perio

1. IMMUNITY
By- Dr. Shilpa Bagal
MDS 1st Year
Dept. of Orthodontics and Dentofacial orthopedics

2. • INTRODUCTION
• IMMUNITY(INNATEANDACQUIRED IMUNITY)
• MECHANISMS
• ANTIGEN
• ANTIBODIES
• ANTIGENANTIBODY REACTION
• IMMUNOGLOBULIN
• STRUCTURE OF IMMUNE SYSTEM
• THE COMPLEMENT SYSTEM
• HYPERSENSITIVITY
• AUTOIMMUNIY
• KEY POINTS
CONTENT

3. The study of immunology, a broad field encompassing both
basic research and clinical, deals with host defense reactions to
foreign entities known as antigens, antigen recognition
molecules and cell mediated host defense functions especially
as they relate to immunity to disease, hypersensitivity,
autoimmunity, immunodeficiency and transplantation
INTRODUCTION

4. Immunity
Innate Immunity Acquired Immunitay
Also known as Non-
adaptive , non specific
and natural immunity
Also known as Adaptive
Immunity, specific
immunity

5. Innate Immunity
Humoral
immunity
Cellular
immunity
Comprised by
complement
Consist of
neutrophils,
macrophages and
natural killer cell

6. Mechanism Of Innate Immunity
Epithelial surfaces
Inflammation
Cellular factors
Acute phase proteins
Fever
• Skin
• Respiratory tract
• Intestinal tract
• Genitourinary tract
• Chemotaxis
• Attachment
• Ingestion
• Intracellular killing

7. Acquired
Immunity
Active
immunity
Passive
immunity
Natural
Through
Clinical or
subclinical
infection
Artificial
Induced by
vaccination
Natural
Through
Transplacental
maternal IgG
antibodies
Artificial
Through
antiserum
injections

8. ANTIGEN
An antigen is a substance which ,
when introduced into a body evokes
immune
specific
response
antibody
to produce a
with which it
reacts in an observable manner.

9. Types of antigen
Complete antigen Haptens
These are substances which
can induce
formation
and can
antibody
by themselves
react specifically
with these antibodies.
Haptens are substances
unable to induce antibody
formation on its own but
can become immunogenic
(capable of inducing
antibodies) when covalently
linked to proteins, called
carrier proteins.

10. ANTIBODIES
Antibodies are substances which are
formed in the serum and tissue fluids
in response to an antigen and react
with that antigen specifically and in
some observable manner.

11. STRUCTURE OF IMMUNOGLOBULIN

13. IMMUNOGLOBULIN
CLASSES

14. IgG
IgA
IgM
IgD
IgE

15. Immunoglobulin G

16. Immunoglobulin A

17. Immunoglobulin M

18. Immunoglobulin D

19. Immunoglobulin E

20. ROLE OF DIFFERENT
IMMUNGLOBULIN
IgG - protects the body fluids
IgA- protects the body surfaces
IgM - protects the blood stream
IgE - mediates reaginic
hypersensitivity
IgD - recognition molecule on the
surface of B lymphocytes

21. ANTIGEN AND ANTIBODY
REACTION

22. COMPLEMENT
SYSTEM
It refers to a system of some non specific
proteins present in normal human and
animal serum , which are activated by
antigen antibody reaction and leads to a
number of biological significant
consequences.

23. COMPONENTS OF COMPLEMENT
SYSTEM
C1
C2
C3
C4
C5
C6
C7
C8
C9

24. CLASSICAL PATHWAY

27. ALTERNATE PATHWAY

28. STRUCTURE OF
IMMUNE SYSTEM

29. ORGANS OF IMMUNE SYSTEM
Primary lymphoid
organ
Secondary lymphoid
organ
• THYMUS
• BONE
MARROW
• LYMPH NODE
• SPLEEN
• MUCOSAASSOCIA
TED
LYMPHOID ISSUE
LOCATED IN
RESPIRA
TORY TRACT
AND GIT

30. CELLS OF IMMUNE SYSTEM
LYMPHOCYTES
MACROPHAGES
MONOCYTES
MAST CELL &
BASOPHILS
EOSINOPHIL
NEUTROPHIL

31. CELLS FUNCTION
1. Lymphocytes (20-50%) Master of immune system
i) B-cells (10-15%) Antibody-based humoral reactions,
transform to plasma cells
a) Plasma cells Secrete immunoglobulins
ii) T-cells (75-80%) Cell-mediated immune reactions
a) T-helper cells (CD4+) (60%) Promote and enhance immune
reaction by elaboration of cytokines
b) T-suppressor cells (CD8+) (30%) Suppress immune reactions but are
directly cytotoxic to antigen
c) NK-cells (10-15%) Part of natural or innate immunity;
cause antibody-dependent cell-
mediated cytotoxicity (ADCC)

32. CELLS FUNCTION
2. Monocytes-macrophages
(~5%)
Antigen recognition
Phagocytosis
Secretory function
Antigen presentation
3. Mast cells and basophils (0-
1%)
Allergic reactions
Wound healing
4. Neutrophils (40-75%) First line of dense against
microorganisms and other small
antigens
5. Eosinophils (1-6%) Allergic reactions
Helminthiasis

33. HYPERSENSTIVITY
REACTION

34. Feature Type I (anaphylactic, atopic)
Definition Rapidly developing immune
response in a previously
sensitized person
Peak action time 15-30 min
Mediated by IgE antibodies
Etiology Genetic basis, pollutants, viral
infection
Examples 1 systemic anaphylaxis
2 local anaphylaxis

36. Feature Type II (CYTOTOXIC)
Definition Reaction of humoral
antibodies that attack cell
surface antigens and cause cell
lysis
Peak action time 15-30 min
Mediated by IgG/IgM antibodies
Etiology HLA linked, exposure to
foreign tissue
Examples 1 cytotoxic antibodies to
blood cell
2cytotoxic antibodies to tissue
components

38. Feature Type III (Immune complex,
arthus reaction)
Definition Result from deposition of
antigen antibody complexes
on tissues
Peak action time Within 6 hours
Mediated by IgG/IgM antibodies
Etiology Persistence of low grade infection,
environmental antigens,
autoimmune response
Examples 1 immune complex
2drug induced vasculitis
3 collagen diseases

40. Feature Type IV (delayed
hypersenstivity)
Definition Cell-mediated slow and
immune response
Peak action time After 24 hours
Mediated by Cell mediated
Etiology CD8 + T cells, cutaneous
antigens
Examples 1) Reaction against
a) Tumor cell
b) Virus infected cell
c) Microbacterial antigen

42. AUTOIMMUNITY

43. Autoimmunity is a
body produces
condition when the
autoantibodies and
immunologically competent T-lymphocytes
against its own tissues. This leads to
structural or functional damage of tissues.
Autoimmunity literally means 'protection
against self' , while it leads to development
of 'injury to self ' .

44. CLASSIFICATIONS OF
AUTOIMUNITY
HEMOCYTOL
YTIC
DISEASE
LOCALIZED OR ORGAN
SPECIFIC DISEASE
SYSTEMIC DISEASE

45. TYPE DISEASE AUTOANTIBODY
Haemocytolytic
diseases
Autoimmune
haemolytic anaemia
1. Anti-red blood cell
antibodies.
Idiopathic
thrombocytopenic.
purpura
2. Antiplatelet
antibodies

46. Localised or Organ
specific diseases
1. Grave's disease
2. Hoshimoto's
thyroiditis
3. Myasthenia gravis
4. . Pernicious anaemia
5. Addison's disease
6. Chronic active
hepatitis
7. Sympathetic
ophthalmia
I. Anti-TSH receptor
autoantibody
2.Antibodies to
thyroglobulin and to
microsomal antigens
3. Antiacetylcholine
antibodies
4.Antibody to gastric
parietal cells and to
vitamin B-12 binding
site of intrinsic factor
5. Antibodies to Adrenal
cells
6.Antinuclear
antibodies;
antihepatocyte antibodies
7. Antibody to uveal or
retinal tissue

47. Systemic diseases
(non-organ
specific)
Rheumatoid
arthritis
Antigammaglobulin
antibodies
2. Systemic lupus
erythematosus
2 . Antinuclear (anti
DNA)
antibodies
3. Goodpasture's
syndrome
3. Antibasement
membrane

48. CORONAVIRUS
(COVID-19)

49. • Coronaviruses (CoV) are a large family of
viruses that cause illness ranging from the
common cold to Middle East Respiratory
Syndrome (MERS-CoV) and Severe Acute
Respiratory Syndrome (SARS-CoV).
• Transmision : Droplets Infected droplets
can spread 1–2 mm and deposit on surfaces.

50. • The types of COVID-19
that have been labelled as
variants of concern are
• Beta: first detected in
SouthAfrica
• Gamma: Brazil
• Delta: India
• Omicron: SouthAfrica
COVID 19
VARIANTS

51. TREATMENT (CORONAVIRUS)
• It is essentially supportive and symptomatic.
• First step to treatment  ISOLATION
• Mild illness  managed at home with
COUNSELLING.
• Antibiotics and antifungals are avoided in confirmed
cases (only given in cases of coinfection).

52. • Drugs introduced for COVID 19
 Ramedesvir
 Arbidol
 IV immunoglobulin
 Interferon
 Chloroquoine

53. VACCINES
• Covid‐19 vaccines based on attenuated SARSCoV‐ 2
virus
– Sinopharm ‐CorV Covid‐19 vaccine
– SinoVac - CoronaVac Covid‐19 vaccine
– Bharat Biotech -Covaxin Covid‐19 vaccine
– Oxford‐AstraZeneca Covid‐19 vaccine
– Janssen.CoV2.S Covid‐19 vaccine
– Gamaleya Sputnik V Covid‐19 vaccine

54. • Covid‐19 vaccines based on RNA
Moderna mRNA‐1273 Covid‐19 vaccine
BioNTech – Pfizer BNT162b2 Covid‐19 vaccine
• Covid‐19 vaccines based on subunit particles
Novavax NVX‐CoV2373 Covid‐19 vaccine

55. KEY POINTS
The specific reactivity induced in a host following an
antigen stimulus is known as the immune response.
A single antibody forming cell or clone produces
antibodies directed against a single antigen or antigenic
determinant only and such antibodies are called
monoclonal antibodies. Hybridoma technique is used to
produce monoclonal antibodies.

56. Immunological tolerance is defined as a state in which
contact with an antigen specifically abolishes the
capacity to mount an immune response against that
particular antigen when it is administered subsequently,
the immune reactivity to other antigens being unaffected.
These immunodeficiency diseases may involve specific
immune functions- Humoral immunity, cell mediated
immunity or both-or nonspecific mechanisms such as
phagocytosis and complement.

57. Hypersensitivity reactions are mainly of four types : type
I (anaphylactic) , type II (cytotoxic), type Ill (immune
complex) and type IV (delayed or cell mediated).
Type I, II and III depends on the interaction of antigen
with humoral antibodies and are known as immediate
type reactions. Type IV reaction is mediated by T-
lymphocytes .
lgE is involved in type I hypersensitivity reaction. Type I
reactions occur in two forms, the systemic form called
anaphylaxis and the localised form called atopy.

58. 1. Harsh Mohan: Textbook of General Pathology
2. Davidson's Medicine: PrinciplesAnd Practice Of Medicine
3. Dr CPBaveja : Textbook of Microbiology
4. Robbins basic pathology 10th edition
5. https://www.ada.org/resources/research/science-and-research-
institute/oral-health- topics/hepatitis-viruses

59. THANK
YOU