IMMUNOLOGY

MUHAMMAD AHMAD IQBAL

 IMMUNITY 2. Physiological Barriers
3. Cellular Barriers
Definition
Physical Barriers
• Immunity is the capability of multicellular
Include all the Organs and their Secretions
organisms to resist harmful microorganisms”
• Immunity refers to the body’s ability to a) Skin
prevent the invasion of pathogens. b) Urogenital Tract
Pathogens are foreign disease c) Gastrointestinal Tract (Mucus Coating)
• causing substances, such as bacteria and d) Respiratory Tract (Mucus Coating)
viruses Physiological Barriers
• Immunology: Immunology is a branch of
Obstacles to Foreign invaders
biomedical science that covers the study of
immune systems in all organisms. a) Gastric Acid-Stomach
b) Saliva-Salivary Glands
Introduction to immunology
Cellular barrier
• Immunology is the study of the ways in which
the body defends itself from infectious Cells of innate immunity
agents and other foreign substances in its a) Neutrophils
environment. b) Mast Cells
• The immune system protects us from c) Basophils
pathogens. d) Dendritic Cells
• It has the ability to discriminate (differentiate) e) Eosinophils
between the individual`s own cells and f) Monocytes
harmful invading organisms. g) Macrophage
• Immune system has mainly two lines of h) Natural Killer Cells
defense/types:
Neutrophils
a) Innate immunity (nonspecific)
b) Acquired/Adaptive immunity (specific) • Most abundant immune cells (60-70%)
Innate Immunity • Phagocytes that kill and eat the pathogens
contain various enzymes in thier granules
• Inborn ability to fight various acute infections • Found in blood highly mobile enter parts of tissue
• Non-specific type of immunity Innate - where other cells cannot
Inborn/Congenital • Usually first cells to respond to infection
Characteristics • Eosinophils
• 2 lobed nucleus - goggle nucleus
• 1st line of defense
• Have granules containg enzymes
• Rapid defense
• Make up about 1-3% of WBC
• The same on re-exposure to antigen (Ag)
• Fight multicellular parasites and some
• No memory cell
bacteria
• Recognize and react against microbes only
• Also responsible for various allergies like
• Block entry of microbes and eliminate
asthama
succeeded microbes which entered the host
• Basophils
Components of Innate Immunity • Least common all WBCs (0.5—1%)
1. Physical Barriers • Important role in fighting parasitic infections
• Also have role in blood clotting Adoptive/Acquired Immunity
• Granules contain heparin also • Not present since birth
• Involved in various allergic reactions • Develops in response to an infection
Mast Cells • Lymphocytes are responsible for
acquired immunity
• Reside in connective tissue and mucous
membranes Components Of Adoptive/Acquired Immunity
• Role in wound healing and microbial defence 2 trillion 20-40% of wbc only 2% circulate in the
• Involved in serious allergic reactions blood
• Have granules containing histamine &
1) B lymphocytes
heparin
2) T lymphocytes
• Help link innate and adaptive to fight against
pathogens B lymphocytes
Macrophage • Humoral immunity
• Humoral immunity is also called antibody-
• Large eaters
mediated immunity.
• Phagocytic cells
• B-lymphocytes produce antibodies against
• Migrate from blood to tissue spaces for
specific antigens
invading pathogens
• One of the imp functions of these antibodies
Monocyte are opsonization
• Monocytes circulate in the blood Types of acquired immunity
• Cell with one lobed nucleus
Dendritic Cell Active immunity
• It is produced by introducing antigenic
• "Dendrite" means branch located in tissues substances i.e., vaccines from outside to
in contact with external environment stimulate antibodies. It is of two types
• Type of antigen presenting cells AKA naturally acquired active immunity:
"langerhan cells" after the scientist Secrete • It occurs when exposure to antigens is un-
interferon intentional
Natural Killer Cells • It is often following a disease such as
mumps, poliomyelitis.
• Destroys the viral infected or damaged cells,
Artificially acquired active immunity:
which might form tumors
• It occurs when exposure to antigens is
• Considered as the third type of lymphocyte,
intentional.
it is often called the non-T, non-B cell
• It is often followed by immune response.
• It is not a phagocytic cell but its granules
Vaccines and toxoids produce such type of
contain hydrolytic enzymes.
response.
Complement System Passive immunity
• Set of about "20" proteins complement the • It is produced by injecting preformed
action of antibodies and other cells in antibodies from external to the body e.g.,
destroying bacteria immunoglobulins. It is of two types;
• Present in many species including plants fish Naturally acquired passive immunity
and invertebrates (congenital immunity)
• It develops when antibodies pass into fetal How antibodies work
circulation form mother blood via placenta. • When an alien substance enters the body,
Artificially acquired passive immunity the immune system is able to recognize it as
• It develops from the intentional injection of foreign because molecules on the surface of
antibody rich serum into the circulation. the antigen differ from those found in the
Passive immunization is used both for body.
prophylaxis and therapeutic purposes. E.g., • To eliminate the invader, the immune system
• For prophylaxis (immunoglobulins, rabies calls on a number of mechanisms, including
antiserum) one of the most important—antibody
• For therapeutic (diphtheria antitoxin production.
Difference b/w innate & adoptive/acquired immunity
• Antibodies are produced by specialized
white blood cells called B lymphocytes (or B
Characteristics Innate Immunity Adaptive Immunity
cells).
Development Present Since Develops After • When an antigen binds to the B-cell surface,
Birth Birth
it stimulates the B cell to divide and mature
Specificity Non-Specific Specific
into a group of identical cells called a clone.
Response Time Fast Slow The mature B cells, called plasma cells,
Inheritence Inherited No Inheritence
secrete millions of antibodies into the
Components Physical Barriers B Lymphocytes bloodstream and lymphatic system
Physiological T Lymphocytes Types of Antibodies
Barriers • These are distinguished by the type of heavy
Cellular Barriers chain found in the molecule.
Potency Less Potent More Potent
• Five types of antibodies are identified:
1) Iga (Ig alpha)
2) Igd (Ig delta)
Antibody
3) Ige (Ig epsilon)
• Definition: “Antibody, also called 4) Igg (Ig gamma)
immunoglobulin, a protective protein 5) Igm (Ig mu).
produced by the immune system in response Among these antibodies, igg forms 75% of the
to the presence of a foreign substance, antibodies in the body.
called an antigen”. IgM
• It is used by the immune system to identify • It is the first antibody to be appeared in
and neutralize pathogens such as bacteria circulation after stimulation of B-
and viruses. lymphocytes.
• The antibody recognizes a unique molecule • It is the largest antibody molecule
of the harmful agent called ANTIGEN, via (pentamer).
the variable region. • It constitutes 5-10% of body antibodies.
• 20% of total plasma proteins (humoral IgA
immunity) • It constitute about 10% of total antibody.
• Rodney Portal and Gerald Edleman • It is present in the serum as well as in the
revealed the structure and got noble prize in secretions
1972 • It provides protection in body cavities
• It has dimer structure
IgG • Kappa (k) chain - K type (60%)
• It is the major circulatory antibody. • Lambda (A) chain -L type (40%)
• It constitutes about 80% of serum antibodies • Heavy chains are of 5 types.
in humans. • They are.
• It is created and released by plasma B.cells. 1. Gamma (γ) IgG
• It is maternal antibody. 2. Alpha (α) IgA
• It has monomer structure. 3. Mu (μ) IgM
IgE 4. Delta (𝛿) IgD
• It plays major role in allergic reactions 5. Epsilon (ɛ) IgE
• It constitutes about less than 1% • One end of chain is called as Amino acid
• It has monomer structure terminal end or N-terminal end.
IgD • Another end is called as Carboxy terminal
• It forms cell surface receptor along with igm end or C-terminal end.
on Blymphocytes. • The four chains are interconnected by
• The function of igd is to signal the B cells to Interchain disulfide bonds. The two heavy
be activated chains are linked by 1 - 13 interchain
Functions of Antibodies disulfide bonds. Each light chain is linked to
heavy chain by a single interchain disulfide
1. IgA plays a role in localized defense
bond.
mechanism in external secretions like tear
• The light chain has 2 intrachain disulfide
2. IgD is involved in recognition of the antigen
bonds and the heavy chain has 4 intrachain
by B lymphocytes
disulfide bonds.
3. IgE is involved in allergic reactions
• The immunoglobulin consists of two regions,
4. IgG is responsible for complement fixation
namely a
5. IgM is also responsible for complement
1) Variable region (V - Region)
fixation.
2) Constant region (C-region).
6. Binds to pathogens
7. Activates the immune system in case of • In the constant region, the amino acid
bacterial pathogens sequence remains constant in most of the
8. Directly attacks viral pathogens immunoglobulins. In the variable region, the
Structure of Antibody amino acid sequence shows variability.
• Immunoglobulin is a glycoprotein.
• It is an Y or T shaped molecule.
• It is made up of 4 polypeptide chain.
• Of these, 2 chains are short chains, also
called as Light chains. (L-Chain) they are
identical.
• The other two are longer chains, called as
Heavy chain. (H - Chain) they are also
identical.
• Each light chain is made of 214 Amino Acids.
Antigen
Each heavy chain is made up of 450 – 700 • Any substance which when introduced into
Amino Acids. the body gives rise to the production of
• There are two types of light chains, named antibodies is called as antigen
as,
• They have immunogenicity, reactivity, and e) Antigens are species-specific.
specificity properties f) The age influences the immunogenicity.
• HAPTEN is a small molecule which alone Very young and very old people exhibit very
cannot provoke the immune response but low immunogenicity
once it combines with body proteins, it can Uses
stimulate the antibody production., e.g., • Stimulates an immune response
penicillin molecules, molecules in cosmetics • Formation of antibodies
and dyes • Detecting blood group
• Immunogen: These may be proteins or Antigen Antibody reaction
polysaccharides and can generate an
• Introduction: Antigens & antibodies combine
immune response on their own.
specifically with each other. This interaction
between them is called 'Antigen Antibody
Types of antigens
reaction'.
Auto Antigen • Abbreviated as Ag - Ab reaction.
• These are person’s own chemical • They form the basis for humoral/antibody
substances that stimulate immune response mediated immunity.
when itself tolerance breaks. • They are used for detection of disease-
Allo Antigen causing agents & some non-specific Ag's
• These antigens are exist in certain but not in like enzymes.
all members of species e.g. A, B, and Rh • When Ag-Ab reaction occurs in-vitro they are
antigens. known as 'serological reactions'.
Foreign Antigen • The reactions b/w Ag & Ab occurs in 3
• These include, milk proteins, hemoglobin stages:
molecule, bacterial toxin, chemical 1) Formation of Ag-Ab complex.
substance found in bacteria 2) Leads to visible events like precipitation,
Heterophile Antigen agglutination etc.
• These substances stimulate the production 3) Destruction of Ag or its neutralization.
of antibodies with tissue of a wide variety of Salient features
unrelated animals • Affinity and avidity are
both measures of binding strength. 1) Specificity.
2) Immune complex.
• While affinity is the measure of the binding
3) Binding Site of Antigen.
strength at a single binding site, avidity is a
4) Binding Force of Antigen
measure of the total binding strength.
Specificity
• Antibodies have between two and ten
• Refers to the ability of an individual antibody
binding sites
combining site to react with only one
Properties of antigen
antigenic determinant (epitope).
a) The antigen should be a foreign substance
to induce an immune response. • Each antibody binds to a specific antigen;
b) The antigens have a molecular mass of an interaction similar to a lock and key,
14,000 to 6,00,000 Da. Immune Complex
c) They are mainly proteins and • An immune complex is formed from the
polysaccharides. integral binding of an antibody to a soluble
d) The more chemically complex they are, the antigen.
more immunogenic they will be. Ag + Ab → Ag-Ab complex
Binding Site of Ag insoluble precipitate of Ag-Ab complex. The
• The part of antigen which combines with Ab causing precipitation is called Precipitin
antibody is called 'Epitope', recognized by and the reaction is called as precipitation
the immune system, specifically by reaction.
antibodies, B cells, or T cells. • Ag + Ab Ag-Ab complex
• Part of an antibody that recognizes an
epitope is called a 'paratope'. Function of precipitation reaction
Binding Force of Ag • Precipitation occurs in two media:
• The binding b/w Ag & Ab in Ag-Ab reaction a) Liquid
is due to three factors namely: b) Gel.
a) Closeness b/w Ag & Ab-> more close = Precipitation In Liquid
good strength of binding. • Antigen - Antibody reaction perform by
b) Non-covalent bonds or Intermolecular placing a constant amount of antibody in a
forces-> hydrogen bonds, vander walls series of tubes and adding increased
forces, hydrophobic bonds. amount of antigen. Antigen - Antibody reacts
c) Affinity of antibody> strength of reaction together resulting in precipitation Plotting the
b/w a single epitope & single paratope. amount of precipitate against increasing
Mechanism Of Ag-Ab Interaction antigen conc. Yeilds a precipitation curve.
• Mechanisms of antigen-antibody interaction Precipitation In Gel
leading to inflammation. Antigen-antibody • Radial Immunodiffusion (Mancini): In these
immune complex formation results in methods agar gel or similar gels are used on
complement activation, opsonization of plates or petriplates. Both Ag and Ab diffuse
target cells, assembly of membrane attack freely in the gel system in all directions. At a
complexes and release of complement certain point depending on the rate of
activators for chemotaxis. diffusion and concentration of the reactants,
• Fc receptor mediated cell activation triggers a zone of equivalence will be formed, which
cellular responses, such as phagocytosis, is seen as a visible precipitation.
antibody-dependent cellular cytotoxicity Diagnostic Applications of Precipitation
(ADCC) and release of inflammatory Tests
mediators. 1. KAHN TEST (VDRL TEST) venereal
Ag + Ab Ag-Ab complex disease research laboratory test.
(Antigen Antibody Reaction) • KAHN test is used for the diagnosis of
TYPES syphilis.
2. ASCOLI TEST
• The types of antigen-antibody reactions are:
• It is diagnostic test for anthrax disease
a) Precipitation Reaction.
Agglutination Test
b) Agglutination Reaction.
c) Complement Fixation. • It is one of important laboratory method to
d) ELISA - Enzyme Linked immunosorbent detect antigen antibody reaction.
Assay. • It provides flexible and useful method for
e) Immunofluorescence. semi quantitating of either antigen or
Precipitation Reaction antibody concentration.
• When a soluble Ag combines with its Ab in • The reaction occurs between insoluble
the presence of an electrolyte (nacl) at a (particulate)antigen and appropriate
particular temperature and ph, it forms an antibody.
• The reaction will result in forming aggregate • It is a commonly used laboratory test to
or agglutinate. detect antibodies in the blood.
• Ag= agglutinogen, Ab= agglutinin • ELISA (Enzyme-Linked Immunosorbent
Types Of Agglutination Reaction Assay)
Direct Agglutination • Qualitative and quantitative measurement of
• To test patient's sera component present in liquid sample
• (Contain antibody) against large antigen. • Step 1: Coating of Antigen on the plate
• Direct agglutination can be used to • Step 2: Addition of enzyme linked Antibody
determine antibody titer. • Step 3. Addition of Substrate
Indirect Agglutination • ELISA or enzyme-linked immunosorbent
• Converting a precipitation reaction to an assay is a colorimetric test that uses
agglutination reaction antibodies and color change to identify a
• Serum is mixed with latex spheres (inert substance
substance) with the soluble antigens • ELISA gives qualitative and quantitative
attached. Information about the presence of an antigen
• Antibodies will then cause visible or antibody
agglutination of the latex spheres with the • EUSA is widely used as a diagnostic test for
soluble antigens attached. many viral diseases including AIDS
Slide Agglutination Test • Indirect ELISA: Used to detect antibody
• Ag suspension in saline added onto a slide against a known antigen.
or tile, now a drop of appropriate antisera • Sandwich ELISA: Used to detect antigen of
(ab) is added, mixed Instant clumping occurs interest
• Clumping after a minute is cosidered false • Competative ELISA: Used to detect how
• Control needs to be processed as well much antigen is present?
• No antisera only ag + saline, to check if the Complement fixation test
ag is Autoagglutinable • The complement fixation test is a blood test
• Used for detecting Typhoid in which a sample of serum is exposed to a
TUBE AGGLUTINATION TESTS particular antigen and complement in order
• A quantitative method to determine whether or not antibodies to
• Serum diluted serially and equal amount of that particular antigen are present.
particulate ag added to all the tubes. • The nature of complement is to react in
• Antibody titre noted combination with antigen–antibody
• Used for detecting Typhoid via WIDAL test, complexes.
Typhus fever, Brucellosis via Weil Felix • The complement fixation test (CFT) is a
reaction classical laboratory diagnostic test, which is
COOMB'S OR ANTI GLOBULIN TEST still used for determination of virus
• To detect incomplete anti Rh abs generated antibodies in patient sera or cerebrospinal
in fluid samples during an acute infection. The
• The Rh-ve mother after the first delivery. test mainly measures igg antibodies
• Direct Coomb's, Indirect Coomb's test Immunofluorescence
• Sensitization of rbcs with the incomplete abs • Immunofluorescence (IF) is a common
occurs in vivo in direct and in vitro in indirect laboratory technique, which is based on the
ELISA use of specific antibodies which have been
chemically conjugated to fluorescent dyes.
Application of Antigen - Antibody Reaction • Skin problems.
The chief use of antigen-antibody reactions is: • Abdominal pain or digestive issues.
• Recurring fever.
• Determination of blood groups for
• Swollen glands.
transfusion
Immunodeficiency Disorders
• Serological ascertainment of exposure to
• Immunodeficiency is a state in which the
infectious agents.
ability of immune system is compromised or
• Development of immunoassays for the
entirely absent to fight against infectious
quantification of various substances.
diseases and cancer.
• To detect the presence or absence of protein Two types of immunodeficiency disorders:
in serum.
• Primary (Congenital immune deficiency
• Determining the characteristics of certain diseases): These disorders are usually
immunodeficiency disease. present at birth and are genetic disorders
CONCLUSION that are usually hereditary (such
• Thus, we hereby conclude with the fact that as common variable immunodeficiency)
antigen-antibody reactions are very • Secondary (Acquired immune deficiency
important for serological testing of human diseases): These disorders generally
beings, as they give you a complete picture develop later in life and often result from use
of all the immune responses occurring the of certain drugs or from another disorder,
body & helps determining the immunological such as diabetes or human
disorders by the antigen (either self or non- immunodeficiency virus (HIV) infection.
self).
Tolerance
Autoimmunity
• Immune tolerance, also referred to as
• Autoimmunity is the system of immune immunological tolerance or
responses of an organism against its own immunotolerance, is an active state of
healthy cells, tissues and other body normal unresponsiveness to specific antigens to
constituents. prevent destructive over reactivity of the
• Any disease that results from such an immune system.
aberrant immune response is termed an • Tolerance is the prevention of an immune
"autoimmune disease". response against a particular antigen. For
Common autoimmune disorders include: instance, the immune system is generally
a) Addison disease.
b) Dermatomyositis
tolerant of self-antigens, so it does not
c) Graves’ disease usually attack the body's own cells, tissues,
d) Multiple sclerosis and organs
e) Pernicious anemia • Immune tolerance therapies are designed to
• Autoimmune disorders in general cannot be reprogram the immune system to stop the
cured, but the condition can be controlled in disease-causing immune attack on self-
many cases. tissue while maintaining the immune
• Historically, treatments include: anti- system's ability to fight infection.
inflammatory drugs – to reduce inflammation Different types of immune tolerance?
and pain. • There are two types of immune tolerance:
Common symptoms of autoimmune disease 1) Self-tolerance
include: 2) Induced tolerance
• Fatigue.
• Joint pain and swelling.
Self-Tolerance 2) Inhalants: Pollen grains, fungi, dust, smoke,
• Self-tolerance refers to the ability of the perfumes and disagreeable odor.
immune system to recognize—and therefore 3) Contactants: Chemical substances, metals,
not respond against—self-produced animals and plants.
antigens. If the immune system loses this 4) Infectious agents: Parasites, bacteria,
ability, the body can start to attack its own viruses and fungi.
cells, which may cause an autoimmune 5) Drugs: Aspirin and antibiotics.
disease. 6) Physical agents: Cold, heat, light, pressure
Induced Tolerance and radiation.
• Induced tolerance occurs when the immune Hypersensitivity
system actively avoids responding to an
• Hypersensitivity (also called hypersensitivity
external antigen. This tolerance is induced
reaction or intolerance) refers to undesirable
by previous encounters with that antigen.
reactions produced by the normal immune
• An example of induced tolerance is a
system, including allergies and
deliberate manipulation of the immune
autoimmunity.
system to avoid the rejection of transplanted
• They are usually referred to as an over-
organs or to provide protection from allergic
reaction of the immune system and these
reactions
reactions may be damaging and
uncomfortable.
ALLERGY
• Types of hypersensitivity reactions
• It is defined as abnormal immune response
• Type I: Reaction mediated by ige antibodies
to a chemical or physical agent (allergen).
(anaphylactic/immediate hypersensitivity)
• During the first exposure to an allergen, the
• Type II: Cytotoxic hypersensitivity (mediated
immune response does not normally
by igg or igm antibodies)
produce any reaction in the body.
• Type III: Reaction mediated by immune
• Sensitization or an initial exposure to the
complexes.
allergen is required for the reaction. So, the
• Type IV: Delayed reaction mediated by
subsequent exposure to the allergen causes
cellular response
variety of inflammatory responses. These
Type I: Reaction mediated by ige antibodies
responses are called allergic reactions or
(anaphylactic/immediate hypersensitivity)
immunological hypersensitivity reactions.
ALLERGENS • This is the immediate allergic response
• Any substance that produces the mediated by ige type of antibodies in
manifestations of allergy is called an response to specific antigen called allergen.
allergen. It may be an antigen or a protein or • Type I hypersensitivity is also known as an
any other type of substance. Even physical immediate reaction
agents can develop allergy. • This reaction may be life threatening as
Allergens are introduced by: accompanied by Anaphylaxis, in which the
mediators induce severe contraction of
a) Contact (e.g.: chemical substance)
body’s smooth muscles
b) Inhalation (e.g.: pollen) • This results in mast cell degranulation and
c) Ingestion (e.g.: food) release of histamine and other inflammatory
d) Injection (e.g.: drug). mediators.
Common Allergens Common Allergens:
1) Food substances: Wheat, egg, milk and • Plant pollens
• Serum proteins
chocolate.
• Drugs like penicillin etc. Type-II (cyto-toxic hypersensitivity
• Mites and foods etc.
Mechanism: • Type II hypersensitivity reaction refers to an
• When allergen (antigen) enters the body, B antibody-mediated immune reaction
lymphocytes produce Ige antibodies. • These reactions occur when a specific
• These antibodies enter the circulation and fix antibody typically igg or igm causes
to the surface of mast cells or basophils destruction of host cells
• A mast cell (also known as a mastocyte or a • Cells involved are WBC, RBC and Platelets
labrocyte) is a resident cell of connective Mechanism:
tissue that contains many granules rich in Complement mediated lysis:
histamine and heparin • Antigens on the cell surface combine with
• Mast cells serve as a first line of defense antibody
against antigens entering the body due to • This may lead to binding of complement
their location in the skin and mucosa which promotes lytic effect
• Basophils circulating leukocytes, also Phagocytosis:
contain granules. • Antigen antibody reaction may lead to
• Now host is sensitized to specific allergen. phagocytosis, may facilitate by killer cells
• On subsequent exposure to same antigen, it Release of destructive substances:
will attach to reactive site of ige and antigen • Arachidonic acid and leukotrienes, which are
antibody reaction will trigger the release of involved in development of inflammation
mediators including histamine, serotonin, Example:
bradykinin, prostaglandin, from mast cells Blood transfusion reaction
and basophils. They contract smooth • Arise from the mixing of incompatible blood
muscles of body. types. To avoid, blood must be
Management: crossmatched before transfusion
• Adrenaline injection Hemolytic disease of newborn (erythroblastosis
• Aminophylline fetalis):
• Artificial respiration • It occurs when Rh- women become pregnant
Desensitization (hypo-sensitization): with Rh+ fetus.
• this involves the injections of allergens • It is caused by the destruction of neonatal
(dilute extracts) over a period of weeks. red blood cells by maternal immunoglobulin
Mechanism of hypo-sensitization: G (igg) antibodies
• These exposures cause the immune system • Antigen-antibody reaction will destroy rbcs of
to produce igg antibodies, which circulate baby and often die or born with jaundice
and neutralize the allergens before they Autoimmune disorders:
contact sensitized cells. • These are the diseases in which body
• IgG antibodies thus act as blocking produce antibodies against its own cells
antibodies. Thrombocytopenia:
Allergic diseases • In this antibody produced against drugs like
• Type I hypersensitivities include atopic aspirin, antibiotics and antihistamines
diseases, which are an exaggerated ige • These combine with antigens and adhere to
mediated immune responses (i.e., allergic: thrombocytes (platelets) causing their lysis.
asthma, rhinitis, conjunctivitis, and • This results in impaired blood clotting and
dermatitis), and allergic diseases, which are hemorrhages
immune responses to foreign allergens (i.e., Agranulocytosis:
anaphylaxis, urticaria, food, and drug • It results in destruction of neutrophils by
allergies) antibodies produced by drugs
 Type-III, immune complex hypersensitivity Type-IV, cell mediated hypersensitivity
• an abnormal immune response is mediated • Type IV hypersensitivity is often called
by the formation of antigen-antibody delayed type hypersensitivity as the reaction
aggregates called "immune complexes." takes several days to develop
• It is caused by the deposition of immune • Unlike the other types, it is not antibody-
complex (antigen-antibody complex) at mediated but rather is a type of cell-
various body locations, mainly blood mediated response.
vessels, kidneys, joints, lungs and skin. • This response involves the interaction of T-
Mechanism: cells, monocytes, and macrophages
• Immune complex interact with complement • This usually develops beginning 18-24 hrs.
system leading to generation of C3a and following contact with antigen and peaks in
C5a which cause the release of vasoactive 2-3 days.
amines from mast cells and basophils, thus Types:
increasing sensitivity reactions. • Infection allergy: it develops when immune
• Immune complex also interacts with platelets system responds to certain microbial agents
leading to thrombosis of small vessels and e.g., bacteria (TB leprosy) and viruses
release of vasoactive amines. (smallpox & mumps etc.)
Diseases: • Contact dermatitis: it develops after
• Serum sickness exposure to broad variety of antigens such
• Arthus reaction as clothing, jewelry, cosmetics and certain
• Rheumatoid arthritis chemicals, shoes etc