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Summary module 6 Immunotechnology (CBI-30806)

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Summary of module 6 of the course Immunotechnology (CBI-30806)

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  • 19 maart 2021
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  • 2019/2020
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Module 6: Hypersensitivity
Hygiene hypothesis
Incidences of infectious disease have been reduced and autoimmune and inflammatory disorders
have increased by a change in life-style in industrialized countries  hygiene hypothesis
 Maybe due to imbalance Th1 vs. Th2
o Th1-promoting viral and bacterial infections would educate the immune system
o Preventing the development of excessive and allergy-promoting Th2
o Would only explain Th2 disorders (asthma and allergies) not Th1/Th17 disorders
(multiple sclerosis, type 1 diabetes)
 Maybe due to prevalence of helminth infections
o Inversely correlated with the prevalence of inflammatory disorders
o Both helminths and allergens elicit Th2-mediated immune responses
o Infected children produce much anti-inflammatory cytokine IL-10
o IL-10 is regulated by Tregs just like anti-inflammatory TGF-β1
o IL-10 and TGF-β1 are able to control both Th2-mediated allergies as well as
Th1/Th17-mediated inflammatory disorders
 Therefor, infections, and infection experience, are believed to be key in maintaining the
balance between regulatory T cells, on one side, and active Th1, Th2 and Th17 cells on the
other

Stimuli of hypersensitivity diseases
Hypersensitivity inducing antigen sources:
 Excessive response to invading microbes causing chronic inflammation
 Reactions against environmental antigens by overproducing IgE causing allergy/type 1
hypersensitivity
 Reactions can be triggered against auto-antigens causing auto-immunity

With hypersensitivity the response is triggered and maintained inappropriately caused by distortion
of the delicate balance between different T helper subsets (Th1, Th2, Th17, Treg) and within specific
T helper cell responses

Classification of hypersensitivity disorders
Four categories of hypersensitivity:
 Immediate hypersensitivity (type I)
o Caused by IgE specific for environmental antigens
o Called allergic or atopic disorder
o Predisposition in the T helper cell balance towards the Th2 subset
o Excessive Th2 response stimulates IgE production
o Sensitization phase: initial exposure to allergens and loading of IgE
o Innate cells will release histamine and trigger inflammation upon re-exposure
 Antibody-mediated/ cytotoxic hypersensitivity (type II)
o Caused by IgG and IgM reacting to the antigens on the cell membrane
o Antibodies activate complement system, recruit inflammatory cells and interfere
with normal cellular functions
o Antigens either own cells or foreign
 Immune complex-mediated hypersensitivity (type III)
o Caused by IgG and IgM
o Antibodies form soluble antigen-antibody complexes in the circulation and are
deposited in tissues
o Causing tissue necrosis by activating the complement cascade and recruitment of
neutrophils

1

,  Cell-mediated/delayed type hypersensitivity (type IV)
o Caused by T lymphocytes that induce inflammation or directly kill target cells
o T lymphocytes become sensitized on initial exposure to the antigen and release
cytokines in subsequent exposure resulting in chronic inflammation




Mechanisms causing hypersensitivity
1. Diseases caused by IgM or IgG antibodies
 Type II and type III
 Antibodies induce inflammation and tissue damage
 Diseases are often not systemic but are restricted to certain organs, causing disease by three
main mechanisms:
o Antibodies bind to cell surface antigens directly opsonize cells or activate the
complement system, resulting in deposition of complement proteins on the cell. The
cells are then marked for phagocytosis
o Antibodies deposited in tissues recruit leukocytes, mainly neutrophils and
macrophages. Activated leukocytes secrete products including lysosomal enzymes
and reactive oxygen species, which cause tissue injury
o Antibodies that bind to normal cellular receptors or other proteins may interfere
with the functions of these and cause disease without inflammation or tissue
damage
 Type III is not dependent on the cellular source of the antigen, but on the site of deposition
o These diseases affect multiple tissues and organs
o Antigen-antibody complexes cause disease when produced in excessive amounts or
are not efficiently cleared and become deposited in tissues

2

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