Immune complex-mediated

Edwards and Jones (31) identified the condensed tannin extracted from cotton plant bracts as a tannin-like polymer of 5, 7, 3, 4 tetrahydroxyflaven 3-4 diol (THF). They demonstrated nonspecific precipitation with IgG, IgM, IgA, five myeloma IgG s and positive gel diffusion reactions with heavy and light chains. Fab and Fc pieces of IgG. Nevertheless, they refuted this reaction as a true antigen-antibody reaction, and subsequently suggested that byssinosis was not an immune complex mediated pulmonary disease. 

The bleeding potential is similar among the agents. However, thrombocytopenia, particularly profound thrombocytopenia (platelet count <50,000 mrrT3) occurs with a two-to four-fold higher frequency with abciximab (0.4— 1.0%) compared with eptifibatide (0-0.2%) or tirofiban (0,1 —0.3%) (6), The exact mechanism of this difference is not clear, However, immune complex-mediated reaction (due to an anamnestic response to the humanized chimeric antibody) may contribute to rapid precipitation of thrombocytopenia with abciximab (6), Platelet counts should, therefore, be measured early (within the first one to four hours) after administration of these agents and followed for the duration of therapy. Platelet transfusion should be considered for profound thrombocytopenia with or without serious bleeding (6). 

The continuous presence or production of tumor antigens along with an antibody response represents a situation, not unlike chronic autoimmune disease, in which the immune complexes may be continually forming. Overt immune complex-mediated disease such as nephritis does occasionally occur, and the presence of tumor-associated antigens and antibodies in immune deposits has been well documented in several instances (C17, Dl,... 

W3. Wallace, M., Leet, G., and Rothwell, P., Immune complex-mediated glomerulonephritis with infectious mononucleosis. Aust. N. Z. J. Med. 4, 192-195 (1974). 

Hebert LA, Cosio FG, Birmingham DJ, Mahan JD, Sharma HM, Smead WL, Goel R. Experimental immune complex-mediated glomerulonephritis in the nonhuman primate. Kidney Int 1991 39 44-56. 

Acquired immunodeficiency renders a host much more susceptible to secondary infections, including cytomegalovirus, syphilis, herpes zoster, fungi, hepatitis B, tuberculosis, and toxoplasmosis. HIV invades the tissues of the optic nerve and initiates an immune complex-mediated response that results in an optic neittopathy. The primary HIV infection may be responsible for color vision defects, loss of contrast sensitivity, and visual field defects. HIV infection itself may also cause direct degeneration of retinal ganglion cell axons in the optic nerve without a secondary opportunistic infection. 

III Immune complex mediated, complement dependent Serum sickness, drug fever, vasculitis... 

Lovett DH, Johnson RJ, Marti HP, Martin J, Davies M, and Couser WG. Structural characterization of the mesangial cell type IV collagenase and enhanced expression in a model of immune complex-mediated glomerulonephritis. Am. J. Pathol. 1992 141(l) 85-98. 

Schatz PL, Mesologites D, Hyun J, Smith GJ, Lahiri B. CaptoprU-induced hypersensitivity lung disease. An immune-complex-mediated phenomenon. Chest 1989 95(3) 685-7. 

Salama A, Gottsche B, Schleiffer T, Mueller-Eckhardt C. Immune complex mediated intravascular hemolysis due to IgM cephalosporin-dependent antibody. Transfusion 1987 27(6) 460-3. 

Endoh T, Yagihashi A, Sasaki M, Watanabe N. Ceftizoxime-induced hemolysis due to immune complexes case report and determination of the epitope responsible for immune complex-mediated hemolysis. Transfusion 1999 39(3) 306-9. 

The authors discussed two possible causal mechanisms, natural infection or an immune complex-mediated mechanism. Infection was excluded by negative bacterial and viral serology and the favorable outcome within a few days without antimicrobial treatment. 

Thrombocytopenia and immune complex-mediated hemolytic anemia have been reported with feprazone (SEDA-7,108). 

Can be immune complex-mediated, antiglomerular basement membrane antibody-mediated, or associated with antineutrophil cytoplasmic autoantibodies. 

Primary IgA nephropathy an immune-complex-mediated disease in which IgA deposits and other pathologic lesions are found in kidney tissues. In contrast, Henoch-Schonlein purpura is a systemic disease that is believed to be closely linked to IgA nephropathy because they share similar immunohistologic features. Only the joints, skin, and gastrointestinal tract are affected in Henoch-Schonlein purpura. Mesangial deposition of IgA immune complex is also seen in patients with celiac disease and dermatitis herpetiformis, possibly due to an increased exposure to antigens. Patients with chronic liver disease may have IgA nephropathy because of reduced clearance of IgA immune complexes. Secondary IgA nephropathy may be present in patients with different connective tissue diseases, carcinomas, and HIV infection. 

There is an increase in serum creatine kinase concentration and electromyography abnormalities. Other serum enzymes, such as the alanine transaminase, aspartate transaminase, and lactate dehydrogenase, also may be increased. Muscle biopsies show a necrotizing inflammatory process. The skin lesions of dermatomyositis show an immune-complex-mediated necrosis of the microvasculature. PM... 

Deshpande V, Chicano S, Finkelberg D, et al. Autoimmune pancreatitis a systemic immune complex mediated disease. Am J Surg Pathol. 2006 30 1537-1545. 

Khurana R Chauhan RS (2002) Pesticide induced immune complex mediated glomerulonephritis in sheep. J Immunol Immunopathol, 4(1-2) 40-42. 

Immediate hypersensitivity Hay fever, urticaria, atopic asthma Antibody-dependent cytotoxic hypersensitivity Immune complex mediated hypersensitivity (Arthus reaction)... 

Mantovani, B., Phagocytosis of immune complexes mediated by IgM and C3 receptors by macrophages from mice treated with glycogen. J Immunol 126(1) 127-130, 1981. 

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