Type III Hypersensitivity Arthus reaction or Immune complex

1
Type III Hypersensitivity( Arthus reaction or
Immune complex )

• Antigen Soluble
• Antibody IgG or IgM
• Complement
• Phagocyte

2
????????????? immune complex

• Persistant infection microbial antigen
• Autoimmunity self antigen
• Extrinsic environmental Ag
• Experimental serum protein Ag

3

4
Mechanism of Tissue Damage

• Ag-Ab complex
• Platelet aggregation
  
• Complement activation
• Anaphylatoxin
• Chemotactic factor
• Thrombus Mast cell
• PMN
• Capillary dilatation
• Proteolytic enzyme
• Tissue Damage

5
Example of Diseases

• 1. Arthus reaction Horse serum
  Rabbit skin Rash , 5-6 h.
• 2. Serum sickness
• Horse serum Human body
  gt 7 days
  Immune complex Clinical features - fever
• - lymph
  node ?? , spleen ??
• -
  arthritis , vasculitis , nephritis

6
3. Autoimmune complex diseases 3.1 Rheumatoid
arthritis Autoantibody( IgM )
IgG IgM-IgG complex 3.2
Systemic lupus erythematosus( SLE )
Autoantibody Nuclear antigen
Immune complex
7
4. Post streptococcal glomerulonephritis
streptococcal infection antiboty to toxin

toxin
antibody-toxin complex

glomerulonephritis
glomerulus
8
5. Dengue hemorrhagic fever ( ??????????? )
Dengue virus infection Antibody to
dengue virus
dengue
virus Vascular
Antibody-dengue virus complex
Vasculitis Skin rash 6.
Hey fever - Farmers lung disease
- Pigeon breeder disease
Antibody Fungal spore
Pneumonitis
Organic material Pneumonitis
9
(No Transcript)
10
(No Transcript)
11
Laboratory Diagnosis for Type III
Hypersensitivity 1. Skin test
antigen skin rash at 5-6
h. 2. Direct immunofluorescence
tissue biopsy IF lumpy
deposit 3. Detection of immune complex
3.1 Polyethylene glycol ( PEG )
precipitation serum 2 PEG
I.C precipitation ELISA,RIA IgG
dissolve wash
12
3.2 ELISA / RIA
13
Laboratory Diagnosis for specific
diseases 1. Rheumatoid arthritis
Rheumatoid factor Passive Latex
Agglutination serum IgG-latex
agglutination 2. Systemic lupus
erythematosus ( SLE ) Antinuclear
antibodies Indirect
immunofluorescence rat liver cell
serum incubate wash
wash incubate anti-human Ig-F

fluorescent microscope
nucleus fluorescence
14
3. Serum sickness Heterophile antibody
serum sheep red cell high
titer, gt 156 Absorption
serum g.p kidney cell sRbc
titer serum beef red cell
sRbc titer
15
Treatment and Prevention
1. Removal of the antigen source -
external antigen avoidance -
microbial infection antibiotics 2.
Suppression of antibody production -
immunosuppressive drugs steroid ,
cyclophosphamide , azathioprine 3. Removal
of immune complex plasmapheresis
patient plasma
out normal plasma in