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Questions and Answers
What defines hypersensitivity in the immune system?
What defines hypersensitivity in the immune system?
What is the primary characteristic of immunodeficiency?
What is the primary characteristic of immunodeficiency?
Which of the following statements correctly describes autoimmunity?
Which of the following statements correctly describes autoimmunity?
What is the result of hypersensitivity reactions upon a second exposure to an antigen?
What is the result of hypersensitivity reactions upon a second exposure to an antigen?
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Which type of immune disorder is characterized by tissue damage due to an excessive immune reaction?
Which type of immune disorder is characterized by tissue damage due to an excessive immune reaction?
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Which of the following best describes the consequences of an autoimmune disease?
Which of the following best describes the consequences of an autoimmune disease?
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Which of these factors can contribute to immunodeficiency?
Which of these factors can contribute to immunodeficiency?
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How can autoimmune diseases manifest in the oral cavity?
How can autoimmune diseases manifest in the oral cavity?
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What is one of the primary triggers for allergic reactions mentioned?
What is one of the primary triggers for allergic reactions mentioned?
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What type of hypersensitivity reaction is characterized by IgG and IgM antibodies binding to cell surfaces?
What type of hypersensitivity reaction is characterized by IgG and IgM antibodies binding to cell surfaces?
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Which symptom is associated with severe allergic reactions?
Which symptom is associated with severe allergic reactions?
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What is a common pharmacological treatment for severe allergic reactions?
What is a common pharmacological treatment for severe allergic reactions?
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What kind of cellular destruction occurs in Type II hypersensitivity reactions?
What kind of cellular destruction occurs in Type II hypersensitivity reactions?
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What is a major consequence of histamine release during an allergic reaction?
What is a major consequence of histamine release during an allergic reaction?
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What is a key symptom indicating a potential allergic reaction?
What is a key symptom indicating a potential allergic reaction?
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Which of the following is a symptom of anaphylaxis?
Which of the following is a symptom of anaphylaxis?
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Which of the following is NOT a treatment for severe allergic reactions?
Which of the following is NOT a treatment for severe allergic reactions?
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What can follow if there is a delay in administering adrenaline during an allergic reaction?
What can follow if there is a delay in administering adrenaline during an allergic reaction?
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What happens to vascular permeability during a Type I hypersensitivity reaction?
What happens to vascular permeability during a Type I hypersensitivity reaction?
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In Type I hypersensitivity reactions, what effect does smooth muscle contraction have?
In Type I hypersensitivity reactions, what effect does smooth muscle contraction have?
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What is opsonization in the context of immune responses?
What is opsonization in the context of immune responses?
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Which of these would NOT be an indicator of a systemic allergic reaction?
Which of these would NOT be an indicator of a systemic allergic reaction?
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What is a characteristic symptom of hypotension in allergic reactions?
What is a characteristic symptom of hypotension in allergic reactions?
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Which type of reaction is NOT commonly associated with latex allergy?
Which type of reaction is NOT commonly associated with latex allergy?
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What can result from significant vasodilation during an allergic reaction?
What can result from significant vasodilation during an allergic reaction?
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The presence of hives is indicative of which type of hypersensitivity response?
The presence of hives is indicative of which type of hypersensitivity response?
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Which of the following allergic triggers can lead to anaphylaxis?
Which of the following allergic triggers can lead to anaphylaxis?
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What role does histamine play in the immune response?
What role does histamine play in the immune response?
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What is a common feature of autoimmune diseases?
What is a common feature of autoimmune diseases?
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Which autoimmune disease primarily affects the pancreas?
Which autoimmune disease primarily affects the pancreas?
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What factor is NOT associated with the breakdown of tolerance to self-antigens?
What factor is NOT associated with the breakdown of tolerance to self-antigens?
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How can infections contribute to autoimmune diseases?
How can infections contribute to autoimmune diseases?
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What is an example of a drug that can induce lupus?
What is an example of a drug that can induce lupus?
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Which of the following is an example of an altered normal body cell?
Which of the following is an example of an altered normal body cell?
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Which statement about autoimmune reactions is true?
Which statement about autoimmune reactions is true?
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What is the primary consequence of severe combined immune deficiencies (SCID)?
What is the primary consequence of severe combined immune deficiencies (SCID)?
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How do B cell immunodeficiencies primarily affect the body?
How do B cell immunodeficiencies primarily affect the body?
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What can manage the effects of B cell immunodeficiencies?
What can manage the effects of B cell immunodeficiencies?
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What characterizes the mutations that lead to T cell immunodeficiencies?
What characterizes the mutations that lead to T cell immunodeficiencies?
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Which type of immune deficiency is characterized by both T and B cell involvement?
Which type of immune deficiency is characterized by both T and B cell involvement?
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What is a common risk associated with T cell immunodeficiencies?
What is a common risk associated with T cell immunodeficiencies?
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Which statement best describes the consequences of SCID in infancy?
Which statement best describes the consequences of SCID in infancy?
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What underlying problem occurs in individuals with B cell deficiencies?
What underlying problem occurs in individuals with B cell deficiencies?
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Which is a characteristic of T cell immunodeficiencies?
Which is a characteristic of T cell immunodeficiencies?
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What can lead to an increased risk of severe bacterial infections?
What can lead to an increased risk of severe bacterial infections?
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Study Notes
Immune Disorders
- Module: Biomedical Sciences
- Tutor: Ms P Lazarou
- Topic: Immune Disorders
GDC Learning Outcomes
- Explain the impact of medical and psychological conditions in the patient.
- Aim: Overview of general immune disorders affecting the population, contextualized to oral manifestations.
Intended Learning Outcomes
- Discuss immunopathology (diseases of the immune system), including hypersensitivity reactions, autoimmunity, and immunodeficiency.
- Define hypersensitivity and outline various types.
- Define immunodeficiency and outline causes.
- Define autoimmune disease and discuss its impact.
- Relate how autoimmune disease manifests in the oral cavity.
Assessment
- Formative: Questions in Biomedical Sciences online quiz.
- Summative: Questions in Biomedical Sciences e-assessment.
Immunopathology
- If the innate or adaptive immune responses become faulty, illnesses or diseases may develop.
- Hypersensitivity: overactive immune response.
- Immunodeficiency: ineffective immune response.
- Autoimmunity: inappropriate reaction to self.
Hypersensitivity
- Excessive immune response causing tissue damage when the body meets an antigen for the second or subsequent times.
- Types: I, II, III, IV
- Type I (Immediate): Allergic reaction (e.g., anaphylaxis).
- Type II (Cytotoxic): Antibodies attack cells (e.g., blood transfusion reactions).
- Type III (Immune Complex): Immune complexes deposit in tissues (e.g., serum sickness).
- Type IV (Delayed): T cell-mediated response (e.g., contact dermatitis).
Type I Hypersensitivity Reaction
- Commonest hypersensitivity reaction, rapid onset (within 1 hour).
- Triggered by re-exposure to an allergen.
- High IgE levels secreted by plasma cells bind to receptors on mast cells and basophils.
- Subsequent exposure to the same allergen initiates mast cell degranulation and release of active mediators (histamine).
Type I cont...
- Reaction can be localized or systemic (life-threatening).
- Triggers: pollen, animal fur, dust mites, mold, some foods.
- Treatment: Avoidance of triggers, pharmacological intervention (inhalers, antihistamines, anti-inflammatory, adrenaline), immunotherapy (severe cases).
- Dental implications: Latex allergy, chlorhexidine allergy, allergy to benzocaine, sodium metabisulphite, dentine bonding agent, contact dermatitis.
Type II Hypersensitivity Reaction - Cytotoxic
- Rare, develops between 2-24 hours.
- Mediated by IgG and IgM antibodies binding to cell surfaces, triggering complement activation or killer cells.
- Results: Opsonization, red blood cell agglutination, cellular lysis.
- Examples: incompatible blood transfusions, drug reactions, autoimmune anemias.
Type III Hypersensitivity Reaction - Immune Complex Mediated
- Develops over hours, days, or weeks.
- IgG and IgM antibodies bind to soluble antigens forming immune complexes.
- Complexes lodge in and pass through blood vessel walls, initiating complement activation.
- Results: Inflammatory and tissue-damaging reactions.
- Examples: Systemic lupus erythematosus, serum sickness, rheumatoid arthritis.
Type IV Hypersensitivity Reaction - Cell Mediated
- Second commonest hypersensitivity type, develops in 2 or more days.
- Cell-mediated, caused by overstimulation of T cells and monocytes/macrophages -> cytokine release.
- Prolonged inflammation, cell death, and tissue damage.
- Mitigated by trigger avoidance and corticosteroids.
Immunodeficiency
- Compromised/absent immune system response to infections.
-
Primary immunodeficiency (PID): Genetic defects resulting in impaired immune function.
- Examples: B-cell deficiencies, T-cell deficiencies, phagocyte disorders, complement defects, Severe combined immunodeficiencies (SCID).
- Secondary immunodeficiency (SID): Resulting from secondary factors (e.g. malnutrition, chronic infections, drug regimens).
Primary Immunodeficiencies
- Genetically determined immune defects.
- Classified based on the specific immune cell defect (B-cells, T-cells, complement, granulocytes).
- Increased risk of infections, malignancies, and autoimmune diseases (e.g., Down's Syndrome and periodontal disease).
Secondary Immunodeficiency
- Caused by secondary/environmental factors that weaken the immune system.
- Examples: Malnutrition, chronic infections (e.g., HIV/AIDS), drug regimens (e.g. chemotherapy).
Oral Implications of Immunosuppressant Drugs
- Increased risk of oral candidiasis, bacterial infections, viral infections, periodontal disease, gingival swelling, oral ulceration, poor healing, and malignancy.
Conditions that Affect Patients' Immunocompetence
- Poorly controlled diabetes, HIV infection, some malignancies (e.g., Hodgkin's disease, leukaemias, lymphomas, multiple myeloma), malnutrition, anaemia, splenectomy, vitamin D deficiency, kidney failure, sickle cell disease.
Periodontal Destruction
- Host defense vs bacterial challenge.
- Impaired immune system affects the balance, leading to increased risk of periodontal disease.
Dental Care Professional Role
- Risk assessment (full histories).
- Liaison with physician.
- Antibiotic premedication before dental surgery.
- Prevention and aggressive treatment of infections
- Good infection control.
- Check post-operative bleeding risk.
- Close monitoring.
Autoimmune Disease
- Chronic, progressive disorder where the immune system mistakenly attacks the body's own tissues.
- Normally body can differentiate self and foreign cells.
- Can be organ-specific (e.g., Type 1 diabetes) or generalized (e.g., systemic lupus erythematosus).
Autoimmunity
- Breakdown of tolerance to self-antigens.
- Factors that trigger include: Emerging hidden antigens, infections, drugs (e.g., penicillin-induced hemolytic anemia, hydralazine-induced lupus), genetics, endocrinological changes.
Autoimmune Disease Testing
- Antinuclear antibody tests (ANA) - look for antibodies attacking cells nuclei.
- Autoantibody tests - search for antibodies to the body's own tissue
- Complete blood count (CBC) to evaluate immune system cells
- C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) to measure inflammation
- Urine tests (urinalysis) for related changes
Autoimmunity Prevalence
- More than 80 known autoimmune conditions.
- Affects 5-7% of the population in the UK.
- 4 million people in the UK live with at least one autoimmune condition.
- Women are disproportionately affected (85% or more patients of multi-autoimmune diseases are female).
Autoimmunity - Effects
- Joint pain and swelling, fatigue, rashes, skin problems, digestive issues, mobility difficulties, mental health problems, lost work and life opportunities.
Autoimmunity Treatment
- No cure, specific drugs and therapy dampen down the immune response, reducing inflammation. (e.g., non-steroidal anti-inflammatory drugs, immunosuppressants).
- Other treatments for specific symptoms (pain, swelling, fatigue, etc.).
- Balanced diet, regular exercise.
Autoimmunity Costs
- Direct and indirect costs in the UK total £13 billion annually for common autoimmune conditions like Type 1 diabetes, Rheumatoid Arthritis, and Multiple sclerosis.
Autoimmune Diseases, 2 Broad Groups
- Organ-specific disease: Auto-antibodies targeting specific body organs (e.g., thyroid, gut, adrenal glands).
- Generalized disease: Immune complexes deposit in various tissues/organs; affecting various systems (e.g., Rheumatoid arthritis, lupus).
Autoimmune Diseases and Oral Manifestations
- Oral signs may be the initial manifestation of various autoimmune diseases.
- Examples include, Systemic lupus erythematosus, Sjögren's syndrome, pemphigus vulgaris, and mucous membrane pemphigoid.
Covid-19 and the Immune System
- Emerging field of research, potential role of rogue antibodies driving severe COVID-19 cases.
- Destructive immune response in acute COVID-19 and Long COVID.
Further Reading
- Provided links for further research on Sjögren syndrome, lupus, and type 1 diabetes.
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Description
This quiz covers immune disorders, focusing on their medical and psychological impacts. Learn about hypersensitivity, autoimmunity, and immunodeficiency, along with their oral manifestations. Assess your knowledge on immunopathology and its implications for patient care.
