alergi lia
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ALLERGY: PATHOPHYSIOLOGYLia Restimulia
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Hypersensitivity (hypersensitivityreaction) refers to undesirable immunereactions produced by the normal immune
system.
Hypersensitivity reactions: four types; based on the mechanisms involved andtime taen for the reaction, a particularclinical condition (disease) may involvemore than one type of reaction.
Hypersensitiv
ity
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Classification of Immunologic Reactions
(Gel and Coombs)
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Allergy
Ig E mediated
(Type Ihypersensitivity)
Non Ig Emediated
Allergy
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!verreaction to an allergen ( antigen thatcauses allergy) after fe" minutes contact
through sin, inhaled through lung,
s"allo"ed or in#ected. Triggered by harmless substances such as;
pollen, dust, animal danders, food, drug or
bee stings or stings from other insects
IgE Mediated:Type I hypersensitivity
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Atopy is the genetic predisposition to mae $gE antibodies in responseto allergen e%posure.
Etiology is unno"n
Primary Atopic Conditions
Alleric r!initis "AR) Sinusitis
Atopic ec#ema "AE)
Alleric ast!ma "AA)
Allergic gastroenteropathy is rare.
These manifestation may coe%ist in the same patients at different times.
Atopy can be asymptomatic.
Atopy
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Genes Identifed to date in
Atopy
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Alleric R!initis "RA)Alleric R!initis "RA)
A$normalities o% t!e nose due tonasal mucosal in&ammatoryprocess
'ediated $y type I !ypersensiti(itySymptoms : snee#in nasal
itc!in r!inorr!ea and nasal
conestionRe(ersi$le spontaneously or *it!
treatment
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RA classi+cationRA classi+cation
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Proteins ,orein serum
-accines
Plant pollens Rye rass
Ra*eed Timot!y rass
.irc! trees
/rus Penicillin
Sul%onamides Local anet!etics
Salicylates
,oods0uts
Sea%ood
Es
Peas $eans
'il1
Insect products .ee (enom
2asp (enom
Ant (enom
Coc1roac! caly3/ust mites
'old spores Animal !air and dander
&ommon allerens associated *it!type I !ypersensti(ity
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'hile firsttime e%posure may only produce amild reaction, repeated e%posures may lead tomore serious reactions.
!nce a person is sensitied (has had a previoussensitivity reaction), even a very limitede%posure to a very small amount of allergen cantrigger a severe reaction.
*ost occur "ithin seconds or minutes aftere%posure to the allergen, but some can occurafter several hours, particularly if the allergencauses a reaction after it is partially digested. $n
very rare cases, reactions develop after + hours.
'ec!anism
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ImmunopathogenesisImmunopathogenesis
-oth mast cells and basophils are
involved in immunopathogenesis of $gE
mediated diseases.
T and B cells play important roles in
the development of these antibodies
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ImmunopathogenesisImmunopathogenesis
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ImmunopathogenesisImmunopathogenesis
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ImmunopathogenesisImmunopathogenesis
*ast cell are abundant in the mucosa of therespiratory, gastrointestinal tracts and in the
sin, "here atopic reaction localie.
*ast cell release mediator cause the pathophysiology of the immediate and late
phases of atopic diseases.
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type I !ypersensti(itytype I !ypersensti(ity "early and late p!ase)"early and late p!ase)
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Re4e3posureRe4e3posure
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.road Alleric Cascade.road Alleric Cascade
4'ediators4'ediators
IL = Interleukin TN!"a= Tumor ne#rosis $a#tor"alpha%ANTE& = %egulated on a#tivation' normal T #ellepressed and se#reted )*AM = )as#ular #elladhesion mole#ule I*AM"+ = Inter#ellular adhesion
mole#ule"+,
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Important Clinical Aspects of ImmediateImportant Clinical Aspects of Immediate
HypersensitivityHypersensitivity
Main organ -isease Mainsymptoms
Typi#alallergens
%oute o$entery
Lun Ast!ma 2!ee#indyspnea
tac!ypnea
Pollens !ousedust animal
danders
In!alation
0ose andEyes
R!initiscon5uncti(itis
Hay %e(er
Runny noseredness and
itc!in o%eyes
Pollens Contact *it!mucous
mem$rane
S1in Ec#ema "atopicdermatitis)6rticaria
Pruritic(esicularlesions
Pruritic$ullouslesions
6ncertain-arious %oods
/rus
6ncertainInestion-arious
Intestinaltract
Allericastroenteropat!y
-omitindiarr!ea
-arious %ood Inestion
Systemic Anap!yla3is S!oc1!ypotension
Insect(enom7$ee
Stin-arious
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Hypersensitivity pneumonitis involves inhalationof an antigen. This leads to an
e%aggerated immune response(hypersensitivity). Type $$$ hypersensitivity
and type $ hypersensitivity occur in
hypersensitivity pneumonitis.
Allergic contact dermatitis.
Allergi# Hypersensitivity. Non IgE
Mediated
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Res!lt Antigen so!rce "echanism #isease
/isease 0oreign $mmunologic Allergy
1rophyla%is 0oreign $mmunologic $mmunity
/isease 2elf $mmunologic Autoimmunity
/isease 0oreign To%ic To%icity
*omparison o$ Allergy /ith other %esponses
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