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Autoimmune Disease
Multiple Sclerosis
Gilang Rizki Al Farizi
Prodi Magister
Fakultas Farmasi Universitas Ahmad Dahlan
Yogyakarta
Introduction
Definisi : Merupakan suatu peradangan diotak dan tulang belakang
yang menyerang substansia alba juga. Kerusakan
karena sel limfosit T pada antigen myelin (dimyelinisasi
Epidemiologi
Discussion Questions:
Why can’t certain blood types be mixed during a transfusion
Why doesn’t the body of a pregnant woman reject the fetus
Most case of MS in western people?
Gen HLA class II
 Alel HLA class II menjadi lebih rinci menjadi
HLA-DRA, -DRB1, DRB -3, - DRB4, -DRB5,
-DPA 1, dan HLA-DQA1, -DQB1
 Pada perkembangan teknologi variasi HLA DRB1
terdapat 50 spesifisitas genom
 Fisiologis HLA kelas II sama halnya dengan
MHC kelas II, yaitu mempresentasikan antigen
exogen, misalnya protein bakteri (bacterial
peptide)
HLA Function
CON,T
Types of Multiple sclerosis
1. Relapsing Limiting MS (RRMS
Ditandai dengan episode relaps atau eksaserbasi yang
diikuti dengan episode remisi (perbaikan
Relapsing Limiting MS (RRMS
2. Secondary progressif MS  tahap lanjut dari stage
RRMS
3. Primary Progressive MS
4. Primary relapsing MS
Medication
1. Deseases Modifying Agent Drugs
a. Interferon beta
b. Glatiramer asetat
c. Fongolimod
d. Natilzumab
e. Metoxantrone
2. Simptomatik
Drugs mecanism in theraphy
MS
Resources:
• Campbell, Neil A. and Reece, Jane B. Biology. Benjamin Cummings., 6th edition. 2002.
• Marieb, Elaine. Essentials of Human Anatomy and Physiology. Pearson Education Inc., 2000.
• www.biology.arizona.edu/immunology/tutorials/immunology/main.html
• www.biologymad.com
• www.cdad.com/nih/immune2/index.html
• www.hhmi.org/biointeractive/disease/animations.html
• www.mayoclinic.com
• www.micro.msb.le.ac.uk/MBChB/2a.html
• www.ncbi.nlm.nih.gov/
• www.niaid.nih.gov/publications/autoimmune/autoimmune.html
• www.northarundel.com/aniplayer
• www.ntri.tamuk.edu/immunology/blood.html
• www.nci.nih.gov/sciencebehind/immune/immune00.html
• www.whfreeman.com/kuby/index.html

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Multiple sclerosis

  • 1. Autoimmune Disease Multiple Sclerosis Gilang Rizki Al Farizi Prodi Magister Fakultas Farmasi Universitas Ahmad Dahlan Yogyakarta
  • 2. Introduction Definisi : Merupakan suatu peradangan diotak dan tulang belakang yang menyerang substansia alba juga. Kerusakan karena sel limfosit T pada antigen myelin (dimyelinisasi
  • 3. Epidemiologi Discussion Questions: Why can’t certain blood types be mixed during a transfusion Why doesn’t the body of a pregnant woman reject the fetus
  • 4. Most case of MS in western people?
  • 5. Gen HLA class II  Alel HLA class II menjadi lebih rinci menjadi HLA-DRA, -DRB1, DRB -3, - DRB4, -DRB5, -DPA 1, dan HLA-DQA1, -DQB1  Pada perkembangan teknologi variasi HLA DRB1 terdapat 50 spesifisitas genom  Fisiologis HLA kelas II sama halnya dengan MHC kelas II, yaitu mempresentasikan antigen exogen, misalnya protein bakteri (bacterial peptide)
  • 8. Types of Multiple sclerosis 1. Relapsing Limiting MS (RRMS Ditandai dengan episode relaps atau eksaserbasi yang diikuti dengan episode remisi (perbaikan Relapsing Limiting MS (RRMS 2. Secondary progressif MS  tahap lanjut dari stage RRMS 3. Primary Progressive MS 4. Primary relapsing MS
  • 9. Medication 1. Deseases Modifying Agent Drugs a. Interferon beta b. Glatiramer asetat c. Fongolimod d. Natilzumab e. Metoxantrone 2. Simptomatik
  • 10. Drugs mecanism in theraphy MS
  • 11. Resources: • Campbell, Neil A. and Reece, Jane B. Biology. Benjamin Cummings., 6th edition. 2002. • Marieb, Elaine. Essentials of Human Anatomy and Physiology. Pearson Education Inc., 2000. • www.biology.arizona.edu/immunology/tutorials/immunology/main.html • www.biologymad.com • www.cdad.com/nih/immune2/index.html • www.hhmi.org/biointeractive/disease/animations.html • www.mayoclinic.com • www.micro.msb.le.ac.uk/MBChB/2a.html • www.ncbi.nlm.nih.gov/ • www.niaid.nih.gov/publications/autoimmune/autoimmune.html • www.northarundel.com/aniplayer • www.ntri.tamuk.edu/immunology/blood.html • www.nci.nih.gov/sciencebehind/immune/immune00.html • www.whfreeman.com/kuby/index.html

Editor's Notes

  1. Menurut National Multiple Sclerosis Society, kira-kira 400,000 orang Amerika tercatat menderita MS, dan pada setiap minggunya sekitar 200 orang didiagnosis MS. Di seluruh dunia, MS mungkin diderita 2.5 juta individu. Umumnya serangan terjadi dalam dekade ketiga dan keempat, walaupun penyakit ini bisa mulai dalam masa kanak-kanak dan juga di atas usia 60 tahun. Secara keseluruhan, MS terjadi lebih sering pada wanita dibandingkan laki-laki, dengan perbandingan adalah kira-kira 2:1
  2. HLA DRB1 terdapat 50 spesifitas genom
  3. Human Leukosit antigen kompleks yang memiliki fungsi biologis HLA sama dengan MHC, memproses dan mempresentasikan antigen eksogen e.g virus, bakteri
  4. Natalizumab blocks the attachment of lymphocytes to vascular cell adhesion molecule (VCAM) in inflamed blood vessels. Interferon- (IFNb) blocks metalloproteinases 2 and 9, which impairs diapedesis. The inducible expression of class II molecules of the major histocompatibility complex is blocked by statins. Glatiramer actetate and altered peptide ligands (APL) interfere with T-cell recognition of myelin in the induced major histocompatibility complex (MHC) class II molecules. T-cell recognition of myelin leads to production of osteopontin (OPN) and interleukin 23 (IL-23), which have a pathogenic role in autoimmune demyelination. B cells are also blocked from entering the central nervous system by natalizumab. When they do gain entry they interact with complement to injure the myelin sheath. Tolerization of B cells can be accomplished with DNA vaccines.