R GOOD DAY

HOPING ALL OF YOU IN GOOD CONDITION AND CAN ENJOY THIS LECTURE
2/4/2014 1

HOST DEFENCE
Randanan Bandaso Dept of Pathology Faculty of Medicine Hasanuddin University

2/4/2014

CURRICULUM VITAE

2/4/2014

2/4/2014

EDUCATION

FACULTY OF MEDICINE Unhas 1969 MSc Mahidol University Bangkok 1975 Surgical Patology FK Unhas 1978 Forensic Patology FK Unhas 1988 Andrology Monash University Melbourne Australia 1989 DFM Netherland 2001

POSITION

2/4/2014

Retired Professor Faculty of Medicine Hasanuddin University

THE PIONEER OF IMMUNOLOGY

2/4/2014 6

2/4/2014

LOUIS PASTEUR (1822-1895) (ATTENUATED VACCINE 1880)

2/4/2014

ELIE METCHNIKOFF (1845-1916) (PHAGOCYTOSIS, CELLULAR DEFENSE THEORY)

2/4/2014

ROBERT KOCH (1843-1910) (THE FOUNDER OF THE CAUSES TUBERCULOSIS)

2/4/2014

EDWARD JENNER BOOK (1798) (THE FOUNDER OF THE VARIOLE VACCINE)

10

KINTAN

ALI SANGKALA

2/4/2014

THE FOUNDER OF IMMUNOLOGY

11

SOME COMMENTS OF THE STUDENTS IN THE SECOND SEMESTER Block 1 (Immunology)

Lack of communication with students Improve communication skills Not so good explanation an elaboration. Give some more examples. Make it more interesting, speak clearly Need to give the student understanding on what he teaches.Dont teach to fast because we us a student need apropriate time to understanding the topic

2/4/2014 12

COMMENT OF THE STUDENT IN THE SECOND SEMESTER Block 1 (Immunology)

Dont to fast if talking and English bad. The most important things is change the illustration of the slide and put more information about the subject in the slide No suggestion for the lecture except please increase the quality of the presentation and speaks English more clear

2/4/2014 13

COMMENT OF THE STUDENT IN THE SECOND SEMESTER Block 1 (Immunology)

Use Indonesian and English it can help. Good Lecture, explanation complete. Thank for teaching, like Dr.Randanan as well, keep up a good work doctor Good explanation in lecture I like the way he teaches us

2/4/2014

14

THE PURPOSE OF LECTURE

AT THE END OF THIS LECTURE YOU SHOULD UNDERSTAND: THE MECHANISM OF HOST DEFENCE: PHYSICAL, CHEMICAL, REFLEX, IMMUNORESPONSE HOMEOSTASIS. DEFECT IN IMMUNO RESPONSE ACTIVE AND PASSIVE ACQUIRED IMMUNITY
2/4/2014 15

Holy Bible
Genesis 1: 26-27 26. Then God said, let us make man in our image, according to Our likeness, 27. So God created man in His own Image; in the image of God. He created him male and female. He created them.
2/4/2014 16

What does it means

God created man in his image the God must be the same human being,has two eyes, two ears and nose. Not true

The man is very perfect, very sophisticated, very complete, more sophisticated than the most sophisticated computer in the world
17

2/4/2014

THE WORLD FULL OF MICROORGASME

Because
God created Created human-being Very perfect And Sophisticated More sophisticated Than the most Sophisticated Computer In the world

BACTERIA,VIRUS, PARASITES

2/4/2014

INFECTION UNCOMMON (?)

18

God gives
NATURAL RESISTENCE ANATOMIC BARRIER PHAGOCYTOSIS COMPLEMENT HOST DEFENCE LOCAL SYSTEMIC NONSPECIFIC SPECIFIC HUMORAL CELLULAR
2/4/2014 19

BACTERIA,VIRUS, PARASITES

HOST DEFENCE LOCAL SYSTEMIC NONSPECIFIC SPECIFIC HUMORAL CELLULAR

2/4/2014 20

BACTERIA,VIRUS, PARASITES

AGE

NUTRITIONAL

PSYCHOLOGICAL

HORMONAL

2/4/2014

THE INFLUENCES OF NATURAL RESISTENCE

21

HOST DEFENCE
SENSATION/REFLEX PHYSICAL DEFENCE

HOMEOSTASIS

CHEMICAL DEFENSE

2/4/2014

IMMUNORESPONSE

22

REFLEX AND SENSATION

MOSQUITO FLY

FEELING

THE HAND WILL FLAP IT

PULL
HOT OR COLD
2/4/2014

TOUCH

23

HOMEOSTASIS

STABILIZATION OF PHYSIOLOGICAL CONDITION IN THE BODY

FAIL OR EXCEED

DISEASES

2/4/2014

24

HOMEOSTASIS
STABILIZATION OF INTERNAL ENVIROMENT IN THE BODY

ANY CHANGES STABILIZATION THE BODY MAINTAIN PHYSIOLOGICAL CONDITION

FAIL OR EXCESSIVE DISEASES

2/4/2014 25

MECHANISM OF HOMEOSTASIS
AUTOREGULATION EXTRINSIC REGULATION

HYPOXIA

NERVE SYSTEM OR ENDOCRIN SISTEM

SUBSTANCES THE BODY NEED OXIGEN HEART BEAT INCREASE THE BLOOD MORE LIQUID

BLOOD SUGAR
INCREASED O2 MORE EASY COMES THE CELL
2/4/2014

INREASE INSULIN
26

HOMEOSTASIS FAILED
EAT TO MUCH
BLOOD PRESSURE DROPS

BLOOD SUGAR INCREASED

INCREASED ADRENALIN

INSULIN FAILED TO INCREASE DM

2/4/2014

FAILED BLOOD P DROPS TO MUCH HYPERTE NSION

27

BLOOD PRESSURE

ADRENALIN

BLOOD FLOW

KIDNEY TUMOR

BLOOD FLOW

2/4/2014

28

NON SPECIFIC IMMUNITY

BODY SURFACE

LOCAL PRODUCTION OF CHEMICAL ANTI MICROBES

DISCHARGE MICROORGANISME FROM THE BODY

BACTERIAL INTERFERENCE (Lactobacillius)

2/4/2014

29

HOW HUMAN BODY PROTECT ITSELF

RESP/DIGES TRACT

SKIN

BATHED A PROTECTIVE FLOWING LAYER OF MUCUS

LACTIC ACID OTHER SUBSTANCE IN SWEAT

TRAP,DISSOLVE AND SWEEP AWAY FOREIGN SUBSTANCES

MAINTAIN ACIDIC pH PREVENT COLONIZATION OF BACTERIA

2/4/2014

RELATIVELY STATIC IN TIME OF NEEDS CAN BE ENHANCED

30

NON SPECIFIC IMMUNITY

FIRST LINE

SCOND LINE

SKIN, SKIN FAT, NORMAL FLORA OF THE SKIN, HIGH TEMPERATURE, MUCOUS, GASTRIC ACID SALIVA, PERISTALTIC, COUGH, NORMAL FLORA OF SKIN,COLON, VAGINA AND MOUTH
2/4/2014

MONOCYT MACROPHAGE GRANULOCYTE NEUTROPHYL EOSINOPHYL BASOPHYL TISSUE UNDER SKIN TISSUE UNDER MUCOUS
31

EPITHELIAL CELLS AS CENSOR TO INFECTION OF BACTERIA

2/4/2014

32

TO PRODUCE INFECTION
MICROORGANISME TO PRODUCE INFECTION SLIP TO THE BARRIER OF SURFACE DEFENCES THIKNESS OF EPITHELIAL IS DIFFERENT NONSPECIFIC

2/4/2014

33

HOST DEFENCE AGAINST ATTACHEMENT TO EPITHELIAL CELL

NORMAL MICROBIAL FLORA, LOCAL FACTOR: FIBRONECTIN, GLYCOPROTEIN pH

ANTIBODY ON MUCOUS SURFACE Ig A LACTOFERIN

2/4/2014

34

bacteria
stimulate

epithel
cytokin

lymphocyte
2/4/2014

macrophage

35

CELLULAR SYSTEM OF SYSTEMIC IMMUNITY

PROFESIONAL PHAGOCYTIC PMN MACROPHAGE

NONPROFESIONAL PHAGOCYTIC ENDOTHELIAL, EPITHELIAL, FIBROBLAST

2/4/2014

TENTARA

RAKYAT BIASA

36

SIGNIFICANCE OF EPITHELIAL CELL PROLIFERATION

MICROBIAL ATTACHEMENT IS NOT NECESSARY FOLLOWED BY CELL PENETRATION M.PNEUMONIAE, C.DIPHTERIAE, B.PERTUSSIS,V.CHOLERA SURFACE SHIGELLA PENETRATE EPITHELIAL CELL SALLMONELA PROCEED TO SYSTEMIC INFECTION INTRAEPITHELIAL PATHOGENS PROTECTECTED FROM ANTIBODY, ANTIBIOTIC, AND INGESTION AND KILLING BY PMN
37

2/4/2014

SUPERFICIAL

INTRACELLULAR

PENETRATE EPITHELIAL

ENTER BLOOD VESSEL

2/4/2014 38

SYSTEMIC INFECTION

DISCHARGE MICROORGANISME FROM THE BODY

10 TRILIUN

MUCOCILIARY ESCALATOR OF RESPIRATORY TRACT OROPHARYNX COUGH OR SWALLOWED DESQUAMATION OF EPITHELIAL CELL REMOVE LARGE AMOUNT OF 2/4/2014BACTERIAL

DEFECATION ELIMINATE 10.000.000.000.000/DAY URINATION ELIMINATE BACTERIAL COLONIZING IN URETHRAL EPITHELIUM. RETENTION OF URINE ENHANCE THE RISK OF INFECTION SALIVATION,LACRIMATION, SNEEZING DISPLACE POTENTIALLY INFECTIVE MICROORGANISME 39

NORMAL MICROBIAL FLORA (COMMENSALS)

BACTERIA, VIRUSES,FUNGI,PROTOZOA LIVE ON OR WITHIN THE HUMAN HOST BUT RARELY CAUSE DISEASE OROPHARYNX: streptococci, neisseria, Hemophylus, Bacteroides, spirochetes

SKIN: Staphylococci, Diphteroid

LARGE INTESTINE: Streptococci, Enterococci, Clostridia,Lactobacili, Enteric bacilli, Bacteroides

2/4/2014

VAGINA; Streptocci, Lactobacilli, Bacteroides,Mycoplasma

40

Normal Flora

Pathogens

Difficult To differentiate
SYMPHTOM AND SIGNS OF INFECTION COUGH AND FEVER INFLAMMATORY CELL

NO SYMPHTOMS AND SIGNS

2/4/2014

41

OBLIGATE PATHOGEN

ISOLATION IS A DIAGNOSTIC OF INFECTION

OPPURTUNISTIC INFECTION

INFECTION OCCUR IN IMMUNOCOMPROMISED HOST

COLONIZATION

THE SYMBIOSIS BETWEEN THE COMMENSAL DISTURBED OVERGOWTH OF EXOGENOUS BACTERIA

NOSOCOMIALLY ACQUIRED
2/4/2014

REPLACEMENT OF NORMAL FLORA IN THE HOSPITAL 42 RESISTENT TO MULTIPLE AB

INFLAMMATION
BLOOD SUPPLY INCREASED GLUCOSA OKSIGEN INCREASED IN CAPILLARY PERMIABILITY MIGRATION OF NEUTROPHYL, MACROPHAGES, LYMPHOCYTE

2/4/2014

43

INFLAMMATION
BLOOD SUPPLY INCREASED GLUKOSA OKSIGEN MICROORGANISM

INCREASED PERMIABILITY

MACROPHAGE

NEUTROPHYL
LYMPHOCYTE
2/4/2014 44

CONTROL OF INFLAMMATION
PRODUCTS

OF PLASMA ENZYMES

CYTOKINES
VASOACTIVE

MEDIATOR MAST CELLS BASOPHILS PLATELETS

2/4/2014

45

MEDIATOR OF INFLAMATION(1)
HISTAMINE MAST CELLS + BASOPPHYL VASCULAR PERMIABILITY, SMOOTH MUSCLE CONTRACTION SEROTONIN PLATLETS VASC PERMIABILITY, SMOOTH MUSCLE CONTRACTION

2/4/2014

46

MEDIATOR OF INFLAMATION (2)

IL8 LYMPHOCYTES MONOCYTE LOCALIZATION C3A COMPLEMENT C3 MAST CELL DEGRANULATION + SMOOTH MUSCLE CONTRACTION. BRADYKININ KININ SYSTEM VASODILATATION

2/4/2014

47

2/4/2014

48

PHYSICAL DEFENCE BY HAIR

HAIR PROTECT BODY FROM HOT EYEBROW

NOSE HAIR

SWEAT AND FOREIGN BODY

INSECT AND DUST

2/4/2014

49

PHYSICAL DEFENCE IN RESPIRATORY TRACT

A LOT OF CAPILLER IN NOSE

COVER BY TIGHT EPITHEL

GOBLET CELL PRODUCE MUCOUS

THE CILIA ESCALATES THE MICROBES AND PARTICLES

2/4/2014 50

REFLEX DEFENCE IN RESPIRATORY TRACT

COUGH IRRIATATION LARYNX, TRACHEA AND BRONCHI

SNEEZING STIMULATION OF NOSE MUCOSA

LARYNGEAL SPASM CHEMICAL, FOREING BODY, WATER

2/4/2014 51

IMMUNE RESPONSE IN RESPIRATORY TRACT

MUCOUS Ig A, PMN, SPESIFIC ANTIBODY

ALVEOLAR MACROPHAGE CLEAN THE ALVEOLI FROM MICROBES AND FOREIGN BODY

2/4/2014

52

2/4/2014

53

2/4/2014

54

2/4/2014

55

THE MICROBES ENTER THE BODY THROUGH THE SKIN

Acid pH and normal flora of the skin, non saturated fatty acid

Intact skin
Tissue fluid Lyzosome Phagocytosis and inflammations

2/4/2014

56

THE MICROBES ENTER THE BODY THROUGH THE RESPIRATORY TRACT

HAIR OF THE NOSE,HOT TEMPERATURE IN THE NOSE, SNEEZING,epiglottis

MUCUS AND CILIA, COUGH

Tissue fluid Lyzosome

Phagocytosis and inflammations

2/4/2014 57

THE MICROBES ENTER THE BODY THROUGH THE DiGISTIVE TRACT

SALIVA

MUCUS AND GASRIC JUICE

DEFECATION

2/4/2014

58

URINATION

2/4/2014

59

MUCUS IN CERVIX

LACTOBACILLUS
2/4/2014 60

SUMMARY OF NONSPECIFIC RESISTENCE

2/4/2014

61

MECHANICAL FACTOR OF NON SPECIFIC RESISTENCE 1

INTACT SKIN Form a physical barries to the entrance of microbes

MUCOUS MEMBRANE

Inhibit the entrance of many microbes, but not as effective as intact skin

MUCOUS

Traps microbes in respiratory and digestive tract

CILIA
2/4/2014

Together with mucous traps and remove microbe And dust from upper respiratory tract
62

ANTIMICROBIAL SUBSTANCE OF NON SPECIFIC RESISTENCE

INTERFERRON (IFN)

Protect uninfected host cell from viral infections

COMPLEMENT

Caused lysis of microbes,promotes phagocytosis Contributes to inflamations, serve us chemotactic agent

PROPERDIN
2/4/2014

Work with complement to bring about same responses as complement.

63

OTHERS NON SPECIFIC RESISTENCE

Ingestion and destruction of foreign particulate matter by macrophage and microphage

PHAGOCYTOSIS

INFLAMMATIONS

Confine and destroy microbes and repair tissue

FEVER
2/4/2014

Inhibit microbial growth and speed up body reactions and repair.

64

CHEMICAL FACTOR OF NON SPECIFIC RESISTENCE 1

GASTRIC JUICE Destroy bacteria and most toxins in stomach

ACID pH OF SKIN

Discourage growth of many microbes

LYZOZYMES

Antimicrobial substance in perpiration, tears, Saliva, nasal secretions and tissue fluid

URINE
2/4/2014

Wash microbes from urethra

65

MECHANICAL FACTOR OF NON SPECIFIC RESISTENCE 2

LACRIMAL APPARATUS
Tear dilute and wash away irritating substances And microbes

SALIVA
EPIGLOTTIS

Washes microbes from surface of teeth and Mucous membrane of mouth

Prevent microbes and dust from entering trachea

URINE
2/4/2014

Wash microbes from urethra

66

SPECIFIC IMMUNITY TO INFECTION

HUMORAL IMMUNORESPONSE

CELL MEDIATED IMMUNERESPONSE

KEY AND HOLE

2/4/2014 67

ACQUIRED IMMUNITY
ACTIVE PASSIVE

INFECTION

VACCINATION

TRANSPLACEN/ COLOSTRUM

ADMINISTRATION OF IMMUNE SERUM

CLINICAL

SUBCLINICAL

2/4/2014

68

H0W ANIMAL
BECOMES IMMUNE NATURAL AND ARTIFICIAL

IMMUNOLOGY
2/4/2014 69

MAN OBSERVED
RECOVERY FROM INFECTION IMMUN

JENNER : VACCINATION OF SMALL FOX SUCCESFULL APLICATION OF OBSERVATION

2/4/2014 70

Cow Cowpox

Human Small Pox

MILKER

DONOT SUFFER SMALLPOX

2/4/2014

EPIDEMIOLOGI OF SMALL POX

71

INFECTION

IMMUNITY

INSEPERABLE
2/4/2014 72

DEFECT IN IMMUNE RESPONSE

CONGENITAL

ACQUIRED

DEFICIENT T CELL B CELL B&T CELL COMPLEMET PHAGOCYTOSIS

2/4/2014

AIDS AGING MALNUTRITION KIDNEY DISEASE IMMUNOSUPRESSIVE RADIATION

73

SUMMARY
THE BODY IS VERY COMPLEX AND SOPHISTICATED. HOST DEFENCE IS VERY IMPORTANT TO SURVIVE HOST DEFENCE CAN BE PHYSICAL, CHEMICAL, REFLECS, BACTERIOLOCIGAL NON SPECIFIC OR SPECIFIC

2/4/2014 74

SUMMARY
SOME FACTORS INFLUENCES THE HOST DEFENCE IMMUNE RESPONSE CAN BE DEFICENT CONGENITALLY OR ACQUIRED ACQUIRED IMMUNITY CAN BE ACTIVE OR PASSIVE.

2/4/2014

75

2/4/2014

76