TABLE 6-2 MECHANISMS OF IMMUNOLOGICALLY MEDIATED HYPERSENSITIVITY REACTIONS

TYPE OF REACTION PROTOTYPIC DISORDER IMMUNE MECHANISMS PATHOLOGIC LESIONS

Immediate (Type I) Hypersensitivity Anaphylaxis; allergies, bronchial Production of IgE antibody --> immediate release of Vascular dilation, edema, smooth
asthma (atopic forms) vasoactive amines and other mediateors from muscle contraction, mucus production,
mastclls; later recruitment of inflammatorycells tissue injury, inflammation

Antibody-mediated (Type II) Autoimmune hemolytic anemia; Production of IgG, IgM --> binds to antigen on Phagocytosis and lysis of cells;
Hypersensitivity Goodpasture syndrome target cell or tissue --> phagocytosis or lysis of inflammation; in some diseases,
target cell by activated complement of Fc functional derangements without cell
receptors; recuitment of leukocytes or tissue injury

Immune complex-mediated (Type III) Systemic lupus erythematosus
Hypersensitivity (SLE); some forms of
glomerulonephritis; serum
sickness; Arthus reaction
Deposition of antigen-antibody complexes --> Inflammation, necrotizing vasculitis
complement activation --> recruitment of (fibrinoid necrosis)
leukocytes by complement products and Fc
receptors --> release of enzymes and other toxic
molecules

Cell-mediated (Type IV) Contact dermatitis; multiple
Hypersensitivity sclerosis; type I diabetes;
rheumatoid arthritis;
inflammatory bowel disease;
tuberculosis
Activated T lymphocytes --> (i) release of cytokines Pericascular cellular infiltrates; edema;
--> inflammation and macrophage activation; (ii) T granuloma formation; cell destruction
cell-mediated cytotoxicity