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1、Chapter20Hypersensitivity超敏反应(Allergy,变态反应)(Anaphylaxis,过敏反应)ConceptAllergen(Anaphylactogen)过敏原secondlyentersensitizedhost.Immuneresponses(toostrong!)thatresultintissueinjuryorphysiologicaldysfunction.HistoryAtfirst,0.1mloftheglycerinextractoftentacle
2、sofActiniaria(seaanemone)海葵甘油提取物22dayslater,asecondinjectionofthesameamountthedognotillthedoganaphylaxisRichet&Portier,1902HypersensitivityTypeI-Immediate速发型TypeII-Cytolytic细胞溶解型TypeIII-IC免疫复合物型TypeIV-Delayed迟发型TypeI Hypersensitivity(Immediate速发型，Anap
3、hylaxis过敏反应)IFeaturesquickvarious,seriousIgEmediatednocomplementinvolvedObviousindividualvariation&geneticfactorsIIMechanismsProteins蛋白Foods食物foreignserum异种血清nuts坚果vaccines疫苗seafood海鲜(fish,shrimp,shellfish,crab)(鱼，虾，贝，蟹)PlantPollens植物花粉peas豌豆ryegrass黑
4、麦beans菜豆ragweed豚草属eggs蛋timothygrass梯牧草milk牛奶birchtrees桦树mushroom磨菇(i)Allergens过敏原(Anaphylactogens)InsectProducts昆虫产物beevenom蜂毒waspvenom黄蜂毒液antvenom蚂蚁毒液cockroachcalyx蟑螂萼dustmites尘螨Drugs药物penicillin青霉素sulfonamides磺胺localanesthetics局麻药salicylates水杨酸盐Mold
5、Spores霉菌孢子AnimalHairandDander动物毛及皮屑(i)Allergens(Anaphylactogens)(ii)Ab:IgETh1:IL-2,IFN-g,TNF-b,IL-12Th2:IL-4,5,6,10,13IL-4→B→IgE(IFN-ginhibitIL-4)(IL-12inhibitIgE)2.BiologicalcharacteristicsofIgE1.GenerationofIgE(1)IgE↑(2)Ach↑(3)Th2↑(4)SIgA↓(5)C1INH↓(
6、C2a↑)AllergicIndividual过敏体质(iii)IgE-FceR+cellsmastcell,basophilDistribution:mastcell:skinandsubmucosa;basophil:blood.2)IgE-FceR3)activationofmastcellBiologicalactivitiesofmastcellandbasophilbasophilmastcell5minafteractivation60minafteractivation1.pref
7、ormedmediators(1)Histamine组胺(2)Kinnogenase激肽原酶2.newlysynthesizedmediators(1)LTs白三烯(SRS-A)(2)PGD2前列腺素(3)PAF血小板活化因子(iv)BiologicalMediatorsIIICommonDiseasesinClinical1Anaphylacticshock过敏性休克1)Medicine(i.e.,penicillin)Penicillin(372,hapten)Intissue,blood(p
8、H7.2~7.6)→6~24hpenicilloyl,penicillenicacid(青霉噻唑醛酸、青霉烯酸)+protein→IgE2)Xenogenicserum异种动物血清2AllergyofrespiratorytractAsthma1)Bronchiaasthma支气管哮喘2)Allergicrhinitis过敏性鼻炎RhinitisAllergyofdigestivetract胃肠道过敏反应Hives荨麻疹Allergyofskin皮肤过敏反应Reactionsofi
