Sumadiono

Pediatric Department
Faculty of Medicine
Gadjah Mada University
1
Yogyakarta

Block 8 - 2003

school of medicine - gadjah mada

university

Immune System

NONSPECIFIC

SPECIFIC

Block 8 - 2003

IMMUNOPATHOLOGY

Immunopathology
Immunodeficiency

Hypersensitivity

Autoimmune

Allergies Definition
are abnormal reactions of the immune
system that occur in response to otherwise
harmless substances.

TERMINOLOGY
. Allergen A substance that provokes an
allergic response.
Allergist. A doctor who diagnoses and
treats allergy-related conditions

 Anaphylaxis. A life-threatening allergic reaction

involving the entire body. Anaphylaxis requires
immediate medical attention.
Antihistamines. These drugs block histamine
a chemical the body releases during an allergic
reaction -- reducing symptoms such as itching,
sneezing, and runny nose.

 Allergic rhinitis Inflammation of the mucous

membranes of the nose and eyes in response to
an allergen.
Anaphylaxis Increased sensitivity caused by
previous exposure to an allergen that can result
in blood vessel dilation and smooth muscle
contraction.
Anaphylaxis can result in sharp blood pressure
drops and difficulty breathing.
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 Antibody A specific protein produced by the

immune system in response to a specific foreign
protein or particle called an antigen.
Antigen A foreign protein to which the body
reacts by making antibodies.
Asthma A lung condition in which the
airways become narrow due to smooth muscle
contraction, causing wheezing, coughing, and
shortness of breath.
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 Conjunctivitis Inflammation of the thin

lining of the eye called the conjunctiva.
Contact dermatitis Inflammation of the skin
as a result of contact with a substance.
(An allergic reaction that occurs after skin comes
in contact with an allergen such as poison ivy,
washing powders, perfumes, or other irritants)
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 Decongestants. Medications that shrink swollen

nasal membranes, decreasing congestion and
mucus, and making it easier to breathe.
Eczema. Chronic inflammation that causes a skin
rash.
Symptoms include itching, crusting, blisters, and
scaling.
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 Mast cells A type of immune system cell that

displays a type of antibody called
immunoglobulin type E (IgE) on its cell surface,
participates in the allergic response by
releasing histamine from intracellular granules.
T cells Immune system cells or more
specifically, white blood cells, that stimulate
cells to create and release antibodies.
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 Epinephrine. A drug used to immediately treat

severe allergic reactions. Also known as
adrenaline.

Allergic rhinitis. an inflammation of the mucus

membranes in the nose.
Symptoms include sneezing, itching, runny nose,
and nasal congestion.
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 Histamine. A chemical released by cell mast

after it's exposed to an allergen.
It causes tissues to become swollen, inflamed,
itchy, and red.
Urticaria/Hives. An allergic reaction of the skin.
Symptoms include itchy, swollen, red bumps that
appear suddenly: lips, tongue, and ears.

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 Nasal spray. Over-the-counter or prescription

drugs that can treat and prevent nasal symptoms
such as congestion and runny nose.
Pollen. a fine, powdery substance released by
trees, grasses, weeds, and flowering plants.

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Rising Prevalence

Aberg. Clin Exp Allergy.

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1995.95:815. Swedish Children

ALLERGIC DISEASES :

Impact on the quality of

life
Impact on work and school
Economic burden
Fatal?
Worldwide Variation in 12-month (ISAAC)
Lancet 1998
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EPIDEMIOLOGY
Allergic Rhinitis : 7.8%
Worldwide, 10% - 30 % of the population.
Drug Allergy
Worldwide: 10% & 20% :hospitalized patients
Food Allergy: 8%
6%: 0-2 years , 9% : 3-5 y, 8%: 6-18y
38.7% : food allergic severe reactions

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EPIDEMIOLOGY
Skin Allergy: 13%
Black children:17%, white:12%, Asian: 10%
children.1
Urticaria: above 20%
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EPIDEMIOLOGY of Urticaria &

Angioedema
ALL AGE
20% OF POPULATION
URTICARIA + ANGIOEDEMA: 49%
URTICARIA ONLY: 40%
ANGIOEDEMA ONLY: 11%
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Epidemiology of Atopic Dermatits

10-20% : >> infant and children
Can continue until adult
Male : Female = 1: 1

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ASTHMA BRONCHIALE
SUSPECTED:
WHEEZY,
EPISODIC,
NIGHT,
POST
ACTIVITY
ATOPY
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Asthma prevalence, children and young

adults

Asthma
prevalence,
children and
young adults

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25

Prevalence of asthma, allergic rhinitis, and atopic

eczema in young Finnish men: 1966-2003

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Allergy

Allergy is a hypersensitivity reaction initiated

by immunological mechanisms
Allergy can be antibody-or cell-mediated. In the
majority of cases the antibody typically
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Allergens
Allergens are antigens which cause allergy.
Most allergens reacting with IgE antibody
are proteins

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Atopy
Atopy is

A personal and/or familial tendency

to become sensitized and produce IgE
antibodies in response to ordinary exposure
to allergens
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HYPERSENSITIVITY REACTIONS
GELL & COOMBS: 4 TYPES
Tipe-I: HYPERSENSITIVITY/ANAPHYLACTIC

Tipe-II: CYTOTOXIC

Tipe-III: IMMUNE COMPLEX

Tipe-IV: CELL MEDIATED

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Type I:

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non IgE mediated

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Type II:

NK cell

Target
cell

Target
cell
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Type III:
Immune complex

Complemen

Ab

Ag

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Type IV:

T cell

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Incidence of different types of allergic

diseases by age

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Allergic March
ATOPY

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Allergic March
ATOPY
FOOD ALLERGY
ATOPIC
DERMATITIS

ASTHMA
ALLERGIC
RHINITIS
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Causes and symptoms

Allergens enter the body through four main routes:

Airways
Skin
Gastrointestinal tract
Circulatory system.
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Types of Allergen
Ingestion

Injection

Inhalantion

Skin Contact

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DUST MITE

INHALANT ALLERGEN

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INHALANT ALLERGEN
Correlation Between Exposure and
Sensitization to

Cockroach

in Asthmatic Patients

SPT positive to cockroach: 52 %

Positive SPT result of American Cockroach in
American Cockroach exposure: 75 %
Positive SPT result of German Cockroach in
German Cockroach exposure: 40 %

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MOLD

POLLEN

INHALANT ALLERGENS

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DOG?
CAT?

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29
12

22
15

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16

15
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13
6

87

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30
25
20
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0

FOOD ALLERGENS

adult
dewasa

49

Prevention

50

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