Allergy and Immunology

  1. Hypersensitivity Reactions
    1. Gell and Coombs Classification
      1. Historical Development
        1. Four-Type System
          1. Clinical Relevance
            1. Mechanistic Basis
            2. Type I Hypersensitivity
              1. IgE-mediated Mechanisms
                1. Sensitization Phase
                  1. Initial Allergen Exposure
                    1. IgE Production
                      1. Mast Cell Sensitization
                      2. Re-exposure Phase
                        1. Cross-linking Events
                          1. Degranulation Triggers
                            1. Mediator Release
                          2. Key Effector Cells
                            1. Mast Cells
                              1. Tissue Distribution
                                1. Granule Contents
                                  1. Activation Mechanisms
                                  2. Basophils
                                    1. Circulating Function
                                      1. Mediator Release
                                        1. Recruitment Mechanisms
                                      2. Inflammatory Mediators
                                        1. Preformed Mediators
                                          1. Histamine
                                            1. Tryptase
                                              1. Heparin
                                              2. Newly Synthesized Mediators
                                                1. Leukotrienes
                                                  1. Prostaglandins
                                                    1. Platelet-activating Factor
                                                    2. Cytokines
                                                      1. IL-4
                                                        1. IL-5
                                                          1. IL-13
                                                            1. TNF-α
                                                          2. Clinical Manifestations
                                                            1. Anaphylaxis
                                                              1. Pathophysiology
                                                                1. Systemic Effects
                                                                  1. Cardiovascular Collapse
                                                                    1. Respiratory Compromise
                                                                    2. Localized Reactions
                                                                      1. Allergic Rhinitis
                                                                        1. Allergic Asthma
                                                                          1. Urticaria
                                                                            1. Angioedema
                                                                            2. Food Allergies
                                                                              1. Common Allergens
                                                                                1. Oral Allergy Syndrome
                                                                                2. Insect Sting Reactions
                                                                                  1. Venom Components
                                                                                    1. Local vs Systemic Reactions
                                                                                3. Type II Hypersensitivity
                                                                                  1. Antibody-mediated Cytotoxicity
                                                                                    1. IgG-mediated Mechanisms
                                                                                      1. IgM-mediated Mechanisms
                                                                                        1. Cell Surface Antigen Targeting
                                                                                        2. Effector Mechanisms
                                                                                          1. Complement-dependent Cytotoxicity
                                                                                            1. Classical Pathway Activation
                                                                                              1. Membrane Attack Complex
                                                                                              2. Antibody-dependent Cell-mediated Cytotoxicity
                                                                                                1. NK Cell Involvement
                                                                                                  1. Fc Receptor Engagement
                                                                                                  2. Opsonization and Phagocytosis
                                                                                                    1. Macrophage Recognition
                                                                                                      1. Complement Opsonins
                                                                                                    2. Clinical Examples
                                                                                                      1. Hemolytic Disease
                                                                                                        1. Autoimmune Hemolytic Anemia
                                                                                                          1. Hemolytic Disease of Newborn
                                                                                                          2. Thrombocytopenia
                                                                                                            1. Immune Thrombocytopenic Purpura
                                                                                                              1. Drug-induced Thrombocytopenia
                                                                                                              2. Organ-specific Autoimmunity
                                                                                                                1. Goodpasture Syndrome
                                                                                                                  1. Myasthenia Gravis
                                                                                                              3. Type III Hypersensitivity
                                                                                                                1. Immune Complex Formation
                                                                                                                  1. Antigen-Antibody Complex Size
                                                                                                                    1. Solubility Factors
                                                                                                                      1. Complement Activation
                                                                                                                      2. Tissue Deposition
                                                                                                                        1. Vascular Deposition Sites
                                                                                                                          1. Glomerular Deposition
                                                                                                                            1. Synovial Deposition
                                                                                                                            2. Inflammatory Response
                                                                                                                              1. Complement Activation
                                                                                                                                1. Neutrophil Recruitment
                                                                                                                                  1. Tissue Damage Mechanisms
                                                                                                                                  2. Clinical Examples
                                                                                                                                    1. Serum Sickness
                                                                                                                                      1. Acute Manifestations
                                                                                                                                        1. Chronic Forms
                                                                                                                                        2. Arthus Reaction
                                                                                                                                          1. Local Immune Complex Disease
                                                                                                                                            1. Vasculitic Changes
                                                                                                                                            2. Systemic Diseases
                                                                                                                                              1. Systemic Lupus Erythematosus
                                                                                                                                                1. Post-infectious Glomerulonephritis
                                                                                                                                            3. Type IV Hypersensitivity
                                                                                                                                              1. T-cell Mediated Mechanisms
                                                                                                                                                1. Sensitization Phase
                                                                                                                                                  1. Antigen Processing
                                                                                                                                                    1. T-cell Priming
                                                                                                                                                    2. Effector Phase
                                                                                                                                                      1. Memory T-cell Activation
                                                                                                                                                        1. Inflammatory Response
                                                                                                                                                      2. Subtypes
                                                                                                                                                        1. Th1-mediated Responses
                                                                                                                                                          1. Macrophage Activation
                                                                                                                                                            1. Granuloma Formation
                                                                                                                                                              1. Tuberculin Reaction
                                                                                                                                                              2. Th2-mediated Responses
                                                                                                                                                                1. Eosinophil Recruitment
                                                                                                                                                                  1. Chronic Inflammation
                                                                                                                                                                  2. Cytotoxic T-cell Responses
                                                                                                                                                                    1. Direct Cytotoxicity
                                                                                                                                                                      1. Tissue Destruction
                                                                                                                                                                    2. Clinical Examples
                                                                                                                                                                      1. Contact Dermatitis
                                                                                                                                                                        1. Allergic Contact Dermatitis
                                                                                                                                                                          1. Common Sensitizers
                                                                                                                                                                          2. Tuberculin Skin Test
                                                                                                                                                                            1. Delayed Reaction
                                                                                                                                                                              1. Clinical Interpretation
                                                                                                                                                                              2. Transplant Rejection
                                                                                                                                                                                1. Acute Rejection
                                                                                                                                                                                  1. Chronic Rejection

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                                                                                                                                                                            3. Clinical Allergic Disorders