Allergic Cascade (cont.)
John P. Cunha, DO, FACOEP
John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.
Steven Doerr, MD
Steven Doerr, MD, is a U.S. board-certified Emergency Medicine Physician. Dr. Doerr received his undergraduate degree in Spanish from the University of Colorado at Boulder. He graduated with his Medical Degree from the University Of Colorado Health Sciences Center in Denver, Colorado in 1998 and completed his residency training in Emergency Medicine from Denver Health Medical Center in Denver, Colorado in 2002, where he also served as Chief Resident.
In this Article
- The allergic cascade facts
- What are the "players" in the allergic cascade?
- What about a more detailed look at the "players"?
- What are cytokines?
- What is the "early phase" of an allergic reaction?
- What is the "late phase" of an allergic reaction?
- What are the symptoms and consequences of the allergic cascade?
- How does understanding the allergic cascade help?
What are the "players" in the allergic cascade?
Our body's immune system is designed to constantly be on the lookout for intruders. It has the ability to distinguish between "self" and "non-self" (foreign substances, which it protects us from). Let us look at this complex process. For example, consider an exposure to ragweed pollen. Once in the body, the ragweed pollen is engulfed by the immune system's scouts, called antigen presenting cells (APC). These APC slice up the ragweed pollen into small fragments, which then combine with special proteins in the cell, called human leukocyte antigens (HLA). HLA function like a guideline to help the body distinguish "self" from "non-self." When combined with the HLA, the fragments become visible to a key player in the allergic cascade, the lymphocytes, which recognizes them as foreign. This ragweed pollen fragment-HLA combination is exposed on the surface of the APC in full view of these specialized white blood cells.
Note these basic concepts of types of important cells and messenger proteins of the immune reaction:
The term white blood cells, or leukocytes, is derived from the Greek words "leukos" meaning white and "cytes" meaning cells. The white blood cells are essential to the immune system and include the monocytes, macrophages, neutrophils, and lymphocytes.
- Lymphocytes are white blood cells that play a key role in both immunity and allergy. They are divided into two types, the T and B lymphocytes. Each type is responsible for a particular branch of the immune system.
- It is the duty of the T-lymphocytes to be ready to directly shift into action to attack foreign substances (cell-mediated immunity). Some T-lymphocytes are experts at "killing" (cytotoxic or killer T cells) while others assist the immune response and are termed "helper" cells (TH cells). The TH cells are further divided into TH1 (infection fighters) and TH2 (allergy promoters), depending on the proteins they release.
- The partners of the T-lymphocytes are the B-lymphocytes. B-lymphocytes are tiny antibody factories that produce antibodies to help destroy foreign substances when stimulated to do so by the TH cells.
- Basophils and eosinophils are other white blood cells that play an important role in allergy. T cells often call these cells into action in allergic conditions. Blood levels of eosinophils are commonly elevated in people with asthma and other allergic diseases.
- Cytokines are a diverse group of proteins that are released by lymphocytes and macrophages in response to an injury or activation, such as by an allergen. They act as chemical signals that "step up" or "step down" the immune reaction.
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