Page 65 - Color Atlas Of Pathophysiology (S Silbernagl Et Al, Thieme 2000)

C. Delayed Hypersensitivity (Type IV)
Insect poisons Macrophage
Pathogen proteins Phago-
(e.g. tuberculin, cytosis
lepromin) Initial contact
Sensitization
Haptens 5 days
(metals, drugs,
cosmetics, plant Repeated Sensitized
constituents, etc.) contact T cells
Endogenous
proteins Chemokines Reactions II
(attraction)
Macrophage IFNγ Presentation to and activation
activation of inflammatory T cells
IL-3/GM-CSF
e.g.: MHC II
Contact dermatitis (see D), TNFβ
tuberculosis, leprosy, Hypersensitivity
allergic encephalitis, After 1–3 days:
thyroiditis, mycosis, Inflammation
bilharziasis, primary TH1 cell
transplant rejection Tissue damage Macrophage
D. Development of Contact Dermatitis Plate 3.14
Watch
Nickel (hapten)
Langerhans
Protein cell
Skin
Hapten
contact
Phagocytosis
and processing

Migration to
regional lymph nodes
Collection of (and transformation
antigen-specific T cells into dendritic cells)
(from blood and lymph)
Presentation to,
proliferation and
differentiation
of TH1 cells

TH1 cell circulation (via blood)
to site of antigen exposure
TNFβ
Monocyte
Chemokines
IFNγ Contact
dermatitis
TH1 cell Macrophage 55
activation
Silbernagl/Lang, Color Atlas of Pathophysiology © 2000 Thieme
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