医学免疫学第十七章？超敏反应汇总.ppt

超敏反应 指机体受到抗原持续刺激或同一抗原再次刺激后产生的一种以机体生理功能紊乱和/或组织损伤为主要表现的病理性免疫反应。 第一节 I型超敏反应 一、参与I型超敏反应的主要成分和细胞 Histamine（组胺）: bronchoconstriction, mucus secretion, vascular permeability, vasodilatation Tryptase（类胰酶）: proteolysis Kininogenase（激肽原酶）: kinins - vascular permeability, vasodilatation, edema 趋化因子: attract neutrophils and basophils 过敏性哮喘 主要由花粉、真菌、尘螨、动物皮毛引起 发生支气管平滑肌痉挛、黏液分泌增多、气道炎症。 急性发作时属于速发相反应。 48小时后进入迟发相才出现典型的气道炎症特征。 Impact of allergic diseases Type-I hypersensitivity common allergy Many organ are be affected by “allergy” Skin test for allergy Skin test for allergy Treatments for allergy Symptomatic Receptor blockers histamines Leukotriene Bronchodialators Prevent mast cell degranulation Ca influx inhibitor (chromolyn sodium) Phosphodiesterase (theophylline) Immunotherapy (hyposensitization) 第二节 II型超敏反应Type II hypersensitivity 一 II型超敏反应产生机制 （Type II hypersensitivity mechanism） Type II hypersensitivity role of neutrophils Type II hypersensitivity induced by exogenous agents Examples of drug-inducedtype II hypersensitivity Red cells: Penicillin, chloropromazine, phenacetin Granulocytes: Quinidine, amidopyridine Platelets: sulphonamides, thiazides 第三节 III型超敏反应Type III hypersensitivity 由中等大小可溶性免疫复合物沉积于局部或全身毛细血管基底膜后，通过激活补体和血小板、嗜碱性、嗜中性粒细胞参与作用下，引起的以充血水肿、局部坏死和中性粒细胞浸润为主要特征的炎症反应和组织损伤。 （三）组织损伤机制（mechanism） Serum sickness mediated by immune complexes Types of immune complex disease Serum sickness Systemic lupus erythematosus Arthus reaction 第四节 Ⅳ型超敏反应 Delayed reaction 48 to 72 hours Characterized by induration and erythema Also known as cell mediated hypersensitivity Tuberculin test is the most common example Antigen heavy metals, poison ivy, rubber, latextuberculin, lepromin, Type IV hypersensitivity the three forms Type IV hypersensitivity reactions Contact dermatitis vs tuberculin reaction Poison ivy / poison oak reaction Contact dermatitis reaction to leather Granuloma in a leprosy patient Comparison of hypersensitivity reactions Arthus reaction Type-II Weal flare r