MD137 Immunology Lecture 4: Allergy & Autoimmunity
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Questions and Answers

Which type of hypersensitivity is mediated by antibodies?

  • Type III (correct)
  • Type II (correct)
  • Type IV
  • Type I (correct)

What role do mast cells play in Type I hypersensitivity reactions?

  • They produce IgE antibodies.
  • They mediate tissue damage directly.
  • They degranulate and release allergic mediators. (correct)
  • They stimulate T cell activation.

What type of reaction is characterized by atopy?

  • Delayed hypersensitivity
  • IgE-mediated allergy (correct)
  • Autoimmune response
  • Food intolerance

Which of the following is NOT considered an atopic condition?

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

In which year were the methods for defining hypersensitivity reactions proposed by Gell and Coombs?

<p>1963 (B)</p> Signup and view all the answers

What is the immediate effect of mast cell degranulation during an allergic reaction?

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

Which lipid mediator is primarily responsible for bronchoconstriction during an allergic response?

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

What characterizes the early/immediate phase of an allergic reaction?

<p>Releasing pre-formed mediators from mast cells (C)</p> Signup and view all the answers

What is a likely consequence of the late-phase response in an allergic reaction?

<p>Tissue remodeling in asthma (C)</p> Signup and view all the answers

What type of immune cell predominantly contributes to the late-phase allergic reaction?

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

What occurs during the second exposure to an allergen in individuals with sensitisation?

<p>Cross-linking of IgE (D)</p> Signup and view all the answers

Which mediator is synthesized de novo during the allergic response?

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

Which statement correctly describes type V hypersensitivity?

<p>It is characterized by the stimulation of receptors by antibodies mimicking ligands. (B)</p> Signup and view all the answers

What is a common clinical manifestation of Grave's disease?

<p>Goitre and weight loss (C)</p> Signup and view all the answers

What occurs when immune complexes are not cleared from the body?

<p>They can deposit in small blood vessels and cause vasculitis. (A)</p> Signup and view all the answers

Which factor is primarily associated with type III hypersensitivity reactions?

<p>Deficiency of complement proteins. (B)</p> Signup and view all the answers

In the context of type IIb hypersensitivity, what is the nature of the antibodies involved?

<p>They specifically target hormone receptors such as TSH. (C)</p> Signup and view all the answers

Which antibody is primarily produced by B cells in response to T helper cell activation during allergic reactions?

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

What triggers the systemic release of vasoactive mediators in anaphylaxis?

<p>Presence of large quantities of allergens in circulation (A)</p> Signup and view all the answers

What characterizes Goodpasture’s syndrome in terms of antibody involvement?

<p>IgG autoantibodies binding to a glycoprotein in the basement membrane (C)</p> Signup and view all the answers

Which of the following is NOT a typical cause of anaphylaxis?

<p>Hypoglycemia (A)</p> Signup and view all the answers

What role do neutrophils play when antibodies bind to tissues during a type II hypersensitivity reaction?

<p>They enhance the antibacterial immune response. (B)</p> Signup and view all the answers

What is a potential consequence of the complement system being activated in type II hypersensitivity reactions?

<p>Increased tissue necrosis (C)</p> Signup and view all the answers

Which of the following is a hallmark symptom of anaphylaxis?

<p>Severe bronchiole constriction (B)</p> Signup and view all the answers

Which environmental factors are associated with triggering Goodpasture's syndrome?

<p>Exposure to solvents, tobacco, and infections (A)</p> Signup and view all the answers

What is a significant result of the systemic release of vasoactive mediators during anaphylaxis?

<p>Massive edema and sudden loss of blood pressure (C)</p> Signup and view all the answers

What type of hypersensitivity reaction is mediated by IgG and IgM binding to antigens on cells or tissues?

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

Flashcards

Hypersensitivity

An exaggerated immune response resulting in tissue damage. It's like your immune system overreacts and attacks harmless things.

Gell & Coombs Classification

A system for classifying hypersensitivity reactions into 5 types (I-V). It helps organize and understand different types of immune over-reactions.

Type I Hypersensitivity

An immediate allergic reaction mediated by IgE antibodies. Mast cells release chemicals (like histamine) causing symptoms.

Atopy

A tendency to produce IgE antibodies against normally harmless allergens. It's like being prone to developing allergies.

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Mast Cell Degranulation

The release of inflammatory mediators like histamine from mast cells, triggered by IgE binding. This causes the symptoms of allergy.

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Sensitisation

The initial exposure to an allergen, which causes the body to produce IgE antibodies that attach to mast cells.

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Pre-formed Mediators

Mediators stored in mast cell granules released immediately upon activation. Examples include histamine, serotonin, and enzymes like tryptase.

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De Novo Mediators

Mediators synthesized after mast cell activation, including cytokines and lipid mediators.

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Lipid Mediators in Allergy

Mediators like leukotrienes, prostaglandins, and lipoxins derived from arachidonic acid, contributing to allergic symptoms.

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Early Phase of Allergy

The immediate allergic reaction occurring within minutes, caused by release of pre-formed mediators from mast cells.

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Late Phase of Allergy

The delayed allergic reaction occurring 4-24 hours later, involving infiltration of immune cells and release of secondary mediators, potentially causing tissue damage.

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Peanut allergy

A type of allergic reaction triggered by peanut protein. The immune system overreacts to peanuts, causing a cascade of events that result in symptoms like rash, swelling, and difficulty breathing.

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Anaphylaxis

A severe allergic reaction that affects the whole body. It happens when the immune system releases chemicals that cause sudden and dangerous drops in blood pressure, airway constriction, and swelling.

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Complement activation

A cascade of proteins in the immune system that helps to fight off infections. In type II hypersensitivity, the complement system is activated by antibodies bound to cells, leading to cell damage and inflammation.

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Goodpasture's syndrome

An autoimmune disorder where the body's immune system attacks the basement membranes of the lungs and kidneys. Autoantibodies target a protein in these membranes, leading to inflammation and damage.

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Autoantibodies

Antibodies that attack the body's own tissues. In Goodpasture's syndrome, autoantibodies target a protein in the basement membrane of the lungs and kidneys.

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Basement membrane

A thin layer of tissue that supports and connects other tissues. In Goodpasture's syndrome, autoantibodies attack the basement membrane of the lungs and kidneys.

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Type IV collagen

A specific type of collagen protein found in the basement membrane of the lungs and kidneys. Autoantibodies in Goodpasture's syndrome target this protein.

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Pulmonary hemorrhage

Bleeding from the lungs. This can occur in Goodpasture's syndrome due to damage to the basement membrane of the lung capillaries.

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Glomerulonephritis

Inflammation of the glomeruli in the kidneys. This can occur in Goodpasture's syndrome due to damage to the basement membrane of the kidney.

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Grave’s Disease

Grave's disease is an autoimmune disorder characterized by hyperthyroidism - the thyroid gland produces too much thyroid hormone. This is caused by antibodies that stimulate the thyroid-stimulating hormone (TSH) receptor, leading to excessive thyroid hormone production.

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Immune Complex Deposition

In Type III hypersensitivity, immune complexes can accumulate in tissues, especially basement membranes (like those lining blood vessels), leading to inflammation and damage.

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Immune Complex Clearance Mechanisms

The body normally clears immune complexes using macrophages and complement proteins. However, these mechanisms can become overwhelmed (saturation) or may not function properly (complement deficiency), leading to immune complex deposition.

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Study Notes

MD137 Immunology - Lecture 4: Allergy & Autoimmunity

  • Learning Objectives:
    • Understand allergy and autoimmunity.
    • Identify four to five types of hypersensitivity reactions.
    • Understand disease mechanisms.
    • Give examples of each hypersensitivity type.

Hypersensitivity

  • An excessive or inappropriate immune response causing tissue damage.
  • 1963 Gell and Coombs classification method.
  • Types I, II, III, and IV reactions distinguished by the mechanisms involved.
  • Type I, II, III mediated by antibodies.
  • Type IV mediated by T cells.

Type I Hypersensitivity (IgE-mediated allergy)

  • Immediate hypersensitivity response.

  • IgE produced by B cells.

  • Atopy: A tendency to produce IgE in response to allergens.

  • IgE binds to mast cell receptors.

  • Cross-linking of IgE by allergens triggers mast cell degranulation.

  • Release of mediators (e.g., histamine).

  • Atopic Conditions:

    • Eczema
    • Allergic rhinitis (hay fever)
    • Asthma
    • Food allergy

Type I Hypersensitivity - Sensitisation

  • First exposure: Allergen causes IgE to bind to FcεRI receptors on mast cells.
  • Second exposure: Cross-linking of IgE triggers mast cell degranulation, leading to allergy symptoms.

Mast Cell Mediators

  • Pre-formed mediators (stored in granules): Released within seconds
    • Enzymes (tryptase, serotonin).
    • Histamine.
  • Synthesized de novo: Released later
    • Cytokines.
    • Lipid mediators.

Lipid Mediators in Allergy

  • Phospholipase A2, Arachidonate.
  • Pathways for lipid mediator formation (12-HETE, 15-lipoxygenase and 5-lipoxygenase, Lipoxins A and B, Cyclooxygenase, Leukotrienes, etc)
  • Outcomes or consequences of these mediators (bronchoconstriction, etc.)

Early/Immediate and Late-phase Reactions

  • Early/immediate phase: Caused by primary mediators released from mast cells, occurring within minutes.
  • Late phase: Infiltrating cells (eosinophils, neutrophils, T cells) release secondary mediators (cytokines, lipid mediators) 4-24 hours later.
  • Long-term tissue damage (e.g., tissue remodeling) is a possible outcome.

Allergy Symptoms

  • Symptoms depend on the affected tissue.
  • Gastrointestinal tract: Increased fluid secretion, peristalsis, diarrhea, vomiting.
  • Airways: Decreased diameter, increased mucus secretion, wheezing, coughing, phlegm.
  • Blood vessels: Increased blood flow, permeability.

Type II Hypersensitivity (IgM/IgG-mediated)

  • Caused by IgG or IgM binding to antigens on cells or tissues.
  • Bound antibodies activate complement or bind to Fc receptors on phagocytes.
  • Leads to cellular destruction, inflammation, or tissue damage.
  • Example: Goodpasture's syndrome

Type III Hypersensitivity (Immune Complex-mediated)

  • Caused primarily by IgG binding to soluble antigens.
  • Immune complexes form, and if not cleared properly, they deposit in tissues.
  • Can lead to inflammation, tissue damage, and vasculitis.
  • Example: Systemic Lupus Erythematosus (SLE).

Type IV Hypersensitivity (T-cell mediated)

  • Delayed-type hypersensitivity.
  • T cell-driven, occurring after a delay (24-72 hours) compared to other hypersensitivity reactions.
  • Includes contact dermatitis, multiple sclerosis, type 1 diabetes mellitus, and rheumatoid arthritis.
  • Example: Contact hypersensitivity, Poison ivy.

Granulomatous Hypersensitivity

  • Forms in response to persistent immune stimulation.
  • Involves macrophages, other immune cells, and tissue inflammation.
  • Examples: Crohn's disease and sarcoidosis.

Multiple Sclerosis (MS)

  • Demyelination and sclerosis of nerve tissue (usually at multiple sites).
  • T cells specific for myelin basic protein.
  • Autoimmune disease affecting the central nervous system (CNS).

Grave's disease

  • Autoimmune disease stimulating hormones.
  • Antibodies mimic TSH binding, stimulating thyroid hormone release.
  • Results in hyperthyroidism.
  • Thyroid gland enlargement (goiter), weight loss, sweating, anxiety, exophthalmos.

Systemic Lupus Erythematosus (SLE)

  • Autoantibodies against DNA and associated proteins.
  • Systemic disease impacting various organs (kidneys, skin, lungs).
  • Can cause kidney damage, butterfly rash, and pulmonary disease.

Summary of Main Points (repeated):

  • Type I, IgE-mediated reactions.
  • Type II, Antibody-mediated reactions.
  • Type III, Immune complex-mediated reactions.
  • Type IV, T-cell mediated reactions.
  • Granulomatous hypersensitivity as a specific reaction pattern and chronic diseases, such as Crohn's disease and multiple sclerosis.

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Explore the concepts of allergy and autoimmunity in this quiz based on MD137 Immunology Lecture 4. Learn about the types of hypersensitivity reactions, their mechanisms, and examples of each type. Test your understanding of how the immune system responds to allergens.

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