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Related Concept Videos

Allergic Reactions: Anaphylaxis01:30

Allergic Reactions: Anaphylaxis

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Anaphylaxis is a severe, life-threatening hypersensitivity reaction mediated by Immunoglobulin E (IgE) antibodies. When IgE binds to allergens, it triggers the release of mediators– histamine, leukotrienes, and prostaglandins from mast cells and basophils. These mediators cause vasodilation, edema, and inflammation, leading to various symptoms.The primary allergens causing anaphylaxis include food items (e.g., peanuts, shellfish), drugs (e.g., penicillin, asparaginase, corticotropin,...
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Hypersensitivity, also known as a hypersensitivity reaction or allergic reaction, is a condition where the body's immune system reacts abnormally to a foreign substance. Such substances, that cause hypersensitivity are referred to as an allergen, could be something typically harmless to most people, like pollen or certain foods.
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Drug-related allergies are immune-mediated responses triggered by the administration of pharmacological agents. These hypersensitivity reactions are classified based on the immune mechanisms involved. The four primary types—Type I, II, III, and IV—are mediated by different immunological pathways and exhibit distinct clinical manifestations.Type I Hypersensitivity/ IgE-Mediated Reactions: Immunoglobulin E (IgE) immediately mediates Type I hypersensitivity reactions. Upon initial...
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Allergic reactions related to drugs are hypersensitivity responses driven by the immune system and bear no connection to the drug's therapeutic action. While drugs in isolation do not trigger an immune response, they can interact with endogenous proteins to form antigens. These antigens stimulate lymphocytes to produce antibodies. IgE-type antibodies attach themselves to mast cells. Upon subsequent exposure to the same stimulus, the antigen-antibody interaction is initiated, unleashing...
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Type III hypersensitivity reactions occur when antigen–antibody complexes form and activate the complement system. Normally, these complexes help the clearance of antigens by phagocytes and red blood cells. However, when large numbers of immune complexes are present, they can deposit in tissues—particularly in the walls of blood vessels—leading to inflammation and tissue injury. These deposits trigger complement activation and neutrophil recruitment, resulting in serum...
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Related Experiment Video

Updated: Mar 9, 2026

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Allergies in orthopaedic and trauma surgery.

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Hypersensitivity reactions to orthopedic implants, often a delayed-type IV reaction, can lead to implant failure. Management requires individualized decisions due to limited evidence on optimal treatments.

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Area of Science:

  • Orthopaedic Surgery
  • Immunology
  • Biomaterials Science

Background:

  • Hypersensitivity reactions to orthopaedic implants are rare but severe complications.
  • These reactions are typically delayed-type (Type IV) hypersensitivity, involving T-lymphocytes and cytokine release, potentially causing bone resorption.
  • Metal alloys and bone cement are common sources of antigens (haptens).

Purpose of the Study:

  • To review the current understanding of hypersensitivity reactions to orthopaedic implants.
  • To discuss diagnostic approaches and treatment strategies for patients experiencing implant hypersensitivity.
  • To highlight the need for further research and development of predictive biomarkers.

Main Methods:

  • Literature review and meta-analysis of existing studies on implant hypersensitivity.
  • Discussion of various diagnostic tests including patch testing, lymphocyte transformation test (LTT), and memory lymphocyte immunostimulation assay (MELISA).
  • Analysis of treatment outcomes for patients with suspected metal or bone-cement hypersensitivity.

Main Results:

  • Meta-analysis confirms a higher incidence of metal hypersensitivity and increased risk of implant failure.
  • Symptoms vary widely, including pain, effusion, delayed healing, and implant instability.
  • No significant differences found between in vivo and in vitro diagnostic methods; predictive tests not routinely recommended.
  • Management is individualized, with alternative implant materials showing promise but lacking long-term data.

Conclusions:

  • Hypersensitivity to orthopaedic implants necessitates careful diagnosis and individualized management.
  • Avoiding suspected causative agents (metals or bone cement components) is crucial.
  • Further large-scale studies and development of predictive biomarkers are essential for improved patient outcomes.