https://userupload.net/ks142zbtu6cl Immunology is a branch of biology[1] that covers the study of immune systems[2] in all organisms.[3] Immunology charts, measures, and contextualizes the physiological functioning of the immune system in states of both health and diseases; malfunctions of the immune system in immunological disorders (such as autoimmune diseases,[4] hypersensitivities,[5] immune deficiency,[6] and transplant rejection[7]); and the physical, chemical, and physiological characteristics of the components of the immune system in vitro,[8] in situ, and in vivo.[9] Immunology has applications in numerous disciplines of medicine, particularly in the fields of organ transplantation, oncology, rheumatology, virology, bacteriology, parasitology, psychiatry, and dermatology. The term was coined by Russian biologist Ilya Ilyich Mechnikov,[10] who advanced studies on immunology and received the Nobel Prize for his work in 1908. He pinned small thorns into starfish larvae and noticed unusual cells surrounding the thorns. This was the active response of the body trying to maintain its integrity. It was Mechnikov who first observed the phenomenon of phagocytosis,[11] in which the body defends itself against a foreign body.

1. BASIC IMMUNOLOGY
Check out ppt download link in description
Or
Download link : https://userupload.net/ks142zbtu6cl

2. 02/02/19 2
Index
• Introduction
• Types of Immunity-Innate immunity
Acquired immunity
• Cellular and humoral immunity
• Development of immune system
• Antigens
• Antibodies-immunoglobulins

3. 02/02/19 3
Index continued
• Antigen antibody reactions
• Complement system
• Functions of immune system
• Hypersensitivity reactions
• Autoimmune diseases
• Immuonology of oral diseases ,transplantation and malignancy
• Recent advances
• Conclusion
• References

4. 02/02/19 4
Introduction
• The term “immune” is derived from Latin word
immunis which means “exempt from taxes”.
Today of course, immunity refers to the body’s
ability to resist infection by pathogenic micro
organisms and their products.
• Much of our knowledge about immune system
comes from the concepts presented by
Metchinkoff and Erlich.

5. CLICK HERE TO DOWNLOAD
THIS PPT
https://userupload.net/ks142zbtu6cl

6. 02/02/19 6
• English scientist Jenner first performed and
published the immunization procedures. He
called these procedures “vaccination”.
• Vacca in Latin meaning cow.

7. 02/02/19 7
Types of immunity
• Immunity against infectious diseases is of
different types:-
1. Innate immunity:-
• Nonspecific immunity
• Specific immunity
2. Acquired immunity:-two types of acquired
immunity are
• Cellular Immunity
• Humoral Immunity

8. 02/02/19 8

9. 02/02/19 9
Innate Immunity
• It is the immunity which an individual possess by
virtue of his genetic and constitutional make up.
• It acts as a first line of defense against infections,
eliminating most potential pathogens before they
establish an overt infection.
• It may be considered at the level of species, races
and individual.

10. 02/02/19 10
Species immunity
• It refers to the total or relative refractoriness to a
pathogen, shown by all members of the species.
• It may be due to different physiological and
biochemical differences between the tissues of
different host species, which determine whether
or not a pathogen can multiply in them.

11. 02/02/19 11
• An early insight to species immunity was gained
by Pasteurs Experiment.

12. 02/02/19 12
Racial immunity
• Within a species different races may show
differences in susceptibility to infections. This is
known as racial immunity.

13. 02/02/19 13
Individual immunity
• Difference in immune resistance showed by
different individuals in a race is known as
individual immunity.

14. 02/02/19 14
Factors influencing the level of innate
immunity in an individual:-
1. Age :- two extremes of life are susceptible to
infections as compared with adults.
• But infections like polio,chickenpox, tend to be
more severe in adults due to hypersensitivity
reactions which cause tissue damage.
• Conversely hepatitis B is asymptomatic in
infants.

15. CLICK HERE TO DOWNLOAD
THIS PPT
https://userupload.net/ks142zbtu6cl

16. 02/02/19 16
2 Hormonal influences
• Endocrine disturbances like diabetes,
hypothyroidism, adrenal dysfunction are
associated with increased susceptibility to
infections.
• Steroids depress host response by their anti
inflammatory and anti phagocytic processes.
• They have beneficial effect as they neutralize the
harmful effects of bacterial toxins.

17. 02/02/19 17
3 Nutrition
• Malnutrition reduces both humoral and cell
mediated immunity.

18. 02/02/19 18
Mechanism of innate immunity
• Body’s first line of defense is intact barrier of
epithelial surfaces.
• Healthy skin possess bactericidal activity to
which the high concentration of salt in the drying
sweat ,the sebaceous secretion and the long chain
fatty acids and soaps contribute.

19. 02/02/19 19
• The mucosa of the respiratory tract has several
innate mechanisms of defence.
• The very entry of nose prevents entry of foreign
particles, and those which pass beyond are held
back by mucous lining and are brought back to
pharynx where they are either swallowed or
coughed up.

20. 02/02/19 20
• Cilia on the respiratory tract propel particles
upwards.
• Gastric juice and saliva represent detrimental
environment to many micro organisms.
• Fluid flow in the oral cavity, urinary tract, git etc
also help to clear micro organisms.
• Lysozyme which is present in lacrimal and nasal
secretions causes lysis of micrococcus
lysodeikitus.

21. 02/02/19 21
• Phagocytosis –Ingestion and destruction of
pathogens by phagocytic cells like neutrophils
and macrophages.
• Natural killer cells –They are group of
lymphocytes that kill many different types of
cancer cells and virus infected cells.

22. 02/02/19 22
• Acute phase proteins :- concentration of
several proteins in the body fluids ,increases
rapidly during tissue injury/infection.
Ex:- C reactive protein
• Inflammation
• Fever

23. 02/02/19 23
• Interferon- protein produced by cells after they
become infected by a virus and thus inhibits the
spread of further development of a viral infection.
• Complement –group of plasma proteins that
produce a cascade of chemical reaction that
ultimately causes lysis of a foreign cell; the
complement cascade can be triggered by specific
or non specific immune mechanisms

24. 02/02/19 24
Acquired immunity
• It can be either natural or artificial immunity.
• It is the resistance developed in the body
against any specific foreign body like
bacteria, viruses, toxins, vaccines or
transplanted tissues.
• Lymphocytes are responsible for acquired
immunity.

25. CLICK HERE TO DOWNLOAD
THIS PPT
https://userupload.net/ks142zbtu6cl

26. 02/02/19 26
Natural Active Immunity
• It develops either after a clinical or an
inapparent infection by an antigen.
• Large majority of adults in the developing
countries have active immunity to diseases
like polio due to repeated exposure.
• This immunity is short lived in viral infections.
• Premunition

27. 02/02/19 27
Artificial active immunity
• It is the resistance induced by vaccines.
• Vaccines are preparation of live / killed micro
organisms or their products used for
immunization.

28. 02/02/19 28

29. 02/02/19 29

30. 02/02/19 30

31. 02/02/19 31
Contraindications for live vaccine
• Persons whose immune response may be
suppressed because of leukemia, lymphoma or
malignancy or because of therapy with
corticosteriods,alkylating agents, antimetabolic
agents/radiation.
• Pregnancy

32. 02/02/19 32
Please remember !!!
• Whenever two live vaccines are required they should be
either given simultaneously at different sites or with an
interval of atleast 3 wks.
• Live vaccines produce immunity usually after single
dose.
• Inadequate refrigerator prior to use have led to failure of
the live vaccines.

33. 02/02/19 33
Inactivate or killed vaccine

34. 02/02/19 34
Toxoids
• Toxins of diptheria or tetanus are detoxified
and used for vaccination.
• Antibodies produced neutralize the toxic
moiety production during infection rather
then acting upon the organisms.

35. 02/02/19 35
Cellular fraction
• Vaccine are prepared from extracellular
fraction.
• Combination - more then one kind of
immunizing agent is included in a vaccine.
• Polyvalent-vaccines prepared from two or
more strains of the same species.

36. 02/02/19 36
Natural passive immunity
• Resistance passively transferred from
mother to the baby.
• Human colostrum is rich in IgA and resistant
to intestinal digestion,gives protection to the
infant.

37. 02/02/19 37
Artificial Passive Immunity
• Resistance passively transferred to the
recipient by the administration of antibodies.
• Disadvantages:-Risk of hypersensitivity
reaction and immune elimination.

38. 02/02/19 38
Indications :-
• Immediate and temporary protection in a non
immune host ,faced with threat of an
infection
• To treat infection
• To suppress the active immunity.

39. 02/02/19 39
• Adoptive immunity
• Combined immunity
• Herd immunity

40. 02/02/19 40

41. 02/02/19 41

42. 02/02/19 42
Antigens
• An antigen has been defined as any substance
which when introduced parentrally into the body
stimulates the production of an antibody with which
it reacts specifically and in an observable manner.
• Haptens are substances which are incapable of
inducing antibody production by themselves but
can react specifically with antibodies.

43. 02/02/19 43
Haptens and epitope
• Haptens may be complex or simple.
• The smallest unit of antigenicity is known as the
antigenic determinant or epitope.
• An epitope usually consists of four or five amino
acid or monosaccharide residues possessing a
specific chemical structure,electrical charge and
steric configuration capable of sensitizing an
immunocyte and of reacting with its complementary
site on the specific antibody or T cell receptor.

44. 02/02/19 44
Determinants of antigenicity
1. Size:-antigenicity is related to molecular
size.
• Very large molecules such as
hemocyanins are highly antigenic whereas
low molecular weight are nonantigenic or
feebly so.
• But sometimes picryl chloride,formaldehyde
or penicillin may be antigenic.

45. 02/02/19 45
2 Chemical nature
• Most naturally occurring antigens are
proteins and polysaccharides.
• Lipids and nucleic acids are less antigenic.
• A certain degree of structural diversity is
required for antigenicity.
• Exception is gelatin.

46. 02/02/19 46
Susceptibility to tissue enzymes
• Substances which are metabolized and are
susceptible to the action of tissue enzyme
behave as antigens.
• Phagocytosis and intracellular enzymes
appear to play an essential role in breaking
down antigens into immunogenic fragments.

47. 02/02/19 47
Foreignness
• Only antigen which are foreign to an individual
induce an immune response.
• An individual does not normally mount an immune
response against his own normal constituent
antigens.
• This was first proposed by Ehrlich who proposed
concept of “horror autotoxicus”
• Antigenicity depends on foreignness and in general
antigens of same species are less antigenic then
distant species.

48. 02/02/19 48
Antigenic specificity
• It was first demonstrated by Obermayer and
Pick and confirmed by Landsteiner.
• Specificity of natural tissue antigens may
belong to different categories like species
specificity, iso specificity,auto specificity and
organ specificity.

49. 02/02/19 49
Specificity
• Species specificity:-tissues of all individuals
in a species contain species specific
antigens.
• There exists some degree of cross reaction
between antigens of related species.
• This immunological relation parallels
phylogenetic relationship.
.

50. 02/02/19 50
Iso specificity
• Antigens found in some but not all members
of a species.
Histocompatibility antigens are those cellular
determinants specific to each individual of a
species

51. 02/02/19 51
Auto specificity
• Self antigens are usually non antigenic but
there are exceptions.
• Sequestrated antigens that are not normally
found free in circulation or tissue fluids are
not recognized as self antigens.

52. 02/02/19 52
Organ specificity
• Some organs, such as the brain, kidney and
lens protein of different species, share the
same antigen.
• Such antigens characteristic of an organ or
tissue and found in different species are
called organ specific antigens.
• Ex. The neuroparalytic complications
following antirabic vaccination.

53. 02/02/19 53
Heterophile(hetrophile)specificity
• The same or closely related antigens may
sometimes occur in different biological
species, classes and kingdom.
• Ex.forssman antigen which is used for
preparation of antibodies

54. 02/02/19 54
Biological classes of antibodies
• Depending on the ability to induce antibody
formation, antigens are classified as T cell
dependent (TD) and T cell independent(TI)
antigens.

55. 02/02/19 55
Differences between TI and TD.
T lymphocyte
independent(TI)
T lymphocyte dependent
(TD)
Structurally simple, complex
Antibody response is
usually limited to IgG and
IgM
Produces all types of
antibody
No immunological
memory
Have immunological
memory
Cause tolerance Do not tolerance

56. 02/02/19 56
Development of T cells
• T cells go through the thymus before
migrating to the lymph nodes. Here pre T
cells develop into thymocytes which divide
up to three times a day.
• They stream out into the blood reach T
dependent zones in lymph nodes and
spleen.

57. 02/02/19 57
Sensitized T Cells
The sensitized T cells then travel to the site
where the antigens originally entered the
body. There, in the inflamed tissue the
sensitized T cells bind to the antigens of the
same kind and then release the chemical
messengers called lymphokines and such T
cells are called killer T cells or cytotoxic T
cells. They also secrete interferons and
tumor necrosis factor

58. 02/02/19 58

59. 02/02/19 59
Cell mediated immunity
• Cell mediated immunity is one which is mediated
by T lymphocytes
• This is the major defense mechanism against
infections by viruses, fungi and few bacteria like
bacteria like tubercle bacillus.
• It occurs through T4 and T8 cells.
• T4 cells mediate delayed hypersensitivity
reactions while ,Cytotoxic reactions are mediated
by T8 cells.

60. 02/02/19 60
Other type of T cells and their function
• Helper T cells help B cells differentiate into
antibody secreting plasma cells by secreting
cytokines such as interleukin 2 and interleukin 4.
• Suppressor T cells act to suppress B cell
differentiation into plasma cells.
• Activated T cells migrate to various lymphoid
tissues throughout the body. when the body is
exposed to the same organism for the 2nd
time
memory cells identify the organism and
immediately and activate other T cells. .

61. 02/02/19 61

62. 02/02/19 62
Applied aspect
• Killer T cells therefore function to defend us
from viral diseases and cancer, but they also
bring about rejection of transplanted tissues
or organs.
• Overall regulators of specific immune
mechanisms.

63. 02/02/19 63
Humoral immune response
• It is mediated by B lymphocyte.These cells
are activated and converted to plasma cells
which secrete specific antibodies which
destroy the corresponding antigen.
• They activate the complement system and
attack and neutralize the antigens.
• They are the major defensive mechanism
against bacterial infections.

64. 02/02/19 64
B cell development
Diagram 651-

65. 02/02/19 65
Role played by different cells
• Antigen presenting cells:-
• Plasma cells:-They produce antibodies and rate
of antibody production is very high.
i.e. 2000 molecules of antibodies/sec.
• Memory cellsMemory cells:-:-they occupy the lymphoidthey occupy the lymphoid
tissues throughout the body and remain in thetissues throughout the body and remain in the
inactive state till they are exposed to the sameinactive state till they are exposed to the same
antigen for the second timeantigen for the second time..

66. 02/02/19 66

67. 02/02/19 67
Antibodies
• They form 20% of the total plasma proteins.
• Though produced by B lymphocytes, these
are found through out the body.
• 5 types of antibodies:-
• IgG, IgA, IgM, IgE,and IgD

68. 02/02/19 68
Structure of antibodies
• Antibodies are gamma globulins with a
molecular weight of 1.5 lakh-9 lakh.
• They are formed by one pair of heavy and
one pair of light chain.
• Heavy chain consists of 400 amino acids and
light chain consists of 200 amino acids.

69. 02/02/19 69

70. 02/02/19 70

71. 02/02/19 71
Mechanism of action of antibodies
• The antibody protects the body from the
invading organisms in two ways:
• By direct actions
• Through complement system.

72. 02/02/19 72

73. 02/02/19 73

74. 02/02/19 74
Functions of antibodies
• IgG :-It constitutes about 80% of the total serum
immunoglobulin.
• It is distributed equally among intravascular and extra
vascular compartments.
• The catabolism of IgG varies with its serum concentration.
• It participates in most immunological reactions such as
complement fixation, precipitation and neutralization of
toxins and viruses.
• Extra cellular killing of target cells coated with IgG antibody
is mediated through the surface of Fc fragment by K cells
bearing the appropriate receptors.

75. 02/02/19 75
Applied aspect
• Passively administered IgG suppress the
homologus antibody synthesis by a
feedback process. This property is used in
isoimmunisation of women by the
administration of anti-Rh(D) IgG during
delivery.
• It is transferred to fetus by the mother.
• It makes its appearance late in infections
after the immune response by IgM

76. 02/02/19 76
IgA
• It is the 2nd
most abundant antibody found in
human body 10-13%.
• It is the major immunoglobulin found in
colostrum, saliva, tears.
• It has 2 subclasses IgA1, IgA2
• It occurs in 2 forms serum and secretory IgA

77. 02/02/19 77

78. 02/02/19 78
Applied Aspect
• SIgA is selectively concentrated in secretions
and on mucus surfaces forming an antibody
paste and is belived to play an important role
in local immunity against respiratory and
intestinal pathogens.
• It inhibits the adherence of micro organisms
to the surface of mucosal cells by covering
the organisms and preventing their entry.

79. 02/02/19 79
IgM
• It constitutes 5-8% of the serum
immunoglobulin
• It is also called millionaire molecule
• It is intravascular in distribution.
• It is oldest immunoglobulin to be present in
an individual
• It is also the earliest immunoglobulin to be
synthesized by the fetus.

80. 02/02/19 80
Applied aspect
• As it is not transported across the placenta
the presence of IgM in the fetus or new born
indicates intra uterine infection and its
detection is useful in diagnosis of congenital
infections.
• It is short lived and disappears early and its
presence indicates a recent infection.
• The anti A and anti B and antibodies to
typhoid o are IgM in nature.

81. 02/02/19 81
• It is believed to be responsible for protection
against blood invasion by micro organisms.
• It is also a major antibody receptor on the
surface of B lymphocyte for antigen
recognition.

82. 02/02/19 82
IgD
• It resembles IgG structurally
• It serves as an recognition receptor for
antigens

83. 02/02/19 83
IgE
• It exhibits unique properties such as heat
lability and affinity towards the mast cells.
• It is chiefly produced by the linings of the
respiratory and intestinal tracts.
• Its deficiency is associated with impaired
immune response and undue susceptibility
to infection.

84. 02/02/19 84
Abnormal Immunoglobulins
• Apart from antibodies, other structurally
similar proteins are seen in serum in many
pathological processes.
• Ex:- Bence Jones proteins.
• Waldenstroms macroglobulinemia.

85. 02/02/19 85

86. Hypersensitivity
• Hypersensitivity is defined as an acquired abnormal
hyper immune reaction to an agent during a second
or subsequent occasion
• Immune response may sometimes be injurious to the
host.
• Sensitized individuals respond to subsequent
antigenic stimuli in an inappropriate or exaggerated
manner, leading to tissue damage, disease or even
death.

88. • The term hypersensitivity refers to the
injurious consequences in the sensitized host,
following contact with specific antigens.
• In the protective processes of immunity, the
focus is on the antigen and what happens to it.
• Hypersensitivity is concerned with what
happens to the host as a result of the immune
reaction.

89. • For induction of hypersensitivity
reactions, the host should have had
contact with the antigen (allergen)
• Priming dose or sensitizing dose.
• Shocking dose.

90. Classification of
hypersensitivity reactions
1. IMMEDIATE REACTIONS (B cell/antibody
mediated)
• Anaphylaxis
• Atopy
• Antibody mediated cell damage
• Arthus reactions
• Serum sickness
2. DELAYED HYPERSENSITIVITY
• Infection (tuberculin) type
• Contact dermatitis type

91. Immediate Hypersensitivity Delayed Hypersensitivity
Appears and recedes rapidly Appears slowly and lasts longer
Induced by antigens or Haptens
by any route
Antigen or hapten intradermally or
with freund’s adjuvant or by skin
contact
Circulating antibodies present
and responsible for reaction
Circulating antibodies may be
absent
Passive transfer possible with
serum
Possible with T cells or transfer
factor
Desensitization easy but short
lived
Difficult but long lasting

92. Coombs and Gell classified hypersensitivity reactions
based on their mechanisms of pathogenesis
• Type I or anaphylactic reactions
• Type II or cytotoxic reactions
• Type III or antibody mediated reactions
• Type IV or cell mediated reactions
• Type V or stimulatory / blocking reactions

93. Type I or anaphylaxis
reaction
• It means exaggerated reactions of the
body to an antigen or any other agent to
which the body has got sensitized
already.
• It develops within few minutes of
exposure to an allergen.
• It is mediated by IgE antibody and other
pharmacological agents.

94. • Antigen antibody reaction occurs with the
release of histamine, serotonin, bradykinin and
the slow reacting factor (SRF)
• Histamine –smooth muscle contraction,
especially in the bronchi and the
gastrointestinal tract, it is a potent vasodilator
and increases permeability.
• Bradykinin has a similar effect
• SRF causes slow contraction of the muscle.

95. • Systemic reactions are likely to follow
parenteral administration and
anaphylactic shock may be dramatic and
fatal
• In man laryngeal edema and bronchiolar
constriction ,circulatory collapse are
most common effects.
• The administration of adrenaline may be
required.

96. • Local anaphylactic reactions can occur
following :-
• Inhalation
• Ingestion of food
PRAUSNITZ KUSTNER REACTION

97. IgE differs from other immunoglobulins in the
following aspect.
• It cannot be demonstrated by the conventional
serological reactions such as precipitation or
complement fixation.
• While atopy occurs commonly in human beings
it is not easy to induce it experimentally in
animals.
• IgE is species specific.
• It is heat sensitive and is inactivated at 56
deg.in 2-4 hrs.
• It does not cross placenta.

98. APPLIED ASPECT
• Allergenic agent to local reaction may be
detected in some cases by skin testing
with possible antigens to which the
subject may be sensitive.
• Desensitization can be done due to either
production of IgG or low dosage
induction of T cell tolerance.

100. CYTOTOXIC REACTIONS
• It involves mostly IgG antibodies, which
bind with antigens on the surface of the
cells, particularly the blood cells.
• Sometimes IgA and IgM antibodies are
also involved.
• Antigens or antigenic groups which
attach themselves to tissue cells, act as
haptens and induce the formation of
antibodies.

101. • IgM is the most important antibody as it deals
most efficiently with particular antigen although
is not always involved.
• It is similar to those reactions occurring in
immune reactions except that the antigen in this
case may be blood platelets, red or white blood
cells with drugs attached to their surface and
the immune response may thus cause
thrombocytopenia, haemolytic anemia or
agrtanulocyotsis.

102. • Ex. Rh incompatibility

103. Type III or Arthus
Phenomenon
• It is an phenomenon at the site of injection of an
antigen and particularly involves the blood vessels of
the subject.
• Excess amounts of antibodies like IgG or IgM are
produced in this type.
• The antigen antibody complexes are precipitated and
deposited in localized areas like joints causing
arthritis, heart causing myocarditis and glomeruli of
kidney producing glomerulonephritis.

105. Type IV or cell mediated
• It is found in allergic reactions due to the
bacteria, viruses and fungi.
• It is also seen in contact dermatitis
caused by chemical allergens and during
tissue rejection of transplanted tissues.
• The importance is the involvement of T
lymphocytes rather than the antibodies.

107. Type V or stimulatory / blocking reactions
• This is seen in autoimmune diseases like
Grave’s Disease or Myasthenia Gravis.
• Grave’s disease:-normally thyroid stimulating
hormone (TSH) combines with surface
receptors of thyroid and cause synthesis and
secretion of thyroid hormones.
• This secretion can be increased by thyroid
stimulating antibodies (TSAB) produced by
plasma cells (B lymphocytes). The excess
secretion of thyroid hormone leads to Grave’s
disease.

108. Myasthenia gravis :-
• It is characterized by weakness, easy
fatigability and paralysis of skeletal
muscles.
• Here IgG auto antibodies are produced
which binds with the receptor of
acetylcholine.

109. Autoimmune diseases
• Normally an antigen induces the immune
response in the body.
• The condition in which the immune system fails
to give response to an antigen is called
tolerance.
• Normally body has tolerance against the self
antigens. However in some occasions, the
tolerance fails or becomes incomplete against
the self antigen. Autoimmunity

110. • It leads to the activation of T lymphocytes
or production of auto antibodies from B
lymphocytes.
• The T lymphocytes attack the body’s
normal cells whose surface contains the
self antigen or autoantigen.

111. Two types of autoimmune diseases
1. Organ specific diseases which affect
only one organ
2. Organ nonspecific or multisystemic
diseases which affect many organs or
systems.

112. HLA system
• In human chromosome 6 there is a series of
molecules called human leukocyte antigen.
• These molecules are recognized by T and B
lymphocytes and these are called HLA antigens
• It is distributed in almost all the tissues of the
body.
• The antibodies are directed against the tissues
possessing the HLA antigens.

113. Who are at risk of developing
autoimmune disease?
• Most autoimmune diseases occur in women, and most
often during their childbearing years. Some of these
diseases also affect African American, American
Indian, and Latina women more than white women.
These diseases tend to run in families, so your genes,
along with the way your immune system responds to
certain triggers or things in the environment, affect
your chances of getting one of these diseases.

114. HASHIMOTOS THYROIDITIS
• Tiredness
• Depression
• Sensitivity to cold
• Weight gain
• Muscle weakness and cramps
• Dry hair
• Tough skin
• Constipation
• Sometimes there are no symptoms
• Tests :-blood test for thyroid stimulating hormone (TSH)

115. Graves’ disease (overactive thyroid)
• Insomnia (not able to sleep)
• Irritability
• Weight loss without dieting
• Heat sensitivity
• Sweating
• Fine brittle hair
• Weakness in your muscles
• Light menstrual periods
• Bulging eyes
• Shaky hands
• Sometimes there are no symptoms

116. Rheumatoid arthritis
• inflammation begins in the tissue lining joints
and then spreads to the whole joint (hand joints
are the most common site, but it can affect
most joints in the body)
• muscle pain
• deformed joints
• weakness
• fatigue
• loss of appetite
• weight loss
• becoming confined to bed in severe cases

117. Blood tests advised :-
• Blood tests may show that patient may
have anemia (when your body does not
have enough red blood cells) and an
antibody called rheumatoid factor (RF).
(Some people with RF never get this
disease, and others with the disease
never have RF.)

118. Immunology of
transplantation
Need for transplantation
Transplant
Donor
Recipient

119. Classification of
transplants
• Based on the tissue or organ
transplanted.
• Based on the anatomical site of origin of
the transplant and the site of the
placement grafts are classified as
orthotopic grafts and heterotopic grafts.
• Fresh organs or stored ones.
• Vital grafts and structural grafts.
• Autograft,isograft,allografts,xenografts.

120. The allograft reaction
• Allografts when placed initially seems to be
accepted by the host for 3-4 days.
• But after 10 days whatever vascular supply has
been set up is disrupted and the graft
undergoes necrosis with ultimately rejection of
the graft.
• This is called as the first set response.
• If the graft is repeated from the same donor
then it is rejected in a accelerated fashion
2nd
set response.

121. Mechanism of allograft
rejection.
• Immunological basis of graft rejection is evident
from the specificity of the second set response.
Accelerated response is seen only when the
graft is from the same donor whereas graft from
another donor will evoke first set response.
• An allograft will be accepted if the animal is
rendered immunologically tolerant.
• Specific immunological tolerance.
• Adoptive immunity

122. Applied aspect
• Transplantation immunity is
predominantly cell mediated, the first
response is brought about purely by T
lymphocytes whereas humoral antibodies
are produced to lesser degree.
• In 2nd
response humoral antibodies are
produced rapidly and abundantly leading
to hyper acute rejection.

123. • The graft remains pale and is rejected
within hours without an attempt at
vascularisation. This is known as white
graft response.

124. Graft versus host reaction
• Here graft mounts an immune response
against host. it occurs in following
conditions:-
• Individual in whom immunological
tolerance is induced.
• The graft contains immunocompetent T
cells
• The recipient contains transplantation
antigens that are absent in the graft.

125. 3 types of reaction usually
seen
• Hyper acute rejection-mediated by
preformed humoral antibody
• Acute rejection-mediated by cellular or
humoral immune response
• Chronic rejection-it may be due to
immunologic or ischemic.

126. Factors favoring allograft
survival
• Most important factor is HLA
compatibility which is done by HLA
typing and tissue matching.
• An allograft rejection is an immunological
process and immune suppression will
inhibit it.
• Any site which is impermeable to immuno
competent cells is an immunologically
privileged site.

127. Applied aspect
• Areas where a lymphatic drainage system
is absent such as brain, hamster cheek
pouch, testes, or where there is lack of
vascularity like cornea are excellent sites
which can accept allografts without
rejection.

128. Immunology of malignancy
• When a cell undergoes a malignant
transformation it acquires new surface
antigens and thus is different from
normal cell. it induces an immune
response.
• These antigens are present only on tumor
cells and absent in normal cells and are
called tumor specific transplantation
antigens (TSTA)

129. Immune Response In Malignancy
• Both humoral and cellular responses are
demonstrated in malignancy.
• Anti TSTA antibodies are demonstrated
in serum.
• According to Burnet, primary function of
cell mediated immunity is to seek and
destroy malignant cells that arise from
somatic mutation and thus prevent tumor
formation.

130. • But due to a very fast rate of proliferation
of tumor cells they may escape out before
the development of immune response
and reach a certain mass which is beyond
the power of immunological attack.

131. Immunology and dental caries
• As the infectious nature of dental caries was
being established it was proposed that, it
may be possible to interfere with caries by
stimulating salivary antibodies.
• Along with salivary antibody the gingival
crevicular fluid contributes components of
immunity to the oral cavity.

132. Immunological protection
• Two strains of streptococci associated with
dental caries.
• Presence of mutans streptococci in plaque is
a requisite for caries formation.
• Initial interaction occurs between pellicle
binding protein and tooth surface.
• With the help of glucans synthesized by GTF
of S. Mutans, these S. Mutans accumulate
on the tooth surface.

133. • Glucan binding protein which is distinct from GTF
binds soluble or insoluble glucan giving rise to
aggregate of S. Mutans
• Immune response to oral infection follows
infectious disease principle.
• Specific polyclonal antibodies to GTF inhibits
mutans streptococci occurrence in vivo and invitro.
• Animals deficient in T cells have more caries then
their euthymic counterparts.

134. Caries vaccine
• The idea of vaccination to immunize the oral
cavity was strengthened by three major
findings:-
• Transmissible and infectious nature of dental
caries
• Understanding of secretory immune system
• Various vaccine studies indicating that dental
caries infection is amenable to
immunological intervention.

135. • Various studies in animals showed that an
increase in immune response was seen by
direct stimulation of GALT.
• A variety of immunization routes have been
tried like
• Intraductal
• Subcutaneous
• Intravenous
• Oral immunization.

136. • Previous notion that salivary IgA antibody
was the protective principle, was reinforced
by these investigations because virtually no
serum IgG antibody could be detected.
• However similar success was never obtained
in oral immunization of monkeys.

137. • Pressure to use individual antigens came
after studies demonstrated that antisera from
rabbits immunized with live whole cells of
mutans streptococci contained antibodies
that cross reacted with human cardiac tissue.
• significance of this study is still not
completely understood.

138. • Various cell components have been used
like
glucosyltransferase
Cell wall antigen.
Passive immunization has been tried with
Murine monoclonal antibody
Immune bovine milk
Egg yolk antibody.

139. Can Caries vaccine be used as a
public health measure?

140. Immunology in periodontal disease
• Periodontal disease is an infection of the
gingival crevice leading to an inflammatory
infiltrate composed of lymphocytes and
plasma cells.
• Gingival epithelium is a semi permeable
membrane.
• The host immune response can be
detrimental or protective in nature.

141. Different types of cells seen in different periodontal
conditions
• Hypersensitivity reactions
• Cytotoxic hypersensitivity
• Chronic inflammation
• AIDS
• Destruction of connective tissue
• Bone resorption
• Juvenile periodontitis
• Adult periodontitis

142. • Increased concentration of secretory IgA
reduces the infection by interfering with
periodontal pathogens.

143. Recent advances

144. Monoclonal antibodies
• Monoclonal antibodies are specific
antibodies produced or derived from a
population or culture of identical or
monoclonal cell.

146. Conclusion
• Immune system with its vast number and
types of cells can be compared to militaristic
type of security force which defends us from
day to day minor infections, injuries to deadly
diseases like cancer.
• A picture of healthy life without good immune
power is impossible to think of!

147. References
• Textbook of microbiology -7th
ed
R.Ananthnarayan,C.K.J.Paniker
• Essential microbiology for dentistry-2nd
ed.
L.P.Samarnayake
• Contemporary oral microbiology and
immunology.-J.Slots,M.Taubman

148. • Review of medical physiology. William F. Ganong.19th
ed. Pg 493-520
• Human physiology –Andrew
Davies,Asa.G.H,Blakeley,Cecil Kidd.
Pg:-530-562
• Text Book Of Physiology –Robert.M.Berne,Matthhew,
Bruce,Satanton.
5 th ed. Pg:-265-274.
• Anthony’s Text Book Of Anatomy And Physiology.17th
ed. Pg:-25-38

149. • Essentials of medical physioloy.
Prema Sembulingam, K.Sembulingam.
3rd
ed. Pg 33-97
• Essentials of medical physiology-Anil Baran
Singh Mahapatra. Pg19-64
• Concised Medical Physiology-Chowdhary.
4th
ed. Pg-19-65.

150. CLICK HERE TO DOWNLOAD
THIS PPT
https://userupload.net/ks142zbtu6cl