Disease of immunity

DAP
 Immune system

Immunodeficiency infections. Ex AIDS

Tumors; on the other hand, a hyperactive
immune system may cause fatal disease, as in
the case of an overwhelming allergic reaction to
the sting of a bee.

The immune system may lose its normal
capacity to distinguish self from non-self,
resulting in immune reactions against one's own
tissues and cells (autoimmunity). Ex ITP
 Immune system

Responsible for safeguarding the body from
disease causing microorganism. It is a part of a
complex system of Host Defense

Host defense : Innate/natural and
acquired/adaptive

Innate defense : physical (skin) and chemical
barriers (Lysozyme found in mucus, saliva, tears
and HCl), complex defense, cells, and natural
killer lymphocyte. Innate immunity is the first
line of defense, because it is always ready

Acquired defense : caused by foreigners
encounter the body ( virus or bacteria)
 Immune respons

There are two main types of adaptive immunity—cell-
mediated (or cellular) immunity _T cell, which is
responsible for defense against intracellular microbes,
and humoral immunity- B cell, which protects against
extracellular microbes and their toxins .

Cellular immunity is mediated by T (thymus-derived)
lymphocytes, mature in Thymus

Humoral immunity is mediated by B (bone marrow-
derived, mature in marrow) lymphocytes and their
secreted products such as lymphokine (IL-2, IL-4,
Interferon-8)

Hummoral immunity = antibody mediated response
 Antigen

Substance can induce immune respons

T and B lymphocyte have specific
receptors to specific antigen molecular
shapes (epitop)

In B cells, the receptors are called by
antibody (an immunoglobuline)

Hapten?Carrier?
 Macrophage

Macrophages are immune and
inflammatory response

Macrophages lack receptors of specific
antigens, but they have specific receptors
for c region of immunoglobuline (Fc)

Macrophages ingest and process the
antigen
 T cell

Types of T Cells

The two main types of T cells are cytotoxic T
cells and helper T cells. Cytotoxic T (Tc) cells
can bring about the destruction of antigen-
bearing cells, such as virus-infected or cancer
cells. Cancer cells also have nonself proteins.
Cytotoxic T cells are responsible for so-called
cell-mediated immunity

Helper T (Th) cells regulate immunity by
secreting cytokines, the chemicals that enhance
the response of other immune cells.
 MHC

The T cell antigen receptor only in
ascociation with specific cell surface
molecules. Also known as HLA

Every person receives one set of MHC
genes from each parent. Both sets are
expreesed on individual cells
 Natural Killer Cells

Natural killer (NK) cells kill virus-

infected cells and tumor cells by cell-to-
cell contact. They are large, granular
lymphocytes with no specificity and no
memory. Their number is not increased by
prior exposure to any kind of cell.
 Complement system

Composed of a number of blood plasma proteins designated by the
letter C and a subscript. A limited amount of activated complement
protein is needed because a cascade effect occurs: Each activated
protein in a series is capable of activating many other proteins.

The complement proteins are activated when pathogens enter the
body. The protein “complement” certain immune responses, which
accounts for their name.

Certain other complement proteins join to form a membrane attack
complex that produces holes in the walls and plasma membranes of
bacteria. Fluids and salts then enter the bacterial cell to the point
that it bursts.

Complement system includes 20 serum proteins

There are 2 pathways : classic and alternate

Classis : Ig M and IgG binds with the antigen and activate C1 next
turn to activates C4, C2 and C3

Alternate : bacterial cell membranes activates C3, and next to C5
and C9
 Cytokines and Immunity

LMWP involved in communications berween

macrophage and lymphocyte

Whenever cancer develops, it is possible that
cytotoxic T cells have not been activated.

With this possibility in mind, cytokines have
been used as immunotherapeutic drugs to
enhance the ability of T cells to fight cancer.

Interferon, and also interleukins, which are
cytokines produced by various white blood cells,
are also being administered for this purpose.
 Pathophysiology manifestation

There are 3 basic reactions :
hypersensitivity, autoimmune response
and alloimmune response
Hypersensitivity

Exogenous antigens occur in dust, pollens, foods, drugs,
microbiologic agents, chemicals, and many blood products used in
clinical practice. The immune responses that may result from such
second exposure exogenous antigens take a variety of forms, such
as itching of the skin, to potentially fatal diseases, such as bronchial
asthma. The various reactions produced are called hypersensitivity
reactions, and tissue injury in these reactions may be caused by
humoral or cell-mediated immune mechanisms.

Injurious immune reactions may be evoked not only by exogenous
environmental antigens, but also by endogenous tissue antigens.
Some of these immune reactions are triggered by homologous
antigens that differ among individuals with different genetic
backgrounds. Transfusion reactions and graft rejection are examples
of immunologic disorders evoked by homologous antigens.
Type 1
 Systemic Anaphylaxis

Systemic anaphylaxis is characterized by vascular shock, widespread

edema, and difficulty in breathing. In humans, systemic anaphylaxis may
occur after administration of foreign proteins (e.g., antisera), hormones,
enzymes, polysaccharides, and drugs (such as the antibiotic penicillin

The severity of the disorder varies with the level of sensitization.

Extremely small doses of antigen may trigger anaphylaxis, for example, the
tiny amounts used in ordinary skin testing for various forms of allergies.
Within minutes after exposure, itching, hives, and skin erythema appear,
followed shortly thereafter by a striking contraction of respiratory
bronchioles and respiratory distress. Laryngeal edema results in
hoarseness. Vomiting, abdominal cramps, diarrhea, and laryngeal
obstruction follow, and the patient may go into shock and even die within
the hour. The risk of anaphylaxis must be borne in mind when certain
therapeutic agents are administered. Although patients at risk can generally
be identified by a previous history of some form of allergy, the absence of
such a history does not preclude the possibility of an anaphylactic reaction.
Type 2
Type 3
Type 4
Autoimmune disease

Body’s normal defense become self
destructive, recognizing self antigen as a
foreign

The causes are not clearly understood
Alloimmune response

Commonly happens in transplantation or
transfusion

The recipients react to antigens, primarily
the HLA of the donor cells

Commonly ascociated with type 2
hypersensitivity reaction
 Immunodeficiency

An absent or depressed immune response
increses susceptability to infection.

Defect of T cell, B cell, lymphoid tissue
 Disorder

AIDS

Caused by gradual destruction of T cell

HIV infection of macrophages has three important implications.

First, monocytes and macrophages represent a veritable virus factory and
reservoir, whose output remains largely protected from host defenses.

Second, macrophages provide a safe vehicle for HIV to be transported to
various parts of the body, including the nervous system.

Third, in late stages of HIV infection, when the CD4+ T-cell numbers
decline greatly, macrophages may be an important site of continued viral
replication.In contrast to tissue macrophages, the number of monocytes in
circulation infected by HIV is low, yet there are unexplained functional
defects that have important consequences for host defense. These defects
include impaired microbicidal activity, decreased chemotaxis, decreased
secretion of IL-1, inappropriate secretion of TNF, and, most important, poor
capacity to present antigens to T cells.
 Homework

Please learn about asthma alergic