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AllergicRhinitis Jax

Allergic Rhinitis, Jackson, 1/23/2013

Define atopy IgE mediated immediate hypersensitivity reaction to certain antigens causing rapid vascular leakage, and mucosal secretions, followed by inflammation
Define immediate hypersensitivity Vascular and smooth muscles reactions that happen within minutes of reintroduction of antigen to previously sensitized individuals
Define late-phase hypersensitivity Mast cell mediators that are cytokines recruit neutrophils and eosinophils to the site of reaction over several hours; Result of tissue injury from repeated bouts of immediate hypersensitivity
Define allergen Antigens that elicit immediate hypersensitivity reactions; any atopic individual can be allergic to one or more antigen
Which cell mediators cause rapid increases in vascular permeability and smooth muscle contractions, causing many symptoms of allergy? Mast cells
Antigens bind to B cells which activate B and T cells in an immune response
In response to an allergen, Th2 cells stimulate the production of IgE
IgE binds to what? Fc receptor on mast cells
List the Ig in order of most concentrated to least concentrated in the human body IgG, IgA, IgM, IgD, IgE
Describe a type 1 allergic reaction Allergen reacts with Th2 cells instead of Th1 cells to produce IgE. IgE binds to the Fc receptors on mast cells and basophils which causes degranulation
A high IgE level is caused by A Th2 helper t cell response
Which cytokines are important for the increase of IgE and increased mucus production IL4 and IL13
What test is used to measure allergen-specific IgE Immunoassay
What does IL4 do? Stimulates B lymphocytes for the allergen to switch to IgE producing plasma cells
In atopic patients, mast cells are coated with IgE antibodies specific for the antigen they are allergic to. This coating of mast cells leads to Sensitization because immune response will be elicited each time the person is exposed to the allergen
Binding of IgE activates mechanical signalling from mast cells causing signal trasduction to what three pathways Degranulation, Synthesis and secretion of lipid mediators, and synthesis and secretion of cytokines
Define degranulation Granule exocytosis leads to vasoactive amines to cause vascular dilation and smooth muscle contraction and proteases to lead to local tissue damage
What do lipid mediators do? Causes prostaglandins to stimulate vascular dilation and leukotrienes to cause prolonged smooth muscle contractions
What do cytokines do? Local inflammation (leukocyte recruitment) and cause the late phase reaction
Explain the pathogenesis of allergic rhinitis Nasal mucosa react to an inhaled allergen by producing histamine and Th2 cells that produce IL-13 (increased mucus production)
Most skin tests for allergies are rapid, sensitive, and cost effective tests for Allergen-specific IgE on the patients mast cells
Positive skin test gives what reaction? Wheal and flare
The wheal and flare reaction is due mainly to Histamine
Which reaction is read for a allergen test? Early phase
Describe an in vitro allergen test Blood is taken to measure blood IgE levels. Total blood IgE is measured and then allergen-specific IgE is measured using an ELISA or fluorescent enzyme
Why would you use an in vitro test instead of a skin test? There is no risk for allergic reactions and it is not affected my any medications the patient may be taking
Created by: mcasto