PRESENTED BY: Agamjeet Singh Batra, VI - N

Allergy
 a damaging immune response by the body to a
substance, especially a particular food, pollen, fur,
or dust, to which it has become hypersensitive.
 An allergy is a immune reaction to something that
does not affect most other people. Substances that
often cause reactions are:
 Pollen
 Dust mites
 Mold spores
 Pet dander
 Food
 Insect stings
 Medicines
Risk factor
 Host factors; heredity, gender, race, and age.
 Environmental factor; infectious diseases during
early childhood, environmental pollution, allergen
levels and dietary changes.
 Allergy

Ig E mediated (Type I
hypersensitivity)
Allergy
Non Ig E mediated
IgE Mediated: Type I

Overreaction to an allergen that is contact through skin,

inhaled through lung, swallowed or injected.

 Triggered by harmless substances such as; pollen,

dust, animal danders, food, … can also occur as a
result of drug or bee stings or stings from other insects
(an allergen).

 An allergen; an antigen that causes allergy. Either

inhaled, ingested, .. Can be complete protein antigens
(Pollen and animal dander) or low molecular weight
proteins.
 Atopy

 Atopy is the genetic predisposition to make IgE antibodies in response to

allergen exposure.

 Etiology is unknown but there is strong evidence for a complex of genes

with a variable degree of expression encoding protein factors.

 Allergic rhinitis, allergic athma, atopic dermatitis are the most

common manifestation of atopy. Allergic gastroenteropathy is rara.
These manifestation may coexist in the same patients at different times.
Atopy can be asymptomatic.
 Mechanism

While first-time exposure may only produce a mild reaction, repeated

exposures may lead to more serious reactions. Once a person is sensitized
(has had a previous sensitivity reaction), even a very limited exposure to a
very small amount of allergen can trigger a severe reaction.

Most occur within seconds or minutes after exposure to the allergen, but
some can occur after several hours, particularly if the allergen causes a
reaction after it is partially digested. In very rare cases, reactions develop
after 24 hours.
 Immunopathogenesis

 Both mast cells and basophils are involved in

immunopathogenesis of IgE mediated diseases.
Mast cells and basophils have a high affinity IgE
cell membrane receptors for IgE.

 Immediate hypersensitivity reactions are

mediated by IgE, but T and B cells play
important roles in the development of these
antibodies
 Mast Cell

 Mast cell are abundant in the mucosa of the

respiratory, gastrointestinal tracts and in the skin,
where atopic reaction localize.

 Mast cell release mediator cause the pathophysiology

of the immediate and late phases of atopic diseases.
 Laboratory Diagnosis

Skin Tests
IgE-Mediated
Allergies
Blood Tests
 Skin Tests

 The cutaneous test

 (prick test, puncture test epicutaneous test)
 Routine diagnosis in diseases (atopic or anaphylactic).
 A single drop of concentrated aqueous allergen extract
placed on the skin which is then pricked lightly with a
needle point at the center of the drop. After 20 minutes the
reaction is graded and recorded
 Laboratory Tests
 IgE levels may be elevated in patients who are
atopic, but the level does not necessarily correlate
with clinical symptoms.
 The tryptase level can be elevated, which is
indicative of mast cell degranulation. False-negative
results can occur.
 An elevated eosinophil count may be observed in
patients with atopic disease.
 RAST/CAP RAST/CAP FEIA (fluorenzymeimmunoassay):
measures antigen-specific IgE.
Prevention

 Avoid triggers such as foods and medications,…… that

have caused an allergic reaction, even a mild one. This
includes detailed questioning about ingredients when eating
away from home. Ingredient labels should also be carefully
examined.
 A medical ID tag should be worn by people who know that
they have serious allergic reaction.
 If any history of a serious allergic reactions, carry
emergency medications (such as diphenihydramine and
injectable epinephrine.
 Do not use your injectable epinephrine on anyone else.
They may have a condition (such as a heart problem) that
could be affected by this drug.
Treatment
Allergens
 a substance that
 causes an allergic
 reaction.
Treatment of Allergens

1) Quercetin: a natural derived compound helps to

stabilize mast cells and prevents them from release
of histamine source: citrus fruits, onions, apples,
tomato etc
2) stinging nettle: treat allergies but without unwanted
side effects of dry mouth and drowsiness . inhibits
body’s ability to produce histamine
3) neti pots and saline rinse
4) Butter bur
Skin Testing
Types of Allergens
INHALENT ALLERGENS
 Inhalant' allergies caused by environmental factors such as pollen,
pets, house dust mites and moulds.
 Such allergies are a reaction by the immune system to a normally
harmless substance.
 This is because the immune system is designed to fight off foreign
bodies.
 When it can't find infection to fight, it looks for something else such
as an allergy to react against.
Causes of four common 'inhalant' allergies
1) HAY FEVER
2)DUST MITES
3) MOULD SPORES
 INGESTANT ALLERGENS
 A substance that is or may be taken into the body by
mouth or through the digestive system.
 Food allergens ordinarily cause gastrointestinal
symptoms, but they may also cause skin rash, puffed lips
and tongue, migraine, rhinitis, or other more serious
effects, such as bronchial asthma.
 Severe cases of eczema of the hands have been
caused by allergenic
 foods.
 CONTACTANT ALLERGENS
 “Any allergens they produce manifestations of
hypersensitivity at the site of skin or other mucous.”

 For Example:
Substances you come in contact with that irritate the skin such
as
 poison ,
 cosmetics ,
 detergents ,
 fabrics and
 dyes cause poison dermatitis.
 INJECTANTS
ALLERGENS
 The injectants

( injectable
preparations and
insects) cause allergy
in a hypersensitive
person, allergic
conditions is known
injectant allergy.
 INFECTANT ALLERGENS
 The bacterial metabolic waste s are considered as
infectant allergens
 Numerous living organisms may cause allergy through
the products they release during their metabolism in the
human body.
 Bronchietasis: an example of infectant allergy:
 The chronic bacterial infection of the bronchioles, where
in the constant presence of bacterial wastes may
sensitize the allergic individual is the of the example.
 INFESTANT ALLERGENS
 In a manner somewhat similar to the infectants,
parasitic organisms may sensitize the human body.
 Invasions of hookworms, tapeworms, pinworms,
threadworms, dermatophytes and other forms have
caused allergic response in susceptible individuals.
 Growth products and metabolic wastes of these
parasites are constantly present in the body and
referred to as infestant allergens.
THANK
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