Nutrition and Immunity
R. J. Jarrett in Nutrition and Disease, 1979
Although IgE mediated Type I hypersensitivity is the most important mechanism in food allergy, other immune mechanisms may play a significant part in some cases. Delayed hypersensitivity (Type IV) to para aminobenzoic acid, acquired through use of suntan lotion, may produce eczema. Ingestion of foodstuffs containing benzoic acid used as a preservative, or related compounds, can cause an exacerbation of the eczema. Type III reactions may occur in milk allergy, as high levels of milk antibodies are present, and complement activation in the serum has been observed following milk challenge. This suggests that antibody-antigen combination has taken place, and raises the possibility that damage to the gut may be produced by an Arthus phenomenon. The numbers of IgA and IgM secreting cells in the lamina propria of the gut are over twice the normal in this condition. Peripheral disease may also be caused by this mechanism, for Heiner in 1960 recognised a rare association between high milk antibodies and pulmonary disease. In milk allergy, positive lymphocyte transformation with milk proteins suggests that even cell mediated immunity could be involved.
Immunopathology
Constantin A. Bona, Francisco A. Bonilla in Textbook of Immunology, 2019
Intradermal injection of antigen into a previously immunized animal generates immune complexes at the injection site. These complexes consist of preformed antibody and the injected antigen. Complement activation leads to neutrophil infiltration of the injection site and tissue destruction. The reaction is detectable 1–3 hours post-injection and reaches a peak after 4–10 hours. The injection site becomes edematous, erythematous, and may ulcerate. This is called the Arthus reaction. Histologically, one observes fibrinoid necrosis. Antibody and complement are detectable with immunostaining. A “passive” Arthus reaction may be induced by simultaneous intradermal injection of antigen and antibody.
The Influence of Pituitary-Adrenal Axis on the Immune System
Istvan Berczi in Pituitary Function and Immunity, 2019
Some of the earliest observations with regards to the effect of ACTH on inflammatory and immune responses were made in rabbits. Thus, Berthrong et al.2 showed that cardiovascular lesions produced by anaphylactic hypersensitivity were inhibited by ACTH treatment. Bjornedoe et al.3 described that treatment of rabbits with ACTH and cortisone reduced their antibody respose to pneumococcal antigens. Similar reductions occurred when the hormones were administered at the beginning of immunization or after immunization was well advanced. Hormone treatment was followed by atrophic changes in lymphoid tissue and a decrease in the number of mononuclear cells. Malkiel and Hargis4 showed that ACTH and cortisone given in physiological doses to rabbits prior to and during, the period of immunization with bovine serum albumin inhibited antibody formation as measured by the quantitative precipitin reaction. ACTH caused a marked diminution of the antibody titer and cortisone induced an almost complete suppression. Germuth and co-workers5 studied the effect of ACTH and cortisone on antibody formation and on the development of Arthus type hypersensitivity. Both hormones suppressed circulating antibody formation, cortisone being more effective than ACTH. The Arthus reaction itself was unaffected if treatment was started when serum antibody concentrations were high. The authors concluded that ACTH and cortisone reduced circulating antibody by inhibiting antibody formation rather than by promoting antibody destruction. Kass and co-workers6 also observed that ACTH in sufficient dosage depressed the production of antibodies in rabbits in a similar fashion to that of hydrocortisone.
Understanding Retinal Vasculitis Associated with Brolucizumab: Complex Pathophysiology or Occam’s Razor?
Published in Ocular Immunology and Inflammation, 2022
Ashish Sharma, Nilesh Kumar, Nikulaa Parachuri, Sonali Singh, Francesco Bandello, Carl D. Regillo, David Boyer, Quan Dong Nguyen
It is possible that small size may allow higher molar concentration and incite a strong local immune reaction leading to inflammation. We have highlighted the role of type III hypersensitivity reaction (HSR) in the past.15 The majority of vasculitic diseases involve the deposition of antigen-antibody complex, which is Type III HSR. These deposits have been shown in the capillary bed and vessel walls and can lead to occlusive vasculitis. Arthus reaction, a subtype of Type III HSR has been reported in patients on systemic monoclonal antibody (mAb), including systemic anti-VEGF therapies. Such reactions are assumed to be due to high antigen load, which leads to a subsequent increase of antibodies.16,17 Arthus reaction is more frequent in patients with auto-immune conditions. The higher molar concentration of brolucizumab (11 and 22 times greater than aflibercept and ranibizumab, respectively), if antigenic, may produce a higher rate of antibody formation. Type III HSR is due to the formation of biologic/ADA immune complexes in the circulation. When these complexes are in the correct stoichiometric ratio, they are deposited in tissues and cause inflammation and tissue damage. The requirement of the correct ratio to have tissue deposition might explain why vasculitis is seen in some individual rather than in clusters as each individual having differing amounts of ADAs leading to different stoichiometric ratios.18
Diagnosis and management of hypersensitivity reactions to vaccines
Published in Expert Review of Clinical Immunology, 2020
Lucrezia Sarti, Guillaume Lezmi, Francesca Mori, Mattia Giovannini, Jean-Christoph Caubet
Injection site reactions, both mild and large, are benign, resolve spontaneously, and most patients with previous large injection site reactions tolerate subsequent vaccine doses [40]. No allergy workup is generally required, and injection site reactions should not delay subsequent vaccination [9,14]. However, high titers of specific IgG to the vaccine in patients with large injection site reactions are strongly suggestive of an Arthus reaction. In this case, future administration may be delayed as long as IgG titers are protective [11]. In children up to 6 years of age, injection site reactions may be less frequent but more pronounced if the vaccine is injected in the thigh rather than the arm [41,42].
The enigmatic nature of the triggering receptor expressed in myeloid cells -1 (TLT- 1)
Published in Platelets, 2021
Siobhan Branfield, A. Valance Washington
Insights to role for TLT-1 in hemostasis came from studies using the reverse Arthus reaction. In the reverse Arthus reaction, immune complexes develop sub dermally and lead to complement deposition and neutrophil infiltration. In normal mice it leaves a bruise, in thrombocytopenic mice it leads to overt bleeding. In these studies, by Goerge et al [44] the β3 mice did not bleed, suggesting that the αIIbβ3/fibrinogen interaction was not important for hemostasis derived from immune triggers. Treml1−/- mice show a distinct petechia when compared to their wild type counterparts [37] suggesting that the TLT-1/fibrinogen interaction may regulate immune functions of platelets.
Related Knowledge Centers
- Antibody
- Immune Complex
- Immunology
- Serous Membrane
- Type III Hypersensitivity
- Hypersensitivity
- Blood Vessel
- Antigen
- Type III Hypersensitivity
- Pulmonary Pleurae
- Pericardium