SECOND WORKSHOP: 2009-02

R. Hugo Martínez Lozano, M.D. Sept-04-2009

Examples of innate immunity: -External barriers -Phagocytosis -Complement -TLR -NK cells

Forms of adpative immunity: -Humoral -Cellular

“missing self” -Viran inf. -Neoplasia -Transplant r.

Lymphocyte

PLASMA CELL
Most prominent Organelle?

TISSUE?

Adaptive immunity: cells and tissues

Immune response
  

Cells Tissues Mechanisms (vgr. HLA systems)
HLA Allele B27 B27 B27 DR4 DR3 DR3 DR3 DR4 DR3/DR4 Relative Risk 90 14 14 4 13 9 5 6 20

Disease Ankylosing spondylitis Postgonococcal arthritis Acute anterior uveitis Rheumatoid arthritis Chronic active hepatitis Primary Sjögren syndrome Type-1 diabetes

HYPERSENSITIVITY REACTIONS

HYPERSENSITIVITY REACTION II

Opsonins (& C)-mediated phagocytosis

Complement (& Fc R)-mediated inflammation

Anti-Receptor disease

SELECTED EXAMPLES OF H.R.-II
     

HEMOLYTIC ANEMIAS GOODPASTURE SYNDROME PEMPHIGUS V. INSULIN-RESISTENT DIABETES MYASTHENIA GRAVIS GRAVES DISESASE

PATHOGENESIS: VASCULITIS (PHASES)

HYPERSENSITIVITY REACTION IV

CONTACT DERMATITIS: Perforins, granzymes laden T cells

SLE:

SKIN… ANTI-B.M. INJURY

IDEM “Wire-loops”

Idem…Diffuse Proliferative glomerulonephritis: Prognosis…

LIBMAN-SACHS ENDOCARDITIS

Pannus

Sjogren syndrome…

Stiffness of the skin. Types of sclerodermia…

CREST SX… Meaning?

Adaptive immunity

Humoral (Abs.) -pyogenic bacteria. -some virus & protozoos (luminal) Cellular (cells & cytokines) -Many fungi -Many viruses -Other intracytoplasmic microbs

IMMUNE DEFICIENCY SYNDROMES.
II.- PRIMARY: RECOMMENDED STUDY: - X-LINKED AGAMMAGLOBULINEMIA - COMMON VARIABLE IMMUNODEF. - ISOLATED IgA DEF. - DiGEORGE SYNDROME - SEVERE COMBINED IMMUNODEF - WISKOTT-ALDRICH SYNDROME

GIARDIA LAMBLIA

CANDIDIASIS

MEASLES’ PNEUMONIA

P.A.S.

“ASPERGILLOMA”

Idem

NEOPLASIA

DEFINITIONS: - TUMOR - NEOPLASIA: “New growth” - CANCER - ONCOLOGY

NEOPLASIA I

BIOLOGY (AND MORPHOLOGY) B M
DIFFERENTIATION CAPSULE (OR PSEUDO) GROWTH RATE NUCLEAR ABNORMALITY MITOSES ARCHITECTURAL AB. METASTASIS

-

WELL ANAPLASIA +++ - OR + + +++ + +++ - 0R + +++ - OR + +++ NO COMMON

R. HUGO MARTINEZ

ADENOCARCINOMA

NEOPLASIA I

NEOPLASTIC DISSEMINATION: I - LOCAL INVASION II- SPREAD: 1) SEEDING (IN CAVITIES) 2) METASTASIS – LYMPH NODES - BLOOD-BORN

Peritoneal carcinomatosis

REGULATORY GENES
   

GROWTH-PROMOTING (PO) GROWTH-INHIBITING (TSG) APOPTOSIS DNA REPAIR

PROTOONCOGENES

PHYSIOLOGIC REGULATORS OF CELL PROLIFERATION & DIFFERENTIATON
- GROWTH FACTORS - GROWTH FACTOR RECEPTORS - REGULATORY PROTEINS –TRANSDUCER - NUCLEAR

- ETC. (Table 7-8, p. 295)
- Examples: FGF, TGF, RAS, Abl, etc.

M.M. (PO fgf3/int-2)

Cholangiocarcinoma (K-ras)

TSG
  

RB P53 OTHER… NF

P16 WT-1 WT-X BRCA AT (ATM)

COLPOSCOPY

CYTOLOGY: HPV SIGNS

RB GENE & RETINOBLASTOMA: “PARADIGM FOR THE 2 HIT HYPOTHESIS”

DNA REPAIR DEFECTS (GENOMIC INSTABILITY)
XERODERMA PIGMENTOSUM

AT

Telomeres: Up to 2000 repeats of the 5’TTAGGG3’ sequence

DETACHMENT

VASCULAR DISS. & HOMING

Pancoast t. + SVC Sx.

Paraneoplastic syndromes

Syndrome
Cushing's Syndrome

Mechanism ACTH-like substance Parathormone-like substance Inappropriate ADH secretion Erythropoietin-like substance Hypercoagulable state

Example Lung (oat cell) carcinoma Lung (SC) carcinoma, other carcinomas Lung (oat cell) carcinoma Renal cell carcinoma Liver cells carcinoma Pancreatic carcinomas & other Various carcinomas and sarcomas Metastatic malignant carcinoid tumors

Hypercalcemia

Hyponatremia

Polycythemia

Trousseau's Syndrome

Hypoglycemia

Insulin-like substance

Carcinoid Syndrome

5-hydroxy-indoleacetic acid (5-HIAA)

FIBROSARCOMA: I-like substance

RENAL CELLS CARCINOMA

ACANTHOSIS NIGRICANS

ACANTHOSIS NIGRICANS 50% OR MORE… Most likely neop?

CACHEXIA

BACTERIOPHAGES, PLASMIDS & TRANSPOSONS

BACTERIOPHAGES & PLASMIDS = VIRULENCE

PLASMIDS & TRANSPOSONS = RESISTANCE

Coliphages T-1 Infecting a bacteria

 

 

TRANSIENT VIRAL INFECTIONS CHRONIC LATENT INF (HERPESVIRUS) CHRONIC PRODUCTIVE INF. TRANSFORMING

TRANSIENT V.I.

MEASLES

Denervation atrophy

CHRONIC LATENT INF.

ORAL HERPES SIMPLEX

HERPETIC ENCEPHALITIS

HERPESZOSTER

CHRONIC PRODUCTIVE

“ATYPICAL” LYPMHOCYTES IN BLOOD ETIOLOGIC AGENT?

T.I

MECHANISMS OF BACTERIAL INJURY
    

ADHERENCE TO HOST CELLS TOXINS ENZYMES INTRACELLULAR B. (IMMUNE RESP.) VIRULENCE

IMMUNE EVASION BY MICROBES
  

VARIATION SHEDDING INHIBITION OF IMMUNITY

MYCOPLASMAS ATACHED TO EPITHELIAL CELL.

Ehrlichia “morulae”

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