Hypersensitivity Types II, III, and IV

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Questions and Answers

What is the main mechanism by which Type II hypersensitivity induces tissue damage?

  • T cells release cytokines that promote inflammation.
  • Plasma cells produce excess antibodies that target pathogens.
  • Antibodies bind to tissues and activate the complement system. (correct)
  • Neutrophils directly phagocytose the antigens.

In the context of frustrated phagocytosis, what happens to neutrophils when they bind IgG antibodies?

  • They successfully phagocytose the bound antigens.
  • They undergo apoptosis to prevent tissue damage.
  • They release granule contents causing inflammation. (correct)
  • They migrate away from the site of infection.

Which of the following substances is released by neutrophils during frustrated phagocytosis?

  • Cytokines
  • Antigens
  • Reactive oxygen species (ROS) (correct)
  • Complement proteins

What is a common result of antibodies binding to antigens on red blood cells in Type II hypersensitivity?

<p>Destruction of the red blood cells (A)</p> Signup and view all the answers

What role do antibodies play in the complement system activation during Type II hypersensitivity?

<p>They form complexes with antigens that trigger the complement pathway. (A)</p> Signup and view all the answers

What is the main characteristic of Type II hypersensitivity reactions?

<p>Antibodies react with antigens on cell surfaces (B)</p> Signup and view all the answers

Which of the following best describes Type III hypersensitivity?

<p>Due to immune complex formation (D)</p> Signup and view all the answers

What is the primary consequence of autoimmune hemolytic anemia?

<p>Decreased number of RBCs (C)</p> Signup and view all the answers

What is a consequence of complement activation in Type II hypersensitivity?

<p>Release of inflammatory mediators (D)</p> Signup and view all the answers

In Type III hypersensitivity, immune complexes are formed when antibodies bind to what?

<p>Soluble antigens (C)</p> Signup and view all the answers

Which mechanism is primarily responsible for Type IV hypersensitivity reactions?

<p>T cell-mediated delayed response (B)</p> Signup and view all the answers

What type of antibodies are typically involved in Type I hypersensitivity reactions?

<p>IgE (B)</p> Signup and view all the answers

Which type of immune complex is most relevant in Type III hypersensitivity?

<p>Very small immune complexes (D)</p> Signup and view all the answers

In terms of skin tests for hypersensitivity diagnosis, what does a positive result typically indicate?

<p>Sensitivity to a specific antigen (B)</p> Signup and view all the answers

What is the role of complement activation in Type III hypersensitivity?

<p>It recruits neutrophils and causes inflammation (D)</p> Signup and view all the answers

What role do autoantibodies play in Type II hypersensitivity reactions?

<p>They target antigens on the surface of self-cells (C)</p> Signup and view all the answers

How do large immune complexes differ from small immune complexes regarding clearance from circulation?

<p>Large complexes can be easily detected and removed (B)</p> Signup and view all the answers

What triggers the formation of the Membrane Attack Complex (MAC) in Type III hypersensitivity?

<p>Complement activation by immune complexes (D)</p> Signup and view all the answers

Which of the following is true regarding the roles of antigens in Type II hypersensitivity?

<p>Antigens are present on the cell surface or in circulation (B)</p> Signup and view all the answers

What is a common characteristic of soluble antigens that leads to immune complex formation?

<p>They can provoke an antibody response (D)</p> Signup and view all the answers

What potential health issue arises from the deposition of immune complexes in blood vessels?

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

Which T cells are primarily involved in type IV hypersensitivity reactions?

<p>Th1, Th17, and CD8+ T lymphocytes (C)</p> Signup and view all the answers

What is the main function of the cytokine IFN-γ produced by Th1 cells?

<p>To activate macrophages (C)</p> Signup and view all the answers

What characterizes delayed-type hypersensitivity reactions?

<p>They usually appear 24-48 hours after antigen challenge. (D)</p> Signup and view all the answers

In type IV hypersensitivity, which of the following would likely not be enhanced by macrophage activation?

<p>Decreased cytolytic activity (A)</p> Signup and view all the answers

What is the role of Toll-like receptors (TLRs) in activated macrophages?

<p>To enhance the ability to phagocytose (A)</p> Signup and view all the answers

Which type of cytokine profile characterizes Th1 cells?

<p>Secretion of IFN-γ (A)</p> Signup and view all the answers

Which of the following statements is true regarding effector T-lymphocytes in delayed-type hypersensitivity?

<p>They secrete cytokines several hours after arriving at the site. (C)</p> Signup and view all the answers

What is the significance of the MHC II expression increase in macrophages activated by Th1 cells?

<p>It improves their capacity for antigen presentation. (D)</p> Signup and view all the answers

What is primarily responsible for guiding T cell migration to the site of infection?

<p>Selectins and chemokine receptors (A)</p> Signup and view all the answers

Which of the following cytokines is NOT mentioned as playing a role in recruiting T cells?

<p>IL-6 (B)</p> Signup and view all the answers

What changes occur in T cells upon activation and differentiation?

<p>Reduction of CCR7 and increase of S1P receptor expression (B)</p> Signup and view all the answers

The movement of T cells from blood vessels into the tissue involves which of the following processes?

<p>Rolling, adhesion, and transmigration (B)</p> Signup and view all the answers

What primarily causes the edema and fibrin deposition in areas of T cell infiltration?

<p>Increased vascular permeability (D)</p> Signup and view all the answers

The role of chemokines at the site of infection includes which function?

<p>Recruiting T cells to the area (C)</p> Signup and view all the answers

What type of cells infiltrate tissues during the immune response in addition to T cells?

<p>Monocytes (D)</p> Signup and view all the answers

Which of the following statements is true regarding T cells and cytokines?

<p>CD4+ T cells produce cytokines that guide T cell migration. (C)</p> Signup and view all the answers

Which of the following statements about superantigen-mediated diseases is true?

<p>They can cause syndromes similar to septic shock. (D)</p> Signup and view all the answers

Which skin testing method is classified as immediate reaction tests?

<p>Scratch test (B), Intradermal test (D)</p> Signup and view all the answers

What is the primary risk associated with intradermal skin tests?

<p>Risk of anaphylaxis (D)</p> Signup and view all the answers

What best describes the purpose of patch testing?

<p>To determine photo-allergic reactions after UV exposure. (B)</p> Signup and view all the answers

How long should skin tests be performed after the resolution of allergic symptoms?

<p>At least 3 weeks but not more than 3 months. (C)</p> Signup and view all the answers

Which of the following describes the skin prick test?

<p>The safest and easiest method for skin testing. (B)</p> Signup and view all the answers

What is the main feature of the photopatch test?

<p>The skin is irradiated with UV light post-patch removal. (C)</p> Signup and view all the answers

How is the skin scrape test performed?

<p>By making a superficial scrape with a blunt tool. (C)</p> Signup and view all the answers

Flashcards

Type II Hypersensitivity

A type of immune reaction where antibodies mistakenly target antigens on the surface of body tissues, leading to tissue damage and inflammation.

Mechanism of Type II Hypersensitivity

Antibodies bind to antigens on the surface of tissue, activating complement and leading to inflammation.

Frustrated Phagocytosis

A process where neutrophils bind to IgG antibodies but cannot engulf the antigen because it's fixed to tissue. This leads to the release of damaging substances from neutrophils.

Membrane Attack Complex (MAC)

A complex of proteins that forms on cell surfaces, triggering lysis (cell death).

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Type II Hypersensitivity: Blood Cells

Antibodies against RBC antigens can cause their destruction, leading to anemia.

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Complement Activation

A component of the immune system that facilitates cell lysis and inflammation, primarily triggered by antibody-antigen complexes.

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Cytotoxic or Cytolytic Reaction

A type of Type II hypersensitivity where the antibody binds to antigens on a cell's surface, leading to cell lysis or damage. This can occur when antibodies attack normal cells (autoantibodies) or foreign antigens on cells.

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Cell Surface Antigen

Antigen present on the cell surface, triggering immune responses in Type II hypersensitivity. It can be a normal part of the cell (autoantigen) or foreign antigen.

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Hapten

A small molecule attaching to a larger molecule, becoming antigenic and triggering an immune response. This commonly occurs in Type II hypersensitivity.

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Autoantibodies

Antibodies that abnormally target self-antigens, leading to immune responses against the body's own tissues. Primarily involved in Type II hypersensitivity.

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Circulating Antigen

Immune responses where the antigen is present on the circulatory system or blood cells.

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Th1-mediated reaction

The most common and significant type of Type IV hypersensitivity reaction, involving the activation of macrophages by Th1 cells.

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Th1 cell

A type of T helper cell that produces IFN-gamma, leading to macrophage activation and other immune responses.

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IFN-gamma

A cytokine produced by Th1 cells that activates macrophages and other immune cells.

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Macrophage

Immune cells that engulf and destroy pathogens, enhance their ability to kill pathogens after activation by IFN-gamma.

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Delayed-type hypersensitivity (DTH)

A type of hypersensitivity reaction that occurs 24-48 hours after exposure to an antigen, characterized by delayed inflammation mediated by T cells.

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T-cell homing

A process where effector T lymphocytes travel to the site of antigen exposure after antigen presentation.

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Cytotoxic T cell (CD8+ T cell) mediated reaction

A type of cell-mediated immune response where T cells directly kill target cells

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What is Type II hypersensitivity?

A type of immune reaction where antibodies mistakenly target antigens on the surface of body tissues, leading to tissue damage and inflammation.

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What happens in Type II hypersensitivity to red blood cells?

When antibodies against RBC antigens bind to the surface of red blood cells, leading to their destruction.

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What is frustrated phagocytosis?

The process where neutrophils adhere to antibody-coated antigens but cannot engulf them due to their attachment to a surface, leading to the release of damaging enzymes.

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What is Type III hypersensitivity?

A type of hypersensitivity reaction where soluble antigens form immune complexes that deposit in blood vessels, triggering inflammation, tissue damage, and vasculitis.

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What are immune complexes and why are they important in Type III hypersensitivity?

Antigen-antibody complexes that form in the blood and can vary in size, with small complexes being most crucial in type III hypersensitivity.

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How do immune complexes cause damage in Type III hypersensitivity?

The process where immune complexes deposit in blood vessels, activating complement, leading to inflammation and vessel damage.

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What is the Membrane Attack Complex (MAC)?

A series of proteins that form a pore on the cell membrane, leading to cell lysis (destruction).

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What is vasculitis?

Inflammation of blood vessels, often caused by the deposition of immune complexes in Type III hypersensitivity.

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T cell migration during immune response

T cells migrate from the bloodstream to the site of infection, a process guided by chemokines and selectins.

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Role of chemokines in T cell migration

Chemokines, such as C3a, C5a, attract T cells to the site of infection.

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T cell receptor changes during activation

Activated T cells undergo significant changes in receptor expression, leading to a decrease in CCR7 and an increase in S1P receptor expression.

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Role of selectins in T cell migration

Selectins, such as P-selectin, E-selectin, and L-selectin, guide T cell movement by facilitating their interaction with the blood vessel walls.

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T cell transmigration into tissues

T cell migration from blood vessels to tissues involves a multistep process involving rolling, adhesion, and transmigration across the endothelium.

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Impact of T cell migration on inflammation

T cell migration contributes to inflammation by recruiting immune cells, such as macrophages, to the site of infection.

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Immune response delay due to T cell migration

The delay in the immune response is due to the time required for T cells to migrate to the site of infection.

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T cells' role at the infection site

T cells are responsible for initiating the immune response at the infection site, leading to localized inflammation and tissue damage.

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Macrophage Resistance

Organisms like Mycobacterium tuberculosis (TB) and leprosy bacteria can resist destruction by macrophages, leading to the formation of giant cells and granulomas in the body.

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Superantigen-Mediated Diseases

Superantigens, like those involved in toxic shock syndrome, cause a strong immune response by activating many T cells non-specifically. This leads to the release of large amounts of inflammatory cytokines, causing a severe immune response similar to septic shock.

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Skin Prick Test

A skin prick test involves pricking the skin with a small amount of allergen to see if there is a reaction.

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Skin Scratch Test

A skin scratch test involves making a deep scratch on the skin with a blunt lancet to introduce the allergen.

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Skin Scrape Test

A skin scrape test involves scraping the superficial layer of the epidermis to assess the presence of allergens.

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Intradermal Test

An intradermal test involves injecting a small amount of allergen under the skin with a syringe.

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Patch Test

A patch test involves applying a patch containing the allergen to the skin and observing for a reaction after a designated period.

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Photopatch Test

Photopatch testing is a modification of the patch test in which, after one day, the patch is removed, and the skin is exposed to UV light. This is especially helpful for assessing photoallergic reactions.

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Study Notes

Hypersensitivity II Lecture Notes

  • Hypersensitivity is a complex topic with multiple types, including type I, II, III, and IV. This lecture focuses on hypersensitivity types II, III and IV.
  • Type II hypersensitivity reactions occur when antibodies bind to antigens on cells or tissues.
  • Antibodies, such as IgG and IgM, bind to "self" or "foreign" antigens on cells, causing various reactions.
  • Type II reactions lead to cell destruction by these reactions; antibody-mediated destruction of cells that may be part of the body's immune system or pathogens.
  • Type III hypersensitivity involves the formation of immune complexes that deposit in blood vessels.
  • These complexes activate complement and inflammatory cells, leading to tissue damage (inflammation) and vasculitis.
  • Common causes of type III hypersensitivity include infections, autoimmune diseases, and exposure to foreign antigens.
  • Type IV hypersensitivity is a T-cell mediated reaction that takes more than 12 hours to develop.
  • Type IV reactions result from T cell activation and the subsequent activation of macrophages, leading to tissue damage.
  • Learning Objectives for the lecture include Antibody-mediated andimmune complex disease (other than IgE). The mechanisms and clinical syndromes, as well as treatments for these reactions. Specific focus on type IV hypersensitivity, including mechanisms, clinical syndromes, and therapy; and principles of skin testing for the diagnosis of hypersensitivity reactions.

Learning Objectives hypersensitivity II

  • Antibody-mediated and immune complex diseases (other than IgE)
  • Their mechanisms, clinical syndromes, and treatments are key topics of interest.
  • Type IV hypersensitivity: mechanisms, clinical syndromes, and therapy will be covered.
  • Skin testing and its role in hypersensitivity diagnostics.

Types of hypersensitivity reactions in further detail

  • Type II hypersensitivity – Antibody-mediated reactions, where antibodies target specific antigens on cells/tissues.
  • Type III hypersensitivity – Immune complex mediated reaction, where antigen-antibody complexes deposit in blood vessels causing inflammation.
  • Type IV hypersensitivity – Cell-mediated reactions that take time (hours to days) to develop. Macrophage activation and T cell function are crucial for these reactions.

Testing for hypersensitivity

  • Skin tests are a common method for diagnosing hypersensitivity reactions. Common tests and descriptions are included.

Additional details

  • Autoimmune diseases: Certain autoimmune conditions are associated with specific types of hypersensitivity reactions.
  • Infections: Infections can also trigger hypersensitivity reactions.
  • Drugs: Some medications can cause hypersensitivity reactions.
  • Procedures: Specific steps for skin sensitization tests were highlighted.

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