Table 1.
Classification of immune-mediated IDRs
| Type | Mediator | Pathogenesis | Clinical picture | Chronology |
|---|---|---|---|---|
| I | IgE | Degranulation of mast cells and basophils | Urticaria, anaphylaxis, allergic rhinitis, bronchospasm, angio-oedema | Immediate (≤1 h) |
| II | IgG/M | FcR dependent cell lysis | Blood cell dyscrasia | Intermediate (5–14 days) |
| III | IgG/M | FcR-dependent immune complexes deposition | Serum sickness, vasculitis, arthus reaction | Intermediate (7–8 days) |
| IVa | TH1 (IFNγ, TNFα) | Monocyte/macrophage mediated inflammatory response | Eczema | Delayed (1–3 weeks) |
| IVb | TH2-IL4, IL5, IL13) | Eosinophils mediated inflammatory response | Maculopapular exanthema, bullous exanthema | Delayed (2–7 weeks) |
| IVc | Cytotoxic T cells (Perforine, Granzym B, FasL) | Cytotoxicity/apoptosis | Maculopapular exanthema, bullous/pustular exanthema | Delayed (1–3 weeks) |
| IVd | T cells (IL8, CXCL8, GM-CSF) | Neutrophils mediated inflammatory response | AGEP, Behςet’s disease | Intermediate (≤2 days) |