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ImmunologyIn Infectious

Disease

Titin Andri WihastutiPSIK FKUB


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Introduction

ImmunologyStudy of the body against foreign invaders Immunity

Special capacity for resistance; condition of being resistantto an infection

VirulenceMeasure of the disease-producing power of an organism

ImmunogensSubstances capable of inducing a specific immuneresponse

AntigensSubstances that react with products of the induce ahumoral and/or cell-mediated immune response


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Introduction

Naturally Acquired Activity Immunityis obtained when a person is exposed to antigens in thecourse of daily life. Antigens enter the body naturally; thebody produces antibodies and specialized lymphocytes

Artificially Acquired Active Immunity

results from vaccination. Antigens are introduced invaccines; the body produces antibodies and specializedlympocytes

Naturally Acquired Passive ImmunityInvolves the natural transfer of antibodies from a mother

to her infant. Antibodies pass from mother to fetus via theplacenta or to the infant in her milk Artificially Acquired Passive Immunity

Involves the introduction of antibodies (rather thanantigen) into the body. Preformed antibodies in immuneserum are introduced into the body by injection


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Sumsum tulang, hati (fetal)Asal sel imunArena perkembangan, maturasi akhir sel B

Thymus (organ limfoid primer)

Arena (perkembangan) dan pendidikan sel T

LeukositAparat sistim imun yang bersifat circulatingrecirculating

Limfonodi (organ limfoid sekunder)Tempat induksi respon imun

Jaringan tubuhArena berlangsungnya respon imun

Komponen Sistem Imun


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Komponen sistem imun

Komponen selularsumsum tulang,

sirkulasi,Jaringan

Dari biji besimenjadianeka peralatan


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Factors that GovernFactors that Govern

Immune Responses :Immune Responses :

a.a. ForeignnessForeignness

b.b. Molecular sizeMolecular size

c.c. Molecular complexityMolecular complexity

d.d. Structural StabilityStructural Stability

e.e. Solubility or degradabilitySolubility or degradability


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MECHANISMS OF IMMUNITY

1.Nonspesific or Innate Immunity Early barriers to infectious disease

Defenses that protect us againts anypathogen

Regardless of the species microbe, is notimproved by repeated exposure to pathogen

Included :

- The first line of defense

(skin, mucous membranes and theirsecretions)

- The second line of defense

(phagocytes, inflammation, antimicrobial)


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2. Specific or Adaptive Immunity

Involves a specific defensive response whenInvolves a specific defensive response whena host is invaded by foreign organism ora host is invaded by foreign organism orother foreign substancesother foreign substances

The third line of defenseThe third line of defense

Dependent on Antigen RecognitionDependent on Antigen Recognition

-- HumoralHumoral : antibodies: antibodies

-- CellCell--mediatedmediated : T cells: T cells

-- CombinationCombination


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Innate immunity


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Routes of infection for pathogens


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Intrinsic epithelial barrier

to infection


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Phases of the immune response


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Bacterial receptors in macrophages


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Inflammation


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Inflammation


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Localvs

Systemic

infection


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Bactericidalagents released by phagocytes

upon ingestion of macrophages


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ConclusionConclusion

The immune responses to pathogenicagents/immunity of infectious diseases areprimarily conducted by natural immune

responses and working in concert with adaptiveresponses

The succesfull of pathogens to invade into, andpersist in the body is pretty much depending on

the status immunity, the virulence factors of theagents and their smartevade mechanismsagaints effectors function of the immune system


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Nilai Normal dalam Tubuh

1. Leukosit ( 5 10 x 109 / L )

Neutrofil : 55-70 % total leukosit

Eosinofil : 1 4 % total leukosit Basofil : 0,5 1 % total leukosit

Monosit : 2 8 % total leukosit

Limfosit : 20 40 % total leukosit

2. Komplemen ( 75 160 U/mL )

C3 : 0,55 1,20 g / L

C4 : 0,2 0,5 g / L

Pemeriksaan Penunjang


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3. Imunoglobulin

Ig G : 500 1500 mg / dL ( 75% total Ig ) Ig M : 50 - 300 mg / dL ( 75% total Ig )

Ig A : 100 490 mg / dL ( 75% total Ig )

Ig E : < 100 IU / mL ( 75% total Ig )

Ig D : < 3 U / mL ( 75% total Ig )


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Gangguan sistem imun

1. Lack of response (imunodefisiensi)contoh: AIDS, leukemia

2. Incorrect response (peny. autoimun)contoh: DM tipe I, miasteniagravis, multiplesclerosis;penyakit Graves.

3. Overactive response (alergi/hipersensitivitas)contoh: asma, rhinitis allergic, rx transfusi


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1. Hypersensitifitas

Respon imun berlebih dan tidak diinginkan

Menimbulkan kerusakan jaringan

Tipe Manifestasi Mek anismeI Reaksi cepat Ig E dan Iglain

II Antibody thd sel IgG dan Ig M

III Kompleks Ab-Ag Biasa IgGIV Lambat Sel yang disensitisasi


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. Defisiensi Imun

Defisiensi Imun nonspesifik :a. Defisiensi komplemen

b. Defisiensi sel NK

c. Defisiensi sistem fagositDefisiensi Imun spesifik :

a. Kongenital

b. Fisiologis (Kehamilan, lansia)

c. Acquired (malnutrisi, infeksi, AIDS)


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3. Autoimun

- Reaksi sistem imun terhadap antigen sel jaringan sendiri

- Limfosit mempunyai reseptorautoantigen

- Sel Limfosit Reaktif (SLR) memberi respon autoimun

- Kegagalan sel T mengenal SELF-NON SELF

Klasifikasi :

a. Autoimun organ spesifik : Skleroderma, Sirosis bilier dll

b. Autoimun non organ spesifik : SLE (Systemic Lupus

Erytematosus)


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Therapi Farmakologi1. Anti inf lamasi

NSAID : menghambat sintesaprostaglandin, efekanalgesik & antipiretik

efek samping : tdk nyaman GIT,edema, waktu

pendarahan lama

2. Anti bakteri /antibiotik

Menghambat pertumbuhan (Bakteristatik) dan membunuh

bakteri (Bakterisid)

a. Penghambat sintesa dinding selbakterib. Pengubahan permeabilitas kapiler

c. Penghambatan sintesaprotein

d. Mengganggu metabolisme sel


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