40. Immunopathological reactions in oral diseases.
Covers immunopathological reactions in the mouth, beginning with the three broad groups: allergic, autoimmune and immunodeficiency conditions. Allergic reactions are set out as four numbered types, each with its mechanism. Autoimmune disorders with oral mucosal involvement and congenital and acquired immunodeficiencies follow. A closing summary includes a table of the four hypersensitivity types with oral examples, plus notes on immune-mediated diseases and practical dental-clinic precautions.
Topic 40 of 40 in the MU Sofia syllabus for Preclinical Paediatrics (Dental Medicine, Year 3). The free AceMed note covers it in 2 sections, about 446 words (4 min of reading), with 15 flashcards.
In this note
IMMUNOPATHOLOGICAL REACTIONS IN ORAL DISEASES
Summary and extra points
IMMUNOPATHOLOGICAL REACTIONS IN ORAL DISEASES
TYPES OF IMMUNOPATHOLOGICAL REACTIONS:
ALLERGIC
AUTOIMMUNE
IMMUNODEFICIENCIES
ALLERGIC REACTIONS
An antigen that causes an allergic response = ALLERGEN
Upon re-entry of antigen, immune responds in one of three ways:
Protective immune response
With increased sensitivity- an allergic reaction
No reaction- anergy
1st Type- Allergic Immediate Reactions
Hypersensitivity by humoral type
Aka anaphylactic or atopic
Rapid immune response involving IgE
It binds to mast cells
2nd Type- Cytotoxic Response
Humoral mediated response of immediate type
Toxic effect on cells, with cytolysis involving IgM, IgD and complement
Target cells are erythrocytes, leukocytes and platelets
3rd Type- Antigen-Antibody Reaction
Immediate reactions
There is a toxic effect of the antigen-antibody complex
4th Type- Cell Mediated Delayed Reaction
Similar to cellular immune reactions
Affects allergy; Bacteria, Viruses, Fungi
AUTOIMMUNE REACTIONS
Immune system is tolerant to its own tissues and antigens
Breach of this tolerance causes autoimmune reactions
Body produces Abs against its own cells and antigens
Adaptive immunity in the mouth may be impaired
Commensal MOs have similar Antigens that bind to molecules of MOs
Macroorganism doesn’t perceive them now as foreign or to develop a cross immune reaction
Body recognises its cells as foreign
Common autoimmune diseases include manifestations in the oral mucosa:
Dermato Bullous
Pemphigus
Lupus erythematodes
Epidermolysis bullosa
IMMUNODEFICIENCIES
Deficits in humoral immunity or in cellular immunity
Susceptibility to infections
CONGENITAL IMMUNODEFICIENCY CONDITIONS
Heritage, most often recessive
Rare syndromes
Appears in childhood
Patients don’t survive for long
Infections are fatal
Affects oral mucosa, gingiva and periodontium
ACQUIRED IMMUNODEFICIENCY CONDITIONS
Malnutrition
Viruses and bacteria
Radiotherapy
Prolonged cytostatics treatment
Corticosteroids and antibiotics
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