SISTEM IMUN

dr. Taufik Ashar, MKM

 Sistem imun : semua mekanisme yg digunakan tubuh

untuk mempertahankan keutuhan tubuh sebagai
perlindungan terhadap bahaya yg dapat ditimbulkan
berbagai bahan dlm lingkungan hidup.
Imunitas : adalah merupakan jawaban reaksi tubuh
terhadap bahan yang dianggap asing secara molekuler
maupun seluler.

SISTEM IMUN
INNATE / NON ADAPTIF
(TIDAK SPESIFIK)

Sejak lahir
Barisan pertahanan :
- Fisik / Mekanik
- Biokimiawi
- Humoral
- Selular
Menghancurkan zat asing

AQURIED / ADAPTIVE
(SPESIFIK)

Berkembang sepanjang
hidup.
Mengenal zat asing &
beradaptasi secara
individual terhadap tiap
jenis patogen.

The Immune System is the Third

Line of Defense Against Infection

SISTEM IMUN NON

SPESIFIK (Innate Immunity
System)
Pertahanan tubuh yg tdk spesifik &
mrp bagian dari sistem immun yg
berfungsi sbg barier terdepan pada
awal terjadinya infeksi penyakit
Natural / native immunity
Sistem imun non spesifik meliputi :
1. Pertahanan Fisik / Mekanik
2. Pertahanan Biokimiawi
3. Pertahanan Humoral
4. Pertahanan Seluler

1. PERTAHANAN
FISIK / MEKANIK
1. Kulit, Selaput
lendir, Silia, Batuk
& Bersin
2. Kulit rusak akibat
luka bakar
3. Selaput lendir
rusak krn asap
rokok
4. Tekanan oksigen
paru bagian atas

2. PERTAHANAN
BIOKIMIAWI
1. pH asam keringat, sekresi sebaseus
serta asam lemak yg dilepas kulit
bsifat asam denaturasi protein
membran bakteri # infeksi.
2. Lisozim di keringat, ludah, air mata,
ASI perlindungan thd bakteri gram
(+) ve mrusak peptidoglikan
dinding sel bakteri
3. Enzim Lakto oksidase di ASI &
Saliva mrusak dinding sel mikroba
kebocoran sitoplasma.

2. PERTAHANAN
BIOKIMIAWI
4. Antibodi & Komplemen di Saliva
berfungsi sbg opsonisasi bakteri.
5. Asam Neuraminik di ASI bersifat
sbg antibakterial terhadap E. Coli &
Stafilokokus
5. Asam Klorida di Lambung
mciptakan suasana asam yg dpt
mcegah infeksi.
6. Enzim Proteolitik, Antibodi &
Empedu di usus halus menciptakan

2. PERTAHANAN
BIOKIMIAWI
7. pH asam di Vagina mcegah
infeksi M.O
8. Spermin di Sperma mcegah
infeksi M.O
9. Laktoferin & Transferin di serum
mikat Fe (besi) yg mrp metabolit
esensial utk pertumbuhan M.O spt
Pseudomonas.

3. PERTAHANAN
HUMORAL
1.
2.
3.
4.

Komplemen (C)
Interferon (IFN)
C-Reaktif Protein (CRP)
Kolektin

KOMPLEMEN (C)

Tdd sejumlah protein yg jika diaktifkan

akan memberi proteksi thd infeksi &
berperan dlm respon Inflamasi.
Diproduksi o/ Monosit & hepatosit
Di serum normal C bersama Antibodi
mampu membunuh bakteri gram (-) ve
C diaktifkan langsung oleh :
- M.O/produknya (jalur alternatif imun
inate)
- Antibodi (jalur klasik imunitas adaptif)

KOMPLEMEN (C)
Lisis sel bakteri dan virus
Opsonisasi dg meningkatkan
fagositosis Ag
Mengikat reseptor komplemen sel
immun meningkatkan fungsi sel
immun
Immun clereance

INTERFERON (IFN)
Mrp sitokin glikoprotein
Diproduksi o/ Makrofage yg
teraktivasi, Natural Killer Sel (NK sel)
& sel tubuh yg mkandung nukleus.
Respon thd infeksi virus.
Mpy efek anti virus & dpt minduksi sel
di sekitar sel yg terinfeksi virus sel
resisten thd virus.

INTERFERON (IFN)
Fungsi membantu respon immun dg :
Menghambat replikasi virus pada host
Aktivasi NK sel dan Makrofage
Meningkatkan presentasi Ag thd
Limfosit
Meningkatkan resistensi sel host yg
terinfeksi virus

C-REACTIVE PROTEIN
(CRP)
Mrp protein fase akut
Dg bantuan Ca mampu mengikat
fosforikolin yg mrp penyusun dinding
M.O
Peningkatan sintesa CRP pada kondisi
Infeksi Viskositas plasma Laju
Endap darah (LED) .

KOLEKTIN
Mrp protein yg berfungsi sbg opsonin
yg mampu mengikat karbohidrat pada
permukaan M.O

4. PERTAHANAN
SELULAR

Fagosit
Makrofage
Natural Killer Sel (NK)
Sel Mast

Blood Cells

LEUKOSIT
leukosit terdiri atas dua kelompok, yaitu :
1. Granulosit ( PMN )
: 70% lekosit
Netrofil : 68% lekosit.
Eosinofil: 1% lekosit
Basofil : 1% lekosit
2. Agranulosit (Sel mononuklear) : 30%
- Limfosit : 25% lekosit
- Monosit / makrofag : 5% lekosit

lekosit

Sel fagosit
Terdiri dari
Netrofil
Monosit/makrofag

Phagocytes
Produced throughout life by the bone
marrow.
Scavengers remove dead cells and
microorganisms.

Neutrophils
60% of WBCs
Patrol tissues as they squeeze out
of the capillaries.
Large numbers are released during
infections
Short lived die after digesting
bacteria
Dead neutrophils make up a large
proportion of pus.

Macrophages
Larger than neutrophils.
Found in the organs, not the blood.
Made in bone marrow as monocytes,
called macrophages once they reach
organs.
Long lived
Initiate immune responses as they
display antigens from the pathogens
to the lymphocytes.

Phagocytosis

Phagocytosis
If cells are under attack they release
histamine.
Histamine plus chemicals from pathogens
mean neutrophils are attracted to the site
of attack.
Pathogens are attached to antibodies and
neutrophils have antibody receptors.
Endocytosis of neutrophil membrane
phagocytic vacuole.
Lysosomes attach to phagocytic vacuole
pathogen digested by proteases

SITOKIN
Sitokin (sito= sel ; kinos= pergerakan)
adalah suatu molekul signaling yg
digunakan komunikasi sel.
Sitokin adalah peptida, protein atau
glikoprotein yg diproduksi sbg respon thd
mikroba /Ag lain yg memperantarai &
mengatur sistem immun.
Sitokin memperantarai reaksi inflamasi dan
berperan sebagai stimulator hematopoiesis

SITOKIN
Sitokin disekresikan oleh sel immun yg
terpapar patogen.
Semua sel berinti khususnya sel
endo/epitel dan makrofage potensial
memproduksi IL-1, IL-6, and TNF-
Kadar Sitokin (IL-6) meningkat 1000 x pada
kondisi infeksi dan trauma
Sitokin berperan dalam pertahanan spesifik
maupun non spesifik.

SITOKIN
Sitokin diklasifikasikan berdasarkan
fungsinya, sel yg mensekresi /target
aksinya
Klasifikasi dari Sitokin :
-Lymphokine (cytokines made by
lymphocytes),
-Monokine (cytokines made by monocytes),
-Chemokine (cytokines w/ chemotactic
activities)

SISTEM IMUN SPESIFIK

(Adaptive Immunity System)
Sistem pertahanan tubuh lapis ketiga
bila innate immunity tdk mampu
mengeliminasi agen penyakit.
Fagosit tdk mengenali agen infeksi krn
hanya sedikit reseptor yg cocok utk
agen tsb atau agen tsb tdk bertindak
sbg faktor antigen terlarut (soluble
antigen) aktif.
Sistem ini melibatkan kerjasama
antara Antibodi, Komplemen, Fagosit,
Sel T, Makrofage.

Lymphocytes
Produce antibodies
B-cells mature in bone marrow then
concentrate in lymph nodes and
spleen
T-cells mature in thymus
B and T cells mature then circulate in
the blood and lymph
Circulation ensures they come into
contact with pathogens and each
other

Components of Human
Immune System

B -Lymphocytes
There are c.10 million different Blymphocytes, each of which make a
different antibody.
The huge variety is caused by genes
coding for abs changing slightly
during development.
There are a small group of clones of
each type of B-lymphocyte

B -Lymphocytes
At the clone stage antibodies do not leave
the B-cells.
The abs are embedded in the plasma
membrane of the cell and are called
antibody receptors.
When the receptors in the membrane
recognise an antigen on the surface of the
pathogen the B-cell divides rapidly.
The antigens are presented to the B-cells
by macrophages

B -Lymphocytes
Some activated B cells PLASMA
CELLS these produce lots of
antibodies, < 1000/sec
The antibodies travel to the blood,
lymph, lining of gut and lungs.
The number of plasma cells goes
down after a few weeks
Antibodies stay in the blood longer
but eventually their numbers go
down too.

B -Lymphocytes
Some activated B cells MEMORY
CELLS.
Memory cells divide rapidly as soon
as the antigen is reintroduced.
There are many more memory cells
than there were clone cells.
When the pathogen/infection infects
again it is destroyed before any
symptoms show.

T-Lymphocytes
Mature T-cells have T cell receptors
which have a very similar structure
to antibodies and are specific to 1
antigen.
They are activated when the receptor
comes into contact with the Ag with
another host cell (e.g. on a
macrophage membrane or an
invaded body cell)

T-Lymphocytes
After activation the cell divides to form:

T-helper cells secrete CYTOKINES

help B cells divide
stimulate macrophages

Cytotoxic T cells (killer T cells)

Kill body cells displaying antigen

Memory T cells
remain in body
Regulator /supressor T cell

LIMFOSIT T
Sistem imun selular spesifik
Efek :
Sel inducer aktivasi sitotoksik
Sel sitotoksik menghancurkan antigen
Tugas khusus sebagai :
a.T helper 1 : mengaktifkan makrofag
b.T helper 2 : membantu sel B hasilkan antibodi
c. T killer

: sel pembunuh

d.T-supressor/T-regulator : mengontrol kerja agar

tak berlebihan

LIMFOSIT B
Sistem imun humoral spesifik
Berkembang jadi :
- Sel plasma yg memproduksi antibodi
Ig G, Ig M, Ig A, Ig D, Ig E
- Sel-sel B-memori :
Menyimpan informasi ttg Antigen
segera mengenali pd kontak ulang

Sirkulasi limfosit
Thymus

Sumsum tulang
Blood stream

Limpa

Kelenjar
limfe

ANTIBODI
ANTIBODI ( Imunoglobulin = Ig):
Bahan yg dibentuk sbg akibat rangsangan
imunogen dan bereaksi secara spesifik dg
imunogen yg menginduksinya .
Dapat bereaksi dgn Ag yg struktural
mendekati Ag penginduksi Ab spesifik, shg
menyebabkan Reaktifitas Silang
(Cross reaction).

ANTIBODI
Fungsi :
1. Mengikat molekul antigen
2. Membangun fenomena biologi
sekunder
- Opsonisasi
- Aktifasi Komplemen
- Efek Sitotoksik

STRUKTUR & FUNGSI

ANTIBODI (Ig)

PENGGOLONGAN
IMUNOGLOBULIN
1.
2.
3.
4.
5.

Imunoglobulin
Imunoglobulin
Imunoglobulin
Imunoglobulin
Imunoglobulin

G (Ig G)
D (Ig D)
M (Ig M)
E (Ig E)
A (Ig A)

Imunoglobulin G (Ig G)
Fungsi utama :
Ab utama pada respon sekunder
melakukan opsonisasi bakteri
sehingga mudah di fagosistosis
mengikat komplemen
menetralkan toksin bakteri dan virus
melintasi plasenta

Imunoglobulin G (Ig G)
75 % Ig
CSF, Urin, Darah, Cairan SSP,
Peritoneal
Menembus plasenta imunitas bayi
6-9 bulan
Meningkat pd Infeksi kronis &
autoimun
Mengaktifkan C via jalur klasik

Imunoglobulin G (Ig G)

Imunoglobulin M (Ig M)
Fungsi :
Mencegah gerakan M patogen
Memudahkan fagositosis
Aglutinator
Mengaktifkan C via jalur klasik
Respon primer terhadap suatu
antigen
Fiksasi komplemen
Reseptor antigen pada permukaan
sel B

Imunoglobulin M (Ig M)

Imunoglobulin D (Ig D)
Marker diferensiasi sel B yg sudah
matang
Kadar meningkat pada infeksi dini
(akut)
Fungsi utama belum jelas
Ditemukan pada banyak
permukaan sel B

Imunoglobulin D (Ig D)

Imunoglobulin A (Ig A)
Terdapat dengan 2 struktur,
1. IgA serum ( monomer atau dimer )
2. Ig A sekretori ( dimer )
keduanya mempunyai rantai J (J
Chain) FUNGSI UTAMA :
-Ig A sekretori menghalangi
pengikatan bakteri dan virus pada
membran mukosa
-tidak mengikat komplemen

Imunoglobulin A (Ig A)
Kadar dalam serum sedikit, meningkat
pada infeksi kronik saluran napas &
GIT.
Menetralisir & mencegah kontak toxin,
virus
Terdapat di cairan sekresi RT, GIT, UGT,
air mata, keringat, saliva, ASI
eq :TB, Sirosis alkoholik, Kolitis
Ulseratif,
Mengaktifkan C via jalur alternatif

Imunoglobulin A (Ig A)

Imunoglobulin A (Ig A)

Imunoglobulin E (Ig E)
Fungsi Utama :
melepaskan mediator dari sel mast
dan basofil setelah seseorang
terkena allergen
pertahanan utama thd infeksi
cacing
( dengan melepas enzim dari
eosinofil )
tidak memfiksasi komplemen

Imunoglobulin E (Ig E)
Mudah diikat sel mast, basofil,
eosinofil
Kadar meningkat pada :
Alergi, infeksi cacing,
Schistosomiasis, trikinosis
Imunitas parasit

Imunoglobulin E (Ig E)

ANTIGEN
Antigen : substansi yang dapat diikat
antibodi spesifik.
Tdk semua Ag menghasilkan respon
imunogenik
Tetapi semua imunogen adalah Ag
(Immunobiology, Janeway and
Travers, 1994).

ANTIGEN
Ag umumnya suatu
proteins/polysaccharides.
Antigen meliputi bagian (coats, capsules,
dinding sel, flagella, fimbrae, dan toxins)
dari bacteria, viruses, dan atau M.O lain.
Lipids dan asam nukleat bersifat antigenik
ketika berikatan dg protein dan polisakarida.
Non mikroba exogen Ag meliputi polen,
putih telur, protein dari transplantasi
jaringan / organ atau permukaan sel darah

ANTIGEN
Tolerogen : substansi yg tidak
mencetuskan respon immun krn
bentuk molekul, bila bentuk molekul
berubah maka Tolerogen Imunogen.
Allergen : substansi yg dpt
menyebabkan reaksi alergi. Reaksi
timbul setelah expose dg Alergen
melalui ingestion, inhalation, injection,
atau kontak dg kulit

ANTIGEN
IMUNOGEN :
Molekul yg dapat menginduksi timbulnya respon imun pd host ybs.
BM >>, epitope >>
ANTIGEN :
BM < 5.000 dalton, single epitope.
EPITOPE
:
bagian Ag yg dpt menginduksi
pembentukan Ab & dpt diikat secara
spesifik oleh bagian Ab atau reseptor pd
limfosit.

Consequences of AntigenAntibody Binding

Antigen-Antibody Complex: Formed
when an antibody binds to an antigen
it recognizes.
Affinity: A measure of binding
strength.
1. Agglutination: Antibodies cause
antigens (microbes) to clump
together.
IgM (decavalent) is more effective that
IgG (bivalent).
Hemagglutination: Agglutination of red
blood cells. Used to determine ABO
blood types and to detect influenza and

Consequences of Antibody
Binding

Humoral Immunity (Continued)

3. Neutralization: IgG inactivates
viruses by binding to their surface
and neutralize toxins by blocking
their active sites.
4. Antibody-dependent cell-mediated
cytotoxicity: Used to destroy large
organisms (e.g.: worms). Target
organism is coated with antibodies
and bombarded with chemicals from
nonspecific immune cells.
5. Complement Activation: Both IgG
and IgM trigger the complement
system which results in cell lysis and

Consequences of Antibody
Binding

RESPON IMMUN
NORMAL
Butuh kesempurnaan komponen :
Utuhnya barrier eksternal
Pengenalan Antigen
Pemrosesan & Presentasi Antigen
Mekanisme bacterial killing
Jumlah, maturasi dan fungsi efektor sel
imunokompeten
Produksi Antibodi, sitokin, kemokin,
molekul adhesi, komplemen, dll.

TANDATANDA
IMUNODEFISIENSI
Sering / rentan terhadap Infeksi :
- Bakteri & patogen ekstra sel
- Virus & patogen intrasel
- Patogen yg tdk umum / jarang
Cenderung menderita kanker
Menderita penyakit autoimmun

Immunity
- New particles take
longer to identify, and
a person remains ill
until a new antibody
can be crafted
- Old particles are
quickly recognized,
and a person may
never become ill from
that invader again.
This person is now

What is immunity?
- Resistance to a disease causing
organism or harmful substance
- Two types
- Active Immunity
- Passive Immunity

Active and Passive

Immunity
Active immunity
Lymphocytes are activated by
antigens on the surface of pathogens
Natural active immunity - acquired
due to infection
Artificial active immunity
vaccination
Takes time for enough B and T cells
to be produced to mount an effective
response.

Active and Passive

Immunity
Passive immunity
B and T cells are not activated and
plasma cells have not produced
antibodies.
The antigen doesnt have to be
encountered for the body to make
the antibodies.
Antibodies appear immediately in
blood but protection is only
temporary.

Active and Passive

Immunity
Artificial passive immunity
Used when a very rapid immune
response is needed e.g. after
infection with tetanus.
Human antibodies are injected. In
the case of tetanus these are
antitoxin antibodies.
Antibodies come from blood donors
who have recently had the tetanus
vaccination.
Only provides short term protection

Active and Passive

Immunity
Natural passive immunity
A mothers antibodies pass across the
placenta to the foetus and remain for
several months.
Colostrum (the first breast milk)
contains lots of IgA which remain on
surface of the babys gut wall and
pass into blood

Vaccination
A preparation containing antigenic
material:
Whole live microorganism
Dead microorganism
Attenuated (harmless)
microorganism
Toxoid (harmless form of toxin)
Preparation of harmless ags

Vaccination
Injection into vein or muscle
Oral