Materi Sistem Imun
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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?
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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