Arthus Phenomenon in Type III Hypersensitivity

Following the skin injection of soluble antigen into the subject previously immunised by a series of the same injections, the Arthus syndrome manifests as local swelling, tissue death, and redness. The tissue damage is the result of the precipitation of antigen-antibody complexes present in the walls of blood vessels; then, the deposits are ingested (phagocytosed) by the neutrophil white blood cells. This specific phenomenon was named after the French physiologist named Maurice Arthus.

Process

After an antigen is injected intradermally, the Arthus reaction occurs, in which the antigen or antibody complexes form in situ. An Arthus reaction occurs if the animal or patient has already been sensitised (has to circulate the antibody). Arthus manifests as local vasculitis due to the accumulation of IgG-based immune complexes in the dermal blood vessels, which is one of the most common mechanisms of type-III hypersensitivity.

Activation of the complement majorly results in the cleavage of soluble complement proteins forming C3a and C5a, which activate the recruitment of PMNs and local mast cell degranulation, resulting in the inflammatory response. The local fibrinoid necrosis with ischemia-aggravating thrombosis present in the tissue vessel walls is induced by the further accumulation of immune complex-related processes. The end result is given as a localized area of induration and redness that typically lasts either a day or so.

The Arthus reactions have been reported infrequently after the vaccinations containing tetanus and diphtheria toxoid. The CDC's description is given below:

Arthus reactions (which are the type-III hypersensitivity reactions) are reported rarely after the vaccination and can take place after either the diphtheria toxoid–containing or tetanus toxoid–containing vaccines. An Arthus reaction is given as a local vasculitis associated with the deposition of immune complexes and activation of the complement. Immune complexes are produced in the setting of high circulating antibody concentration and high local concentration of vaccine antigens.

These reactions are characterized by severe pain, swelling, induration, haemorrhage, edema, and necrosis occasionally. Usually, these signs and symptoms occur 4–12 hours after vaccination. And, ACIP has recommended that the persons who experience an Arthus reaction after the dose of tetanus toxoid–containing vaccine should not receive Td more frequently than for every 10 years, even for tetanus prophylaxis, being a part of the wound management.

Cause of Arthritis

There are no single or numerous causes for arthritis. This is because of the fact that there are around 150 multiple types of arthritis, and often many factors contribute to an individual developing this common problem.

Different Types of Arthritis

This disease also can also affect other body parts. Arthritis causes pain, loss of movement, and at times swelling. A few types of arthritis are given as follows:

Osteoarthritis, which is a degenerative joint disease, where the cartilage that covers the ends of bones present in the joint deteriorates, causing pain and movement loss as bone begins to rub against the bone. It is a very prevalent form of arthritis.

Rheumatoid arthritis, which is an autoimmune disease where the joint lining becomes inflamed as part of the immune system activity of the body. Rheumatoid arthritis is the most serious and disabling type, which mostly affects women.

Infective arthritis (Septic arthritis because of the direct infection to, Whipples and Lyme disease and the Chlamydia reactive arthritis from slow-growing occult infections)

Post Infectious arthritis (which is Reactive arthritis that follows the infections elsewhere such as Salmonella and Shigella Typhimurium. Note that arthritis itself is sterile and it is an aberrant immune response to infection)

Gout, which mostly affects men. Usually, it is the result of a defect in the chemistry body. Most often, this painful condition attacks the small joints, especially the big toe. Fortunately, gout almost always may be completely controlled with the medication and changes in diet.

Ankylosing spondylitis is a kind of arthritis, which affects the spine. Resultantly, inflammation, the bones of the spine grow together.

Juvenile arthritis is a general term for all types of arthritis that happen in children. Children can develop childhood forms of lupus or juvenile rheumatoid arthritis, ankylosing spondylitis, or other arthritis types.

The systemic lupus erythematosus (lupus) is a serious disorder, which can damage and inflame joints and other connective tissues throughout the whole body.

Scleroderma is a disease of the connective tissue of the body, which causes hardening and thickening of the skin.

Fibromyalgia, where the widespread pain affects the attachments to the bone and muscles. It mostly affects women.

Preventing Arthritis

As the particular causes of the various types of arthritis remain unclear, it is difficult to say what can assist in the prevention of arthritis development. However, a few steps that can be beneficial in reducing the effects of arthritis are given below.

Maintain Appropriate Weight.

Protect the joints from overuse and injuries

Regularly exercise to maintain healthy bones, joints, and muscles. Normal physiotherapy treatment is beneficial, maintaining optimum spinal or joint range of motion and flexibility.

Eat a Healthy Diet as the Nutrients are Vital for Joint Health

Hydrate your body

Water makes up 70% of the cartilage in joints and plays a primary role in the lubrication and shock-absorbing properties of healthy joints.