Hypersensitivity
Hypersensitivity (also called hypersensitivity reaction) refers to undesirable (damaging, discomfort-producing and sometimes fatal) reactions produced by the normal immune system. Hypersensitivity reactions require a pre-sensitized (immune) state of the host. The four-group classification was expounded by P. H. G. Gell and Robin Coombs in 1963.[1]
Coombs and Gell classification
Comparison of hypersensitivity types
Type |
Alternative names [2] |
Often mentioned disorders[2] |
Mediators[2] |
1 |
Allergy (immediate) |
|
|
2 |
Cytotoxic, antibody-dependent |
- Autoimmune hemolytic anemia
- Thrombocytopenia
- Erythroblastosis fetalis
- Goodpasture's syndrome
|
|
3 |
Immune complex disease |
- Serum sickness
- Arthus reaction
- SLE
|
|
4 |
Delayed-type hypersensitivity[3] (DTH), Cell-mediated immune memory response, antibody-independent |
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Type 5
This is an additional type that is sometimes (often in Britain) used as a distinction from Type 2.[4]
Instead of binding to cell surface components, the antibodies recognize and bind to the cell surface receptors, which either prevents the intended ligand binding with the receptor or mimics the effects of the ligand, thus impairing cell signalling.
Some clinical examples:
The use of "Type 5" is rare. These conditions are more frequently classified as Type 2, though sometimes they are specifically segregated into its own subcategory of Type 2.
References
- ↑ Gell PGH, Coombs RRA, eds. Clinical Aspects of Immunology. 1st ed. Oxford, England: Blackwell; 1963.
- ↑ 2.0 2.1 2.2 Unless else specified in boxes, then ref is: Lippincott's Illustrated Reviews: Immunology. Paperback: 384 pages. Publisher: Lippincott Williams & Wilkins; (July 1, 2007). Language: English. ISBN-10: 0781795435. ISBN-13: 978-0781795432. Page 195
- ↑ Black, CA. Delayed Type Hypersensitivity: Current Theories with an Historic Perspective Dermatol. Online J. (May 1999) 5(1):7 at http://dermatology.cdlib.org/DOJvol5num1/reviews/black.html
- ↑ Rajan TV (July 2003). "The Gell-Coombs classification of hypersensitivity reactions: a re-interpretation". Trends Immunol. 24 (7): 376–9. PMID 12860528. http://linkinghub.elsevier.com/retrieve/pii/S147149060300142X.
External links
Medical conditions (Diseases, Disorders, Illness, Syndromes, Symptoms, Medical signs, Injuries, etc.) |
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(A/B, 001-139) |
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(C/D, 140-239) |
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Immune disorder
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Immunodeficiency · Immunoproliferative disorders · Hypersensitivity
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(E, 240-279) |
Endocrine disease · Nutrition disorder · Inborn error of metabolism
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(F, 290-319) |
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(G, 320-359) |
Nervous system disease (CNS, PNS)
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(H, 360-389) |
Eye disease · Ear disease
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(I, 390-459) |
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(J, 460-519) |
Respiratory disease (Obstructive lung disease, Restrictive lung disease, Pneumonia)
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(K, 520-579) |
Stomatognathic disease · Digestive disease (Esophageal, Stomach, Enteropathy, Liver, Pancreatic)
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(L, 680-709) |
Skin disease
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(M, 710-739) |
Musculoskeletal disorders
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(N, 580-629) |
Urologic disease (Nephropathy, Urinary bladder disease) · Breast disease
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(O, 630-679) |
Complications of pregnancy
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(P, 760-779) |
Fetal disease
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(Q, 740-759) |
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(R, 780-799) |
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(S/T, 800-999) |
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Consequences of external causes (T15-T35, T66-T98, 930-959, 990-995) |
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General external causes |
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Other external causes |
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Certain early complications of trauma |
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Complications of surgical and medical care |
Serum sickness - Malignant hyperthermia - Transfusion hemosiderosis - Herxheimer reaction - Graft-versus-host disease
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Pathology: Immune disorders (primarily D80-D89, 273, 279) |
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Immunodeficiency |
Primary
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Hypogammaglobulinemia/agammaglobulinemia (X-linked, Transient of infancy) - Dysgammaglobulinemia (IgA, IgG, IgM) - Hyper IgM syndrome (2, 3, 4, 5) - Common variable immunodeficiency
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DiGeorge syndrome - Nezelof syndrome - Purine nucleoside phosphorylase deficiency - Ataxia telangiectasia - Hyper IgM syndrome (1)
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Severe combined (B+T)
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x-linked: X-SCID
autosomal: Adenosine deaminase deficiency - Omenn syndrome - ZAP70 deficiency - Bare lymphocyte syndrome
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Complement deficiency
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PBD
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Other
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ICF syndrome - Wiskott-Aldrich syndrome - WHIM syndrome
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Acquired
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Immunoproliferative |
Hypergammaglobulinemia
Paraproteinemia (Cryoglobulinemia, Heavy chain disease, POEMS syndrome, Monoclonal gammopathy of undetermined significance)
Lymphoproliferative disorders: Sarcoidosis (Lupus pernio)
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Other |
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See also hematological malignancy and hematology
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Immune disorders: Hypersensitivity and autoimmune diseases |
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I/allergy/atopy
(IgE) |
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II/ADCC
(IgM, IgG) |
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III
(Immune complex) |
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IV/cell-mediated
(T-cells) |
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Unknown/
multiple |
Sjögren's syndrome · Hypersensitivity pneumonitis (Allergic bronchopulmonary aspergillosis) · Autoimmune hepatitis · Transplant rejection
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