#IMMUNOLOGY

FIG 4.1 ***

Box 4.1 *****
Box 4.2 ***
NK cells ***
Fig 4.7 ***
Fig 4.8 *****
CRP,ESR,BOX 4.4 ********* (Conditions with Normal CRP)
Box 4.5 ***** (previous year question Specially complement & Ab)
Box 4.9 ********* (Pre formed & newly synthesized name only, effect - পড়লে ভাল)
Box 4.10 *********
Fig 4.9 *****
Box 4.12 ***** (Rx name only) ( *** IM adrenaline)
Investigation ***
Immune deficiency *** (headlines/name)
Common variable immunodeficiency ***
Box 4.15 ** (Ig conc. ***)
Box 4.16 ***
Amyloidosis *** ( Congo red , apple green birefringence)
Box 4.18 *** (Very difficult.. Read if possible)
Box 4.21 ***** ( Difficult,পড়তে হবে☹️)
BOX 4.26 ***** (Name, A/E of calcineurin inhibitors)
Hereditary angioedema ***

হলে যাবার আগে অবশ্যই দেখবেন ****************

Box 4.20 & 4.25 ( Everything)

FROM LANGE
* Components of innate immunity **
* Innate vs adaptive immunity **********
* Active vs passive immunity **********
* Primary vs secondary response *********
* Properties of immunoglobulin ***** ( Highest conc., Structure   থেকে বাকি পয়েন্ট গুলা)
* Function of complement (Anaphylatoxin, Chemotaxis,Cell lysis, Opsonization ) *********

(From guide )
* Examples of opsonin ***
* Immunodeficiency disorders ***** L/15th/ T 68.1)
* Mechanism of autoimmunity ***

FIG 4.1
+ Cells of innate immunity
+ Lymph node section (কোথায় কোন cell  থাকে)
PHAGOCYTES
* Neutrophil
* Monocytes
* Macrophages

BOX 4.2
+ কঠিন বক্স।পড়লে ভাল। না পারলে চাপ নেওয়ার দরকার নাই।

Important

IFN @
* Antiviral
* Used in hepatitis C & malignacy

IFN ¥ 
* Antimicrobial

IL -2
* Proliferation and differentiation of antigen-specific T lymphocytes

IL-4
* Maturation of B and T cells, and production of IgE antibody

IL-17
* Involved in mucosal immunity and control of extracellular pathogens
* Antibody to IL-17 used in psoriasis, psoriatic arthritis and ankylosing spondylitis

COMPLEMENT

ACTIVATION OF PATHWAYS

CLASSICAL
* IgM or IgG

ALTERNATE
* Lipopolysaccharide of gm (-) bacteria
* Teichoic acid of gm (+) bacteria

LECTIN
* Mannose binding lectin

+++ Activation of complement by any of these pathways results in activation of C3

NK CELLS

+ Large granular lymphocytes 

+ Defence against tumours & viruses
+ Exhibit features of both the adaptive and the innate immune systems
+ Morphologically similar to lymphocytes and recognise similar ligands
+ Not antigen-specific 
+ Cannot generate immunological memory

RELEASED SUBSTANCE
+ pore-forming proteins such as perforin
+ proteolytic enzymes called granzymes 
+ cytokines such as TNF-α  and IFN-γ

ADAPTIVE IMMUNE SYSTEM ***

+ Specificity 
+ Can discriminate between very small differences in molecular structure
+ Highly adaptive
+ Can respond to an almost unlimited number of molecules
+ Possesses immunological memory

LYMPHOID ORGANS ***

PRIMARY
* Bone marrow 
    * T and B lymphocytes differentiate 
    *  B lymphocytes mature
* Thymus
    *  T-cell maturation

SECONDARY
* Spleen
* Lymph node
* Mucosa-associated lymphoid tissue. 

spleen is the largest of the secondary lymphoid organs. Mucosa-associated lymphoid

tissuetonsils, adenoids and Peyer’s patches in the small intestine.

Fig. 4.6  The structure of an immunoglobulin (antibody) molecule. The variable region is
responsible for antigen binding, whereas the constant region can interact with immunoglobulin
receptors expressed on immune cells

BOX 4.3
* Complement activation
* Opsonization
* External secretion

CELLULAR IMMUNITY
* Virus
* Fungi
* Intracellular bacteria

Fig 4.7  
Th1
* Cytokines  TNF-α, IFN-γ, IL-2 
* Function - Pro-inflammatory 
* Delayed-type hypersensitivity responses

Th2
* IL-4, IL-5, IL-10, IL-13
*  Function - B-cell activation , Eosinophil activation
* Promote allergic responses (

Th17
* Cytokines IL-17 
* Function - Mucosal immunity, Pro-inflammatory 

Regulatory T cell ***

* Cytokines - IL-10, TGF-β 
* Function - Anti-inflammatory

SPECIALISED ANTIGEN PRESENTING CELLS

(CD 80 & 86)
* Dendritic cells
* Macrophages
* B lymphocyte

*** Type I hypersensitivity  is relevant in allergy but is not associated with autoimmune disease.

BOX 4.21
MUST TO READ
* Ig type
* Associated disease
* Electrophoresis, RF, complement, viscosity

Box 4.23

Hereditary angioedema *****

Idiopathic & ACEi associated ***

MUST
* Pathogenesis
* Mediator
* C/F
* Investigation
*** Acute cellular rejection - Most common (SBA)

COMPLICATIONS OF IMMUNOSUPPRESSION
* Infection (CMV, pneumocystis)
* Malignacy

**** Live vaccine shouldn't be given