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Aspek Imunologi

Transfusi Darah

Umi S Intansari
TOPICS

1. Components of the immune system

2. Basic principles of innate and adaptive


immunity
3. Complement system
4. Immunoglobulin
5. Red cell alloimmunization
6. Immune-mediated Red cell destruction
Components of the immune system

White blood cells


Lymphoid organ

Primary lymphoid organ:
Bone marrow & fetal liver
Thymus:
Secondary lymphoid organ
Lymph nodes, spleen, lymphoid tissue

induction sites for immune responses
Body tissues
effector sites for immune responses
Humoral: Complement, Antibodies, Cytokine
cells

Blood cells derived from bone marrow cells

Adaptive imm
Innate imm
cells

Blood cells migrate through blood and lymph nodes or home to


tissues
Myeloid cells in immunity cells
cells

Lymphoid cells
Resting lymphocytes
are round cells with a
large nucleus
Lymphoid organ
Secondary lymphoid
organs are found
throughout the body.

B cells mature in BM
T cells migrate to
Thymus and
undergo maturation

Blood stream

Thoracic
duct

Lymph nodes

Distribution of lymphoid tissues in the body


Lymphoid organ
White blood cells
migrate through blood,
lymph nodes and
tissues.

Lymph from body


surfaces drains through
the draining lymph nodes
into the thoracic duct and
then into the blood
circulation.

Lymphocytes
recirculate between
blood and lymph
organ until encounter
their Ag
TOPICS

1. Components of the immune system

2. Basic principles of innate and adaptive


immunity
Step of immune response

The response to an initial infection occurs in three phases


Principles of innate and adaptive immunity

Feature Innate Adaptive


Foreign molc Structures shared by Wide range of very
microbes, recognized as particular molc
pattern
Nature of Germline encoded - Somatic mutation wide
recognition receptor limited range of specificities

Speed of response immediate Time for cell movement &


interaction between cells
Memory none Efficient

Humoral complement Antibodies


component
Cellular component Neutrophil, M, NK cells, Lymphocytes
DC,
Recognition
Different pathogen/ antigen require different
response mechanism for detection,
recognition & destroying them
Receptors:
Recognition

TCR BCR

Dendritic cells stimulate T B cells need help from activated T


cells by the presentation of cells for their activation
antigen APC
Recognition
Antigen presenting cells (APCs)

Dendritic cells catch antigen in the periphery and present it in lymph nodes
Macrophages catch extracelular pathogen
B cells catch soluble antigens in the circulation and presents it in lymph nodes
Antigen Presentation

Phagocytes internalize
pathogens, degrade
them in endosomes
and present the
peptides on MHC II

B cells bind antigens on


the BCR, degrade them
in vesicles and present
the peptides also on
MHC II
Figure 5-2

Th1 Th2

Th1 (inflammatory T cell) : activate Macrophage to destroy


intravesicular pathogen
Th2 (helper cell) : activate B cell to produce Antibody
Activation
Figure 8-27
TOPICS
1. Components of the immune system

2. Basic principles of innate and adaptive


immunity

3. Complement system

4. Immunoglobulin

5. Red cell alloimmunization

6. Immune-mediated Red cell destruction


Three pathway of complement system
Effector action of complement
Phagocytosis is activate by C5a via CR1
Membrane-attack complex formation
TOPICS
1. Components of the immune system

2. Basic principles of innate and adaptive


immunity

3. Complement system

4. Immunoglobulin

5. Red cell alloimmunization

6. Immune-mediated Red cell destruction


Effector mechanism
Antibodies
Immmunity mediated by Ab: Structure of an antibody molecule
humoral immunity

*
Ag binding site
B cells produce antibodies
which can recognize soluble *
antigen

An immunoglobulin molecule
has two identical H-chains
and two identical L-chains

The variable regions of Abs


are encoded by multiple
gene fragments

Variable region determine


Ag binding specificity

Immunoglobulin is a general term for antibodiess


Maturation of B cell producing antibody

IgM is the first to produced


before isotype switching

low affinity but compensate by


pentameric form

After maturation B cell will


express different set of isotypes
depend on effector site:
IgG : abundant, blood
circulation
IgA : dimeric (mucosa) ,
circulation (monomeric)
IgE : mast cell, hypersensitivity
Antibody function

Fc role

so far FAB determine specific


function of antibody

But, Fc also plays role


Antibody function : Fc
role
1. macrophage ingestion
Figure 9-31

2. Ig: Ag:C complex in complement


activation
Antibody function : Fc
role
3. activate Natural Killer (NK) cell
Figure 9-32

4. activate Sel Mast


Figure 9-19 part 1 of 2
The course of typical antibody response

Vaccination induces the production of protective antibodies by plasma cells B cells

B cells response to antigenic


stimulation:

1. Proliferation and
maturation: formation of
plasma cells
2. Secretion of antibodies

Repeated stimulation
with the same antigen
increases the antibody
concentration to that
antigen

Immunological memory
Ability of immune system to make second response to same ag more effective & efficiently
TOPICS
1. Components of the immune system
2. Basic principles of innate and adaptive
immunity
3. Complement system
4. Immunoglobulin

5. Red cell alloimmunization

6. Immune-mediated Red cell destruction


Red cell alloimmunization

The mechanism of red cell alloimmunization is not well


understood.

Blood
Allogeneic RBC circulation
tranfused,degraded

Uptake by APCs,
Ab production
B cells, presented
to T cell
Red cell alloimmunization

Rh-mothers
Rh- mothersmake
makeanti
antiRh
RhAb
Ab
whenthey
when theyexposed
exposedto
toRh+
Rh+
fetalRBC.
fetal RBC.

MaternalIgG
Maternal IgGantibodies
antibodiesare
are
Transportedacross
Transported acrossthe
theplacenta
placenta
tothe
to thefetus
fetus

IgGanti
IgG antiRh
Rhcoated
coatedthe
thefetal
fetalRBC
RBC
destroyed
destroyedby
byphagocytic
phagocyticcells
cells
Hemolytic
Hemolyticanemia
anemia
mechanism of HLA alloimmunization due to
leukocytes present in platelet transfusion
TOPICS
1. Components of the immune system

2. Basic principles of innate and adaptive


immunity

3. Complement system

4. Immunoglobulin

5. Red cell alloimmunization

6. Immune-mediated Red cell destruction


Immune-mediated Red Cell Destruction