Dr Susan Kakakhel

Allergy and Hypersensitivity

Ooh no
KMU Learning Objectives

 Define Allergy and Allergen

 Describe the Path physiology of Allergy and
Hypersensitivity
 Define and classify hypersensitivity reaction
 Compare immediate and delayed
hypersensitivity reactions
 List the diseases associated with
hypersensitivity reactions
Definations
 Allergy: An abnormal immunological response to an
otherwise harmless environmental stimulus (e.g.,
food, pollen, animal dander)

 Allergen: An Antigen capable of stimulating an

immune response
Or
Antigen that reacts specifically with a specific type of
IgE reagin antibody

 Atopy : Greek word meaning “unusual”

 Definitions

 Hypersensitivity reaction: A condition in which the

immune system, which normally serves a protective
role, has a harmful effect

 Anaphylaxis: An acute potentially fatal multi organ

system reaction caused by release of chemical
mediators by mast cells and basophils

 Autoimmune disease: An abnormal immunological

response directed against an antigen that is actually
part of the body itself
Types of Hypersenitivity

Hypersensitivity reactions are classified into four

types.

 Type I: Immediate Hypersensitivity (Anaphylactic

Reaction) These allergic reactions are systemic or
localized, as in allergic dermatitis (e.g., hives, wheal
and erythema reactions)
 Type II: Cytotoxic Reaction (Antibody-dependent)
 Type III: Immune Complex Reaction
 Type IV: Cell-Mediated (Delayed Hypersensitivity)
TYPE 4 HYPERSENSITIVITY

 Type IV hypersensitivity reactions are

referred to as delayed and cell-mediated.

 Clinical features, diagnostics, and treatment

depend on the underlying etiology.
 Pathophysiology
 T cell-mediated reaction
 Sensitization: Antigen penetrates the skin → uptake
by Langerhans cell → migration to lymph nodes and
formation of sensitized T lymphocytes
 Eruption: Repeated contact with antigen →
secretion of lymphokines and cytokines (e.g., IFNγ,
TNFα) by presensitized T lymphocytes →
macrophage activation and inflammatory reaction
in tissue
TYPE 1 HYPERSENSITIVITY
 Type I hypersensitivity reactions are referred to as immediate
and include anaphylactic and atopic immune responses
 Pathophysiology
 IgE is formed as a result of prior sensitization (i.e., contact
with the antigen) and coats mast cells and basophils.
 Subsequent encounter with antigen results in an IgE-
mediated reaction by preformed IgE antibodies: Free antigen
binds to two adjacent IgE antibodies (crosslinking) →
degranulation of cells
 Release of histamine and other mediators (e.g.,
prostaglandin, platelet-activating factor, leukotrienes,
heparin, tryptase) →
Urticaria
Urticaria

 It results from antigen entering specific skin

areas and causing localized anaphylactoid
reaction
 Histamine released locally causes
1.Vasodialtion
2.Increased local permeability of the capillaries
which lead to local circumscribed areas of
swelling called hives
Hay fever

 When the allergen reagin reaction occurs in the

nose
 Histamine released in the response to the
reaction causes local intranasal vascular dilation
with resultant increased capillary pressure and
increased permeability
 Both effects causes rapid fluid leakage into
nasal cavities and into deeper structures of the
nose
 Nasal lining becomes swollen and secretory
Hay fever
Asthma

 In Asthma the allergic reagin reaction

happens in the bronchioles of the lungs

 The product released from the mast cells is

believed to be slow reacting substance of
anaphylaxis which causes spasm of the
bronchiolar smooth muscle
Asthma