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TRNG I HC NNG LM TP.H CH MINH KHOA CNTY LP DH08DY

NHM THC HIN 1. Bi Th Cnh 2. Nguyn Hunh Xun An 3. L Th Bch Thy 4. L Th Thu Thy 5. Nguyn Th Ngc Trm 6. Th Tuyt Trinh 7. Nguyn Th Kim L 8. Hunh Tr Ton

Cc khi nimMin dch (immunity) L kh nng bo v ca c th chng li nhng tc nhn gy bnh xm nhp t bn ngoi: yu t truyn nhim nh vi sinh vt,cn trng,k sinh trng,cc protein l gy c cho c th. Min dch hc (immunus) L mn hc nghin cu v h thng min dch v cc p ng ca h thng ny trc cc tc nhn gy bnh xm nhp vo c th.

H thng min dch L tp hp cc t bo, m v cc phn t tham gia vo qu trnh khng chng nhim trng.

p ng min dch Bao gm s nhn bit tc nhn gy bnh hoc nhng cht l,tip theo l nhng phn ng nhm loi b chng ra khi c th.

H THNG MIN DCHMin dch bm sinh (innate immunity) c vai tr bo v c th ngay lp tc (ngay khi mi sinh ra cng nh ngay khi nhim trng mi xy ra) chng li nhim trng. Min dch thch ng (adaptive immunity) l trng thi min dch xut hin chm hn v tham gia bo v c th chng nhim trng giai on mun hn nhng hiu qu hn.

Cc c ch cn bn ca min dch bm sinh v thch ng

MIN DCH THCH NGMin dch dch th (Humoral Immunity)

l cch min dch do cc t bo min dch tit khng th vo mu (kt hp vi cc khng nguyn tng ng). Cch min dch c hiu ng nht trong vic chng li s xm nhp ca vi khun,virus n tc ng trung gian qua cc Protein (khng th) hoc globulin min dch (Immunglobulin-Ig) cc khng th ny do t bo lymphocyte B sn sinh do s kch thch ca helper T cell.

MIN DCH THCH NGMin dch t bo (CellularImmunity) l s chng li cc t bo thm nhim virus, k sinh trng, cc m l thng qua cc tc ng trung gian ca cc t bo lymphocyte.

MIN DCH T BO

Cc c quan lympho trung ng

Cc c quan lympho ngoi bin

MIN DCH T BODa vo c im,chc nng c th chia thnh 4 nhm: Nhm lymphocyte: lymphocyte T, lymphocyteB, t bo NK(natural killer cells). Nhm thc bo: mono/i thc bo,t bo ui gai,bch cu ht trung tnh,bch cu a axit. Nhm t bo b tr: bch cu a base,dng bo,tiu cu. Nhm t bo khc: t bo ni mch.

Lymphocyte BNgun gc : c bt u t gan phi,khong 7-8 tun sau c thai. Sau pht trin ty xng, thnh thc y hoc ti Bursa Fabricius ca gia cm. IgMIgM CD34 Khng c Ig C C S

T bo gc sinh mu

Tin B (Pro-B cell)

B sm (Early B cell)

B mun (Late B cell)

B chn (Mature B cell)

Qu trnh trng thnh ca B lymphocyte

CC C QUAN TO LYMPHOCYTE B ````````````````````````````````````C quan trung ng

- Thi k phi: pht trin gan phi.

- Trc v sau : pht trin ty xng.- Trng thnh: pht trin ty. - loi chim: pht trin ti Bursa Fabricious.

CC C QUAN TO LYMPHOCYTE BC quan ngoi bin:- Hch lymphocyte: T bo B sm pht trin trung tm mm,t bo B chn c mt vng Marginal Zone. - Lch: lymphocyte B cha trng thnh c pht trin trung tm mm.B trng thnh c mt mu tun hon. - H thng lymphocyte h tiu ha: amidan, mng Payer ni tp trung t bo B1-B. - Mu tun hon: c mt t bo chn sinh sn t ty xng.

CHC NNG Sinh ra cc khng th di s kch thch ca Lymphocyte T. mt s i thc bo lm nhim v by v tp trung khng nguyn. Phn ln cc khng nguyn u b cc i thc bo bt v x l.Sau i thc bo c nhim v trnh din cc khng nguyn cho lymphocyte T.

Lymphocyte TNgun gcLymphocyte T c sinh ra ty xng, di chuyn v tuyn c (thymus) v thnh thc y, sau vo mu, mt t vo hch lm ba.

S lng t bo lympho T c duy tr n nh nh s cn bng gia cc t bo mi n t tu xng v t bo cht do khng tip xc khng nguyn. Thi gian na i sng ca t bo lympho T nguyn vn vo khong 3-6 thng i vi loi chut v 1 nm i vi loi ngi.

Phn loi t bo TDa vo chc nng chia thnh 4 loi: T bo lymphocyte T hiu ng (effector T, k hiu l Te hay cn gi l lymphocyte git-Killer T (Tk )Trc tip tham gia min dch t bo,c kh nng ph hy,phn gii vt l, t bo ung th. T bo lymphocyte T h tr (Helper T cell, k hiu TH ) Hip ng vi bch cu n nhn ln xc tin hot ha t bo lympho B.

T bo lymphocyte T c ch (Suppesor T, k hiu Ts) C vai tr c ch v hot ha t bo lympho B v cc t bo T khc, tham gia iu ha min dch. T bo lymphocyte T nh (Memory T, k hiu Tm): Tng sinh v p ng min dch.

Da vo du n protein mng CD tng ng vi chc chia thnh 5 loi: Lympho T h tr ( TH=T helper) -c CD4+ -nhim v hot ha v thc y hot ng ca cc lympho T khc thng qua vic tit ra Interleukin-2. Lympho T gy qu mn mun (TDTH: Delayed Type Hypersensitivity T cell) nhim v tit lymphokin hot ha i thc bo v bch cu khc dn n biu hin qu mn mun.

Lympho T iu ha ngc (TFR: Feedback

regulator T lymphocyte cn gi l lympho T cm ng c ch) tc dng hot ha lympho T c ch.

Lympho T c ch (Ts=T suppressor)

-c CD8+ -nhim v iu ha p ng min dch, c ch hot ng ca cc loi Lympho bo khc. Lympho T c (CTL=cytotoxic

lymphocyte=TC) Nhim v tn cng trc tip cc t bo c khng nguyn l trn b mt.

T bo Lympho T vi cc Protein b mt ca n

CHC NNG CC T BO TChc nng h tr ca cc t bo CD4: Nhn bit khng nguyn c trnh din bi cc phn t MHC lp II. Thc hin chc nng h tr bng cch tit ra cc lymphokin khi c hot ho (chng hn bi khng nguyn) cc lymphokin s cm ng cc t bo lympho B sn xut ra khng th.

Chc nng c t bo ca cc t bo CD8: - Ch nhn bit khng nguyn khi kt hp vi cc phn t MHC lp I. - Chu trch nhim v vic ly gii cc t bo c biu l khng nguyn l trn b mt ca chng, c bit nh l khng nguyn virus. Chc nng hot ha i thc bo: - T bo lympho T c kh nng tit ra nhng lymphokin hot ha i thc bo (GM-CSF, IFN, TNF-) - Gip cc i thc bo tr nn hot ng m dit cc vi sinh vt thng xuyn hay nht thi, ngay bn trong cc t bo y

Chc nng iu ho phn ng vim, to mu: T bo lympho T tit ra cc lymphokin IL-4, IL-5, IL-6 c nhng tc ng khc quan trng trong phn ng vim, to mu. Chc nng iu ha p ng min dch Ca cc t bo lympho T c ch. Khi c suy gim t bo ny th hay xut hin nhng biu hin ri lon min dch nh d ng, t mn

Cc phng php cha bnh trn c s min dch:Liu php t bo, liu php gen, cc cht kim hm, kch thch min dch v iu ha min dch cha cc bnh nhim trng, bnh t min, bnh suy gim min dch bm sinh hoc mc phi. ng thi liu php min dch c ng dng trong cy ghp thay th cc c quan.

TIM CHNG,VACXIN PHNG V CHA BNHTim chng l gy min dch ch ng gip c th c kh nng to ra mt c ch bo v chng li s xm nhp ca mt c th xm lc hoc c t ca n.

Vacxin l cc tc nhn gy bnh dc lm gim bt c tnh hoc lm mt hot ng hoc l cc tiu n v ca cc c t vi khun hoc virus.

CC DNG VACXIN1.Vacxin vi khunCc vi khun c th c git hoc lm mt hoat tnh iu ch tc nhn gy min dch hu ch. a/ Vacxin gim bt c tnh - BCG i vi bnh lao. b/ Vacxinh gy bt hot tnh -Bordetella pertussis i vi ho g. -Salmonella typhi v S.paratyphi i vi bnh st thng hn.

c/ Vacxin cc tiu n v hoc c t: -Neurotoxin ca Clostridium tetani :c iu ch vacxn un vn -c t ca Corynebacterium diphtheriae lm mt hot tnh bng x l ha hc c iu ch vacxin bch hu.

-Polixacarit thnh t bo vi khun Haemophilus influenzae typ c iu ch vacxin vim mng no.

2.CC VACXIN K SINH TRNG

K sinh trng l nhng c th a bov k sinh nhiu vt ch trung gian trong vng i ca chng.

N lun thay i c ch tinh vi nhmtrn thot s p ng min dch ca vt ch.

3.CC VACXIN VIRUS- c iu ch cc dng virus sng gim c tnh hoc dng virus b git hoc cc tiu n v khng nguyn virus. - Vacxin sng lm gim c tnh nh vacxin st pht ban, bi lit, quai b, bnh si. - Vacxin b git: vacxin bi lit dng tim, vacxin cm, vacxin ch di. - Cc vacxin gm cc tiu n v: vacxin Hepatit B, vacxin cm.

-S DNG CC THUC KiM HM MiN DCH- S DNG CC XITOKIN V ANTIXITOKIN

- LiU PHP MiN DCH T BO- LiU PHP GEN CHNG UNG TH

Qu Vit Qut

Bng Ci

Ti - t

Cam - Chanh

C chua C rt

Ng Cc

Tht B - Mng Ty

HOT HA T BO THai tn hiu t cc t bo trnh din khng nguyn - Tn hiu 1: Cht tip nhn ca t bo T nhn din phc hp khng nguynMHC trn t bo trnh din khng nguyn . - Tn hiu 2: L tn hiu ng kch thch qua phn t B7 trn t bo trnh din khng nguyn gn ln phn t CD28 ca t bo T

HOT HA T BO TT bo T tip xc khng nguyn c kch thch ang giai on GO chuyn sang G1 ca chu k t bo Kch thc gia tng ln khong 8-10m, nhiu bo tng hn, c cc c quan v gia tng lng RNA trong bo tng tr thnh nguyn bo lympho T

HOT HA T BO T1. Sinh tng hp protein mi- Ngay sau khi c kch thch, t bo lympho T bt u sao chp cc gen m trc y vn yn lng v tng hp mt lot cc protein mi. - Nhng protein ny gm: + Cc cytokin l cht kch thch s pht trin v bit ho ca chnh t bo lympho v cc t bo hiu qu khc; + Cc th th cytokin lm cho t bo lympho p ng tt hn vi cytokin;

HOT HA T BO T2. Tng sinh t boCc t bo lympho c hiu vi khng nguyn s chuyn sang thi k phn bo (Go sang G1) to nn s tng sinh mnh m i vi clone t bo c hiu khng nguyn ny.

A: hnh nh KHV quang hc lympho bo mu ngoi vi B hnh nh KHV in t lympho bo nh C hnh nh KHV in t nguyn bo lympho

HOT HA T BO T3. S bit ho thnh t bo hiu quT bo TH: mang trn b mt nhng phn t protein tng tc vi cc ligand trn cc t bo khc (i thc bo trong min dch t bo, t bo B trong min dch dch th), ng thi tit cytokin hot ho cc t bo khc.T bo TC: mang nhng ht cha cc protein c th git virus v t bo ung th.

HOT HA T BO T4. S bit ho thnh t bo nhBn cnh t bo B, mt s t bo T c bit ho thnh t bo nh. C th tn ti mt cch yn lng trong nhiu nm sau khi khng nguyn c loi b.

HOT HA T BO T4. S bit ho thnh t bo nh T bo nh c mang trn b mt nhng protein gip phn bit chng vi t bo nguyn vn v t bo hiu qu mi c hot ho. Intergrin: protein kt dnh CD44: thc y s di chuyn ca t bo nh n ni nhim trng

BIT HA CHN DNG T BO TTi tuyn c: 2 qun th chnhT bo tuyn c vng v 90%

qun th bn trong tuyn c phn ln cha trng thnh c chung mt s du n vi cc tin t bo (CD2) nhng v sau cn xut hin thm mt s khc na.

T bo tuyn c vng li 10%

qun th trng thnh trn mng mt ca chng c nhng du n mi (CD3, CD4 hay CD8) cng nh l receptor T (TCR=T Cell Receptor).

BIT HA CHN DNG T BO T T bo lympho tip thu mt s hun luyn min dch gm c: kh nng nhn bit khng nguyn kh nng phn bit khng nguyn ca mnh vi khng nguyn l (khng phi ca mnh) S hun luyn qua 2 qu trnh Chn lc dng tnh v chn lc m tnh

BIT HA CHN DNG T BO T1. S chn lc dng tnh

Lin quan n kh nng nhn bit ra cc phn t MHC trn cc t bo khc thng qua TCR c