免疫4月17hypersensitivity.Detection.ppt
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1、Chapter 20 Hypersensitivity 超敏反应,(Allergy, 变态反应) (Anaphylaxis, 过敏反应),Concept,Allergen (Anaphylactogen) 过敏原secondly enter sensitized host. Immune responses (too strong!) that result in tissue injury or physiological dysfunction.,History,At first,0.1ml of the glycerin extract of tentacles of Actiniari
2、a(sea anemone)海葵甘油提取物 22 days later, a second injection of the same amount,the dog not ill,the dog anaphylaxis,Richet & Portier, 1902,Hypersensitivity,Type I -Immediate 速发型 Type II - Cytolytic 细胞溶解型 Type III - I C 免疫复合物型 Type IV - Delayed 迟发型,Type I Hypersensitivity (Immediate速发型 ,Anaphylaxis过敏反应),I
3、 Features,quick various, serious IgE mediated no complement involved Obvious individual variation & genetic factors,II Mechanisms,Proteins 蛋白 Foods 食物 foreign serum 异种血清 nuts 坚果 vaccines 疫苗 seafood 海鲜 (fish,shrimp,shellfish,crab) (鱼,虾,贝,蟹) Plant Pollens 植物花粉 peas 豌豆 rye grass 黑麦 beans 菜豆 ragweed 豚草属
4、 eggs 蛋 timothy grass 梯牧草 milk 牛奶 birch trees 桦树 mushroom 磨菇,(i) Allergens 过敏原(Anaphylactogens),Insect Products 昆虫产物 bee venom 蜂毒 wasp venom 黄蜂毒液 ant venom 蚂蚁毒液 cockroach calyx 蟑螂萼 dust mites 尘螨 Drugs 药物 penicillin 青霉素 sulfonamides 磺胺 local anesthetics 局麻药 salicylates 水杨酸盐 Mold Spores 霉菌孢子 Animal Ha
5、ir and Dander 动物毛及皮屑,(i) Allergens (Anaphylactogens),(ii) Ab: IgE,Th1: IL-2,IFN-g,TNF-b, IL-12 Th2: IL-4,5,6,10,13 IL-4BIgE (IFN-g inhibit IL-4) (IL-12 inhibit IgE),2.Biological characteristics of IgE,1.Generation of IgE,(1) IgE (2) Ach (3) Th2 (4) SIgA (5) C1INH (C2a ),Allergic Individual过敏体质,(iii)
6、 IgE-FceR+ cells,mast cell, basophil Distribution: mast cell: skin and submucosa; basophil: blood. 2) IgE-FceR 3) activation of mast cell,Biological activities of mast cell and basophil,basophil,1.preformed mediators (1)Histamine 组胺 (2)Kinnogenase 激肽原酶 2.newly synthesized mediators (1)LTs 白三烯 (SRS-A
7、) (2)PGD2 前列腺素 (3)PAF 血小板活化因子,(iv) Biological Mediators,III Common Diseases in Clinical,1 Anaphylactic shock过敏性休克 1) Medicine (i.e., penicillin) Penicillin (372, hapten) In tissue, blood (pH7.27.6) 624h penicilloyl, penicillenic acid (青霉噻唑醛酸、青霉烯酸)+protein IgE 2) Xenogenic serum异种动物血清,2 Allergy of re
8、spiratory tract,Asthma,1) Bronchia asthma 支气管哮喘,2)Allergic rhinitis 过敏性鼻炎,Rhinitis,Allergy of digestive tract 胃肠道过敏反应,Hives荨麻疹,Allergy of skin 皮肤过敏反应,Reactions of immediate hypersensitivity,The wheal can involve an area of skin as large as several centimeters in diameter.,The wheal and flare respons
9、e typically subsides after about 15 to 20 minutes.,IV Diagnosis,skin test IgE detection,skin test,Skin tests with Grass pollen allergen植物花粉 in a patient with typical summer hay fever枯草热,Read at 20 min,Skin tests with different allergens,IgE detection,V Prevention&treatment of Hypersensitivity,Preven
10、tion Identify the offending allergen, avoid contact if possible! (找出变应原,避免接触)! 1)Penicillin skin test 2)Xenogenic serum skin test,(ii) Treatment,1. Desensitization 脱敏 1)Xenogenic anti-serum 2)Allergen 2. Anti-hypersensitivity 抗过敏,2 Type Hypersensitivity,(Cytotoxic type 细胞毒性 Cytolytic type 细胞溶解型) Fea
11、ture: Ab: IgG、IgM Complement involved Cell: M、NK Reaction on cell,一、机制,二、Common Diseases in Clinical:,(一) Blood transfusion reaction 输血反应,ABO blood groups and serum antibodies,(二) Hemolytic disease of the newborn 新生儿溶血症 (erythroblastosis fetalis) 胎儿红细胞增多症,1.Hapten type: i.e: penicillin degrade BPO(h
12、apten)+RBC Anti-BPO penicillin again RBC-BPO-Anti-BPO Complement hemolytic anemia,(三) Immune Hemolytic Anemia 免疫溶血性贫血,2.IC type:,Medicine (Hapten) + tissue pro Ab medicine again Hapten + Ab IC C3b, Fc RBC, Platelet, neutrophil (hemolytic anemia 溶贫, thrombocytopenia 血小板减少性紫癜, neutropenia 中性白细胞减少症),1.
13、Autoimmune (hemolytic) anemia -Methyldopa甲基多巴 RBC 2.Goodpastures syndrome肺肾综合征 3.Glomerulonephritis(20%)肾小球肾炎 Commom Ag(streptococcus and glomerular basement membrane) 4.Anti-hormone-Ab,(四) Autoimmune Diseases:, Graves Disease 甲状腺功能亢进 LATS长效甲状腺刺激素Thyroid 甲状腺Thyroxine甲状腺素 Myasthenia gravis重症肌无力: Anti
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