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i cng bnh l min dch

I. Mt s khi nim c bn v p ng min dch - nh ngha: min dch l kh nng ca c th nhn ra v loi b cc vt l (khng nguyn). - p ng min dch chia ra 2 loi

- p ng min dch chia ra 2 loi

.Min dch t nhin (min dch khng c hiu) .Min dch thu c (min dch c hiu)

1.1. Min dch t nhin L kh nng t bo v ca mt c th c ngay t lc mi sinh khng i hi phi c s tip xc trc ca c th vi cc khng nguyn ca vt l.

1.2. Min dch c hiu

L trng thi min dch xut hin khi c th c tip xc vi khng nguyn (khng nguyn c a vo ch ng hay ngu nhin).

1.2.1. Ngun gc ca cc t bo min dch


TB gc
Dng HC Dng BC ht Dng n nhn Dng lympho

Dn

Hng cu

Cc BC n nhn

Monocyle v i thc bo

Ti n lympho

Tiu

Tuyn c

Lympho B

Lympho T

NK (Natural killer)

TDTH
( Qu mn chm)

Th Tc

Ts

(H tr) (c TB) (c ch)

1.2.2. Vai tr ca cc lympho - Th (h tr) v TDTH (qu mn chm): gi l T-CD4. - Ts (c ch), Tc (c t bo): gi l T-CD8. * Lympho T: - Th (lympho T h tr): + iu ha ton b h thng MD thng qua lymphokin.

+ Hot ha cc tiu qun th T trong min dch t bo. - Tc (lympho T c t bo): + Tn cng trc tip cc t bo, git cht cc vi khun i khi c t bo ca chnh bn thn. + Trc tip tiu dit khng nguyn bng ly gii t bo.

Ts (lympho c ch t bo): c ch chc nng ca Th, Tc iu ha hot ng ca cc t bo khc gi khng gy phn ng min dch qu mc (c hi ho c th). TDTH (lympho T qu mn mun): + To vim kh tr KN thu ht i thc bo.

+ To lympho T nh to p ng min dch ln 2 mnh, nhanh hn ln u. * Lympho B: + Thc bo khng nguyn gii thiu cho lympho B k cn c hot ho bi i thc bo v Th thnh plasmocyle sinh KT tiu dit KN

+ Mt s tr thnh lympho B nh. * NK (Natural killer) Tiu dit khng c hiu vi t bo u v t bo cha VR bng cht tit ca chng (perforin). 1.2.3. hnh thc p ng min dch. - Min dch qua trung gian t bo: tiu dit khng nguyn. - Min dch dch th: sn xut khng th tiu dit khng nguyn.

Qu trnh p ng min dch c iu ho bi Th v Ts.


Khng nguyn i thc bo
Hot ho

Tc
Dit KN Tc nh

Th(CD4)

Lympho B

Th nh

Lympho B nh

Plasmocyte

Sinh KT

1.3. Cc thnh phn p ng min dch c hiu. 1.3.1. Khng nguyn - Khi nim: + Khng nguyn l nhng cht khi xm nhp vo c th c kh nng kch thch c th sinh khng th c hiu v kt hp vi khng th. + Bn cht: Khng nguyn l nhng phn t protein hoc polysaccarid c trng lng phn t > 10.000 Da, l cht l vi c th.

- Phn loi: * Theo tnh cht khng nguyn: + Khng nguyn hon ton: Kch thch c th to khng th c hiu v kt hp vi khng th . + KNkhng hon ton (hapten): .C trng lng phn t < 10.000 Da. Kt hp c vi khng th nhng khng c kh nng kch thch c th sinh KT

.Chng c kh nng gn vo cc phn t protein ca mt c th no to phc hp hapten protein c trng lng phn t cao khng nguuyn hon ton. * Theo ngun gc khng nguyn: + D khng nguyn: c ngun gc t nhng c th khc loi. + ng khng nguyn: c ngun gc t nhng c th cng loi (ABO).

+ T khng nguyn: bn thn c th sinh ra do protein ca c th b bin i thnh khng nguyn vi c th mnh. 1.3.2. Khng th. L nhng thnh phn globulin huyt thanh c to ra trong qu trnh p ng min dch v c kh nng kt hp c hiu vi khng nguyn.

- C 5 loi globulin min dch: IgG, IgA, IgD, IgE, IgM. +Cu trc: gn ging nhau gm mt hoc nhiu n v. 1 n v = 1 phn t protein c 4 chui a peptid: 2 nng, 2 nh ni bng cu ni disulfua, trn phn t KTc 2 v tr kt hpKN. + Chc nng ca khng th:

. KT do KN no to ra ch kt hp vi KN y. . KT gy bt hot KN hoc tp chung KN. - C ch tc dng ca KT: .Tncng trc tip ln KN theo cc c ch sau: + Ngng kt: Nhiu phn t ln c KN b mt (HC, VK) gp KT c hiu ngng

+ Kt ta: phc hp phn t ca KN ho tan kt ta xung. + Trung ho: KT ph ln nhng v tr c ca tc nhn mang KN. + Lm v TB: Mt s KTrt mnh tn cng trc tip ln mng TB ca tc nhn v TB. .T/D gin tip: hot ho h thng b th (trong iu kin bnh thng, tc dng trc tip khng

1.3.3. B th - L mt trong nhng h thng protein huyt tng, bao gm 9 thnh phn C1, C2, C3, ..., C9. + Cc thnh phn ca h thng b th l tin enzym v cc tin cht, c tc dng dy truyn.

+ Bnh thng b th c mt trong huyt tng, dng khng hot ng, khi c hot ho hot ng gy ph/ sinh hc trong ph/ MD. - Hot ho b th: + Con ng ton vn: t C1 C9, khi pht s kt hp KN KT thng mng TB (KN nm trn mng TB).

+ ng tt: C3 C9 khng cn c s kt hp KNKT. - Chc nng ca b th: Tc dng ln khng nguyn bng cch: + Dit TB bng ly gii TB VK hoc cc tc nhn khc. + Thc y s thc bo bng hin tng opsonin ho. + Ngng kt: lm thay i b mt tc nhn xm nhp chng dnh vo nhau ngng kt.

+ Trung ho VR: cc men v sn phm b th khc tn cng vo cu trc ca VR chng tr thnh khng c. + ho ng ng: hp dn BCTT v i thc bo. + lm v t bo: Phc hp ca nhiu b th trc tip lm v mng TB ca VK.

+ Hnh thnh phn ng vim: tng tnh thm thnh mch, hp dn tp chung TC ti ch vim, hot ho 1 s lympo B, T +X l PHMD: Thanh thi PHMD, ngn cn chng ln ln, d ho tan v kh lng ng.

II. C ch bnh l ca D - MD - Chc nng ca h thng MD: loi tr KN l nhm bo v c c th c ton vn hoc thot ra khi t/d gy bnh ca KN. - Trong iu kin nht nh h thng MD c th p ng bt thng gy hi cho c th.

+ p ng qu mc: Gy qu
mn + p ng cha hoc khng p ng: suy gim MD. + p ng sai lch: Gy bnh t min.

2.1. Qu mn + MD (mn cm): c th c gy MD (ch ng hay th ng) sn sng p ng KN mn cm KN + Qu mn: p ng KN qu mnh m bnh l. + Biu hin qu mn: sc phn v, atopy, d ng...

Khng nguyn
H min dch p ng ng mc p ng km p ng qu mc

Khi bnh, phng bnh NK, mc bnh Bnh l qu mn MD Sinh l MD bnh l Suy gim MD Qu mn

2.1.1. Qu mn typ I (tc th qua trung gian IgE l KT dch th) 2.1.2. Qu mn typ II (c TB qua trung gian KT) 2.1.3. Qu mn typ III (Qua trung gian phc hp MD) 2.1.4. Qu mn typ IV: (mun qua trung gian TB)

2.2. Suy gim MD Trng thi p ng MD khng t yu cu, h thng MD khng hon chnh tng phn hoc ton b.

2.2.1. Suy gim MD bm sinh - Do TB gc - Dng lympho B - Dng lympho T - C 2 dng lympho B v lympho T - Suy gim MD khng c hiu: khng hon chnh tng phn h MD gim b th, gim chc nng thc bo

2.2.2. Suy gim MD mc phi: - Gim nguyn liu tng hp KT: protein -> gim p ng MD - Tn thng h MD: + K di cn tu + Nhim x + Thuc chng K, corticoid, KS + Nhim trng: VK, VR (HIV)

2.3. C ch cc bnh t min: - Mt thnh phn ca c th thay i tnh cht, cu hnh do tc nhn vt l, ho hc, sinh hc -> l i vi c th -> sinh KT - KN l c cu trc tng t 1 thnh phn no ca c th -> KTchng li KN l, chng li lun thnh phn c th.

- Mt s KN ca c th bnh th-

ng t hoc cha tip xc vi h MD ca c th -> chn thng -> vo mu -> yu t l vi h MD -> sinh KTchng li. - Ri lon cn bng Ts v Th trong hot ho lympho B sinh KT & c ch dng Th t phn ng

Thank you!