Allergy Development and Responses Quiz
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What is the purpose of the primary contact or sensitization stage in the development of an allergy?

  • To trigger immediate allergic symptoms
  • To alleviate symptoms of allergic reactions
  • To prime the immune system for future allergen exposure (correct)
  • To prevent the release of IgE antibodies

    • During the provocation stage of an allergic reaction, what occurs after the allergen binds to the IgE-mast cell complex?

  • The body experiences an increase in vasodilation and bronchoconstriction (correct)
  • The immune system produces more TH cells
  • Mast cells release additional IgE antibodies
  • Antigen processing is initiated by basophils

    • Where are mast cells predominantly located in the body?

  • Only in the gastrointestinal tract
  • In the connective tissue of virtually all organs (correct)
  • In the bloodstream and lymphatic system
  • In the neural tissue of the brain

    • How many IgE antibodies can each mast cell bind?

    <p>10,000-40,000</p> Signup and view all the answers

    What triggers the degranulation of mast cells during an allergic response?

    <p>The binding of allergen to the IgE-mast cell complex</p> Signup and view all the answers

    What does bradykinin primarily cause in the respiratory system?

    <p>Dilation of peripheral arterioles</p> Signup and view all the answers

    Which of the following is NOT associated with atopic disease?

    <p>Colitis</p> Signup and view all the answers

    Which symptoms are characteristic of systemic anaphylaxis?

    <p>Sudden respiratory and circulatory disruption</p> Signup and view all the answers

    What type of allergy reaction is characterized by a wheal and flare inflammatory response?

    <p>Cutaneous anaphylaxis</p> Signup and view all the answers

    What is a common symptom of food allergies?

    <p>Abdominal pain</p> Signup and view all the answers

    Which method is commonly used to diagnose allergies?

    <p>Skin testing</p> Signup and view all the answers

    What can trigger anaphylactic shock?

    <p>Insect stings</p> Signup and view all the answers

    What distinguishes drug allergies from other types of allergies?

    <p>They can affect any tissue and vary in severity.</p> Signup and view all the answers

    What is the term for the study of diseases associated with underreactivity and overreactivity of the immune response?

    <p>Immunopathology</p> Signup and view all the answers

    Which type of allergic reaction is characterized by immediate onset and involves IgE-mediated responses?

    <p>Type I</p> Signup and view all the answers

    What is the major difference between localized chronic allergies and systemic allergic reactions?

    <p>Systemic reactions can cause airway obstruction and collapse.</p> Signup and view all the answers

    Which of the following statements regarding Type I allergies is false?

    <p>They always result in systemic reactions.</p> Signup and view all the answers

    What type of hypersensitivity involves T-cell mediated reactions?

    <p>Type IV</p> Signup and view all the answers

    Which of the following mechanisms is involved in antibody-mediated incompatibilities?

    <p>IgG and IgM antibodies</p> Signup and view all the answers

    What triggers the allergic responses classified under Type I reactions?

    <p>Allergens</p> Signup and view all the answers

    In which condition can immune complex diseases be found?

    <p>Rheumatoid arthritis</p> Signup and view all the answers

    Which factors can affect the onset of allergies?

    <p>Age, infection, and geography</p> Signup and view all the answers

    What distinguishes atopic allergies from non-atopic allergies?

    <p>Atopic allergies have a genetic component.</p> Signup and view all the answers

    What condition can occur during a second pregnancy involving an Rh+ child?

    <p>Hemolytic Disease of the Newborn</p> Signup and view all the answers

    What is the role of passive immunization in preventing complications related to Rh incompatibility?

    <p>Prevention of sensitization to the Rh antigen</p> Signup and view all the answers

    Which type of hypersensitivity is primarily associated with immune complex diseases?

    <p>Type III Hypersensitivity</p> Signup and view all the answers

    What immediate reaction occurs in the Arthus reaction?

    <p>Localized dermal injury from inflamed blood vessels</p> Signup and view all the answers

    Which is an example of a Type IV hypersensitivity reaction?

    <p>Contact Dermatitis</p> Signup and view all the answers

    In contact dermatitis, which cells are primarily responsible for processing the allergen?

    <p>Dendritic cells</p> Signup and view all the answers

    What is typically involved in the pathophysiology of delayed hypersensitivity in Type IV diseases?

    <p>T cell response to self or foreign antigens</p> Signup and view all the answers

    What is a common outcome of immune complexes being deposited in tissues?

    <p>Damaging inflammatory response</p> Signup and view all the answers

    Which virulence factor significantly increases the tissue penetration of Candida?

    <p>Conversion to hyphal forms</p> Signup and view all the answers

    Which of the following conditions is NOT a risk factor for invasive or systemic Candidiasis?

    <p>Mechanical ventilation for less than 3 days</p> Signup and view all the answers

    What percentage of HIV-positive individuals NOT on HAART therapy eventually develops oropharyngeal candidiasis?

    <p>90%</p> Signup and view all the answers

    Which host defect would NOT contribute to an increased risk of Candidiasis?

    <p>High immunoglobulin levels</p> Signup and view all the answers

    What is the approximate mortality rate for blood-borne Candida and disseminated Candidiasis?

    <p>25-30%</p> Signup and view all the answers

    What characterizes Myasthenia gravis?

    <p>Antibodies against acetylcholine receptors</p> Signup and view all the answers

    Which disease involves T cells and antibodies destroying the myelin sheath?

    <p>Multiple sclerosis</p> Signup and view all the answers

    What is a common characteristic of systemic lupus erythematosus (SLE)?

    <p>Production of autoantibodies against various organs</p> Signup and view all the answers

    What distinguishes type I diabetes in terms of immune response?

    <p>Stimulation of insulin-secreting cell destruction</p> Signup and view all the answers

    Which disease primarily causes chronic inflammation of the joints?

    <p>Rheumatoid arthritis</p> Signup and view all the answers

    Goodpasture syndrome primarily affects which part of the body?

    <p>Kidney</p> Signup and view all the answers

    What is a common complication associated with rheumatic fever?

    <p>Cross-reactivity with heart valve tissue</p> Signup and view all the answers

    Which organs can be affected by systemic lupus erythematosus (SLE)?

    <p>Various organs including the skin and joints</p> Signup and view all the answers

    Which virulence factor aids in the increased tissue penetration of Candida?

    <p>Conversion to hyphal forms</p> Signup and view all the answers

    Which of the following conditions does NOT increase the risk of invasive or systemic Candidiasis?

    <p>Severe dehydration</p> Signup and view all the answers

    What percentage of HIV-positive individuals NOT on HAART therapy is likely to develop oropharyngeal candidiasis?

    <p>90%</p> Signup and view all the answers

    Which host defect does NOT contribute to the increased risk of Candidiasis?

    <p>Hypertension</p> Signup and view all the answers

    What is the primary role of histamine in an allergic reaction?

    <p>Acts as a vasodilator and smooth muscle constrictor</p> Signup and view all the answers

    Which of the following chemical mediators is known for producing prolonged bronchospasm in asthmatic individuals?

    <p>Leukotrienes</p> Signup and view all the answers

    What are common targets for the chemical mediators released during an allergic response?

    <p>Skin, upper respiratory tract, and GI tract</p> Signup and view all the answers

    What effect do prostaglandins have in the context of allergic reactions?

    <p>Serve as powerful inflammatory agents</p> Signup and view all the answers

    Which of the following responses is associated with systemic targets during an allergic reaction?

    <p>Vascular dilation and constriction impacting blood pressure</p> Signup and view all the answers

    Which type of graft involves tissue from genetically identical individuals?

    <p>Isograft</p> Signup and view all the answers

    What occurs when host T cells release interleukin-2 during an organ transplant?

    <p>It expands TH and TC cells specific for donor antigens.</p> Signup and view all the answers

    In conditions of autoimmunity, the immune system loses tolerance primarily due to:

    <p>Formation of autoantibodies and sensitized T cells.</p> Signup and view all the answers

    Which statement best describes the mechanism of graft versus host disease (GVHD)?

    <p>It happens when donor T cells recognize recipient tissues as foreign.</p> Signup and view all the answers

    What best describes the autoimmunity associated with systemic lupus erythematosus (SLE)?

    <p>It presents with both systemic and organ-specific disruption.</p> Signup and view all the answers

    What is the role of lymphokines released by TC cells in graft rejection?

    <p>To initiate the rejection process.</p> Signup and view all the answers

    Which theory suggests that some lymphocyte clones are not subjected to the tolerance process?

    <p>Forbidden clones theory</p> Signup and view all the answers

    Which factor is NOT linked to the susceptibility of autoimmune diseases?

    <p>Age of diagnosis</p> Signup and view all the answers

    What is the primary target of antibodies in Myasthenia gravis?

    <p>Acetylcholine receptors</p> Signup and view all the answers

    Which of the following diseases is characterized by the destruction of insulin-secreting cells?

    <p>Type I diabetes</p> Signup and view all the answers

    In which disease do T cells and antibodies lead to the destruction of neurons?

    <p>Multiple sclerosis</p> Signup and view all the answers

    Goodpasture syndrome primarily causes damage to which part of the body?

    <p>Kidneys</p> Signup and view all the answers

    Which condition is characterized by autoantibodies affecting a variety of organs and tissues, including the skin and kidneys?

    <p>Systemic lupus erythematosus</p> Signup and view all the answers

    Rheumatic fever is associated with antibodies that affect which part of the body?

    <p>Heart valve tissue</p> Signup and view all the answers

    What characteristic symptom is associated with Systemic lupus erythematosus?

    <p>Facial rash</p> Signup and view all the answers

    Which disease is known for causing progressive, debilitating damage to the joints?

    <p>Rheumatoid Arthritis</p> Signup and view all the answers

    What is desensitization therapy primarily aimed at preventing?

    <p>Binding of IgE to allergens</p> Signup and view all the answers

    Which blood type contains antibodies that react against both A and B antigens?

    <p>Type O</p> Signup and view all the answers

    Which statement about Rh incompatibility is true?

    <p>Rh- mothers can develop antibodies against Rh+ blood.</p> Signup and view all the answers

    Which immune response involves the lysis of foreign cells by antibodies and complement?

    <p>Type II hypersensitivity</p> Signup and view all the answers

    Which blood group cannot have anti-A or anti-B antibodies?

    <p>Type AB</p> Signup and view all the answers

    Which type of antibody is associated with Type A blood?

    <p>Anti-B</p> Signup and view all the answers

    What are the primary components involved in the potential transfusion reaction?

    <p>Antibodies and foreign antigens</p> Signup and view all the answers

    What is the main characteristic of antibodies found in Type O blood?

    <p>Both anti-A and anti-B antibodies</p> Signup and view all the answers

    Which antibodies would a person with Type AB blood contain?

    <p>No antibodies against A or B</p> Signup and view all the answers

    What is a potential outcome if an Rh- mother carries an Rh+ child?

    <p>The mother may develop Rh antibodies that affect future pregnancies.</p> Signup and view all the answers

    What is the primary effect of Graves' disease on hormone levels?

    <p>Increases levels of thyroxin</p> Signup and view all the answers

    Which of the following describes the mechanism of Hashimoto's thyroiditis?

    <p>Autoantibodies and T cells react to the thyroid gland</p> Signup and view all the answers

    What type of disease is characterized by the damage to the myelin sheath of nerve cells?

    <p>Multiple sclerosis</p> Signup and view all the answers

    What characterizes primary immunodeficiencies?

    <p>Congenital and often due to genetic errors</p> Signup and view all the answers

    How do autoantibodies contribute to the development of Type I Diabetes mellitus?

    <p>By attacking and damaging beta cells in the pancreas</p> Signup and view all the answers

    What is one possible cause of the genetic alterations seen in abnormal cell growth?

    <p>Activation of oncogenes</p> Signup and view all the answers

    What is a significant clinical manifestation of myasthenia gravis?

    <p>Pronounced muscle weakness</p> Signup and view all the answers

    Which cells are primarily responsible for immune surveillance against cancer?

    <p>TC cells, NK cells, and macrophages</p> Signup and view all the answers

    What happens to the body in secondary immunodeficiencies?

    <p>They arise after birth due to external factors</p> Signup and view all the answers

    Study Notes

    Disorders in Immunity

    • Disorders in immunity are studied to understand disease states associated with under-reactivity and over-reactivity of the immune response.
    • Types of disorders include: allergy/hypersensitivity, autoimmunity, immunodeficiency, and cancer. These are interconnected as disorders affecting one can affect others.

    The Immune Response

    • The study of disease states associated with under-reactivity and over-reactivity of the immune response.
    • Allergy/Hypersensitivity: exaggerated, misdirected immune responses to an allergen (antigen).
    • Autoimmunity: abnormal responses to self-antigens.
    • Immunodeficiency: deficiency or loss of immunity.
    • Cancer: both a cause and effect of immune dysfunction.

    Immune System Disorders

    • Describes reactions that can lead to diseases in the immune system.
    • Overreactions (Allergies and Hypersensitivities): Type I (immediate), Type II (antibody-mediated), Type III (immune complex), Type IV (cell-mediated).
    • Underreactions and Loss of Immune Function: lack of T-cell surveillance leading to cancer cell survival; lack of T cells, B cells (or both) compromises the immune system.

    Allergy/Hypersensitivity Reactions

    • Classification of Immunopathologies caused by overreactions to antigens.
    • Types include: Immediate, Antibody-mediated incompatibilities, Immune complex diseases, and Cell-mediated hypersensitivities, each with examples and systems involved.

    Type I Allergic Reactions

    • Allergies share a similar physiological mechanism; generally immediate in onset and associated with exposure to specific antigens.
    • Severity levels: chronic local allergy (e.g., hay fever, asthma) vs. systemic, explosive reaction (involving airway obstruction and circulatory collapse).
    • Factors that affect allergy onset include familial predisposition, age, infection, and geographic area. Atopic allergies may be lifelong or ‘outgrown’, potentially developing later in life.

    Nature of Allergens and Their Portals of Entry

    • Allergens have immunogenic characteristics.
    • Allergens typically enter through epithelial portals, like respiratory, gastrointestinal, or skin.
    • The organ where the allergic reaction occurs may not be the same as the entry portal.

    Common Allergens, Classified by Portal of Entry

    • A table categorizing common allergens (e.g., inhalants, ingestants, injectants, contactants) based on their entry route into the body.

    Stages in the Development of Allergy

    • Primary contact/Sensitization: Initial allergen exposure; generally no signs or symptoms. Dendritic cells activate TH cells in lymph nodes. Interaction between TH and B cells produces plasma cells – which make IgE that attaches to mast cells and basophils. Priming the immune system.

    • Subsequent Exposure to Allergen and Provocation: If the same allergen is again encountered, it goes directly to previously primed mast cells leading to degranulation; release of allergic mediators resulting in systemic distribution & symptoms in various organs.

    Role of Mast Cells and Basophils

    • Ubiquitous location in tissues.
    • Mast cells in connective tissue, abundant in lungs, skin, GI, and genitourinary tract.
    • Basophils circulate in blood, migrate into tissues.
    • Each mast cell can bind many IgE; Contains physiologically active cytokines, histamine, etc.
    • They degranulate/release contents in response to allergens.

    Cytokines, Target Organs, and Allergic Symptoms

    • Chemical mediators released by mast cells and basophils cause allergic symptoms alone or in combination affecting skin, upper respiratory tract, Gl tract, and conjunctiva (causing rashes, itching, redness, rhinitis, sneezing, diarrhea, and shedding tears)
    • Target systemic tissues including smooth muscles, mucous glands, and nervous tissue causing blood pressure and respiration changes.

    Main Chemical Mediators

    • Histamine: most profuse and fastest acting; stimulates smooth muscle, glands and eosinophils. Response to chemical depends on location.
    • Serotonin: similar effects as histamine.
    • Leukotrienes ("slow reacting substance of anaphylaxis"): cause prolonged bronchospasm, vascular permeability, and mucus secretion (asthma).
    • Prostaglandins: powerful inflammatory agents, regulate smooth muscle contraction.
    • Bradykinin: causes prolonged contraction of bronchioles, dilation of peripheral arterioles, increased capillary permeability, and mucus secretion.

    Reactions to Inflammatory Cytokines

    • Effects of chemical mediators on various parts of the body (in response to inflammation)
    • Reactions such as headache, dilated blood vessels, wheezing, difficulty breathing, coughing, etc., in various organs, indicating a systemic reaction.

    Diseases Associated with Type I Allergy

    • Atopic diseases (e.g., hay fever, rhinitis, asthma, atopic dermatitis, food allergies).
    • Symptoms like: nasal congestion, breathing difficulties, skin rashes or itchy skin, gastrointestinal problems, and in extreme cases, anaphylaxis.
    • Drug allergies are also significant, affecting any tissue, severity from mild to potentially fatal.
    • Includes Anaphylaxis, with symptoms like itching, sneezing, difficult breathing, prostration, convulsions, and potential death, occurring in two types: cutaneous and systemic.

    Anaphylaxis

    • A reaction of an animal injected with foreign protein.
    • Symptoms include itching, sneezing, difficult breathing, prostration, convulsions, and possible death.
    • Two types in humans: cutaneous anaphylaxis (wheal and flare reaction) and systemic anaphylaxis (anaphylactic shock).

    Diagnosis of Allergy

    • Skin testing is important to distinguish between allergies and infections.

    Environmental Allergens

    • Lists common allergens based on their route of entry into the body.

    Treatment and Prevention Methods

    • Avoiding the allergen is the initial step.
    • Corticosteroids inhibit IgE production and T-cell activity.
    • Cromolyn stabilizes mast cell membranes.
    • Antihistamines counteract cytokine effects on smooth muscle.
    • Monoclonal drugs inactivate IgE.
    • Desensitization therapy involves injecting allergens to stimulate IgG production, preventing IgE-allergen binding

    Type II Hypersensitivities

    • Reactions which lead to lysis of foreign cells involving antibodies and complement.
    • Transfusion reactions (ABO blood groups and Rh factor) can also cause hemolytic disease of the newborn.

    Human ABO Antigens and Blood Types

    • Four distinct blood types (A, B, AB, and O) based on inherited glycoproteins on red blood cells.
    • Individuals with Type O blood lack A and B glycoproteins; other tissue cells can also carry A and B antigens.
    • A table (Table 16.3) displays the characteristics of ABO blood groups, including the antigens present/absent in each blood type and the antibodies found in the plasma.

    Antibodies Against A and B Antigens

    • Body produces antibodies against different antigens (e.g., Type A contains antibodies that react to B antigens).
    • This is a factor in transfusion reactions, indicating why certain blood types cannot be mixed.

    Interpretation of Blood Typing

    • Agglutination test results are shown with examples (blood is labeled as type A, AB, B, or O based on the reactions with anti-A and anti-B sera).

    Transfusion Reactions

    • Occur when incompatible blood types are mixed in a transfusion.
    • The process of incompatible blood mixing results in clumping of red-blood cells and triggering of the complement cascades causing hemolysis.

    Hemolytic Disease of the Newborn

    • Rh incompatibility between mother and fetus, especially concerning in subsequent pregnancies.
    • Fetal red blood cells can leak into the mother's blood stream and sensitizes the mother's immune system to the Rh factor causing a reaction with subsequent Rh positive pregnancies.

    Type III Hypersensitivity

    • Reaction of soluble antigen with antibody, causing deposition of the resulting complexes in tissues (basement membranes).
    • Localized or systemic responses. Examples: Arthus reaction, serum sickness.

    Pathogenesis of Immune Complex Disease

    • Describes the stages of formation and action on tissues/organs leading to disease.

    Immunopathologies Involving T Cells

    • Type IV Hypersensitivity: delayed hypersensitivity reactions that manifest days after exposure to an antigen. In type IV, T cells respond to antigens on self or transplanted tissues which include problems like delayed allergic reactions, contact dermatitis, and graft rejection.

    Contact Dermatitis

    • Reactions with a delay in manifesting days after exposure to antigens/allergens causing injury/inflammation. This is a skin reaction to chemicals; the exposure to the chemical triggers a response in the immune system. This includes the processes from initial contact to the reaction, including steps like absorption of the chemical, dendritic cells recognizing the chemical, and T-cell activation.

    T Cells and Organ Transplantation

    • Explains host rejection of transplanted tissues; graft destruction from cytotoxic T cells of the recipient. This includes both host rejection of the graft and graft rejection of the host tissues.

    Classes of Grafts

    • Different types of grafts categorized based on MHC similarity between donor and recipient: autografts (self-to-self), isografts (identical twins), allografts (different individuals of the same species), xenografts (different species). This includes methods to prevent rejection, like tissue typing and mixed lymphocyte reactions.

    Autoimmunity

    • Situations where the immune system attacks the body's own tissues.
    • This can take a systemic or organ-specific form. Examples: systemic lupus erythematosus, rheumatoid arthritis, endocrine autoimmunities, myasthenia gravis, and multiple sclerosis. Genetic and environmental factors can influence susceptibility.

    The Origins of Disease

    • Theories of auto-immunity, like sequestered antigen theory (some tissues are immunologically privileged during development), forbidden clones (some T cells are not exposed to self-antigens), and molecular mimicry (microbial antigens resemble self-antigens).

    Autoimmune Diseases

    • A table summarizing a variety of autoimmune diseases with associated targets and characteristics.

    Systemic Autoimmunities

    • Discusses systemic lupus erythematosus (SLE) leading to inflammation and rheumatoid arthritis (RA) leading to joint damage affecting lungs, eyes, skin, and nervous systems. Includes the symptoms of SLE and RA.

    Endocrine Glands Autoimmunities

    • Autoimmune disorders specifically affecting endocrine glands/hormone production and affecting thyroid (Graves' and Hashimoto's), pancreas (I diabetes). Lists symptoms for each endocrine issue.

    Neuromuscular Autoimmunities

    • Disorders affecting the muscles and nerves: Myasthenia gravis, and Multiple sclerosis. Includes the symptoms for each disease.

    Immunodeficiency Diseases

    • Describes the absence or dysfunction of components of the immune response system (B and T cells, phagocytes, and complement).
    • Separates primary (congenital) and secondary (acquired) deficiencies. Includes examples and causes.

    Primary Immunodeficiencies

    • A table giving detailed information about various primary immunodeficiencies – including genetic defects, characteristics and treatment. Includes examples and their symptoms.

    The Immune System and Cancer

    • Immune surveillance: The body's systems keeping an eye out for and eliminating cancer cells through their innate/adaptive immune system.
    • The potential for abnormal cell growth, self-contained or cancerous growths, errors in cell division leading to mutations (e.g., mitosis errors, genetic damage, oncogene activation, retroviruses), and the implications for disease development. Including specifics like tumor classification (non-spreading/self-contained and cancerous). Immunity and cancer.

    Medical Moment: Candidiasis

    • Candida albicans is a ubiquitous yeast (dimorphic) and can be an opportunistic infection in the body.

    Pathogenesis of Candidiasis

    • Virulence factors include adherence molecules and acid proteases/phospholipase. Conversion to hyphal forms makes them better at penetrating tissues. Includes details about factors that contribute to the spread of the infection

    Epidemiology of Invasive Candidiasis

    • Risk factors for invasive candidasis include weakened immune systems, broad spectrum antibiotics, and exposure to the fungus, including specific examples of compromised systems in susceptible people.

    Epidemiology of Invasive Candidiasis - continued

    • Common fungal infection that affects immunocompromised people. Often, 90% of HIV positive patients not undergoing HAART therapy eventually develops oropharyngeal candidiasis and disseminated candidasis mortality rates of 25-30%. Candida is commonly found in fecal flora of almost 40-65% of people, including statistic information.

    Drug-Resistant Candida Species

    • Significant threat, particularly in hospitalized populations; 2017 data showing significant cases and deaths of individuals due to resistance to antibiotic/drugs that are important to keep the fungus in check. Includes statistic information about cases and deaths.

    Signs and Symptoms of Candida Infections

    • Systemic, GI, and cutaneous infections with typical signs/symptoms including fever, organ involvement, and skin problems. Symptoms can range from mouth sores to widespread health complications.  Includes detailed symptoms for each type of infection.

    Treatment for Candida Infections

    • Treatment options for systemic vs. superficial infections detailed, including specific drugs like fluconazole.

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