imunologi kulit dah

7/31/2019 Imunologi Kulit Dah

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imunologi kulit

dr. Ahmad Garli, Sp.KK


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DEFENISI

Kulit adalah organ penting dalam sistem

imunitas terutama yang paling berperan adalah

imunitas seluler. Imunitas kulit terdiri dari :

1. Sistem fungsional

2. Imunogenetik

3. Struktur selBarrier kulit adalah penting dalam sistem non

imunologik.


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1. SISTEM FUNGSIONAL

Fungsi Nonsistem

Peran dari aliran limfe dan limfonodes dan

pembuluh darah dalam sistem imunologi.

Fungsi komplemen yang bersifat lysis

opsonization, granulisasi dan kemotaksis dari

netrofil dan makrofag.


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2. IMUNOGENETIK

Adanya HLA genes cluster reaksi hypersensitivity

dari pada kulit adalah reaksi yang berlebihan yang

menyebabkan kerusakan dari pada jaringan.

Ada 4 tipe, yaitu :

1. Type I (immediete)

2. Type II (antibody-dependdent cytotoxicity)

3. Type III (immuno complex desease)

4. Type IV (cell mediated or delayed)


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Type I (immediate)


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IgE is bound to the surface of mast cells by Fcreceptors. On encountering antigen (e.g. housedust

mite, food or pollen) the IgE molecules becomecrosslinked, producing degranulation and therelease of inflammatory mediators. These includepreformed mediators (such as histamine) and newlyformed ones (e.g. prostaglandins or leukotrienes)The result in the skin is urticaria. although massivehistamine release can cause anaphylaxis. The

response occurs within minutes. although a delayedcomponent is recognized. Factors other than IgE cancause mast cell degranulation.


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Type II (antibody-dependent cytotoxicity)


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Antibodies directed against an antigen on target

skin cells or structures induce cytotoxic by killer T

cells or by complement activation. For example.

lgG pemphigus antibodies directed against

desmoglein on the keratinocyte surface result in

activation of complement. attraction of effectorcells and the lysis of the keratinocytes Intra

epidermal blisters result. Haemolytic anaemia and

transfusion reactions are other examples of type IIhypersensitivity. Some of these conditions are

autoimmune


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Type III (immune complex disease)


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Immune complexes formed by the combination ofantigen and antibodies in the blood are deposited inthe walls of small vessels, often those of the skin.Complement activation, platelet aggregation and therelease of lysosomal enzymes from polymorphs causevascular damage. This leucocytoclastic vasculitis isseen with, for example, systemic lupus erythematosusand dermatomyositis, but also occurs with microbialinfections such as infective endocarditis. The Arthus

reaction is due to immune complex formation at a

local site. It can be induced in the skin by anintradermal injection, and is maximal at 4-10 hoursafter injection.


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Type IV (cell-mediated or delayed)


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Immunology

1. Skin Provides a Physical Barrier to infection

2. Langerhans cells form outposts of the cellular

immune system and can resent antigens to

immunocompeten cells e.g. T lymphocytes

3. T cells circulate through normal skin and form

part of the skin-associated lymphoid tissue.

They are localized by adhesion molecules


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4. Keratinocytes can be immunologically active

cells

5. All four types of hypersensitivity reaction

occur in the skin

6. Genetic factors modulate immunological

responses. Certain HLA antigens are

associated with increased risk of skin disease


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3. STRUKTUR SEL

1. Langerhans sel yang berasal dari sumsum

tulang adalah sel yang paling penting dalam

imunitas

2. T limfosit :

- Helper

- Delayed type hipersensitivity

- Cytotoxic

- Supresor


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3. Mast sel, yang melepas histamine dan

molekul vaso aktif

4. Keratonisit, yang menghasilkan sitokines


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TERIMA KASIH

imunologi kulit dah

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