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.
.
:
(1 Nature of Antigen
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(3 Amount that Enter
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Pencilline :
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) ((Anaphylactic Shock).
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Dermatitis
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Serum Sickness .

IgE IgA.
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.


.

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. Fc
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Histidin Decarboxylase .

.
H1 H2
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.
IL-8 8 .
.IgE

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. 48



. 13 5 4 3
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.(Methacholine
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11

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.

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.

Complement-Mediated Reactions

, .

12

 Fc .C3b
Fc .C3b
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)
( -
IgGFc .

)Antibody-Dependent Cell-Mediated Cytotoxicity (ADCC
Fc
) ,
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.
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T )
perforin .granzymes
, .
, ,
,
.

FcIII) IgGFc .(CD16
IgG IgG1 IgG3

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) (FcRII , ,
Fc IgE )
(.

Antibody-Mediated Cellular Dysfunction

. ,
.
,
.

Examples of Cytotoxic Hypersensitivity Reactions

Transfusion Reaction
.
, O ,
, A IgM B

13

, A ,B .
A , .
A ,
.
IgM ) IgM
( ,
.


.

Drug-Induced Reactions
,
.
, .
. ,
, .
)
( . )purpura
( ) , , ( ,
.
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) ( ) (
.

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,
:
Fc .C3b

Rhesus-Incompatibility Reactions

.Rh
Rh
%85
.
+Rh ) (%15
.-Rh -Rh -Rh
.+Rh
.
IgG Rh
IgG .

14


IgG Rh
IgG . Rh
.

Fc IgG
Fc .


.
Rh " Rh "
72 .
+Rh .
Rh " "Rhogam
D
.Rh
.
Autoimmune Reactions Involving Cell Membrane Receptors

"myasthenia
."gravis ))
acetylcholine receptors
.

- )) Grave's disease
))Thyroid Stimulating hormone
) (TSH ) (Thyroid epithelial cells
.

:
Autoimmune Reactions Involving Other Cell Membrane Determinants

) ( .


Fc C3b

)
(
.
)
(
) (

15

 Fc
C3b



.

IgE
,


.
:
Immune Complex Reactions: Type III Hypersenstivity

-
IgG Fc .
C3b
) .(Kupffer cells -


.

.

((Arthus reactions
.
DNA
)(SLE
)(Systemic Lupus Erythromatous
.

.
-
) .(Glomerular Disease -

.

)
( .
, ,
) , C3a .(C5a

)( ) , (
.

16


IgG IgM .
, CD16
.
- / )
( . C3a C5a

, .

. )TNF-
( ,(IL1) 1
).(PDGF-Platelet Derived Growth Factor

:
Systemic Immune Complex Disease: SLE


.
.

.

.
IgG Fc
.
.

.
.

.


.
.
)) .Serum Sickness
.
" "
. .

.
.



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17


.

.
heterologous


.
.
.


.
.
Infection-Associated Immune Complex Disease

.Rheumatic) (fever
group A streptococci
.

.

.
.
IgM Fc IgG.

.

.

"" ) syndrome) Goodpasture .


(Degradative
.( enzyme ""
.
.


.
.
) (

.

18


.
) .(Complement Deficiency
.
C3b .CRI

.


.
. C1 C2 C4
.


.
.
Localized Immune Complex Disease
1903
.
.
24 .
.

. " "
.
.

IgG .
)
( ) (-Venules

.
.
.

" ."farmers lung
)Extrinsic
(allergic alveolitis .

.
8 6 .
IgG
thermophilic .

19


.




.

T
) (

T
.

T




T
T
.
)Antigen
(APC) (Presenting Cells T

Monocytes ) .(Macrophages

.



.

)General Characteristic and Pathophysiology of Delayed-Type Hypersenstivity (DTH

. :

.

:
-1 TH1 .
-2 TH1 .

20

 -3 .
) 72-24(
.
) (DTH
.

Mechanisms of DTH
DTH
.

. ) (
) (TH1
)) (DTH ( . .10

.
24 72

.
) DTH (.
) (TH1

) ) Interferon- .
)(TH1
.
.(IL-12) 12 )(IL-12
) (TH2 ) (TH1
. ) (IL-12
.
.
) ( CD8+ T cells
.
) (CD8+ T cells
)
(


MHC
).( CD8+T cells
DTH
Consequences of DTH

.
DTH
.

21

 IFN-
.
.

:DTH
DTH
.
:
Contact Sensitivity
DTH

.
) 72 48( . DTH
)poison ivy dermatitis (
poison ivy vine .


) ( )
( ) (


. ) (2,4Dinitrochlorobenzene

.
. T


.
.

.
TH1
.DTH
)( DTH

.
T


.

22


3
.

Granulomatous Hypersensitivity

.

.

.
) 28-21(
.

.
.
.

.DTH

DTH CD8 + T
.

Tuberculine-Type Hypersensitivity

72-48 .

.
DTH . ,
, PPD (Purified protein
) .derivative PPD ) (Mantoux test
.

72-48 72
.
.
,
.
,
. ,
.
)B (B-cells

23

 . ) (Fibrin
.

PPD ,
.
)
( PPD
T .
, PPD

,
M. bovis
. ) M. bovis bacillus Calmette-Guerin (BCG
.

. BCG

.

Allograft Rejection

) (
.
,MHC T .
.
T
.
.
DTH
Additional Examples of DTH

, ) 24(
.
,
.
T MHC T .
,

T .

.
, ,
.
.

24

 . ,

.
.
DTH
. DTH ,
. DTH
DTH
.
DTH
T DTH

. Steroids
.DTH DTH

,

25