Immunity

1. PRESENTED BY-
DR. SONAL KALE
PG-1st YEAR
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2.  Definition
 Functions
 Types of immunity
 Innate immunity
 Acquired immunity
 B and T cell immunity
 Line of defense
 Immunological disorders
 Hypersensitivity
 Autoimmune
 Immunodeficiency
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3. Is the state of having sufficient
biological defenses to avoid infection,
disease, or other unwanted biological
invasion.
It is the capability of the body to
resist harmful microbes from entering
it.
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4.  Destroy pathogens
 Detect and kill abnormal cells
 Remove dead cells and other debris from the
body
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5. Acquired Immunity Innate Immunity
(specific) (non-specific)
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6.  It comes because of genetic and
constitutional make up.
 It has no relationship with previous bacterial
infection and immunization.
 It acts as first line of defense against
infections, micro organisms, their products
before they cause a disease.
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7.  The various non-specific defense mechanisms
are present.
1.anatomical and physical barriers.
2.physiological and chemical
barriers.
3.biological barriers.
4.general barriers.
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8.  The barriers prevent the entry of pathogens
into the host.
 These include
Ex; skin, mucous membrane, coughing
and sneezing, etc.
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10.  The respiratory , GIT etc. lined by mucous
membrane.
 It blocks the micro organisms because of its
sticky nature.
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11.  The mechanical actions may help in
driving out the foreign particles that
enter the digestive and respiratory
system.
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12.  Human milk: this is very rich in anti
bacterial substances.
Ex: IgA, lacto feritin, neuraminic acid
etc. they fight against E.coli and
staphylococci.
 Secretion of the digestive tract: stomach
has microbicidal effect. This is due to the
presence of HCL in the gastric juice. This
HCL is secreted by oxyntic cell lining
stomach.
 Nasal secretion and saliva.
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13.  These includes mono nuclear phagocytic
system which was originally called reticulo
endothelial system(RES).
 Biological barriers include endocytosis.
 Endocytosis: it is the process in which cells
absorb materials from the outside of the
environment by engulfing them with their
cell membrane forming a vesicle called as
endosome.
Types: the absorbing of material
from the out side of the environment of cell
is commonly divided in to 2 types.
1.Phagocytosis
2.Pinocytosis
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14. The very young and very old are most
susceptible to infections.
Fetus is protected by placental barriers.
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15. ACQUIRED IMMUNITY
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16. Acquired Immunity
A. Naturally Acquired Active Immunity
B. Artificially Acquired Active Immunity
C. Naturally Acquired Passive Immunity
D. Artificially Acquired Passive Immunity
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17.  Naturally acquired active immunity is
obtained when a person is exposed to
antigens and develops a primary immune
response, which leads to immunological
memory.
 The immune system then responds by
producing antibodies and specialized
lymphocytes. Usually, the immunity is for
a long term.
 Examples, include measles, pox
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18.  This type of immunity is “natural”
because it is not induced by deliberate
exposure.
 Many disorders of immune system
function can affect the formation of
active immunity such as
immunodeficiency disorders.
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19.  Artificially acquired active immunity results
from vaccination or immunizations.
 Vaccination introduces specially prepared
antigens into the body and stimulates a
primary response against the antigen without
causing symptoms of the disease.
 These antigens are no longer able to cause
disease, but they are still able to stimulate
an immune. response.
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20.  Examples –
polio vaccine
cholera vaccine
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21.  Naturally acquired passive immunity
involves the natural transfer of antibodies
from a mother to a child.
 An expectant mother is able to pass some
of her antibodies to her fetus across the
placenta.
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22.  IgG is the only antibody that can pass
through the placenta.
 Passive immunity is also provided through the
transfer of IgA antibodies found in breast
milk that are transferred to the gut of the
infant, protecting against bacterial
infections, until the newborn can synthesize
its own antibodies.
 Generally, naturally acquired passive
immunity lasts only as long as the antibodies
are active, usually a few weeks or 6 months.
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23.  Artificially acquired passive immunity involves an
injection of antibodies into the body.
 It is a short-term immunization induced by the
transfer of antibodies, which can be administered
in several forms; as human or animal blood
plasma, as pooled human immunoglobulin for
intravenous (IVIG) or intramuscular (IG) use, and
in the form of monoclonal antibodies (MAb).
 Passive transfer is used prophylactically in the
case of immunodeficiency diseases, such as hypo-
gammaglobulinemia.
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24.  It is also used in the treatment of several
types of acute infections.
 Immunity derived from passive
immunization lasts for only a short period
of time.
 These antibodies come from an animal or
human who is already immune to the
disease.
 Examples- in tetanus, staphylococcal
poisoning.
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27. Third line defense
 Sometimes the second line of defense
is still not enough and the pathogen is
then heading for the body's last line of
defense, the immune system.
 The immune system recognizes,
attacks, destroys, and remembers each
pathogen that enters the body.
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28.  Unlike the first line and second line
defense the immune system
differentiates among pathogens.
 For each type of pathogen, the
immune system produces cells that
are specific for that particular
pathogen.
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29. Immunity is also classified according to the cells
involved:-
Humoral Immunity
Cellular Immunity
 This depends on coordinated activity of T & B
lymphocytes
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30.  The extracellular spaces are protected by
humoral immune response.
 In this the antibodies produced by B-cells
cause the destruction of extracellular
microorganisms , thus preventing the spread
of intracellular infection.
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31.  Once a pathogen enters a cell, it can no
longer be detected by the humoral immune
response ; instead, the cell-mediated
immune response must take over to kill the
infected cell before it can allow the virus or
bacteria to replicate and spread.
 T-cells recognize infected cells by interacting
with antigen.
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32. Humoral Immunity Cellular Immunity
Type of cells B-Cells T-Cell
Antibody Involvement Yes No
Location of pathogen Extracellular Intracellular
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33.  Immunity is the result of the action of two types
lymphocytes, the B lymphocytes and the T
lymphocytes.
 B cells produce antibodies that are secreted into the
blood and lymph.
 T cells attack the cells that have antigens that they
recognize.
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34. IMMUNOLOGICAL DISORDERS
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35. There are three types of immunological
disorders
1. Hypersensitivity
2. Autoimmune disease
3. Immunodeficiency
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36.  “Immune response that results in tissue
injury or other physiological changes are
called hypersensitivity (allergic) reactions”.
(Mellors, 1999)
 “ It is an abnormal reaction to any type of
stimuli”.
(Smeltzer, et al, 2004)
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37. Hypersensitivity reactions are classified into
four types:
 Type I: anaphylactic hypersensitivity
 Type II: cytotoxic hypersensitivity
 Type III: immune complex hypersensitivity
 Type IV: cell mediated hypersensitivity
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38. Type I: Anaphylactic hypersensitivity:
 It is an immediate reaction beginning within
minutes of exposure to an antigen.
 It is mediated by IgE antibodies.
 It requires previous exposure to specific
antigen.
 It usually affects on skin, lungs and
gastrointestinal tract.
 Examples: Asthma
 Allergic rhinitis
 Systemic anaphylaxis.
 Atopic dermatitis
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39. Type II: cytotoxic hypersensitivity
 It occurs when the system mistakenly
identifies a normal constituent of the body as
foreign.
 This reaction may be a result of cross-
reacting antibody, possibly leading to cell and
tissue damage .
 It involves activation of complement by IgG
or IgM antibody binding to an antigenic cell.
Examples: Myasthenia gravis
Blood Transfusion reaction
Thrombocytopenia
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40. Type III: Immune complex hypersensitivity
 It involves in the formation of immune
complexes when antigen binds to antibodies.
 These type III complexes deposit in tissues or
vascular endothelium and leads to injury
with the help of vasoactive amines and the
increase number of circulating complexes.
 The joints and kidneys are particularly
susceptible.
Examples: Systemic lupus erythromatosus
Rheumatoid arthritis
Serum sickness
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41. Type IV: Cell mediated hypersensitivity
 Also known as cellular hypersensitivity.
 It occurs 24-72 hrs after exposure to an
allergen .
 The reaction is mediated by sensitized T cells
and macrophages.
 The reaction results in tissue damage by
releasing lymphokines, macrophages and
lysozymes.
 Examples: Contact dermatitis
 Tuberculin test
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42. A. Autoimmune diseases occur when the immune
system of the body responds to its own tissues
as if they were foreign.
B. May result from normal reactions to antigens
that are similar( though not identical) to the
host’s normal antigens.
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43. Autoimmune reactions occur over a
spectrum ranging from organ-specific to
widespread response not limited to any
one tissue
1. Grave’s disease (thyroid) and Insulin-
dependent diabetes mellitus (pancreas) are
organ specific
2. Lupus and rheumatoid arthritis are considered
widespread
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44.  AIDS
 Leukemia
 Viral hepatitis
 Multiple myeloma
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45.  Linear gingival erythema.
 Xerostomia
 Oral hairy leukoplakia
 Necrotizing ulcerative gingivitis
 Necrotizing ulcerative periodontitits
 Candidiasis
 Kaposis sarcoma
 Ulcerative diseases-apthous ulcers
-herpetic ulcers
(Perspective – Oral Manifestations Volume 13 Issue 5 December 2005/January
2006)
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46.  Paleness of the oral mucosa
 Gingival bleeding
 Gingival hyperplasia
 Petechiae
 Hemorrhages
 Ulcerative necrotic lesions
(Journal of IMAB - Annual Proceeding (Scientific Papers) 2013, vol. 19, issue 4, ORAL
SIGNS OF LEUKEMIA AND DENTAL MANAGEMENT – literature data and case report)
46

47.  Lichen planus
 Sjogren’s Syndrome
 Mucosal membrane pailness
 Bleeding disorders
 Petechiae
 Increased vulnerability to bruising,
 Gingivitis
(Journal of IMAB - Annual Proceeding (Scientific Papers) 2013, vol. 19, issue 4, ORAL
MANIFESTATIONS OF HEPATITIS C VIRUS)
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48.  Burning sensation in mouth
 Pain localized in the jaws or teeth
 Paresthesia
 Swelling
 Soft tissue masses
 Mobility of the teeth
 Migration of teeth
 Hemorrhage and pathologic fracture due to
osteolytic bone lesions.
(Oral Oncology EXTRA (2004) 40 13–15, Burning mouth syndrome as the initial sign of
multiple myeloma)
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49.  Tetanus
 The World Health organization has
recommended childhood immunization with
Tetanus vaccine (or TT containing vaccines) with
a 5 doses schedule .
 This included a 3 doses in infancy as DPT,
followed by booster at 4-7 year and another
dose at 12-15 years of age .
 However, the national immunization schedule in
Universal Immunization Program (UIP) in India,
recommends at least 7 doses of Tetanus vaccine
are administered in various combinations (3
doses of DPT in infancy, 2 booster doses at 16-24
months and 5-6 years of age, 2 TTs at 10 and 16
years of age).
 Adults get additional TT doses following injuries.
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50.  Antitoxin- tetanus antitoxin, such as tetanus
immune globulin is given. However, the
antitoxin can neutralize only toxin that hasn't
yet bonded to nerve tissue.
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51.  Antiretroviral therapy (ART) is treatment of
people infected with human
immunodeficiency virus (HIV) using anti-HIV
drugs. The standard treatment consists of a
combination of at least three drugs (often
called “highly active antiretroviral therapy”
or HAART) that suppress HIV replication.
Three drugs are used in order to reduce the
likelihood of the virus developing resistance.
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52.  The U.S. National Institutes of Health
recommends using one of the following
programs for people who begin treatment for
HIV:
 Efavirenz + tenofovir + emtricitabine
 Ritonavir-boosted atazanavir + tenofovir +
emtricitabine
 Ritonavir-boosted darunavir + tenofovir +
emtricitabine
 Raltegravir + tenofovir + emtricitabine
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53.  chemotherapy to kill leukemia cells using
strong anti-cancer drugs;
 interferon therapy to slow the reproduction
of leukemia cells and promote the immune
system's anti-leukemia activity;
 radiation therapy to kill cancer cells by
exposure to high-energy radiation;
 stem cell transplantation (SCT) to enable
treatment with high doses of chemotherapy
and radiation therapy;
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54.  The use of the drug ‘Bortezomib’,
administered intravenously is the most
important advance in reducing the myeloma
load rapidly.
 Thalidomide, Lenalidomide and
pomalidomide collectively called IMIDs
(Immunomodulatory drugs) are a group of
agents that can be used orally and are
extremely effective, especially when
combined with Bortezomib in treatment.
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55.  TOXICOLOGIC PATHOLOG, Volume 15, Number 3,
1987 , Structure and Function of the Immune
System* KEVIN T. SCHULTZ AND FRANZISKA
GRIEDER
 Oral Oncology EXTRA (2004) 40 13–15, Burning
mouth syndrome as the initial sign of multiple
myeloma.
 Journal of IMAB - Annual Proceeding (Scientific
Papers) 2013, vol. 19, issue 4, ORAL
MANIFESTATIONS OF HEPATITIS C VIRUS.
55

56.  Journal of IMAB - Annual Proceeding
(Scientific Papers) 2013, vol. 19, issue 4,
ORAL SIGNS OF LEUKEMIA AND DENTAL
MANAGEMENT – literature data and case
report.
 Perspective – Oral Manifestations Volume
13 Issue 5 December 2005/January 2006.
 Kennedy MA. A brief review of the basics
of immunology: the innate and adaptive
response. Vet Clin North Am Small Anim
Pract. 2010 May;40(3):369-79. doi:
10.1016/j.cvsm.2010.01.003.
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