Arthus reaction
In immunology
Immunology is a broad branch of biomedical science that covers the study of all aspects of the immune system in all organisms. It deals with the physiological functioning of the immune system in states of both health and diseases; malfunctions of the immune system in immunological disorders ; the...

, the Arthus reaction is a type of local type III hypersensitivity reaction. Type III hypersensitivity
Hypersensitivity refers to undesirable reactions produced by the normal immune system, including allergies and autoimmunity. These reactions may be damaging, uncomfortable, or occasionally fatal. Hypersensitivity reactions require a pre-sensitized state of the host. The four-group classification...

 reactions are immune complex
Immune complex
An immune complex is formed from the integral binding of an antibody to a soluble antigen. The bound antigen acting as a specific epitope, bound to an antibody is referred to as a singular immune complex....

-mediated, and involve the deposition of antigen
An antigen is a foreign molecule that, when introduced into the body, triggers the production of an antibody by the immune system. The immune system will then kill or neutralize the antigen that is recognized as a foreign and potentially harmful invader. These invaders can be molecules such as...

An antibody, also known as an immunoglobulin, is a large Y-shaped protein used by the immune system to identify and neutralize foreign objects such as bacteria and viruses. The antibody recognizes a unique part of the foreign target, termed an antigen...

 complexes mainly in the vascular
Blood vessel
The blood vessels are the part of the circulatory system that transports blood throughout the body. There are three major types of blood vessels: the arteries, which carry the blood away from the heart; the capillaries, which enable the actual exchange of water and chemicals between the blood and...

 walls, serosa (pleura, pericardium
The pericardium is a double-walled sac that contains the heart and the roots of the great vessels.-Layers:...

, synovium
Synovial membrane is the soft tissue found between the articular capsule and the joint cavity of synovial joints....

), and glomeruli.


The Arthus reaction was discovered by Nicolas Maurice Arthus
Nicolas Maurice Arthus
Nicolas Maurice Arthus was a French immunologist and physiologist. The Arthus reaction, a localized inflammatory response, is named after him.Arthus was born January 9, 1862 in Angers, France....

 in 1903.
Arthus repeatedly injected horse
The horse is one of two extant subspecies of Equus ferus, or the wild horse. It is a single-hooved mammal belonging to the taxonomic family Equidae. The horse has evolved over the past 45 to 55 million years from a small multi-toed creature into the large, single-toed animal of today...

Blood plasma
Blood plasma is the straw-colored liquid component of blood in which the blood cells in whole blood are normally suspended. It makes up about 55% of the total blood volume. It is the intravascular fluid part of extracellular fluid...

 subcutaneously into rabbit
Rabbits are small mammals in the family Leporidae of the order Lagomorpha, found in several parts of the world...

s. After four injections,
he found that there was edema
Edema or oedema ; both words from the Greek , oídēma "swelling"), formerly known as dropsy or hydropsy, is an abnormal accumulation of fluid beneath the skin or in one or more cavities of the body that produces swelling...

 and that the serum was absorbed slowly. Further injections eventually led to gangrene
Gangrene is a serious and potentially life-threatening condition that arises when a considerable mass of body tissue dies . This may occur after an injury or infection, or in people suffering from any chronic health problem affecting blood circulation. The primary cause of gangrene is reduced blood...



The Arthus reaction involves the in situ formation of antigen/antibody complexes after the intradermal injection of an antigen. If the animal/patient was previously sensitized (has circulating antibody), an Arthus reaction occurs. This manifests as local vasculitis
Vasculitis refers to a heterogeneous group of disorders that are characterized by inflammatory destruction of blood vessels. Both arteries and veins are affected. Lymphangitis is sometimes considered a type of vasculitis...

 due to deposition of immune complexes in dermal blood vessels. Activation of complement and recruitment of PMNs
Granulocytes are a category of white blood cells characterized by the presence of granules in their cytoplasm. They are also called polymorphonuclear leukocytes because of the varying shapes of the nucleus, which is usually lobed into three segments...

 ensue, resulting in an inflammatory response.

Arthus reactions have been infrequently reported after vaccination
Vaccination is the administration of antigenic material to stimulate the immune system of an individual to develop adaptive immunity to a disease. Vaccines can prevent or ameliorate the effects of infection by many pathogens...

Diphtheria is an upper respiratory tract illness caused by Corynebacterium diphtheriae, a facultative anaerobic, Gram-positive bacterium. It is characterized by sore throat, low fever, and an adherent membrane on the tonsils, pharynx, and/or nasal cavity...

 and tetanus
Tetanus is a medical condition characterized by a prolonged contraction of skeletal muscle fibers. The primary symptoms are caused by tetanospasmin, a neurotoxin produced by the Gram-positive, rod-shaped, obligate anaerobic bacterium Clostridium tetani...

. To quote from the CDC
Centers for Disease Control and Prevention
The Centers for Disease Control and Prevention are a United States federal agency under the Department of Health and Human Services headquartered in Druid Hills, unincorporated DeKalb County, Georgia, in Greater Atlanta...


Arthus reactions (type III hypersensitivity reactions) are
rarely reported after vaccination and can occur after tetanus
toxoid–containing or diphtheria toxoid–containing vaccines. An Arthus
reaction is a local vasculitis associated with deposition of
immune complexes and activation of complement. Immune
complexes form in the setting of high local concentration of
vaccine antigens and high circulating antibody concentration. Arthus reactions are characterized by
severe pain, swelling, induration, edema, hemorrhage, and
occasionally by necrosis. These symptoms and signs usually
occur 4–12 hours after vaccination.....ACIP has recommended that
persons who experienced an Arthus reaction after a dose of
tetanus toxoid–containing vaccine should not receive Td more
frequently than every 10 years, even for tetanus prophylaxis as
part of wound management.

See also

  • Serum sickness
    Serum sickness
    Serum sickness in humans is a reaction to proteins in antiserum derived from an non-human animal source. It is a type of hypersensitivity, specifically immune complex hypersensitivity . The term serum sickness–like reaction is occasionally used to refer to similar illnesses that arise from the...

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