Diseases Of Immunity I

DISEASES OF IMMUNITY I R. HUGO MARTÍNEZ LOZANO, M.D. Sep-12, 2006

LEARNING OBJECTIVES: K & U GENERAL FEATURES - INNATE & ADAPTIVE - CELLS & TISSUES - MECHANISMS (HLA) DISORDERS OF THE IMMUNE SYSTEM - HYPERSENSITIVITY REACTIONS - TYPES - MECHANISMS - MEDICAL SIGNIFICANCE!!! Ref. pp. 194-217 & lecture’s information 

TOLL-LIKE RECEPTORS (TLR)

NK CELLS

PLASMA CELL

B Lymphocytes

Central Lymphoid Organ Antigen Receptor

Bone Marrow Bursa of Fabricus (chicken) Immunoglobulin (Ig) or B cell receptor (BCR)

T lymphocytes

Thymus T cell Receptor (TCR)

Ligands

Antigen

Co-receptor

CD19, CR2

Antigenic peptide plus MHC CD4 or CD8

Receptor Isotypes

IgM, IgD, IgG, IgE, IgA

none known

Generation of Diversity

Ig H and L gene rearrangement Two Signals:

TCR α/β gene rearrangement

Activation Requirements Activation Features

Antigen + T cells Help or Antigen + Microbial Factors Proliferation Antibody Secretion

Effector cells

Plasma cell

Memory

Memory B cells Clonal deletion/inactivation in

Selection against Self

Two Signals: Antigen+ Co-stimulatory Signals Proliferation Cytokine Secretion Cytotoxicity Helper Cells (Th1 and Th2) Cytotoxic cells (Tc) Memory T cells Clonal deletion/inactivation in

NORMAL LYMPH NODE

CLOSE-UP

TONSILS

TISSUE?

TISSUE?

BONE MARROW

BASOPHIL

HLA COMPLEX

n o f

HLA & RELATED RISK FOR DISEASES

Disease H LAnkylosing spondylitis A Postgonococcal arthritis w Acute anterior uveitis i t Rheumatoid arthritis h Chronic active hepatitis D i Primary Sjögren syndrome s e a sType-1 diabetes e

HLA Allele

Relative Risk

B27

90

B27

14

B27

14

DR4

4

DR3

13

DR3

9

DR3

5

DR4

6

DR3/DR4

20

HYPERSENSITIVITY REACTIONS

HYPERSENSITIVITY REACTIONS TYPE I

Immediate reaction

HYPERSENSITIVITY REACTION I 



LOCAL:- ATOPY – DERMATITIS - RHINITIS - ASTHMA - URTICARIA - GASTROINTESTINAL - ETC. SYSTEMIC: ANAPHYLAXIS

HYPERSENSITIVITY REACTION II

HYPERSENSITIVITY REACTION II

HYPERSENSITIVITY REACTION II

SELECTED EXAMPLES OF H.R.-II      

HEMOLYTIC ANEMIAS GOODPASTURE SYNDROME PEMPHIGUS V. INSULIN-RESISTENT DIABETES MYASTHENIA GRAVIS GRAVES DISESASE

HYDROPS FETALIS

PENPHYGUS VULGARIS

HYPERSENSITIVITY REACTIONS III SOME EXAMPLES

HYPERSENSITIVITY REACTION IV 

TYPES: - DELAYED (GRANULOMA) - T-CELL MEDIATED CYTOTOXICITY

HYPERSENSITIVITY REACTION IV

TUBERCULOUS GRANULOMAS

TB

"Increíble el primer animal que soñó con otro animal. Monstruoso el primer vertebrado que logró incorporarse sobre dos pies y así esparció el terror entre las bestias normales que aún se arrastraban, con alegre y natural cercanía, por el fango creador. Asombrosos el primer telefonazo, el primer hervor, la primera canción y el primer taparrabos...” Carlos Fuentes (Terra nostra)

QUESTIONS?