immune diseases the war withinweb.med.unsw.edu.au/pathology/genm1000_immunity.pdfimmune diseases...

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Miracles and misadventures Miracles and misadventures Immune diseases Immune diseases Function of the Immune System Function of the Immune System Denis Wakefield Denis Wakefield School of Pathology UNSW, Australia School of Pathology UNSW, Australia Immune diseases Immune diseases School of Pathology UNSW, Australia • Infections • Allergy • Cancer • Autoimmunity Immune diseases Immune diseases The war within The war within School of Pathology UNSW, Australia • Physical barriers • Cells • Molecules Immune diseases Immune diseases School of Pathology UNSW, Australia • Infections • Allergy • Cancer • Autoimmunity

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Page 1: Immune diseases The war withinweb.med.unsw.edu.au/pathology/GENM1000_Immunity.pdfImmune diseases Denis Wakefield School of Pathology UNSW, Australia Autoimmunity Autoimmunity Autoimmunity

Miracles and misadventuresMiracles and misadventuresImmune diseasesImmune diseases

Function of the Immune SystemFunction of the Immune System

Denis WakefieldDenis Wakefield

School of Pathology UNSW, AustraliaSchool of Pathology UNSW, Australia

Immune diseasesImmune diseases

School of Pathology UNSW, Australia

• Infections

• Allergy

• Cancer

• Autoimmunity

Immune diseasesImmune diseasesThe war withinThe war within

School of Pathology UNSW, Australia

• Physical barriers

• Cells

• Molecules

Immune diseasesImmune diseases

School of Pathology UNSW, Australia

• Infections

• Allergy

• Cancer

• Autoimmunity

Page 2: Immune diseases The war withinweb.med.unsw.edu.au/pathology/GENM1000_Immunity.pdfImmune diseases Denis Wakefield School of Pathology UNSW, Australia Autoimmunity Autoimmunity Autoimmunity

Miracles and misadventuresMiracles and misadventuresImmune diseasesImmune diseases

Autoimmunity and AllergyAutoimmunity and Allergy

Denis WakefieldDenis Wakefield

School of Pathology UNSW, AustraliaSchool of Pathology UNSW, Australia

Immune diseasesImmune diseases

School of Pathology UNSW, Australia

• Autoimmunity

• Allergy

• Immunodeficiency

• Transplantation

AUTOIMMUNE DISEASEAUTOIMMUNE DISEASE

OUTLINE

DEFINITIONCRITERIA FOR AIDSPECTRUM OF AIDPATHOGENESISGENES, GERMS AND GENDERAUTOANTIBODIESEXAMPLES OF AID

AUTOIMMUNE DISEASEAUTOIMMUNE DISEASE

DEFINITION

HARMFUL IMMUNOLOGICAL PROCESS

CHARACTERISED BY EITHER ANTIBODY OR CELL MEDIATED REACTION

DIRECTED TOWARDS SELF COMPONENTS

Page 3: Immune diseases The war withinweb.med.unsw.edu.au/pathology/GENM1000_Immunity.pdfImmune diseases Denis Wakefield School of Pathology UNSW, Australia Autoimmunity Autoimmunity Autoimmunity

AUTOIMMUNE DISEASEAUTOIMMUNE DISEASE

CRITERIA

PRESENCE OF AUTOIMMUNE RESPONSE

IMMUNISATION PRODUCES DISEASE

PASSIVE TRANSFER BY Ab OR LYMPHOCYTES

RESPONDS TO IMMUNOSUPPRESSION

AutoimmunityAutoimmunity

School of Pathology UNSW, Australia

Autoimmunity: sex differencesAutoimmunity: sex differences

School of Pathology UNSW, Australia

AUTOIMMUNE DISEASESAUTOIMMUNE DISEASESPATHOGENESIS

ANTIBODY MEDIATED

IMMUNE COMPLEX MEDIATED

CELL MEDIATED

Organ specific V Organ non-specific

Page 4: Immune diseases The war withinweb.med.unsw.edu.au/pathology/GENM1000_Immunity.pdfImmune diseases Denis Wakefield School of Pathology UNSW, Australia Autoimmunity Autoimmunity Autoimmunity

AUTOIMMUNE DISEASESAUTOIMMUNE DISEASES

ANTIBODY MEDIATED

THYROID-Thyrotoxicosis

GASTRIC- PERNICIOUS ANAEMIA

MYASTHENIA GRAVIS

Autoimmune Thyroid Autoimmune Thyroid diseasaediseasae

School of Pathology UNSW, Australia

Pernicious anaemia

Macrocytic RBC

Hypersegmented PMN

Page 5: Immune diseases The war withinweb.med.unsw.edu.au/pathology/GENM1000_Immunity.pdfImmune diseases Denis Wakefield School of Pathology UNSW, Australia Autoimmunity Autoimmunity Autoimmunity

MyastheniaMyasthenia GravisGravis AUTOIMMUNE DISEASES

IMMUNE COMPLEX MEDIATED

S.L.E.R.A.VASCULITIS

Systemic Lupus Systemic Lupus ErythematosisErythematosis

Laboratory of Ocular immunology UNSW, Australia

A 27 year old woman presented

with a visual field defect in the L

eye, head-aches and a facial rash.

She had a positive ANA and

proteinuria.

Rheumatoid arthritisRheumatoid arthritis

School of Pathology UNSW, Australia

Page 6: Immune diseases The war withinweb.med.unsw.edu.au/pathology/GENM1000_Immunity.pdfImmune diseases Denis Wakefield School of Pathology UNSW, Australia Autoimmunity Autoimmunity Autoimmunity

Systemic Systemic VasculitisVasculitis

Rheumatoid arthritis

Wegeners granulomatosis

Relapsing polychondritis

Polyarteritis nodosa

Inflammatory bowel disease

Systemic vasculitis

Systemic infection

AUTOIMMUNE DISEASESAUTOIMMUNE DISEASES

CELL MEDIATED DISEASES

DIABETES MELLITUS

MULTIPLE SCLEROSIS

SjogrensSjogrens syndromesyndrome

School of Pathology UNSW, Australia

SchirmersSchirmers testtest

AllergyDefinitions

Type 1 hypersensitivity

Hightened state of reactivity

Atopy- genetic predisposition to allergy

Hayfever, Asthma, eczema

School of Pathology UNSW, Australia

Page 7: Immune diseases The war withinweb.med.unsw.edu.au/pathology/GENM1000_Immunity.pdfImmune diseases Denis Wakefield School of Pathology UNSW, Australia Autoimmunity Autoimmunity Autoimmunity

Allergic Allergic conjuntivitisconjuntivitis

School of Pathology UNSW, Australia

AngioedemaAngioedema

School of Pathology UNSW, Australia

Asthma

School of Pathology UNSW, Australia

Allergic dermatitis: Allergic dermatitis: excemaexcema

School of Pathology UNSW, Australia

Page 8: Immune diseases The war withinweb.med.unsw.edu.au/pathology/GENM1000_Immunity.pdfImmune diseases Denis Wakefield School of Pathology UNSW, Australia Autoimmunity Autoimmunity Autoimmunity

AllergyCommon Allergens

House dust and house dust mitePollensAnimal dandersMoulds and fungiiFoodsDrugsInsects

School of Pathology UNSW, Australia

Allergy-HDM

TransplantationAims

• Preservation of organ function

• Preservation of quality of life

• Prevention of rejection-acute/chronic

• Prevention of treatment complications

School of Pathology UNSW, Australia

Page 9: Immune diseases The war withinweb.med.unsw.edu.au/pathology/GENM1000_Immunity.pdfImmune diseases Denis Wakefield School of Pathology UNSW, Australia Autoimmunity Autoimmunity Autoimmunity

Transplantation

• Kidney, heart, lung, liver

• Bone marrow

• Cornea

School of Pathology UNSW, Australia

Transplantation

Key Elements• Foreign HLA antigens• Immune response• Rejection• Life long immunosupression

School of Pathology UNSW, Australia

Immunosuppression

Transplantation

• Steroids

• Imuran, cyclosporin, mycophenolate

• Anti-Tcell antibody

School of Pathology UNSW, Australia

Immune diseases

Denis Wakefield

School of Pathology UNSW, Australia

Page 10: Immune diseases The war withinweb.med.unsw.edu.au/pathology/GENM1000_Immunity.pdfImmune diseases Denis Wakefield School of Pathology UNSW, Australia Autoimmunity Autoimmunity Autoimmunity

AutoimmunityAutoimmunity AutoimmunityAutoimmunity

AutoimmunityAutoimmunity

Organ Specific v NonOrgan Specific v Non--Organ specificOrgan specific

ThyroidPancreasAdrenalMuscle

JointsBlood vesselsExocrine glandsNerves

Autoimmune thyroid diseaseAutoimmune thyroid disease

Page 11: Immune diseases The war withinweb.med.unsw.edu.au/pathology/GENM1000_Immunity.pdfImmune diseases Denis Wakefield School of Pathology UNSW, Australia Autoimmunity Autoimmunity Autoimmunity

AUTOIMMUNE DISEASES Immune diseases

School of Pathology UNSW, Australia

AutoimmunityAutoimmunity

School of Pathology UNSW, Australia

Page 12: Immune diseases The war withinweb.med.unsw.edu.au/pathology/GENM1000_Immunity.pdfImmune diseases Denis Wakefield School of Pathology UNSW, Australia Autoimmunity Autoimmunity Autoimmunity

MS and AutoimmunityMS and Autoimmunity

School of Pathology UNSW, Australia