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ALLERGY: PATHOPHYSIOLOGYLia Restimulia

 

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Hypersensitivity (hypersensitivityreaction) refers to undesirable immunereactions produced by the normal immune

system.

Hypersensitivity reactions: four types; based on the mechanisms involved andtime taen for the reaction, a particularclinical condition (disease) may involvemore than one type of reaction.

Hypersensitiv

ity

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Classification of Immunologic Reactions

(Gel and Coombs) 

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Allergy

Ig E mediated

(Type Ihypersensitivity)

Non Ig Emediated

Allergy

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!verreaction to an allergen ( antigen thatcauses allergy) after fe" minutes contact

through sin, inhaled through lung,

s"allo"ed or in#ected. Triggered by harmless substances such as;

 pollen, dust, animal danders, food, drug or

 bee stings or stings from other insects

IgE Mediated:Type I hypersensitivity

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Atopy is the genetic predisposition to mae $gE antibodies in responseto allergen e%posure.

Etiology is unno"n

Primary Atopic Conditions

Alleric r!initis "AR) Sinusitis

Atopic ec#ema "AE)

Alleric ast!ma "AA)

Allergic gastroenteropathy is rare.

These manifestation may coe%ist in the same patients at different times.

Atopy can be asymptomatic.

Atopy

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 Genes Identifed to date in

Atopy

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Alleric R!initis "RA)Alleric R!initis "RA)

A$normalities o% t!e nose due tonasal mucosal in&ammatoryprocess

'ediated $y type I !ypersensiti(itySymptoms : snee#in nasal

itc!in r!inorr!ea and nasal

conestionRe(ersi$le spontaneously or *it!

treatment

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RA classi+cationRA classi+cation

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Proteins ,orein serum

-accines

Plant pollens Rye rass

Ra*eed Timot!y rass

.irc! trees

/rus Penicillin

Sul%onamides Local anet!etics

Salicylates

,oods0uts

Sea%ood

Es

Peas $eans

'il1

Insect products .ee (enom

2asp (enom

Ant (enom

Coc1roac! caly3/ust mites

'old spores Animal !air and dander

&ommon allerens associated *it!type I !ypersensti(ity

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'hile firsttime e%posure may only produce amild reaction, repeated e%posures may lead tomore serious reactions.

!nce a person is sensitied (has had a previoussensitivity reaction), even a very limitede%posure to a very small amount of allergen cantrigger a severe reaction.

*ost occur "ithin seconds or minutes aftere%posure to the allergen, but some can occurafter several hours, particularly if the allergencauses a reaction after it is partially digested. $n

very rare cases, reactions develop after + hours.

'ec!anism

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ImmunopathogenesisImmunopathogenesis

-oth mast cells and basophils are

involved in immunopathogenesis of $gE

mediated diseases.

T and B cells play important roles in

the development of these antibodies

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ImmunopathogenesisImmunopathogenesis

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ImmunopathogenesisImmunopathogenesis

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ImmunopathogenesisImmunopathogenesis

*ast cell are abundant in the mucosa of therespiratory, gastrointestinal tracts and in the

sin, "here atopic reaction localie.

*ast cell release mediator cause the pathophysiology of the immediate and late

 phases of atopic diseases.

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type I !ypersensti(itytype I !ypersensti(ity "early and late p!ase)"early and late p!ase)

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Re4e3posureRe4e3posure

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.road Alleric Cascade.road Alleric Cascade

4'ediators4'ediators

IL = Interleukin TN!"a= Tumor ne#rosis $a#tor"alpha%ANTE& = %egulated on a#tivation' normal T #ellepressed and se#reted )*AM = )as#ular #elladhesion mole#ule I*AM"+ = Inter#ellular adhesion

mole#ule"+,

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Important Clinical Aspects of ImmediateImportant Clinical Aspects of Immediate

HypersensitivityHypersensitivity

Main organ -isease Mainsymptoms

Typi#alallergens

%oute o$entery

Lun Ast!ma 2!ee#indyspnea

tac!ypnea

Pollens !ousedust animal

danders

In!alation

0ose andEyes

R!initiscon5uncti(itis

Hay %e(er

Runny noseredness and

itc!in o%eyes

Pollens Contact *it!mucous

mem$rane

S1in Ec#ema "atopicdermatitis)6rticaria

Pruritic(esicularlesions

Pruritic$ullouslesions

6ncertain-arious %oods

/rus

6ncertainInestion-arious

Intestinaltract

Allericastroenteropat!y

-omitindiarr!ea

-arious %ood Inestion

Systemic Anap!yla3is S!oc1!ypotension

Insect(enom7$ee

Stin-arious

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Hypersensitivity pneumonitis involves inhalationof an antigen. This leads to an

e%aggerated immune response(hypersensitivity). Type $$$ hypersensitivity

and type $ hypersensitivity occur in

hypersensitivity pneumonitis. 

Allergic contact dermatitis.

Allergi# Hypersensitivity. Non IgE

Mediated

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Res!lt Antigen so!rce "echanism #isease

/isease 0oreign $mmunologic Allergy

1rophyla%is 0oreign $mmunologic $mmunity

/isease 2elf $mmunologic Autoimmunity

/isease 0oreign To%ic To%icity

*omparison o$ Allergy /ith other %esponses

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