immunopathological reaction (reaction of hypersensitivity) type i. allergens - definition, division...

23
Immunopathological reaction (reaction of hypersensitivity) type I. Allergens - definition, division and nomenclature. Anaphylaxis - pathophysiology, clinical manifestation, treatment. Diagnostic procedures used in allergology. Treatment of allergic diseases. Examples of diseases based on immunopathological reaction of type I.

Upload: silvester-phelps

Post on 18-Dec-2015

221 views

Category:

Documents


0 download

TRANSCRIPT

Page 1: Immunopathological reaction (reaction of hypersensitivity) type I.  Allergens - definition, division and nomenclature.  Anaphylaxis - pathophysiology,

Immunopathological reaction (reaction of hypersensitivity) type I. Allergens - definition, division and nomenclature.

Anaphylaxis - pathophysiology, clinical manifestation, treatment.

Diagnostic procedures used in allergology.

Treatment of allergic diseases. Examples of diseases based on immunopathological reaction of type I.

Page 2: Immunopathological reaction (reaction of hypersensitivity) type I.  Allergens - definition, division and nomenclature.  Anaphylaxis - pathophysiology,

Mechanism of IgE–mediated reaction

Type I – Allergy

Allergen IgE bound to the surface of the mast cell

Degranulation, mediator release

+

Page 3: Immunopathological reaction (reaction of hypersensitivity) type I.  Allergens - definition, division and nomenclature.  Anaphylaxis - pathophysiology,

Allergicreaction

IL-4

IL-5

Eosinophil

IgE

B

T

T

Th2

APC

Allergen

T

Th1

IFN- BIgG

IL-12

IL-12

Th1/Th2 response

Page 4: Immunopathological reaction (reaction of hypersensitivity) type I.  Allergens - definition, division and nomenclature.  Anaphylaxis - pathophysiology,

Immunopathological reaction (reaction of hypersensitivity) type I. Allergens - definition, division and nomenclature.

Anaphylaxis - pathophysiology, clinical manifestation, treatment.

Diagnostic procedures used in allergology.

Treatment of allergic diseases. Examples of diseases based on immunopathological reaction of type I.

Page 5: Immunopathological reaction (reaction of hypersensitivity) type I.  Allergens - definition, division and nomenclature.  Anaphylaxis - pathophysiology,

Allergens

Inhaled (airborne)

Food

Venoms

Drugs

Page 6: Immunopathological reaction (reaction of hypersensitivity) type I.  Allergens - definition, division and nomenclature.  Anaphylaxis - pathophysiology,

Inhaledallergens

seasonal

perennial

pollen

molds

mites

animals

birchgrass

mugwort

ragweed

EXAMPLES

Alternaria

Cladosporium

Aspergillus

Dermatophagoidespteronyssinus

Dermatophagoidesfarinae

cat

dog

Page 7: Immunopathological reaction (reaction of hypersensitivity) type I.  Allergens - definition, division and nomenclature.  Anaphylaxis - pathophysiology,

Foodallergens

EXAMPLES

cow s milk

eggs

vegetables, fruits, nuts

fish, seafood

aditivesAGE

Page 8: Immunopathological reaction (reaction of hypersensitivity) type I.  Allergens - definition, division and nomenclature.  Anaphylaxis - pathophysiology,

Hymenoptera venom allergens

EXAMPLES

honey bee(bumble bee)

wasp, yellow jacket(hornet)

Page 9: Immunopathological reaction (reaction of hypersensitivity) type I.  Allergens - definition, division and nomenclature.  Anaphylaxis - pathophysiology,

Drug allergens

EXAMPLES

penicillines, cephalosporines

non-steroidal antiinflammatory drugs

iodine contrast media

local anesthetics

peripheral myorelaxants

latex

ethylenoxid

Page 10: Immunopathological reaction (reaction of hypersensitivity) type I.  Allergens - definition, division and nomenclature.  Anaphylaxis - pathophysiology,

Immunopathological reaction (reaction of hypersensitivity) type I. Allergens - definition, division and nomenclature.

Anaphylaxis - pathophysiology, clinical manifestation, treatment.

Diagnostic procedures used in allergology.

Treatment of allergic diseases. Examples of diseases based on immunopathological reaction of type I.

Page 11: Immunopathological reaction (reaction of hypersensitivity) type I.  Allergens - definition, division and nomenclature.  Anaphylaxis - pathophysiology,

Anaphylaxis

Grade Skin GI-tract Respiratory tract

Cardiovascular system

I Itching, urticaria, flush, angioedema

- - -

II Itching, urticaria, flush, angioedema

Nausea, cramps

Rhinorrhoea, dyspnea

Tachycardia, arythmia, decrease of blood

pressure

III Itching, urticaria, flush, angioedema

Diarrhoea Laryngeal oedema,

bronchospasm

Cardiovascular shock, faints

IV Itching, urticaria, flush, angioedema

Diarrhoea Respiratory arrest

Cardial arrest

Page 12: Immunopathological reaction (reaction of hypersensitivity) type I.  Allergens - definition, division and nomenclature.  Anaphylaxis - pathophysiology,

Treatment of anaphylaxis

Adrenaline / Epinephrine:

Intramuscular – in patients with clinical symptoms of shock, oedema of the airways and pronounced dyspnoea

Dosage in adults:

0.5 ml - 1:1000 dilution In case of necessity repeat every 5-10 minutes

Page 13: Immunopathological reaction (reaction of hypersensitivity) type I.  Allergens - definition, division and nomenclature.  Anaphylaxis - pathophysiology,

Immunopathological reaction (reaction of hypersensitivity) type I. Allergens - definition, division and nomenclature.

Anaphylaxis - pathophysiology, clinical manifestation, treatment.

Diagnostic procedures used in allergology.

Treatment of allergic diseases. Examples of diseases based on immunopathological reaction of type I.

Page 14: Immunopathological reaction (reaction of hypersensitivity) type I.  Allergens - definition, division and nomenclature.  Anaphylaxis - pathophysiology,

Diagnosis of allergy

History

Clinical examination

Skin tests

Specific IgE in the serum

Provocation and elimination tests

Page 15: Immunopathological reaction (reaction of hypersensitivity) type I.  Allergens - definition, division and nomenclature.  Anaphylaxis - pathophysiology,
Page 16: Immunopathological reaction (reaction of hypersensitivity) type I.  Allergens - definition, division and nomenclature.  Anaphylaxis - pathophysiology,

Immunopathological reaction (reaction of hypersensitivity) type I. Allergens - definition, division and nomenclature.

Anaphylaxis - pathophysiology, clinical manifestation, treatment.

Diagnostic procedures used in allergology.

Treatment of allergic diseases. Examples of diseases based on immunopathological reaction of type I.

Page 17: Immunopathological reaction (reaction of hypersensitivity) type I.  Allergens - definition, division and nomenclature.  Anaphylaxis - pathophysiology,

Treatment of allergic diseases

Alle

rgen

avo

idan

ce

Ph

arm

aco

ther

apy

Sp

ecif

ic

imm

un

oth

erap

y

Page 18: Immunopathological reaction (reaction of hypersensitivity) type I.  Allergens - definition, division and nomenclature.  Anaphylaxis - pathophysiology,

Alle

rgen

avo

idan

ce • Anti-mites bedding

• Pollen filters

• Stay in mountains during pollen season

• Animal avoidance

Page 19: Immunopathological reaction (reaction of hypersensitivity) type I.  Allergens - definition, division and nomenclature.  Anaphylaxis - pathophysiology,

Ph

arm

aco

ther

apy • Antihistamines

• Corticosteroids

• Symptomathic treatment

Page 20: Immunopathological reaction (reaction of hypersensitivity) type I.  Allergens - definition, division and nomenclature.  Anaphylaxis - pathophysiology,

Sp

ecif

ic

imm

un

oth

erap

y • Subcutaneous

• Sublingual

Page 21: Immunopathological reaction (reaction of hypersensitivity) type I.  Allergens - definition, division and nomenclature.  Anaphylaxis - pathophysiology,

APC

IgE

IL-4

IL-5 Allergicresponse

EosinophilTh2

B-cell

+

+

Tr1

IL-10

TGF-b

--

+

IT

Th1

IgG

IFN-gB-cell

IT -CD4

CD80/86

T cell

Allergen

TCRHLA

CD28

Page 22: Immunopathological reaction (reaction of hypersensitivity) type I.  Allergens - definition, division and nomenclature.  Anaphylaxis - pathophysiology,

Immunopathological reaction (reaction of hypersensitivity) type I. Allergens - definition, division and nomenclature.

Anaphylaxis - pathophysiology, clinical manifestation, treatment.

Diagnostic procedures used in allergology.

Treatment of allergic diseases. Examples of diseases based on immunopathological reaction of type I.

Page 23: Immunopathological reaction (reaction of hypersensitivity) type I.  Allergens - definition, division and nomenclature.  Anaphylaxis - pathophysiology,

Atopic diseases

Allergic asthma is chronic inflammatory disease of the airways in which a wide variety of cells (mast cells. Eosinophils, TH2 lymphocytes) and mediators play a role.

Atopic dermatitis

Allergic rhinitis

Allergic asthma

• Allergic rhinitis is affection of the nose (and ocular conjunctiva) caused by IgE-mediated inflammation of nasal mucosa after allergen exposure.

• Atopic dermatitis is inflammatory disease of the skin which is mediated by T cells and stimulated by IgE-dependent reactions.

IgE mediated food allergy Allergy