Antibody-Mediated Hypersensitivity Types

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Questions and Answers

What is the primary immunoglobulin involved in natural antibody-mediated reactions against RBC antigens?

  • IgE
  • IgA
  • IgG
  • IgM (correct)

Which autoimmune condition is characterized by IgG autoantibodies binding to acetylcholine receptors?

  • Myasthenia gravis (correct)
  • Pemphigus
  • Graves' Disease
  • Goodpasture’s syndrome

What mechanism primarily causes hemolytic disease of the newborn?

  • Complement activation on maternal RBCs
  • IgM binding to fetal RBCs
  • IgG-coated maternal antibodies destroying fetal RBCs (correct)
  • Incompatibility of Rh antigens

What is the effect of IgG in autoimmune hemolytic anemia (AIHA)?

<p>It opsonizes RBC fragments for macrophage phagocytosis. (A)</p> Signup and view all the answers

Which condition involves antibodies that stimulate rather than block receptor activity?

<p>Graves’ Disease (A)</p> Signup and view all the answers

What component primarily contributes to the activation of complement in Type II hypersensitivity?

<p>IgM antibodies (C)</p> Signup and view all the answers

Which autoimmune condition specifically targets the basement membrane of the lungs and glomeruli?

<p>Goodpasture’s syndrome (C)</p> Signup and view all the answers

What is the role of IgM in incompatible ABO blood transfusions?

<p>Agglutinating and complement activation of RBCs (A)</p> Signup and view all the answers

Flashcards

Antibody-Mediated Hypersensitivity

A type of hypersensitivity involving IgG and IgM antibodies binding to cell surfaces, leading to damage.

IgG and IgM in Hemolysis

IgG and IgM antibodies play key roles in the immune-mediated hemolysis of red blood cells.

Alloimmune Hemolysis

A condition where IgG-coated red blood cells are destroyed by macrophages, often in newborns or after blood transfusion.

Autoimmune Hemolysis

A type of hemolysis caused by the body's own antibodies, including IgG and IgM against red blood cells.

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Goodpasture’s Syndrome

An autoimmune condition where IgG attacks the basement membrane in lungs and kidneys.

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Graves’ Disease

An autoimmune disorder characterized by hyperthyroidism due to IgG antibodies binding TSH receptors.

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Myasthenia Gravis

An autoimmune disease where IgG antibodies block acetylcholine receptors, causing muscle weakness.

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AIHA (Auto-Immune Hemolytic Anemia)

A condition where autoantibodies lead to the destruction of red blood cells, often in autoimmune diseases.

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Study Notes

Antibody-Mediated Hypersensitivity (Type II)

  • IgG and IgM bind to cell surfaces, triggering several effects:

    • Complement activation
    • Antibody opsonization
    • Hormonal receptor binding
  • Damage/Effects:

    • Red blood cells
    • Solid tissues
    • Functional effects (sometimes a type V hypersensitivity)

Immune-Mediated Hemolysis (Red Blood Cells)

  • ABO and Rh antigens:

    • ABO: Oligosaccharides triggering IgM natural antibodies
    • Rh: Protein triggering IgG antibodies
    • I-system: Self-antigen implicated in autoimmune hemolytic anemia (AIHA)
  • IgM antibodies:

    • Effective complement activators (MAC), damaging red blood cells.
  • IgG antibodies:

    • Less effective complement activators than IgM.
    • Opsonize red blood cell fragments for phagocytosis by macrophages.

Types of Immune-Mediated Hemolysis

  • Alloimmune hemolysis:
    • Hemolytic disease of the newborn
    • Gradual destruction of fetal IgG-coated red blood cells (RBCs) by macrophages in the spleen/liver.
    • Incompatible ABO blood transfusions
    • Rapid (seconds) destruction by IgM natural antibodies, causing RBC aggregation and complement activation.

Anti-Red Blood Cell Antibodies

  • IgM:
    • Effective complement activators; cause rapid cell lysis.
  • IgG:
    • Less effective complement activators.
    • Opsonize RBC fragments for phagocytosis.

Autoimmune Hemolysis

  • Triggered by infections, drugs, or as part of autoimmune diseases (e.g., Systemic Lupus Erythematosus (SLE)).
  • B-cell clonal expansion leading to autoantibodies (AIAs).
  • AIHA:
    • IgG autoantibodies (warm antibodies)
    • IgM autoantibodies (cold antibodies) that are active below 37° Celsius.

Type II Autoimmune Hypersensitivity Against Solid Tissues

  • Goodpasture's syndrome (GPS):
    • IgG autoantibodies against the basement membrane of lungs and glomeruli.
  • Pemphigus:
    • IgG autoantibodies against intercellular cement protein (desmoglein) leading to blistering skin conditions.
  • Myasthenia gravis:
    • IgG autoantibodies against acetylcholine receptors in skeletal muscles causing muscle weakness.

Graves' Disease (Type V Hypersensitivity "Stimulatory")

  • Most common cause of hyperthyroidism, often in young women with family history.
  • Linked to HLA-DR3.
  • Auto-antibodies (IgG) bind to TSH receptors, mimicking TSH hormone stimulation, leading to increased thyroxine secretion.
  • Exophthalmos (protruding eyes): T-cell infiltration of the orbit due to an autoimmune reaction.

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