SOME KEY POINTS

T-cell B-cell
From thymus Bursa of fabricius
8! of circulati"# $! of circulati"# lym%hs i" bloo&
'o"# li(e&
T-)ell rece%tors I# rece%tors o" its surface
T-cells *see* a"ti#e" as %e%ti&es ON'Y i" associatio" +ith host surface M,) -Ma.or
histocom%tability/ molecules
There are three classes of M,) molecule
0/ M,) class I 1 +hich %rimarily %rese"t i"tracellular a"ti#e"s2
$/ M,) class II 1 +hich %rimarily %rese"t e3tracellular a"ti#e"s2
4/ M,) class III5 com%o"e"ts of com%leme"t system -)$1 )61 Bf/ co&e for M,)
)788 Tc cells ca" o"ly reco#"i9e a"ti#e" i" associatio" +ith M,) I2
)768 Th cells ca" o"ly bi"& a"ti#e" i" associatio" +ith M,) II2
M:);OP,:<ES5

I" li(er1 are =>a =u%ffer cells
I" s%lee"1 littoral cells
I" s=i"1 la"#erha"s cells
I" lym%h "o&e1 &e"&ritic cells

Ma.or histocom%atibility com%le3 -M,)/ > ,uma" leu=ocyte a"ti#e" - ,':/

<e"e is %rese"t o" the short arm of chromosome "o2 ?
M,) class I :#s
are e3%resse& o" e(ery "ucleate& cell of the bo&y
,':-:1 ,':-B1 ,':-)
M,) class II :# are e3%resse& o"ly o" cells i"(ol(e& i" the immu"e res%o"se
'ym%hocytes
Macro%ha#es
E"&othelial cells
M,) class III re#io"
E"co&es for com%leme"t com%o"e"ts -e2#21 )$1 )61 factor B/ a"& some e"co&e cyto=i"es -e2#21
TNF-@/ 2

7iseases asso +ith ,': ty%es5

:"=ylosis s%o"&ylitisA ,':-B$B
Post #o"ococcal arthritisC,':- B$B
;heumatoi& arthritis---,':-7;6
Primary S.o#re" Sy"&romeA ,':-7;4
,emochromatosis---,':-:4

,y%erse"siti(ity
refers to u"&esirable -&ama#i"#1 &iscomfort-%ro&uci"# a"& sometimes fatal/ reactio"s %ro&uce&
by the "ormal immu"e system2 ,y%erse"siti(ity reactio"s reDuire a %re-se"siti9e& -immu"e/ state
of the host2

Ty%e I5 a"a%hylactic r3"
Ty%e II5 cytoto3ic ty%e
Ty%e III5 Immu"e com%le3 &isease
Ty%e IE5 )ell me&iate&> &elaye& ,ST

)om%ariso" of 7iffere"t Ty%es of hy%erse"siti(ity
characteristics ty%e-I
-a"a%hylactic ty%e-II
-cytoto3ic ty%e-III
-immu"e com%le3 ty%e-IE
-&elaye& ty%e/
a"tibo&y I#E I#<1 I#M I#<1 I#M "o"e
a"ti#e" E3o#e"eous )ell surface Soluble tissues F or#a"s
;es%"se time 0G-4 mi" mi"utes-hours 4-8 hrs 68-B$ hours
a%%eara"ce Hheal F flare lysis a"& "ecrosis erythema a"& e&ema1"ecrosis erythema a"&
i"&uratio"
histolo#y baso%hils a"& eosi"o%hil a"tibo&y a"& com%leme"t com%leme"t a"& "eutro%hils
mo"ocytes a"& lym%hocytes
tra"sferre& +ith :"tibo&y :"tibo&y :"tibo&y T-cell
e3am%les aller#ic asthma1 hay fe(er Erythroblastosis fetalis1 <oo&%astureIs "e%hritis S'E1 farmerIs
lu"# &isease
tuberculi" test1 %oiso" i(y1 #ra"uloma
Tra"s%la"t re.ectio"
occurs +he" a tra"s%la"te& or#a" or tissue fails to be acce%te& by the bo&y of the tra"s%la"t
reci%ie"t2
Ty%es of re.ectio"5
02 ,y%eracute re.ectio"5 ,y%eracute re.ectio" is a com%leme"t-me&iate& res%o"se i" reci%ie"ts
+ith %re-e3isti"# a"tibo&ies to the &o"or -for e3am%le1 :BO bloo& ty%e a"tibo&ies/2 ,y%eracute
re.ectio" occurs +ithi"2 This is a %articular ris= i" =i&"ey tra"s%la"ts,y%eracute re.ectio" is the
li=ely outcome of 3e"otra"s%la"te& or#a"s2
$2 :cute re.ectio"5 :cute re.ectio" usually be#i"s o"e +ee= after tra"s%la"tatio" -as o%%ose& to
hy%eracute re.ectio"1 +hich is imme&iate/2 The ris= of acute re.ectio" is hi#hest i" the first three
mo"ths after tra"s%la"tatio"2 It is cause& by mismatche& ,': a"ti#e"s1 +hich are %rese"t o" all
cells of the bo&y2 Tissues such as the =i&"ey or the li(er +hich are hi#hly (asculari9e& -rich i"
bloo& (essels/1 are ofte" the earliest (ictims of acute re.ectio"
42 )hro"ic re.ectio"5 The term *chro"ic re.ectio"* +as i"itially a term use& to &escribe a lo"#-term
loss of fu"ctio" i" tra"s%la"te& or#a"s1 associate& +ith fibrosis of the i"ter"al bloo& (essels of the
tra"s%la"te& tissue It ca" be cause& by a member of the Mi"or ,istocom%atibility )om%le3 such
as the ,-Y #e"e of the male Y chromosome2
;e.ectio" mecha"isms5 ;e.ectio" is a" a&a%ti(e immu"e res%o"se a"& is me&iate& throu#h both T
cell me&iate& a"& humoral immu"e -a"tibo&ies/ mecha"isms2
Systemic 'u%us Erythematosus
Ele(e" )riteria establishe& by the :merica" ;heumatism :ssociatio"
malar -o(er the chee=s of the face/ *butterfly* rash
&iscoi& s=i" rash5 %atchy re&"ess that ca" cause scarri"#
%hotose"siti(ity5 s=i" rash i" reactio" to su"li#ht e3%osure
mucus membra"e ulcers5 ulcers of the li"i"# of the mouth1 "ose or throat
arthritis5 $ or more s+olle"1 te"&er .oi"ts of the e3tremities
%leuritis>%ericar&itis5 i"flammatio" of the li"i"# tissue arou"& the heart or lu"#s1 usually
associate& +ith chest %ai" +ith breathi"#
=i&"ey ab"ormalities5 ab"ormal amou"ts of uri"e %rotei" or clum%s of cellular eleme"ts calle&
casts
brai" irritatio"5 ma"ifeste& by sei9ures -co"(ulsio"s/ a"&>or %sychosis
bloo& cou"t ab"ormalities5 lo+ cou"ts of +hite or re& bloo& cells1 or %latelets
immu"olo#ic &isor&er5 ab"ormal immu"e tests i"clu&e a"ti-7N: or a"ti-Sm -Smith/ a"tibo&ies1
falsely %ositi(e bloo& test for sy%hilis1 a"ticar&ioli%i" a"tibo&ies1 lu%us a"ticoa#ula"t1 or %ositi(e
'E %re% test
a"ti"uclear a"tibo&y5 %ositi(e :N: a"tibo&y testi"#
S.J#re"Is sy"&rome
autoimmu"e &isor&er i" +hich immu"e cells attac= a"& &estroy the e3ocri"e #la"&s that %ro&uce
tears a"& sali(a
Patie"ts +ith S.J#re"Is sy"&rome ha(e a hi#her rate of "o"-,o&#=i" lym%homa
The most commo" lym%homas are sali(ary e3tra"o&al mar#i"al 9o"e B cell lym%homas -M:'T
lym%homas i" the sali(ary #la"&s/ a"& &iffuse lar#e B-cell lym%homa
:myloi&osis
amyloi&osis refers to a (ariety of co"&itio"s i" +hich amyloi& %rotei"s are ab"ormally &e%osite&
i" or#a"s a"&>or tissues1 causi"# &isease
at least 0G biolo#ically &isti"ct forms of amyloi&
2:myloi& ty%e 7escri%tio"
:'amyloi& li#ht chai" )o"tai"s immu"o#lobuli" li#ht-chai" -K1L/ &eri(e& from %lasma cells
::amyloi& associate& No"-immu"o#lobuli" %rotei" ma&e i" the li(er
:MM amyloi& Fou"& i" :l9heimer &isease brai" lesio"s
:TT;Tra"sthyreti" : muta"t form of a "ormal serum %rotei" that is &e%osite& i" the #e"etically
&etermi"e& familial amyloi& %oly"euro%athies2
TT; is also &e%osite& i" the heart i" se"ile systemic amyloi&osis2
:M$ m M$ micro#lobuli" Not to be co"fuse& +ith :M1 M$m is a "ormal serum %rotei"1 %art of
ma.or ,istocom%atability com%le3 -M,)/ )lass 0molecules2 )a" occur i" lo"# term haemo&ialysis2
PrP Prio" relate& %rotei" I" Prio" &iseases1 misfol&e& %rio" %rotei"s &e%osit i" tissues a"&
resemble amyloi& %rotei"s2
)lassificatio" of amyloi&osis
Primary -&isor&ere& immu"e cell fu"ctio"/ 5multi%le myeloma a"& other immu"ocyte
&yscrasias2
Seco"&ary -reacti(e/ 5as a com%licatio" of some other chro"ic i"flammatory or tissue
&estructi(e &isease
:cDuire& immu"e &eficie"cy sy"&rome or acDuire& immu"o&eficie"cy sy"&rome -:I7S or :i&s/ is
a set of sym%toms a"& i"fectio"s resulti"# from the &ama#e to the huma" immu"e system cause&
by the huma" immu"o&eficie"cy (irus -,IE
Ma.or :# of ,IE

E"(elo%e :#5 #%0$1 #% 60
Shell :# %08 -"ucleoca%si& %rotei"/
)ore :# 5 %$61 %0G1 %GG
Polymerase :#5 %401 %G01 %??