IMMUNOLOGY

& SEROLOGY
NATIONAL UNIVERSITY – MANILA
COLLEGE OF ALLIED HEALTH
3rd YEAR BSMT - MED 21R
 GROUP 2
LUMOR, ANGELO
GARCIA, MARIA MYCHAELA
AUSTRIA, NATANIA JASMINE ANGELA

SANTOS, GWYNETH VIANA, FRANCESCA JORELLA

BAISAS, JANYN KAYLA SANTOS, NICOLE ASHBEL

SOHAL, MUSKAN MARTIN, MICAELA

REYES, MACHELLE ANN ROTAIRO, CHARLIZE ELISABETH

MENDOZA, MARCUS DAVE

DE LOS REYES, JOHN CARLO

HYPERSENSITIVITY
Hypersensitivity reactions (HR) This exaggerated response is
triggered by the interaction of the immune system with an antigen
(allergen) and is referred to as hypersensitivity. Hypersensitivity
reactions are classified into four types by Coombs and Gell. The
first three types are considered immediate hypersensitivity
reactions because they occur within 24 hours. The fourth type is
considered a delayed hypersensitivity reaction because it usually
occurs more than 12 hours after exposure to the allergen, with a
maximal reaction time between 48 and 72 hours.
 Four Types of Hypersensitivity

Type I or Anaphylactic Response : reaction mediated by IgE

antibodies

Type II or Cytotoxic-Mediated Response : reaction mediated by

IgG or IgM antibodies

Type III or Immunocomplex Reactions : reaction mediated by immune

complexes IgM and IgG
antibodies

Type IV or Cell-mediated Reaction : reaction is mediated by T cells

Hypersensitivity
Type I
 Type I Anaphylactic Reactions
Type I hypersensitivity reactions can
range from life-threatening
anaphylactic reactions to milder
manifestations associated with food
allergies.
Immunologic Activity
Mast cells (tissue basophils) are the cellular
receptors for IgE, which attaches to their outer
surface. These cells are common in connective
tissues, lungs, and uterus and around blood
vessels. They are also abundant in the liver,
kidney, spleen, heart, and other organs. The
granules contain a complex of heparin, histamine,
and zinc ions, with heparin in a ratio of
approximately 6:1 with histamine.
Etiology
Atopic allergies are mostly naturally
occurring, and the source of antigenic
exposure is not always known. Atopic
illnesses were among the frst antibody-
associated diseases demonstrating a
strong familial or genetic tendency
Immediate hypersensitivity is the basis of acute
allergic reactions caused by molecules released by
mast cells when an allergen interacts with
membrane-bound IgE (Fig. 25.1). Acute allergic
reactions result from the release of preformed
granule-associated mediators, membrane-derived
lipids, cytokines, and chemokines when an allergen
interacts with IgE that is bound to mast cells or
basophils by the alpha chain of the high-afnity IgE
receptor (FcεRI-α).

Anaphylaxis is the clinical response
to immunologic formation and
fixation between a specifc antigen
and a tissue-fixing antibody
2. Activated mast cells and basophils
release various mediators
1. Attaches to the IgE antibody fxed
to the surface membrane of mast cells
and basophils. Cross-linking of two
IgE molecules is necessary to initiate
mediator release from mast cells.
3. The efects of mediator release
produce vascular changes and
activation of platelets, eosinophils,
neutrophils, and the coagulation
cascade.

Physical allergies like heat, cold, ultraviolet light)
cause a physiochemical derangement of
proteins or polysaccharides of the skin and
transform them into autoantigens responsible
for the allergic reaction.
Anaphylactoid reactions are not mediated by antigen–
antibody interaction; instead, ofending substances act directly
on the mast cells, causing release of mediators, or on the
tissues, such as anaphylotoxins of the complement. Direct
chemical degranulation of mast cells may be the cause of
anaphylactoid reactions resulting from the infusion of
macromolecules, such as proteins.
Atopic reaction. In a person with atopy, exposure of
the skin, nose, or airway to an allergen produces
allergen-specifc IgG antibodies. In response to the
allergen, the T cells (when tested in vitro) exhibit
moderate proliferation and production of interferon-γ
(IFN-γ) by type 1 helper T (T1) cells . In comparison,
individuals with atopy have an exaggerated response
characterized by the production of allergen-specifc IgE
antibodies and positive reactions to extracts of
common airborne allergens when tested with a skin
prick test. T cells from the blood of atopic patients
respond to allergens in vitro by inducing cytokines
produced by T2 cells
 Mechanisms of Tissue
Injury and Disease
of Type I Hypersensitivity
Anaphylaxis is a medical emergency as it can lead to acute, life-threatening respiratory
failure. It is an IgE-mediated process.

Allergic bronchial asthma is an atopic disease, characterized by bronchospasm. It may

also be a chronic inflammatory disease.

Allergic rhinitis is another atopic disease where histamine and leukotrienes are
responsible for rhinorrhea, sneezing, and nasal obstruction.

Allergic conjunctivitis presents with rhinitis and is IgE-mediated. Itching and eye
problems including watering, redness, and swelling always occur.

Food allergy (IgE-mediated) from food intolerance that can be a cause for a variety of
etiologies including malabsorption and celiac disease.

Atopic eczema is an IgE-mediated disease that affects the skin and has an
immunopathogenesis very similar to that of allergic asthma and allergic rhinitis, which are
present in more than half of these patients.

Drugs allergy reactions by any mechanism of hypersensitivity. For example, penicillin may
cause anaphylaxis, which is IgE-mediated but most responses are trivial.