imunologi kulit dah
TRANSCRIPT
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imunologi kulit
dr. Ahmad Garli, Sp.KK
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DEFENISI
Kulit adalah organ penting dalam sistem
imunitas terutama yang paling berperan adalah
imunitas seluler. Imunitas kulit terdiri dari :
1. Sistem fungsional
2. Imunogenetik
3. Struktur selBarrier kulit adalah penting dalam sistem non
imunologik.
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1. SISTEM FUNGSIONAL
Fungsi Nonsistem
Peran dari aliran limfe dan limfonodes dan
pembuluh darah dalam sistem imunologi.
Fungsi komplemen yang bersifat lysis
opsonization, granulisasi dan kemotaksis dari
netrofil dan makrofag.
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2. IMUNOGENETIK
Adanya HLA genes cluster reaksi hypersensitivity
dari pada kulit adalah reaksi yang berlebihan yang
menyebabkan kerusakan dari pada jaringan.
Ada 4 tipe, yaitu :
1. Type I (immediete)
2. Type II (antibody-dependdent cytotoxicity)
3. Type III (immuno complex desease)
4. Type IV (cell mediated or delayed)
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Type I (immediate)
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IgE is bound to the surface of mast cells by Fcreceptors. On encountering antigen (e.g. housedust
mite, food or pollen) the IgE molecules becomecrosslinked, producing degranulation and therelease of inflammatory mediators. These includepreformed mediators (such as histamine) and newlyformed ones (e.g. prostaglandins or leukotrienes)The result in the skin is urticaria. although massivehistamine release can cause anaphylaxis. The
response occurs within minutes. although a delayedcomponent is recognized. Factors other than IgE cancause mast cell degranulation.
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Type II (antibody-dependent cytotoxicity)
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Antibodies directed against an antigen on target
skin cells or structures induce cytotoxic by killer T
cells or by complement activation. For example.
lgG pemphigus antibodies directed against
desmoglein on the keratinocyte surface result in
activation of complement. attraction of effectorcells and the lysis of the keratinocytes Intra
epidermal blisters result. Haemolytic anaemia and
transfusion reactions are other examples of type IIhypersensitivity. Some of these conditions are
autoimmune
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Type III (immune complex disease)
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Immune complexes formed by the combination ofantigen and antibodies in the blood are deposited inthe walls of small vessels, often those of the skin.Complement activation, platelet aggregation and therelease of lysosomal enzymes from polymorphs causevascular damage. This leucocytoclastic vasculitis isseen with, for example, systemic lupus erythematosusand dermatomyositis, but also occurs with microbialinfections such as infective endocarditis. The Arthus
reaction is due to immune complex formation at a
local site. It can be induced in the skin by anintradermal injection, and is maximal at 4-10 hoursafter injection.
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Type IV (cell-mediated or delayed)
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Immunology
1. Skin Provides a Physical Barrier to infection
2. Langerhans cells form outposts of the cellular
immune system and can resent antigens to
immunocompeten cells e.g. T lymphocytes
3. T cells circulate through normal skin and form
part of the skin-associated lymphoid tissue.
They are localized by adhesion molecules
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4. Keratinocytes can be immunologically active
cells
5. All four types of hypersensitivity reaction
occur in the skin
6. Genetic factors modulate immunological
responses. Certain HLA antigens are
associated with increased risk of skin disease
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3. STRUKTUR SEL
1. Langerhans sel yang berasal dari sumsum
tulang adalah sel yang paling penting dalam
imunitas
2. T limfosit :
- Helper
- Delayed type hipersensitivity
- Cytotoxic
- Supresor
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3. Mast sel, yang melepas histamine dan
molekul vaso aktif
4. Keratonisit, yang menghasilkan sitokines
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TERIMA KASIH