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Hypersensitivity Reaction Types

Aug 17, 2025

Overview

This lecture explains the four types of hypersensitivity reactions, highlighting mechanisms, key antibodies, timelines, and relevant clinical examples.

Type I Hypersensitivity (Anaphylactic)

  • Type I reactions are immediate allergic responses, often occurring within minutes of exposure.
  • IgE antibodies bind to mast cells or basophils, causing degranulation and release of inflammatory mediators, mainly histamine.
  • Histamine increases blood vessel permeability, causes swelling, redness, mucus production, and smooth muscle contraction (e.g., difficulty breathing).
  • Antihistamines help mild reactions; epinephrine is needed for severe anaphylactic shock.
  • Systemic anaphylaxis is life-threatening, often triggered by bee stings, foods (e.g., peanuts), or drugs (e.g., penicillin).
  • Localized reactions include asthma, hay fever, and hives.

Type II Hypersensitivity (Cytotoxic)

  • Type II reactions occur within 5–8 hours.
  • Involves IgM and IgG antibodies, which activate complement to destroy target cells.
  • Classic examples: transfusion reactions and hemolytic disease of the newborn.

Type III Hypersensitivity (Immune Complex)

  • Type III reactions form antigen-antibody (mainly IgG) complexes in blood serum.
  • These complexes trigger inflammation and can damage organs (e.g., kidneys).
  • Reaction occurs in response to soluble antigens, not cell-associated ones.

Type IV Hypersensitivity (Delayed/Cell-Mediated)

  • Type IV reactions occur 24–48 hours after antigen exposure.
  • Not antibody-mediated; involves T cells and other immune cells.
  • Examples: transplant rejection, contact dermatitis (e.g., poison ivy, latex allergy), and tuberculin skin test reactions.

Key Terms & Definitions

  • Anaphylaxis — Severe, rapid allergic reaction that can be life-threatening.
  • IgE — Antibody associated with allergic (type I) reactions.
  • Mast cells/Basophils — White blood cells releasing histamine during allergic responses.
  • Degranulation — Release of substances from immune cells, initiating inflammation.
  • Histamine — Molecule causing vessel permeability, swelling, and mucus in allergies.
  • Complement — Group of proteins that help antibodies destroy pathogens.
  • Immune Complex — Cluster of antigens and antibodies causing type III reaction.
  • Contact Dermatitis — Skin inflammation caused by direct contact with allergens.

Action Items / Next Steps

  • Review examples of each hypersensitivity type.
  • Practice distinguishing between hypersensitivity mechanisms.
  • Prepare for questions about clinical scenarios involving allergic and immune responses.