Pathophysiology of autoimmune and allergic diseases. Hypersensitivity reactions type II type IV
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1 Pathophysiology of autoimmune and allergic diseases Hypersensitivity reactions type II type IV Audrey NOSBAUM, Florence HACARD, Marc VOCANSON, Frédéric BERARD, Jean François NICOLAS Allergologie et Immunologie Clinique, INSERM U1111 CIRI, CHU Lyon Sud Hypersensitivity reactions 1. Immunology definition Hypersensitivity reactions = inappropriate and damaging immune response to an antigen caused by adaptive immunity (Igs and/or T cells) - Allergic diseases - Autoimmune diseases 2. Allergy définition Hypersensitivity reactions = inappropriate and damaging immune response to a molecule caused by both innate and/or adaptive immunity - Allergic HS - Non allergic HS 1
2 Hypersensibilité (HS) HS Allergique HS Non Allergique 2
3 Hypersensibilités Classification de Gell & Coombs Antibody T cells Th1/Type 1 Th2/Type 2 Cytotoxic Th17/Type 17 Maladies autoimmunes et allergiques Dermatoses autoimmunes et allergiques Allergies médicaments Anaphylaxie Rhinite allergique Asthme (crise) Urticaire contact Réaction transf. Anémie hémol. Thyroidite Myasthénie Pemphigus Pemphigoide Urticaire chroni. Maladie sérique Lupus érythémateux Choc anaphylactique Cytopénies medic. Vascularites immuno allerg. IDR tuberculine Asthme chron. Rhinite chron. Vascularites Psoriasis Dermatite atopique SEP Vitiligo Pelade Eczéma contact Exanthème médic. DRESS Lyell Stevens Johnson Sclérose en plaque Mal. de Crohn Psoriasis Hypersensibilités Classification de Gell & Coombs Antibody T cells Th1/Type 1 Th2/Type 2 Cytotoxic Th17/Type 17 Maladies autoimmunes et allergiques Anaphylaxie Rhinite allergique Asthme (crise) Réaction transf. Anémie hémol. Thyroidite Myasthénie Maladie sérique Lupus érythémateux IDR tuberculine Asthme chron. Rhinite chron. SEP Sclérose en plaque Mal. de Crohn 3
4 Hypersensibilité de type II due à des IgG spécifiques PEMPHIGUS Hypersensibilités Classification de Gell & Coombs Antibody T cells Th1/Type 1 Th2/Type 2 Cytotoxic Th17/Type 17 Maladies autoimmunes et allergiques Anaphylaxie Rhinite allergique Asthme (crise) Réaction transf. Anémie hémol. Thyroidite Myasthénie Maladie sérique Lupus érythémateux IDR tuberculine Asthme chron. Rhinite chron. SEP Sclérose en plaque Mal. de Crohn 4
5 Figure Hypersensibilité de type III due à des complexes immuns VASCULITES PURPURA RHUMATOIDE 5
6 Hypersensibilités Classification de Gell & Coombs Antibody T cells Th1/Type 1 Th2/Type 2 Cytotoxic Th17/Type 17 Maladies autoimmunes et allergiques Anaphylaxie Rhinite allergique Asthme (crise) Réaction transf. Anémie hémol. Thyroidite Myasthénie Maladie sérique Lupus érythémateux IDR tuberculine Asthme chron. Rhinite chron. SEP Sclérose en plaque Mal. de Crohn 6
7 Type 1 Immunity 7
8 Type 2 Immunity Type 3/ type 17 Immunity 8
9 Hypersensibilité de type IV (HS retardée) due à des LT PSORIASIS Th17 Type 17 Hypersensibilité de type IV (HS retardée) due à des LT DERMATITE ATOPIQUE Th2 Type 2 9
10 Toxidermies Drug allergy Cytotoxic Severity Prevalence SEVERE 1 TEN: Toxic Epidermal Necrolysis MODERATE 2 DRESS: Drug Rash with Eosino &Systemic symptoms 3 AGEP: Acute Generalized Exanthematous Pustulosis 4 - FDE: Fixed Drug Eruption 5 - Generalized Erythema multiform 6 - Linear IgA Dermatosis MILD 7 - MPE: Maculo-papular exanthema Département Allergologie et Immunologie Clinique Clinical Research Unit INSERM translational research team Allergology & Clinical Immunology Department 10
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