青岛大学基础医学院医学免疫学chapter19.pptxVIP

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)types of hypersensitivity reactionsType I: Immediate hypersensitivity Type II: Cytotoxic or cytolysis hypersensitivityType III: Immune complex hypersensitivityType IV:Delayed-type hypersensitivity and T cell-mediated cytolysisSection 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一 Components involved 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（二）IgEallergin---IgEIgE + mast cell basophil——sensitization（三）mast cell , basophil and high-affinity IgE Fc receptor on their surfaceMast cell activation productsPreformed mediatorsHistamine: bronchoconstriction, mucus secretion, vascular permeability, vasodilatationKininogenase: kinins - vascular permeability, vasodilatation, edemaECFA: attract neutrophils and basophilsMast cell activation productsNewly formed mediatorsLeukotriene B4:attract neutrophils and basophilsLeukotriene C4 D4: same as heparin but 1000 x potentProstaglandin D2: kinins - vascular permeability, vasodilatation, edemaPAF:platelet aggregation, microthrombi formation, heparin release（四） Eosinophil 二 the course and mechanism of type I hypersensitivity三 clinical common disease(一) Systemic anaphylaxis: drug anaphylactic shock serum anaphylactic shock (二) Respiratory anaphylaxis : Anaphylactic rhinitis Anaphylactic asthma(三) alimentary tract anaphylaxis (四) Skin anaphylaxis: Urticaria, eczema四 principle of Treatments for allergy(一） test for allergen：skin testRagweedControlSkin test for allergyHistamine(二）desensitivity therapy（三）medicine therapy（四）new immunotherapyNew