Allergic reaction type IV (tuberculin, cellular, DTH) – Abstract

Allergic
reaction
IV
type (tuberculin, cellular, DTH)


Allergens
– very large, with which the antibodies
can not cope. It grafts.
Antiallergen:



  • natural
    primary: UM, testicles in men


  • secondary
    acquired, or atypical (tumor
    cells, aging, embryonic),
    induced under the action of physical,
    chemical factors



For
sensitization sensitized answer
T-lymphocytes.


When
contact of the allergen with the lymphocyte ,
T-lymphocyte is activated.


2
ways of activation:



  1. the way
    – if the clone of sensitized
    T lymphocytes is insufficient, the lymphocyte
    turns into blast – blast transformation.
    After 12 hours in culture lymphocytes
    the increase in the content of
    protein, after 48 hours the cells begin
    shares


  2. the way
    – if a sufficient number of lymphocytes.
    The lymphocytes release biologically active substances – lymphokines
    (mediators).



Allocate
3 groups of lymphokines:



  1. lymphokines,
    acting on lymphocytes




  • mitogens
    (stimulates mitosis) or blasttransformation
    factor


  • factor
    transfer – transfers the information about
    sensitization in the intact (untrained)
    lymphocytes


  • immunoregulatory
    factors (helper-suppressor)




  1. lymphokines,
    acting on the phagocytes:




  • factors
    chemotaxis


  • factors
    activating micro – and macrophages


  • factors
    suppressing the migration of phagocytes




  1. lymphokines,
    acting on target cells:




  • lymphotoxin
    (tumor necrosis factor, TNF)


  • interferon


  • factor
    inhibiting proliferation


  • factor
    skin reactivity



Active
a lymphocyte attaches to target cells,
with the help of membrane-associated
enzymes (phospholipase and perforin)
damage the membrane of target cells and
affects her lymphotoxin.
Further cell lysis is carried out
phagocytes, i.e. develops aseptic
inflammation.


Clinical
of allergic reaction IV
type



  1. Tuberculin
    test (Mantoux)



Tuberculin
– toxin of Mycobacterium tuberculosis.
Administered in the middle third of the forearm.
The result removed in 72 hours
measure the size of the papules. In norm – diameter
= up to 1 cm; if the papule pouted in the body
there is a Mycobacterium, and immunity
non-sterile, i.e. weakened are
at the insertion point. But if mycobacteria
active – the papule is huge, sometimes
in the middle of the necrosis.



  1. Contact
    dermatitis, eczema.



Develops
when in contact with low molecular weight
substances. Can be pharmacists,
photographers. Can occur life.


Contact
an Allergy occurs when contact. And then
no contact is formed eczema.



  1. Reaction
    transplant rejection. First
    disturbed function of the graft, and
    then the graft is removed from
    body.


  2. Antitumor
    immunity



Allergic
reaction
V
type (receptor-mediated)


Allergens
– BAV, hormones and their receptors.


For
sensitisation answer – IgG.


Interaction
AG with At occurs at the receptor or
from the complex of AG and Al is formed on
the receptor. Resulting
or stimulation or inhibition of the function
cells.


Very
often targeted endocrine
cancer 
endocrinopathy.














Stimulating
type



Inhibiting
type




  • thyrotoxic
    goiter (antibody to the TSH receptor)





  • Thyroiditis
    Hashimoto’s (the antibody to thyroglobulin)


  • Insulin
    diabetes mellitus (At receptors
    insulin in tissues)


  • Insulinzavisimy
    diabetes (At the receptors
    β-cells)


  • Myasthenia gravis
    gravis (antibody to N-cholinergic receptors)




The relationship
Allergy and immunity


Traced
in the experiments Topley.



  1. Sea
    mumps is administered 0.1 ml of antioedema
    serum of the rabbit.



Through
Day 1-3: introduce 2.0 ml serum antioedema
rabbit + 0.01 ml horse serum 
There is no shock. Many antibodies.



  1. From
    Guinea pig And took its 2.0 ml serum,
    and introduced another Guinea pig.



Through
1-3 days she was injected with 1ml of serum antioedema

Shock, death. A lot of antigen.



  1. 0.1 ml
    antioedema serum of the rabbit.



Through
1-3 days: 2.0 ml serum antioedema
rabbit + 1.0 ml horse serum 
Shock, death. A lot of antigen.



  1. From
    Guinea pigs during the previous
    it was taken 2 ml serum, and put 4
    pig.



Through
1-3 days: she was injected with 1.0 mo horse serum

There is no shock. All antibodies during shock
connected. In the Guinea pig D
only the antigen.


Disease
immune autoaggression



  • Violation
    the functioning of the body


  • Caused by
    the development of pathogenic immune responses


  • Directed
    against its own cells and non-cellular
    structures



Options
pathogenesis of diseases of immune autoaggression

















Action
a pathogenic factor



Pathogenic
changes in the immune system



Pathogenic
changes outside of the immune system



Disease
immune autoaggression


“Immunodependent”


(“Antigennegative”)



Disease
immune autoaggression


“Immunodependent”


(“Antigen”)



Initial
stages of pathogenesis “Immunodependent”
diseases of autoaggression


Pathogenic
factor



  1. Violation
    the normal ratio of Th/Ts


  2. Cancel
    anergy of T cells to autoantigens


  3. Nonspecific
    polyclonal activation of lymphocytes




Education
“forbidden” autoaggressive clones


immune cells
and immunoglobulins



development
“immunogenicity” diseases of autoaggression


“Immunoanalysis”


Pathogenic
factor




  1. When
    the abolition of the natural antigen



Sympathetic
the ophthalmia – occurs in not injured
the eye with penetrating injury of other
eyes



  1. Introduction
    in the body of antigens, similar to
    endogenous (the phenomenon of “antigenic
    of mimicry”)



Against
another AG are produced At, but they
partially similar to their AG. Occurs
children iskusstvennomu.


Maybe
occur when taking penicillin.



  1. Modification
    antigens of the organism. Very often such
    properties are haptens.


  2. Modification
    genome (mutations) in the cells of the body.




Development
“immune-dependent” diseases of autoaggression


Types
autoimmune diseases


In
depending on the number of affected organs:



  • Monoarsenide
    (organospecific) – Thyroiditis
    Hashimoto, glomerulonephritis


  • Organ
    (systemic or generalized) – System
    lupus erythematosus, scleroderma, rheumatism



Disease
Central nervous system:



  • Schizophrenia
    – stimulating antibody to the receptor
    dopamine


  • Parkinsonism
    – a blocking antibody to the receptors for dopamine



Disease
thyroid gland – Thyroid
goiter – stimulating antibody to the receptor
TSH; Hashimoto’s Thyroiditis – blocking


Stomach
– Anemia of Edison-Meremere – At to
parietal cells of the stomach or At
internal factor Castle


In
depending on the dominant mechanism
development:



  • Humoral
    (β-cell) – Hashimoto’s thyroiditis,
    autoimmune hemolytic anemia,
    autoimmune thrombocytopenia, systemic
    lupus erythematosus


  • T-cell
    (T-lymphocytic) – poymyosh syndrome
    Sjogren (loss of glands)


  • Combined
    (T-,b-cell) – polymyositis, scleroderma,
    dermatomyositis, rheumatoid arthritis,
    glomerulonephritis



Pseudoallergic
reaction


Distinctive
hell – the absence of the first immunologically
stages of allergic reaction.


Example
– the phenomenon of Mikhail Shvartsman.


Playback
the phenomenon of Edison-Sakharov:


In
the basis of allergic III
type on the subcutaneous administration of protein –
local anaphylaxis. In the experiment he
recreated under rule 5 fives.
Rabbit subcutaneously five times with an interval of
5 days is entered by 5ml of 5% solution
of egg albumin. After the 3rd injection
in the area of injection – swelling, itching, redness.
5 days after the last injection
at the injection site – necrosis is developed.


Playback
the phenomenon of Mikhail Shvartsman:


Rabbit
subcutaneously culture of microorganisms.
Then, the next day, intravenously below
introduced culture of microorganisms. And
the primary injection occurs
necrosis. If intravenous culture
microorganisms to make together with
heparin, necrosis will not. Through
the day of sensitization will not. Heparin
cannot prevent allergic
response.


Mechanism
development of allergic responses:



  1. Admission
    the body LIBERATI HISTAMINE
    (antispasmodics, local anesthetics,
    muscle relaxants, iodine-containing substances,
    the plasma substitutes, vitamins, some
    food products).


  2. Activation
    of complement via the alternative path
    bacterial lipopolysaccharides
    or drugs.


  3. Violation
    of arachidonic acid metabolism with
    the shift of metabolism towards
    primary education
    leukotriene (aspirin asthma).



Symptoms
– bronchospasm, urticaria, anaphylactoid
shock.


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