T Hücre aracılı Hastalıklar (Tip 4 Hipersensitivite), delayed-type hypersensitivity; DTH; cell-mediated hypersensitivity

DiseaseTarget antigenEffects
Allergic contact dermatitisEnvironmental chemicals, like urushiol (from poison ivy and poison oak), metals (e.g. nickel), topical medicationepidermal necrosis, inflammation, skin rash, and blisters
Autoimmune myocarditisMyosin heavy chain proteinCardiomyopathy
Diabetes mellitus type 1Pancreatic beta cell proteins (possibly insulin, glutamate decarboxylase)Insulitis, beta cell destruction
GranulomasVarious, depending on underlying diseaseWalled-off lesion containing macrophages and other cells
Some peripheral neuropathiesSchwann cell antigenNeuritis, paralysis
Hashimoto’s thyroiditisThyroglobulin antigenHypothyroidism, hard goiter, follicular thymitis
Inflammatory bowel diseaseEnteric microbiota and/or self antigensHyperactivation of T-cells, cytokine release, recruitment of macrophages and other immune cells, inflammation
Multiple sclerosisMyelin antigens (e.g., myelin basic protein)Myelin destruction, inflammation
Rheumatoid arthritisPossibly collagen and/or citrullinated self proteinsChronic arthritis, inflammation, destruction of articular cartilage and bone
Tuberculin reaction (Mantoux test)TuberculinInduration and erythema around injection site indicates previous exposure

An example of a tuberculosis (TB) infection

Some other clinical examples:

Urushiol-induced contact dermatitis

Chronic transplant rejection

Coeliac disease

Giant cell arteritis

Graft-versus-host disease

Leprosy

Type IV/cell-mediated
(T cells)
I-Foreign
Allergic contact dermatitis
Mantoux test

II-Autoimmune
Coeliac disease
Giant cell arteritis
Hashimoto’s thyroiditis
Multiple sclerosis
Postorgasmic illness syndrome
Reactive arthritis
Type 1 diabetes

III-GVHD
Transfusion-associated graft-versus-host disease