Hypersensitivity reaction

Definition

An immunologic reaction which produces

tissue damage on reexposure to antigen.
 Classification
1) Type I (IgE-mediated)
2) Type II (Fc and complement-mediated)
(Cytotoxic Hypersensitivity )
3) Type III (Immune complex-mediated)
(Toxic Complex Hypersensitivity )
4) Type IV (Delayed-type hypersensitivity)
(T-Cell Mediated Hypersensitivity)
Type I Hypersensitivity
 Type I (IgE-mediated)

– Occur within minutes of exposure to

antigen
– Antigens combine with IgE
antibodies bound to mast cells and
basophils, causing degranulation and
release several mediators:
• Histamine: Dilates and increases
permeability of blood vessels (swelling
and redness), increases mucus secretion
(runny nose), smooth muscle contraction
(bronchi).
• Prostaglandins: Contraction of smooth
muscle of respiratory system and
increased mucus secretion.
• Leukotrienes: Bronchial spasms.
 Type I Hypersensitivity Diseases

Allergic rhinoconjunctivitis (hay fever)

Asthma
Eczema (atopic dermatitis)
Acute urticaria
Anaphylaxis
 Type II Hypersensitivity Reactions:
( Cytotoxic Hypersensitivity )

• Complement-mediated cytolysis
• Antibody-dependent cell-mediated
cytotoxicity (ADCC).
Eg :Transfusion reactions:
• ABO Blood group system:
Incompatible donor cells are lysed as
they enter bloodstream
 –
Hemolytic Disease of the Newborn
HDN

Hemolytic disease of newborn:

Fetal cells are destroyed by maternal
anti-Rh antibodies that cross the
-
placenta. an Rh mother forms antibodies to
her Rh fetus; usually requires subsequent
+

exposure to the antigen to be hemolytic

Hemolytic Disease of the Newborn
 Type III Hypersensitivity
Toxic Complex Hypersensitivity (Immune Complex
Mediated Hypersensitivity)

Involve reactions against soluble antigens

circulating in serum.
– Antibody-Antigen immune complexes
are deposited in organs, activate
complement, and cause inflammatory
damage.
Immune Complex Mediated
Hypersensitivity
 Serum Sickness

Following serum therapy. eg

Hyperimmune globulin, Anti Snake
venum.→ Formation of immune
complexes, its deposition on the endothelial
lining of BVs all over the body, leads to
inflammation.
Delayed-type hypersensitivity (DTH)
T-Cell Mediated Hypersensitivity
 Reactions are delayed by one or more
days (delayed type hypersensitivity).
Delay is due to migration of macrophages
and T cells to site of foreign antigens.
e.g. Lung cavities seen in Mycobacterium
tuberculosis
 Tuberculin

Intradermal (ID) inoculation of purified

protein derivates (PPD) in sensitized
individual leads to induration &
inflammation in 48-72 hrs.
 Contact dermatitis

Ag possibly enters through sebaceous

glands
Lesions vary from macules & papules to
vesicles which subsequently breakdown
lead to acute eczematous dermatitis.
 Examples of Microbial-Induced
DTH

Viruses (destructive skin rashes)

• smallpox
• measles
• herpes simplex
Fungi
• candidiasis
• dematomycosis
Parasites
• leishmaniasis
• schistosomiasis