Immunology for the otolaryngic allergist

An understanding of immunology is imperative for the practitioner of otolaryngic allergy. Figure 9 provides an overview of the allergic reaction. Complex immunologic mechanisms involving cellular and humoral elements are involved in allergic reactions. The primary cells of the immune response are lymphocytes, macrophages, eosinophils, mast cells, and basophils. Humoral immunity involves five classes of immunoglobulin: IgM, IgA, IgD, IgG, and IgE. Preformed (eg, histamine) and newly formed mediators (eg, prostaglandins, leukotrienes), interleukins, and the complement chain (classical and alternative pathways) are involved in various types of allergic reactions.