type IV hypersensitivity

IV型アレルギー

WordNet

1. write by means of a keyboard with types; "type the acceptance letter, please" (同)typewrite
2. a small metal block bearing a raised character on one end; produces a printed character when inked and pressed on paper; "he dropped a case of type, so they made him pick them up"
3. (biology) the taxonomic group whose characteristics are used to define the next higher taxon
4. a subdivision of a particular kind of thing; "what type of sculpture do you prefer?"
5. all of the tokens of the same symbol; "the word `element contains five different types of character"
6. printed characters; "small type is hard to read"
7. identify as belonging to a certain type; "Such people can practically be typed" (同)typecast
8. the 9th letter of the Roman alphabet (同)i
9. pathological sensitivity
10. extreme sensitivity
11. writing done with a typewriter (同)typewriting

PrepTutorEJDIC

1. 〈C〉(…の)『型』,タイプ,類型,種類(kind)《+of+名》 / 〈C〉(その種類の特質を最もよく表している)『典型』,手本,模範《+of+名》 / 〈U〉《集合的に》活字;〈C〉(1個の)活字 / 〈U〉(印刷された)字体,活字 / 〈C〉(貨幣・メダルなどの)模様,図柄 / 〈C〉血液型(blood group) / …‘を'タイプに打つ / (…として)…‘を'分類する《+名+as+名(doing)》 / …‘の'型を決める / タイプライターを打つ
2. 『私は』私が
3. iodineの化学記号
4. 過敏,過敏症

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/01/07 22:27:25」(JST)

wiki en

[Wiki en表示]

Type IV hypersensitivity
Classification and external resources
MeSH	D006968

Type 4 hypersensitivity is often called delayed type hypersensitivity as the reaction takes two to three days to develop. Unlike the other types, it is not antibody mediated but rather is a type of cell-mediated response.

CD4+ helper T cells recognize antigen in a complex with Class II major histocompatibility complex. The antigen-presenting cells in this case are macrophages that secrete IL-12, which stimulates the proliferation of further CD4+ T_h1 cells. CD4+ T cells secrete IL-2 and interferon gamma, further inducing the release of other T_h1 cytokines, thus mediating the immune response. Activated CD8+ T cells destroy target cells on contact, whereas activated macrophages produce hydrolytic enzymes and, on presentation with certain intracellular pathogens, transform into multinucleated giant cells.

Examples

Disease	Target antigen	Effects
Diabetes mellitus type 1	Pancreatic beta cell proteins (possibly insulin, Glutamate decarboxylase)	Insulitis Beta cell destruction
Multiple sclerosis	Oligodendrocyte proteins (myelin basic protein, proteolipid protein)	Demyelinating disease Perivascular inflammation Paralysis Ocular lesions
Some peripheral neuropathies	Schwann cell antigen	Neuritis Paralysis
Hashimoto's Thyroiditis	Thyroglobulin antigen	Hypothyroidism Hard goiter Follicular thymitis
Crohn's disease	Unknown	Chronic inflammation of ileum and colon
Allergic contact dermatitis	Environmental chemicals, e.g. poison ivy, nickel	Dermatitis with usually short-lived itching
Mantoux test* (diagnostic)	Tuberculin	Skin induration indicates TB exposure
Unless else specified in boxes, then ref is: * - Mantoux test not taken from

An example of a TB infection that came under control: M. tuberculosis are engulfed by macrophages after being identified as foreign, but due to an immuno-escape mechanism peculiar to mycobacteria, TB bacteria are able to block the fusion of their enclosing phagosome with lysosomes which would destroy the bacteria. Thereby TB can continue to replicate within macrophages. After several weeks, the immune system somehow [mechanism as yet unexplained] ramps up and, on stimulation with IFN-gamma, the macrophages become capable of killing M. tuberculosis by forming phagolysosomes and nitric oxide radicals. However the hyper-activated macrophages secrete TNF which recruits multiple monocytes into the battle. These cells differentiate into epithelioid histiocytes which wall off the infected cells, but at the cost of significant inflammation and local damage.

Some other clinical examples:

• Temporal arteritis
• Hashimoto's thyroiditis
• Symptoms of leprosy
• Symptoms of tuberculosis
• Coeliac disease
• Graft-versus-host disease
• Chronic transplant rejection

See also

• Type I hypersensitivity
• Type II hypersensitivity
• Type III hypersensitivity
• Type V hypersensitivity

References

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

• 1. 薬物アレルギー：分類および臨床的特徴 drug allergy classification and clinical features
• 2. 発疹性（麻疹様）薬疹 exanthematous morbilliform drug eruption
• 3. 薬物アレルギー患者へのアプローチ an approach to the patient with drug allergy
• 4. 薬物アレルギー：病因 drug allergy pathogenesis
• 5. 2型糖尿病の治療のためのジペプチジルペプチダーゼ4（DPP-4）阻害剤 dipeptidyl peptidase 4 dpp 4 inhibitors for the treatment of type 2 diabetes mellitus

English Journal

• Insights into the poor prognosis of allopurinol-induced severe cutaneous adverse reactions: the impact of renal insufficiency, high plasma levels of oxypurinol and granulysin.

• Chung WH1, Chang WC2, Stocker SL3, Juo CG4, Graham GG3, Lee MH3, Williams KM3, Tian YC5, Juan KC5, Jan Wu YJ6, Yang CH7, Chang CJ8, Lin YJ8, Day RO3, Hung SI2.
• Annals of the rheumatic diseases.Ann Rheum Dis.2015 Dec;74(12):2157-64. doi: 10.1136/annrheumdis-2014-205577. Epub 2014 Aug 12.
• OBJECTIVE: Allopurinol, an antihyperuricaemic agent, is one of the common causes of life-threatening severe cutaneous adverse reactions (SCAR), including drug rash with eosinophilia and systemic symptoms (DRESS), Stevens-Johnson syndrome (SJS) and toxic epidermal necrosis (TEN). The prognostic facto
• PMID 25115449

• Evaluation of Cytokine Profile and HLA Association in Benznidazole Related Cutaneous Reactions in Patients With Chagas Disease.

• Salvador F1, Sánchez-Montalvá A1, Martínez-Gallo M2, Sala-Cunill A3, Viñas L2, García-Prat M2, Aparicio G4, Sao Avilés A1, Artaza MÁ5, Ferrer B6, Molina I1.
• Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.Clin Infect Dis.2015 Dec 1;61(11):1688-94. doi: 10.1093/cid/civ690. Epub 2015 Aug 11.
• BACKGROUND: Benznidazole is the drug of choice for Chagas disease. The major drawback of this drug is the high adverse events rate, being cutaneous reactions the most frequent one, leading to definitive withdrawal of treatment in 15%-30% of patients.METHODS: Prospective observational study where adu
• PMID 26265500

• Do Patients With a Failed Metal-on-metal Hip Implant With a Pseudotumor Present Differences in Their Peripheral Blood Lymphocyte Subpopulations?

• Catelas I1,2,3, Lehoux EA4, Hurda I5, Baskey SJ4, Gala L6,7, Foster R8,9, Kim PR6,7, Beaulé PE6,7.
• Clinical orthopaedics and related research.Clin Orthop Relat Res.2015 Dec;473(12):3903-14. doi: 10.1007/s11999-015-4466-8. Epub 2015 Sep 1.
• BACKGROUND: Early adverse tissue reactions around metal-on-metal (MoM) hip replacements, especially pseudotumors, are a major concern. Because the causes and pathomechanisms of these pseudotumors remain largely unknown, clinical monitoring of patients with MoM bearings is challenging.QUESTIONS/PURPO
• PMID 26324830

Japanese Journal

• Survivin and PSMA loaded dendritic cell vaccine for the treatment of Prostate Cancer

• Biological and Pharmaceutical Bulletin advpub(0), 2015
• NAID 130004872305

• 夏型過敏性肺炎 (特集 過敏性肺炎 : 最近のトピックス)

• 細胞 45(12), 555-558, 2013-11
• NAID 40019987697

• Diesel exhaust (DE) aggravates pathology of delayed-type hypersensitivity (DTH) Induced by methyl-bovine serum albumin (mBSA) in mice

• Journal of toxicological sciences 34(5), 483-492, 2009-10-01
• NAID 110007358580

Related Links

• type IV hypersensitivity - definition of type IV hypersensitivity ...

type IV hypersensitivity see Gell and Coombs classification, under classification. type IV hypersensitivity. See cell-mediated immune response. Want to thank TFD for its existence? Tell a friend about us, add a link to this page, .? ...

• Type IV Hypersensitivity

The classical mechanistic explanantion is illustrated above. Delayed type hypersensitivity results when an antigen presenting cell, typically a tissue dendritic cell which has picked up antigen, processed it and displayed ...

Related Pictures

---

★リンクテーブル★

リンク元	「IV型アレルギー」「delayed hypersensitivity」
拡張検索	「type IV hypersensitivity reactions」
関連記事	「type」「I」「IV」「typed」「typing」

「IV型アレルギー」

　　[★]

英

type IV allergic reaction

同

IV型アレルギー反応、type IV hypersensitivity、遅延型アレルギー反応 delayed allergic reaction delayed type allergic reaction、遅延型過敏症 delayed-type hypersensitivity delayed type hypersensitivity DTH、遅延型過敏症アレルギー、遅延型アレルギー、遅延型過敏性免疫反応、遅延型過敏反応

関

アレルギー

概念

• 抗原特異的T細胞によって起こる細胞性免疫反応

関与する細胞・物質

• 1.

• 1) 抗原提示細胞：マクロファージ、樹状細胞
• 2) 抗原に感作されたT細胞(IV型アレルギーの原因となっているT細胞 = T_DTH)

• 2. T細胞が放出するサイトカイン(昔の言葉でリンホカイン)
• 3. 2.によって動員される細胞：T細胞、マクロファージ

アレルギー反応発現までの時間

• ピークは24-48hr　　⇔　I型アレルギーは即時

病態生理

• 体内に侵入した抗原は樹状細胞やマクロファージなどの抗原提示細胞に貪食され分解されて、MHC class IIに抗原をのせてT細胞に提示する。T細胞は感作され、再び抗原刺激を受けるとINF-γやTNF-αなどのサイトカインを産生し炎症を惹起する。この反応は抗原進入後48時間程度でピークとなる。(SPE.291)
• ここで活性化されるT細胞がTh2細胞優位である場合、I型アレルギー反応の遅延型反応のような反応を呈する。

主な疾患

• 1. 接触性皮膚炎 contact dermatitis

• アレルゲン：うるし、銀杏など、装飾品(めがね、イヤリング、時計など)、下着、外用薬、化粧品
• アレルゲンテスト：パッチテスト(皮膚貼付試験: アレルゲン貼付後24-48時間後に判定)

• 2. アトピー性皮膚炎 atopic dermatitis, atopic eczema

• I型アレルギー + IV型アレルギー

• 3. 慢性肉芽種症 chronic granuloma

• アレルゲン：結核、癩(らい)、サルコドーシスの原因となる病原体

IV型アレルギーを利用した検査

• 1. ツベルクリンテスト
• 2. 光田反応

• 癩抗原(レプラミン)注射後、硬結を判定

• 3. ディック反応

• 猩紅熱のディック毒素の判定

• 4. フライ反応

• 鼡径リンパ肉芽腫(第4性病)の判定

• 5. DNCB感作試験

「delayed hypersensitivity」

　　[★]

遅延型過敏症

関

type IV hypersensitivity

「type IV hypersensitivity reactions」

　　[★]

関

hypersensitivity reactions＆type IV

関

hypersensitivity reactions＆type IV

「type」

　　[★]

• n.

• 型、タイプ、(生物)タイプ標本

(windows)ファイル内容表示(linux -> cat])

ex. type report_20111118.jp.htm | php a.php > report_20111118.jp.jp.jp.html

関

form、mode、pattern、type specimen、typed

　 　 　 　 　 　 　 　

「I」

　　[★]

• イソロイシン isoleucine
• イノシン inosine
• 阻害剤 inhibitor
• iodine
• ヨード iodide
• I因子 factor I

　 　 　

「IV」

　　[★]

• adj.

• 静脈内の

関

i.v.、intravascular、intravenous、intravenously

「typed」

　　[★]

• adj.

• 型の

関

form、mode、pattern、type

「typing」

　　[★]

• n.

• タイプで打つこと、タイピング。分類