The Immune System: Morphofunctional Peculiarities, Methods of Examination, Semiology of Diseases
The Immune System: Morphofunctional Peculiarities, Methods of Examination, Semiology of Diseases
peripheral organs
spleen
lymph nodes
gut-associated lymphoid tissue
(tonsils, Peyer's patches, and
appendix), SALT (skin-…) and other
lymphoid tissue of mucous
membrane
Bone marrow
is a central organ of
immune system
weeks of gestation.
From 20 week bone marrow is source of stem cells for myelopoesis
and lymphopoesis
Thymomegalia
These conditions
The innate
It is formed earlier in
It is characterized by
ontogenesis and provides the antigen-specific
function of protection before responses to a foreign
final maturing more perfect antigen or pathogen
mechanisms
mastcells degranulation
Classic pathway –
activated by interaction
of antigen and antibody Alternative pathway –
to form immune recognizing of a bacteria
complexes surface antigen
The innate immune system
Humoral factors
The complement system
The adaptive immune system
Cellular Humoral
T lymphocytes B lymphocytes
The adaptive immune system
Cellular immunity (T –cells)
The pool T cells is established in the thymus early in life and is
maintained throughout life both by new T cell production in the thymus
and by antigen-driven expansion of virgin peripheral T cells into
"memory" T cells that reside in peripheral lymphoid organs
Surface markers of T cells – CD3, CD4, and CD8.
In lymph nodes, T cells occupy deep paracortical areas around B cell
germinal centres, and in the spleen, they are located in periarteriolar
areas of white pulp.
Function:
CD8+ cytotoxic T cells capable of lysis of virus-infected or foreign
cells
CD4+ T cells- helper are also the primary regulatory cells of T and B
lymphocyte and monocyte function by the production of cytokines
and by direct cell contact. CD4+ have an important role in activation
of B cells and induction of Ig isotype switching
The adaptive immune system
Humoral immunity (B cells)
Mature B cells comprise 10 to 15% of human peripheral blood
lymphocytes
IgA fixes complement via the alternative complement pathway and has potent
antiviral activity in humans by prevention of virus binding to respiratory and
gastrointestinal epithelial cells
IgA is the second largest group of immunoglobulins and it cannot cross the
placenta
Its presence in human breast milk lowers the incidence of enteric infections in
breastfed infants
Immunoglobulin M
IgM is the first immunoglobulin to appear in the immune response
(primary antibody response)
Blood group antibodies are also in the IgG class, and therefore can
freely cross the placenta to cause hemolytic disease of the newborn
During first 3-6 months maternal IgG has been destroying but level of
own Igs is not high enough – it’s physiological hypoimmune condition.
IgG reaches the level of adults till 5-6 yrs.
Immunoglobulin E, D
A palpation
lymph nodes, spleen, liver to reveal pathological symptoms
(infection) from respiratory,
cardiovascular and other systems
A percussion which can be clinical manifestation of
immune system disorders
An auscultation
Paraclinical methods of investigation
Cell-mediated immunity
Phagocytosis
Complement
Laboratory Evaluation
of Cellular immunity
Quantification of blood cell populations by
immunofluorescence assays employing monoclonal antibody
markers T cells: CD3, CD4, CD8
Activation markers T cells - CD154
T cell functional evaluation
• Delayed hypersensitivity skin tests
• Proliferative response to mitogens (anti-CD3
antibody, phytohemagglutinin, concanavalin A)
• Cytokine production
Laboratory Evaluation
of Humoral immunity
Quantification of blood cell populations by
immunofluorescence assays employing monoclonal antibody
markers B cells: CD19, CD20, CD21
Activation markers B cells - CD80
Serum immunoglobulin levels: IgM, IgG, IgA, IgD, IgE
B cell functional evaluation
•Natural or commonly acquired antibodies: isohemagglutinins;
antibodies to common viruses (influenza, rubella) and bacterial toxins
(diphtheria, tetanus)
• Response to immunization with protein (tetanus toxoid) and
carbohydrate (pneumococcal vaccine, H. influenzae B vaccine)
antigens
•Quantitative IgG subclass determinations (G1, G2, G3, G4)
Laboratory Evaluation
of Phagocytosis and Complement
Quantification of blood cell populations by
immunofluorescence assays employing monoclonal antibody
markers NK cells: CD16/CD56
Monocytes: CD15
Phagocyte function
1. Reduction of nitroblue tetrazolium
2. Chemotaxis assays
3. Bactericidal activity
Complement
1. CH50 assays
2. C3, C4, and other components
The basic group of diseases with
pathology of immune system
in there pathogenesis
Cellular
Clinical manifestation
recurrent or chronic bacterial infections (Sino-pulmonary infection,
otitis, meningitis, and bacteremia), frequently with organisms such as
Streptococci, Haemophilus influenzae, and Staphylococci.
Examples
Wiskott-Aldrich syndrome – an X-linked recessive
disorder – thrombocytopenia, otitis, pneumonia and eczema
during the first 6 mo of life. Hepatosplenomegaly and
lymphadenopathy are common. Serum IgG and IgE are
markedly elevated.
Examples
Chronic granulomatosis
Acquired immunodeficiency syndrome
(AIDS)
is the most dangerous disease of an
immune system