This document contains lecture notes on clinical immunology from Walter Wakhunu Waswa of North Coast Medical Training College. It covers various topics including: - Classification of the immune response into innate and acquired systems. - Types of hypersensitivity reactions including anaphylaxis, urticaria, hay fever, and asthma. - Autoimmune diseases where the immune system attacks the body's own tissues, listing various conditions. - Immunization methods including active immunization through vaccination and passive immunization through antibody transfer.

1. North Coast Medical Training College
AN INTRODUCTION TO
CLINICAL
IMMUNOLOGY
WALTER WAKHUNU
WASWA,BSC.MLS,MSC.MED.EDU.

2. Classification of the immune response
Body Immune
System
Innate
Epithelium WBC Ab
Acquired
Active Passive
WALTER WAKHUNU
WASWA,BSC.MLS,MSC.MED.EDU.

3. WALTER WAKHUNU
WASWA,BSC.MLS,MSC.MED.EDU.

4. Hypersensitivity/allergy dses
1. ANAPHYLAXIS
2. URTICARIA
3. HAY FEVER
4. ASTHMA
WALTER WAKHUNU
WASWA,BSC.MLS,MSC.MED.EDU.

5. anaphylaxis
• triggered by sensitivit to substances like
penicillin,peanuts or latex rubber
WALTER WAKHUNU
WASWA,BSC.MLS,MSC.MED.EDU.

6. Hay fever
• Atopic/immediate hypersensitivity to to
foreign poteins eg pollen mites animal
dander=
WALTER WAKHUNU
WASWA,BSC.MLS,MSC.MED.EDU.

7. asthma
• INHERITED IgE
Outcome
• Responsive imm.rxn to allergen
• Outcome=inflamation of the airways
• Obstraction of the airways=bronchioles
• Secretion of mucous
• Bronchoconstriction
• Dyspenea
• Wheezing
WALTER WAKHUNU
WASWA,BSC.MLS,MSC.MED.EDU.

8. AUTOIMMUNE DISEASES
• When the immune response
fail to recognize its own tissues
1. alopecia areata
2. autoimmune hemolytic
anemia
3. autoimmune hepatitis
4. dermatomyositis
5. diabetes (type 1)
6. some forms of juvenile
idiopathic arthritis
7. glomerulonephritis
8. Graves’ disease
9. Guillain-Barré syndrome
10. idiopathic thrombocytopenic
purpura
11. myasthenia gravis
12. some forms of myocarditis
13. multiple sclerosis
14. pemphigus/pemphigoid
15. pernicious anemia
16. polyarteritis nodosa
17 polymyositis
18. primary biliary cirrhosis
19. psoriasis
20. rheumatoid arthritis
21. scleroderma/systemic sclerosis
22. Sjögren’s syndrome
23. systemic lupus erythematosus
24. some forms of thyroiditis
25. some forms of uveitis
26. vitiligo
27. granulomatosis with polyangiitis
WALTER WAKHUNU
(Wegener’s)
WASWA,BSC.MLS,MSC.MED.EDU.

9. Rheumatoid athritis
• Ab to synovial membranes
• principally attacks flexible
(synovial) joints
• inflammatory r around the joints
• swelling of synovial cells,
• excess synovial fluid,
• development of fibrous tissue in
the synovium.
• destruction of articular cartilage
and ankylosis (fusion) of the
joints.
• RA can also produce diffuse. WALTER WAKHUNU
WASWA,BSC.MLS,MSC.MED.EDU.

10. Hashimoto’s dse
• Ab to thyroglobulin
=hypothyroidism causing
inflammation and, in most
cases, eventual destruction of
the gland.
• Outcome
• fatigue, weight gain, pale or
puffy face, feeling cold, joint
and muscle pain, constipation,
dry and thinning hair, heavy
menstrual flow or irregular
periods, depression, a slowed
heart rate, and problems
getting pregnant and
maintaining pregnancy. WALTER WAKHUNU
WASWA,BSC.MLS,MSC.MED.EDU.

11. Grave’s dse
• Ab to thyroid
cells=hyperthyroidsm/goit
er
• Outcome
• such as increased
heartbeat,
• muscle weakness,
• disturbed sleep,
• irritability.
• causing bulging eyes
WALTER WAKHUNU
WASWA,BSC.MLS,MSC.MED.EDU.

12. Autoimmune haemolytic anaemia
• Ab to rbcs
• Outcome
• Abnormal and accelerated
destruction of red cells and, in some
anemias, their precursors
• Increased breakdown of
hemoglobin, which may result in:
increased bilirubin level (mainly
indirect-reacting) with jaundice
• increased fecal and urinary
urobilinogen
• Hemoglobinemia,
methemalbuminemia,
hemoglobinuria and
hemosiderinuria
WALTER WAKHUNU
WASWA,BSC.MLS,MSC.MED.EDU.

13. myasthenia
• Women
• 20-40yrs
• Ab bind and block
acetyl choline receptors
of neuromuscular
junction
• =extensive muscle
weakness
WALTER WAKHUNU
WASWA,BSC.MLS,MSC.MED.EDU.

14. Diabetes type 1
• A condition in which the
immune system
destroys insulin-producing
cells of the
pancreas, making it
impossible for the body
to use glucose for
energy.
• Type 1 diabetes usually
occurs in children and
young adults.
WALTER WAKHUNU
WASWA,BSC.MLS,MSC.MED.EDU.

15. vitiligo
• A disorder in which the
immune system
destroys pigment-making
cells called
melanocytes. This
results in white patches
of skin on different
parts of the body.
WALTER WAKHUNU
WASWA,BSC.MLS,MSC.MED.EDU.

16. Immunodeficiency
• Immunodeficiency (or immune deficiency) is a state in which
the immune system's ability to fight infectious disease is
compromised or entirely absent
• Prone to infectious diseases
CAN BE
• PRIMARY/inborn /congenital
• Hereditary and X-LINKED
– Lymphocyte deficiency
– Granulocytes deficiency
•
WALTER WAKHUNU
WASWA,BSC.MLS,MSC.MED.EDU.

17. WALTER WAKHUNU
WASWA,BSC.MLS,MSC.MED.EDU.

18. SECONDARY/acquired
1. malnutrition.
2. aging .
3. diseases directly or indirectly
cause immunosuppression
many types of cancer,
particularly those of the bone
marrow and blood cells
4. leukemia,
5. lymphoma,
6. multiple myeloma
7. acquired immunodeficiency
syndrome .
8. HIV directly infects a small
number of T helper cells, and
also impairs other immune
system responses indirectly.
• particular medications.
chemotherapy,
• disease-modifying antirheumatic
drugs,
• immunosuppressive drugs after
organ transplants,
glucocorticoids. For medications,
the term immunosuppressant
generally refers to both beneficial
and potential adverse effects of
decreasing the function of the
immune system, while the term
immunodeficiency generally
refers solely to the adverse effect
of increased risk for infection
WALTER WAKHUNU
WASWA,BSC.MLS,MSC.MED.EDU.

19. IMMUNIZATION
ACTIVE
ATTENUATED/
WEAKENED
INACTIVE/K
ILLED
GENETICALL
Y
ENGINEERE
D
TOXOID
PASSIVE
GAMMA
GLOBULIN
BOOSTERS
WALTER WAKHUNU
WASWA,BSC.MLS,MSC.MED.EDU.

20. Active immunization
• 1. Active Immunization (= Immunization
or Vaccination)
• a. Active Immunization Defined - a
person's own immune system is stimulated
• b. Vaccine Defined - an agent containing
antigen capable of inducing active immunity
without causing disease;
WALTER WAKHUNU
WASWA,BSC.MLS,MSC.MED.EDU.

21. passive
• a. Defined - Ab's from an immune person or
animal are transferred to a patient; like an Ab
transfusion!
WALTER WAKHUNU
WASWA,BSC.MLS,MSC.MED.EDU.

22. reflection
• Why do you think innate immunity
is not sufficient enough to fight
infectious diseases?
• The reason above gives us the role
of adaptive immunity.
• What would be the effect of
defective adaptive
immunity?=suscptibility to dses.
WALTER WAKHUNU
WASWA,BSC.MLS,MSC.MED.EDU.

23. How is immunity induced
to an individual?
WALTER WAKHUNU
WASWA,BSC.MLS,MSC.MED.EDU.

24. ANSWER
1. By infection
2. Vaccination (active immunity)
3. Transfer of ab or lymphocytes
from an actively immunized
individual (passive immunity)
eg?
WALTER WAKHUNU
WASWA,BSC.MLS,MSC.MED.EDU.

25. cont
4.New borns accquire ab frm
their mothers through the
placenta and milk.
-shortlived before the child is
active immunized.
WALTER WAKHUNU
WASWA,BSC.MLS,MSC.MED.EDU.

26. Immunocompromised states
• inborn
• congenital primary
• acquired
• AIDS
• CHEMOTHERAPY
• IRRADITIATION
secondary
WALTER WAKHUNU
WASWA,BSC.MLS,MSC.MED.EDU.

27. ASSIGNMENT FOR THE GROUPS
• GROUP 1:GET IMAGES
OF
IMMUNOCOMPROMISE
D PATIENTS
• GROUP2:GET
INFORMATION ON
IMMUNOCOMPROMISE
D CHILDREN
• GROUP3:GET
INFORMATION ON
IMMUNOCOMPROMISED
FEMALE PATIENTS
• GROUP 4:GET
INFORMATION ON
IMMUNOCOMPROMISED
MALE PATIENTS
ALL THE ABOVE INFORMATION SHOULD BE IN POWERPOINT AND
SHALL BE PRESENTED AFTER TWO DAYS
WALTER WAKHUNU
WASWA,BSC.MLS,MSC.MED.EDU.

28. Compliment system
Compliment system
The outcome
WALTER WAKHUNU
WASWA,BSC.MLS,MSC.MED.EDU.

29. INITIATION Compliment
system
1.Classical pathway =triggered by the Ab-Ag complex
2.Alternative pathway =triggered by the microbe ie
cell wall endotoxins&OTHER COMPONENTS
3.Lectin mannose pathway=TRIGERED BY MANNOSE
RESIDUE ON THE MICROBES
WALTER WAKHUNU
WASWA,BSC.MLS,MSC.MED.EDU.

30. OUTCOME OF THE COMPLIMENT
SYSTEM
INFLAMATION
PHAGOCYTOSIS
LYSIS OF THE MICROBE
WALTER WAKHUNU
WASWA,BSC.MLS,MSC.MED.EDU.

31. Outcome of tissue injury
TISSUE
INJURY
INFLAMATION
COMPLIMENT
ACTIVATION
opsinization
HYPERSENSITIVITY
INDUCED MAST
CELL
prostaglandin
HISTAMINE
ANAPHYLAXIS
VASCULAR PERMEABILITY
Vascular effect
WALTER WAKHUNU
WASWA,BSC.MLS,MSC.MED.EDU.

32. Opsonization
•What do you think would
be the role of opsonin?
• you can imagine the stick
thing for grabbing.
• Sticky thinks are easy to
grab. WALTER WAKHUNU
WASWA,BSC.MLS,MSC.MED.EDU.

33. COMPLIMENT SYSTEM
• What is the immunological relevance of the
compliment system
• Enhances effectiveness of innate and adaptive
WALTER WAKHUNU
WASWA,BSC.MLS,MSC.MED.EDU.

34. Outcome f the compliment system
1. MAC=Lesion on the surface of the Ag
2. Inflamation= histamine
3. Vasodilation=vasodilators
4. chemotaxis chemicals=attract neutrophils
and macrophages into the region=site of
infection
5. Opsonization =cell membranes of Ag bcomes
sticky easier to be done wat?
WALTER WAKHUNU
WASWA,BSC.MLS,MSC.MED.EDU.

35. INDIVIDUAL ASSIGNMENT
INTERFERON
• What are they?
• When are they released
DEADLINE:AFTER TWO DAYS
WALTER WAKHUNU
WASWA,BSC.MLS,MSC.MED.EDU.

36. opsonin
• Substance that bind to particulate antigen and
induce their phagocytosis by macrophages
and neutrophils
Substances
1) Opsonising antibodies
2) Compliment proteins
WALTER WAKHUNU
WASWA,BSC.MLS,MSC.MED.EDU.

37. • STORY TIME
• Once upon a time, there was no malaria in
Manda Island
• Every inhabitant lived and slept comfortably
with little or minimal covering
• The main inhabitant were fishermen
• Then one day Abdul,a villager of Manda island
decided to visit the mainland.
• That day it the waves were so strong and he
couldn’t return back.
WALTER WAKHUNU
WASWA,BSC.MLS,MSC.MED.EDU.

38. • So he slept on his boat till morning
• On waking up his whole body was itching and
some flying insect were biting him
• When the sea had calmed he went back to his
home
• After some days he fell sick
• Luckly for him he recovered
• After some weeks more bizarr insect kept biting
the community
WALTER WAKHUNU
WASWA,BSC.MLS,MSC.MED.EDU.

39. • People died of this mysterious disease
especially the children and pregnant women
and the elderly
• After three years the no of peaple dying of the
mysterious disease rapidly dwindle
• Why?
WALTER WAKHUNU
WASWA,BSC.MLS,MSC.MED.EDU.