医学英语医英immunesystem.ppt

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1、Lymphatic/ImmunesystemGangXINDepartmentofMicrobiologyandImmunologySmallpoxdeathsofanestimated300to500millionpeopleEdwardJenner1749-1823FatherofImmunologyIn1796L.vaccinus,relatingtoacow,vacca1802caricatureofJennervaccinatingpatientswhofeareditwouldmakethemsproutcowlikeappendages.The announcement by t

2、he 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?Howdoe

3、sitwork?Whatisimmunity?immunitynImmunesystemnImmuneresponsenImmunologynImmunologistnImmunodeficiencynImmunocompromisednIMMUNITYIMMUNIS(EXEMPT)Latin:ProtectionfromlegalprosecutionNow,inmedicalterms:freeofdisease.BubbleboyDavidVetter(19711984)severecombinedimmunodeficiency(SCID)InfectionLymphomacongen

4、italimmunodeficiencypresentatbirthHIVandAIDSnHIV-humanimmunodeficiencyvirusnAIDS-acquiredimmunedeficiencysyndromeARC:AIDS-relatedcomplexARCisAprodromalphaseofeffectsphaseofinfectionwithHIV.Symptomscanincluderecurringfever,unexplainedweightloss,swollenlymphglands,diarrhea,orfungalinfectionofthemouth.

5、CandidainfectionsOpportunityInfectionandCancernFungal,bacterial,viralandprotozoalinfectionnThemostfrequentopportunistictumour,Kaposissarcoma,isobservedin20%ofpatientswithAIDS.nMalignantlymphomasarealsofrequentlyseeninAIDSpatients.KaposissarcomaKaposissarcomaKaposissarcomaontheskinofanAIDSpatient.lym

6、phomaFunctionsofImmunesystemnimmunedefencedefenseagaistinfectiousdiseasesnimmunesurveillancekillcancercellsnimmunehomeostasismaintaininternalequilibriumWhereisimmunesystem?OrgansCellsMoleculesImmuneorgansCentralimmuneorgansnThesiteofgeneration,differentiationandmaturationoflymphocytesnincludingbonem

7、arrowthymusBonemarrowHematopoieticstemcellMyeloidprogenitorLymphoidprogenitorFunctions:ThesiteofgenerationofallcirculatingbloodcellsThesiteofBcellmaturationhemo-+G.poisis,amakingThymusLocatedbetweenthebreastboneandheart.Function:TcelleducationPeripheralimmuneorgansandtissuesnThesitewherelymphocytesa

8、reresidentandresponsetoforeignantigensLymphnodesSpleenMALT(mucosal-associatedlymphoidtissue)SALTLymphnodesnLymphnodes-Smallbean-shapedglandsnLymph-fluidwithinlymphaticvesselsnLymphaticvessel-nLymphaticvessel-Lymphvesselsthatcarrylymphtoalymphnodearecalledtheafferentlymphvessel,andonethatcarriesitfro

9、malymphnodeiscalledtheefferentlymphvessel,fromwherethelymphmaytraveltoanotherlymphnode,maybereturnedtoavein,ormaytraveltoalargerlymphduct.CollectsexcesstissuefluidthroughoutbodyPurifiesitasitpassesthroughsystemReturnsittocirculatorysystemLymphnodesnMajorgroupsoflymphnodesarelocatedinthetonsils,armpi

10、ts,neck,groinandmediastinum.Functions:nFilterharmfulsubstancesfromthetissuesnJohn,15/Mntoothachesinleftsideoffacenonedaylaterneckalsostartedtohurt(onlyontheleftside)naftertakingthepenicillinfor2days,toothhasforthemostpartstoppedhurtingandfacedoesntachenearlyasmuchhisneckseemsmoreswollen.atoothabsces

11、sandlymphnodeswereswollenimmunesystemisworkingovertimefightingtheabscessSitesforLymphNodesNameLocationDrainsfluidfromAxillaryArmpitsArmsCervicalNeckHeadandneckInguinalGroinLegsandpelvisMediastinalChestWithinchestcavitySpleennintheupperleftabdomenFunctions:nmajorsiteofimmuneresponsetoblood-borneantig

12、ensnFiltersoutanddestroysoldredbloodcells,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)ImmunecellsHematopoieticstemcellMyeloidprogenitorLymphoidpr

13、ogenitorLympoid:Tlymphocyte;Blymphocyte;NaturalkillercellMyeloid:neutrophil;basophil;eosinophil;monocyte;redbloodcellNeutrophilsphagocytosisMonocytesandmacrophagesAfterenteringintotissue,monocytesdifferentiateintotissuemacrophages.Playcentralrolesininnateandadaptiveimmunity,andareimportanteffectorce

14、llsfortheeliminationofmicrobes.Functions:phagocytosis,intracellularandextra-cellularkilling,tissuerepair,antigenpresentationMonocytesandmacrophagesmacrophagesEosinophilscytoplasmicgranulesthatareeasilystainedbyeosinorotheraciddyes.associatedwithparasiticinfectionandallergicreactions.Basophilscytopla

15、smicgranulesthatareeasilystainedbybasicdyes.associatedwithparasiticinfectionsandallergicreactions.TandBLymphocytesNaturalKiller(NK)cellsnalsoknownaslargegranularlymphocytes(LGL)nkillinfectedandmalignantcellsMoleculesnAntibodynComplementsnCytokinesAntibody&ImmunoglobulinPlasmacellNeutralizationClasse

16、sofIgnIgG;IgA;IgM;IgE;IgDComplementsystemcytokinesecretedproteinsthatworkasmediatorsofimmuneandinflammatoryreactions.Cytokinesprovideamechanismforcellsoftheimmunesystemto“talk”tooneanothertocoordinatearesponseHowdoestheimmunesystemwork?InnateandadaptiveimmunityFirstlineofdefense(nonspecific)secondli

17、neofdefenseinnateimmunitynBarriersTheskinisanimportantphysicalbarrierthatprotectstheentirebodyfromexternalpathogens.Theacidinthestomachservesasanaturalkillerordestroyerofpathogensthatenterthedigestivetract.ucirculatingcells(phagocytes，NKcells)ubloodproteinsandcytokinesInnateandadaptiveimmunityAdapti

18、veimmunity3Phases,2TypesnSpecificnacquired57 Recognition Activation EffectorHumoralimmunityCell-mediatedimmunityInnateandAdaptiveImmunityDose1Dose2:1monthDose3:6monthsHBV vaccine:61TheprimaryimmuneresponseFour phases of the primary responsenalag phasewherenoantibodyisdetectednalog phaseinwhichtheant

19、ibodytiterriseslogarithmicallynaplateau phaseduringwhichtheantibodytiterstabilizesnaphase(decline)duringwhichtheantibodyisclearedComparison of Primary and Secondary ResponsesHighHighaffinityaffinity63Primary and Secondary Responses differ significantlyThepropertiesoftheprimaryandsecondaryantibodyres

20、ponsesdiffer.nTheprimaryresponsehasalonglagperiod,alogarithmicriseinantibodyformation,ashortplateau,andthenadecline.IgMisthefirstantibodyclassproduced,followedbyagradualswitchtootherclasses,suchasIgG.nThesecondaryresponsehasashorterlagtime,amorerapidlogarithmicphase,alongerplateauphase,andaslowerdec

21、linethantheprimaryresponse.MostlyIgGandotherisotypesareproducedinthesecondaryresponseratherthanIgM,andtheaverageaffinityofantibodyproducedishigher.Naturalimmunityoccursthroughcontactwithadisease.Artificial:contrivedbyartratherthannatureArtificial/naturalimmunizationPassive/activeimmunitynPassiveimmu

22、nityResultswhenapersonreceivesprotectivesubstancesproducedbyanotherhumanoranimalnActiveimmunityDevelopsimmunityfollowingdirectexposuretopathogennlocaltreatmentofthewoundnvaccinationnadministrationofrabiesimmunoglobulinpost-exposure prophylaxisLymphaticsystemLymphaticandimmunesystemnLymphaticSystemNe

23、tworkofvesselsthatpicksupexcesstissuefluid,cleansesit,andreturnsittocirculatorysystemPicksupfatsabsorbedbydigestivesystemnImmuneSystemFightsdiseaseandinfectionsLymphaticsystemnThelymphaticsystemconsistsofaconductingnetworkoflymphaticvessels,lymphaticorgansandlymph.nThemajor(encapsulated)lymphaticorg

24、ansarethelymphnodes.AnatomyandPhysiologynFirst,removesexcesstissuefluidCollectsexcesstissuefluidthroughoutbodyPurifiesitasitpassesthroughsystemReturnsittocirculatorysystemAnatomyandPhysiologynSecond,lymphvesselsaroundthesmallintestineassistwithfatabsorptionPicksupabsorbedfatsDeliverstocirculatorysys

25、temTheselymphvesselsarecalledlacteals(乳糜管)AnatomyandPhysiologynThird,lymphaticandimmunesystemsworktogetherFormagroupofcells,tissues,organs,&moleculesDefenseagainstpathogensuIncludingforeigninvadersandowncellsthathavebecomediseasedLymphatic&ImmuneCombiningFormsnadenoid/oadenoidsnimmun/oprotectionnlym

26、ph/olymphnlymphaden/o lymphnodenlymphangi/o lymphvesselLymphatic&ImmuneCombiningFormsnpath/odiseasensplen/ospleennthym/othymusntonsill/otonsilsntox/opoisonn-globulinglobalproteinWordBuildingwithadenoid/o&immun/oectomyadenoidectomy surgicalremovalofadenoidsitisadenoiditisinflammationofadenoidslogisti

27、mmunologistimmunityspecialistlymphadenectomysurgicalremovalofalymphnode;donetotestformalignancyormetastasisLymphatic&ImmuneVocabularyallergenantigencausinganallergicreactionallergistphysicianwhospecializesintestingforandtreatingallergiesallergyhypersensitivitytoacommonsubstanceautoimmunediseasedisea

28、seresultingfromimmunesystemattackingitsownbodyisifapathogen;examplesincluderheumatoidarthritisandsystemiclupuserythematosusLymphatic&ImmuneVocabularyhivesappearanceofwhealsaspartofallergicreactionhumanimmunodeficiencyvirus(HIV)virusthatcausesAIDS;knownasaretrovirusimmunocompromisedimmunesystemthatdo

29、esnotfunctionproperly;alsocalledimmunodeficiencydisorderimmunoglobulinsantibodies;assistinprotectingthebodyLymphatic&ImmuneVocabularyimmunologybranchofmedicineconcernedwithtreatingimmunesystemdisordersinflammationtissuesresponsetoinjury;redness,pain,swelling,andfeelinghottotouchlymphedemaexcessiveti

30、ssuefluidduetoblockedlymphaticflowurticariasevereitchingassociatedwithhivesLymphaticandImmuneAbbreviationsAIDSacquiredimmunodeficiencysyndromeARCAIDS-relatedcomplexELISAenzyme-linkedimmunosorbentassayGVHDgraftvs.hostdiseaseHDHodgkinsdiseaseHIVhumanimmunodeficiencyvirusLymphatic&ImmuneAbbreviationsIgimmunoglobulinKSKaposissarcomamonomononucleosisNHLnon-HodgkinslymphomaNKnaturalkillercellsPCPPneumocystis cariniipneumoniaSCIDseverecombinedimmunodeficiencysyndrome