prepared by MD, Marta R. Gerasymchuk, pathophysiology department of IFNMU, Ukraine

1. РATHOLOGY
OF IMMUNE
REACTIVITY.
АLLERGY
By M.D., Marta R. Gerasymchuk
PATHOPHYSIOLOGY DEPARTMENT
IFNMU 20.09.2012

2. Resistance is a state of insusceptibility of an
organism to the influence of pathogenic factors.
There are such types of resistance:
► active and passive,
► primary and secondary,
► specific and unspecific.
Active resistance is a result of the organism adaptation to the long
time pathological factor influences.
Passive resistance is a result of anatomical and physiological
peculiarities of each organism.
Primary (congenital) resistance is a result of the inherited
peculiarities of an organism and it manifest itself after birth of the
person.
Secondary (acquired) resistance is a result of organism functional
reactions changes, which occur during the whole life.
Unspecific resistance is the opposition to the influence of many
pathological agents.
Specific resistance is the opposition to the defined agent influence,
for example, microorganisms; its result is activation of the
immune system.

3. Reactivity is ability of the organism to
alter functional activity of the systems
and organs for the adaptation of
organism to new conditions of the
environment for the survival. The
concept “reactivity” is connected with
the concept “resistance”.

4. Types of reactivity
There are biological reactivity and individual reactivity.
Biological reactivity is a result of the morphological
and physiological peculiarities of all individuals, which
are of the same biological species. For example: some
species of birds, fishes, and animal change the vital
activity according to the changes of the seasons.
Individual reactivity is the reactivity of every individual.
Individual reactivity is determined by age, sex, heredity,
constitution, and functional conditions of organism’s
regulatory systems, external environmental influences.
For example: some diseases arise only in infant
organism (measles, roseola, small pox, rachitis, scarlet-
fever) but not in adult’s one.

5. Individual reactivity of an organism is realized by
specific and unspecific mechanisms.
• The specific mechanisms are formed by immune system.
There are physiological specific mechanisms and pathological ones.
• The specific physiological mechanisms of the individual reactivity are
the immune reactions, which form the specific resistance to some
antigens (bacteries, viruses, fungus, tumours cells).
• The pathological specific mechanisms of the individual reactivity can
cause development of the immunodeficiency or immunodepressive
conditions of an organism or the allergic reactions and diseases.
• The unspecific mechanisms of the reactivity are
physiological and pathological.
• Physiological unspecific reactivity is the vital reactions complex of
the healthy organism in normal life conditions.
• Pathological unspecific reactivity is the complex of an organism’s
reactions in abnormal life conditions as a result of the decrease of the
adaptive potential of an organism (for example: shock, collapse,
narcosis).
Mechanisms of the unspecific reactivity are realized by means of nervous
system reactions (central nervous system, vegetative nervous system),
endocrine system reactions; barrier systems; cell’s reactions; humoral
reactions.

6. barrier systems
The barrier systems preserve an organism
against the pathological factors of the
external environment. There are external
and internal barriers.
The external barriers
• The external barriers are skin, mucous
membranes, liver, spleen, lymphatic
nodes and other organs, which have the
cells of the system of mononuclear
phagocytes.

7. Internal barriers
• There are internal barriers in the organism, which are
named histohematic barriers. Wall of a capillary has
the function of a barrier. The wall of a capillary lets in
only the nutritious substances and does not let in the
toxins, medicines.
• Examples of internal barriers:
1. hematoencephalic (blood-brain),
2. hematoophtalmic (blood-eye tissue),
3. hematolabirintic (blood-lymph of a labyrinth),
4. hematoovarial (blood-ovarium tissue),
5. hematotestical (blood-testicular tissue)
6. hematothyriod (blood-thyriod tissue),
7. placenta (mother’s blood-foetus blood).
• Connective tissue, which surrounds the vessels and
penetrates into a tissue, executes the protective function
too.

8. Components of the Adaptive
• antigens Immune System
• antibodies
• lymph system
• lymphocytes Antigen
– B cells
– T cells Antibody
– NK cell (Natural
Killer) B cell
T cell
NK cell

9. 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.

10. 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.

11. Classification of allergens
I. By the structure the allergens are divided
into:
Complete (valuable) – at penetrating into the
organism they cause the formation of antibodies
or sensitized T- lymphocyte. After the chemical
structure they are proteins.
Incomplete (partial) – at penetrating into the
organism they contact with the organism’s
proteins (the conjugated connection). At the same
times complex antigens are generated which are
capable to sensitize the organism i.e. to cause the
formation of antibodies and sensitized T-
lymphocyte. After the chemical structure they are
haptens.

12. All allergens are divided into two groups – exogenous and
endogenous allergens (autoallergens).
Exogenous allergens come into the organism from outside,
endoallergens are formed in the organism. There are few allergens
classifications. According to the origin exogenous allergens are divided
into following groups:
a)allergens of noninfectious origin:
•epidermal,
•home,
•pollen,
•food,
•industrial and officinal;
b) allergens of infectious origin:
•bacterial,
•fungous,
•viral.
Domestic allergens. Main role among them domestic dust plays,
which includes particles, bed-clothes, furniture, bacteria.

13. Canine and cat allergens
Epidermal allergens. To this group refer: scurf, wool, birds, fur, fish, scales.
Professional sensitization by epidermal allergen is observed in sheepmen,
horsemen, poultry farms workers, hairdressers.

14. Officinal allergens. Any officinal preparation
with a little exception causes the development of
an officinal allergy. Medicines or their
metabolites are, as usual, haptens. In case of
sensitization of the organism to one preparation,
allergic reactions to other medicines, having
alike chemical structure can arise.
Pollen allergens
Pollen allergens. Allergic diseases are caused by shallow plants, pollen. It is called
pollinosis. The diverse types of pollen can have the general allergens, therefore in
pollinosis
people, sensitive to one type of pollen, a reaction on its other kinds is possible.

15. Food allergens. Many food products can
be by allergens. They are usually fish,
wheat, beans, tomatoes, milk, eggs.
Chemical substances added to food products
(dye-stuffs, antioxidants, aromatic and other
substances) may also be allergens.
Food allergens

16. Industrial allergens. The industrial
allergens for the most are haptens. In each
industrial production a particular admission of
chemical matters is used. These are: resin,
glue and covering materials, plastics, dye-
stuffs, metals and their salts, wood products,
latex, perfumer substances, washing means,
synthetic cloths and others.
Washing means

17. Allergens of infectious origin. Those
infectious diseases, in pathogenesis of
which allergy plays a leading role, were
named infectiously allergic. These are all
the chronic infections (tuberculosis,
lepra, brucellosis, rheumatism,
syphilis, chronic candidosis etc.). The
widespread allergens are the fungi. Lepra
Many nonpathogenic fungi while
entering the organism cause
sensitization and development of
diverse allergic diseases (bronchial
asthma). Such fungi are contained in
atmospheric air, dwellings, domestic dust,
food products. With biotechnological
development a possibility of sensitization
on enterprises on production of stern
squire, vitamins, antibiotics, enzymes
arises. Fungi

19. The ways of the allergens penetrating
into the organism:
 Enteral (alimentary, nutritional, nutritive
way).
 Inhalation.
 Parenteral.
 Contact.
 Transplantation.

20. Pathogenesis of allergic reactions
R.A.Cook picked out allergic reactions of
•immediate type and
•allergic reactions of delayed-type or
hypersensitization of delayed-type.
delayed-type
In the base of classification the time of appearing of
reaction after contact with allergen has been placed.
The reactions of immediate type developed during
15-20 minutes,
delayed-type – after 1-2 days.
However it does not envelop all the variety of
allergy displays. For example, some reactions
develop over 4-6 or 12-18 hours.

21. CLASSIFICATION OF ALLERGY
BY R.A. COOK
Immediate-type allergy
1. Anaphylaxis
2. Serum sickness
3. Atopic allergy
а) pollinosis (hay fever,
rhinitis, conjunctivitis)
b) bronchial asthma
c) Hives
d) Quinke’s edema

22. Delayed-type allergy
 1. Bacterial
 2. Contact dermatosis
 3. Autoallergy
 4. Transplant rejection

23. I – IgE,
II, III – IgM, G,
IV – T-effectors,
The classification by V - IgM, G
P.Gell, R.Coombs is HYPERSENSITIVITY
widely spread in the world. It
is based on pathogenic
principle.
IMMEDIATE DELAYED
By Rought (in 1980)
V type - stimulating.
TYPE I TYPE II TYPE III TYPE IV
Ig E - mediated Cytotoxic Immune Complex Cellular
23

24.  Lymphocytes are heterogenic according to their functions, markers,
receptors.
 The T-lymphocytes acquire the specific antigen receptors, with the help of
which they identify an antigen and other markers.
 There are such types of T-cells: T-helpers, T-effectors. The last ones form
sensitized lymphocytes or killers, which participate in realization of allergic
reaction of delayed-type and realize cytotoxic action on cell-target.
 The B-lymphocytes produce 5
classes of immunoglobulins
IgG, IgM, IgA, IgE, IgD.
 These cells during ripening
acquire the receptors for
antigen on their membranes.
 During binding of such B-cells
with proper allergens and after
the signal, received from T-
helper, they become activated,
and proliferation and
differentiation into antibody
producing cells starts.

25. Immune Response Summary
Displays copy of antigen
on surface of cell
Antigen
Macrophage
Cellular Immunity Helper T - Cell Antibody Immunity
Active Cytotoxic T-Cell Active B - Cell
Kills Infected Cells Memory T- Cell Plasma Cell Memory B-Cell
Antibodies
Deactivates Antigens

26. Cellular Immunity .vs. Antibody Immunity
Cellular Immunity Antibody or Humoral Immunity
• Carried out by T-Cells • Carried out by B-cells
• Infected cells are killed by • Antibodies are produced
Cytotoxic T –Cells. and dumped into blood
stream.
• Antibodies bind to
antigens and deactivate
them.

27. Antibodies
• agglutination and
precipitation
– enhances phagocytosis by gathering
antigens into clumps
• opsonization
– coating an antigen with antibody
enhances phagocytosis

28. Antibodies

29. THE PATHOGENESIS OF
ALLERGIC REACTIONS
Stage I: immunological.
Stage II: pathochemical changes.
Stage III: pathophysiological changes.

30. 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, organs and tissues of
the organism with a clinical display.

31.  Sensibilization is the
immunologically mediated
increasing sensitiveness of
the organism to the allergens.
 Sensibilization
(sensitizing) are:
 active (independent
production of immunoglobulin
by the organism)
 passive (introduction of the ready antibodies from
actively sensitized animals). The synthesis of the
antibodies begins on the 3rd - 4th day after the first
penetrating of the allergen and achieves the maximum
in 2 weeks.

32. Type I hypersensitivity
reaction
• IgE and IgG4 are formed as an
answer to penetrating of allergen
into the organism. They get fixed
on the mast cells and basophiles
of blood.
• These cells have on their surface
Fc-receptors for immunoglobulin.
The state of sensitization of the
organism appears. If the same
allergen again gets into the organism
or it still stays in the organism after
the first penetration, connection of
antigen with IgE-antibodies occurs.
The same thing is observed with
IgG4. They bind with their receptors 1. Initial antigen contact
on basophiles, macrophages,
eosinophiles, trombocytes.
Depending on the quantity of
molecules of IgE-antibodies
connected to antigen, quantity of
antigen we can observe either
inhibition of activity of the cell or its
activation and transfer of the process
to the next, pathochemical stage.

33. Stage II (pathochemical)
 At the repeated
penetrating the allergen
associates with the
Fc-fragment of IgE
activating of basophiles activation
of arachidonic acid cascade is
liberation of prostaglandins and
leukotrienes degranulation of
mast cells (the freeing of biologically
active substances (BAS).

34. • Activation of the mast and
basophile cells leads to
releasing of different
mediators.
• Histamine is localized in ready
form in granules of the mast
cells and basophile leucocytes.
In the blood of healthy people
histamine almost totally stays
in basophile leucocytes.
• Histamine acts on the tissues
cells through the receptors of
two types – H1 and H2. Their
correlation and spreading on
the cells of different cells is
different.

35.  Stimulation of H1 promotes to contraction of smooth
muscles, endothelial cells and postcapillary part of
microcirculation. This leads to increasing of permeability of
vessels, development of edema and inflammation.
 Stimulation of H2 causes the opposite effects.
effects
 Besides this releasing of histamine from basophile leucocytes and
from the lungs is diminished through them, the function of the
lymphocytes modulates, formation of migration ingibitory factor
(MIF) by T-lymphocytes gets
oppressed, releasing of
lysosome enzymes by
neutrophile leucocytes
diminishes as well. In many
cases the increasing of
quantity of histamine in blood
is observed in the intensive
stage of bronchial asthma,
nettle-rash, officinal allergy.

37.  Stage III.
 Under the influence of mediators the permeability of vessels and
chemotaxis of neutrophiles and eosinophiles increase, which leads
to development of inflammatory reaction.
 The increasing of permeability of vessels promotes the exit of
fluid, immunoglobulins and complement into tissues. With the help
of mediators and also through the IgE-antibodies, the cytotoxic
effect of macrophages is activated, secretion of enzymes,
prostaglandins and leukotriens, trombocyte activating factor is
stimulated.
 The released mediators cause also a damaging action onto cells
and connective tissue structures.
 Bronchospasm develops in respiratory organs. These effects are
clinically manifested by attacks of bronchial asthma, rhinitis,
conjunctivitis, nettle-rash, skin itch, diarrhea.
 They distinguish the local reactions of the anaphylactic type.
E.g.: bronchial asthma, pollinosis (or pollen disease, grass pollen
allergy, hay fever), nettle-rash (or hives)
and general ones (anaphylactic shock).

39. ► Is the Most Dangerous Form of a Type I
Hypersensitivity
► Allergens in the bloodstream can trigger mast
cell degranulation that contracts smooth
muscle
► Small veins constrict and capillary pores
expand, forcing fluid into the tissues
 A drop in blood pressure, edema, and rash
occur
► Contractions in the gastrointestinal tract and
bronchial muscles cause cramps and
shortness of breath
► The lungs fill with carbon dioxide
 This can cause death by asphyxiation in 10-15 39
minutes

40. 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 develop,
danger for the life of the patient appears.

43. Cytotoxic reaction
• Antigens:
a) components of membranes of own cells (unchanged and
changed under the action of different factors);
b) antigens are fixed (adsorbed) on cellular membranes (for
example, medicinal preparations);
c) noncellular components of tissues (collagen, myelin).
• Antibodies: IgG1, IgG2, IgG3, rare Ig M and Ig A.

44. THE PATHOGENESIS OF THE CYTOTOXIC TYPE ALLERGIC
REACTIONS
► Stage II:
Mediators of the cytotoxic type allergic reactions:
► Complement components; Lysosomal enzymes;
► Oxygen’s radicals; TNF;
► Perforin (channel - forming protein) .
The damage of the cell with the antigen properties
may be caused by three reasons:
► the 1st variant – complement-mediated cytotoxicity . Cytotoxic type of the
► the 2nd variant – antibody-mediated immune clearance allergy can be a
(phagocytosis ). manifestation of
► the 3rd variant – antibody-dependent [cell-mediated] officinal allergy with
cytotoxicity
the development of
leucocytopenia,
Stage III: trombocytopenia,
► Remedies [medicamentous] allergy;
hemolytic anemia etc.
► Hemolytic anemia (illness) of newborns; This may also happen
► Post transfusion reactions (shock) in incompatible in blood transfusion
and also in rhesus
blood transfusion after the groups of АВО or Rhesus factor;
► Auto allergic diseases. incompatibility of
mother and fetus.

46. Pathogenesis of immune complex diseases
Immunological stage. Many exogenous and endogenous antigens participate in
formation of immune complexes. Among them there are officinal preparations (penicillin,
sulfanilamides), antitoxic vaccines, allogen gamma-globulins, food product (milk, egg
white), inhalation allergen (home dust, fungi).
An antigen and antibody are in the free state (not fixed on the surface of cells). Their co-
operation takes place in blood and other liquids of organism. In case of penetration of
soluble antigen into the organism IgG and IgM antibodies are formed. These antibodies
can cause the formation of precipitate and connection to antigen.
Immune complex can be formed in tissues or in blood flow.
Pathochemical stage. Under the influence of immune complexes the following
mediators are formed: fragments C3a, C5a, C4a of the complement, lyzosomal enzymes
of phagocytes, kinines, superoxyde anion-radical.

47. Pathophysiological
stage. Usually immune
complexes are placed on
vessels of cannalicular
apparatus of kidneys,
inflammation with alteration,
exudation and proliferation
(glomerulonephritis)
glomerulonephritis
develops, in case if the
complexes are placed in the
lungs alveolitis appears, in
skin – dermatitis.
The inflammation may lead to formation of ulcers, hemorrhages,
thrombosis is possible in the vessels. This type of allergic
reactions is the prominent one in development of serum, some
cases of officinal and food allergy, some autoallergic diseases
(rheumatoid arthritis, systemic red lupus erythematosus). In
case of massive activation of complement anaphylactic shock,
bronchial asthma may develop.

48.  In systemic lupus
erythematosus (a.k.a.
SLE, lupus), nuclear
components of
disintegrating white blood
cells elicit IgG production
 Immune complexes
aggregate in the skin and
organs, causing rash and
lesions
 Rheumatoid arthritis
(RA) is an inflammatory
condition resulting in
accumulation of immune
complexes in joints 48

49. Cell-Mediated Immunity
cytotoxic T cells recognize
the non-self cell and induce apoptosis
(cell self death) in the viral infected or
other microbial infected cell
– this process also recognizes cancer cells and
destroys them
– unfortunately this process also recognizes
and destroys non-self
tissue or organ
transplants

50. Immunological stage. Cell-mediated hypersensitivity reaction
☻ The foreign antigen is
1. Initial contact with antigen
phagocyted by macrophages
and get to T-helpers.
☻ At the same time
macrophages secrete IL-1,
which stimulates T-helpers.
T-helpers
The latest excrete the growth
factor pro-T-lymphocytes –
IL-2, which activates and
supports proliferation of
antigen stimulated T-cells.
☻ This process leads to
formation of sensitized
lymphocytes.
lymphocytes
☻ They belong to T-
lymphocytes and in the cell
membrane they have
receptors of the antibody
type, which are able to
connect with the antigen.
antigen
☻ In case of repeated
penetration of the allergen
into the organism it binds
with the sensitized
lymphocytes.
lymphocytes

51. 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,
lymphokines
interleukines, chemotaxic factors, factor of transfer)
mobilization of different cells (macrophages, polymorph-
nuclear), 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.
phagocytosis
It takes part in formation of granulems during infectious-
allergic diseases, increase the ability of macrophages
to destroy certain kinds of bacteria.
• There are several kinds of chemotaxic factors, each
factors
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
influence of α-interferon and nonspecific mitogens. It
acts a modulating influence on cellular and
humoral mechanisms of immune reaction.
• Besides lymphokines, lizosome enzymes also provide
a damaging activity. They are released during
phagocytosis and destroying of cells. Kallikreine-kinine
system is also activated. Histamine doesn’t play a big role
in this type of allergic reactions.

52. Pathophysiological stage. A particular form of
lymphokines (lymphotoxin, interferon) shows a cytotoxic
action and decreases activity of cell. In allergic reaction of
delayed type damaging action may develop in several
ways:
• 1) direct cytotoxic action of sensitized T-lymphocytes
on target-cells, which acquired autoallergen properties;
• 2) cytotoxic activity of T-lymphocytes, mediated by
lymphotoxin;
lymphotoxin
• 3) releasing of lysosome enzyme, which damage tissue
enzyme
structures during phagocytosis.
• Inflammation that is associated to immune reaction by
action of mediators is a component of allergic reaction of
delayed-type. Nevertheless inflammation is at the same
delayed-type
time a factor of damage of function of the organs.
• Allergic reactions of delayed type make the base of
development of infectious-allergic diseases (tuberculosis,
lepra, brucellosis, syphilis), rejection of transplant, and
transplant
autoallergic diseases (disturbance of nervous system,
endocrine glands etc.).

54.  Contact dermatitis
develops after
exposure to a variety
of allergens
– Repeated exposures
cause drying to skin
with erythema and
scaling
54

55. • Transplantation of Tissues or
Organs Is an Important Medical
Therapy
– An autograft is a graft taken
from one part of the body and
transplanted to another part of
the same body
– An isograft is a graft from one
identical twin to the other twin
– Allografts are grafts between
genetically different members of
the same species
– Xenografts are grafts between
members of different species
(rarely successful)
55

58. Pseudoallergic reactions
• Pseudoallergy is a pathological process, which is clinically similar
to allergy but doesn’t have an immune stage of its development.
Pseudoallergy differs from a simple one by the absence of first (immune)
(immune
stage. The rest two stages – releasing of mediators (pathochemical) and
pathochemical
pathophysiological (stage of clinical manifestations) are the same both in
manifestations
pseudoallergy and a real one. To pseudoallergic reactions refer only
processes in the development of which the leading role play mediators,
which are formed also in pathochemical stage of true allergic reactions.
• The reason of pseudoallergy is any substance that acts directly on effector
cells (fat cells, basophiles etc.) or biological fluids and cause releasing of
mediators from the cells or production of them in the fluids. Practically most of
the allergens can lead to development of both allergic and pseudoallergic
reactions. This depends on nature of the substance, its phase, frequency of
introduction into the organism and reactivity of the organism. Pseudoallergic
reactions usually occur in officinal and food intolerance. Many remedies more
usually lead to development of pseudoallergy than true allergy.
• Clinical picture of pseudoallergic diseases is close to one of allergic diseases.
Development of such pathological processes as increasing of permeability of
vessels, edema, inflammation, spasm of smooth muscles, destroying of blood
cells lay in the base of this clinical picture. These processes may be local, organic
and systemic. They are presented by rhinitis, nettle-rash, Kvinke’s edema,
periodical headaches, disturbance of gastro-intestinal tract, bronchial asthma,
vaccine disease, anaphylactic shock and also damaging of certain organs.

59. Preventing of allergy. Hyposensitization
• Prophylaxis of an allergic disease depends on its character and group of the allergens. It
consists of measures of preventing of penetration of given allergen into the organism
and preventing of the influence of different irritating factors on the organism. If
sensitization has already occurred and allergic diseases has already started, the
following measures are appropriate.
• 1. Suppression of antibodies and sensitized lymphocytes production with the help of
immune depressants, ionizing radiation, cytostatics, specific lymphocyte vaccines and
monoclonal antibodies.
• 2. Specific desensitization by Bezredka. Desensitization is provided by little doses of the
Bezredka
antigen, which do not cause severe reactions. The doses are introduced repeatedly after
certain intervals of time, during which produced mediators get inactivated in the
organism. The main dose of the antigen is introduced after antibodies binding. This
method is effective in introduction of foreign medical vaccines.
• 3. Inactivation of biological active substances. For this purpose antihistamine
substances
preparations, inhibitors of proteolytic enzymes etc. are introduced.
• 4. Protection of the cells from the influence of biological active substance and also
normalizing of functional disorders in organs and systems (narcotic,
spasmolytic substances,
receptor blockers etc.).

60.  Immunodeficiencies Can Involve Any
Aspect of the Immune System
 Primary immunodeficiency is the result of a
genetic abnormality
 Secondary immunodeficiency is acquired later
in life
60

61.  X-linked (Bruton) agammaglobulinemia is a
congenital humoral immunodeficiency
 B cells fail to develop so patients lack mature
B cells, plasma cells, and antibodies
 It is a sex-linked trait, more common
in males than females
 In DiGeorge syndrome, the thymus fails to
mature in the embryo so T cells do not develop
 Patients with Ataxia-Telangiectasia:
 have malfunctioning B and T cells
 are deficient in IgA and IgE
 Paralysis and dementia lead to death by age 30 61

62. ► Severe combined
immunodeficiency
disease (SCID) involved
lymph nodes deficient in B
and T cells
 One form is caused by an
enzyme deficiency that can be
corrected using gene therapy
► In Chédiak-Higashi
syndrome , lysosome within
phagocytes cannot release
their contents to kill microbes
► In chronic granulomatous
disease, phagocytes do not
produce substances to kill
microbes 62