Materi Sistem Imun

ALTERATION IN IMMUNE ALTERATION IN IMMUNE

FUNCTIONFUNCTION

HeningHening P. A. P. A. SyahrinSyahrin, M , M BiomedBiomed., MANP., MANP

DKKD FIKUIDKKD FIKUI

[email protected]@ui.edu

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Key QuestionsKey Questions

What the potential mechanisms lead to What the potential mechanisms lead to autoimmune diseases?autoimmune diseases?

How do type I, II, III, & IV hypersensitivity How do type I, II, III, & IV hypersensitivity reactions differ according to the immune type reactions differ according to the immune type cells involved and the mechanism of tissue cells involved and the mechanism of tissue injury?injury?

What the common features of autoimmune What the common features of autoimmune disorders and certain types of hypersensitivity disorders and certain types of hypersensitivity disorders?disorders?

How do the etiologies of primary and secondary How do the etiologies of primary and secondary immune deficiency disorders differ?immune deficiency disorders differ?

What are the clinical features of the common What are the clinical features of the common immunodeficiency disorders?immunodeficiency disorders?



Overview Overview

What is the purpose of immune system?What is the purpose of immune system?

to defense the body against invasion of to defense the body against invasion of

infection by foreign substances called infection by foreign substances called

antigensantigens

NormallyNormally-- works efficientlyworks efficiently

In some situationIn some situation-- inappropriate responseinappropriate response

diseasesdiseases



Two general categories of immune Two general categories of immune

disordersdisorders

1.1. Excessive immune responseExcessive immune response

over/ over/ hyperfunctioninghyperfunctioning

includes: autoimmune & hypersensitivity includes: autoimmune & hypersensitivity disordersdisorders

2.2. Deficient immune responseDeficient immune response

ineffective immune response because ineffective immune response because of congenital, genetic and acquired of congenital, genetic and acquired dysfunction. E.g. SCID, HIVdysfunction. E.g. SCID, HIV

Other situation: rejection of transplantOther situation: rejection of transplant



Excessive immune responseExcessive immune response

Autoimmune can be seen as a way of describing Autoimmune can be seen as a way of describing

the etiology/cause of abnormal excessive the etiology/cause of abnormal excessive

immune response toward self tissueimmune response toward self tissue

Hypersensitivity disorders describes mechanisms Hypersensitivity disorders describes mechanisms

of injury, how the injury occursof injury, how the injury occurs

Autoimmune reactions are mediated through Autoimmune reactions are mediated through

type II & III hypersensitivity mechanisms type II & III hypersensitivity mechanisms



Autoimmunity Autoimmunity When does it happen?When does it happen?

A personA persons own cells are recognized as foreign s own cells are recognized as foreign and induce immune response that injures self and induce immune response that injures self tissuestissues

Lost of self tolerance Lost of self tolerance

Lead to reaction between self antigen and Lead to reaction between self antigen and immune response immune response

Several theories have been proposes to explainSeveral theories have been proposes to explain



Autoimmune mechanismsAutoimmune mechanisms

A.A. Hidden antigenHidden antigen

1. spermatozoa, 1. spermatozoa, 2.semious tubules, 3. 2.semious tubules, 3. keratin, 4. sebumkeratin, 4. sebum

B. Change of antigenic B. Change of antigenic profile through profile through chemical action; chemical action; 1. 1. chemicals, 2. surface chemicals, 2. surface receptors, 3. changed receptors, 3. changed antigenic profilesantigenic profiles

C. Change of antigenic C. Change of antigenic profile through viral profile through viral action; action; 1. viruses, 2. 1. viruses, 2. cells, 3. surface cells, 3. surface antigen, 4. virusantigen, 4. virus--coded coded antigensantigens

D. Antibody cross reaction, D. Antibody cross reaction, with foreign with foreign AbAb and and the bodythe bodys own cells own cell



Autoimmune theoriesAutoimmune theories1.1. Antigenic mimicry evoked by viruses or Antigenic mimicry evoked by viruses or bacteria bacteria epitopesepitopes

2.2. Sequestered antigens triggers the immune Sequestered antigens triggers the immune responseresponse-- when the site contains hidden self when the site contains hidden self antigens are damaged antigens are damaged

3.3. Number of T cellNumber of T cell--some self product are not some self product are not exposed to the developing T cellsexposed to the developing T cells

4.4. Number of B cell Number of B cell certain B cell lose their certain B cell lose their responsiveness to suppressor T cell signalsresponsiveness to suppressor T cell signals

There is genetic predisposition, associated with There is genetic predisposition, associated with MHC types and female genderMHC types and female gender

Viruses may alter self cellsViruses may alter self cells



Hypersensitivity Hypersensitivity

Is a normal immune response that is Is a normal immune response that is

inappropriate triggered or excessive or inappropriate triggered or excessive or

produces undesirable effect on the bodyproduces undesirable effect on the body

Basic mechanism: AgBasic mechanism: Ag--AbAb reaction or specific reaction or specific

antigenantigen--lymphocyte interactionlymphocyte interaction

There are 4 type hypersensitivity reactionsThere are 4 type hypersensitivity reactions



Hypersensitivity (2)Hypersensitivity (2)

TipeTipe I I is an immediate allergic 0f is an immediate allergic 0f anaphilacticanaphilactic--type reaction mediated primarily by sensitized type reaction mediated primarily by sensitized mast cellsmast cells

Type II occurs when antibodies are formed Type II occurs when antibodies are formed when against antigens or cell surface, usually when against antigens or cell surface, usually resulting lyses target cellsresulting lyses target cells

Type III AgType III Ag--AbAb are deposit in tissues and result are deposit in tissues and result in activation of complement and subsequent in activation of complement and subsequent tissue inflammation and destructiontissue inflammation and destruction

Type IV is T cell mediated and does not require Type IV is T cell mediated and does not require AbAb productionproduction



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Type III hypersensitivity reaction

Type III hypersensitivity reaction


Immunodeficiency disordersImmunodeficiency disorders

PrimaryPrimary-- may be congenital, genetic or acquiredmay be congenital, genetic or acquired

SecondarySecondary-- as a result of other process such as as a result of other process such as poor nutrition, stress, & drugpoor nutrition, stress, & drug

SCID: impairment of both T & B cellsSCID: impairment of both T & B cells

Infant with SCID is prone to sepsis & Infant with SCID is prone to sepsis & opportunistic infectionopportunistic infection

DiGeorgeDiGeorge syndromesyndrome-- T cell agenesis related to T cell agenesis related to thymus function; chronic thymus function; chronic mucocutaneusmucocutaneuscandidiasiscandidiasis due to abnormal T cells/cannot due to abnormal T cells/cannot respond to respond to candidacandida

IgAIgA deficiency is caused by B cell abnormalitydeficiency is caused by B cell abnormality



Immunodeficiency disordersImmunodeficiency disorders

Problem with Problem with neuroendocrinneuroendocrin & immune system & immune system interaction cause secondary immunodeficiencyinteraction cause secondary immunodeficiency

Stress increases corticosteroid productionStress increases corticosteroid productionincrease susceptibility to infectionincrease susceptibility to infection

Medication such as cancer drug and steroid Medication such as cancer drug and steroid affect immune response and can lead to affect immune response and can lead to secondary secondary immunosupressionimmunosupression

Malnutrition is a major cause of immune system Malnutrition is a major cause of immune system dysfunction; lymphocyte dysfunction and altered dysfunction; lymphocyte dysfunction and altered stem cell developmentstem cell development



Materi Sistem Imun

Documents

immune alteration

immune type reactions

immune type cells

purpose of immune system

hypersensitivity reactions

autoimmune reactions

mechanisms of injury

autoimmune diseases