COLLEGE OF MEDICINE AND HEALTH SCIENCES

Department of Medical Laboratory Science

For 2nd year Midwifery students

IMMUNOLOGY

ALTERED IMMUNITY

By Abel.A
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 Altered/ disorder immune response

Hypersensitivity reaction
Immune deficiency
Autoimmune disease

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 Objectives

Upon completion of this session the student will be

able to:
• Define hypersensitivity

• Describe the classification (types) of

hypersensitivity reaction.
• Describe diseases and the mechanism of
damage associated with hypersensitivity
reactions
• Explain what mean by immune deficiency
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• Define autoimmune disease and describe
 Hypersensitivity reaction

• In normal condition

• an immune response eliminates antigen without

extensively damaging the host’s tissue

• Under certain circumstances, however, this response

can have
• excessive or inappropriate activation of the immune system
• deleterious effects, resulting in
• significant tissue damage or even death

• This inappropriate immune response is termed

11/29/2024 hypersensitivity or allergy

By Abel.A 4
 Hypersensitivity reaction…
• mediated by pre existing immunity to
self or foreign antigen
• require pre-sensitized (immune) state
of the host
• an increased response
• inappropriate immune response to an
antigen.
• may develop in the course of either
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 Classification of hypersensitivity

• Based on mechanism involved and time taken for

the reactions
• Type I (anaphylactic) reactions

• Type II (cytotoxic) reactions

• Type III (immune complex) reactions

• Type IV (T-cell-mediated) reactions

• Type I, II & III occur within the humoral branch

and are mediated by antibody or antigen-antibody
complexes
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 Hypersensitivity reaction…
Type I (anaphylactic) reactions

• known as immediate hypersensitivity

• Occur within minutes (15-30 minutes) of exposure to
antigen

• mediated by IgE

• Cross-linking of cell-bound IgE antibodies to antigen

• degranulation of mast cells or basophils and

release d/t mediators such as histamine
• Dilates and increases permeability of blood vessels

• (swelling and redness),

• increases mucus secretion (runny nose),

11/29/2024 • smooth muscle contraction

By Abel.A (bronchi) 7
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 Type I (anaphylactic) reactions…

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 Type I hypersensitive reaction…

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 Type I (anaphylactic) reactions…
It can be

• systemic : shock-like and often fatal state

• localized: Limited to a specific target tissue or organ

and
• Allergic rhinitis (hay fever): reaction of airborne
allergens with sensitized mast cells of nasal mucosa to
induce the release of inflammatory active chemicals
• Asthma: D/t allergens trigger an asthmatic attack
(allergic asthma)
• Atopic dermatitis: inflammatory disease of skin
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 Type II (Cytotoxic) Reactions

• AKA cytotoxic responses

• Mediated by IgG or IgM

binding to an antigenic cell
• activation complement
system, or
• results in the activation of
cytotoxic immune cells

• The reaction time is

minutes to hours
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 Type II (Cytotoxic) reactions…
• Cytolytic or cytotoxic effect d/t organs and tissue

• e.g Transfusion reaction

• ABO Blood group system (IgM)
• Incompatible donor cells are lysed as they enter
bloodstream
• massive intravascular hemolysis of the transfused red blood cells
by antibody plus complement

• Hemolytic disease: Rh incompatibility

• Rh negative can be sensitized to destroy Rh positive
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blood cells
 Type II (Cytotoxic) reactions…

• Hemolytic disease of the newborn:

• Ab to Rh antigen (IgG)/ Rh
incompatibility
• maternal IgG AB specific for fetal
blood-group antigens cross the
placenta and destroy fetal red blood
cells

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 Type III (immune complex) reactions
• Usually involves IgA antibodies bind to soluble antigen
• large antibody-Antigen immune complexes formed

• Deposited and not easily cleared by the phagocytic cells

• initiates a recruitment of neutrophils and release

granular
• activate complement

• developed localized reaction & can inflammatory tissue-

damaging

• e.g. Serum sickness: formation of immune complexes &

inflammation
• blood-vessel walls , synovial membrane of joints or glomerular basement
membrane of the kidney or Lung

15-Oct-24 • GlomerulonephritisBy inflammatory

Abel.A kidney damage 15
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 Type III (immune complex) reactions…

Formation of circulating immune complexes

contributes to the pathogenesis of a number of
conditions other than serum sickness
Autoimmune diseases:

Systemic lupus erythematous

Rheumatoid arthritis: joint

Infectious diseases
Post-streptococcal glomerulonephritis
Meningitis
Hepatitis
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 Type III (immune complex)
reactions…

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 Type IV (Cell-Mediated) reactions
• Called delayed-type hypersensitivity

• delayed by one or more days

• delay in time required for the reaction to develop

& cytokines to induce localized influxes of
macrophages and their activation

• Involved by sensitized lymphocytes by intracellular

pathogens
• Not induced by circulating Ab

• sensitized lymphocytes release lymphokines

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which activate leucocytes, macrophages
 Type IV (Cell-Mediated) reactions…
• Reactions are frequently displayed on the skin:
• dermatitis- itching, redness, swelling, pain.

e.g. Mycobacterium tuberculosis developed a

localized inflammatory response when injected
intra-dermally cause granulomatous reaction
• Tuberculosis skin test

• Agent:
• Poison, cosmetics, topical medication

• Latex in gloves and condoms

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 Phases of the DTH(Type IV) response

Sensitization phase
• initial sensitization phase of 1–2 weeks after
primary contact with an antigen
• TH cells are activated and clonally expanded
by antigen presented together with the
requisite class II MHC molecule on an
appropriate antigen presenting cell

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 Type IV (Cell-Mediated) Reactions

• Effector phase
• A subsequent exposure to the antigen
induces the effector phase of the DTH
response
• response generally peaks 48–72hr after
second contact
• TH1 cells secrete a variety of cytokines
that recruit and activate macrophages and

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other nonspecific inflammatory
By Abel.A
cells 22
 Summary of hypersensitive reaction

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 Summary of hypersensitive reaction

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 Review questions

Define hypersensitivity

Describe the types of hypersensitivity

reaction
Explain diseases associated with
hypersensitivity reactions

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 Immunodeficie
ncy
• Loss or inadequate function of various
components of the immune system/ body’s
defensive mechanisms
• Or an abnormality of the immune system
that renders a person susceptible to
diseases normally prevented by a normal
functioning immune system

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 Immunodeficiency…

• Can occur in any part or state of the immune

system
• Physical barrier, phagocytes, B lymphocytes, T
lymphocytes, complement, natural killer cells
• Or other homeostatic systems in the body will
be disrupted by the defect

• The immune-compromised host

• has an impaired function of immune system

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• is at high risk of infection
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 Immunodeficiency….
It can be:

• Congenital (primary) immunodeficiency

• genetic abnormality

• defect in lymphocyte maturation

• Acquired (secondary) immunodeficiency

• Results from infections, nutritional deficiencies or

treatments
• AIDS, chronic leukemia

• E.g. problem with T lymphocytes (both CD4+ helper cells )

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 Immunodeficiency
….

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 Autoimmun s B ad…
Turn
ity Whe n t he G
o o d

Definition:

• Autoimmunity: failure of an organism in

recognizing its own constituent parts as self
• immune system response to self component causes

• localized or systemic injury

• Autoimmune disease: any disease that results from

aberrant immune response to recognizing self-cells
• E.g Grave’s disease: antibodies attach to TSH receptors on
thyroid gland and stimulate production of thyroid hormone
cause Goiter (enlarged thyroid)
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 Mechanisms of Autoimmunity
 Breakdown of immunological homeostasis or

 Breakdown in regulation because of genetic

predisposition permits
• Immune stimulation
• activation of self-reactive clones of T-cells or B-cells

• Organ function stimulated, or blocked by auto Ab’s

• resulting in localized/systemic autoimmune disease

• Molecular mimicry: Cross reacting foreign Ags epitopes

between an infectious agent and its host e.g Rheumatic fever

• Sequestered Ags: some deep tissue may not exposed to

11/29/2024 immune system: Ag released from hidden location
By Abel.A 32
 Autoimmunity…
Self Ag are found in hidden location : Sequestered Ags
organ damage

Hidden Ag released

Reaches blood stream

Encounter Ag sensitive cells

Stimulate autoimmunity

e.g Rheumatoid Arthritis

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 Autoimmunity…

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 Autoimmunity…

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 Autoimmunity…

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 Rheumatic fever/heart disease

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 Applications of
Immunology
• Immunization/vaccination

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 Immunization/vaccination

• Immunity to infectious microorganisms can be

achieved by active or passive
immunization/vaccination

• Can be acquired either by

• natural processes (usually by transfer from

mother to fetus or by previous infection by
the organism) or
• artificial means such as injection of
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antibodies or vaccines
By Abel.A 39
 Immunization/
vaccination…
Vaccines
• A biological substances that stimulate the immune
system
• Prepared from pathogens that can raise a
protective immune response, without causing
illness as immunotherapy
• will stimulate the immune cells &

• help to create memory cells that can later mount a

vigorous immune response to an encounter with
11/29/2024 the real pathogen By Abel.A 40
 Vaccines…

• It can
• Prevent the debilitating and & fatal
infectious diseases.
• Help to eliminate the illness and
disability
• protect the vaccinated individual or
protect society
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 Immunization/ vaccination…

• Aim of an ideal vaccine:

• To produce the same immune protection
which usually follows natural infection
but without causing disease
• Or prepare the immune system for future
exposure to a virulent pathogen for
immediate clearance

• To generate long-lasting immunity

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• To interrupt spread of infection
 Immunization Acquired through Effect

Passive Natural maternal immunity • Elicits

• Natural Immune globin/antibody short-term
• artificial protection
immunity
Antitoxin

Active Natural infection • Elicits

• Natural Vaccines long-term
• artificial • Whole organism protection
immunity • Live attenuated: Tuberculosis
• Whole Killed/Inactivated: Anthrax
• Purified microbial macromolecules (toxins)
• Toxoids, microbial antigen or polysaccharide capsules
• DAN vaccine

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 Immunization/ vaccination…
common vaccines use
• Inactivated (killed)

• but still antigenic

• Live/altered: attenuated microorganisms

• Lose ability to cause significant disease (pathogenicity)

• Purified macromolecules from pathogen, capable of

producing an immune response
• inactivated toxins

• capsular polysaccharides

• recombinant microbial antigens

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 Review question

 Explain the important of vaccination

 List various vaccine type

 Differentiate between passive and active immunity

 Describe the difference between attenuated and

inactivated vaccines

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 THANK YOU

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