
20/06/2025
🌟 (Gell and Coombs Classification)
Type→ Name →Immune Component→Mechanism of Damage →Onset →Examples
I→ Immediate (Anaphylactic) IgE + Mast cells/Basophils Allergen cross-links IgE on mast cells → Histamine release Seconds to minutes Asthma, Anaphylaxis, Hay fever, Urticaria, Food allergy
II → Cytotoxic (Antibody-mediated) IgG/IgM + Complement or ADCC Antibodies bind to antigens on cells → Cell destruction Minutes to hours Hemolytic anemia, Goodpasture's, Rheumatic fever, GBS
III→ Immune Complex IgG/IgM + Antigen + Complement Immune complexes deposit in tissues → Inflammation Hours to days SLE, Post-streptococcal GN, Serum sickness, Arthus reaction
IV→ Delayed-type (Cell-mediated) T cells (CD4+/CD8+) Sensitized T cells release cytokines → Macrophage activation or cytotoxicity 48–72 hours Tuberculosis, Contact dermatitis, Type 1 diabetes, MS
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🔍 Detailed Explanation of Each Type
✅ Type I – Immediate Hypersensitivity
Main antibody: IgE
Cells involved: Mast cells, basophils
Pathway: First exposure sensitizes → IgE binds to mast cells → Second exposure causes degranulation → Histamine release
Clinical signs: Swelling, itching, bronchospasm, hypotension (in anaphylaxis)
✅ Type II – Cytotoxic Hypersensitivity
Main antibodies: IgG, IgM
Pathway: Antibodies bind to cell surface antigens → Activate complement or ADCC → Cell lysis or opsonization
Key feature: Destruction of specific cells
Examples:
Autoimmune hemolytic anemia
Myasthenia gravis
Graves' disease (also has stimulatory antibodies)
✅ Type III – Immune Complex-Mediated Hypersensitivity
Main components: Antigen–antibody (IgG/IgM) complexes + complement
Pathway: Complexes deposit in small vessels → Complement activation → Neutrophil recruitment → Inflammation & tissue damage
Examples:
Systemic lupus erythematosus (SLE)
Post-streptococcal glomerulonephritis
Serum sickness
Arthus reaction (localized)
✅ Type IV – Delayed-type Hypersensitivity
Main cells: T lymphocytes (CD4+ helper T cells, CD8+ cytotoxic T cells)
Pathway: Antigen-presenting cells activate T cells → Cytokine release or direct killing → Tissue damage
Not antibody mediated
Examples:
Tuberculin skin test (Mantoux test)
Contact dermatitis (e.g., poison ivy, nickel)
Type 1 diabetes mellitus
Multiple sclerosis
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📌 Mnemonic to Remember Types:
"ACID"
A – Type I: Anaphylactic (IgE)
C – Type II: Cytotoxic (IgG/IgM)
I – Type III: Immune complex
D – Type IV: Delayed (T-cell)
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