MIEN DCH

KHONG AC HIEU
TS. Hoang Tien My
I. AI CNG
Vi khuan

Ky sinh trung Vi
rut

Vi nam

Sc e khang CT MDKH
MDH:Mddt &
Mdtb
C
THE
II. CAC YEU TO E
KHANG
KHONG AC HIEU
1. DA & NIEM MAC
Hang rao chong au tien cua
c the
1.1.Cac VSV thng tru:
- Canh tranh s dung chat dinh
dng
- Tiet ra cac acid beo, ion H
+

1.2.Cac yeu to e khang tren
bieu mo:
1.2.1. Nhng yeu to c hoc:
- S chuyen ong lien tuc cua
nhung mao tren be mat tb bieu
mo ho hap
- Phan xa ho, hat hi
- Dong chay cua nc mat,
nc tieu
- Mang nhay (b ng ho
hap)
1.2.2.Surfactans
- Giam sc cang be mat
- Ngan nga s bam dnh va loai
tr VSV
1.2.3. Lactoferrin
- Co trong dch tiet c the (b
sa me)
- Tac dung: hap thu cac ion Fe t
do
- Ngan chan s tang trng cua
VSV
1.2.4. Lysozyme
- Nc mat, nc bot va chat
nhay PQ
- Tac dung lam v Peptidoglycan
VK Gr(+)
1.2.5. Tallow
- Chat beo do tuyen mo hoi tiet ra
- Tac dung diet nam
1.2.6. Acid
- HCl dch v, pH acid am ao
- Chong lai s tang trng va
nh c VSV
2. BO THE (Complement)
2.1.nh ngha:
BT la 1 he thong enzyme rat phc
tap gom nhieu thanh phan t C
1

en C
9

2.2. Nguon goc: chu yeu t tb nhu
mo gan
(ngoai ra TB, tieu cau, tb
si)
2.3. Nguon cha: huyet tng,
huyet thanh




2.4.ac iem hoat ong:
Hoat ong theo kieu phan ng
day chuyen trong mot trat t
nhat nh, thanh phan trc sau
khi c hoat hoa lai co kha
nang xuc tac s hoat hoa cua
th. phan sau (Dong thac BT)
S hoat ong cua BT dien ra
theo 2 con ng:
Con ng co ien (Classical
pathway)
Con ng thay oi (Alternative
pathway)

2.4.1 C.ng co ien: phu thuoc
[m.dch]
Ngoai ra: CRP-VK, Peptidoglycan,
Endotoxin
2.4.2 C.ng thay oi: Mang tb
khac loai
Can yeu to B, D va Properdin
2.4.3 Hoat tnh cua BT:
+ Hoat tnh lam tan tb (quan trong
nhat)
+ Hoat tnh phan ve: C
3
a va C
5
a
+ Hoat tnh hoa ng ong
+ Hoat tnh mien dch ket dnh
+ Hoat tnh huy ong bach cau
CON NG CO IEN CON NG
THAY OI
C1 C3
C4,C2 B, D factor
[C4b2b] C3 C3 [C3bBb] Properdin
C3a C3a
C3b [C4b2b3b] [C3bBb3b] C3b

C5
C5a
C5b
C6,C7,C8,C9


TB B LY GIAI

C5b-C9
3. AI THC BAO (Macrophage)
Phan bo cac to chc c the
Bao ve c the: bat, nuot va tieu
vi sinh vat
Hien tng thc bao (dang
hat)
Hien tng am bao (dang
hoa tan)
Hien tng thc bao: 3 giai oan
G bam : VSV bam len be mat
TB
G nuot : Phagosome + Lysosome
G tieu : Enz. t Lysosome
Phagosome
VSV ton tai trong Phagosome NT
noi bao
4. BACH CAU AI TOAN (Eosinophil)
Hat trong tb chat cha: Major basic
protein
Cationic protein

Huy hoai mang ky sinh
trung
KST hoat hoa he BT theo con
ng thay oi nhng lai e
khang vi C
9
C
3
b gay mien dch ket dnh hoat
hoa BC
ai toan tieu diet
KST

5. TNH GAY OC TB GAN TB
KHONG .HIEU
(Non-specific cell bounding
cytotoxicity)
ong vai tro quan trong trong viec
nhan dien sm va loai bo cac tb
b nhiem virut, vi khuan, tb ung th
Co vai tro trong phan ng loai
bo manh ghep (ghep tuy xng,
ghep tim, than)
Bao gom: BC n nhan, BC a nhan
va Lympho bao hat ln
Tb diet va Tb diet t nhien
6. S SAN XUAT CAC CHAT
HOAT MACH
Histamin & Leucotrienes
*Lam dan mach ngoai bien
*Giup bach cau xuyen mach
7. C-REACTIVE PROTEIN (CRP)
La yeu to xuat hien sm trong
huyet thanh
Giup chan oan sm benh
nhiem trung
[CRP-VK] hoat hoa he BT theo con
ng co ien
8. INTERFERON (IFN)

Glycoprotein 20.000 40.000
Tao ra t tb ngi hoac V nhiem
virut
Ngoai ra: TB, nguyen bao si,
lympho bao
Phan loai: , , IFN
Co tnh ac hieu loai
C che: ngan chan s dch ma
cua virut



Hoat ong cua IFN:

Ngan chan s sao chep cua virut
trong tb
IFN c che s dch ma protein
virut bang cach tong hp 3
protein:
2,5 olionucleotide synthetase
Endonuclease
Protein kinase

IFN tao ra ngi th tac dung tot
ngi
IFN khong tac ong trc tiep cac
phan t virut ngoai tb
IFN xuat hien sm vai gi sau khi
virut sao chep ngan chan c
s lan tran virut
IFN kch thch tb diet t nhien
IFN kch thch hoat ong cua TB
IFN co the chong c vai loai
ung th
IFN dung ieu tr viem gan man
tnh do HBV va HCV