DISEASE OF
IMMUNE SYSTEM
Sharon Hazel Joyce C. Sebastian,RMT
Immune System
Defense against microbial invasion and to
accomplish this is by distuinguishing self
from non-self.
Innate
NONSPECIFIC
Adaptive
ANTIGEN-SPECIFIC
Hypersensitivity and Autoimmune
Disorders
CATEGORIES:
* Hypersensitivity reactions
* Autoimmunity
* Deficiency
* Amyloidosis
-is a rare, serious disease caused by
accumulation of proteins in the form of
abnormal, insoluble fibres, known
asamyloidfibrils, within the extracellular
space in the tissues of the body.
Mechanisms:
* Exogenous/Endogenous
* Diseases result of Hypersensitivity
response
* Hypersensitivity Reactions represents
an imbalance between immune effectors
mechanisms and control mechanisms
Mechanisms of Immunologically Mediated Hypersensitivity
Reactions:
*Immediate Hypersensitivity (TYPE1)
- Anaphylaxis; allergies; bronchial asthma
EXPOSURE
Productuon of IgE antibody
Immediate release of vasoactive amines and other mediator
from mast cells
Recruitment of inflammatory cells
**Vascular Dilation; Edema; smooth muscle contraction;
mucus Production; tissue injury; INFLAMMATION**
*Antibody- Mediated Hypersensitivity
(TYPE II)
- Autoimmine hemolytic
anemia;Goodpasture syndrome
EXPOSURE
Production of IgG, IgM
B
Binds to antigen on target cell/tissue
Phagocytosis/ lysis of target cell
Recruitment of LEUKOCYTES
Phagocytosis and lysis of cells; Inflammation
*Immune complex-mediated
Hypersensitivity (TYPE III)
- SLE; Some forms of glomerulonephritis; serum
sickness; Arthus reaction
Deposition of antigen-antibody complexes
Complement activation
Recruitment of Leukocytes by complement
products and Fc receptors
Release of Enzymes and other toxic molecules
**Inflammation;Necrotizing Vasculitis**
*Cell- mediated Hypersensitivity (TYPE IV)
- Contact dermatitis; multiple sclerosis; type 1
diabetes; rheumatoid arthritis; inflammatory
bowel disease; tuberculosis
Activated T Lymphocytes
Release of Cytokines
Infammation and Macrophage activation
T cell-mediated cytotoxicity
** Perivascular cellular infiltrates; Edema;
Granuloma formation; cell destruction**
Systemic Anaphylaxis
follows parenteral or oral administration of foreign proteins, drugs, foos or
insect toxins.
EXPOSURE
Pruritus, Urticaria and Erythema
(minutes after)
Bronchoconstriction and laryngeal edema
Laryngeal obstruction, hypotensive shock and DEATH
( with in Minutes to Hours)
SYSTEMIC LUPUS ERYTHEMATOSUS
Prototypical systemic autoimmune disorder,
characterized by numerous autoantibodies,
especially ANA (Antinuclear antibodies.
- mostly in women (9:1)
- Malar erythema
ETIOLOGY:
*Genetic Factor
*Immunologic Factor
*Environmental Factor
Clinical Features:
MINIMAL symptoms(Hematuria, rash)
Recurrent Flares and remissions
(Immunosuppresive regimens)
* thrombocytopenia
* leukopenia
* anemia
5- 10 years survival (Renal Failure or
intercurrent infections)
Sjgren Syndrome
Characterized by dry eyes (keratoconjunctivitis
sicca) and mouth (xerostomia) resulting from
immune-mediated lacrimal and salivary
destruction.
- most px have rheumatoid factor w/o
Rheumatoid arthritis
CLINICAL FEATURES:
Xerostomia
Keratoconjuctivitis
Renal tubular dysfunction
Mikulicz syndrome
-lip biopsy
SYSTEMIC SCLEROSIS
- Chronic autoimmune inflammatory
disorder characterized by widespread
vascular injury and progrssive perivascular
and interntitial fibrosis of multiple organs.
CLINICAL FEATURES:
* Cutaneous fibrosis
* Raynauds phenomenon
* Dysphagia
* Gastrointestinal ( Malabsorptio,intestinal
pain or obstruction)
AIDS
Acquired Immunodeficiencies Syndrome
-caused by the retrovirus HIV; it is
characterized by profound suppression of Tcell-mediated immunity leading to
opportunistic infxn, secondary neoplasms
and neurologic disorders.
TRANSMISSION:
Sexual contact
Parenteral inoculation
Vertical transmission from mother to
fetus/newborn
Major Risk Groups:
Homosexual/Bisexual
IV drug Users
Hemophiliacs (Factor VII/IX concentrates)
Blood/Components Recipient
Heterosexual Contact
NEOPLASIA
Neoplasm new growth
Tumor - abnormal masses of tissue
Tumors are classified based on clinical
behaviors:
Benign
- innocent
- characterized by a localized lesion
without spread to other sites and amenable
to surgical resection.
Malignant
- cancer
- aggressive behavior including
invasion and destruction of adjacent tissues
and capacity for spread to other sites
(metastasis)
*carcinoma epithelial cells*
*sarcoma mesenchymal cell*
Differentiation
refers to how closely tumor cells histological
resemble their normal cell countepart
Anaplasia - lack of differentiation
HISTOLOGIC changes in tumors:
*Pleomorphism - variation in the shape and
size of cells and nuclei
*Abnormal nuclear morphology
Hyperchromatic nuclei with irregular
clumped chromatin, prominent nucleoli, and
inc. Nuclear to cytoplasmic ratios (1:1 vs.
normal ratios 1:4 to 1:6)
Abundant
and atypical mitoses- e.g. tripolar
mitoses, Mercedes-Benz sign
Loss of polarity disturbed orientation
Tumor giant cells - cells w/ single polypoid
nuclei or multiple nuclei
Ischemic necrosis due to insufficient
vascular supply
Dysplasia term used to describe the
constellation of histologic changes seen in
neoplasm.
-loss of cellular uniformity and
architectural organization
Metastasis
-involves invasion of lymphatics, blood
vessel or body cavities by tumor followed by
transport and growth of secondary tumor
cell masses.
-this is the single most imp. Feature
distinguishing benign from malignant.
Grading degree of differentiation
Staging size of the primary tumor and the
extent of local and distant spread.
Laboratory Diagnosis of Cancer
Histologic examination
-most imp. Method of diagnosis
*surgical biopsy (complete clinical data)
*frozen section (cryostat)
Cytologic interpretation
-based chiefly on changes in the
appearance of individual cells.
*FNAB (Fine Needle Aspirate Biopsy)
*Cytologic smear (Pap smear)
Immunohistochemistry
-detects all products or surface markers
using specific antibodies.
-fluorescent labels or chemical rxn tht
generate a colored product
USES:
Diagnosis of undifferentiated tumors by
the detection of tissue specific intermediate
filaments or other markers
Determination of the site of origin of
metastases by using rgnt that identify
specific cell type e.g. PSA, CEA, AFP
Detection of molecules that have prognostic
or therapeutic significance e.g. ERB-B2, HER2/NEU
Flow Cytometry
- used in rapid and quantitate measure the
presence of membrane antigens or DNA content
of tumor cells
- diagnosis and classification of leukemias and
lymphoma
Tumor markers
-not specific for malignancy
-CEA, PSA, AFP
INFECTIOUS DISEASES
Infectious Agents:
*Prions - composed only of a modified host
protein called prion protein
- lack RNA and DNA
- spongiform encephalopathies
*Virus - obligate intracellular organisms
requiring host cell metabolism
- contain either DNA or RNA
*Bacteria - lack nuclei and other membrane bound
organelles but have cell walls
Mycoplasma lack of cell walls and are the smallest of
the free living microbes.
*Fungi - eukaryote w/ thick, chitin-containing cell
walls and ergosterol containing cell membrane
*Protozoa - Gardia,Trichomonas
*Helminths -complex life cycle involving humans
and intermediate host
*Ectoparasites -insects or arthropods
Route of Entry:
Skin
G.I. Tract
Respiratory Tract
Urogenital Tract
Some Infectious Diseases:
Measles (Rubeola)
- RNA paramyxovirus transmitted by respiratory
droplets
Mumps
Poliovirus
- spherical, uncapsulated RNA enterovirus
-fecal-oral route
West Nile Virus
-arthropod-borneflavivirus
-dengue and yellow fever
ENVIRONMENAL & Nutritional
DISEASE
Refers to conditions caused by exposure to
chemical or physical agents
Malnutrition increase the risk of ifnx.
Drug-resistant strains due to clinical and
agricultural antibiotic
How CLIMATE Change
affects Human Body?
Cardiovascular and Respiratory diseases
Gastroenteritis and epidemic infxn
Vector-borne infectious diseases
Malnutrition
Environmental Pollution
LUNG - major organ affected
- outdoor/indoor
Ozone -interaction of oxygen and UV
radiation
- major component of smog
- Ozone Toxicity (cough, chest
discomfortand pulmonary inflammation)
Metals as Environmental Pollutants:
Lead -present in air where leade gasoline is
burned,soil and house dust contaminated w/
leaded paint.
-basophilic stippling
Mercury
-neuronal toxicity
Arsenic -found in soil and water and used in
herbicides and wood preservative
Cadmium -mining, electroplating and improper
disposal of nickel cadmium batterie
Drug Abuse
Cocaine
-Extracted from coca leaves and snorted or
injected
-Cardiovascular and CNS effect
Heroin
-alkaloid of the poppy plant, injected
subcutaneously or intravenously
-SUDDEN DEATH, Pulmonary Injury,
Infection, Skin Pathology, Renal Pathology
Ampethamines
-methamphetamines, addictive drug that
induces CNS dopamine release and thereby
slows glutamate release.
Marijuana
-Cannabis sativa
Oral Contraceptives
- contain a synthetic estradiol and variable
amounts of progestin
Anabolic Seroids
-synthetic versions of testosterone
Acetaminophen
- Analgesic, liver failure
Aspirin
- inhibit plt. Aggregation
- For px possible to have thrombosis but Never
administer in Dengue Px
NUTRITIONAL Disease
Appropriate diet provides adequate a colic
intake to satisfy the need of our body.
Poverty is the major determinant of primary
malnutrition.
PEM (Protein-Energy Malnutrition)
- inadequate dietary intake of pretein and
calories.
-Marasmus & Kwashiokor
Anorexia
-self induced starvation
Bulimia
-food binging followed by self-induced
vomiting
Obesity
- massive problem , caloric imbalance w/
intake greater than expenditure.
VITAMIN deficiency
