Summary

* Disorders caused by abnormal immune responses are called hypersensitivity diseases. Pathologic immune responses may be autoimmune responses directed against self antigens or uncontrolled and excessive responses to foreign (e.g., microbial) antigens.

* Hypersensitivity diseases may result from antibodies that bind to cells or tissues, circulating immune complexes that are deposited in tissues, or T lymphocytes reactive with antigens in tissues.

* The effector mechanisms of antibody-mediated tissue injury are complement activation and Fc receptor-mediated inflammation. Some antibodies cause disease by interfering with normal cellular functions without producing tissue injury.

* The effector mechanisms of T cell-mediated tissue injury are inflammatory reactions induced by cytokines secreted mainly by CD4+ TH1 and TH17 cells and cell lysis by CTLs. The classical T cellmediated reaction is delayed-type hypersensitivity, induced by activation of previously primed T cells and the production of cytokines that recruit and activate various leukocytes, predominantly macrophages.

* The current treatment of autoimmune diseases is targeted at reducing immune activation and the injurious consequences of the autoimmune reaction. A future goal of therapy is to inhibit the

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