Hypersensitivity

The term hypersensitivity refers to the undesirable injurious consequences in

the sensitized host, following contact with a specific antigen.
Hypersensitivity is concerned with what happens to the host as a result of
inappropriate immune reaction.
The term allergy refers to all immune process harmful to the host, such as
hypersensitivity and autoimmunity.
Definition
Discovery of hypersensitivity (1902)
On an journey to south sea cruise
Physalia
(Portuguese man-of-war)
The aqueous extracts of the jellyfish( Physalia)
were found to be extremely toxic to
ducks and rabbits.
On returning to France
As physalia could not be obtained ,so comparatively they decided to study about
Actiniaria
(Sea Anemone)
EXPERIMENTS WERE PERFORMED ON DOGS
To find out the lethal dose of the substance
0.1ml glycerin extract
Kept on increasing the dose
Reaches an quantity
where its lethal to dog
THE SAME EXPERIMENT WAS
PERFORMED AFTER 22 DAYS ON THE
SAME DOG
Same 0.1 ml of glycerin extract
was given
In a few seconds breathing became distressful,
it was seizing with diarrhea, vomiting blood
and died within 25min.
The first dose which was given has provoked an Immune response which
recruits a group of appropriate B or T Lymphocytes.
This is known as sensitizing or priming dose
Subsequent contact with allergen causes manifestations of hypersensitivity.
This is known as shocking dose
Traditional classification
Delayed hypersensitivity Immediate hypersensitiviy
1. Appears and receeds rapidly 1. Appears slowly and lasts longer.
2. Induced by antigens or haptens by any route 2.Antigens or hapten intradermally or with
Freunds adjuvant or by skin contact.
3. Antibody mediated reaction. 3. Cell mediated reaction.
4. Passive transfer possible with serum 4. cannot be possible with serum but possible
with T cells or transfer factor.
5. Desensitisation easy,but short-lived. 5. Difficult but long-lasting.
Cytolytic and
cytotoxic
IgE type
Immune
complex
Delayed
hypersensitivity
Stimulatory
hypersensitivity
(Coombs and Gell)
Pneumonic
Clinical symptoms
Introduction to treatment
1.Prevent further contact with allergen
2. Insure airway potency
3.Administer intramuscular adrenaline
4.Administer antihistaminic
5.Administer corticosteroids

Epinephrine injection
2. Insure airway potency if not.
It causes laryngeal edema which in turn leads to bronchoconstriction
which sometimes may lead to asphyxia and death.

Due to laryngeal edema the patient cannot be intubated. In that condition
emergency tracheotomy can be performed to save the patients from asphxia.
Clinical case
A patient of age 20 yrs brought with a complaint of seizures. Suspecting of neurological problem.
She was advised to get an contrast Magnetic Resonance Imaging(MRI) by a dye
named gadolinium which give an better understanding of pathology of brain
and its blood vessels.so she was given the dye prior to the Imaging.
During the imaging she was experiencing signs of distress, dyspnea ,tachycardia.
She was immediately given epinephrine( 0.3-1.0ml, 1:1000 dilutions) but the laryngeal edema
didnt subside due to this they performed emergency tracheotomy. Here is video of the case.