HYPERSENSITIVITY

1. Allergic Response
2. Allergic Response Type
Type I III:
Immediate Hypersensitivity
Type IV:
Delayed Type Hypersensitivity

Allergic Responses
Reexposed to antigen that has
encountered previously
Allergic symptoms are caused by immune
reponses (Immune product).
Immediate Hypersensivity :
antibody (B) and cytokines (T)

Allergic Response Type

Type (Group) I (Anaphylactic)
pollen (first)

pollen (second)

Mast
Cell

IgE
Mast
Cell

degranulasi

histamine release

Allergic Response Type

Type (Group) II (Cytotoxic)
IgG
RED
CELLS

Surface Antigen

Direct Cell LYSIS or

C5a reqruitment of Neutrophyl
to phagocytose cell

Allergic Response Type

Type (Group) III (Immunocomplex)
Neut

IgG
IgM C

Neut
Integrin
ICAM-1
VCAM-1

VASCULITIS

IgG
IgM C

complement

Immunocomplex Diseases
Allergic Diseases
Arthur Reaction (vaccine,drug,insect bite)
SerumSickness (Protein & nonprotein drugs)
Nonalleric Diseases
Lupus erythematosus
Vasculitis
Glomerulonephritis
Rheumatoid arthritis
Acute allograft rejection.

Allergic Response Type

Type (Group) IV
(Delayed Type Hipersensitivity or T cell
mediated monocyte/ macrophage activation
or Cell Mediated Hypersensitivity)
Exp:
Allergic Contact Dermatitis.
Hypersensitivity Pneumonitis
Photoallergic Contact Dermatitis.

Allergic Response Type

Type IV (Abbas)
Delayed type hypersensitivity
Th1/Tc

IL-2
INF
TNF

Tissue injury

Activated macrophage
inflammation

T cell mediated cytolysis.

Tc

Tc

Target
cells
Cell killing & tissue injury

IL-12

antigen

promote

Th0

inhibit

Th1

Th2
IL-10

IL-2
TNF

INF

DTH

B Cell

TGF

IL-4
IgE

IH

IL-5

Eosinophil

DRUG ALLERGY
CLASS SPECIFIC IMMUNE
REACTANT

MEDIATORS

Ig E

Mast Cell and

basophil-derived

II

IgG,*Ig M

Complement

III

IgG,IgM
(Immunocomplex)

Complement

IV

T lymphocyes

T cell cytokines

DISEASES
Atopy
Anaphylaxis
Uricaria/angioedema
Immune hemolytic
anemia,
Neutropenia
Serum Sickness
Allegic
contact dermaitis

DRUG ALLERGY
DRUG
ANTIGEN

CARRIER
PROTEIN
(TISSUE)

CONYUGATE

SPECIFIC
ANTIBODY

1. Native molecule
drug

2. Hydrolisis/biotransformation products
drug
metabolite

3. Interaction of the drug/drug metabolite and the protein

drug or
drug
metabolite

4. Conformational change in the tissue protein

drug or
drug
metabolite

DRUG ALLERGY TESTING METHODS

IMMUNOLOGIC
REACTION
TYPE I

TYPE II
TYPE III
TYPE IV

IN VIVO
Immediate skin prick
and intradermal
None
Intradermal Arthus Test
Patch Test

IN VITRO
RAST. ELISA

Coombs
Precipitin Test
RAST,ELISA
Lymphocyte
Proliferation.