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Immunology - Hypersensitivity Reactions (dropped image link…

- - - - Clinical Cases
        
        Clinical Case
        
        Clinical Case
        
        Notes:
        
        note that
        
        Allergic Reaction example
        
        Notes:
        
        note that in an allergic reaction, the first exposure ever to the antigen has a class switch from IgM to IgE antibodies that bind to the specific antigen
        
        these IgE are now ready in B cells to be released if the antigen = allergen ever enters again
        
        second exposure --> these IgE antibodies bind to basophils and mast cells = granulocytes
        --> cause them to release granules, cytokines, and interleukins
        --> histamine, leukotrienes, proteases, prostaglandins, etc.
        
        Clinical Case
        
        Allergic Reaction example 2
        
        Notes:
        
        note that the IgE that are produced for people who have allergies, these are not just free floating antibodies in the tissues or blood,
        
        they are mostly IgE antibodies that are surface bound to granulocytes like basophils and mast cells
        
        once the antgien or allergen enters the tissue it binds to IgE on these granulocytes and they release histamine, etc.
        
        Clinical Case
      - 3 phases of Type 1 rxns
        
        1 = Prephase = sensitization tot he antigen
        --> makes IgE antibodies that attach to mast cells and antibodies
        
        2 = Immediate inflammation phase = release of preformed IgE and tryptase
        --> tryptase levels used for diagnosis
        
        3 = Delayed inflammation phase = infiltration and inflammation from the cytokines left over from the early phase of type 1 rxn
        --> proteases cause most of delayed phase
        
        2 = Immediate inflammation phase
        
        2 = Immediate inflammation phase = release of preformed IgE and tryptase
        --> tryptase levels used for diagnosis
        
        Binding of the antigen to IgE on
        
        antigen IgE binding
        --> on high affinity FcER IgE recetors are specific binders to the Fc portions of antibodies
        
        Aggregation of the high affinity FcER IgE recetors
        
        agregation of multiple receptors to one antigen is what causes the release of granules from the mast cells and basophils
        
        this makes sense since the level of reaction response depends on the sensitization to the antigen and how much IgE you have made
        
        thus more exposure
        --> more IgE bound to high affinity receptors
        --> more high affinity IgE receptors can aggregate and release more granules
        
        1 more item...
        
        3 = Delayed inflammation phase
        
        3 = Delayed inflammation phase = infiltration and inflammation from the cytokines left over from the early phase of type 1 rxn
        
        --> proteases cause most of delayed phase
        
        Prephase = sensitization to the antigen
        
        makes IgE antibodies that attach to mast cells and antibodies
        
        2 = Immediate inflammation phase = release of preformed histamine and tryptase
        --> tryptase levels used for diagnosis
        
        3 = Delayed inflammation phase = infiltration and inflammation from the cytokines left over from the early phase of type 1 rxn
        --> proteases cause most of delayed phase
        
        depends on also the prephase granules that are present inside of mast cells and basophils
        
        *Preformed Granules of mast cells and basophils
        
        depends on also the prephase granules that are present inside of mast cells and basophils
        
        *IgE Fc attachment to mast cells and basophiles
        
        important for prephase of hypersensitivity type 1 rxns
        
        high affinity FcER IgE recetors are specific binders to the Fc portions of antibodies
  - - - "HENOCH PAAAPacy" = pope Henoch-Schonlein German pope fictional
        
        PAAAP = purpura
        
        A = IgA complexes cause vasculitis systemicall
        
        arthralgia = from the IgA complexes collecting in joints
        
        Abdominal pain = again from the IgA
      - Henoch-Schonlein Purpura case
        
        Notes:
        
        note that HS purpura present with PAAAP as in this case
        
        Case presentation:
    - - ASS example
        
        Case presentation:
        
        Notes:
        
        note that ASS = acute serum sickness is a common way people who are allergic to certain medications or venom
        --> happens 1 wk - 2wks after being given them
        
        type 3 hypersensitivity reaction
        
        immune complexes of IgM and IgG and also complement cytokine = C3 get depositied in tissues and cause pruritic rashes and fever and
        
        FAP symptoms = fever arthralgias, Pruritic rash
        
        note that because you get these depositions int he issue of the Imune complexes and the C3, you have less c3 total circulating in the blood
  - - - *Tuberculin skin testing (Tuberculin TB)
        
        Type 4 Hypersensitivity Reaction
        
        also candida injection for general CD8 testing
        
        Clinical Cases
        
        Clinical Case
        
        Clinical Case
        
        Notes:
        
        note that
        
        *Candida Antigen skin testing
        
        note that virtually all people react to the candida antigen so this is used as a control
        
        only people who would not rect to it are SCID or other immunodeficient people
    - - Clinical Cases
        
        Posion Ivy Dermatitis
        
        Notes:
        
        note that Poison Ivy Dermatitis is a type 4 hypersensitivity reaction
        --> think that it usually takes a few days for poison ivy dermatitis to actually appear
        
        Case presentation:
        
        Clinical Case
        
        Clinical Case
        
        Notes:
        
        note that
- - - - Cmooth depostion = Good Pasture = 2 words = type 2 reaction
        Cmooth depostion = Good Pasture
        lump-I bumby-I depostiion = Immune Complex Depostin = ICD = 3 words = TYPE 3 reaction
        ICD = PSG = lump-I bumby-I depostiion
    - - *TB test = type 4 DELAYED reaction
        
        classic example of type 4 reaction
        
        since for a TB test you have to wait 48-72 hours for there to be a reaction
        
        this means it is type 4 reaction and Macrophages peak at day 3 after inflammation
        --> hence type 4
        --> TH1 activating = macrophages and CD8+ cells