Arthus Systemic

Type III Reactions These reactions involve the presence of antigen-antibody complexes, particularly those formed as a result of the production of autoantibodies. These complexes deposit in various tissues and involve inflammatory cells as well as complement, resulting in tissue damage due to the production of proteolytic enzymes by polymorphonuclear leukocytes and macrophages. A number of autoimmune diseases result from these reactions. Some clinical examples include systemic lupus erythematosus, rheumatoid arthritis, immune complex glomerulonephritis, Arthus reaction and serum sickness. 

Systemic lupus erythematosus (SLE or lupus), serum sickness, arthus reaction. Mediated by IgG and complement. 

General reactions (seen in some older children and adults) are usually limited to brief fever sustained fever and other systemic reactions are uncommon unless the person has been hyperimmunized. After the administration of DT vaccine, local reactions, generally erythema and induration, with or without tenderness, can occur. In hyperimmunized cases, Arthus-type hypersensitivity reactions can occur. These characteristically severe local reactions generally start 2-8 hours after an injection. People who have such reactions usually have very high serum antitoxin concentrations and one should be careful not to administer a booster more than once every 10 years. 

Arthus reactions and systemic reactions have commonly been reported after booster doses of polysaccharide vaccine and are thought to result from antigen-antibody reactions involving antibodies induced by the previous immunization (16). Data on revaccination of children are not yet sufficient to provide a basis for recommendation. 

Examples Allergic rhinitis, asthma, systemic anaphylaxis Some drug allergies (eg.. penicillin) Serum sickness, Arthus reaction Tuberculin reaction, contact dermatitis (with IVc) Chronic asthma, chronic allergic rhinitis Maculopapular exanthema with eosinophilia Contact dermatitis, Maculopapular and bullous exanthema, hepatitis AQEP Beh t disease... 

Allergy a hypersensitivity of the immune apparatus s pathological immune reaction induced either by antibodies (immediate hypersensitivity) or by lymphoid cells (delayed type A.). Unlike the delayed type, immediate hypersensitivity can be passively transmitted in the serum. Symptoms of immediate hy-peisensitivity begin shortly after contact and decay rapidly, but delayed type symptoms do not attain a maximum for 24-48 hours then decline slowly over days or weeks Examples of immediate type A. are anaphylaxis the Arthus reaction and serum sickness. The best known A., anaphylaxia, can occur as a local (cutaneous) reaction (e.g. a rash with blisters) or as a systemic reaction (anaphylactic shock). Asthma, hay fever and nettle rashes are also examples of local anaphylactic reactions which are induced by reagins (see Immunoglobulins IgE). Only primates can be sensitized by injection with human reagins. An example of delayed type A. is the tuberculin reaction, which is based on a cellular immune response. 

Glovsky et al. observed an anticomplementary activity for levopimaric acid (45), a derivative of abietic acid, and prepared a number of synthetic derivatives such as maleopimaric acid (46) and fumaropimaric acid (47), being Diels-Alder substitution products of levopimaric acid v ith maleic anhydride or fumaric acid, respectively [28, 29]. Maleic acid is cis-butenedioic acid, fumaric acid is trans-butenedioic acid. Maleopimaric acid inhibited complement-mediated haemolysis via classical path-way activation (45% inhibition at a concentration of 500 iM), Fumaropimaic acid inhibited in vivo complement-dependent systemic Frossman, cutaneous Frossman, and reverse passive Arthus reactions. These pimaric acid derivatives have already been included in earlier reviews on complement-active compounds [8, 30]. The... 

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