Question

Describe the cellular immunology events that give rise to an anaphylactic response to peanuts?

What are some of the emergency treatments we can administer for patients experiencing anaphylaxis?

Answer 1

That response is known as hypersensitivity. There are various types of hypersensitivity. But this one is type I or IgE mediated. It occurs in two phases sensitisation and subsequent exposure. The sensitisation occurs when the allergin enters the body for first time. The antigen presenting cells present this to the naive T helper cells in lymph nodes and  secrete pro stimulatory molecules. This primes the T helper cells and convert them into T helper 2 cells. They stimulate production and synthesis of eosinophils and make B cells undergo antibody class switching to produce IgE antibodies. These IgE antibodies bind to mast cells. On subsequent exposure, these allergies bind to mast cells and make them degranualte releasing pro inflammatory mediators like histamine. It causes symptoms like vasodilation, broncho constriction, edema, etc. These are early reactions. Late reactions involving T helper 2 cells, eosinophils, basophils and leukotrienes which causes late symptoms. This could lead to anaphylactic shock.

The treatment focuses on reversing the effects. This is an emergency and require immediate medial intervention. We prescribe antihistamines, corticosteroids and epinephrine.

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