SPECIFIC AND NON SPECIFIC IMMMUNE SYSTEM

Dr Nova Kurniati, SpPD. K-AI. FINASIM

Div Allergy & Clinical Immunology Medical Faculty Muhammadya University

Components of the Immune System

I. Nonspecific (Innate/ Non-adaptive) II. Specific (Acquired/ Adaptive)

Immune System

NonSpecific

Specific

Phyisic / Mechanic
- Intact Skin - Mucus - Coughing - Sneezing - Saliva, tears, - perspiration, - urine, - Vomiting,diarrhea

Humoral
- Biochemic
- Lysozyme - Neuroam ac - Lactoferrin

Cellular
- Phagocyt - PMN - MN -Cell Nol

Humoral / B Cell
-Imm. Glob - IgM - IgG - IgA - IgD - IgE

Cellular / T Cells
- Th Cell - Tc Cell - Ts/ Tr Cell - Tdth Cell

- Complement - Interferons - CRP

- NK Cell
- K Cell - Mediator Cell - Eos

- Mast, etc

COMPLEMENT MEDIATORS

CLASSIC PATHWAY ACTIVATION

ALTERNATIVE PATH ACTIVATION

A L T E R A L T

MAC

Aktivasi komplemen menghasilkan sejumlah molekul efektor yg punya efek biologik

INTERFERON

DIKUTIP DARI IMUNOLOGI DASAR KARNEN G.

NONSPESIFIC CELLULAR IMM SYS

PHAGOCYTOSIS: Macrophage & PMN

DIKUTIP DARI IMUNOLOGI DASAR KARNEN G.

SPECIFIC IMM SYSTEM

DIKUTIP DARI IMUNOLOGI DASAR KARNEN G.

Interaksi antara molekul2 kostimulator mengatifkan sel T yg dalam keadaan istirahat. Aktifasi oleh APC: melalui TCR & kompleks MHC Tapi tanpa disertai 2 kostimulator (B7) anergi

SPECIFIC CELLULAR IMM SYST

Antibody function Opsonin

The concept of the specific immune response

LPS

M cell

Gastrointestinal epithelium

APC
Ag
T Helper / CD4 T cell

MHC class II
TCR

TH1

TH3

TH2

IL-2, TNF-, MHC class I

INF- TGF-
IgG

IL-4, IL-6, IL-10

B cell

T cytotoxic / CD8 T Cell

Cellular immunity

IgM IgA

Target cell

Humoral immunity

Hipersensitivitas

2a

5a

6a

8a

9a

29d

30d

31d

Autoimun

Loss of Tolerance in Autoimmune Disease

Susceptibility genes (usually multiple) Loss of tolerance Triggering factors (probably environmental)

Auto reactive T cells

Auto reactive B cells

Inadequate regulatory mechanism

Persistent pathogenic autoantibodies Persistent pathogenic immune complexes Persistent damaging autoreactive T cell

Mechanism of Autoantibody Secretion

Uptake of autoantigen

Proposed Mechanisms of Autoimmunity

Release of Sequestered Antigens

Some self-antigens are sequestered in specialized tissues and cannot be expressed in the thymus or bone marrow. These are not seen by the developing immune system will not induce self-tolerance. Exposure of T cells to these normally sequestered/tissuespecific self-antigens in the periphery results in their activation.

Cross-reacting Antigens (Molecular Mimicry)

Examples of Molecular Mimicry

Antigen Recognized by Autoantibodies in Systemic Autoimmune Diseases

Antinuclear antibodies
Anti-ss-DNA antibody Anti-ds DNA antibody Anti-polyADP ribose antibody Anti-Scl-70 antibody Anti-centromere antibody Anti-histone antibody

Localization Recognized Antigen

ss-DNA ds-DNA poly ADPribose

Disease
SLE etc. SLE SLE SSc CREST Drug induce lupus

Chromatin

DNA topoimerase l centromere Histone

Anti-U1RNP antibody Anti-Sm antibody Anti-U2RNP antibody Anti-SS-A/Ro antibody Anti-SS-B/La antibody

Nucleus

Anti-PCNA antibody

U1RNP U1, U2, U4/U6, U5 RNP U2RNP hY1~hY5 RNP RNA polymerase III trancription termination factor DNA polymerase auxiliary factor DNA dependent protein kinase activation factor

MCTD SLE Overlap syndrome SjS etc. SjS

SLE

Type II Hypersensitivity

Type II Hypersensitivity Autoimmunity

Autoimmune Diseases due to Type II Hypersensitivity

Type III Hypersensitivity

Type III Hypersensitivity Autoimmunity

Autoimmune Diseases due to Type III Hypersensitivity

Systemic Lupus Erythematosus

Systemic Lupus Erythematosus

Autoantibodies against Prevalence

Double stranded DNA (dsDNA)

Single stranded DNA (ssDNA) Histones U1-nRNP

30-90%
70-95% 50-80% 15-40%

Sm
SS-A (Ro) SS-B (La) Cyclin I (PCNA)

5-30%
20-60% 10-20% 3%

Ku
Ribosomal P proteins Cardiolipin, -2-glycoprotein 1

5-10%
5-20% 20-40%

Criteria for Diagnosis of SLE

Malar rash Discoid rash Photosensitivity Oral ulcers Arthritis Serositis Neurological disorder seizure psychosis . Renal disorder proteinuria > 0.5g Casts

Haematologic disorder Haemolytic anemia leukopenia lymphopenia thrombocytopenia Immunological disorder anti-dsDNA anti-Sm anti-phospholipids ANA positivity

Rheumatoid arthritis

Autoantibodies against
Histones

Prevalence
Rare

Single stranded DNA (ssDNA)

RANA

8%
90-95%

Rheumatoid factors
Fillagrin (keratin)

65-90%
50%

Type IV Hypersensitivity

Autoimmune Diseases due to Type IV Hypersensitivity

Defisiensi imun

1.

Struktur HIV

2. Siklus Hidup HIV

Thank You