Pathology

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T-Lymphocytes

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T-Cells are thymus derived; they function in the peripheral blood in cell mediated immunity by recognizing specific antigents present on the surface of another cell and respond with various effector/regulator functions according to T-cell type (CD4 helpers or CD8 killer cells)

Front 2

B-Lymphocytes

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B Cells are Bone marrow derived and do not function in cell mediated immunity because they do not interact with antigen binding sites; they bear immunoglobuln on the cell membrane but do not release it.

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NK (Natural Killer) Cells

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NK cells ar a subgroup of lymphocytes that have the ability to recognize and kill various tumor and virus infected cells.

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How major histocompatibility compatibility (MHC) antigens function

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MHC - Main target for the rejection of transplanted organs. Gene is on short arm of chromosome.

Cell surface MHC antigens bind fragments of foreign proteins and then present these molecules to antigen-specific T cells for recognition and response.

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Type I Hypersensitivity

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Immediate type or anaphylaxis (occurs in minutes)

-Hives (swelling and edema)

-Hay fever (sneezing, conjct.)

-Anaphylactic Syndrome - bronchial constriction, airway obstruction.

*Characterized by specific antibody (IgE) taht binds to receptors on basophils and mast cells that react with specific antigen.

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Type II Hypersensitivity

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Caused by IgG and IgM cytotoxic antibodies directly against antigens on cell surfaces or in CT (have ability to activate complement system)

-Graves disease

-Autoimmune hemolytic anemias, Good pasture syndrome

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Type III Hypersensitivity

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Immune Complex Disease

- Involve tissue injury mediated by immune complexes.

-Autoimmune disease of CT, (systemic lupus, rheumatoid arthritis)

-Serum Sickness

-(SLE) Systemic Lupus Erythematosus

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Type IV Hypersensitivity

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Cell mediated immunity

-Antigen elicited cellular immune reaction that results in tissue damage but does not require te participation of antibodies.

-Chronic thyroiditis, sjogen syndrome

-Primary biliary cirrhosis

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Hyperacute Organ tissue rejection

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Occurs in minutes to hours and shows interstitial edema, infiltrates of PMNs (polys), intravascular thrombi, and fibrinoid necrosis -sudden cessation of urine, output accompanied by fever and pain.

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Acute Organ Tissue Rejection

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Occurs in first few weeks to months and, in addition to the above findings, shows infiltrates of monos, tubular damage and vasculitis. Sudden onset of azotemia and oliguria (retention of waste products normally excreted in urine)

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Chronic rejection of Organ tissue

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Occurs months to years after transplant, characterized by arteriolar sclerosis, tubular atrophy, fibrosis and capillary wall thickening - progressive azotemia, oliguria, hypertension, weight gain.

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Acquired Immunodficiency Syndrome (AIDS)

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AIDS is caused by the human immunodeficiency Virus (HIV) infection of CD4 T-lymphocytes depleting this cell population and leading to loss of cellular immunity. In the typical patient, all elements of the immune system is progressively impaired, including T-Cells, B-Cells, NK cells and monocyte/macrophages. Patients are htus unable to generate adequate immune responses to a host of opportunistic infections and tumors.

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Systemic Lupus Erythematosus (SLE)

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SLE is a chronic, multisystem, autoimmune inflammatory diseae typically involving kidneys, joints, serous membranes, and skin. Etiology unknown the body forms autoantibodies against a variety of self-antigens including plasma proteins, cell surface antigens, intracellular components, and nuclear DNA. Tissue injury is caused by deposition of antigen-antibody complexes creating vasculitis, synovitis and glomerulonephritis. SLE is considered a prototype of TYPE III HYPERSENSITIVITY REACTION.