relatively effective in allergic rhinitis.
• Histamine is one of the primary mediators of a type I reaction.
Type I: Immediate Hypersensitivity (Allergy)
Prostaglandins and Leukotrienes

• Prostaglandins and leukotrienes are derived from arachidonic

acid via the cyclooxygenase pathway.

• Prostaglandins chiefly produce bronchoconstriction.

• Leukotrienes chiefly cause increased permeability of

capillaries.

• These mediators, along with cytokines such as TNF-α and IL-

4, are referred to as secondary mediators of a type I reaction.
Examples of Type I: Immediate Hypersensitivity
(Allergy)
Clinical conditions:

• Allergic Conjunctivitis

• Anaphylatic shock : penicillin allergy, bite or sting by insect

• Bronchial asthma: pollen, animal dander

• Hay fever : contact with pollen

• Gastrointestinal allergy: food allergy

• Atopic dermatitis :skin rashes , urticaria

Type I: Immediate Hypersensitivity (Allergy)

Atopy

• Atopic hypersensitivity disorders exhibit a strong familial

predisposition and are associated with elevated IgE levels.

• Predisposition to atopy is clearly genetic, but symptoms are

induced by exposure to specific allergens.

Type I: Immediate Hypersensitivity (Allergy)

Treatment and Prevention of Anaphylactic Reactions

• Treatment aims to reverse the action of mediators by

maintaining the airway, providing artificial ventilation if
necessary, and supporting cardiac function.

• Antihistamines, epinephrine,, and corticosteroids.

• Prevention relies on identification of the allergen (often by

skin test or IgE antibody serology) and subsequent avoidance.
Type I : Anaphylatic (Immediate) Summary
IgE antibody is induced by the allergen and binds via its Fc receptor to
mast cells and eosinophils. After encountering the antigen again, the fixed
IgE becomes cross-linked, which induces degranulation and release of
mediators, especially histamine.
References: