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Allergy (from Greek allos other,

ergon action) is the state of the
increasing sensitiveness of the
organism to the repeated penetrating of
allergen which is characterized by
immunological mechanisms and self
injury.

Allergy is an immune response,

which is followed by damage of
own tissues.
Allergic diseases is a group of diseases, in
development base of which damage lies, caused by an
immune reaction on allergens. Allergic diseases are
widely spread among people. It is considered that they
cover about 10 % of earth population. In different
countries these sizes vacillate from 1 to 50 % and more.

General etiology of allergic diseases

The cause of allergic diseases is the allergen, the conditions of their
appearing are the specific peculiarities of the environment and state of organism
reactivity.

Allergen is a substance that causes

development of an allergic reaction.
Allergens have all properties of antigens (macromolecularity, mainly protein
nature, foreign for a particular organism). However allergic reactions can be
caused by substances of not only antigen nature, but also substances, not
possessing these properties. To this group belong many officinal preparations,
bacterial products, polysaccharides, simple chemical substances (bromine, iodine,
chrome, nickel). These substances are called
haptens.
While entering the organism they become
antigens (allergens) only after binding with
tissues proteins. Here with complex antigens,
which sensitize the organism are formed.

THE PATHOGENESIS OF
ALLERGIC REACTIONS
STAGE I: IMMUNOLOGICAL
STAGE II: PATHOCHEMICAL
CHANGES
STAGE III: PATHOPHYSIOLOGICAL
CHANGES

In the development
of allergic reaction
there are three
stages:
1. Immunological stage. It covers all
the changes in immune system during
the penetration of an allergen into the organism,
formation of antibodies or sensitized lymphocytes
and their binding with the repeatedly entering
allergen.
2. Pathochemical stage. Its sense is in formation of
biological active substances.The stimulus to their
formation is the binding of allergen to antibodies or
sensitized lymphocytes at the end of immunological
stage.
3. Pathophysiological stage. It is described by
pathogenic action of formed mediators onto cells,

Anaphylactic
shock
Anaphylactic shock develops in severe
complication. Spasm of smooth muscles of
internal organs with clinical manifestation of
bronchospasm (cough, expiratory
breathlessness),
spasm of gastro-intestinal tract muscles (spastic
pain in the whole abdomen, nausea, vomiting,
diarrhea),
spasm of uterus in women (pain below abdomen)
are observed.
Spastic phenomena are worsened by edemas of
mucous covers of internal organs, during the
edema of larynx the picture of asphyxia may
develop.
The arterial pressure is sharply decreased, the heart
insufficiency, ischemia of brain, seizes paralysis

Pathochemical stage. This leads to morphological,

biochemical and functional change in
lymphocytes.
They are presented by blast transformation and
proliferation,
increasing of synthesis of DNA, RNA and proteins and
excretion of different mediators, which are called
lymphokines. With the help of lymphokines (MIF,
interleukines, chemotaxic factors, factor of
transfer)
mobilization of different cells (macrophages,
polymorphnuclear), increasing of chemotaxic activity and
placing in
the site of allergen occur.
MIF promotes accumulation of macrophages in
the site
of allergic damage, increases their activity and
phagocytosis.
It takes part in formation of granulems during
infectiousallergic diseases, increase the ability of macrophages
to destroy certain kinds of bacteria.
There are several kinds of chemotaxic factors,
each
of which is called chemotaxis of leukocytes
macrophages, neutrophiles, eosinophiles and
basophiles.
Lymphotoxins cause damage and destroying of all
different target-cells.
Interferon is secreted by lymphocytes and under
the

TYPES OF REJECTION

Transplantation rejection involves a humoral or cell-mediated

host response against
MHC antigens in the donor graft.
1. Hyperacute rejection - irreversible reaction occurs within
minutes.
Pathogenesis
1) ABO incompatibility or action of preformed anti-HLA antibodies
in the recipient directed against donor antigens in vascular
endothelium
2) Type II hypersensitivity reaction (pathologic finding: vessel
thrombosis)
Exampleblood group A person receives a blood group B heart.
2. Acute rejection, most common transplant rejection; reversible
reaction that occurs within days to weeks
1) Type IV cell-mediated hypersensitivity:
(a) Host CD4 T cells release cytokines, resulting in activation of
host macrophages, proliferation of CD8 T cells, and destruction
of donor graft cells.
(b) Extensive interstitial round cell lymphocytic infiltrate in the
graft, edema, and endothelial cell injury
2) Antibody-mediated type II hypersensitivity reaction:
(a) Cytokines from CD4 T cells promote B-cell differentiation into
plasma cells,