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allergy, or allergenic disease, or hypersensitivity

antigen, foreign substance that, when introduced into the body, is capable of adhering to lymphocytes, which are the body's infection-fighting white blood cells. An antigen that induces an immune response--i.e., stimulates the lymphocytes to produce antibody or to attack the antigen directly--is called an immunogen. Virtually any large foreign molecule can act as an antigen, including those contained in bacteria, viruses, protozoa, helminths, foods, snake venoms, egg white, serum components, red blood cells, and other cells and tissues of various species, including humans. On the surface of the antigens are molecules, called antigenic determinants, that fit and bind to receptor molecules of complementary structure on the surface of the lymphocytes. The binding of the lymphocytes' receptors to the antigens' surface molecules stimulates the lymphocytes to multiply and to initiate an immune response--including the production of antibody, the activation of cytotoxic cells, or both--against the antigen (see immunity ). The amount of antibody formed in response to stimulation depends on the kind and amount of antigen involved, the route of entry to the body, and individual characteristics of the host. See also antibody ; lymphocyte. (see also Index: antigen-antibody reaction)

Copyright 1994-1999 Encyclopedia Britannica

allergen, substance that in some persons induces the hypersensitive state of allergy and stimulates the formation of reaginic antibodies. Allergens may be naturally occurring or of synthetic origin and include pollen, mold spores, dust, animal dander, insect debris, foods, blood serum, and drugs. Identification of allergens is made by studying both the site of symptoms (e.g., inhalants such as molds, pollens, and dander usually affect the eyes, nose, and bronchi; cosmetics often affect the skin of the face and hands) and the time that symptoms appear (e.g., seasonal allergy to pollen). See also antigen ; reagin .

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Copyright 1994-1999 Encyclopedia Britannica

lymphocyte, type of leukocyte (white blood cell) that is of fundamental importance in the immune system. In humans, lymphocytes make up 20-25 percent of the total number of leukocytes.

The two primary types of lymphocytes are B lymphocytes and T lymphocytes, or B cells and T cells. Both originate from stem cells in the bone marrow and travel in the blood to lymphoid tissues, such as the spleen, tonsils, and lymph nodes. Most T cells are long-lived, their life span averaging 2 to 4 years, while most B cells are short-lived, with an average life span of a week to a few months.

Through receptor molecules on their surfaces, lymphocytes are able to bind to antigens (foreign substances or microorganisms that the host recognizes as "nonself") and help remove them from the body. Each lymphocyte bears receptors that bind to a specific antigen. The ability to respond to virtually any antigen comes from the fact that the body contains millions of lymphocytes, with many carrying unique receptors.

Once stimulated by binding to an antigen, such as a bacterium or a virus, a B cell multiplies into a clone of identical cells. Some of these cloned B cells differentiate into plasma cells that produce antibody molecules. These antibodies are closely modeled after the receptors of the precursor B cell, and, once released into the blood and lymph, they bind to the target antigen and initiate its neutralization or destruction (see antibody ). Antibody production continues for several days, until the antigen has been overcome. Other B cells, called memory cells, are stimulated to multiply but do not differentiate into plasma cells; they provide the immune system with long-lasting memory and a heightened sensitivity to a particular type of antigen should it return to the host.

Before arriving in the lymphoid tissues, T cells mature in the thymus, where they multiply and differentiate into helper, suppressor, and cytotoxic T cells. Once stimulated by the appropriate antigen, helper T cells secrete lymphokines, which stimulate the differentiation of B cells into plasma cells, thereby promoting antibody production. Suppressor T cells act to diminish this reaction, hence their name. Cytotoxic T cells, which are activated by the leukokine interleukin 2, bind to and kill infected cells (especially those infected by viruses). See also leukocyte .

Copyright 1994-1999 Encyclopedia Britannica

T cell, or T lymphocyte, or thymus-derived cell, or thymus-derived lymphocyte (cytology)

B cell, or B lymphocyte, or thymus-independent lymphocyte (biol.)

antigen-antibody reaction, or immune reaction, or immunological response (biol.)

IgE, or immunoglobulin E (biochem.)

mast cell, type of cell of the immune system of vertebrate animals. Mast cells mediate inflammatory responses such as hypersensitivity and allergic reactions. They are scattered throughout the connective tissues of the body, especially beneath the surface of the skin, near blood vessels and lymphatic vessels, within nerves, throughout the respiratory system, and in the digestive and urinary tracts. Mast cells store a number of different chemical mediators--including histamine, interleukins (IL-4 and IL-5), proteoglycans (e.g., heparin), and various enzymes--in coarse granules found throughout the cytoplasm of the cell. Upon stimulation by an allergen, the mast cells release the contents of their granules (called degranulation) into the surrounding tissues. The chemical mediators produce local responses characteristic of an allergic reaction, such as increased permeability of blood vessels (i.e., inflammation and swelling), contraction of smooth muscles (e.g., bronchial muscles), and increased mucus production.

Copyright 1994-1999 Encyclopedia Britannica

anaphylaxis, in immunology, a severe, immediate, often fatal bodily reaction to contact with a foreign substance, or antigen, to which the individual has become sensitized. The condition has been extensively studied in guinea pigs, a species very liable to anaphylactic shock. The first injection of an antigen, such as egg albumin, into the body of this animal is generally harmless. A similar injection two or three weeks later has quite a different result. Within a few minutes or even seconds after reinjection, the animal sneezes, scratches its nose, becomes restless, and has great difficulty in breathing. The guinea pig may then die from asphyxia owing to its inability, in spite of violent effort, to ventilate its lungs effectively.

Anaphylaxis occurs, with varying severity, in many animals. Rats are resistant, rabbits moderately so. In humans it occurs rarely, after such events as injection of antiserum or antibiotic or after bee or wasp stings. Symptoms in humans include itching of the scalp and tongue, skin flush of the whole body, difficulty in breathing because of swelling or spasm of the bronchi, an abrupt fall in blood pressure, and unconsciousness. In milder cases, hives may spread over the whole body, and often there is a severe headache. Treatment, which must begin within a few minutes of attack, involves the injection of epinephrine (adrenaline), followed by the administration of antihistamines, cortisone, or similar drugs.

The mechanism of anaphylaxis is not fully understood but results from antigen-antibody reactions taking place on the surface of mast cells, thus damaging them and causing them to suddenly release a combination of chemicals including histamine and leukotrienes. These in turn produce the symptoms of anaphylactic shock. Anaphylaxis may occur after contact with extremely small amounts of antigen and is more common in persons with a history of atopic dermatitis.

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desensitization, also called HYPOSENSITIZATION, treatment that attempts to eliminate allergic reactions, as of hay fever or bronchial asthma, by a series of injections in graded strengths of the substance to which the person is sensitive (e.g., pollen, house dust). Extracts of the material to be injected are purified and put into an alkaline buffer solution, to which epinephrine (adrenaline) is often added to minimize local inflammatory reactions. The first injections contain little antigen, but, as desensitization progresses, more and more is added. A three-month program of injections often suffices for hay-fever sufferers, but asthmatics may require a longer program.

Desensitization is successful in about 80 percent of hay-fever sufferers and up to 90 percent of asthmatics; treatment is more effective in persons with a few, well-defined allergies than in those allergic to many substances. The success of desensitization is attributed to special antibodies, called blocking antibodies, that appear in the serum after treatment and combine preferentially with allergen. This prevents the reaction of allergen with allergic antibodies in the skin and precludes an allergic reaction. Desensitization can also be required when a penicillin-sensitive person contracts a disease such as bacterial endocarditis, which is best treated with penicillin. See also allergy ; anaphylaxis ; antibody ; antigen .

Copyright 1994-1999 Encyclopedia Britannica

complement, in blood chemistry, a complex system of at least 20 proteins, known as complement components, found in the normal blood serum of humans and other vertebrates. The complement system mediates many immunological phenomena, including the lyses (bursting) of foreign and infected cells, the phagocytosis (ingestion) of foreign particles and cell debris, and the inflammation of surrounding tissue.

In the late 19th century complement was identified as one of two substances in human serum responsible for killing bacteria, the other substance being antibody. Complement was so named because it "complemented" the action of the antibody, meaning it was necessary for cell lyses to occur.

Each complement component is a protein, made up of polypeptides (chains of amino acids held together by peptide bonds). The immunologic activity of complement begins when one component binds to an antigen-antibody complex and begins a chemical chain reaction with other components. In one process, called complement fixation, activated components pierce the outer membrane of the bacterium or cell to which the antibody is attached, effectively lying and killing it. In another process, fragments of complement released during the reaction attract macrophages, which engulf and digest the particle. Such fragments can also cause the release of histamine and attract a flood of phagocytic granulocytes, which contribute to the swelling and discoloration common to inflammation.

The components of complement differ in life spans and periods of activity; this factor, as well as the presence of inhibitors in the blood, helps explain why complement is activated only at a site of microbial invasion and not throughout the whole body.

Copyright 1994-1999 Encyclopedia Britannica

delayed allergic reaction

type IV hypersensitivity, or delayed allergic reaction, or delayed hypersensitivity (med.)

Copyright 1994-1999 Encyclopedia Britannica

allergies

As explained earlier, the immune system must be able to recognize and respond to almost any foreign molecule, since it cannot foretell which molecules will be characteristic of potentially infective agents and which will not. Consequently, an immune response can be induced by materials that have nothing to do with infection, and the mechanisms brought into play, though beneficial for eliminating microbes, are not necessarily beneficial when otherwise innocuous substances are concerned. Furthermore, even initially protective mechanisms can cause secondary disorders when they operate on too great a scale or for longer than necessary, thereby damaging tissues remote from the infection. The terms allergy and hypersensitivity are commonly used to describe inappropriate immune responses that occur when a subject is reexposed to substances that were harmless when encountered for the first time. (see also Index: drug allergy)

The manifestations of a particular allergic reaction depend upon which of the immune mechanisms predominates in the response. Based on this criterion, immunologists recognize four types of hypersensitivity reactions. Types I, II, and III involve antibody-mediated mechanisms and are of rapid onset. Type IV, on the other hand, stems from cell-mediated mechanisms and has a delayed onset. Although this categorization is useful, it should be noted that an allergy can involve a combination of hypersensitivity reactions.

Copyright 1994-1999 Encyclopedia Britannica

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