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    ImmunologyIn Infectious

    Disease

    Titin Andri WihastutiPSIK FKUB

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    Introduction

    ImmunologyStudy of the body against foreign invaders Immunity

    Special capacity for resistance; condition of being resistantto an infection

    VirulenceMeasure of the disease-producing power of an organism

    ImmunogensSubstances capable of inducing a specific immuneresponse

    AntigensSubstances that react with products of the induce ahumoral and/or cell-mediated immune response

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    Introduction

    Naturally Acquired Activity Immunityis obtained when a person is exposed to antigens in thecourse of daily life. Antigens enter the body naturally; thebody produces antibodies and specialized lymphocytes

    Artificially Acquired Active Immunity

    results from vaccination. Antigens are introduced invaccines; the body produces antibodies and specializedlympocytes

    Naturally Acquired Passive ImmunityInvolves the natural transfer of antibodies from a mother

    to her infant. Antibodies pass from mother to fetus via theplacenta or to the infant in her milk Artificially Acquired Passive Immunity

    Involves the introduction of antibodies (rather thanantigen) into the body. Preformed antibodies in immuneserum are introduced into the body by injection

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    Sumsum tulang, hati (fetal)Asal sel imunArena perkembangan, maturasi akhir sel B

    Thymus (organ limfoid primer)

    Arena (perkembangan) dan pendidikan sel T

    LeukositAparat sistim imun yang bersifat circulatingrecirculating

    Limfonodi (organ limfoid sekunder)Tempat induksi respon imun

    Jaringan tubuhArena berlangsungnya respon imun

    Komponen Sistem Imun

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    Komponen sistem imun

    Komponen selularsumsum tulang,

    sirkulasi,Jaringan

    Dari biji besimenjadianeka peralatan

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    Factors that GovernFactors that Govern

    Immune Responses :Immune Responses :

    a.a. ForeignnessForeignness

    b.b. Molecular sizeMolecular size

    c.c. Molecular complexityMolecular complexity

    d.d. Structural StabilityStructural Stability

    e.e. Solubility or degradabilitySolubility or degradability

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    MECHANISMS OF IMMUNITY

    1.Nonspesific or Innate Immunity Early barriers to infectious disease

    Defenses that protect us againts anypathogen

    Regardless of the species microbe, is notimproved by repeated exposure to pathogen

    Included :

    - The first line of defense

    (skin, mucous membranes and theirsecretions)

    - The second line of defense

    (phagocytes, inflammation, antimicrobial)

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    2. Specific or Adaptive Immunity

    Involves a specific defensive response whenInvolves a specific defensive response whena host is invaded by foreign organism ora host is invaded by foreign organism orother foreign substancesother foreign substances

    The third line of defenseThe third line of defense

    Dependent on Antigen RecognitionDependent on Antigen Recognition

    -- HumoralHumoral : antibodies: antibodies

    -- CellCell--mediatedmediated : T cells: T cells

    -- CombinationCombination

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    Innate immunity

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    Routes of infection for pathogens

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    Intrinsic epithelial barrier

    to infection

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    Phases of the immune response

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    Bacterial receptors in macrophages

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    Inflammation

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    Inflammation

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    Localvs

    Systemic

    infection

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    Bactericidalagents released by phagocytes

    upon ingestion of macrophages

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    ConclusionConclusion

    The immune responses to pathogenicagents/immunity of infectious diseases areprimarily conducted by natural immune

    responses and working in concert with adaptiveresponses

    The succesfull of pathogens to invade into, andpersist in the body is pretty much depending on

    the status immunity, the virulence factors of theagents and their smartevade mechanismsagaints effectors function of the immune system

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    Nilai Normal dalam Tubuh

    1. Leukosit ( 5 10 x 109 / L )

    Neutrofil : 55-70 % total leukosit

    Eosinofil : 1 4 % total leukosit Basofil : 0,5 1 % total leukosit

    Monosit : 2 8 % total leukosit

    Limfosit : 20 40 % total leukosit

    2. Komplemen ( 75 160 U/mL )

    C3 : 0,55 1,20 g / L

    C4 : 0,2 0,5 g / L

    Pemeriksaan Penunjang

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    3. Imunoglobulin

    Ig G : 500 1500 mg / dL ( 75% total Ig ) Ig M : 50 - 300 mg / dL ( 75% total Ig )

    Ig A : 100 490 mg / dL ( 75% total Ig )

    Ig E : < 100 IU / mL ( 75% total Ig )

    Ig D : < 3 U / mL ( 75% total Ig )

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    Gangguan sistem imun

    1. Lack of response (imunodefisiensi)contoh: AIDS, leukemia

    2. Incorrect response (peny. autoimun)contoh: DM tipe I, miasteniagravis, multiplesclerosis;penyakit Graves.

    3. Overactive response (alergi/hipersensitivitas)contoh: asma, rhinitis allergic, rx transfusi

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    1. Hypersensitifitas

    Respon imun berlebih dan tidak diinginkan

    Menimbulkan kerusakan jaringan

    Tipe Manifestasi Mek anismeI Reaksi cepat Ig E dan Iglain

    II Antibody thd sel IgG dan Ig M

    III Kompleks Ab-Ag Biasa IgGIV Lambat Sel yang disensitisasi

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    . Defisiensi Imun

    Defisiensi Imun nonspesifik :a. Defisiensi komplemen

    b. Defisiensi sel NK

    c. Defisiensi sistem fagositDefisiensi Imun spesifik :

    a. Kongenital

    b. Fisiologis (Kehamilan, lansia)

    c. Acquired (malnutrisi, infeksi, AIDS)

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    3. Autoimun

    - Reaksi sistem imun terhadap antigen sel jaringan sendiri

    - Limfosit mempunyai reseptorautoantigen

    - Sel Limfosit Reaktif (SLR) memberi respon autoimun

    - Kegagalan sel T mengenal SELF-NON SELF

    Klasifikasi :

    a. Autoimun organ spesifik : Skleroderma, Sirosis bilier dll

    b. Autoimun non organ spesifik : SLE (Systemic Lupus

    Erytematosus)

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    Therapi Farmakologi1. Anti inf lamasi

    NSAID : menghambat sintesaprostaglandin, efekanalgesik & antipiretik

    efek samping : tdk nyaman GIT,edema, waktu

    pendarahan lama

    2. Anti bakteri /antibiotik

    Menghambat pertumbuhan (Bakteristatik) dan membunuh

    bakteri (Bakterisid)

    a. Penghambat sintesa dinding selbakterib. Pengubahan permeabilitas kapiler

    c. Penghambatan sintesaprotein

    d. Mengganggu metabolisme sel

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