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34 Cards in this Set
- Front
- Back
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kid stung by bee, arm swells, started to swell. If this is a hypersensitivity rxn, what is the likely role of IgE antibody?
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Cross linking allergen specificity IgE triggers mast cell degranulation
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what Ig's activate the classic complement pathway
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IgG and IgM
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recurrent sinusitis, nasal blockage, and rhinorrhea.. elevated IgE suggested an allergy as the cause...how would you measure allergen specific IgE response
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RAST
(form of an immunoassay) |
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what cytokine is most important for the increased IgE antibody?
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IL-4
important for Type I HS rxns |
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where does IL-4 Come from (what cells produce it)
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TH-2
helper T cells, involved in allergic rxns induces isotype switching to IgE |
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what is like IL-4 but is seen in asthma?
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IL 13 (produces IgE anti-body, and increases mucus production)
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what does IL 1 do
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fever response
important in innate inflammatory response (along with TNF alpha) |
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What does IL 3 do?
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growth factor
helps cells differentiate along different lines, found in the bone marrow hematopoetic factor (ya, ya, i can't spell) |
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what does IL 12 do?
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produced by dendritic cells
differentiates TH-1 helper cells |
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what does TGF-beta do in general?
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inhibitory to activation of macrophage and T cells etc
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what is important about the early phase vs. late phase rxn?
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Early: type I HS rxn (wheal flare)
Late: area of erythema, hardening of the skin, cellular infiltration |
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how long does prick testing take for a skin allergen test?
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positive wheal and flare 5 -15 minutes after prick testing
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how can you tell the diff btw cold and allergy when considering:
cough/general aches and pains |
Cold: common
Allergy: not really |
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how can you tell the diff btw cold and allergy when considering:
fatigue and conjuctivitis |
Cold: not common
Allergy: conjuctivitis can be seen |
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how can you tell the diff btw cold and allergy when considering:
sneezing, sore throat, rhinorrhea |
usual in both
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how can you tell the diff btw cold and allergy when considering:
fever |
Cold: rare
Allergy: almost never |
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how can you tell the diff btw cold and allergy when considering:
duration |
Cold: 3-14 days
Allergy: maybe weeks |
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what is Thymic stromal lymphopoietin (TSLP)
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cytokine produced by epithelial cells
acts like IL 7 supports the growth of B cells and T cells **Acts on dendritic cells to influence development of Th2 T cells --turns on allergies! |
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What is the "switch" that can turn on allergic response?
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TSLP
**Acts on dendritic cells to influence development of Th2 T cells..which sets up IgE isotype switching |
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What mechanisms are involved in anaphylaxis?
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IgE bound to mast cells
Allergen triggers mast cell degranulation Systemic release of inflammatory mediators |
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immediate action for anaphylaxis?
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EPI!
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is Extrinsic allergic alveolitis mediated by IgE?
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NO!
done by T-cells, antibody, and immune complexes |
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cough, dyspnea, caused by microorgansims from chemicals, plant, and animal product...
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Extrinsic allergic alveolitis
Hypersensitivity pneumonitis |
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guy comes in, says he is a farmer, has been coughing and having trouble breathing...what could be going on?
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Extrinsic allergic alveolitis
Hypersensitivity pneumonitis |
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what are the 3 forms of hypersensitivity pneumonitis?
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acute: 4-8 hours after work**
Subacute: insidious beginning over weeks, with cough, dyspnea, and weight loss chronic: from low-dose continuous exposure. Fatigue and weight loss, with gradual dyspnea |
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pt says they were at work and a whole cloud of dust was coming from the silo...4 hours later they were having resp problems...please be specific as to what this is...
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ACUTE hypersensitivity pneumonitis
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what mostly mediates hypersensitivity pneumonitis? (3)
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Macrophages
CD4/8 T cells TH1 response Type III and IV HS rxn NOT TYPE I HS RXN!! |
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treatment of HS pneumonitis?
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avoidance
oral corticosteroids (if chronic) |
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rhinorrhea, sneezing, nasal itching and obstruction, conjunctivitis, swelling around eyes, pale swollen nasal mucosa
what do they have? |
Allergic Rhinitis
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50 yo farmer, worsening chronic cough, wieght loss, dyspnea, non-smoker, no allergies, neg PPD. IgE is normal. FEV1 and FVC are reduced... cause of his problem?
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Hypersensitivity pneumonitis
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Define allergy, atopy, allergen and hypersensitivity
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1) Allergy - a disease or reaction caused by an immune response to one or more environmental antigens, resulting in tissue inflammation and organ dysfunction; a type of hypersensitivity
2) Allergen - any antigen that causes allergy 3) Hypersensitivity - a state of heightened reactivity to antigen; Hypersensitivity reaction is an immune response to innocuous antigens that lead to symptomatic reactions upon re-exposure. 4) Atopy - a genetically determined state of hypersensitivity to common environmental allergens, mediated by IgE antibodies 5) Allergic Rhinitis (Hay Fever) - most common clinical expression of atopic hypersensitivity |
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Describe the role of IgE antibody in atopic disease.
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Allergen is taken up by antigen-presenting cells such as dendritic cells which then activate TH2 helper T cells. TH2 cells produce IL-4 which promotes IgE synthesis
IgE will bind to the surface of mast cells via FcE receptors. Subsequent exposure to the allergen triggers mast cell degranulation. |
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Distinguishing features of IgE? 4
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Normally only 0.004% of serum Ig
Serum levels elevated in atopic disease Binds high affinity FcERI Does not fix complement or cross placenta |
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what can be used as anti-IgE therapy?
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Omalizumab
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