Allergy Asthma Proc. 2012 May-Jun;33 Suppl 1:96-99. doi: 10.2500/aap.2012.33.3561.
The original Gell and Coomb's classification categorizes hypersensitivity reactions into four subtypes according to the type of immune response and the effector mechanism responsible for cell and tissue injury: type I, immediate or IgE mediated; type II, cytotoxic or IgG/IgM mediated; type III, IgG/IgM immune complex mediated; and type IV, delayed-type hypersensitivity or T-cell mediated. The classification has been improved so that type IIa is the former type II and type IIb is antibody-mediated cell stimulating (Graves Disease and the "autoimmune" type of chronic idiopathic urticaria). Type IV has four major categories: type IVa is CD4(+)Th1 lymphocyte mediated with activation of macrophages (granuloma formation and type I diabetes mellitus); type IVb is CD4(+)Th2 lymphocyte mediated with eosinophilic involvement (persistent asthma and allergic rhinitis); type IVc is cytotoxic CD8(+) T lymphocyte with involvement of perforin-granzme B in apoptosis (Stevens-Johnson syndrome and toxic epidermal necrolysis); type IVd is T-lymphocyte-driven neutrophilic inflammation (pustular psoriasis and acute generalized exanthematous pustulosis). Some diseases have multiple types of immunologic hypersensitivity.
原来的 Gell 和 Coomb 分类根据免疫反应的类型和导致细胞和组织损伤的效应机制，将超敏反应分为四种亚型：I 型，即速发型或 IgE 介导型；II 型，即细胞毒性或 IgG/IgM 介导型；III 型，即 IgG/IgM 免疫复合物介导型；IV 型，即迟发型超敏反应或 T 细胞介导型。该分类已得到改进，因此 IIa 型是以前的 II 型，IIb 型是抗体介导的细胞刺激（Graves 病和“自身免疫性”慢性特发性荨麻疹）。IV 型有四个主要类别：IVa 型是 CD4(+)Th1 淋巴细胞介导的巨噬细胞激活（肉芽肿形成和 I 型糖尿病）；IVb 型是 CD4(+)Th2 淋巴细胞介导的嗜酸性粒细胞参与（持续性哮喘和过敏性鼻炎）；IVc 型是细胞毒性 CD8(+)T 淋巴细胞，涉及穿孔素-颗粒酶 B 诱导的细胞凋亡（Stevens-Johnson 综合征和中毒性表皮坏死松解症）；IVd 型是 T 淋巴细胞驱动的中性粒细胞炎症（脓疱型银屑病和急性泛发性脓疱性银屑病）。一些疾病具有多种类型的免疫超敏反应。
