Hypersensitivity Reactions?

[rspr41]

According to a question in Kaplan Q bank Helmnith infections seem to be a type I hypersensitivity reactions due to the increased IgE. However while listening to Golijan and looking at his notes he states that these infections are inf act a Type II not Type I hypersensitivity due to the fact that the body destroyes these through ADCC killing. Curious if anyone knew who was right and any information would be appreciated.


Thanks

[beefy]

sparked my curiosity, cuz i have been taking goljan's words as law, found a recent review on Helminths (march 2008) Human Hookworm Infection in the 21st Century

"Eosinophilia, mastocytosis, and IgE stimulation are the three main immune alterations observed during a hookworm infection in humans. But the overall immune responses of human hosts to hookworm infection are remarkably similar to infections with other helminths: dominated by the production of T-helper-2 (Th2) cytokines interleukin (IL)-4, IL-5, IL-9, IL-10, and IL-13, which is consistent with the development of strong IgE, eosinophil, and mast cell responses mentioned above........A concomitant observation was the high level of IL-10 compared to other cytokines (IL-4, IL-5, and IL-13) that accompany chronic hookworm infection and the decline that accompanies treatment..................These high levels of IL-10 observed in the sera and in vitro cultures with crude antigen extracts are thought to play a principal role in minimizing what is effectively an immediate (type 1) hypersensitive (allergic) responses (Pritchard and Brown, 2001)." <------ HOWEVER this specific cited article is older than goljan's notes/rapid review book...dammit

its kinda long and boring article ... i would be interested in seeing the actual question from kaplan to see how they worded it .. the deciding factor i guess is if there's inflammation it would be type 1, but then again IL-10 is anti-inflammatory so then how could it be type 1... i assume the usmle people keep there info/questions up to date.... bleh..

anyone else have any idea? goljan vs kaplan!

[rspr41]

Found this while I was redoing Golijian today: From his slides:


The overlying transitional epithelium has been replaced by squamous epithelium (see arrow). This is an example of squamous metaplasia and is due to the inflammatory reaction in the submucosa hosted against the eggs of S. hematobium (see arrow). Squamous metaplasia may progress to dysplasia and squamous cancer. Note the heavy eosinophil inflammatory infiltrate around the eggs. Eosinophils attach to IgE coating the surface of the eggs and degranulate with release of major basic protein (MBP). MBP destroys the eggs. This is an example of a type II hypersensitivity reaction. (Ci057)


Guess golijian wins...