Chapter 2: Type I allergy: Mechanisms in Lecture 514.094 of the Medical University Vienna the effector phase and Anaphylaxis The Pathophysiology of Allergy Eva Untersmayr-Elsenhuber Department ofPathophysiologyandAllergyResearch Lecture 514.094 The Pathophysiology of Allergy Chapter 2: Type I allergy: Mechanisms in effector phase and Anaphylaxis Eva Untersmayr-Elsenhuber Department of Pathophysiology and Allergy Research Medical University Vienna Chapter 2: Type I allergy: Mechanisms in Lecture 514.094 of the Medical University Vienna the effector phase and Anaphylaxis The Pathophysiology of Allergy Eva Untersmayr-Elsenhuber Department ofPathophysiologyandAllergyResearch Topics of lecture (cid:8226) Clincal presentation of allergic reactions (cid:8226) Key players in allergic inflammation - IgE - Allergen - Mast cells - Eosinophils, inflammatory cells (cid:8226) Mechanisms of anaphylactic reactions Chapter 2: Type I allergy: Mechanisms in Lecture 514.094 of the Medical University Vienna the effector phase and Anaphylaxis The Pathophysiology of Allergy Eva Untersmayr-Elsenhuber Department ofPathophysiologyandAllergyResearch Clinical presentation of allergic reactions Allergy against inhalative proteins (cid:8226) Respiratory symptoms Wheezing, rhinitis Conjunctivitis Asthma Mild (cid:224) severe In all age groups Gibson PG et al. Lancet 2010 (cid:8226) Cutaneous and gastrointestinal http://www.raksar.com/shop/r/raksar/i mg-lib/con_20051229134550_i.JPG symptoms Eczema Oral allergy syndrom Katelaris CH. Curr OpinAllergy Clin Immunol. 2010 Chapter 2: Type I allergy: Mechanisms in Lecture 514.094 of the Medical University Vienna the effector phase and Anaphylaxis The Pathophysiology of Allergy Eva Untersmayr-Elsenhuber Department ofPathophysiologyandAllergyResearch Clinical presentation of allergic reactions Allergy against food compounds (cid:8226) Gastrointestinal symptoms Abdomial pain Nausea, vomiting Diarrhea (cid:8226) Respiratory and cutaneous http://sip.uki.at/img/bauchschmerz/Schmerz_Bauchschmerz.jpg symptoms Rhinitis, conjunctivitis Asthma Eczema, urticaria, angioedema (cid:8226) Generalized anaphylactic symptoms Sicherer SH, Sampson HA. JACI 2010 Chapter 2: Type I allergy: Mechanisms in Lecture 514.094 of the Medical University Vienna the effector phase and Anaphylaxis The Pathophysiology of Allergy Eva Untersmayr-Elsenhuber Department ofPathophysiologyandAllergyResearch Clinical presentation of allergic reactions Allergy against drugs (cid:8226) Respiratory symptoms Wheezing, rhinitis Conjunctivitis Asthma (cid:8226) Cutaneous symptoms Eczema http://www.allergiewelle.de/wp- content/uploads/2009/11/angioodem-fdgarrett.jpg Urticaria Angioedema (cid:8226) Generalized anaphylactic symptoms Chapter 2: Type I allergy: Mechanisms in Lecture 514.094 of the Medical University Vienna the effector phase and Anaphylaxis The Pathophysiology of Allergy Eva Untersmayr-Elsenhuber Department ofPathophysiologyandAllergyResearch Time course of allergic reactions Immediate reaction immediate Late phase Onset within seconds due to preformed or rapidly synthesized mediators (cid:224) vascular permeability (cid:224) contraction of smooth muscle Late phase reaction immediate Late phase Induced synthesis and release of mediators (cid:224) recruiting of eosinophils and Th2 lymphocytes (cid:224) second phase of smooth muscle contraction, sustained edema, airway hyperreactivity www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=imm&part=A1734 Chapter 2: Type I allergy: Mechanisms in Lecture 514.094 of the Medical University Vienna the effector phase and Anaphylaxis The Pathophysiology of Allergy Eva Untersmayr-Elsenhuber Department ofPathophysiologyandAllergyResearch Time course of allergic reactions immediate Late phase www.ncbi.nlm.nih.gov/bookshelf/br.fcgi? book=imm&part=A1734 Laché M et al. Nat Rev Immunol 2006 Key players in immediate reactions IgE bound via Fc(cid:949)RI to mast cells and basophils (cid:224) mediator release Chapter 2: Type I allergy: Mechanisms in Lecture 514.094 of the Medical University Vienna the effector phase and Anaphylaxis The Pathophysiology of Allergy Eva Untersmayr-Elsenhuber Department ofPathophysiologyandAllergyResearch Time course of allergic reactions immediate Late phase www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=imm&part=A1734 Key players in late phase reaction Network of inflammatory cells: eosinophils (50% of infiltrate), allergen-specific T-cells, mast cells, basophils, Th1 cells Laché M et al. Nat Rev Immunol 2006 Chapter 2: Type I allergy: Mechanisms in Lecture 514.094 of the Medical University Vienna the effector phase and Anaphylaxis The Pathophysiology of Allergy Eva Untersmayr-Elsenhuber Department ofPathophysiologyandAllergyResearch Chronic allergic inflammation Due to repetitive or persistant allergen exposure Innate immune cells (eosinophils, basophils, neutrophils and monocyte/macroph ages) and adaptive immune cells (Th2- cells, other T-cells, B-cells) take up residence in tissue Galli SJ et al. Nature 2008 Chapter 2: Type I allergy: Mechanisms in Lecture 514.094 of the Medical University Vienna the effector phase and Anaphylaxis The Pathophysiology of Allergy Eva Untersmayr-Elsenhuber Department ofPathophysiologyandAllergyResearch