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When Someone'S Immune System Overreacts To Something Harmless It'S Called
An allergist/immunologist is a medical doctor who specializes in treating and managing allergies, asthma, and other immune system disorders. An allergist/immunologist treats conditions involving the immune system. Common conditions that affect the immune system include the following: In this article, we discuss what allergist/immunologists do, the types of conditions that they treat, and how they differ from rheumatologists. Share on PinterestAllergist/immunologists may help treat allergic rhinitis, asthma, and urticaria.An allergist/immunologist is a medical doctor who specializes in diagnosing, treating, and managing health conditions that affect the immune system.People with allergies often work with these healthcare professionals. Allergies occur when the immune system overreacts to a usually harmless substance, such as pet dander, insect stings, or specific proteins in food.Allergist/immunologists may help treat the following immune-related conditions:Allergic rhinitis is an allergic reaction that causes inflammation in the nose and airways. Allergic conjunctivitis causes inflammation around the eyes when the person comes into contact with an allergen. Anaphylaxis refers to a severe, life threatening allergic reaction that can make breathing difficult or impossible and may cause low blood pressure and vomiting. Injectable epinephrine can help minimize these symptoms, but the person will require immediate medical attention.Asthma is a chronic condition that causes inflammation and excess mucus production in the airways, which can make breathing difficult. Other asthma symptoms include wheezing, coughing, and chest tightness. Atopic dermatitis is a type of eczema that causes a red, itchy skin rash. It occurs most frequently in individuals who have underlying allergies. In some cases, certain environmental or food triggers may aggravate it.Urticaria, or hives, refers to red, itchy welts that develop on areas of the skin following exposure to a food or medication allergen. The welts may also develop after contact with an environmental allergen, such as animal dander, or even as part of an autoimmune-like reaction.Eosinophilic esophagitis occurs when a type of white blood cell called an eosinophil accumulates in the esophagus (food pipe), resulting in chronic inflammation and tissue damage. Primary immunodeficiency diseases that occur when different types of immune cells or proteins malfunction or are missing.Autoinflammatory syndromes, which cause spontaneous inflammation due to an overactive immune response.Allergist/immunologists in the U.S. complete at least 9 years of graduate-level education and training before they start seeing patients. Allergy/immunology is an internal medicine or pediatric subspecialty. Clinical allergist/immunologists treat people who have allergies or immunologic diseases. They usually work in private or state-run healthcare facilities. Academic allergist/immunologists plan and conduct research studies in the field of allergy and immunology. Some academic allergist/immunologists also see patients in a clinical setting. Allergist/immunologists can choose to focus on treating or researching other medical subspecialties in addition to allergy and immunology. These can include: general or transplant surgery autoimmune diseasesinfectious diseases oncology (cancer)Allergist/immunologists perform a wide range of tests and procedures to identify and treat immune conditions. Clinical allergist/immunologists work with patients directly. During the initial visit, an allergist/immunologist will review the person’s medical history. They may ask questions regarding a person’s: current symptomscurrent medicationsprevious treatments and their effectsfamily medical history exposure to environmental toxinsAfter gathering enough background information, an allergist/immunologist might recommend one or more tests to help them diagnose the underlying immune condition. They may use:Patch tests, which can help identify specific substances that cause allergic skin reactions.Skin prick tests to identify specific immediate allergies to environmental and food triggers.Antibody tests to measure the levels of antibodies present in the blood. Allergist/immunologists use these tests when they diagnose immunodeficiency conditions and allergies.T cell tests, which measure the number of specialized immune cells, called T cells, in the blood. Allergist/Immunologists also use this test to evaluate a person’s T cell activity. Once an allergist/immunologist diagnoses an underlying condition, they can plan the best course of action. Treatments for allergic and immune diseases vary and can include:antihistamines, topical corticosteroids, and over-the-counter decongestants for minor environmental allergies corticosteroid creams and ointments for allergic skin reactionsepinephrine injections for severe systemic allergic reactions immunoglobulin replacement or stem cell transplantation for primary immunodeficiency diseases antibiotics to prevent recurring infections Allergist/immunologists can also educate people about their condition and provide valuable lifestyle and dietary tips to help them manage their symptoms. People currently receiving treatment for an allergic/immunological condition can expect to see their allergist/immunologist for regular follow-up appointments. At a follow-up appointment, an allergist/immunologist may run additional tests to evaluate the person’s condition. They will also ask them about any new or worsening symptoms or side effects relating to the medication. The exact education requirements for allergist/immunologists vary by country. Allergist/immunologists in the U.S. undergo the following education programs before beginning their practice:4 year bachelor’s degree at a college or university 4 years at medical school 3 year residency in internal medicine or pediatrics 2 or 3 year fellowship in allergy and immunology Most allergist/immunologists take an average of 9 years to complete their graduate education and specialized training. This training ends with the fellowship program, during which they will get experience in treating specific types of allergic and immune conditions. As with allergy and immunology, rheumatology is a subspecialty within the fields of internal medicine and pediatrics.Allergist/immunologists and rheumatologists both treat conditions that result from problems with the immune system. However, allergist/immunologists treat systemic allergic conditions and immunodeficiency, whereas rheumatologists treat autoimmune diseases and other musculoskeletal diseases, such as arthritis, fibromyalgia, and chronic pain. People should contact an allergist/immunologist if they have an allergic reaction or experience frequent, recurring infections. Rheumatologists can help diagnose and treat people who have autoimmune diseases or chronic muscle or joint pain.Allergist/immunologists diagnose, treat, and manage various immunologic conditions, including allergies, asthma, and immunodeficiency diseases. Many allergist/immunologists combine their clinical experience with academic research to discover how the immune system functions and test new treatments. Allergist/immunologists are not the only medical doctors who treat immunologic diseases. Rheumatologists treat and manage musculoskeletal symptoms that result from inflammatory and autoimmune diseases.
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Hypersensitivity, Overview of the 4 Types, Animation.
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Hypersensitivity refers to abnormal reactions of the immune system against certain antigens. It includes exaggerated reactions to otherwise harmless environmental antigens, commonly known as allergies; and inappropriate reactions against the body’s own antigens, or autoimmune diseases.
Reactions can range from a mild rash, to damaged organs, to fatal anaphylactic shock.
There are 2 principal groups of factors contributing to hypersensitivity:
– Imbalance between effectors and regulators of immune response: in some people, mechanisms that normally moderate the immune system are compromised, causing it to overreact to harmless, non-infectious antigens.
– Self-reactivity of immune cells: during their development in the thymus and bone marrow, T-cells and B-cells learn to not react to the body’s own antigens; self-reactive cells are normally eliminated; but in some people, some of these cells escape and may attack their own tissues once activated.
Hypersensitivity reactions only occur in pre-sensitized individuals. Patients must have had a previous contact with the antigen, which produced no symptoms, but during which the body had started making antibodies or activated immune cells that may cause symptoms in subsequent exposures to the same antigen.
Hypersensitivity is classified into 4 types based on mechanisms of action:
In type I hypersensitivity, a previous exposure to the antigen results in production of a class of antibodies called IgE. IgE molecules bind to their receptors on the surface of mast cells and basophils. Upon re-exposure to the same antigen, or sometimes a similar antigen, the antigen binds to adjacent IgE molecules, bringing their receptors together, triggering a signaling cascade that induces the release of histamine and other inflammatory chemicals. These chemicals cause dilation of blood vessels, smooth muscle spasms, and are responsible for symptoms such as edema, rash, difficulty breathing due to bronchospasm, abdominal cramping, vomiting and diarrhea. The reactions are immediate, within minutes of contact with the antigen, and can range from mild to severe. Severe reactions may lead to anaphylactic shock, a life-threatening condition in which blood pressure drops and airways narrow to a dangerous level. Most allergies are type I hypersensitivity reactions.
In type II hypersensitivity, previously formed IgG or IgM antibodies bind to antigens on the surface of a particular cell type. Antibody binding marks the cells for destruction, either by the complement system or phagocytosis. The antibodies may also interfere with normal functions of the cells without killing them. Type II is at the basis of many autoimmune diseases, where the body produces antibodies to destroy its own cells. Another example is hemolytic disease of the newborn, where maternal antibodies bind to D-antigen on the surface of fetal red blood cells and destroy them.
Type III hypersensitivity reactions are also mediated by IgM or IgG, but in this case, the antibodies bind to free-floating antigens, forming antibody-antigen complexes. The complement system is activated and inflammation results, causing damage to the affected tissue. A typical example is serum sickness, induced by a large amount of antigens in the blood. Immune complexes are deposited in the walls of blood vessels, triggering their inflammation, or vasculitis.
Type IV hypersensitivity is a delayed reaction, mediated by T-cells. Pre-sensitized T-cells are produced during a previous contact with the antigen. Upon re-exposure to the same antigen, T-helper cells release inflammatory cytokines, while T-killers induce cytotoxic reactions. Typical examples are allergic reactions to substances that come into direct contact with the skin, known as contact dermatitis. Type IV is also the basis of the tuberculosis skin test.
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