医学英语医英immunesystem.ppt

Lymphatic/ImmunesystemGangXINDepartmentofMicrobiologyandImmunologySmallpoxdeathsofanestimated300to500millionpeopleEdwardJenner1749-1823FatherofImmunologyIn1796L.vaccinus,relatingtoacow,vacca1802caricatureofJennervaccinatingpatientswhofeareditwouldmakethemsproutcowlikeappendages.The announcement by the WHO that smallpox was the first disease that had been eradicated worldwide by a program of vaccinationLouisPasteur1822-1895The The“Father”“Father”of the of the Modern MicrobiologyModern MicrobiologyVaccines:1880,chickencholera1881,anthrax1885,rabiesconsciouslyimmunesystemWhatisit?Whereisit?Howdoesitwork?Whatisimmunity?immunitynImmunesystemnImmuneresponsenImmunologynImmunologistnImmunodeficiencynImmunocompromisednIMMUNITYIMMUNIS(EXEMPT)Latin:ProtectionfromlegalprosecutionNow,inmedicalterms:freeofdisease.BubbleboyDavidVetter(19711984)severecombinedimmunodeficiency(SCID)InfectionLymphomacongenitalimmunodeficiencypresentatbirthHIVandAIDSnHIV-humanimmunodeficiencyvirusnAIDS-acquiredimmunedeficiencysyndromeARC:AIDS-relatedcomplexARCisAprodromalphaseofeffectsphaseofinfectionwithHIV.Symptomscanincluderecurringfever,unexplainedweightloss,swollenlymphglands,diarrhea,orfungalinfectionofthemouth.CandidainfectionsOpportunityInfectionandCancernFungal,bacterial,viralandprotozoalinfectionnThemostfrequentopportunistictumour,Kaposissarcoma,isobservedin20%ofpatientswithAIDS.nMalignantlymphomasarealsofrequentlyseeninAIDSpatients.KaposissarcomaKaposissarcomaKaposissarcomaontheskinofanAIDSpatient.lymphomaFunctionsofImmunesystemnimmunedefencedefenseagaistinfectiousdiseasesnimmunesurveillancekillcancercellsnimmunehomeostasismaintaininternalequilibriumWhereisimmunesystem?OrgansCellsMoleculesImmuneorgansCentralimmuneorgansnThesiteofgeneration,differentiationandmaturationoflymphocytesnincludingbonemarrowthymusBonemarrowHematopoieticstemcellMyeloidprogenitorLymphoidprogenitorFunctions:ThesiteofgenerationofallcirculatingbloodcellsThesiteofBcellmaturationhemo-+G.poisis,amakingThymusLocatedbetweenthebreastboneandheart.Function:TcelleducationPeripheralimmuneorgansandtissuesnThesitewherelymphocytesareresidentandresponsetoforeignantigensLymphnodesSpleenMALT(mucosal-associatedlymphoidtissue)SALTLymphnodesnLymphnodes-Smallbean-shapedglandsnLymph-fluidwithinlymphaticvesselsnLymphaticvessel-nLymphaticvessel-Lymphvesselsthatcarrylymphtoalymphnodearecalledtheafferentlymphvessel,andonethatcarriesitfromalymphnodeiscalledtheefferentlymphvessel,fromwherethelymphmaytraveltoanotherlymphnode,maybereturnedtoavein,ormaytraveltoalargerlymphduct.CollectsexcesstissuefluidthroughoutbodyPurifiesitasitpassesthroughsystemReturnsittocirculatorysystemLymphnodesnMajorgroupsoflymphnodesarelocatedinthetonsils,armpits,neck,groinandmediastinum.Functions:nFilterharmfulsubstancesfromthetissuesnJohn,15/Mntoothachesinleftsideoffacenonedaylaterneckalsostartedtohurt(onlyontheleftside)naftertakingthepenicillinfor2days,toothhasforthemostpartstoppedhurtingandfacedoesntachenearlyasmuchhisneckseemsmoreswollen.atoothabscessandlymphnodeswereswollenimmunesystemisworkingovertimefightingtheabscessSitesforLymphNodesNameLocationDrainsfluidfromAxillaryArmpitsArmsCervicalNeckHeadandneckInguinalGroinLegsandpelvisMediastinalChestWithinchestcavitySpleennintheupperleftabdomenFunctions:nmajorsiteofimmuneresponsetoblood-borneantigensnFiltersoutanddestroysoldredbloodcells,recyclingtheironMALT(mucosal-associatedlymphoidtissue)Tonsil（扁桃体）（扁桃体）,Peyerspatch（派氏（派氏集合淋巴结）集合淋巴结）,appendix（阑尾）（阑尾）GALT(Gut)NALT(nasal)BALT(bronchial)Functions:LocalimmuneresponseSecretoryIgA(sIgA)ImmunecellsHematopoieticstemcellMyeloidprogenitorLymphoidprogenitorLympoid:Tlymphocyte;Blymphocyte;NaturalkillercellMyeloid:neutrophil;basophil;eosinophil;monocyte;redbloodcellNeutrophilsphagocytosisMonocytesandmacrophagesAfterenteringintotissue,monocytesdifferentiateintotissuemacrophages.Playcentralrolesininnateandadaptiveimmunity,andareimportanteffectorcellsfortheeliminationofmicrobes.Functions:phagocytosis,intracellularandextra-cellularkilling,tissuerepair,antigenpresentationMonocytesandmacrophagesmacrophagesEosinophilscytoplasmicgranulesthatareeasilystainedbyeosinorotheraciddyes.associatedwithparasiticinfectionandallergicreactions.Basophilscytoplasmicgranulesthatareeasilystainedbybasicdyes.associatedwithparasiticinfectionsandallergicreactions.TandBLymphocytesNaturalKiller(NK)cellsnalsoknownaslargegranularlymphocytes(LGL)nkillinfectedandmalignantcellsMoleculesnAntibodynComplementsnCytokinesAntibody&ImmunoglobulinPlasmacellNeutralizationClassesofIgnIgG;IgA;IgM;IgE;IgDComplementsystemcytokinesecretedproteinsthatworkasmediatorsofimmuneandinflammatoryreactions.Cytokinesprovideamechanismforcellsoftheimmunesystemto“talk”tooneanothertocoordinatearesponseHowdoestheimmunesystemwork?InnateandadaptiveimmunityFirstlineofdefense(nonspecific)secondlineofdefenseinnateimmunitynBarriersTheskinisanimportantphysicalbarrierthatprotectstheentirebodyfromexternalpathogens.Theacidinthestomachservesasanaturalkillerordestroyerofpathogensthatenterthedigestivetract.ucirculatingcells(phagocytes，NKcells)ubloodproteinsandcytokinesInnateandadaptiveimmunityAdaptiveimmunity3Phases,2TypesnSpecificnacquired57 Recognition Activation EffectorHumoralimmunityCell-mediatedimmunityInnateandAdaptiveImmunityDose1Dose2:1monthDose3:6monthsHBV vaccine:61TheprimaryimmuneresponseFour phases of the primary responsenalag phasewherenoantibodyisdetectednalog phaseinwhichtheantibodytiterriseslogarithmicallynaplateau phaseduringwhichtheantibodytiterstabilizesnaphase(decline)duringwhichtheantibodyisclearedComparison of Primary and Secondary ResponsesHighHighaffinityaffinity63Primary and Secondary Responses differ significantlyThepropertiesoftheprimaryandsecondaryantibodyresponsesdiffer.nTheprimaryresponsehasalonglagperiod,alogarithmicriseinantibodyformation,ashortplateau,andthenadecline.IgMisthefirstantibodyclassproduced,followedbyagradualswitchtootherclasses,suchasIgG.nThesecondaryresponsehasashorterlagtime,amorerapidlogarithmicphase,alongerplateauphase,andaslowerdeclinethantheprimaryresponse.MostlyIgGandotherisotypesareproducedinthesecondaryresponseratherthanIgM,andtheaverageaffinityofantibodyproducedishigher.Naturalimmunityoccursthroughcontactwithadisease.Artificial:contrivedbyartratherthannatureArtificial/naturalimmunizationPassive/activeimmunitynPassiveimmunityResultswhenapersonreceivesprotectivesubstancesproducedbyanotherhumanoranimalnActiveimmunityDevelopsimmunityfollowingdirectexposuretopathogennlocaltreatmentofthewoundnvaccinationnadministrationofrabiesimmunoglobulinpost-exposure prophylaxisLymphaticsystemLymphaticandimmunesystemnLymphaticSystemNetworkofvesselsthatpicksupexcesstissuefluid,cleansesit,andreturnsittocirculatorysystemPicksupfatsabsorbedbydigestivesystemnImmuneSystemFightsdiseaseandinfectionsLymphaticsystemnThelymphaticsystemconsistsofaconductingnetworkoflymphaticvessels,lymphaticorgansandlymph.nThemajor(encapsulated)lymphaticorgansarethelymphnodes.AnatomyandPhysiologynFirst,removesexcesstissuefluidCollectsexcesstissuefluidthroughoutbodyPurifiesitasitpassesthroughsystemReturnsittocirculatorysystemAnatomyandPhysiologynSecond,lymphvesselsaroundthesmallintestineassistwithfatabsorptionPicksupabsorbedfatsDeliverstocirculatorysystemTheselymphvesselsarecalledlacteals(乳糜管)AnatomyandPhysiologynThird,lymphaticandimmunesystemsworktogetherFormagroupofcells,tissues,organs,&moleculesDefenseagainstpathogensuIncludingforeigninvadersandowncellsthathavebecomediseasedLymphatic&ImmuneCombiningFormsnadenoid/oadenoidsnimmun/oprotectionnlymph/olymphnlymphaden/o lymphnodenlymphangi/o lymphvesselLymphatic&ImmuneCombiningFormsnpath/odiseasensplen/ospleennthym/othymusntonsill/otonsilsntox/opoisonn-globulinglobalproteinWordBuildingwithadenoid/o&immun/oectomyadenoidectomy surgicalremovalofadenoidsitisadenoiditisinflammationofadenoidslogistimmunologistimmunityspecialistlymphadenectomysurgicalremovalofalymphnode;donetotestformalignancyormetastasisLymphatic&ImmuneVocabularyallergenantigencausinganallergicreactionallergistphysicianwhospecializesintestingforandtreatingallergiesallergyhypersensitivitytoacommonsubstanceautoimmunediseasediseaseresultingfromimmunesystemattackingitsownbodyisifapathogen;examplesincluderheumatoidarthritisandsystemiclupuserythematosusLymphatic&ImmuneVocabularyhivesappearanceofwhealsaspartofallergicreactionhumanimmunodeficiencyvirus(HIV)virusthatcausesAIDS;knownasaretrovirusimmunocompromisedimmunesystemthatdoesnotfunctionproperly;alsocalledimmunodeficiencydisorderimmunoglobulinsantibodies;assistinprotectingthebodyLymphatic&ImmuneVocabularyimmunologybranchofmedicineconcernedwithtreatingimmunesystemdisordersinflammationtissuesresponsetoinjury;redness,pain,swelling,andfeelinghottotouchlymphedemaexcessivetissuefluidduetoblockedlymphaticflowurticariasevereitchingassociatedwithhivesLymphaticandImmuneAbbreviationsAIDSacquiredimmunodeficiencysyndromeARCAIDS-relatedcomplexELISAenzyme-linkedimmunosorbentassayGVHDgraftvs.hostdiseaseHDHodgkinsdiseaseHIVhumanimmunodeficiencyvirusLymphatic&ImmuneAbbreviationsIgimmunoglobulinKSKaposissarcomamonomononucleosisNHLnon-HodgkinslymphomaNKnaturalkillercellsPCPPneumocystis cariniipneumoniaSCIDseverecombinedimmunodeficiencysyndrome