MAY VALZON

SELEKSI NEGATIF SEL B DI SUMSUM TULANG =

CENTRAL TOLERANCE
(-) LOLOS
(+) APOTOSIS ATAU CLONAL DELETION

SELEKSI GANDA ( POSITIF & NEGATIF) SEL T IMMATUR DI TIMUS

Macam-macam transplantasi
Autograft
Isograft
Allograft
Xenograft

Immune Recognition of Allografts:

1. Jalur langsung
2. Jalur tidak langsung

Immune Recognition of Allografts

Mekanisme:
1. Utama T-cell
mediated rejection
2. Antibody mediated
rejection
terkadang juga bisa

Types and mechanisms of

rejection:

Hyperacute rejection (menit-jam)

Sudah ada antidonor antibodies di dalam tubuh resepien
Contoh: org yg pernah di tranfusi, wanita multipara
Skrining awal : preformed anti-HLA antibodies and cross-

matching

Acute cellular rejection (hari-minggu)

T cells destroy graft parenchyma by cytotoxicity and DTH

reaction

Acute vascular rejection

1 bln pasca tranplantasi
T cells and antibodies damage graft vasculature.

Chronic rejection
Bulan-tahun

Methods of Improving Graft

Survival

HLA matching
survival improves with increasing number of loci

matched

Immunosuppression
cyclosporine, the related FK506, mofetil

mycophenolate (MMF), rapamycin, azathioprine,

corticosteroids, antilymphocyte globulins, and
monoclonal antibodies (e.g., monoclonal antiCD3)
suppress T-cell-mediated immunity by inhibiting
transcription of cytokine genes Il-2
SE increased susceptibility to opportunistic
fungal, viral, and other infections

Transplantation of Hematopoietic
Cells

graft-versus-host disease (GVHD)

transplanted into recipients who are

immunologically compromised
Tidak ada penolakan malah sel donor
mengenali sel resepien sbg antigen
autoimun

immune deficiency
Terjadi pasca transplantasi
Infeksi oportunistik

PENYAKIT IMUNODEFISIENSI
Primer caused by inherited defects
affecting immune system development
Sekunder secondary effects of other
diseases:

contoh: infection, malnutrition, aging,

immunosuppression, autoimmunity, atau

chemotherapy

Gambaran klinis tergantung

komponen sistem imun yang mana yang
defek

Primary Immune Deficiencies

Kasus jarang, umumnya defek genetik
Contoh:

X-Linked Agammaglobulinemia (XLA, Bruton

Disease) failure of pre-B cells to

differentiate into B cells
Common Variable Immunodeficiency
Isolated IgA Deficiency

 Hyper-IgM Syndrome
Thymic Hypoplasia: DiGeorge Syndrome
Severe Combined Immunodeficiency
Immune Deficiency with Thrombocytopenia

and Eczema: Wiskott-Aldrich Syndrome

Genetic Deficiencies of Components of
Innate Immunity

Secondary Immune Deficiencies

Acquired Immunodeficiency Syndrome

Tugas Pelajari Sendiri dari berbagai sumber!

AMYLOIDOSIS

Definisi: protein pathologik yg terdposit di MES

diberbagai jaringan menimbukan berbagai
manifestasi klinis
Amyloid
Misfolding protein jk normal larut
Mengapa dinamai amyloid??
Terpulasa dg cat Congo red

Faktor yg mempengaruhi
aggregasi protein
Umun senile amyloidosis
Jumlah meningkat keadaan inflamasi
kronis
Sekresi berkurang dialisis jangka
panjang
Mutasi suatu gen pengkode protein
Proteolisis yang terbatas Alzheimer

AL (amyloid light chain) protein, SAA (serum amyloid-associated)

protein, ATTR (Transthyretin) protein

Klasifikasi