The Pathophysiology of Allergy Lecture 514.094 The Pathophysiology of Allergy Chapter 2

50 Pages·2010·5.17 MB·English

Chapter 2: Type I allergy: Mechanisms in
Lecture 514.094 of the Medical University Vienna
the effector phase and Anaphylaxis
The Pathophysiology of Allergy
Eva Untersmayr-Elsenhuber
Department ofPathophysiologyandAllergyResearch
Lecture 514.094 The Pathophysiology of Allergy
Chapter 2: Type I allergy:
Mechanisms in effector phase
and Anaphylaxis
Eva Untersmayr-Elsenhuber
Department of Pathophysiology
and Allergy Research
Medical University Vienna
Chapter 2: Type I allergy: Mechanisms in
Lecture 514.094 of the Medical University Vienna
the effector phase and Anaphylaxis
The Pathophysiology of Allergy
Eva Untersmayr-Elsenhuber
Department ofPathophysiologyandAllergyResearch
Topics of lecture
(cid:8226) Clincal presentation of allergic reactions
(cid:8226) Key players in allergic inflammation
- IgE
- Allergen
- Mast cells
- Eosinophils, inflammatory cells
(cid:8226) Mechanisms of anaphylactic reactions
Chapter 2: Type I allergy: Mechanisms in
Lecture 514.094 of the Medical University Vienna
the effector phase and Anaphylaxis
The Pathophysiology of Allergy
Eva Untersmayr-Elsenhuber
Department ofPathophysiologyandAllergyResearch
Clinical presentation of allergic reactions
Allergy against inhalative proteins
(cid:8226) Respiratory symptoms
Wheezing, rhinitis
Conjunctivitis
Asthma Mild (cid:224) severe
In all age groups
Gibson PG et al. Lancet 2010
(cid:8226) Cutaneous and gastrointestinal http://www.raksar.com/shop/r/raksar/i
mg-lib/con_20051229134550_i.JPG
symptoms
Eczema
Oral allergy syndrom
Katelaris CH. Curr OpinAllergy Clin Immunol. 2010
Chapter 2: Type I allergy: Mechanisms in
Lecture 514.094 of the Medical University Vienna
the effector phase and Anaphylaxis
The Pathophysiology of Allergy
Eva Untersmayr-Elsenhuber
Department ofPathophysiologyandAllergyResearch
Clinical presentation of allergic reactions
Allergy against food compounds
(cid:8226) Gastrointestinal symptoms
Abdomial pain
Nausea, vomiting
Diarrhea
(cid:8226) Respiratory and cutaneous
http://sip.uki.at/img/bauchschmerz/Schmerz_Bauchschmerz.jpg
symptoms
Rhinitis, conjunctivitis
Asthma
Eczema, urticaria, angioedema
(cid:8226) Generalized anaphylactic symptoms
Sicherer SH, Sampson HA. JACI 2010
Chapter 2: Type I allergy: Mechanisms in
Lecture 514.094 of the Medical University Vienna
the effector phase and Anaphylaxis
The Pathophysiology of Allergy
Eva Untersmayr-Elsenhuber
Department ofPathophysiologyandAllergyResearch
Clinical presentation of allergic reactions
Allergy against drugs
(cid:8226) Respiratory symptoms
Wheezing, rhinitis
Conjunctivitis
Asthma
(cid:8226) Cutaneous symptoms
Eczema
http://www.allergiewelle.de/wp-
content/uploads/2009/11/angioodem-fdgarrett.jpg
Urticaria
Angioedema
(cid:8226) Generalized anaphylactic symptoms
Chapter 2: Type I allergy: Mechanisms in
Lecture 514.094 of the Medical University Vienna
the effector phase and Anaphylaxis
The Pathophysiology of Allergy
Eva Untersmayr-Elsenhuber
Department ofPathophysiologyandAllergyResearch
Time course of allergic reactions
Immediate reaction immediate Late phase
Onset within seconds
due to preformed or rapidly
synthesized mediators
(cid:224) vascular permeability
(cid:224) contraction of smooth
muscle
Late phase reaction
immediate Late phase
Induced synthesis and
release of mediators
(cid:224) recruiting of eosinophils
and Th2 lymphocytes
(cid:224) second phase of smooth
muscle contraction,
sustained edema, airway
hyperreactivity
www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=imm&part=A1734
Chapter 2: Type I allergy: Mechanisms in
Lecture 514.094 of the Medical University Vienna
the effector phase and Anaphylaxis
The Pathophysiology of Allergy
Eva Untersmayr-Elsenhuber
Department ofPathophysiologyandAllergyResearch
Time course of allergic reactions
immediate Late phase
www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?
book=imm&part=A1734
Laché M et al.
Nat Rev Immunol 2006
Key players in immediate reactions
IgE bound via Fc(cid:949)RI to mast cells and basophils
(cid:224) mediator release
Chapter 2: Type I allergy: Mechanisms in
Lecture 514.094 of the Medical University Vienna
the effector phase and Anaphylaxis
The Pathophysiology of Allergy
Eva Untersmayr-Elsenhuber
Department ofPathophysiologyandAllergyResearch
Time course of allergic reactions
immediate Late phase
www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=imm&part=A1734
Key players in late phase
reaction
Network of inflammatory cells:
eosinophils (50% of infiltrate),
allergen-specific T-cells, mast cells,
basophils, Th1 cells
Laché M et al. Nat Rev Immunol 2006
Chapter 2: Type I allergy: Mechanisms in
Lecture 514.094 of the Medical University Vienna
the effector phase and Anaphylaxis
The Pathophysiology of Allergy
Eva Untersmayr-Elsenhuber
Department ofPathophysiologyandAllergyResearch
Chronic allergic inflammation
Due to repetitive
or persistant
allergen exposure
Innate immune cells
(eosinophils,
basophils,
neutrophils and
monocyte/macroph
ages) and adaptive
immune cells (Th2-
cells, other T-cells,
B-cells) take up
residence in tissue
Galli SJ et al. Nature 2008
Chapter 2: Type I allergy: Mechanisms in
Lecture 514.094 of the Medical University Vienna
the effector phase and Anaphylaxis
The Pathophysiology of Allergy
Eva Untersmayr-Elsenhuber
Department ofPathophysiologyandAllergyResearch