Imunologi Gizi

(GZ.213)
2 sks
Indra Wibowo
Januari 2018
Kompetensi Dasar
• Memahami konsep anatomi dan fungsi sistem imun,
organ dan sel yang terlibat
• Memahami sistem pertahanan tubuh (sistem imun) non
spesifik
• Memahami sistem pertahanan tubuh (sistem imun)
spesifik
• Memahami konsep antibodi-antigen, komplemen,
sitokin
Evalusi perkuliahan
• UTS : 40%
• UAS : 40%
• Kuis/Tugas : 20%
Konsep dasar imunologi
• Pengertian istilah-istilah dalam imunologi
• Imunitas: pertahanan terhadap penyakit, terutama penyakit infeksi.
• Sistem imun: kumpulan sel, jaringan, organ, dan molekul yang
memediasi pertahanan terhadap infeksi.
• Respon imun: reaksi yang terkoordinasi dari sel dan molekul yang
terlibat terhadap mikroba atau agen infeksi.

• Imunologi: ilmu yang mempelajari sistem imun, termasuk

responnya terhadap mikroba patogen dan jaringan yang rusak dan
juga perannya pada suatu penyakit
Konsep dasar imunologi
• Fungsi fisiologi penting dari sistem imun adalah untuk
mencegah atau mengeradikasi infeksi

FIGURE 1-1 Importance of the immune system in health and disease. This table summarizes some of
the physiologic functions of the immune system and its role in disease. AIDS, Acquired immunodeciency
syndrome.
 Konsep dasar imunologi
• Fungsi fisiologi penting dari sistem imun adalah untuk
mencegah atau mengeradikasi infeksi

FIGURE 1-2 Effectiveness of vaccination for some common infectious diseases. The striking decrease in the incidence
of selected infectious diseases in the United States for which effective vaccines have been developed. (Modified from
Orenstein WA, Hinman AR, Bart KJ, Hadler SC: Immunization. In Mandell GL, Bennett JE, Dolin R, editors: Principles
and practices of infectious diseases, 4th edition, New York, 1995, Churchill Livingstone; and MMWR 64, No. 20, 2015.)
Konsep dasar imunologi
• Pertanyaan penting yang akan dibahas di bab ini:
• Apa tipe respon imun yang melindungi individu dari infeksi?

• Apa karakteristik penting imunitas, dan apa mekanisme yang

bertanggung jawab untuk karakteristik tersebut?

• Bagaimana sel dan jaringan dalam sistem imun terorganisir

untuk menemukan dan merespon terhadap mikroba sehingga
dapat dieliminasi?
Imunitas bawaan dan dapatan
• Pertahanan inang:
• Imunitas bawaan
• innate/natural/native immunity
• Proteksi cepat terhadap serangan mikroba
• Individu sehat
• Secara filogenetik lebih tua
• Lini pertama – menahan masuknya mikroba
• kulit dan jaringan mukosa
• Sel dan antibiotik alami yang ditemukan di jar. epitel
• Melewati lini pertama – masuk ke jaringan dan sirkulasi
• fagosit – limfosit terspesialisasi – innate lymphoid cells – NK cells
• Protein plasma – sistem komplemen
• Meningkatkan imunitas adaptif/bawaan
• Mengenali struktur yang sama pada suatu kelas bakteri
Imunitas bawaan dan dapatan
• Pertahanan inang:
• Imunitas dapatan
• acquired/adaptive immunity
• Pertahanan yang berkembang lebih lambat dan terspesialisasi
• Membutuhkan diferensiasi dan penambahan limfosit
• Menyediakan pertahanan yang lebih efektif
• Terdiri dari limfosit dan produknya (antibodi)
• Melawan patogen pada manusia yang mungkin melewati pertahanan
bawaan
• Mengenali berbagai macam molekul yang dikenali reseptor spesifik
• Molekul dari mikroba ataupun agen non-infeksi
• Antigen: substansi yang secara spesifik dapat dikelai oleh antibodi
atau sel limfosit
• Dapat menggunakan sel dan molekul dari imunitas bawaan
 Imunitas bawaan dan dapatan

FIGURE 1-3 Principal mechanisms of innate and adaptive immunity. The mechanisms of innate immunity provide the initial defense against infections.
Some mechanisms (e.g., epithelial barriers) prevent infections, and other mechanisms (e.g., phagocytes, natural killer [NK] cells and other innate
lymphoid cells [ILCs], the complement system) eliminate microbes. Adaptive immune responses develop later and are mediated by lymphocytes and
their products. Antibodies block infections and eliminate microbes, and T lymphocytes eradicate intracellular microbes. The kinetics of the innate and
adaptive immune responses are approximations and may vary in different infections.
Imunitas Dapatan: Dua tipe

• Imunitas humoral
• Mikroba ekstraseluler

• Melibatkan protein antibodi à

• sirkulasi dan cairan mukosa (usus dan pernafasan)

• Menghentikan mikroba yang ada di ekstrasel sehingga mencegah

infeksi

• Limfosit B
Imunitas Dapatan: Dua tipe

• Imunitas yang dimediasi oleh sel

• Mikroba intrasel

• Limfosit T – mengenali antigen mikroba yang di

• Mengaktifkan fagosit untuk menghancurkan mikroba yang telah
dicerna dlm vesikel intrasel
• Membunuh sel yang terinfeksi mikroba dalam sitoplasma
Imunitas Dapatan: Dua tipe

• Spesifitas limfosit B dan T berbeda

• Limfosit T hanya mengenali protein

• Limfosit B (antibodi) mengenali protein, karbohidrat, asam

nukleat, dan lipid
 Imunitas Bawaan dan Dapatan

FIGURE 1-4 Types of adaptive immunity. In humoral immunity, B lymphocytes secrete antibodies that eliminate extracellular microbes. In cell-
mediated immunity, different types of T lymphocytes recruit and activate phagocytes to destroy ingested microbes and kill infected cells.
Imunitas
• Imunitas aktif
• Individu didedahkan pada antigen dari suatu mikroba
sehingga dapat menimbulkan respon aktif untuk
mengeradikasi infeksi dan mengembangkan resistensi
terhadap infeksi yang timbul kemudian oleh mikroba
tersebut.
• Individu yang kebal vs. individu naïve
• Imunitas pasif
• Individu naïve menerima antibodi atau sel (cth. Limfosit) dari
individu lainnya yang sudah kebal pada suatu infeksi.
• Contoh fisiologi: bayi baru lahir
 Imunitas dapatan: Sifat

FIGURE 1-5 Properties of adaptive immune responses. This table summarizes the important properties of adaptive immune responses and how each
feature contributes to host defense against microbes.
 Seleksi klonal

FIGURE 1-6 Clonal selection. Mature lymphocytes with receptors for many antigens develop before encounter- ing these antigens. A clone refers to a
population of lymphocytes with identical antigen receptors and therefore speci cities; all of these cells are presumably derived from one precursor
cell. Each antigen (e.g., X and Y) selects a preexisting clone of speci c lymphocytes and stimulates the proliferation and differentiation of that clone.
The diagram shows only B lymphocytes giving rise to antibody-secreting cells, but the same principle applies to T lym- phocytes. The antigens shown
are surface molecules of microbes, but clonal selection also is true for extracellular soluble and intracellular antigens.
 Memori Sistem Imun Respon imun primer
Respon imun sekunder

FIGURE 1-7 Primary and secondary immune responses. Antigens X and Y induce the production of differ- ent antibodies (a re ection of speci city). The
secondary response to antigen X is more rapid and larger than the primary response (illustrating memory) and is different from the primary response
to antigen Y (again re ecting speci city). Antibody levels decline with time after each immunization. The level of antibody produced is shown as
arbitrary values and varies with the type of antigen exposure. Only B cells are shown, but the same features are seen with T cell responses to
antigens. The time after immunization may be 1 to 3 weeks for a primary response and 2 to 7 days for a secondary response, but the kinetics vary,
depending on the antigen and the nature of im- munization.
Sifat lain Imunitas Adaptif/Dapatan
• Limfosit yang teraktivasi oleh antigen akan berproliferasi
menghasilkan ribuan progeni yang mengenali antigen
yang sama
• Respon imun bersifat terspesialisasi, respon berbeda
untuk melawan bakteri yang berbeda.
• Semua respon imun bersifat terbatas dan menurun
setelah infeksi tereliminasi sehingga sistem kembali ke
keadaan istirahat
• Sistem imun akan bereaksi terhadap sejumlah besar
mikroba dan antigen, namun tidak bereaksi thd antigen
tubuh sendiri – immunologic tolerance
 Sel yang terlibat pada sistem imun

FIGURE 1-8 Principal cells of the immune system. The major cell types involved in immune responses and the key functions of these cells.
Micrographs illustrate the morphology of some cells of each type.
Kelas Limfosit
FIGURE 1-9 Classes of lymphocytes. Different classes of
lymphocytes in the adaptive immune system recog- nize
distinct types of antigens and differentiate into effector cells
whose function is to eliminate the antigens. B lymphocytes
recognize soluble or cell surface antigens and differentiate
into antibody-secreting cells. Helper T lymphocytes recognize
antigens on the surfaces of antigen-presenting cells and
secrete cytokines, which stimu- late different mechanisms of
immunity and in ammation. Cytotoxic T lymphocytes recognize
antigens in infected cells and kill these cells. (Note that T
lymphocytes recognize peptides that are displayed by MHC
molecules, dis- cussed in Chapter 3.) Regulatory T cells limit
the activation of other lymphocytes, especially of T cells, and
prevent autoimmunity.
 Pematangan Limfosit

FIGURE 1-10 Maturation of lymphocytes. Lymphocytes develop from precursors in the generative lymphoid organs (bone marrow and thymus).
Mature lymphocytes enter the peripheral lymphoid organs, where they re- spond to foreign antigens and recirculate in the blood and lymph. Some
immature B cells leave the bone marrow and complete their maturation in the spleen (not shown).
Tahapan perkembangan Limfosit
FIGURE 1-11 Stages in the life history of lymphocytes. A, Naive
lymphocytes recognize foreign antigens to initiate adaptive immune
responses. Naive lymphocytes need signals in addition to antigens
to proliferate and differentiate into effector cells; these additional
signals are not shown. Effector cells, which develop from naive
cells, function to eliminate antigens. The effector cells of the B
lymphocyte lineage are antibody-secreting plasma cells (some of
which are long-lived). The effector cells of the CD4 T lymphocyte
lineage produce cytokines. (The effector cells of the CD8 lineage are
CTLs; these are not shown.) Other progeny of the antigen-
stimulated lympho- cytes differentiate into long-lived memory cells.
B, The important characteristics of naive, effector, and memory cells
in the B and T lymphocyte lineages are summarized. The generation
and functions of effector cells, including changes in migration
patterns and types of immunoglobulin produced, are described in
later chapters.
 Perubahan proporsi sel T naïve dan
memori dengan umur

FIGURE 1-12 Change in proportions of naive and memory T cells with age. The proportions of naive and memory T cells are based on data from
multiple healthy individuals. The estimate of thymic output is an approximation. (Courtesy of Dr. Donna L. Farber, Columbia University College of
Physicians and Surgeons, New York.)
Antigen presenting cells (APCs)
• Ditemukan di kulit, saluran pencernaan dan pernafasan.
• Terletak di jaringan epitel yang akan:
• Menangkap antigen
• Mentrasportasikan ke jaringan limfoid
• Mempresentasikan ke limfosit T
• Sel dentritik
• Follicular dendritic cell (FDC)
• Ditemukan di germinal center
• Mempresentasikan antigen yang akan menstimulasi
diferensiasi sel B di folikel (tidak mempresentasikan ke sel T)
Jaringan yang terlibat dalam sistem
imun
• Organ limfoid generatif
• Sumsung tulang dan timus
• Mature dan kompeten untuk merespon thd antigen

• Organ limfoid periferal

• Nodus limf, limpa, sistem imun kuntan dan mukosal
• Menginduksi perkembangan sistem imun adaptif
• Tugas utama: membawa sel-sel yang jarang bertemu (cth. Sel
T helper dan limfosit B) untuk berinteraksi.
 Organ limfoid perifer
FIGURE 1-14 Morphology of lymph nodes. A, Schematic diagram
shows the structural organization of a lymph node. B, Light
micrograph shows a cross section of a lymph node with numerous
follicles in the cortex, some of which contain lightly stained central
areas (germinal centers).
FIGURE 1-15 Morphology of the spleen. A, Sche- matic diagram
shows a splenic arteriole surrounded by the periarteriolar lymphoid
sheath (PALS) and attached follicle containing a prominent germinal
center. The PALS and lymphoid follicles together constitute the white
pulp. B, Light micrograph of a section of spleen shows an arteriole
with the PALS and a follicle with a germinal center. These are
surrounded by the red pulp, which is rich in vascular sinusoids.
 Sistem imun mukosal

FIGURE 1-16 Mucosal immune system. Schematic diagram of the mucosal immune system uses the small bowel as an example. Many commensal
bacteria are present in the lumen. The mucus-secreting epithelium pro- vides an innate barrier to microbial invasion (discussed in Chapter 2).
Specialized epithelial cells, such as M cells, promote the transport of antigens from the lumen into underlying tissues. Cells in the lamina propria,
including dendritic cells, T lymphocytes, and macrophages, provide innate and adaptive immune defense against invading microbes; some of these
cells are organized into specialized structures, such as Peyer’s patches in the small in- testine. Immunoglobulin A (IgA) is a type of antibody abundantly
produced in mucosal tissues that is transported into the lumen, where it binds and neutralizes microbes (see Chapter 8).
 Sistem imun mukosal

FIGURE 1-17 Segregation of T and B lymphocytes in different regions of peripheral lymphoid organs. A, Schematic diagram illustrates the path by
which naive T and B lymphocytes migrate to different areas of a lymph node. Naive B and T lymphocytes enter through a high endothelial venule
(HEV), shown in cross section, and are drawn to different areas of the node by chemokines that are produced in these areas and bind selectively to
either cell type. Also shown is the migration of dendritic cells, which pick up antigens from epithelia, enter through afferent lymphatic vessels, and
migrate to the T cell–rich areas of the node (see Chapter 3). B, In this histologic section of a lymph node, the B lymphocytes, located in the follicles,
are stained green, and the T cells, in the parafollicular cortex, are stained red using immuno uorescence. In this technique, a section of the tissue is
stained with antibodies speci c for T or B cells coupled to uorochromes that emit different colors when excited at the appropriate wavelengths. The
anatomic segregation of T and B cells also occurs in the spleen (not shown). (Courtesy Drs. Kathryn Pape and Jennifer Walter, University of Minnesota
Medical School, Minneapolis.)
 Sistem imun mukosal

FIGURE 1-18 Migration of T lymphocytes. Naive T lymphocytes migrate from the blood through high endo- thelial venules into the T cell zones of
lymph nodes, where the cells are activated by antigens. Activated T cells exit the nodes, enter the bloodstream, and migrate preferentially to
peripheral tissues at sites of infection and in ammation. The adhesion molecules involved in the attachment of T cells to endothelial cells are
described in Chapters 5 and 6.