基础医学院医学免疫学-chapter19课件

1、Chapter 19 hypersensitivity 又称变态反应（allergy）是指机体受某些抗原刺激时，出现生理功能紊乱或组织细胞损伤的异常适应性免疫应答。异常的或病理性的免疫应答，具有特异性(specificity)和记忆性(anamnesis) 变应原（allergen）：完全抗原(complete antigen)或半抗原(hapten)Chapter 19 hypersensitivity types of hypersensitivity reactionsType I: Immediate hypersensitivity Type II: Cytotoxic or cyt

2、olysis hypersensitivityType III: Immune complex hypersensitivityType IV:Delayed-type hypersensitivity and T cell-mediated cytolysistypes of hypersensitivity reacSection 1 type I hypersensitivity(anaphylaxis)发生快，消退也快常引起生理功能紊乱，几乎不发生严重组织细胞损伤有明显个体差异和遗传背景Section 1 type I hypersensiti一 Components involved

3、 in type I hypersensitivity（一）allergenCommon allergens1. some drug & chemicals：penicillin, sulfanilamide, procaine, organic iodin, etc.2. Inhaled allergen :pollen ,dust-mite feces, mold spore, animal coat, etc.3.oral allergen ：milk, egg, fish, shrimp, shellfish, etc.4.enzyme：cysteine protein, 枯草菌溶素一

4、 Components involved in type（二）IgEallergin-IgEIgE + mast cell & basophilsensitization（二）IgEallergin-IgEIgE + ma基础医学院医学免疫学-chapter19课件（三）mast cell , basophil and high-affinity IgE Fc receptor on their surface（三）mast cell , basophil and hiMast cell activation productsHistamine: bronchoconstriction, mu

5、cus secretion, vascular permeability, vasodilatationKininogenase: kinins - vascular permeability, vasodilatation, edemaECFA: attract neutrophils and basophilsPreformed mediatorsMast cell activation productsHMast cell activation productsNewly formed mediatorsLeukotriene B4:attract neutrophils and bas

6、ophilsLeukotriene C4 & D4: same as heparin but 1000 x potentProstaglandin D2: kinins - vascular permeability, vasodilatation, edemaPAF:platelet aggregation, microthrombi formation, heparin releaseMast cell activation productsN基础医学院医学免疫学-chapter19课件（四） Eosinophil （四） Eosinophil 二 the course and mecha

7、nism of type I hypersensitivity二 the course and mechanism of 基础医学院医学免疫学-chapter19课件三 clinical common disease(一) Systemic anaphylaxis: drug anaphylactic shock serum anaphylactic shock 三 clinical common disease(一) (二) Respiratory anaphylaxis : Anaphylactic rhinitis Anaphylactic asthma(二) Respiratory a

8、naphylaxis :(三) alimentary tract anaphylaxis (四) Skin anaphylaxis: Urticaria, eczema(三) alimentary tract anaphylaxRagweedControlHistamineSkin test for allergy四 principle of Treatments for allergy(一） test for allergen：skin testRagweedControlHistamineSkin te(二）desensitivity therapy（三）medicine therapy（

9、四）new immunotherapy(二）desensitivity therapy（三）medNew therapy for asthma and allergy: blocking the Fc portion of IgE from binding to the FceR on mast cellsNew therapy for asthma and allSection 2 type II hypersensitivityType II hypersensitivityis caused by antibodies to altered cell-surface components

10、Section 2 type II hypersensititarget cells and their surface antigenTarget cellsSurface antigen on target cells target cells and their surface基础医学院医学免疫学-chapter19课件基础医学院医学免疫学-chapter19课件二 diseases of type II hypersensitivityTransfusion reactionAutoimmune haemolytic anaemialung haemorrage- nephritis

11、syndrome /Goodpastures syndrome二 diseases of type II hyperseHaemolytic disease of the newbornHaemolytic disease of the newDrug induced hypocytosisDrug induced hypocytosisThyrotoxicosis/ Graves diseaseThyrotoxicosis/ Graves diseaseSection 3 type III hypersensitivitySection 3 type III hypersensitMecha

12、nism of type III hypersensitivity（一）formation of intermediate size immune complex and depositionMechanism of type III hypersenFigure 10-29Figure 10-29（二）mechanism of tissue injury produced by immune complex deposition1. Action of complement2. neutrophil3. Action of platelet（二）mechanism of tissue inj

13、ury 基础医学院医学免疫学-chapter19课件二 clinical common diseases（一）local immune complex diseaseArthus反应 类Arthus反应二 clinical common diseases（一）lTypes of immune complex diseaseautoimmunityself antigenkidney, joint, arteries, skinpersistent infectionbacterial, viral, parasitic, etc.infected organ, kidneyinhaled an

14、tigensmold, plant or animal antigenlunginjected materialserumkidney, skin, arteries, jointcauseantigensite of depositionTypes of immune complex diseas（二）systemic immune complex disease（二）systemic immune complex disFigure 10-31Figure 10-31Serum sicknessSerum sicknessSection 4 Type IV hypersensitivity

15、Section 4 Type IV hypersensit一 mechanism（一）formation of effector cells and memory cells一 mechanism（一）formation of ef基础医学院医学免疫学-chapter19课件（二） effector cells mediated inflammation and cytotoxicityCD4+Th1 cell mediated inflammation and tissue injuryCD8+CTL mediated cytotoxicity （二） effector cells medi

16、ated in基础医学院医学免疫学-chapter19课件Clinical common diseaseInfectious delayed hypersensitivityContact dermatitisClinical common diseaseInfectiDelayed hypersensitivity reactionspersistent antigen stimulus, chronic infectionM, giant cells, epitheloid cells, fibroblastshardening21-28 daysgranulomaintradermal:

17、 tuberculin, lepromin, etc.lymphocytes, monocyteslocal induration48-72 hourstuberculinepidermal: heavy metals, poison ivy, rubber, latexT cells, later macrophageseczema48-72 hourscontactdermatitisantigen and sitehistologyclinical appearancetime of reactiontypeDelayed hypersensitivity reactMechanism

18、of damage in contact hypersensitivityMechanism of damage in contactComparison of hypersensitivity reactionsTB test, poison ivy, granulomafarmers lung, SLEpemphigus, Goodpasturehay fever, asthmaexamplesType-IVType-IIIType-IIType-IcharacteristicantibodyIgEIgG, IgMIgG, IgMnoneantigenExogenouscell surfacecellularsolubleresponse ti