Disorders Associated with

the Immune System

Hypersensitivity
An overly sensitive or overly reactive immune system
Syn.allergy
Allergen – when an individual who has sensitized by
previous exposure to an antigen
Types of Hypersensitivity
1. Type 1 (Anaphylactic) Reactions
 Occurs within 2 to 30 minutes after a person
sensitized to an antigen is reexposed to that antigen
 Anaphylaxis is an exclusive term for the reactions
caused when certain antigens combine with IgE
antibodies
 Reactions can be systemic – can produce shock and
breathing difficulties, sometimes fatal
Localized reactions – hay fever, asthma and hives
IgE antibodies produce in response to antigen (venom
of insects or plant pollen) where they bind with mast
cells and basophils
Systemic Anaphylaxis
(Anaphylactic Shock)
Injected antigen are more likely to cause a dramatic
response than antigen introduced via other POE
Can result when an individual sensitized to an antigen
is exposed to it again
The release of mediators causes peripheral blood
vessels through out the body to enlarge resulting in
drop in BP
E.g penicillin
Localized Anaphylaxis
Usually associated with antigens that are ingested
(foods)or inhaled (pollen)
Symptoms depends primarily on the route
Allergies of URT –plant pollen, fungal spores,dander
teary eyes, coughing,sneezing
Allergies of LRT (asthma)
Food intolerances – lactose in milk
GIT – eating of food (seafoods) ; hives
“8 foods “
Prevention of Anaphylactic Reactions
1. Assortment of Foods
2. Skin test
3. Avoid the allergen
4. Desensitization
Type II (Cytoxic Reactions)
Involves the activation of complement by the
combination of IgG and IgM antibodies with an
antigenic cells.
e.g Transfusion reactions
The ABO Blood group system
The Rh Blood Group systems
Blood Transfusion and Rh Incompatibility
Hemolytic Disease of the Newborn
Drug Induced Cytotoxic Reactions
Type III (Immune Complex) Reactions
Antibodies against soluble antigens circulating in the
serum
Antigen antibody complexes are deposited in organs
and cause inflammatory damage
Immune complexes form only when certain ratios of
antigen antibody occur
Antibodies involved are usually IgG
Type III (Immune Complex) Reactions
A significant excess of antibody leads to formation of
complement fixing complexes that are rapidly
removed from the body by phagocytosis
e.g. Glomerulonephritis – is an immnue complex
condition resulting from infection that causes
inflammatory damage to the kidney glomeruli.
Type IV (Delayed Cell- Mediated) Reactions
Involves cell mediated and T-cells
“delayed hypersensitivity”
Not apparent for a day or more
A major factor in the delay is the time required for the
participating T-cells and macrophages to migrate and
accumulate near the foreign antigens.
e.g. Transplanted rejections –mediated by cytotoxic T
lymphocytes (CTL)
Causes of Delayed Cell- Mediated Reactions:
• Certain foreign antigens, those that bind to tissue cells
are phagocytized by macrophages and then presented
to receptors on the T-cell surface.
• Contact between the antigenic determinant sites and
appropriate T cells cause the T cell to proliferare into
mature differentiated T cells and memory cells.
Delayed Cell Mediated Hypersensitivity
Reactions to Skin
e.g skin test for TB – located withhin macrophages
E.g allergic contact dermatitis – caused by haptens
(aa)
E.g latex
Autoimmune Diseases
The action of the immune system is in response to self
antigens and caused damage to one’s own organs
Occur when there is a loss of self tolerance
The ability of the immune system’s ability to
discriminate self from non self
Review:
• T-cells is capable of distinguishing self from non self –
as they pass thru the thymus
• Any t cells that will target host cells are eliminated by
thymic selection
Autoimmune
• loss of self tolerance leads to production of antibodies
or a response to sensitized T-ce;;s against a person own
tissue antigen
• Antibodies attack self
Cytotoxic Autoimmune reactions
Grave’s disease – caused by long-acting thyroid
stimulators – these antibodies are attached to
receptors on thyroid glands.
Thyroid glands are stimulated to produce increased
amount of thyroid hormone
Myasthenia Gravis
• Muslces becomes progressively weaker
• Caused by antibodies that coat the acethycholine
receptors
Immune Complex Autoimmune Reactions
SLE –produces antibodies directed at components of
their own cells, including DNA
RA – immune complexes of IgM, IgG and complement
are deposited in the jpints
Cell Mediated Autoimmune Reactions
• Multiple Sclerosis – neurological disease in which
the T-cells and macrophages attack the myelin sheath
of nerves
• Epstein Barr
• IDDM –T cells involve
• Psoriasis - autoimmune
Reactions to related to the HLA complex
Human Leukocytes Antigen (HLA) complex
HLA typing –used to identify and compare
Use in transplant surgery
PCR –polymerase chain reactions – amplify the DNA
Reactions to Transplantation
Tranplants recognized as non self are rejected-
attacked by T-cells that directly lyse the grafted cells,
by macrophages activated by T cells and in certain
cases , by antibodies, which activate complement
system and injure blood vessels supplying the
transplanted tissue
Privileged sites and Privileged tissue
Eyes – immunologically priveleged site
Privileged tissue – does not stimulate an immune
rejection
Stem Cells
Master cells that are capable of generating any of the
myriad cell types that make up the body
Embryonic stem cells (ESCs) –pluripotent –they are
capable of generating many different types of tissue
cells.
Adult Stem cells (ASCs)
IPS
HSCs
Grafts
• When a tissue is grafted or implanted (burn pt)
• Autograft –one tissue is implanted to other part
• Isograft – same (twins)
• Allograft – not the same
• Xenograft(xenotransplantation) - animals
Bone marrow transplantation
Recipients are individual who lack the capacity to
produce B and T cells
E.g. Leukemia
Enable the recipient to produce healthy RBC, immune
system cells
Graft vs host disease – BM contains
immunocompetnet cells that mount to cell mediated
response
Umbilical cord blood
Immunosuppression
Transplant rejection
Suppress cell mediated immunity
Use of medication to suppress the immunity thereby
inhibiting rejection
Then immune system and cancer
Cell mediated
Cytotoxic t lymphocytes
Activated macrophages
The immunotherapy for cancer
Therapeutic
Prophylactic
Immunodeficiencies
Congenital – Di-george syndrome
Acquired immunodeficiencies – Hodgskin
AIDS
`HIV