immunopathological reaction (reaction of hypersensitivity) type i. allergens - definition, division...

Immunopathological reaction (reaction of hypersensitivity) type I. Allergens - definition, division and nomenclature.

Anaphylaxis - pathophysiology, clinical manifestation, treatment.

Diagnostic procedures used in allergology.

Treatment of allergic diseases. Examples of diseases based on immunopathological reaction of type I.

Mechanism of IgE–mediated reaction

Type I – Allergy

Allergen IgE bound to the surface of the mast cell

Degranulation, mediator release

+

Allergicreaction

IL-4

IL-5

Eosinophil

IgE

B

T

T

Th2

APC

Allergen

T

Th1

IFN- BIgG

IL-12

IL-12

Th1/Th2 response

Immunopathological reaction (reaction of hypersensitivity) type I. Allergens - definition, division and nomenclature.

Anaphylaxis - pathophysiology, clinical manifestation, treatment.

Diagnostic procedures used in allergology.

Treatment of allergic diseases. Examples of diseases based on immunopathological reaction of type I.

Allergens

Inhaled (airborne)

Food

Venoms

Drugs

Inhaledallergens

seasonal

perennial

pollen

molds

mites

animals

birchgrass

mugwort

ragweed

EXAMPLES

Alternaria

Cladosporium

Aspergillus

Dermatophagoidespteronyssinus

Dermatophagoidesfarinae

cat

dog

Foodallergens

EXAMPLES

cow s milk

eggs

vegetables, fruits, nuts

fish, seafood

aditivesAGE

Hymenoptera venom allergens

EXAMPLES

honey bee(bumble bee)

wasp, yellow jacket(hornet)

Drug allergens

EXAMPLES

penicillines, cephalosporines

non-steroidal antiinflammatory drugs

iodine contrast media

local anesthetics

peripheral myorelaxants

latex

ethylenoxid

Immunopathological reaction (reaction of hypersensitivity) type I. Allergens - definition, division and nomenclature.

Anaphylaxis - pathophysiology, clinical manifestation, treatment.

Diagnostic procedures used in allergology.

Treatment of allergic diseases. Examples of diseases based on immunopathological reaction of type I.

Anaphylaxis

Grade Skin GI-tract Respiratory tract

Cardiovascular system

I Itching, urticaria, flush, angioedema

- - -

II Itching, urticaria, flush, angioedema

Nausea, cramps

Rhinorrhoea, dyspnea

Tachycardia, arythmia, decrease of blood

pressure

III Itching, urticaria, flush, angioedema

Diarrhoea Laryngeal oedema,

bronchospasm

Cardiovascular shock, faints

IV Itching, urticaria, flush, angioedema

Diarrhoea Respiratory arrest

Cardial arrest

Treatment of anaphylaxis

Adrenaline / Epinephrine:

Intramuscular – in patients with clinical symptoms of shock, oedema of the airways and pronounced dyspnoea

Dosage in adults:

0.5 ml - 1:1000 dilution In case of necessity repeat every 5-10 minutes

Immunopathological reaction (reaction of hypersensitivity) type I. Allergens - definition, division and nomenclature.

Anaphylaxis - pathophysiology, clinical manifestation, treatment.

Diagnostic procedures used in allergology.

Treatment of allergic diseases. Examples of diseases based on immunopathological reaction of type I.

Diagnosis of allergy

History

Clinical examination

Skin tests

Specific IgE in the serum

Provocation and elimination tests

Immunopathological reaction (reaction of hypersensitivity) type I. Allergens - definition, division and nomenclature.

Anaphylaxis - pathophysiology, clinical manifestation, treatment.

Diagnostic procedures used in allergology.

Treatment of allergic diseases. Examples of diseases based on immunopathological reaction of type I.

Treatment of allergic diseases

Alle

rgen

avo

idan

ce

Ph

arm

aco

ther

apy

Sp

ecif

ic

imm

un

oth

erap

y

Alle

rgen

avo

idan

ce • Anti-mites bedding

• Pollen filters

• Stay in mountains during pollen season

• Animal avoidance

Ph

arm

aco

ther

apy • Antihistamines

• Corticosteroids

• Symptomathic treatment

Sp

ecif

ic

imm

un

oth

erap

y • Subcutaneous

• Sublingual

APC

IgE

IL-4

IL-5 Allergicresponse

EosinophilTh2

B-cell

+

+

Tr1

IL-10

TGF-b

--

+

IT

Th1

IgG

IFN-gB-cell

IT -CD4

CD80/86

T cell

Allergen

TCRHLA

CD28

Immunopathological reaction (reaction of hypersensitivity) type I. Allergens - definition, division and nomenclature.

Anaphylaxis - pathophysiology, clinical manifestation, treatment.

Diagnostic procedures used in allergology.

Treatment of allergic diseases. Examples of diseases based on immunopathological reaction of type I.

Atopic diseases

Allergic asthma is chronic inflammatory disease of the airways in which a wide variety of cells (mast cells. Eosinophils, TH2 lymphocytes) and mediators play a role.

Atopic dermatitis

Allergic rhinitis

Allergic asthma

• Allergic rhinitis is affection of the nose (and ocular conjunctiva) caused by IgE-mediated inflammation of nasal mucosa after allergen exposure.

• Atopic dermatitis is inflammatory disease of the skin which is mediated by T cells and stimulated by IgE-dependent reactions.

IgE mediated food allergy Allergy