SISTEM IMUN DAN

HEMATOLOGI
dr. Ahmad Husairi, MAg, M. Imun
 Terminologi
• Immunity is defined as resistance to
disease, specifically infectious disease
• The collection of cells, tissues, and
molecules that mediate resistance to
infections is called the immune system, and
the coordinated reaction of these cells and
molecules to infectious microbes comprises
an immune response
• Immunology is the study of the immune
system, including its responses to microbial
pathogens and damaged tissues and its role
in disease
• The most important physiologic function
of the immune system is to prevent or
eradicate infections
 Sistem Imun
1. Imunitas innate (less spesific, natural,
native)
a. Seluler
b. Humoral
2. Imunitas adaptif (more spesific, acquired)
a. Seluler
b. Humoral
 INNATE AND ADAPTIVE IMMUNITY

• Host defenses are grouped under innate

immunity, which provides immediate
protection against microbial invasion, and
adaptive immunity, which develops more
slowly and provides more specialized
defense against infections
NK cells = Natural Killer cells, ILCs = innate lymphoid cells
 Tipe Imunitas Adaptif
1. Humoral immunity is mediated by
proteins called antibodies, which are
produced by cells called B lymphocytes
2. Defense against such intracellular
microbes is called cell-mediated
immunity because it is mediated by cells,
which are called T lymphocytes
Types of
adaptive
immunity
• Immunity may be induced in an individual
by infection or vaccination (active
immunity) or conferred on an individual by
transfer of antibodies or lymphocytes from
an actively immunized individual (passive
immunity)
Properties of
adaptive
immune
responses
 Tissues (Organs) of The Immune
System
1. Peripheral (secondary) lymphoid organs:
lymph nodes, the spleen, and the mucosal
and cutaneous immune systems (MALT:
mucosa-associated lymphoid tissue)
2. Generative (primary/central) lymphoid
organs: bone marrow and thymus
 Nodus Lymphaticus
• Berbentuk oval atau seperti ginjal
• Hilum
• Cortex
• Medulla
• Vasa efferent muncul dari medulla
• Vasa afferent bermuara ke cortex
 Systema Lymphaticum
Terdiri atas:
• Vasa lymphatica
• Jaringan lymphoid
Fungsi:
1. Transportasi material nutritif yang tidak
dapat diangkut via kapiler darah
2. Membawa lymphocyt ke aliran darah
 Vasa Lymphatica
• Terdiri atas:
1. Vasa capillare
2. Vasa afferent dan efferent
3. Vasa collectiva
4. Truncus lymphaticus
• Vasa lymphatica tidak terdapat di
epidermis, rambut, cornea, kuku,
articulatio, cartilago tertentu, encephalon,
medulla spinalis, medulla ossium
Distribusi vasa lymphatica dan jaringan limfoid
 Drainase Limfe
di Regio Caput et Collum
• Nll. superficialis: nll. occipitalis, nll. mastoidea
(retroauricularis/auricularis posterior), nll.
preauricularis et parotidea, nll. submandibularis,
nll.submentalis
• Nll. cervicalis superficialis: dari nll.occipitalis dan
nll. mastoidea
• Nll. cervicalis profundi: dari nll. preauricularis et
parotidea, nll. submandibularis, dan nll.
submentalis
 Lien
• Terletak terutama di regio hypochondriaca
sinistra, tepi posteriornya membentang ke
dalam regio epigastrica
• Tepi anteriornya mencapai linea axillaris
media
• Tidak dapat dipalpasi
 Lien
• facies diaphragmatica, facies visceralis,
margo superior (margo crenatus),margo
inferior (margo obtusus), extremitas
anterior, dan extremitas posterior
• Facies visceralis memunyai impressio
gastrica, impressio renalis, impressio
pancreatica, dan impressio colica
• hilum
 MALT:
mucosa-associated lymphoid tissue
• GALT (gut-associated lymphoid tissue)
• NALT (nasal-associated lymphoid tissue)
• BALT (bronchal-associated lymphoid
tissue)
 Tonsila
1. Annulus (cincin) lymphaticus pharyngealis
(ring Waldeyer)
1. Tonsila pharyngealis (nasopharyngealis)
2. Tonsila palatina
3. Tonsila lingualis
2. Folikel limfe:
a. noduli lymphatici aggregatii (plaque
Peyeri) di lamina propria ileum
 Tonsila
nasopharyngealis

Tonsila palatina

Tonsila lingualis
b. Tonsila intestinalis di appendix
vermiformis
 Thymus
• Organ sentral sistem limfoid
• Ukuran dan aktivitas thymus sangat
bervariasi
• Mengalami involusi setelah pubertas
• Lobus: dexter, sinister, dan pyramidalis
• Terletak di leher, di dalam mediastina
superior dan anterior
 Thymus
 Tempat maturasi sel T
 Organ imunologik primer yg penting utk
perkembangan kekebalan seluler pd masa anak-
anak
 Medulla Ossium
• Organ sentral sistem limfoid
• T.a. medulla ossium flava (yellow marrow)
dan medulla ossium rubra (red marrow)
• Pd masa fetus dan waktu lahir: medulla
ossium rubra ada di seluruh skeleton
• Medulla ossium rubra scr bertahap diganti
medulla ossium flava dari ujung distal ke
ujung proximal
 Medulla Ossium
• Pada usia 20-25 th: medulla ossium rubra
hanya ada di vertebra, sternum, costa,
clavicula, scapula, pelvis (os coxae), ossa
cranii, dan ujung proximal femur dan
humerus
• Pada usia tua: medulla ossium ossa cranii
mengalami degenerasi (gelatinous marrow)
 Medulla Ossium (Bone
Marrow)
 Tempat pembentukan sebagian besar sel darah yang matur,
meliputi erithrocyt, granulocyte, monocyt, dan peristiwa
awal maturasi sel B
 Terdiri atas:
- Stroma
- Jaringan haemopoetic
- Sinusoid
 Pembentukan semua sel darah disebut hematopoiesis
 Summary
• The physiologic function of the immune
system is to protect individuals against
infections
• Innate immunity is the early line of defense,
mediated by cells and molecules that are
always present and ready to eliminate
infectious microbes
• Adaptive immunity is mediated by
lymphocytes stimulated by microbial
antigens, requires clonal expansion and
differentiation of the lymphocytes before it
is effective, and responds more effectively
against each successive exposure to a
microbe
• Lymphocytes are the cells of adaptive
immunity and are the only cells with
clonally distributed receptors with fine
specificities for different antigens
• Adaptive immunity consists of humoral
immunity, in which antibodies neutralize
and eradicate extracellular microbes
and toxins, and cell-mediated immunity,
in which T lymphocytes eradicate
intracellular microbes
• Adaptive immune responses consist of
sequential phases: antigen recognition
by lymphocytes, activation of the
lymphocytes to proliferate and to
differentiate into effector and memory
cells, elimination of the microbes,
decline of the immune response, and
long-lived memory
• Different populations of lymphocytes serve
distinct functions and may be distinguished
by the surface expression of particular
membrane molecules
• B lymphocytes are the only cells that
produce antibodies. B lymphocytes express
membrane antibodies that recognize
antigens, and the progeny of activated B
cells, called plasma cells, secrete the
antibodies that neutralize and eliminate the
antigen
• T lymphocytes recognize peptide fragments of
protein antigens displayed on other cells.
• Helper T lymphocytes produce cytokines that
activate phagocytes to destroy ingested microbes,
recruit leukocytes, and activate B lymphocytes to
produce antibodies. Cytotoxic T lymphocytes
(CTLs) kill infected cells harboring microbes in
the cytoplasm
• Antigen-presenting cells (APCs) capture
antigens of microbes that enter through
epithelia, concentrate these antigens in
lymphoid organs, and display the
antigens for recognition by T cells
• Lymphocytes and APCs are organized in
peripheral lymphoid organs, where immune
responses are initiated and develop
• Naive lymphocytes circulate through peripheral
lymphoid organs, searching for foreign antigens.
Effector T lymphocytes migrate to peripheral sites
of infection, where they function to eliminate
infectious microbes. Plasma cells remain in
lymphoid organs and the bone marrow, where they
secrete antibodies that enter the circulation and
find and eliminate microbes
BEBERAPA HAL POKOK YANG TERKAIT RESPONS IMUN:

1. MHC (MAJOR HISTOCOMPATIBILITY COMPLEX)

2. SITOKIN DAN HANTARAN SINYAL

3. KOMPLEMEN

4. ANTIGEN DAN ANTIBODI

 Antigen-presenting Cell (APC)
• Sel yang menangkap, memproses,
menunjukkan antigen, dan mengaktivasi
limfosit T disebut APC
• Pemameran (presenting) antigen dilakukan
oleh protein khusus yang disebut molekul
MHC (major histocompatibility complex)
 VH
Ag. BINDING SURFACE

CH-1
VL
CL

CH-2
COMPLEMEN
BINDING SITE
CH-3

FC

STRUKTUR ANTIBODI

JENIS RANTAI BERAT KELAS ANTIBODI

RANTAI-µ Ig-M
RANTAI-α Ig-A
RANTAI-γ Ig-G
RANTAI-σ Ig-D
RANTAI-ε Ig-E

JENIS RANTAI RINGAN TIPE ANTIBODI

RANTAI-λ TIPE-λ
RANTAI-κ TIPE-κ
 Kepustakaan
• Abbas AK et al. 2015. Cellular and Molecular
Immunology 8th ed. Elsevier Saunders,
Philadelphia
• Abbas AK, Lichtmann AH and Pillai S 2016.
Basic Immunology: Functions and Disorders of
The Immune System 5th ed. Elsevier, Canada
• Murphy K dan Weaper C 2017: Janeway’s
Immunobiology 9th ed. Garland Science, New York
dan London