Hypersensitivity, Allergy, and Asthma: Understanding the Immune Response

This article discusses the relationship between hypersensitivity, allergy, and asthma. It explains the immune response and the different types of allergic reactions. It also covers anaphylaxis and the immune response of asthma.

HYPERSENSITIVITY, ALLERGY, AND ASTHMA
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Hypersensitivity, Allergy, and Asthma
Allergic reactions are sensitive reactions that occur in the body when the body detects a
foreign particle or substance. Allergic illnesses affect about 30% - 35% of total children and
the rate of this condition has been increasing in recent decades1. Children who are atopic
possess a great development of antibodies when some releases certain chemicals that results
in in a reaction accompanied by inflammation of the target organ which are exposed. Asthma,
1 Custovic A. “Indoor allergens are a primary cause of asthma: Asthma and the environment.” Eur
Respir Rev, 2012: 155-158.
(Figure 2, Jarvis D., et al.
2013)

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food allergies and allergic rhinitis are closely interrelated. The three can occur together, or
one condition may ultimately improve the other, or another shape may evolve.
Allergy
Allergy is also known as hypersensitivity
which is a response that arises when the immune
system responds to the harmful substances from
the environment. Allergies are of different
categories of allergens which include; food, drugs
indoor, outdoor, etc. according to allergic diseases.
There is a different type of allergic
diseases which include atopic dermatitis, allergic asthma, and allergic rhinitis.2
Immunology means how the body responds to any foreign materials that
get inside the body. According to scientific definition, hypersensitivity reaction
is classified into four different immunological methods. Type 1 sensitivity is symbolised by
production of immunoglobulin (protein that is produced by plasma cells that neutralize
pathogen like viruses and bacteria) that is produced during sensitization phase. The
immunoglobulin attaches to receptor cells on the mast cells and to the basophils. The second
type is characterised by humoral response that is aided by IgM (largest antibody that is
released first in exposure to antigen) that produces alongside the antigen of the body. The
2 Romano A, Torres MJ, Castells M, Sanz ML, Blanca M. Diagnosis and management of drug hypersensitivity
reactions. J Allergy Clin Immunol. 2011;127:S67-73: 21354502
(Figure 4, Romano A., et al. 2011)
(Figure 3, Xu W, Lan Q, Chen M, et al.,
2012).

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kind of the example that is type 11 is called drug-induced cytopenia resulting from penicillin,
transfusion reactions and also cephalosporin (antibiotics).3
When biding occurs, it kills the target cell
in different ways. Immunoglobulins are proteins
that are released by lymphocytes and plasma
cells .Immunoglobulins can happen when there is
an activation of the classical complement
pathways that in turn leads to a condition called
cytolysis. Secondly is when the antibody cytotoxicity that brings about the breakdown of the
target cells by cells called natural killer cells. Third way is through recognition of Fc cells by
phagocytic cells that leads to opsonisation or destruction of the target cell.
Type III sensitivity entails production of the resistant complexes that are not well
removed by immunity cells just like malaria and occurs within the next four to six hours. The
build-up of an antibody that is bound to antigens in the tissues results
due to excess antigen with the insufficient or immunosuppressant
release. There is also another way how sensitivity occurs due to
production of excess antibody. The manifestation of the stable immune complexes ultimately
leads to inflammation responses because the white blood cells are activated.4
The one more time allergic sensitivity is called delayed response that is majorly facilitated by
T-cells. The good known representative is called contact allergy
3 Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma. [Bethesda, Md.]: U.S. Dept. of
Health and Human Services, National Institutes of Health, National Heart, Lung, and Blood Institute, 2007.
4 JL, Warburton D, Togbe D, Ryffel B, Zheng SG, Shi W. 2012. Adoptive transfer of induced‐treg cells effectively
attenuates murine airway allergic inflammation. PLoS One. 2012;7(7):e40314.
(Figure 6, O’Rourke S. T
2006)
(Figure 5, Custovic A., et al.
2012)

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Anaphylaxis
This is a harsh allergic reaction that occurs due to rapid production of chemical from
mast cell tissues. This response occurs at a very short period of time like one minute and the
patient shows a wide range of symptoms. Anaphylaxis may lead to death if it advances to
cardiorespiratory section.5 Other manifestation that occurs includes intraoral oedema,
cramping in the abdominal part, diarrhoea and vomiting. It is especially critical in children
and can masquerade as asthma. There are many types of food that triggers anaphylaxis. The
types include seafood, tree nuts, peanuts, fish and milk. Antigens may be inside the food
hidden and is very difficult to identify.
The last type of allergic hypersensitivity is type IV called the delayed response that is
principally mediated by T-cells, and the best example is called the contact allergy.
The five classifications of allergy are accepted and give a universal
definition of hypersensitivity irrespective of targeted tissue or organ.
Asthma
Asthma is a type of allergic reaction that is characterized by difficulty
in breathing. It is one of the most studied allergic diseases which are provoked
by allergy which ranges 75% -80% of the asthmatic problem. Based on the world
inventiveness for asthma, the definition as a chronic inflammatory illness of the breathing
system involving mediators and many cells. The signs lead to specific occurrences that
include difficulty in breathing, chest tightness, coughing and wheezing. The medical
manifestation of asthma appears in childhood, but some appear sometime late, sometimes
5 O’Rourke S. T. “Interior Surface Materials and Asthma in Adults: A Population-based Incident Case-Control
Study”. American Journal of Epidemiology, March 2006.
(Figure 7, Romano A., et al. 2011)

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after 40 years. The estimate is that 300 million people agonized from asthma around the
globe and estimated that by the year 2025 the number would have reached 400 million
people.6
Immune Response of Asthma
Asthmatic condition is a very detailed characteristic that is caused by some genes and
environmental condition. Asthma gives some medical
conditions that are known to have different sub phenotype.
People who do research come into agreement that asthma is
not only one disease but combination of disorders that have a
common manifestation. These manifestations are bronchus inflammation, bronchus
sensitivity secretion of much mucus and also inflammation. Such information shows that
these outward characteristics come from allergy response which in turn triggers immune
response. 7% people who have allergy tends to develop asthmatic condition and this
convinces us that the present unique outward characteristic that gives a different result when
compared to allergy. CD4+ cells (glycoprotein found on the surface of immune cells e.g.
macrophages) are the primary cells that are associated with asthma together with mast cells
and eosinophil which are types of white blood cells. Mast cells are cells that are filled with
basophils and they release histamine during allergic reactions.7
6 Xu W, Lan Q, Chen M, Chen H, Zhu N, Zhou X, Wang J, Fan H, Yan CS, Kuang JL, Warburton D, Togbe D, Ryffel B,
Zheng SG, Shi W. 2012. Adoptive transfer of induced treg cells effectively attenuates murine airway allergic‐
inflammation. PLoS One. 2012;7(7):e40314.
7 Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma. [Bethesda, Md.]: U.S. Dept. of
Health and Human Services, National Institutes of Health, National Heart, Lung, and Blood Institute, 2007.
(Figure 8, Jarvis D., Chinn S., et al 2010)

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When allergy material gets into the breathing system and is not removed by the barriers in the
nose such as small hairs and mucus, and later comes to contact with dendritic cells which
then organises and finally eats away the allergy causing. There are various steps of the
inflammatory reaction in asthma, from contact with the allergen to remodelling. During the
process allergic materials penetrates in breathing system, allergic material then tries to come
into contact with dendritic cells which affects and eats away allergic materials. Some of these
dendritic cells move to lymph node to attach the antigen to the T cells.8
Conclusion
Allergies in young children are due to the relationship between environmental and
genetic factors. The best approach to any child who has a greater risk of allergy as well as
asthma is to give proper diet and be kept free from any environmental factors that may cause
the diseases. All allergic diseases are accompanied with inflammation.
Bibliography
8 Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma. [Bethesda, Md.]: U.S. Dept. of
Health and Human Services, National Institutes of Health, National Heart, Lung, and Blood Institute, 2007.
(Figure 9, Expert Panel Report 3 2008)

9
Custovic A. “Indoor allergens are a primary cause of asthma: Asthma and the environment.”
Eur Respir Rev, 2012: 155-158.
Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma. [Bethesda,
Md.]: U.S. Dept. of Health and Human Services, National Institutes of Health,
National Heart, Lung, and Blood Institute, 2007.
Jarvis D., Chinn S., Luczynska C., & Burney P. “The Association of Family Size with Atopy
and Atopic Disease.” Clin Exp Allergy, 2010.
JL, Warburton D, Togbe D, Ryffel B, Zheng SG, Shi W. 2012. Adoptive transfer of induced‐
treg cells effectively attenuates murine airway allergic inflammation. PLoS One.
2012;7(7):e40314.
Lenz HJ. Management and preparedness for infusion and hypersensitivity reactions.
Oncologist. 2007;12:601-9: 17522249
O’Rourke S. T. “Interior Surface Materials and Asthma in Adults: A Population-based
Incident Case-Control Study”. American Journal of Epidemiology, March 2006.
Romano A, Torres MJ, Castells M, Sanz ML, Blanca M. Diagnosis and management of drug
hypersensitivity reactions. J Allergy Clin Immunol. 2011;127:S67-73: 21354502
Xu W, Lan Q, Chen M, Chen H, Zhu N, Zhou X, Wang J, Fan H, Yan CS, Kuang JL,
Warburton D, Togbe D, Ryffel B, Zheng SG, Shi W. 2012. Adoptive transfer of
induced‐treg cells effectively attenuates murine airway allergic inflammation. PLoS
One. 2012;7(7):e40314.