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Miễn dịch học cơ sở
Miễn dịch học cơ sở
Miễn dịch học cơ sở
o~Ai
gpQ
IMNt
NH XUI BN I HC QC GIA H Ni
MIN DCH HC
C S
(In ln th ba, c sa cha v b sung)
Ill
Mc lc
27
27
31
37
37
43
44
IV
45
46
47
50
51
51
52
53
55
Chng V. B th
5 . 1. Khi nim
5 .2 . Cc protein ca b th
5.3. Cc tin trnh hot ho b th
5.3.1. Con ng hot ho c in
5.3.2. Con ng hot ho b th nh lectin MBL
5.3.3. Con ng hot ho bn cnh v cc yu t hot ho b th
5.3.4. Phc h tn cng mng (MAC)
5.4. Hiu qu sinh hc ca s hot ho b th
5.5. B th v cc c ch trn thot ca vi sinh vt
5.6. Cc h thng khc ca huyt tng tham gia vo cc c
ch bo v v c ch vim
5.7. Cc bnh l pht sinh do thiu ht b th bm sinh
Tm tt chng V
61
61
62
63
63
64
65
68
69
69
72
58
58
60
72
74
75
75
75
77
78
79
79
80
80
81
81
83
84
85
86
103
103
104
109
111
112
114
115
VI
116
121
121
122
122
123
127
129
130
133
119
133
134
134
134
136
136
137
138
139
140
140
140
147
147
148
148
152
153
153
VII
153
153
154
154
154
155
155
155
155
156
156
156
156
163
165
165
165
166
167
168
169
171
173
173
174
174
174
175
176
176
177
177
179
180
184
VIII
Tm tt chng XIII
192
195
195
196
196
197
200
204
205
208
209
211
211
212
214
215
215
216
216
218
Cu hi n tp min dch c s
Mt s dng cu hi min dch
221
226
Ph lc
Ph lc I. c im cu trc v chc nng ca cc khng
nguyn CD
Ph lc II. Gii ngha danh t min dch
231
233
339
275
Li gii thiu
1.1. n h n gh a v m in dch hc
Danh t Immunus theo ngha nguyn gc l: c min
gim. Tnh trng u tin min gim mt s bnh truyn nhim
nh bnh u ma (variole) bnh si (rougeole) v mt s bnh
khc v.v... c bit t lu nhng ngi b mc bnh mt
ln. Tt c c th sng cn c c tnh quan trng l nhn bit v
dung np nhng ci ca bn thn (Self), ng thi nhn bit v
thi b nhng ci khng phi ca bn thn (Nonself), xa l
vi c th. Min dch hc l mt mn khoa hc sinh hc v y hc
chuyn nghin cu cc qu trnh nhn bit cc cht l, gi l
khng nguyn (antigen) v hu qu ca s nhn bit , l s
p ng min dch (immune response). S nhn bit ny c c
l do kh nng tdng tc ca mt phc h cc t bo trong h
min dch ca c th ngi v ng vt.
1.2. L ch s n g h in cu m in dch hc
Min dch hc (Immunology) ngy nay tr thnh mt mn
khoa hc. Tuy ch mi tn ti khong trn 100 nm nhng s
ng gp ca n cho cc ngnh sinh hc ni chung v y dc hc
ni ring ngy cng thy r. Nhng pht minh ch yu trong
lnh vc nghin cu min dch hc theo thi gian c trnh by tm
tt nh sau:
Nm 1881: Nhng tng v tnh min dch (Immunity) ln
u tin c Luis Pasteur v Koch xng. Tip theo ,
hin tng thc bo (Phagocytosis) c Metchnikoff quan st
thy. K thut vacxin phng bnh di chnh thc c Luis
Pasteur p dng. Nm 1890, cc nh bc hc Von Behring v Eh-
Cc t chc ngoi t bo
Cc t chc trong t bo
t bo thc bo l cc t bo a nhn trung tnh (PNN: Polynuclear Neutrophil) chim t l cao trong cc bch cu ca mu.
T B Dgun tu
xng l i mi
Yu t hoi ho T B ngun
t
T B kbi thu dong lym pio
Erythropoietin
I L 3, G M -C S F. I L 1, IL 6
Throm bpoietn,
IL
Nguyn bo
bng cu C FU
Tln thn
T bo nhn bychcu
J _
khng l
M fai
Tin thn
bchcu
1LS
<>
V
Hng cu
Tiu cu
ch cu
Bch
a
k ir n
Bch cu
M il
Bch cu
(rng tinh
T B mono
10
11
12
13
14
cm tc th c gi l phn v, qu mn cm gy c do cc
phc h min dch, qu mn cm mun v qu mn cm kch
thch. Hin tng phn v c vai tr tham gia ca khng th lp
IgE v cu trc ca chng c lm sng t (Ishizaka).
1.3.6. Ci bn thn v khng phi bn thn (self, nonself)
H thng min dch cn phi nhn bit v phn bit c ci
bn thn v ci khng phi bn thn ngha l phn bit c
nhng cht l so vi c th v nhng cht do chnh c th sinh
ra. Tuy nhin trong nhng trng hp bnh l, c th c th sn
xut ra cc khng th chng li cc cht ca bn thn gy nn
bnh l. l cc trng hp ca bnh t min (autoimmune'
disease) c Ehrlich v Morgenoth (1902) pht hin ra.
1.3.7. Cc phn ng khng nguyn - khng th in vitro
Nh tnh c hiu phn ng min dch khng nguyn - khng
th v nhy ca n, cc k thut xt nghim min dch
c hnh thnh cho php nh lng cc cht nng
nanogam/ lt. l cc k thut kt ta min dch, ngng kt
min dch, phn ng c nh b th, khuch tn min dch,
phng php nh du min dch hunh quang v in di min
dch.
1.3.8. Cc loi p ng min dch v l thuyt la chn dng
Tt c cc p ng min dch din bin theo hai giai on ch
yu l nhn bit khng nguyn v phn ng loi b khng
nguyn. Trong p ng min dch c hiu, cc lympho m bo
cho giai on nhn bit, cn giai on nhn bit s to iu kin
cho mt qu trnh la chn dng (clonal selection). Mi mt t
bo T hoc B ch nhn bit mt khng nguyn ring bit, v ton
b, h thng min dch c th nhn bit c hiu hng nghn
khng nguyn v mi mt lympho ch nhn bit mt khng
nguyn. Do Burnet (1958) a ra l thuyt chn dng, theo
th mt dng t bo min dch ch c th sn xut ra mt kiu
khng th p ng li vi mt quyt nh khng nguyn nht
nh. L thuyt ny c lm sng t bng k thut lai t bo
15
16
S sinh sn v chn ca
t bo B c la chn
Cc khng th 2 c sn xut
Hnh 1.5 Theo l thuyt la chn dng, mi t bo sn xut khng th
(t bo B) c t chng trnh tng hp ch mt loi khng th
c mt di dng mt th th nm trn b mt t bo ca n tng tc
c hiu vi mt khng nguyn. Sau khi tip xc vi khng nguyn, t
bo B c kch thch, sinh sn v s bit ha thnh cc t bo plasma
tng hp ra cc khng th. Mt s t bo B khc c hiu vi khng
nguyn cho, khng bit ho v s tr thnh cc t bo ghi nh min
dch, c i sng lu di. (Theo I. Roitt et al, 1993)
18
Khng nguyn
> A <J
<1 ^
i'
T - c c h
Oi
T - hot ho T - gy c
di thc bo
'
&
T - b tr '
t bo B
U
r K h n g th 1
V
T b o K
i thc bo
c hot ho T- gy c 1 (ADCC)
C c t bo h u q u
1
--------
min dch qua trung gian t bo xy ra tip theo s trnh din khng
nguyn v s hot ho cc t bo T, c kim tra bng cc lympho T
c ch (suppressor T cell) v lympho T b tr (Helper T cell). Mt s t
bo T (cc t bo hot ho i thc bo) tit ra cc lymphokin hot ho
cc chc nng thc bo ca i thc bo v dit vi khun. Cc t bo T
gy c c hot ho bng khng nguyn cng VI s gip ca cc
t bo b tr v hp tc tip theo vi cc t bo B sn xut khng
th. Cc t bo K (Killer Cell) c th th mng c i lc cao lin kt VI
mnh Fc ca cc Ig, hip ng tc dng vi khng th phn hu t
bo ch b nhim khun, cn gi l ADCC (T bo gy c ph thuc
khng the: Antibody- dependent cell mediated Cytotoxicity). Cc t
bo NK phn ng khng cn tnh c hiu. (Theo I. Roitt et al, 1993).
T bao mast
20())
ai thue bcio
r
c
19
2.1. n h n g h a v k h i n im c h u n g v k h n g n g u y n
Thut ng khng nguyn (antigen, vit tt Ag) dng chi
mt cht c kh nng gy ra p ng min dch khi c a vo
c th ca mt ng vt thch hp hoc mt cht c kh nng
phn ng vi mt khng th hoc mt t bo ca h thng min
dch. Nh vy, tt c nhng cht t nhin hoc tng hp c h
thng min ch nhn bit u c gi l cc khng nguyn.
Khi mt khng nguyn xm nhp vo c th, cc lympho c th
nhn bit c hiu bng cch kt hp vi khng nguyn nh th
th c hiu. S nhn bit ny gy cm ng sinh sn lympho-B
v bit ha qun th t bo ny thnh cc t bo plasma c kh
nng sn xut khng th chng li khng nguyn xm nhp.
l p ng min dch th dch. p ng min dch cng c th
gy ra s xut hin qun th lympho-T min dch mang cc th
th c hiu vi khng nguyn. l s p ng min dch qua
trung gian t bo.
Tnh phn ng ca khng nguyn hoc kh nng nhn bit,
kh nng lin kt c hiu ca khng nguyn vi khng th hoc
vi th th ca t bo ph thuc vo mt phn cu trc gii hn
ca khng nguyn. Phn cu trc gii hn ny c gi l quyt
nh khng nguyn (antigenic determinant) hay epitop. cn phi
phn bit hai c tnh khc nhau ca cc epitop l tnh khng
nguyn (antigenecity) v tnh sinh min dch (immunogenecity).
Tnh khng nguyn l c tnh ca mt epitop c cu trc ba
chiu lin kt b sung vi phn cu trc ba chiu ca phn t
khng th. Phn cu trc ny ca phn t khng th hoc ca
th th c gi l paratop. Tnh min dch ca mt epitop l c
tnh gy ra mt p ng min dch trong mt c th. Trong
trng hp khng nguyn l cc protein, ngi ta c th nhn
20
2 .2 . P h n n g c h o
21
2.3 H a p ten v p r o te in m an g
C rt nhiu cht ha l c c phn t lng nh, phn cc
mnh c kh nng gy ra s tng hp mt khng th dc hiu
sau khi c kt hp vi phn t mang c kch thc ln hn.
Cc cht ha hc ny c gi l hapten v c COI l tng
dng vi nhng quyt nh khng nguyn tch ri. Cc hapten
c kha nng phn ng vi cc khng th c hiu ca chng. Mt
quyt nh khng nguyn thuc v mt i phn t t nhin
trong khi mt hapten cn phi lin kt VI mt phn t bng mt
phn ng ha hc c th gy cm ng sn xut mt khng
th. gy ra mt phn ng min dch in vivo, mt hapten cn
phi kt hp vi mt protein mang. V vy, ngi ta c th tng
hp nhng polipeptit nhn to c cu trc bit c th mang
mt hoc hai quyt nh khng nguyn. S kt hp ca hapten
v protein mang s to ra mt cu trc sinh min dch c t nht
hai quyt nh khng nguyn khc nhau.
2.4. T n h k h n g n g u y n c a c c c h t sin h tr n g hp
(b io p o ly m e r )
c tnh khng nguyn ca mt cht c xc nh bng s c
mt hay vng mt ca tnh sinh min dch. Ngi ta phn bit ra
cc loi khng nguyn sau y:
- Autoantigen c mt chnh bn thn mt c th.
- Alloantigen c trng cho cc nhm c th trong cng mt
loi.
- Isoantigen c mt tt c cc c th ca cng mt loi.
- Xenoantigen (heteroantigen) c mt cc c th ca nhng
loi khc nhau.
Cc cu trc cng khc nhau s cng biu hin tnh khng
nguyn r rt.
Protein: Hu nh tt c protein dng hnh si hoc hnh cu
u l nhng cht sinh min dch. Mc d protein l mt nhm
cht khng nguyn rt ln trong thin nhin, nhng do cu trc
v thnh phn ho hc ca chng rt phc tp nn vic hiu bit
cu trc khng nguyn ca cc protein cha c nhiu. Ch
trong mt s trng hp nh myoglobin, lyzozim v mt s virus
22
23
2.5. S th c h n g c a c c vi sin h v t b n g c c h c i
b i n c c k h n g n g u y n c a c h n g
Ngi ta cho rng ton b kho d tr cc peptit c nhn bit
bi cc lympho - T ca mt c th, ph thuc vo cu trc ca cc
phn t ca MHC v ph thuc vo c ch dung np i vi cc
peptit ca bn thn khi c s bit ha ca cc lympho - T. Nu
mt lympho - T ca h thng min dch c phn ng chng li cc
thnh phn ca bn thn th s a n tnh trng bnh t
min. Trong qu trnh pht trin ca h thYig min dch, khi cc
t bo T nhn bit thnh phn ca bn thn c th gy ra phn
ng i khng th lp tc qun th t bo T b loi b bi
chnh h thng min dch.
Cc vi sinh vt c th s dng nhng chin lc khc nhau
tu thot khi s nhn bit ca vt ch bng cch ci bin cc
peptit khng nguyn ca mnh. Chng c th bt chc cc cu
trc peptit ca c th vt ch. Nhng s ci bin ny ch c
xut hin nu vi sinh vt sng lu di trong vt ch. l
trng hp ca bnh nhim trng mn tnh. Cng tng t nh
vy, cc t bo ung th c th b ph hy bi h thng min dch
v chng hon ton khc l vi cc t bo bnh thng ca c th.
Tuy nhin trong mt s trng hp cc t bo ung th c th t
ci bin khng nguyn ca chng trn thot khi s ph hy
24
2.6. Im m u n o g e n v k h n n g p n g m i n d c h
Immunogen l mt khng nguyn c c hai tnh cht: tnh
khng nguyn v tnh sinh min dch. Tnh khng nguvn c
biu hin bng cc epitop c nhn dng v lin kt vi khng
th hoc vi th th ca khng nguyn. Tnh sinh min dch biu
hin kh nng p ng min dch to ra khng th hoc to
ra s p ng min dch qua trung gian t bo. Mt s' cht c
tnh khng nguyn nhng kch thc li qu nh khng th c
kh nng to ra p ng min dch. V d, 2,4D l mt cht kch
thch sinh trng cng c mt trong thuc tr su c khi lng
phn t rt nh khng th to ra c khng th khi gy min
dch. Mt vi peptit c phn t lng nh hn 3.000Da cng hu
nh khng to ra kh njig sinh khng th khi gy min dch.
Tuy nhin nhng cht trn khi kt hp vi cc prot.ein mang
(Carrier protein) s c kh nng tr thnh immunogen v p
ng min dch to khng th.
25
Tm tt chng II
27
28
29
30
Domain
Vng
lin kt
khng
nguyn
Ch2 C||3
31
32
33
(hnh 3.5). Nng IgD trong huyt thanh ngi khe rt thp
khong t 0,04mg * 0,05mg/ml
34
Domain
Mu ui
35
F (a b ),
pFc
C c p e p t it n h
IT
r
:cr . I
CLUJ
II-
PKPXIN
4L.
X
't
-&
V tr i c t t h c a p c a
p apain
PA PAIN
*****
\
Fc
36
IgM
Khng
IgA
IgA, Khng
c
IgA2
IgD
khng
gT
khng
1
L__
Nng
Chc nng sinh hc
trong
huyt
thanh,
mg/100 ml
150-170
800-1700 Nhn bit virus, vi
khun, c t'
Hot ho b th
Lin kt vi th th Fcy
Qua mng nhau thai
970, dng : 50-250 Xut hin u tin sau
pentame 9 : 60-270 khi kch thch Ag.
Dng
Ngng kt hng cu vi
monome
khun, virus.
trong
Lin kt vi Ag, hot ho
bnh
u
b th.
tu
160
0*100-400 Chng li vi khun, virus,
320, dng 9 : 85-450 nguyn sinh ng vt
nh c mt tuyn nhy.
dime
trong IgA
Hot ho b th theo con
tit v c
ng xen k.
dng
Tham gia vo opsonin ho
tetrame
khi phn ng vi th th
Fca
175
< 10
Ch yu tm thy t boj
B, c th khi tip xc vi
Ag, truyn tn hiu hot
ho t bo B
<0,03 Tham gia phn ng vim
190
d ng, qu mn khi lin
kt vi t bo mast
Khi
lng
phn t
37
3.3. M i q u a n h gi a cu tr c v ch c n n g c a c c
k h n g th
Chc nng u tin ca cc khng th l lin kt vi khng
nguyn c hiu vi chng, tham gia vo cc p ng min dch
dch th (trung ho cc c t vi khun v virus), p ng min
dch trung gian t bo (tham gia hin tng opsonin ho, to
iu kin bt gi v tiu ho khng nguyn, vi khun v.v...). S
hot ho b th l c ch c hiu qu quan trng nht ca cc
IgG v IgG:t. H thng b th l mt nhm cc phc h protein
huyt thanh tham gia vo phn ng vim. Sau khi lin kt vi
khng nguyn, cc IgM, IgG, IgG) c th hot ho mt dy cc
enzim ca b th. Trong khi cc IgG^ t c hiu qu ny. Cc
IgG,, IgA, IgD v IgE khng c kh nng hot ho b th.
ngi tt c cc IgG u vt qua hng ro nhau thai n
vi tr s sinh v thc hin chc nng min dch th ng. Cc
ng vt khc khng c kh nng ny tuy nhin sau khi sinh IgG
ca sa m s c truyn cho c th ng vt con mi sinh qua
ng tiu ho. Cc nghin cu v cu trc ca cc khu vc chc
nng v cc di n v chc nng ca cc Ig cho thy mi mt
n v cu trc l kt qu ca s tin ho ring bit theo chc
nng c hiu. Chng hn cc vng d bin i V|, V| l vng
lin kt vi khng nguyn, cn cc khu vc khc tr th cho cc
chc nng sinh hc ca khng the. Ngi ta cng bit rng cc
di n v C lq ca b th tng tc vi khu vc Cy2 (IgG) v
mt v tr kim tra s trao i cht ca cc phn t Ig nm cng
mt khu vc. Nhng tng tc i vi cc i thc bo v t bo
mono c c l nh v tr khu vc Cy3. Cc v tr gi ln nhau
ca 2 khu vc mnh Fc c th l Cy2 v Cy3 c hiu qu hip
ng tham gia tng tc vi cc th th ca cc t bo.
3.4. C s d i tr u y n v tn h a d n g c a k h n g th
Theo l thuyt la chn dng ca Jerne v Burnet, Dreyer v
Bennett t c s khoa hc gii thch tnh a dng cu trc
ca cc khng th. C 3 c ch cho php h thng min dch sn
xut ra cc vng d bin i V ca chui nng v chui nh cc
mc khc nhau:
38
39
40
Locus ch u n h X
V
_ LVv-a Jii
4*1
: * = = 4 i * = =
1 V *1
L ocuschui nh
t Vfl
12 V?
L 2 v *2
C*
J *4
m = = = = = m t= = = m t
K
13 v*3
L ocus ch u i n n g
V M1
J2
C *1
L V* -40
*
L3 Vm3
J-S
c,
f lH s 51 1
0*1-27
J h 1-
Chui nh
Chui nng
AND mm
: T~
Tlthp soma
~ r
ADN ni D-J
~ . r
....
Ti t hp soma
L
= .; r ~
V J
ADN ni VDJ
Sp xp li
- r
Phin m
Bn phin m
u tin ARN
I- v
-M h -
m ww
AAA
L V DJ.
Ct ni
m ARN
Phin dch
Cc chui
polypeptit ca Ig
\/
L
V-
\/
J
m t
AND mm.
C ch to vng cho ct ni cc manh gen.
C ch loi h cc mnh intron v exon khc*.
Lp gip cc minh gen ph hp c hot tnh cho vng bin i
41
nh* i l l l
IV
ADN mm
IV
D-
Tl t hp soma
ADN ni D-J
Ti t hp soma
VJ
~ -------Phin m
_____
Bn phin m u
tin ARN
0;
,
13 5
1
l V
n
= M
<
c
..... , ........
11
---- ------------ -
- f n 5 ii5 6 M
polypptii
T
. ..... i .. .
r ~ r ~ cp 0 \
w
mARN
Cc chui
calg
L V
L VM
Ct ni
________ 1
Bll
m
c
j a r t B
42
1.
L, V,
l* V*
Vr lr
= o * = = o e h = :* = =
2.
3.
.
Lt
4.
V,
-----------------------u
----------------------- L H K J --------------------------
V, J
t f l -
ADN mm.
C ch to vng cho ct ni cc mnh gen.
C ch loi b cc mnh intron v exon khc.
Lp gip cc mnh gen ph hp c hoat tnh cho vng bin
i
43
hp
44
KHNG NGUYN
k h n g th
d a dng
lym pho B
TB u tu
k h n g th
n d n g
45
3.7. Cc th th c a ly m p h o B (BCR )
Cc th th ca lympho B c to thnh t cc Ig c cu
trc ging nh mt phn t khng th ho tan nhng u
tn cng c ca cc chui nng c xuyn su vo mng t
bo lympho B. Vng xuyn qua mng t bo ca phn t Ig
c chiu di khong 20 gc axit amin v mt on ngn ca
trnh t tn cng c nm trong phn t bo cht. Cc BCR
ca lympho B chn bao gm mt IgM v mt IgD (mlgM,
mlgD) ca mng t bo, c mt chui nh ging nhau v cng
mt khu vc V||. Cc chui n v s l s ghp ni ca cng mt
bn sao |A-5. Cc Ig mng l nhng monome (i2L2 ) BCR ca
lympho B ghi nh khng cha ng mlgD ngha l ch gm
mt lp Ig (c th l mlgM, mIgG3 hoc mlgGl V..V..) ngoi
ra cc mlg ca lympho B cn kt hp vi mt heterodime
c hnh thnh t cc phn t Iga (CD79a) v IgP (CD79b).
Cc phn t Iga v IgP lin kt vi nhau bng mt cu disunfua nm ngoi t bo. Chc nng ca cc phn t Iga v
IgP l truyn dn tn hiu nh s kt hp ca BCR vi khng
nguyn c hiu. S nhn bit khng nguyn ny c thc
46
47
3.9. Cc du h iu protein b it ho t bo
Cc phn t protein bit ho ca mng t bo bch cu
c pht hin nh s dng cc khng th n dng nhn bit
tnh c hiu chng. Chng c t tn l du hiu protein
bit ho hoc cm bit ho (CD: Cluster of Differentiation) v
c nh s th t. Hin nay ngi ta pht hin c 314
CD (xem ph lc 1). Chc nng min dch, cu trc phn t, 8
biu hin trn b mt t bo v mi quan h h hng gia chng
rt a dng v phc tp. Mt s ln cc CD v ang c
nghin cu v ngun gc gen biu hin v chc nng min dch
cng nh bnh l nh: CD3, CD4, CD7, CDg, CD10 v.v...
Chng hn, CD3 biu hin cc t bo tuyn c (Thymocytes)
v cc t bo T, v cho php s biu hin ca TCR, ng vai tr
trong vic truyn tn hiu khi TCR tip xc vi mnh peptid
khng nguyn. CD3 l mt glycoprotein xuyn mng c 4 domain
ngoi bo, kiu dng Ig. CD4 c mt tt c cc lympho THcha
chn v biu hin 2/3 cc lympho T ngoi vi. Hai domain u
tn cng N ca CD< l v tr lin kt vi mt vng ca cc phn
48
49
(3 s>
V,.
S cc
50
gen to
ra tnh
a dng 70
cc
m nh a
Vu
57
12
S cc
gerc *o
ra m/i
a dng
cc
m nh p
'*I
>
&rY*3
tyj-0f2 4J.-A3 c*
Locus ca chui p
v - y
5*
cy
flllllH
0|i2
J|2 _ _
Cpv?
I Hl III
Locus ca chui Y
V-Vy
_J1_
Cr1
H N K |-|I IJ 4 H
C2
50
Tm tt chng III
51
4.1. M u
Nh chng ta bit cc chng trc, cc th th (recep
tors) nhn bit khng nguyn ca cc lympho B (BCR) s tng
tc theo khng gian vi cc epitop ca phn t khng nguyn.
Trong khi cc th th ca lympho T (TCR) tng tc vi cc
peptit ca khng nguyn c lin kt t trc vi cc phn
t ca phc h ph hp t chc ch yu (MHC - Major histocom
patibility complexes). Cc phn t protein ca phc h MHC
c m ho bi mt h thng gen ca phc h MHC nm trn
mng t bo trnh din khng nguyn APC (Antigen presenting
cell).
Vic pht hin ra cc sn phm protein ca MHC c tnh cht
ngu nhin v do tnh cc k a hnh ca cc phn t ny c mt
mi t bo ng vt. T ngi ta c th hiu r vai tr ca
chng trong qu trnh thi b cc mnh lai ghp. Khi nghin cu
c tnh ch't h thng s kim tra di truyn ca qu trnh thi b
cc khi u chut, Peter Gorer (1936) xc nh r cc khng
nguyn c m ho bi mt locus ca MIIC. Khng nguyn ny
c mt hng cu v cc t bo khc cho php kh nng thi b
hoc chp nhn cc mnh lai ghp ngha l kim tra kh nng
ph hp t chc ca m lai ghp. Cc cng trnh nghin cu tip
theo ca nhiu nh bc hc nh Georges Snell, Barij Benacerraf,
Hugh Mac Devitt cho php hiu bit cc gen cc locus khc
nhau ca lp I v lp II ca MHC. Cc cng trnh ca Jean
Dauset t 1958 cp ti vic nghin cu MHC ca loi ngi
v c gi l h thng HLA (Human Leucocyte Antigens) cho
thy chc nng sinh hc ch yu ca cc phn t HLA l trnh
din peptit khng nguyn cho cc lympho T.
52
53
54
HLA-I
Mng
HLA-II
VVVVVVYVVYVVV
*"iLJL>A \Mt<-?-!tL tlci
il>
Vng t bo cht
J V jZ j
ft li_
_
_t I_
_
_>v i ? t T V
55
Tm ng (centromer)
a)
N him sc th 6
Lp III
Lp II
' Iv p
**4 I
t
['
-m
Off
Ctr*
DP
DQ
DR
Lp I
a -m -A
i . 4A
C4BC4AB1C2 HSPTNF
c> J I /
V
M IN I
DP
A1
A.
DM
TAt't
m V
H -' A i' B
DQ
tt
0 1
/(I
O'
DR
4.4. S p h n b, iu ho b iu h in v ch c n n g ca
cc phan t HLA
Cc phn t HLA lp I: c mt phn ln cc t bo ca c th
(t 104 n 5.105 phn t/mt t bo) c bit nhiu cc t bo
lympho v i thc bo). C t hn t bo gan cha r t t hoc
bng khng hng cu, t bo thn kinh trung ng, mt 8 loi
t bo biu m ca ty v tuyn nc bt, v.v... Mt s t bo ung
th khng c cc phn t lp I. T l tng hp v biu hin trn
mng ca cc phn t HLA lp I tng ln nh tc ng ca inteferon a v p.
Chc nng ca cc phn t HLA lp I trnh din cc peptit
khng nguyn cho cc lympho T cha ng phn t CD8 bc l
trn b m t t bo. Cc lympho T ny gi l Lympho T- CD8*
56
L
Hnh 4.4: S cu trc rnh lin kt MHC-II. Cc pep*
tit lin kt vi rnh MHC-II bng s tng tc dc theo
chiu di cua rnh lin kt
58
4.5. H t h n g H L A li n q u a n n q u n t h c h n g t c
v cc bnh l
S kt hp gia mt alen ca mt locus v mt alen ca locus
khc i khi xy ra mnh hn so vi s kt hp ngu nhin. S
m t cn bng ca mt mi lin kt cc alen thng c trng cho
mt qun th chng tc. Chng hn s kt hp gia cc gen HLA
ca lp III xy ra tng ng vi cc dng chng tc BFS, C2C,
C4A3 v C4B1 c mt ti 40% chng tc chu u (Caucasoid)
v ch c 12% chng tc da en. T cc nghin cu v s
phn b gen ca HLA s cho php tm hiu lch s c dn ca
mi vng v s di c ca cc qun th ngi.
Ngi ta cng nhn thy c gn 40 loi bnh l c lin quan
vi h thng HLA. Mt s bnh gy ra do ch mt gen HLA nh
bnh huyt sc t t pht, thiu ht enzim hydroxylaz-21, thiu
ht b th C2 hoc C4. cc ngi ng hp t mang gen bnh
l th triu chng bnh thy r c t l mc bnh l 1/100.000
ngi. Mt s bnh khc c lin quan n mt gen c kh nng l
DR2 gy ng m mt. Mt s alen ca lp II cng gy ra bnh t
min. Bnh vim khp t sng lin quan n mt khng nguyn
HLA-B27 c xc nh bng phng php huyt thanh thuc
mt phn t ca HLA lp I gy ra.
59
60
Tm tt chng IV
61
Chng V. B th
62
5.2. Cc p rotein ca b th
Thnh phn ca cc protein tham gia vo con ng c in v
phc h phn hu mng (phc h tn cng mng) l nhng b
th c k hiu t C l n C9. Hp cht Cl c to thnh t 3
tiu n v l Clq, C lr v C ls (xem hnh 5.1). Cc mnh peptit
do enzim phn hu c k hiu l C3a, C3b. Ch i k hiu cho
mt phn t b mt hot tnh, v d C3bi. Cc loi protein ca
con ng bn cnh xen k c k hiu bng cc ch ci in.
Chng hn p l propecdin, yu t" B l C3 tin hot ho, yu t D
l C3 tin hot ho convectaz. Trng thi hot ng ca cc phc
h b th c k hiu c gch ngang trn. V d: C4bC2a.
Cc protein ca b th c khuynh hng t pht hnh thnh
cc phc h thun nghch bao gm nhiu phn t. l trng
hp i vi Clq, C lr v C ls khi c mt ion Ca2+ v i vi C4,
C2. Trng hp i vi C3 v yu t B, cn phi c ion Mg2* v
i vi hp cht C5, C6, C7, C8 v C9 l 5 hp cht c th kt
hp vi nhau hnh thnh phc h tn cng mng (Membrane
Attack Complex- MAC).
c tnh hot ng rt c bit ca b th l lin kt vi b
m t ca cc vt th c hot tnh sinh hc nh phc h khng
nguyn-khng th, cc t bo, cc vi khun, virus, k sinh trng
v.v... Khi cc yu t C3 v C4 b phn hu s to ra mt v tr lin
kt vi mng trong thi gian rt ngn (di 10 phn nghn giy).
Nh lin kt ny lin quan n mt cu tio-este bn trong
tng i khng n nh v c kh nng c nh mt vt th
bng mt lin kt cng ho tr. Nu thiu mt cht tip nhn b
th ng lc, phn t b th t do trong tun hon mu nhanh
chng b mt hot tnh. V trn b mt mng t bo ca chnh
bn thn c th c axit sialic nh l mt tc nhn bo v chng
li s lin kt ca C3b nn rt ngho v tr tip nhn b th. Tri
li, mng t bo vi sinh vt hoc t bo ng vt khc bit v
chng loi pht sinh kh giu v tr tip nhn b th, s to iu
kin tt cho s lin kt vi b th.
Cc protein b th c tng hp gan, cc t bo biu m
rut (Cl), cc t bo mono v i thc bo. Thi gian bn hu
63
64
65
66
C4
Carboxypeptidaz N C3 Carboxypeptidaz N
C4a
'
U C4b
_
'
> ^ - C l q r 2 s 2 D A F - - * + ----- *C4b2
C2a
Cl-INH
/6
C3a
&
C3b^__Yu t'
"
C2b
C4b2a3b
C2
C5 convertaz
(B)
67
Con d ng c in
Con dng bn cn h
C3bBb3b
C4b2a3b
(C)
-* C5
C5b
C6, C7
P ro tein s
v
SP-40,40
C5b67
(-) l iu ho km hm
(+) l iu ho hot ho
68
69
5.4. Hiu
qu
sinh hc
ca s hot
ho b th
70
71
Phc h Ag - Ab
iC l
C4
C2
mannoza ca b mt
yi khun
b mt vi khun
(LPS, Zimozan .)
C3
B
D
LMB - MASP
C4
C2
I-
_________
C3 - CONVBRTASE
C3b
... ... ,
Cc thnh phn b
th khc: C5b, C6,
C7, C8, C9
Opsonin vi khun v
loi b phc h min
dch
Hnh S.4. S tm tt mi quan h v h qu
ca ba con ng hot ho b th
72
hp t ca Clq, C4 (kiu ng hp
l C2 (vi tn s 1/100.000) thng
h thng. S thiu ht di truyn
C4B) thng gp cc bnh nhn
73
74
Tm tt chng V
75
76
/ / \ i V
J_ J
\ \ s1./^
-
i - - i y
A
/' 'v
('
\ \
* 1*4
khng
c n u i V
\
vV
n Bg uu y n
nng
. V
_
---- ----- ..
<i>
77
K hng th
L in k t
hydro
tt-
I
Z1 -
L c t n h i n
Lc V an d e r
W aa ls
s
K hng
nguyn
? / )
Lc k nc
HO r a <
78
79
6.2. Cc k th u t m in dch
Cc k thut c s dng trong nghin cu min dch cn c
vo tnh cht ca phn ng khng nguyn-khng th dng kt
ta hay ngng kt, hoc kh nng phn ng khng nguynkhng th lin kt vi b th, phn ng khng nguyn - khng
th c nh du hay lin kt vi mt enzim nht nh. Trn c s
, c hng lot cc phng php xt nghim min dch c
ng dng.
6.2.1.K th u t kt ta trong mi trng lng
6.2.1.1. Xt nghim kt ta vng
y l k thut n gin nht khi ngi ta s dng mt ng
nghim nh cha mt dung dch khng nguyn y ng
nghim. Tip theo cho t t mt dung dch huyt thanh min
dch v quan st vng kt ta gia hai lp tip xc ca phc h
Ag-Ab. K th u t ny vn dc s dng kim tra nhanh chng
s p ng min dch ca mt ng vt ang trong qu trnh gy
min dch hoc xc nh nhm Lancefield ca cc streptococ
cus. l xt nghim kt ta Lancefield.
.2.U. Xc n h c ca cc kt ta phc h Ag-Ab.
K thut ny thc hin rt d dng nhng cn mt my phc
tp c ngun nh sng bc x mnh v n sc c truyn qua
mt ng nghim cha mt khng nguyn v mt huyt thanh
min dch tng ng. Tia sng b nhiu x cng ln th mt
kt ta cng cao. Ngi ta nh lng trong vng d tha khng
th nh mt huyt thanh cho ng cong. Ngi ta c mt
80
81
82
6.2.5.1. K th u t p h n hy t bo bn g b th
K thut ny c thc hin i vi t bo hng cu, s dng
nhiu nh lng b th. y hng cu cu c s dng
kt hp vi cc khng th c hiu trong cc iu kin khng
ngng kt s c trn ln vi mi trng sinh phm xt
nghim. Cng tan hng cu (hemolysis) c nh gi sau
khi 30 pht 37c v li tm. Tip theo o m t quang hc
ca hemoglobin c gii phng ra. Ngi ta nh lng b th c
m t trong mi trng theo n v CH-50. CH-50 l k hiu hot
ng phn hy hng cu cu c lm nhy cm bng mt
loi khng th c hiu. Mt n v CH-50 l s" lng b th cn
thit lm phn hy mt na s lng hng cu huyn ph.
6.2.5.2. K th u t c nh b th
K thut ny ch cho php pht hin cc khng th c kh
nng hot ha b th. B th ca huyt thanh xt nghim cn
c lm bt hot t trc nhit 56c trong 30 pht. Phn
ng tip theo c thc hin theo hai giai on:
- Giai on th nht: huyt thanh xt nghim loi b b
th v cho thm 3 n v CH50 ca b th chut Cobaye
chun t trc. Nu huyt thanh cha cc khng th th s
kt hp vi mt khng nguyn v c' nh b th trong thi
gian (1 gi 37c hoc 18 gi 4c v tip theo 1 gi 37C).
- Giai on hai: thm h thng hin hnh c cu thnh t
hng cu cu kt hp vi cc Ig c hiu trong cc iu kin
khng ngng kt.
B th c c nh giai on u, ngi ta khng thy
hin tng phn hy hng cu. Tri li, nu huyt thanh xt
nghim khng cha khng th c hiu th b th cn li sn c
kh nng lm phn hy hng cu giai on hai ca phn ng.
Phn ng ny cn hai xt nghim kim tra: mt xt nghim
khng c khng nguyn v mt xt nghim khng c khng th,
ngha l cc kim tra cho phn ng khng th gii thch c khi
khng nguyn hoc huyt thanh ch c' nh ring b th.
83
84
86
Tm tt chng VI
87
7.2. Cc c quan s cp
C quan s cp cn gi l c quan lympho trung ng. C quan
ny cng xut hin sm trong i sng phi thai trc khi c c
quan th cp. Qu trnh tng sinh cc t bo lympho nhng c
quan s cp c lp vi tt c cc kch thch khng nguyn. Vai
tr ca cc c quan ny l: Cho php cc t bo ngun lympho
giai on u tin c bit ha v sinh sn, c "hc tp"
dung np cc thnh phn cu trc ca bn th n c th, ngha
l hc cch nhn bit "ci bn thn".
88
89
90
91
92
93
Cc dng t bo
T bo ngun min dch
T bo tin thn T
Cc yu t' bit
ha ca tuyn
c
Yu t' bit ha
tuyn c
^
T bo c v
N
T bo c ty
Vi tr bit
ha
M to mu
Tuyn c
Mu v c quan
bch huyt
.
i
Bit ha tip theo chc nng
Chc nng iu ha
(T b tr : Th v T c ch :Ts)
94
T khi thu
i vo tuyn c
Protimoxit
CD4
CD8khng cha TCR
LP V
X
APOPTOSIS
cha TCR
a ,p
LP TU
CD8*
\
OVIHI '
TOt
$ ( p e p tit
% H ,q
t bo
biu m
CD4*
CHN DUNG TNH
BN NGOI TUYN
CHN M TN
i ra vn g ngoi vi, tr
th n h cc t bo lympho chn, k t hp
c h iu vi M HC,
khng c c tn h t
p h n ng
95
96
Khng nguyn
fPlfi*
t bo plasma
rz> \m o
Nguyn bo B
_______
__
khng nguyn_____ J
ghi nh
I^nn^o
-ngA
97
98
^ VHch vm
hng (V.A)
Hch amian
Tuyn c
__ Lch
Cc tm peyer ca rut non
Rut tha
Mch bch huyt
Tu xng
V\. \t I
Lp v
i Lp cn
i vV \
V*SN \
v/
Mch bch
huyt i
99
100
101
Tm tt chng VII
103
104
8.2. S trn h d in k hn g n gu yn
8.2.1. Trnh din khng nguyn ni sinh
Khng nguyn ni sinh khng nguyn ca bn thn v cng
l nhng khng nguyn ca virus nm bn trong t bo cht
(Cytosol) ca t bo b nhim s c ch bin bng vi th proteasome, mt phc h gm 28 tiu n v trong c hai tiu n
v l LMP2 v LMP7 c vai tr tiu ho khng nguyn ni sinh
(LMP2 v LMP7 c m ho trong phc h gen HLAII, xem
hnh 4.2). Pettt khng nguyn c ch bin s c TAP1 v
TAP2 vn chuyn vo khoang li ni cht lin kt vi rnh
ca HLAI mi c tng hp nhng cn nm khoang li ni
cht. Vic lin kt ca peptit khng nguyn vi HLA I c s gip
ca cc phn t bo mu Calnexin, Calreticulin v mt pro
tein tr gip cho TAPI l TAPASIN. Sau ch ring phc h
HLAI-peptit khng nguyn c ng gi bng bc mng v c
vn chuyn ln b mt t bo ch b nhim trnh din cho t
bo T-CD8+. nhng t bo khng b nhim virus ni bo, cc
peptit ca protein bn thn lun lun lp y rnh lin kt ca
105
106
107
___
/
M n g sinh
cht
Pept.it
k h n g n g u y n
Io
>1
B m y (olg
Calnexin*
Calreticulin
Peptit
Proteasome
(LMP2-7)
108
' M H C -II
109
(B)
(A)
T bo ch
T bo tr n h din
A
P h n t
M H C l p II
psn!t< c0
cD
P h n t M HC
lpl
V~
^
P e p tit
k h n g n gu y n
M(
5 (\
\
\
CD4
T h th t bo T
CD8
y r ir * U ru s
T bo Tyrozinkinaz
T CD4
vTC K in k ifM s
Tyrozinkinaz
T bo
T CD8+
110
Ill
8.4. S iu ho p ng m in dch
Mt khng nguyn l khi xm nhp vo c th s gy ra p
ng min dch dch th (sn xut ra cc khng th) v p ng
min dch qua trung gian t bo.
T lu, ngi ta bit rt r kho d tr ca h min dch rt
a dng v c th thch ng vi bt k mt khng nguyn no.
Mt con th hoc mt con chut c kh nng tng hp ra cc
khng th khng ch chng li cc virus v/hoc vi khun c mt
trong mt sinh thi m cn chng li tt c cc phn t protein
c cu trc rt khc nhau nh anbumin, insulin ca nhiu ngun
gc khc nhau hoc thm ch mt cht mi c tng hp
phng th nghim khng tn ti trong t nhin.
C ch no c th gii thch cho kh nng sn xu't ra cc loi
protein b sung cho cu trc ca khng nguyn l rt phong ph
? c nhiu gi thuyt gii thch cho c ch iu ho p ng
min dch. Ngi ta cho rng p ng min dch c biu hin
ba dng: iu ho p ng min dch th dch, tc l iu ho
vic sn xut cc khng th ho tan, iu ho p ng min dch
qua trung gian t bo v cui cng l kh nng iu ho nh s
tng tc min dch thn kinh - ni tit vi s tham gia ca
nhiu loi hocmon v cc cht dn truyn xung thn kinh.
112
113
114
115
116
8.7.1.
Cht truyn
dn thn kinh,
cc peptit thn
kinh v cc
hocmon
Intelkin, xitokin
v khng th
117
118
119
Tm tt chng VIII
122
123
124
125
Nhm
mu
Khng
nguyn
mng hng
cu
Khng th trong
huyt thanh
Kh nng Kh nng
nhn
cho
Khng th chng B
A, AB
A, 0
Khng th chng A
B, AB
B, 0
AB
A v B
Khng c khng th
AB
A, B, 0,
AB
Khng c
126
2/ Khng nguyn H
------- >
+ (al-3) GalNAc
3/ Khng nguyn H
------- >
+(al*3) Gal
Gen B (galactozamil transferaza)
127
Khng nguyn
Vi khun, virus
Qu mn mun
k sinh trng.
thu c
Protein (+ t cht dy )
Qu mn mun.
Thai b khi u
Khng nguyn m t bo
Gv ra mt s bnh t min
128
129
9.2,3.3. Qu m n u h a t
Qu mn to u ht xy ra do b nhim vi khun. c bit
trong bnh lao, ngi ta pht hin thy cc u ht trong cc vng
phi b tn thng.
Trong bnh phong, ngi ta thy c cc u ht c to ra t
cc t bo biu m, b nhiu t bo lympho xm nhp. Mt s"
bnh nhim k sinh trng sn mng (Schistosoma) cng c dng
qu mn mun to ra cc u ht.
9.2.4. Qu mn do kch thch (Kiu V)
Dng qu mn ny xy ra khi c mt dng khng th, chng
hn mt khng th c sinh ra do t bo tuyn gip b kch
thch cc bnh nhn Basedow. Khng th ny c th gi l t
khng th (autoantibody) tc ng ln th th mng t bo tuyn
gip, kch thch t bo tuyn gip lm thay i cu hnh khng
gian th th ca hocmon TSH (Thyroid stimulating hormone) v
do gy bin i tng hp AMPv. Hon cnh cng tng t xy
ra vi cc lympho B khi c s kch thch ca mt khng th
to ra chng li cc Ig trn b mt t bo B.
130
Tm tt chng IX
133
10.1. M i n d c h c h n g vi s in h v t
Min dch chng vi khun v chVig nm s dng mt c
ch tng hp qua trung gian t bo v c ch phn t, ngy cng
c pht trin theo s tin ha ca cc loi, ng thi thch
ng i vi h sinh thi vi khun V? vt ch.
Trong s cc c ch ny, quan trng nht l s p ng min
dch t nhin tc l min dch khng c hiu. l h thng b
th, cc thc bo, cc xitokin. y l s p ng tc thi nhm
bt gi v ph hy tc nhn gy bnh. Trong khi phn ng
vim, cng l s p ng t nhin cho php trnh c s lan
truyn ca vi sinh vt. Tnh min dch thch ng c hiu s
dng tt c cc c ch min dch t nhin c hiu qu v s min
dch thu c, c luyn tp trong i sng cho c th sinh
vt c th sng st, i mt vi mt th gii y ry vi sinh vt
v cc tc nhn c hi. Trong c im min dch tip thu c
c tnh ghi nh min dch cho php chng ta thc hin phdng
php tim chng phng bnh.
Ngrii ta phn bit hai dng vi sinh vt xm nhp vo c th l
vi sinh vt pht trin ngoi bo v vi sinh vt pht trin ni bo.
Cc vi sinh vt pht trin ngoi bo d trYi thot khi tc ng
ca b th v cc thc bo nhng l ch tc ng ca cc khng
th c hiu. Trong khi cc vi sinh vt pht trin ni bo (vi
khun v k sinh trng) ch c th b ph hy nh s hot ha
ca i thc bo, bng cc xitokin do lynipho T tit ra tiong
trng hp p ng min dch c hiu.
10.1.3.
1:*r>
136
137
138
139
140
10.3.1.Khi nim
Hi chng tng sinh min dch l nhng bnh tng cng qu
trnh sinh sn ca t bo dng lympho (t bo T v B). Nghin
cu hi chng ny lm tng thm s hiu bit v h min dch,
cho php phn tch v chn on s lan truyn dng t bo n
dng, cc qun th v cc phn t xut hin mt s lng rt t
trong c th bnh thng. Vic nghin cu cu trc cc phn t
Ig trong cc bnh tng sinh min dch cho php hiu bit cc Ig
n dng trong bnh l trc khi pht minh ra phng php sn
xut cc khng th n dng ng dng cho y hc.
Nghin cu hi chng tng sinh min dch gip cho vic phn
loi chnh xc hn cc bnh l v t bo hc v di truyn t bo,
tm hiu c mi quan h gia hi chng bnh ny vi cc loi
virus (E-BV, HTLV-1...).
10.3.2.Tnh n dng ca bnh tng sinh min dch lympho
Trong a s" trng hp ung th, sinh sn t bo mang tnh
n dng. iu ny c chng minh nh mt dng t bo ca
bnh ch tit ra mt loi khng th dn dng c cu trc ging
nhau.
141
I
I
41ti
14
:>
anti-lp
SM\
a n u
U1pi
s?
jn! .
S*N
.
" :
.1
ntln
r!" *
*''
'-
s>
Upl
li jl
anf*t.
SMN
142
*0 M
< '
^
~~
m>
m w t - mm m*-F
'
*** rflv
/
> * 4 * 7 # t ,*
3. IgG (u tu).
4. IgA K (tng sinh macroglobulin).
5.
6.
7.
8.
143
144
HTLV-1
146
Nhim sc the K
Nhim sc ihc 14
Nhim sc th' X
Nhim sc th 14
C-myc
Hnh 10.3. S chuyn on ca gen C-myc locus ca chui
nng trong bnh lymphoma Burkitt. (theo I. Roitt. 1990.)
Sau y l tng kt mt s v d v s chuyn on ca cc
nhim sc th trong cc hi chng tng sinh min dch.
Bng 10.1. S chuyn on cc nhim sc th gy ra bnh tng sinh
min dch (theo Kaplan v Delpech - Biologie molculaire et Mdicine,
trang 479 - Paris 1993)
N h i m
sc
th
K iu u n g
Ly m pho l
C-myc
C-myc
bCl - 1
11
bCl - 2
18
Pbx
Lymphoma
Burkitt
Lymphoma
Hurkit
Lymphoma
BurkiM
Leukemia
lymphoma
Lvmphoma
nang
l^*uk(*mia
lymphoma
U uk(ima
Ivmphonia
Gcn th
nht
th
Chuyn don
G en
th
2
N h i m
sc
th
t(8:14)(q24:q32)
ltfH
14
t(2;8)(qll;q24)
IgK
t(8:22)(c|24;ql 1)
|R|-
22
1(1 l;14)(c|13;q32)
\\\
14
1.(14:18)(<|32:<|21)
ItfH
11
I(1:19)(c|2:*:qi:i)
E2A
19
t(5:H)(q:n;c|.T2)
Ik H
11
f(11:H)(c|1.):q32)
TR(M)
14
t(7;19)(q.M:q34)
TRC-B
TRC l
Lympho li
IL :*
f>
Lympho T
tai - 1
Tan - 1
Leukemia
lymphoma
i/cukcmia
nguyn
bo
TKC
11
Ix'ukomia
147
( nyc
Hox
11
10
rbtn
11
TCKA
lymphoma
Leukemia
lymphoma
Leukemia
lymphoma
lx*ukomia
lymphoma
Leukemia
lymphoma
1(8; 11)(q24:ql \ )
TKC-A
1(11:14)(<|25.<jl 1)
TRC 1)
14
TRC-I)
inv(14)(q11:q.T2)
Ir H
148
149
150
dch. 0 bnh nhn ph i tuyn tin lit lnh tnh(bemgn hyperplasia), nng PSA cng tng trong huvt thanh v c
pht hin nhy hn so vi PAP(Prostatic acid phosphatase).
S sn xut PSA c th b c ch bng cch iu tr vi anti androgen.
7. PAP (Photphataza axit ca tuyn tin lit: Prostatic Acid
Phosphatase) l mt glycoprotein 100 kDa c sn xut t ly*
sosome ca t bo biu m(epithelian cell), photphataza axit
bao gm 5 isozvm c mt nhiu loi t bo v dch c th
khc nhau nh. tiu cu, hng cu, h thng li ni m (gan,
lch), tu xng v t bo m tuyn tin lit. Tuy nhin
tuyn tin lit, isozym bng 2 c trng cho m c gi l
PAP nhng khng c hiu cho ung th v nng ca n cn
tng ln bnh ph i tuyn tin lit lnh tnh. Ch th PAP
cng c dng xc nh v theo di iu tr bnh ung th
biu m tuyn tin lit (Prostate Careinoma). Nng PAP
tng ln huyt thanh ch r s tin trin ca bnh ung th.
Trong khi ngi khoe bnh thng nng PAP l 0
0,2ng/ml.
Chc nng sinh hc ca PAP l xc tc cho s thu phn cc
monoeste ca axit photphoric trong tinh dch. iu kin hot
ng ti u pH 4,5 - 6. cn ch l PAP rt nhy cm vi
nhit , d bin tnh, cn xc nh hot tnh ngay sau khi ly
mu v ba qun mu trong iu kin lnh. Tri VI PSA, vic
sn xut PAP khng b anti - anrogen km hm.
8. P2-M (Beta 2 - Microglubulin) l thnh phn chui nh ca
HLAI c mt hu nh tt c cc t bo cha nhn, c bit
nng d cao b mt cc t bo ympho. ^2-M c khi lng
11,8 kDa v dc phn lp nc tiu ca bnh nhn cha
protein niu. Bnh thng, ngi kho cng pht hin c
trong huyt thanh c 3,4 ig /ml, nc tiu c 0,154 |ig/ml.
Trong khi cc bnh nhn ung th dng lympho (bnh a
u tu, leukaemia), nn^ 32-M tng cao, ch r thi gian sng
st ngn.
Trong cc trng hp bnh lnh tnh (vim cu thn, ng thn,
bnh nhn AIDS , bnh nhn ri lon chc nng min dch) ch
th [32-M cng l mt gi tr cn c coi trng. iu ng ch
l (V2-M ca nc tiu km n nh, ph thuc vo pH.
152
Tm tt chng X
154
155
156
157
158
159
capxit
160
161
162
163
Tm tt chng XI
166
12.1.2.1. S y n l n g m in dch
Ngi ta thy r h min dch dung np vi cc thnh phn
ca bn thn c th v hin tng ny gi l s yn lng min
dch. Cc thnh phn ca bn thn ch c th tr thnh cht gy
min dch (immunogene) nu chng kt hp vi cc phn t lp
II ca MHC. Tuy vy, cc phn t trong tun hon mu c th b
bt gi bi cc lympho B, b ci bin v kt hp vi cc phn t
lp II ca MHC nhng nng thp s khng to ra i lc
gi tn hiu cho cc t bo T. Nhng t bo B thng xuyn
yn lng.
S yn lng min dch cng c th do khng c cc gen m ho
cho cc th th ca t bo lympho chng li mt s" quyt nh
khng nguyn ca thnh phn bn thn.
12.1.2.2. C c h loi b dng
Ngi ta c nhiu bng chng cho thy c mt c ch loi b
tt c nhng t bo c hiu vi bn thn m khng lm thay
i phn cn li ca kho d tr cc t bo lympho. V vy, chnh
cc khng nguyn ca bn thn (autoantigen) tham gia la
chn loi b cc dng. Thin hng c bit ca c th s sinh l
kh nng dung np nn trong qu trnh pht trin h min dch,
cc t bo lympho c mt giai on tip xc vi autoantigen
v gy ra ci cht cho cc dng lympho t phn ng. l c ch
loi b dng.
Mt s bnh t min ca ngi km theo s tng cao nng
ca cc t khng th (autoantibody) c hiu gy ra bnh l. Tuy
nhin cng c mt sbnh t min lin kt vi cc t khng th
nhng vai tr gy bnh ca cc t khng th khng r rng. Mt
s bnh vim mn tnh khng kt hp vi cc t khng th c
hiu li do hiu qu bnh l cu cc lympho T- t phn ng.
Cc quan st lm sng bnh t min cho php phn bit s
khc nhau ca bnh nh cc bnh c hiu vi c quan hoc vi
m t bo (v d bnh vim tuyn gip, chng nhc c, bnh
Pemphigus v cc bnh t min h thng nh lupus ban ri
167
C quan
D y
Bnh Basedow
Tiu ng tui tr
ph thuc insulin.
Thiu mu Biermer
rut
Thn
C
Da
Gan
Hi chng
Goodpasture
Chng nhc c
Bnh thp khp c.
Bnh Pemphigus
Bnh tri tc.
Vim gan c tnh
Vim gan mn tnh.
Bnh vy nn.
168
169
170
171
Tm tt chng XII
173
13.1. M u
Theo cc nghin cu v c sinh hc v tin ha, nhiu nh
khoa hc nh Grass, Devillier (1965); Carrol (1988); Margulis,
Schwartz (1988) cho rng, loi ngi v phn ln cc loi ng
vt khc u thuc v mt ngnh ln cc ng vt c dy sng
(Chordata). H min dch ca chng th hin ba c im sau
y:
1. S c mt m hch biu m lympho vng hu lin kt vi
cc khe mang.
2. S c mt cc m ty lympho kt hp vi ng tiu ha.
3. C kh nng nhn bit cc khng nguyn ngoi lai (alloantigene) v phn ng chng li chng.
Trong khi s khc nhau ch yu gia cc ng vt dy sng
v c xng sng vi cc ng vt khng xng sng l ng vt
khng xng sng khng c phn ng ca khng nguyn l vi
mt cht ha gii c hiu kiu khng th immunoglobulin,
ngoi tr ng vt da gai (Echinoderma). Cc phn ng bo v
ca cc ng vt nh bt bin, giun, thn mm, nhuyn th, cn
trng loi cu gai c hnh thi khc nhau. Hn na, mc d c s
pht hin hin tng thc bo ca Metchnikoff vo nm 1882
ng vt ngnh da gai (sao bin) nhng s lng cc cng trnh
nghin cu v tnh min dch ca ng vt khng xng sng
vn cn hn ch v mang tnh l t cho n nhng nm 60 ca
th k 20. Tuy nhin ngnh chn khp (Arthropoda) l ngnh
ng vt khng xng sng chim 90% s loi ng vt bit,
s lng cc nghin cu v tnh min dch kh phong ph v tp
trung theo ba hng chnh: cc t bo tham gia vo tnh min
dch, cc cht ha gii min dch v cc phn ng min dch.
174
175
176
13.3.1 Cc ng vt hi tiu
Ngnh c dy sng (Chordata) gm 3 ngnh ph l ngnh ph
sng ui (Urochordata) hay cn gi l ngnh c bao (Tunicata),
177
178
179
180
181
182
183
184
185
(hnh 13.1).
C th tm tt mt s c im quan trng v c quan min dch,
tnh min dch t bo v dch th ca b linh trng v mt s
c im ca chng.
13.3.6.1. Tu x ng ca b lin h trng
y l c quan min dch s cp, l ngun to ra tt c cc t
bo mu c chc nng tun hon mu ca c th. Ln u tin,
cc tc gi Stasney J. v Higgins GM m t thnh phn tu
xng ca kh Rhesus (M acaca m u la tto ), vo nm 1936 (The
bone marrow of the monkey. Anat. Rec., (1936) 67: 219) v cho
bit tu xng ca kh Rhesus gm 39% l cc t bo hng cu,
53% l cc t bo bch cu a nhn, 4,5% l cc t bo lympho,
6% l cc t bo mono. Khi so snh VI loi ngi, ngi ta thy
kh Rhesus c s" lng d tr cc t bo ngun to hng cu ln
hn.
Tu xng ca loi kh ui sc chu M (Marmoset) thuc chi
C a llith r ix c hnh thi khc thng c nghin cu kh chi
tit. S biu hin ca MHC v vai tr ca n trong cy ghp tu
xng c nghin cu.
186
187
188
IgG
IgA
Chimpanz
0,59 - 2,4
11,3 - 18,0
0,97 - 2,12
Kh Orang Outang
0,20 - 0,9
10,5 - 13,3
0,90 - 1,9
Kh u ch Babouin
0,30 - 1,8
11,0- 13,3
0,1 -4,1
Macaca mulatta
Macaca arctoides
0,80 - 2,0
12,0 - 30,0
0,3 - 0,9
1,00- 1,2
8,5- 11,1
3,1 - 4,3
Ngi
0,60 - 1,5
7,7 - 13,5
1,8- 2,8
Cc loi
189
190
Lp I
Ngi
D/DR
Bf
Chimpanz
D/DR
B
C2
C4
B
C2
Bf
Rhesus
D/DR
C2
Bf
191
192
Tm tt chng XIII
193
195
14.1. Vi n t lch s
196
197
198
199
200
201
202
K h n g nguyn
Kiu k h n g nguyn
u ng
CD 19/20/22
T h th E G F
erbB 2
th
th
th
L euk em ia t
RFB4
bo B
T h th
T h th c hiu u n g
K h n g th
th i t k
Cc k h n g nguyn bit ho
ung
D ng u n g
V, no, phi
th
V, d dy
e23
L eu k em ia t
A nti-Tac
/ Oncogen
T h th IL-2
Th th bc l qu mc
bo T
T h th IL-4
Th th bc l qu mc
Thn
T h th IL*6
T h th bc l qu mc
a u tu.
mieloma
Lewis Y
T h th EGF
t bin
K h n g nguyn p h t trin
V, d dy,
C acbohydrat
rut kt
Th
th c
hiu u ng
/ Oncogen
th
Gan, no
B3, BI
MR1, YlO
2(W
t h th IL 2. Do c th p h t h i n n h a n h cc khi u c kch
thc r t nh. Hn n a vic s d n g liu p h p m i n dch p h n g
x p h h u t bo u n g t h b n g cc m n h k h n g t h ti t hp
n h d u u n g t h dc hiu cao c t h loi b c cc khi u nh
v t bo u n g th, t gy c i vi n h n g t bo b n h thng.
204
205
hp II-I 2 (hot dng ca NF - AT, cng phi hp vi yu t NF AT nam trong nhn). Tc dng ca phc h thuc khi lin kt
vi cc protein ni bo c hiu s nh hng ti s hot ha t
bo T bng cch km hm hot ng ca Calxineurin.
206
207
208
209
210
212
ta c h n g m i n h s c m t c a cc t bo TCl)4, TCD8. i th c
bo, ly m p h o B, t bo git t n h i n NK. c b n g c h n g cho
t h y cc c ch c h im u th tr o n g p n g s in h l m in dch
cng
t n g
214
Thi gian cy
ghp
C ch min dich c th
xy ra
Cc khng th mi
hnh thnh
Thi b rt cp
T 1 n 5 ngy
Cc lympho T
Thi b cp tnh
T tun th 2
Cc lympho T
T nhiu thng
Cc khng th, b th v
n hng nm
cc phn t bm dnh
Thi b ko
(trng din)
di
216
Ab*
Ab
Ab*
Ab
Huyt thanh th (b th
v khng th)
Cht mu (eosin Y)
thm
mu
khng
khng
khng
Kim tra
217
Kiu tc (ng
Azathioprin
Km hm s tong hp purin
Corticosteroid
Cyclosporin A
Tacrolimus
Si roll nius
218
219
221
I. Cu hi n tp min dch c s
Chng I
1. V s mi quan h gia min dch t nhin (min dch bm
sinh) v min dch tip thu (min dch c hiu hoc thch
ng). T nu r thnh phn t bo a nhn, c tnh ca t
bo NK, thnh phn cc i thc bo v cc thnh phn min
dch th dch (b th, xintokin, khng th).
2. Thnh phn v c tnh ca cc t bo lympho Tv t bo
lympho B.
3. V s bit ho v v tr bit ho ca t bo lympho T.
4. V s bit ho v v tr bit ho ca t bo lympho B.
5. Thnh phn v chc nng ca cc Xitokin.
6. Trnh by tm tt l thuyt la chn dng trong min dch v
v s km theo gii thch.
7. Nguyn tc c bn trong liu php tim chng vacxin. Cho v
d v cc dng vacxin c s dng hin nay.
Chng II
1. nh ngha v khng nguyn.
2. Gii thch r tnh khng nguyn (antigenecity) v tnh min
dch ca khng nguyn (mmunologenecity). Khi gy min dch
cho ng vt nhn khng th, khng nguyn s dng cn c
nhng c im no?
3. Th no l mt hapten?
4. Nu c tnh sinh min dch ca mt s dng khng nguyn.
222
Chng III
1.V s mt phn t khng th v cho bit c im ca
chui nng, chui nh ca phn t khng th. Ch r v tr ca
Fab (mnh khng th kt vi khng nguyn), F(ab)2, Fc (mnh
peptit d kt tinh ca khng th. S lng cc cu lin kt
disunfua ca khng th IgG.
2. Phn loi cc khng th v chc nng ca tng loi khng th.
3. C s di truyn v tnh a dng ca khng th.
4. Thnh phn phn t, h gen v cc chc nng ca cc th th
lympho B (BCR).
5. Thnh phn phn t v cc chc nng ca cc th th lympho
T(TCR).
6. Nguyn tc v s sn xut khng th n dng (monoclonal
antibody) v khng th ti t hp.
Chng IV
1. V s v cu trc phn t HLA - lp I v HLA - lp II v so
snh s khc nhau v cu trc v chc nng?
2. V s v s nh khu ca cc gen m ha cho cc phn t
HLA - I, HLA - II v nu mt s c im chnh ca cc phc
h gen ny.
Chng V
1. Cc thnh phn protein ca b th.
2. V s con ng hot ho b th theo c ch c in (c ch
c hiu). Nu r cc b th tham gia v cc yu t iu ho
con ng ny. So snh vi con ng hot ho b th c lectin
MB tham gia vi con ng c in.
3. V s con ng hot ho b th theo c ch bn cnh (c
ch khng c hiu). Nu r cc b th tham gia v cc yu t
iu ho.
4. Hiu qu sinh hc ca hot ho b th l g? V s km theo
hiu qu tn cng ph v mngt bo vi khun v t bo ch
c hi.
223
Chng VI
1. Nu c tnh chung ca phn ng khng nguyn - khng th?
2 . c im nguyn tc ca phng php khuch tn min dch
Ouchterlony?
3. Nguyn tc v c dim ca k thut ELISA.
Chng VII
1. Thnh phn cc c quan min dch s cp (c quan lympho
trung ng) v vai tr sinh hc ca chng.
2. Thnh phn cc c quan min dch th cp (hay ngoi vi) v
chc nng sinh hc ca chng.
3. Thnh phn cc t bo trnh din khng nguyn (APC).
Chng VIII
1. Trnh by qu trnh hp tc gia cc i thc bo v cc lymphoT.
2. V s s trnh din khng nguyn cho cc dng t bo T.
Nu r c tnh hiu qu ca cc cm bit ho khng nguyn
CD4 v CD8.
3. Nu s hp tc gia lympho T b tr (Th) v lympho B v hiu
qu sinh hc.
4. So snh hai dng iu ho min dch bng cc lympho T c ch
c hiu v khng c hiu.
5. Nu r c ch iu ho p ng min dch bng c ch mng
li Idiotip.
6. Vai tr ca h thn kinh v ni tit trong iu ho p ng
min dch.
224
Chng IX v chng X
1. C ch min dch ca hin tng qu mn phn v c s tham
gia ca IgE.
2. C ch min dch v hu qu ca qu mn c s tham gia ca
IgM v IgG.
3. Nu hai loi bnh qu mn kiu II: bnh tan hng cu v
ngng kt hng cu do truyn mu v do khng ph hp
khng nguyn Rhesus.
4. Nu tm tt cc c ch min dch chng li s xm nhp ca vi
khun (vi khun, vi nm) v k sinh trng.
5. Quan im hin i v ung th.
6. Nu cc kiu t bo v cc yu t th dch p ng chng
li
ung th.
7. Hi chng ung th ca dng t bo Lympho B: bnh u tu, ung
th bch cu, Bnh u lympho (lymphoma).
8. Hi chng u dng t bo lympho T.
9. Nguyn nhn t bin gen v t bin nhim sc th ca cc
loi bnh ung th. c im lm sng ca mt s bnh ung
th. Mt s ch th ung th,ng dng trong chn on v theo
di bnh.
10.Liu php min dch khng th chng ung th.
11.Trnh by liu php gen chng ung th.
12.Trnh by liu php s dng Xitokin chng ung th.
13.Trnh by liu php min dch t bo chng ung th.
Chng XI
1. Cc biu hin bnh thiu ht min dch (nguyn thu dng
lympho B do nhim trng ti din).
2. Trnh by biu hin thiu ht min dch nguyn thu dng
lympho T do yu t di truyn.
3. Trnh by cc con ng ly lan bnh thiu ht min dch mc
phi do HIV.
4. Trnh by cu trc ca virus HIV.
5. Nu cc giai on tin trin bnh l do nhim HIV ngi.
6. V sao khi nhim HIV, h min dch ca ngi b suy gim,
khng phng cu cha?
Chng XII
nh n g h a d u n g n p min (lch l g?
Chng XIII
1. c
2. c
3. c
4. c
5. c
im
dim
im
im
im
Chng XIV
1. Nguyn tc min dch hc ca liu php cha bnh bng tim
chng (vaccination).
2. Nguyn tc chung ca sn xut vacxin.
3. Cc dng vacxin c sn xut hin nay trn th gii v Vit
Nam
4. C th sn xut vacxin cha bnh cho cc loi ng vt (gia
cm, thu cm) no c hiu qu ti nht? V sao?
Chng XV
1. C ch thi b cc mnh ghp.
2. Nu mt s' c im lm sng ch yu trong cy ghp.
3. V sao ni mang thai l trng thi t nhin ca cy ghp d
gen (allograft).
226
227
a) Hy ch n p n n g n h t cho cc cu hi:
228
B = Ig M
D = Khng c loi no c
229
B : T bo B
D: K hng c loi no
I.
6. T bo no sn xut ra IFN-y.
Cu 8 : Cho cc trng hp sau. hy chn mt ch ci:
A:CD4f
B:CD8+
C: C hai loi trn
D: Khng c loi no.
1. Loi t bo no tham gia vo qu trnh tip nhn s trnh din
khng nguyn.
2. Loi t bo no tham gia vo qu trnh tip nhn s trnh din
khng nguyn ni sinh.
3. Loi t bo no tham gia vo qu trnh tip nhn s trnh din
khng nguyn ngoi sinh.
4. Loi t bo gy c Tc c cha cm bit ho khng nguyn CD
no.
5. Loi t bo no c vai tr quan trng trong nhim khi pht
virus HIV -1.
Cu 9 : So snh cu trc phn t, chc nng min dch v h
gen ca phc h HLA.
CulO : C ch t bo hc v phn t ca s trnh din khng
nguyn.
C u l 1 : Chng minh s a dng ca khng th bng c ch di
truyn v ti t hp gen.
Cu 12 : C ch t bo hc v phn t ca s trnh din khng
nguyn.
Cu 13 : Nu ng dng ca cc xitokin (cytokinee) trong cha
bnh truyn nhim v bnh ung th.
Cu 14 : Nu ng dng khng th ti t hp trong cha bnh.
Cu 15 : Phn tch cc c ch thi b mnh ghp.
Cu 16: V sao trong cy ghp tng (m t bo hoc c quan)
cn phi s dng liu php km hm min dch.
PH LC
233
Khng
nguyn
CD
Biu hin t
bo
Trng
lng
phn
(kDa)
Cc t bo 43 - 49
GDI
a,b,c,d tuyn c v,
cc t bo
Langerhan,
cc t bo
tua, t bo B
(CDlc), biu
m rut, c
trn,
mch
mu (CDld)
Cc t bo T, 45 -58
CD2
cc t bo
tuyn c, cc
t bo NK
CD3
Cc t bo
tuyn c, cc
t bo T
y: 2528
5:20
e: 2 0
CD4
Cc tp hp
con t bo
tuyn c. Cc
t bo T:TI 11
55
Cc chc nng
Cc ln Mi quan
khc he ho hng
Phn t ging
MHC lp I, kt
hp
vi
P2microglobulin.
C
vai
tr
chuyn
ho
trong vic trnh
din cc khng
nguyn cht bo
Immu
noglobulin
Phn t dnh TI 1 ,
bm, lin kt vi LFA-2
CD58 (LFA-3).
Lin kt vi Lck
ni bo v hot
ho t bo T
Kt hp vi th T3
th
khng
nguyn t bo T
(TCR). Cn thit
cho biu hin b
mt t bo v
truyn tn hiu
nh TCR.
ng thu th T4, L3T4
cho cc phn t
MHC lp II.
Lin kt vi Lck
Immu
noglobulin
Immu
noglobulin
Immu
noglobulin
.....
234
CD5
CD6
CD7
Biu
hien
benh
[y
CD 8
CD9
v
TH 2
(khoang 2/3
cc te bo T
ngoai
vi),
hach cu dan
nhan,
dai
thirc bo.
Cc te bo
tuyen rc, cc
te bo T, tap
hap con cc
te bo B
Cc te bo
tuyen rc, cc
te bo T, cc
te bo B a
benh
bach
cu man tinh
Cc te bo
tao mau da
nng, cc te
bo tuyen lie,
cc te bo T
tren be mt te
bo chat mang.
Thu the cho
gpl20 HIV - 1 v
HIV-2.
67
1 0 0
40
vai
f l , Ly 1
Ihn
thu
(an
thi)
r 12
Thu
the
thu
don
(an
xc
thi)
Chua r, domain
te bo cht lien
ket vai PI 3
kinaza bng lien
ket cheo.
La
d'u hieu cho
benh bach cu
cap tinh te bo T
v benh bach
cu
te
bo
nguon da nng
Dng thu the T 8 ,
cho cc phn tir Lyt2,3
MHC lap I. Lien
ket vai Lek trn
b^ mat mang te
bo cht
Cc tp hop a:32-34
con te bo : 32-34
tuyen rc, cc
[6 bo T gay
dc te bo
(khoang 1/3
cc te bo T
ngoai vi)
24
Tien te bo
Lm trung gian
cho sir ket tu
B, cc bach
tieu cu v hoat
cu
dan
ho
nh
nhn, te bo
ira axit, bach
FcyRIIa, c the
cu ira kiem,
dng vai tr
the
don
xc
Immu
noglobu
lin
Im m u
noglobu
lin
Protein
vt
qua
mang
4
ln, cng
dirac goi
l protein
235
Cl) 10
iiii
hiri
benh
1
ly
tic'll call, cc
t hao T hot
ho, no v
cc t ho
than
kinh
Hiioai
hin.
c
c trn c
mach.
11CI thn t
bo B v I ,
cc t ho
tim
tuy
xng.
trong s dch
chu ven t ho.
xu v 11
mng
(TM4)
i
1
100
CDl la Cc t bo
lympho, bch
cu ht, cc
hch cu dn
nhn v di
thc bo
180
|C D 1 Ib Cc t bo
dng tu v
t bo NK
170
C D llc Cc t bo
dng tu
150
.......
, , 1
1
Hndopep
ti(iaza
trung
tnh,
khng
nguvn
bch cu
cp tnh
ph bin
(CALLA
)
Di n v a L LPA-l
Integrin a
ca
integrin
LFA-1 (kt hp
vi CD 18); lin
kt vi CD54
(ICAM-1),
CD 102 (ICAM2), v CD50
(ICAM-3)
Integrin a
Di dn v a M Mac-1
(cht kt
ca
integrin
dnh
t
CR3 (kt hp
bo)
vi CD 18): lin
kt vi CD54,
thnh phn b
th iC3b, v cc
protein
trong
cht nn ngoi
bo
Integrin a
Di n v cxX CR4,
ca integrin CR4 p 150, 95
(kt
h(tp vi
CD 18): lin kt
vi fibrinogen.
Proteina/a kim
loi km. L du
hiu cho bnh
bch cu cp
tnh tin t bo
B (ALL)
236
C D lld
Bch cu
125
CDwl2 Bch cu dn
nhn,
bch
cu ht, tiu
cu
CD13
CD14
CD15
CD 15s
90-120
Integrin a
Aminopeptidaza N
^ewisx
(Le*)
SialylLewis*
(sLe)
CD 15 sunphat
CD15U
CD 16
Di n v a D
ca integrin, kt
hp vi CD 18;
lin
kt
vi
CD50
Cha r
Bch
trung
cc t
NK, i
bo
cu
tnh,
bo
thc
50-80
Poly-Nacetyllactosamin
Cc cu
trc
cacbohydrat
Immu
noglobu
lin
237
CDw 17 Bch
cu
trung
tnh,
bch cu n
nhn,
tiu
cu
CD 18 Bch cu
95
CD 19
Cc t bo B
95
CD20
Cc t bo B
33-37
CD21
Cc t' bo B
trng thnh,
cc t bo
tua nang
145
CD22
Cc t bo B
trng thnh
a:130
: 140
Lactosyl
ceramide, mt glycosphingolipid
b mt t bo
I
1
Di dn v integrin P2, kt
hp vi C D lla ,
b,c v d
To thnh phc
hp vi CD21
(CR2) v CD81
(TAPA-1), ng
th th cho cc
t bo B- domain nm trong
t bo cht lin
kt vi tyrozin
kinaza v PI3kinaza t bo
cht.
Cc
oligomer
CD20 c th to
thnh mt knh
ion Ca2\ c th
ng vai tr
trong iu ho
qu trnh hot
ho t bo B
Th th i vi CR2
cc thnh phn
b th C3d, virut
Epstein -Barr.
Cng vi CD19
v CD81, CD21
to ng th th
di vi cc t
bo B
Lin kt vi Sia- BL-CAM
loconj ugate
Integrin
Immu
noglobu
lin
Cha
4
on pro
tein
xuyn
mng
Protein
iu
khin b
th (CCP)
immu
noglobu
lin
238
CD23
CD24
CD25
CD26
CD27
CD28
Cc t bo B
trng thnh,
cc i thc
bo hot ho,
bch cu a
axit, cc t
bo tua nang,
cc tiu cu
Cc t bo B,
cc bch cu
ht
Cc t bo T
hot ho, cc
t bo B v
cc bch cu
n nhn
Cc t bo B
v T hot
ho; cc i
thc bo
Cc t bo
tuyn
c
thuc
tu
xng, cc t
bo T, NK,
mt s t bo
B
Cc tp hp
con t bo T,
cc t bo B
hot ho
45
35-45
55
110
55
44
L th th i lc PccRIl
thp cho IgE,
iu ho s tng
hp IgE, l cu
t gn cho ng
th th CD 19:
CD21: CD18
Lectin
dng c
Cha r
Th
tng
ng
ngi
ca
khng
nguyn
bn nhit
chut
(USA)
CCP
Chui a ca thu Tac
th IL-2
Exopeptidaza,
ct cc dipeptit
X-Pro hay XAla u N t cc
polypeptit
Lin kt vi
CD70, c th
hot ng nh
mt cht ng
kch thch i
vi cc t bo B
v T.
Hoi ha ac t bo
T nguyn thu, l
th th di \i cc
11 hiu dng kch
thch (till hiu 2 ), lin
kt vi CD80 (B7.1 )
vCD86(B72)
Dipepti- Glycopro
dyl pep- tein
tidaza IV xuyn
mng
dng II.
Thu
th
TNF
Tp 44
Immu
noglobu
lin
v
CD 8 6
(H7.2)
2;u)
('1
) 2 ()
Bach cau
130
Integrin \\
1C I)>0
Cac te bao T,
B, NK hoat
hoa , cac
bach can dan
nil an
('1)31
CD32
CD 3 3
CD34
CD35
40
67
Cac te bao 16
tien
dang
tuy, cac bach
cau dan nhan
Cac tien te 105-120 La cau tu giln
bao tao mau,
cho CD62L (Lni m mao
selectin)
mach
I hu the bo the CR1
Hong cau, te
2 50
I, lien ket vai
bo B, bach
C3b va C4b, lam
cu dan nhan,
trung gian cho
bach
can
sir thirc bao
tiling
tinh,
bach can ira
axit, cac te
bao tua nanc
Thu
INI
the
Immu
noglobu
lin
Immu
noglobu
lin
Immu
noglobu
lin
Mucin
CCP
240
CD36
Tiu
cu,
bch cu n
nhn, cc t
bo ni m
88
CD37
Cc t bo B
trng thnh,
cc t bo T
trng thnh,
cc t bo
dng tu
40 -52
CD38
Cc t bo B
v T s cp,
cc t bo T
hot
ho,
bch cu
Cc t bo B
hoat ha, cc
t bo NK
hot ho, i
thc bo ,
cc t ba
tua
Cc t bo B,
i thc bo,
cc t bo
tua, cc t
bo biu m
c bn
45
CD39
CD40
Phn t kt dnh
tiu cu: bao
gm s nhn
bit v s thc
bo ca cc t
bo
cht
c
chng trnh
Cha r, c th
lin quan n s
truyn tn hiu,
to thnh phc
h vi CD53,
CD81, CD82 v
MHC lp II
NAD glycohydrolaza,
lm
tng s nhn i
t bo B
78
Cha r, c th
lm trung gian
cho s kt dnh
ca cc t bo B
48
Lin kt vi
CD 154
(CD40L), l th
th cho tn hiu
ng kch thch
i vi cc t
bo
B,
kch
thch s sinh
trng, s bit
ho, s ng m
isotype ca cc
t bo B, v s
to thnh cyto
kine bi cc i
thc bo v cc
t bo tua
GPIV,
GPIIIb
tiu cu
Protein
xuvn qua
mng
4
ln
T10
Thu
TNF
th
241
CD4I
Pllb
CD42
a,b,c,d
Tiu cu, t
bo
nhn
khng l
Biu hin
bnh l
a; CiPIX on lp
b: GPIba giu Leuc: GPIbp cine
d: GPV
CD43
Bch
cu,
ngoi tr cc
t bo B ngh
CD44
Bch
cu,
hng cu
CD45
Tt c cc t
bo to mu
CD45
RO
Tp hp con
t bo T, tp
hp con t
bo B, bch
cu
dn
nhn,
i
thc
--. bo
Integrin alb, kt
hp vi CD61 d
to thnh GPIIb,
lin kt vi fi
22
brinogen,
fibronectin, yu t
von Willebrand,
Jtirombospondin
Lin kt vi yu
a: 23
b: 135, t von Wille
brand, thrombin,
23
cn thit cho s
c: 2 2
d: 85
kt dnh tiu cu
cc v tr tn
thng
115-135 C cu trc ko
(bch cu di, di khong
trung
45 nm v c th
l cht chng
tnh)
95-115 dnh
(cc t
bo T)
80 - 95 Lin kt vi axit
hyalurronic, lm
trung gian cho
s kt dnh ca
cc bach cu
1 8 0 -2 40 Tyrozin
phot(nhiu phrta7a, lm lng s
ng
truyn n hiu qua
dng)
th th khng
nguyn ca cc t
bo B v T, c nhiu
ng dng do s
phn ct lun phin
180
ng dng ca
CD45
khng
cha exon A, B,
c no
Integrin a
Leukosianin
sialophorin
Mucin
Khng
nguyn
Hemes,
Pgp-1.
Protein
lin kt
Khng
Fibronectin
nguyn
dng III
ph bin
bach cu
(LCA),
T2 0 0 ,
B220
Fibronectin
dng II
242
CD45
RA
CD45
RB
CD46
Cc t bo B
v tp hp
con t bo
T(t bo T
nguyn
thu), bch
cu n nhn
Tp hp con
t bo T, t
bo B, bch
cu
n
nhn,
i
thc
bo,
bach cu hat
Cc t bo c
nhn to mu
v khng to
mu
56/66
(cc bin
th phn
ct)
CD47
Tt c cc t
bo
47 - 52
CD48
Bch cu
40-47
CD49a Cc t bo T
hot
ho,
bch cu n
nhn, t bo
thn kinh, c
trn
CD49b Cc t bo B;
bch cu n
nhn;
tiu
cu; t bo
nhn khng
l; cc t bo
thn
kinh,
biu m, ni
m; t ho
hu xng
200
160
L protein ng
yu t mng,
lin kt vi C3b
v C4b cho php
phn hu chng
nh yu t I
Phn
t
kt
dnh, th th
thrombospondin
Cu t gn gi
inh cho CD244
Integrin a l , kt
hp vi CD29,
lin kt vi colagen, laminin - 1
Fibronectin
dng II
1200
Fibronectin
dng II
MCP
CCP
IAP,
MER 6 ,
OA3
Blast-1
Siu
h
immu
noglobulin
Immu
noglobulin
Integrin a
VLA-1
Integrin a
Integrin a2, kt VLA-2,
GPIa
tiu
hp vi CD29,
lin kt vi co- cu
lagen, laminin
U M ')i
C.ac t bo B,
nhin t ho
(lnh hm
Phn h rng
bao gm cc
t bo B, t
bo tuyn c,
bch cu dn
nhn,
hch
cu ht, cc
t ho tua
CD49e Phn b rnc
bao gm cc
t bo T ghi
; nh,
bch
cu
dn
nhn,
tiu
cu
bo
CD49f T
lvmho
T,
bch cu dn
nhn,
tiu
cu, t bo
nhn khng
l,
nguyn
bo
dinh
dng
CD50 T bo tuyn
c, cc t bo
B, cc t ho
T, bch cu
dn
nhn,
bach cu hat
n m i
125,30
150
Integnn a
Inlegrin
(X
135, 25
Intcgrin , kt VI.A
hp vi CD29,
lin kt \i fibronectin, invasin
Inteurin
a
c
125, 25
Integrin a 6 , . t VLA - 6
hp vi CD2
lin
kt
wi
laminin, invasii.
merosinc
Integrin a
Lin kt vi KAM -3
CD1 1 a/CD 18
integrin
Immunoglobulin
130
244
CD51
Tiu cu, t
bo
nhn
khng l
CD52
T bo tuyn
c, cc t bo
T, cc t' bo
B (khng c
t
bo
plasma),
bch cu n
nhn,
bch
cu ht, tinh
trng (sper
matozoa)
Bch cu
CD53
125, 24 Integrin aV , kt
hp vi CD61,
lin kt vi vi
tronectin, yu t'
von Willebrand,
fibrinogen,
v
thrombospondin;
c
th l th th
cho cc t bo
cht c chng
trnh.
25
Cha r, l ch
cho cc khng
th m c s
dng lm suy
yu cc t bo T
t tu xng
Th th Integrin a
vi
tronectin
CAMPA
TH- 1 ,
HES
35-42
Cha r
CD54
Cc t bo
to mu v
khng
to
mu
75-115
CD55
Cc t bo
to mu v
khng
to
mu
60-70
MRC
0X 44
Protein
xuyn qua
mng 4 ln
Immu
noglobulin
CCP
245
bo 135 - 2 2 0 ng dng ca
phan t kt dnh
t bo thn kinh
(NCAM), phn
t kt dnh
CD57 Cc t bo
Oligosacarit,
NK, Tp hp
c tm thy
con cc t
trn nhiu gly
bo T, cc t
coprotein b mt
t bo
bo B, v
bch cu n
nhn
CD58 Cc t bo 55 - 70 Khng nguyn 3
kt hp chc
to mu v
khng
to
nng bch cu
(LFA-3),
lin
mu
kt vi CD2,
phn t kt dnh
CD59 Cc t bo
19
Lin kt vi cc
to mu v
thnh phn b
khng
to
th C 8 v C9
ngn cn s kt
mu
hp ca phc h
tn cng mng
Disialyl
ganCD60a
glioside
D3
(GD3)
9O-acetylCD60b
GD3
CD56
Cc
NK
7GD3
CD60c
CD61
Tiu cu, t
bo
nhn
khng l, i
Ihc bo
110
O-acetyl-
Di n v P3
integrin, kt hp
vi
CD41
(GPIIb/IIIa)
hoc CD51 (th
th vitronectin)
NKH - 1
Immunoglobin
H N K -1 ,
Leu-7
LFA-3
Immu
noglobulin
Protectin, Ly - 6
cht c
ch Mac
Cu
trc
carbohy
drate
Cu
trc
carbohy
drate
Cu
trc
carbohy
drate
integrin
246
CD62K Ni m
140
CD62L Cc t bo B,
cc t bo T,
bch cu dn
nhn, t bo
NK
150
140
Tiu cu hot
ho,
bch
cu
n
nhn,
i
thc bo
Bch cu n
nhn,
i
thc bo
Cc t bo
dng tuv
53
CD63
CD64
CD65
Phn t kt dnh
bch cu ni m
(LAMh
lin
kt vi sialylLewis',
lm
trung gian cho
s tng tc ln
ca cc bch
cu trung tnh
trn ni m.
Phn t kt dnh
bch
cu
(LAM), lin kt
vi CD34, GlyCAM, lm trung
gian
cho
s
tng tc ln vi
ni m.
Phn
t
kt
dnh, lin kt vi
CD 162 (PSGL1 ),
lm trung
gian cho tng
tc ca tiu cu
vi cc t bo
ni m, bch
cu n nhn,
v bch cu ln
trn ni m
Cha r, l pro
tein mng lysosom
chuyn
ti b mt t bo
sau khi hoat ho
72
Lectin
ELAM1,
E- dng
ECiF,
!electin
CCP
1
LAM -i,
Eselectin,
LECAM-
Lectin
dang
EOF,
CCP
c,
v
c,
v
pselectin,
PADGE
M
Lectin
dng
EGF,
CCP
c,
v
Khng
Protein
nguyn
xuyn qua
hot ho mng 4 ln
tiu cu
Bach
C.III 160 - ISO Cha
r,
l
tiling t]111)
thnh vin ca
h
khng
nguyn phi ung
l th (CHA)
Cl )6 6 h Bach can ht 95 - 1 0 0 ; Cha r. thnh
i vin
ca
ho
khng
nguyn
phi uns th
(CEA)
Cl )6 6 c Bach
cu ! 90
Cha r, thnh
trmiiZ
tnh,
vin
ca
h
uim th hiu
khng
nguyn
phi ung tlur
m rut kt
(CEA)
Cl Wt;i
call
CDll Bach
trung tnh
30
CD6 6 0
CD 6 8
110
Glyco
Immu
protein- 1 noglobulin
mt
\(lk P -1 )
CD67
1 Immu11l
trc (v noulohu
C.
Khng
Immunguyn ;1 noglohulin
phan nd
cho
khng
dc hiu
(NCA)
Cha r, thnh
Immu
noglobulin
vin
ca
h
khng
nguyn
phi ung th
(CHA)
Immu
Cha r, thnh Khng
noglobulin
vin
ca
h nguyn
khng
nguyn phi ung
phi ung ih th
(CEA)
(CEA)
Immu
Cha r, thnh Glyco
noglobulin
vin
ca
h protein
khng
nguyn dc hiu
phi ung th thai
(CEA)
Cha r
MacroMucin
sialin
kxm GC t ho
Kmixilt
CD69
Phn t Lectin
cm ng dng c
s hot
ho
248
CD70
h o a tho
Cc t bo B
v T hot
ho, v cc
i thc bo
75, 95.
170
Cc t bo 13
gia thi
k phi thai
Nhm
mu Pk
Globotriaocyl- ce
ramic!
(C.b3)
TNF
Lectin
dng c
Cu
trc
cacbohydrate
249
vi c to Shiga,
lin kt cho
cm ng ci
cht c chng
trnh
0)79 Cc t bo B a: 40 -45 Thnh phn ca Iga, Ig3
u.
: 37 th th khng
nguyn t bo B
tng ng vi
CD3, cn thit
cho s biu hin
b mt t bo v
s truyn tn
hiu
L cht dng B7 (ngy
CD80 Tp hp con
60
kch thch, cu nay:
t bo B
t gn cho CD28 B7.1),
BB1
vCTLA-4
26
Kt hp vi ch ca
CD81 Cc t bo
CD 19, CD21 cc
lympho
to thnh ng khng
th th t bo B th
khng li
s nhn
i
(TAPA1)
R2
50 -53 Cha r
CD82 Bch cu
CD83 Cc t ho tua,
cc t bo B,
cc l' bo
l^angerhans
CDw84 Bch cu n
nhn,
tiu
cu, cc t
bo B tun
hon
CD85 Cc t bo
tua
Immu
noglobulin
Immu
noglobulin
Protein
xuyn
mng 4
Protein
xuyn
mng 4
Immu
noglobulin
43
Cha r
HB15
73
Cha r
GR16
Immu
noglobulin
Ho ILT/LIR
GR4
Siu
h
Immu
noglobulin
250
CD86 Bch cu dn
80
nhn, t bo
B hot ho,
cc t bo
tua
CD87 Bch cu ht, 35 - 59
bch cu n
nhn.
di
thc bo, cc
t bo T, NK,
mt lot cc
dng t bo
khng
to
mu
CD88 Bch
cu
43
nhiu dng
nhn,
i
thc bo, t
bo Mast
CD89 Bch cu n 50-70
nhn,
di
thc
bo,
bch cu ht,
bch
cu
trung tnh,
tp hp con
t' bo B, tp
hp con t
bT
CD90 Tin t bo
18
tuyn
c
CD344
(ngi),
t
bo tuyn c,
t bo T
(chut)
CD91 Bch cu n 515,85
nhn, nhiu
t bo khng
tao mu
CD92 Bch
cu
70
trung tnh,
bach
cu dn
-----1
______________
Cu t gn cho B7.2
CD28
v
CTLA4
Immu
noglobulin
Ly-6
Th th cho C5aR
thnh phn b
th C5a
Th th
cp i
vi pro
tein Cl
Th th IgA
FcaR
Immu
noglobulin
Cha r
Thy-1
Immu
noglobulin
Thu
Ih
EOF, LDL
Th the a2
macroglobulin
Cha r
GR9
nhn,
tiu
can, ni m
cu
Cl )()3 Hch
trung
tnh,
hch cu n
nhn, ni m
am
Tp hp con
t bo T. t
bo NK
CD95 Mt
loi
1dng t ho,
phn b in
vivo cha r
rng
CD% Cc t bo T
hoat ho, t
bo NK
CD97
120
Cha r
GR 11
43
Cha r
KP43
Lin kt vi cu Apo-1,
t gn Fas ging Fas
TNF, gy ra ci
cht c chng
trnh
Cha r
160
Biu hin
mun
tng hot
ho
t
bo
T
(TACTIL
E)
Cc t bo B 75 - 85 Lin kt vi GR1
v T hot
CD55
ho,
bch
cu
n
nhn, bch
cu ..hat
Cc t bo 80, 45 C th l cht 4F2,
hetvn chuyn axit FRP-1
BX t bo
git t nhin, erodimer amin
bch cu ht,
tt c cc dng
t bo ngi
Cc t bo
Cha r
MIC2,
32
lympho mu
E2
ngoi vi, t
bo tuyn c
Cc t bo
Cha r
150
C.R3
to mu
homodim
er
BPC#4
Bch cu n
Cha r
120
nhn, bch homodim
cu hat, t ... _J?r
45
Lectin
dng c
Thu
TNF
th
Immu
noglobulin
EGF, th
th
cp
i
vi
protein G
CD98
CD99
CD 100
CD 101
Sema
phor in
Immu
noglobulin
252
CD 102
CD 103
CD 104
CD 105
CD 106
bo tua, t
bo T hot
ho
Cc t bo
lympho nghi,
bch cu n
nhn, cc t
bo ni m
c
mch
(mnh nht)
Cc t bo
lympho ni
biu m, 26% cc t
bo lympho
mu ngoi vi
T bo tuyn
c CD4, CD8,
cc t bo thn
kinh, biu m,
v mt s t
bo ni m,
cc t bo
Schwann,
nguyn bo
dinh dng.
Q c t bo
ni m, cc
bch cu n
nhn v i
thc bo hot
ho , tp hp
con cc t
bo
tu
xng
Cc t bo
ni m
220
Integrin P4 kt InIntegrinP
hp vi CD49f, tegrinfM
lin kt vi cc
laminin
90
Lin kt
homodim TGF-P
er
100-110
110
vi Endoglin
VCAM-1 Immu
Phn t kt
noglobulin
dnh, cu t gn
cho VLA-4 (integrin a 4p.)
Cha r, l pro Protein
tein mng ly- mng 1
sosom chuyn lin kt
253
ho,
bch
cu
trung
tnh
hot
lio, ni m
hoat ho
CD 07 Tiu cu hot
ho, cc t
b
bo T hot
ho,
bch
cu
trung
tnh
hot
ho, ni m
hoat ho
cu,
CD 108 Hng
cc t bo
lympho tun
hon, nguvn
ho lympho
ti b mt t bo 1lysosom
sau khi hot ho 1:LAMP1)
120
80
Cha r
CD 109 Cc t bo T
hot ho, tiu
cu hot ho,
ni m mach
CD 110 Tiu cu
CD111 Cc t bo
dng tu
CD112 Cc t bo
dngtu
GDI 14 Bch cu hat,
bch cu dn
nhn
170
Cha r
CD 115 Bch cu dn
nhn,
i
thc bo
150
GDI 16 Bch cu dn
nhn, bch
cu
trung
tnh,
bch
cu a axit,
ni m
70-85
GR2,
Khng
nguvn
nhm
mu John
MillonHagen
Nhn t
hot ho
tiu cu,
GR56
MPL, TPO R
PPRl/Nectinl
PRR2
150
Th th yu t
kch thch dng
bach cu ht (CiCSF)
Th th yu t
kch thch dng
dai thc bo (MCSF)
Chui a th th
yu t kch thch
dng bch cu
hat - ai thc
bo (GM-CSF)
Immu
noglobulin,
fibronectin
dng III
M-CSFR, Immu
c-fms
noglobulin,
tyrozin
kinaza
GMThu the cy
CSFRa tokine, fibronectin
dng III
254
CDI17 T tin t
bo to mu
145
Th th yu t t
bo
ngun
(SCF)
C -K it
Immu
noglobulin.
tyrozin
kinaza
Fibronectin
dng III
Thu
TNF
the
Thu
TNF
the
Immu
noglobulin
Immu
noglobulin
Th th cy
tokine, fibronectin
dng in
Th th cy
tokine, fibronectin
dng III
(1)124 Cc t bo B 130-150
v T trng
thnh, cc t
ho tin to
mu
Cl)125 Bch cu a 55-60
axit,
hch
cu a kim,
cc t ho 13
hoat ho
CD 126 Cc t bo B
80
hot ho v
cc t bo
plasma
(mnh), phn
ln bch cu
(yu)
CD 127 Tin lympho 68-79
tu xng, t c kh
bo tin B, t nng to
bo T trng homoim
thnh, bch
er
cu n nhn
CDw
128
Bch
cu
trung tnh,
1
bch cu a
kim, tp hp
con t bo T
CD 129 Vn
cha
c
xc
nh
CD 130 Phn ln cc
dng t bo,
mnh
trn
cc t bo B
hot ho v
cc t bo
plasma
58-67
130
Th th IL-4
IL-4K
Th the cy
tokine, fibronectin
dng III
Th th IL-5
IL-5R
Th th cy
tokine, fibronectin
dng III
Di n v a IL-6Ra
th th II.-6
Immu
noglobu
lin,th th
cytokine,
fibronectin
dng III
Th th IL-7
IL-7R
Fibronectin
dng III
Th th IL-8
IL-8R
Th
th
cp i vi
protein G
Di dn v
chung ca IL-6,
IL-11,
oncostatin-M
(OSM) v cc
th th yu t c
ch bnh bch
cu (LIF)
IL-6RP,
ILHRp,
OSMR,
LIFR,
IFR
Immu
noglobulin,
th th cy
tokine,
fibronectin
dng III
256
CDw T tin t
131 bo tu, bch
cu ht
140
CD 132 Cc t bo B,
cc t bo T,
t bo NK, t
bo
Mast,
bch
cu
trung tnh
CD133 Cc t bo
ngun/
t
tin
CD 134 Cc t bo T
hot ho
64
Di n v p
chung ca IL-3,
IL-5, v cc th
th GM-CSF
Chui y th th
IL-2, di n
vi chung ca cc
th th IL-2, IL4, IL-7, IL-9, v
IL-15
AC133
IL-3RP,
IL-5R3,
GMCSFR
C th hot 0X40
ng nh mt
cht ng kch
thch phn t kt
dnh
CD 135 Tin thn t 130,155 Th th yu t FLK2,
bo a nng,
sinh trng
STK-I
t tin t bo
B v bch
cu n nhn
dng tu
CDw Bch cu n
180
Ho
hng MSP-R,
136 nhn, t bo
ng, s thc RON
biu m, h
bo, sinh trng
t bo, v bit
thn
kinh
trung ng
ho
v ngoi vi
CDw T bo lymCht ng kch ILA
137 pho B v T,
thch s nhn (c
bch cu n
i t bo T
cm ng
nhn, mt s
bi
s
hot ho
t bo biu
m
t
bo
lympho),
4-1BB
50
Th th cy
tokine, fibronectin
dng III
Th th cy
tokine
Thu
TNF
th
Immu
noglobulin,
tyrozin
kinaza
Tyrozin
kinaza
Thu
TNF
the
CD 138 T bo B
Cl) 139 T bo B
CD 140 T bo m,
a.b mt s t bo
ni m
GDI 41 Cc t bo
ni m c
mch
CD 142 T bo kera
tin biu m,
cc t bo
biu m khc
nhau, t bo
dng sao, t
bo
Schwann.
Khng c
cc t bo
lin h trc
tip vi bo
1
tng,tr khi
dc to ra
bi cc cht
trung
gian
!
phn
ng
vim.
CD 143 Cc t bo
ni
I,
ngoi tr cc
mch
mu
1
ln v thn,
cc t bo
biu m ca
mp thn v
Cc ln kt
hepran sulphate
proteoglvcan,
collagen dng 1
209, 2281 Cha r
a: 180 Chui a v [}
h: 180 th th yu t
sinh
trng
ngun gc tiu
cau (PDGI )
105
Cht
chng
dng, lin kt
vi
thrombin,
phc h sau
hoai ho protein
c
45 - 47 Nhn t khi
u chnh ca
hin tng ng
cc. Lin kt vi
yu t Vila,
phc h ny
hot ho cc yu
t VII, IX, v X
170 - ISO
Peptidaza kim
loi Zn dipeptiyl peptidaza
, phan ct angio
tensin 1 v bradykinin t cc
(lang tin thn
Syndecan-1
Thrombo Lectin
modulin dang
fetoEOF
modulin
c,
Yen to Fibronectin
mo,
dng III
throm
boplastin
enzym
chuyen
hoa an
giotensin
(ACE)
258
rut non, t
bo
thn
kinh,
di
thc bo hot
ho v mt
s t bo T.
Dng ho tan
trong
bo
tng
CD 144 Cc t bo
ni m
CD 145 Cc t bo
ni m, mt
s t bo
m
CD 146 Ni m
130
25, 90,
Thit lp ch
ni kt dnh
cc t bo ni
m
Cha r
Cadherin-5,
VEcadherin
Phn t c kh
nng kt dnh,
nh v ch ni
t bo - t bo.
Phn t c kh
nng kt dnh
MCAM, Immu
MUC18, noglobulin
S-ENDO
Cadherin
110
130
M6 , neu- Immu
rothelin, noglobulin
EMMPR
IN,
basigin,
OX-47
CD 148 Bch cu ht, 240 - 260 c ch lin h s HPTPt
Fibronectin
bch cu n
sinh trng ca
dng
III,
t bo
protein tynhn, t bo
rozin phottua, t bo T,
phataza
nguyn bo
si, t bo
thn kinh
Immu
CD 150 Cc t bo 75 - 95 Cha r
SLAM
noglobulin
tuyn c, cc
t bo lympho hot ho
32
Kt hp vi in- PETA-3, Protein
CD151 Tiu cu, t
SFA-I
xuyn
bo
nhn
tegrin l
mng 4
khng l, t
bo biu m,
t bo ni m
CD 147 Bch
cu,
hng
cu,
tiu cu, t
bo ni m
55-65
CD 152 Cc t bo T
hot ho
33
CD 153 Cc t ba I 38 - 40
hot ho, i
thc bo hot
ho,
hch
cu
trung
tnh, t bo B
CD 154 Cc t bo T- 30 dng
CD4
hot trimer
ho
CD 155 Bch cu dn
nhn,
i
thc bo, t
bo tuyn c,
cc
noron
CNS
CD 156 Bch
cu
trung
tnh,
a
bch cu n
nhn
CD
156b
CD 157 Bch cu ht,
bch cu dn
nhn, t bo
m
tu
xng, t bo
ni m c
mch, t bo
tua nang
80-90
69
Thu
th cho CTLA-4
B7.
(CD80),
B7.2
(CD 8 6 );
cht diu ho
m tnh s hot
ho t bo T
Cu t gn cho CD30L
CD30, c th
dng kch thch
cc t bo T
Cu t gn cho
CD40, cht cm
ng ca s hot
ho v nhn i
t bo B
Chc
nng
thng
thng
cha r, th th
cho poliovirut
CD40L,
TRAP,
T-BAM,
gp39
Cha r, c th
lin quan n s
trn dch bch
cu integrin (integrin leukocyte
extravasation)
MS2,
ADAM 8
(mt proteaza kim
loi
v
khng
phi integrin)
Immu
noglobulin
TNF
Thu
TNF
th
Th th Immu
noglobulin
poliovirut
TACE/ADAM1
7: cu trc kt
dnh
42 - 45 ADP-ribosyl cy- BST-1
(50
claza,
ADP
bch cu vng-riboz hydolaza
n
nhn)
260
CD 158 T bo NK
CD 158 Tp hp con
t bo NK
a
50 hoc
58 '
CD 158 Tp hp con
b
t b o N K
50 hoc
58 '
CD 159 Cc
a
NK
bo
CD 160 Cc t bo T
CD161 Cc t bo NK,
cc t bo T
cu
CD 162 Bch
trung tnh, t
bo lympho,
bch cu n
nhn
CD 162 Cc t bo
R
NK
CD 163 Bch cu n
nhn,
i
thc bo
CD 164 Cc t bo
biu
m,
bch cu n
nhn, cc t
bo m tu
xng
CD 165 T bo tuyn
c, t bo
biu
m
Ho KIR
c ch tnh c p50.1,
t bo NK trn p58.1
cc
phn
t
MHC ip I lin
kt
c ch tnh c p50.2,
t bo NK trn p58.2
HLA-CW3 lin
kt v cc alen
lin quan
Lin kt vi NKG2A
CD94 to
thnh th th
NK; c ch tnh
c t bo NK
trn cc phn t
MHC lp I lin
kt
BY55
44
iu ho tnh NKRP1
c t bo NK
1 2 0 dng Cu t gn cho PSGL-1
homodim CD62P
er
Immu
noglobulin
Immu
noglobulin
Lectin
dng c
Mucin
PEN 5
130
Cha r
Ml 30
80
Cha r
MUC-24 Mucin
(protein
24 dc
a glycosyl ho)
37
2\\
tuyn c, cc
c
noron CNS,
do luv, VO
Bowman
CD 1661 cac to bo 1 100 -105 (au t gn cho
( 1) 6 , bao gm
hot
ho,
biu
m
s ko di (ly
tuyn
c,
thn kinh innguyn bo
tegrin
si, cc 1 1 0 ron
CD 167 Cc t bo 63, 64 1 Lin kt vi codng
biu m binh
lagen
a
thng
v dimer
bin i
A XAM, Iinnunoglobulin
BEN,
DMGRASP,
SC- 1
DDR 1 ,
Fyrozin
trkH, cak, kinaza th
eddrl
th,
discoidin lin
quan
CD 168 Cc t bo 5 ng Phn
t
kt RHAM
dng:
ung tlur v
dnh. Th
M
58, 60, th cho s vn
64, 70, ng c trung
ho bi axit hya
84
luronic
s
dch chuyn t
bo trung gian
CD 169 Tp hp con
Phn
t
kt Siaload- Siu
h
185
dnh. Lin kt hesin
di thc bo
immu
vi cacbohydrat
noglobulin,
sialyl ho, c
h sialoath lm trung
hesin
gian cho s lin
kt i thc bo
vi bch cu ht
v t bo lympho
CD 170 Bch
cu 67 dng Phn
t
kt Siglec-5. Siu
h
trung tnh
homodim dnh.
Lectin OBBP2, immu
er
ging Ig lin kt CD33L2 noglobulin,
axit
sialic
h siaload(Siglec).
ui
hesin
nm trong vng
t bo cht cha
motif (vng bo
th) ITIM
262
2 0 0 Phn
t
kt
CD 171 Noron, cc t
2 2 0 ,
dnh, lin kt vi
ho
CD24,
Schwann, cc TLPT CD9,
t bo lymchnh
CD56, cng l
pho v bch xc thay lin kt liomocu n nhn i theo philic
dng tu, cc dng t
ho
t bo B, cc
t bo T CD4 (khng
phi t bo
T-CD 8 )
115-120 Phn
t
kt
CD 172
a
dnh,
protein
xuyn mng l
c cht ca tyrozin kinaza th
th hot ho
(RTKs) v lin
kt vi cc do
main SH2
CD 173 Tt c cc t
bo
CD 174 Tt c cc t
bo
CD 175 Tt c cc t
bo
CD 175 Tt c cc t
s
bo
CD 176 Tt c cc t
bo
CD 177 Cc t bo
dngtu
56 - 64
L I,
NCAML1
Siu
h
immu
noglobulin
SIRP,
Siu
h
SHPS1 ,
Immu
MYD- 1 , noglobulin
SIRP-CX1 , c cht
dng
khng thu
th
protein
^yrozin
photphataza 1
(PTPNS1 )
Nhm mu H
type 2 ,
phn
hydratcacbon
Nhm
mu
Lewis y, phn
hydratccbon
Nhm mu Tn,
phn
hydratcacbon
Nhm mu Sialyl-Tn. phn hydratcacbon
Nhm mu TF,
phn
hvdratcacbon
NB1
l
mt N B 1
khng
nguyn
c hiu bach
-----------------------
26,
CD 178 Cc t bo T
hot ho
38 - 42
CD 179 Cc t bo B
nguyn thu
a
16 -18
CD 179 T bo B
b
22
cu trung tnh
1ln kt CiPI, chi
dc tm thy
bch cu trung
tnh c mt
ngi
trng
thnh
c
NBl(97r ngi
cho kho) NHI
dc hiu hin
u tin giai
on t bo tuv
ca qu trnh
bit ho dang
tu
Cu t gn Fas,
lien kt vi Fas
gy ra ci cht
c chng trnh
Chui
immunoglobin kt hp
khng cng ho
tr vi CD 17%
to thnh mt
chui nh thay
th m l mt
thnh phn ca
th th tin t
bo B ng vai
tr quan trng
giai on u
bit ho t bo B
Polypeptit
1
ging
immu
noglobulin X kt
hp khng cng
ho
tr
vi
CD179a to
thnh mt chui
nh thay th
dc biu hin
mt cch chn
lc giai on
FasL
Siu
TNF
ho
VpreB,
JGVPB,
Igi
Siu
h
immu
noglobulin
IGLLI,
Siu
h
A.50GL5) immu
noglobulin
g VPB.1
4.
264
CD 180 T bo B
95-105
46 -52
46 -52
u ca s pht
trin t bo B.
Cc dt bin
trong
gen
CDl79b dn ti
lm suy yu s
pht trin t bo
B v bnh thiu
globulin
gama
huyt ngi
Protein
mng
dng 1 bao gm
cc on lp
giu
Leucin
ngoi
bo
(LRR). Kt hp
vi 1 phn t
c gi l MD1 v to thnh
phc h th th
b mt t' bo
RP105/MD-1 ,
hot ng phi
hp vi TLR4
diu khin s
nhn bit t bo
B v s truyn
tn
hiu ca
lipopolysacarit
(LPS)
Th th chtho
vn ng c x c ,
lin quan n
ho hng ng
ca cc t bo
lympho B c
tnh. Lin kt
vi INP10 v
MIGLin kt vi SDF1 (LESTR/fusin),
hoi dng nh
mt
cofactor
LY64,
RP105
Th
th
ging Toll
(TRL)
CXCR3,
th
th
cp i
protein G
9 (GPR9)
Cc th th
cht
ho
vn ng,
Siu h th
th cp i
protein G
CXCR4,
NPY3R,
LESTR,
fusin.
Cc th th
cht
ho
vn dng,
Siu ho thu
265
('1)34' cha
I
trim thnh
lion
c m 95 Cc te ho
tien daim 111V
c.
CDw
197
Cc te ho
Ivin pho B v
T hot ho,
diu
ho
mnh ln t
bo
B b
nhim EBV
v t bo T b
nhim HHV 6
hay7
CD200 Cc dng t
bo B v no
hnh thng
266
CD201 Cc t
ni m
bo
49
CD202 Cc t
b
ni m
bo
140
CD203 Cc t bo
dng tu( t
c
cung,
bch
cu a kim,
v cc t bo
mast)
101
Th th b mt
t bo ni m
(EPCR) c kh
nng lin kt i
lc cao protein
c v protein c
hot ho. N
c iu ho
gim xung nh
tip xc ni m
vi yu t hoi
t ung th
Tyrozin kinaza
th th, lin kt
vi
angiopoietin- 1 ,
quan
trng trong vic
hnh thnh inach
mu. c bit
cho hnh thnh
h thng mch
trong cc t bo
ni m. Nhng
khuyt tt
TEK i km vi
nhng c th d
tt tnh mch di
truyn,
con
ng truyn tn
hiu TEK quan
trng cho s lin
lc t bo ni
m-t bo c
trn trong qu
trnh to hnh
tnh mach
Thuc mt lot
enzym
ngoi
bo lin quan
n
s thu
phn cc nucleotit
ngoi
bo. Chng xc
EPCR
H phc h
ph hp td
chc
ch
yu GDI
VMCM,
TEK (tyrozin
kinaza,
ni m),
TIE2 (tyrozin
kinaza c
cc do
main
lng
ng Ig
v EGF),
VMCM1
Siu h
immu
noglobu
lin, tyrozin kinaza
NPP3,
B1 0 ,
PDNP3,
PD-ip,
gpl 30RB
13-6
Cc
protein
xuyn
mng
dng
II,
h pyrophot-
tc cho s phn
ct cc lin kt
phosphodieste
v lin kt photphosunphat ca
cc phn tr bao
gm ieoxynucleotit, NAD v
cc gc ng
ca nucleotit
Lm trung gian
220
0 ) 2 0 4 Cc t bo
cho s lin kt,
dng tuV
s
tip
thu
(nut), v x l
mt lot cc i
phn t tch din
m. Lin quan
den
s
lng
dng bnh hc
ca cholesterol
cc
thnh
ng
mch
trong qu trnh
hnh thnh bnh
x va ng
mach
CD205 Cc t bo
Khng nguyn
205
tua
t bo lympho
75, th th bt
gi
khng
nguyn gi nh
trn cc t bo
tua
CD206 i thc bo, 175-190 Glycoprotein
t bo ni m
mng dng I, v
d bit duy
nht v lectin
dng c cha
nhiu CRD dng
c (cc domain
nhn bit cacbohydrat), n lin
kt vi cc cu
phata/a/p
hotphodicsteraza
nucleotit
ngoai bo
(E-
NPP)
Yu
t
thu dn
(n xc
thi) i
thc bo
R
(MSRl)
H th
th n xc
thi (thu
dn),
ging colagen
LY75,
DEC205,
GP200MR 6
Protein
xuyn
mng
dng I
Th th
Siu h
mannoza lectin
i thc dng c
bo
(MMR),
MRC1
268
CD207 Cc t bo
Langerhans
40
CD208 Cc t bo
tua an vo
nhau
trong
cc bo quan
lympho
7 0-90
CD209 Cc
tua
bo
44
Langerin Siu
h
lectin
dng c
Protein
mng kt
hp vi
D
lysosom,
DCLAMP
H phc
h
ph
hp
t
chc ch
yu
DCSiu
h
lectin
SIGN
(Phi in- dng c
tegrin bt
gi
ICAM3
c hiu
t
ho
2(9
I1 nh vng ua)
lin h !)C-t
ho '\\ kch thch
s nhiem hiu
qua cc t ho
trans m biu
hin cc th the
CD4 v th th
cht ho hng
(lng;
protein
xuyn
mng
1 (lng II
Cc t bo B, 90-1 10 1Th th inter IL-IORa
CD
VV210 cc t bo T
leukin 1 0 a v p
ILb tr, v cc
1 0 RA,
t bo ca
HILdng
hch
10R, ILcu
n
1 0 R,
nhn/i thc
IL-10RB,
bo
CRF2-4,
CRFB4
130
CD212 Cc t bo
Chui p th th IL-12R
CD4,
CD 8 ,
IL- 1 2 ,
protein IL-12RB
v NK hot
xuyn
mng
ho
dng I lin quan
n s truyn tn
hiu IL-12
C D 213 Cc t bo B, 60 - 70 Th th lin kt ILi lc thp vi 1 3 R a lf
bch cu n
a1
nhn, nguycn
1L 13, cng vi NR4, ILbo si, t
L-4Ra c th 13Ra
1
bo ni m.
to thnh mt
th th chc
nng cho II.-13,
cng c coi
nh l mt pro
tein phu tr thay
i
di
vi
chui
gamma
th th cytokine
chung cho qu
trnh truycn tn
hiu IL-4
H
th
th cyto
kine lp II
Siu
h
th
th
cytokine
to mu
Siu
h
th
th
cytokine
to mu
...........................1
270
CD213 Cc t bo B,
bch cu n
a2
nhn, nguyn
bo si, cc
t bo ni m
CDw Cc t bo T
217 ghi nh hot
ho
120
CD239 Cc t bo
hng cu
78
Th th IL-13 nh
mt monomer lin
k i lc cao vi in
terleukin-13
( IL-13), nhung
khng lin k vi
IL-4: cc t bo
ngi biu hin IL13RA2 cho thy
lin kt IL-13 c
hiu Mi i lc cao
Homodimer th
th interleukin
17
Protein
mng
dng I. Khng
nguyn F8/G253
ngi,
B-CAM, l mt
glycoprotein b
mt t bo c
biu hin vi mt
kiu phn b' hn
ch trong cc m
trng thnh v
bo thai bnh
thng v c
iu ho mnh
ln sau s bin
i c tnh trong
mt s' dng t
bo. Cu trc
ton th ca n
ging vi cu
trc ca du hiu
ung th ngi
MUC18 v phn
t kt dnh thn
kinh g SCI
IL-13Ra Siu h
the
2,
IL- th
cytokine
13BP
to mu
I1-17R,
Cc th
CTLA-8 th cyto
kine/ cht
ho
hng
ng
B-CAM Siu
h
(Phn t immu
kt dnh noglobulin
t bo B),
LU,
nhm
mu Luj
ther
2 71
CD240 Cc t ho
CH
hng cu
45,5
CD240 Cc t bo
hng cu
D
45,5
CD241 Cc t bo
hng cu
50
Nhn mu Rliesus,
khuig ngiiwn GcBe.
C th l mt phn
ca phc h digome
o chc nng knh
hay vn chuyn ing
mng hng cn N
rthhknccaovd
gi su trong \p kp
lpL
Nhm
mu
Rhesus, khng
nguyn D. C
th l mt phn
ca phc h oligome c chc
nng knh hay
vn
chuyn
trong
mng
hng
cu.
Khng c mt
kiu hnh khng
c RHD ngi
da trng
Glycoprotein kt
hp nhm mu
Rhesus RH50,
thnh phn ca
phc h nhiu
di
n
v
khng
nguyn
RH, cn thit
cho
s
vn
chuyn v s kt
hp phc h
mng Rh vi b
mt t bo hng
cu,
c tnh
tng ng cao
vi RH, cc
thnh
phn
30kD.
Cc
RHCE,
RH30A,
RHPI,
Rh4
Ho Rh
RhD,
Rh4,
RhPI,
Rhll,
Rh30D
H oR h
RhAg,
RH50A
H Rh
9 79
CD242 Cc t bo
hng cu
42
CD243 Cc t
ngun
tin
bo
/t
170
CD244 Cc
NK
bo
66
khuyt
tt
RhAg l nguyn
nhn ca bnh
thiu mu kinh
nin di km vi
stomatocytosis
v spherocyto
sis, lm gim
tnh thm lc, v
tng tnh thm
cation.
Phn t kt dnh
ni bo 4, nhm
mu
LandSteiner-Wiener.
Cc phn t LVV
c th gy ra tc
mch kt hp
vi au cp tnh
bnh hng cu
hnh li lim
Protein
1
khng a thuc
(Glycoprotein
P-gp s dng
ATP bm cc
thuc k nc ra
khi t bo, v
vy nng ni
bo v tnh dc
ca chng tng
ln. Gen MDR1
c nhn trong
cc dng t bo
khng a thuc.
2B4 l mt gly
coprotein b mt
t bo c quan
h vi CD2 v
trong iu ho
chc nng t bo
git t nhin v
t bo lympho
h
ICAM-4, Siu
LVV
immu
noglobu
lin, phn
t
kt
dnh ni
bo
(ICams)
MDR-1,
p-170
Siu
h
ABC ca
cc pro
tein
vn
chuyn
lin
kt
ATP
h
Cu
t Siu
gn cm immu
ng
s noglobulin
hoat ho
2B4,
t
bo NK
(NAIL)
27:*
.......
CD245 Cc t ho I
220 - 240
T. Chc nng s
cp ca 2B4 l
ciu chinh tng
tc th th-cu
t gn khc d
tng cng hot
ho bach cu.
Protein tng tc NPAT
cyclinE/
Cdk2
p220. NPAT lin
quan n s kin
pha
cha kho
v lin kt hot
tnh kinaza cyclinE/ Cdk2 tun
hon vi qu
trinh phin m
gen histon ph
thuc sao chp.
Gen NPAT can
thit cho s duy
tr t bo v c
th l thnh vin
ca
cc
gen
thng
trc
(housekeeping
gene)
Kinaza
lympho ALK
ghp (t bo ln
CD30*), ng vai
tr quan trng
trong s pht trin
no, lin quan n
cc bnh Hodgkin
hay fi lympho
khng
phi
I odgkin nt ghp
vi s hon vi
t(2;5)(p23 q35)
hay inv2(23,q35).
S pht sinh ung
th nh chc nng
kinaza c hoat
H
th
th insu
lin
ca
protein tyrozin
kinaza
274
CD247 Cc t bo T,
NK
16
25
55-60
42
ho bi s oli
gomer ho ca
NPM1-ALK c
lm trung gian bi
phn NPM1
h
Th th t bo Chui , Siu
immu
T, c vai tr CD3Z
noglobulin
trong tp hp v
biu hin phc
h TCR cng
nh truyn tn
hiu nh vo s
khi dng khng
nguyn. TCR,
cng
vi
TCRap v het
erodimer y5 v
CD3-y ,-S, v -e
tao thnh phc
h TCR-CD3.
Chui ng
mt vai tr quan
trng trong vic
nhn bit khng
nguyn cp i
vi mt vi con
ng truyn tn
hiu ni bo.
Biu hin thp
ca
khng
nguyn dn ti
p ng min
dch sai hng.
c ch s hot
Siu h Ig
ho t bo T
iu ho hot
ho t bo
Hot ho NK v
CTL
H
C-lectin
275
276
2 78
279
280
281
mt hng cu to ch ph hu hng cu
A u to im m u n e response: p ng min dch, s p ng
min dch chng li cc khng nguyn ca bn thn, cng gi l
tnh t min (Autoimmunity).
A u to im m u n e th ro b o c v to p e n ic p u rp u ra : Bnh xut hyt
t min do thiu ht tiu cu Cc t khng th pht sinh trong
bnh ny lin kt vi cc tiu cu to ch ph hu tiu cu, lm
tr lin kt.
A zath io p rin e: Mt loi thuc km hm min dch mnh c
kh nng dit cc t bo tng sinh nhanh. Cc t bo ny gm
cc t bo lympho gy ra p ng thi b m t bo cy ghp.
p sheet: L gp p, mt dng cu trc bc 2 c bn ca phn t
protein.
B acteria: Vi khun, mt dng vi sinh vt nhn s (procariote)
bao gm nhiu loi v nhiu chng khc nhau. Vi khun c th
sng trn b mt t bo khong khng bn ngoi mt t bo vt
ch, trong cc bng mng (vesicles) hoc trong cht dch t bo
(cytosol). Rt nhiu loi vi khun gy ra cc bnh truyn
nhim khc nhau.
B are ly m p h o cy te syndrom e: Hi chng thiu ht nghim
trng dng t bo lympho, trong MHC lp II khng c biu
h in trn b m t t bo do th iu h t m t s gen diu ho khc
282
2f t : *
khng th c hiu.
CDR: Vng xc nh b sung (Complementarity determining
regions).
CDR1, CDR2, CDR3: L ba vng xc nh tnh b sung ti
v tr tn cng ca khu vc bin i (V.Domain) trn cc phn
t khng th hoc trn cc TCR. Ba vng ny to nn cc thng
lng (loop) tip xc trc tip vi khng nguyn hoc peptit.
284
285
C h ro n ic g r a n u lo m a to u s disease: Bnh u ht mn (u ht
mn tnh). l bnh thiu ht min dch, trong d c nhiu u
ht hnh thnh (lo vic loi tr khng dy ca cc t bo thc
bo. Bnh do thiu ht h thng enzyme NADP-H oxidase dng
to ra gc superoxit tham gia dit vi khun.
Clonal deletion: S loi b dng, s loi b nc t bo lympho cha chn bng cch lin kt VI cc t khng nguyn(auto
286
287
nh
288
2H9
k h n g
n g u y n .
290
291
mt ca t bo B.
DiGeorge Syntrom e: Hi chng DiGeorge, mt bnh thiu
ht di truyn theo gen ln, dng nh biu hin s thiu ht
pht trin cc chm t bo thn kinh quan trng. Hu qu bnh
cn l s thiu ht truyn hoocmon parathyroid dn n mt
kh nng pht trin biu m tuyn thymus.
Dir 'ect coom bs test: Xt nghim (test) coomb trc tip, s
dng anti-Ig to ngng kt cc t bo hng cu nhm pht hin
c c
k h n g
t h
b a o
q u a n h
b o
h n g
c u
t r o n g
b n h
m i n
292
293
b o
v i
k h u n
c h t
t r o n g
t h
n h i m
b n h ,
t r i
V I
E n h a n c e rs: L nhn^ trnh t c hiu nm trong ADN gonom c tc dng hot ha s phin m (transcription).
ELISA: Xt nghim min dch hp ph lin kt enzym, l k
thut c s dng rng ri trong sinh hc, y hc cng nh min
dch hc.
Eosinophils: L nhng t bo bch cu a axit c tc dng
bo v chng li nhim bnh k sinh trng. Cc t bo ny c
hot ha bng cc t bo lympho trong p ng min dch thch
ng. Bnh thng mt t bo a axit trong mu rt thp
nhng s c tng ln rt cao trong trng hp b d ng hoc b
nhim trng.
E otax in 1, E o tax in 2: l cc chemokin, cc cht tit c bn
cht ha hc tc ng c hiu ln bch cu a axit.
Epitope: Quyt nh khng nguyn, l mt trnh t cu trc
nm trn phn t khng nguyn c nhn bit bi cc khng
th hoc cc th th ca khng nguyn. Mt Epitope ca t bo
T l mt trnh t peptit ngn t mt khng nguyn c bn ch't
protein c lin kt vi phn t MHC v dc nhn bit bi mt
t bo T ring bit. Cc epitope ca t bo B l nhng quyt nh
khng nguyn c cc t bo B nhn bit. Cc epitope ny c
cu trc gin on, in hnh ngha l c cu trc khng gian
nht nh.
E pitope sp read in g : S lan ta epitope c m t mt thc
t l cc p ng min dch di vi cc t khng nguyn (Autoantigen) c khuynh hng da dng hn v dai dng hn.
E p s te in - B a r r virus (EBV): L nhng herpesvirus gy
nhim chn lc ln cc t bo B ca ngi bng cch lin kt vi
cc th th ca b th (CR2 hoc cn gi l CD21). EBV thng
lin quan cht ch vi bnh ung th vm hng.
E q u ilib riu m dialysis: S thm tch cn bng, l mt k
thut trong cc khng th trong ti thm tch c bc l ty
theo s lng thay i ca cc phn t khng nguyn c th
294
295
296
297
m t
p r o t e in
m a n g
( p r o t e in
c a r r ie r )
t o
t h n h
m t
k h n g
298
2 99
300
ICAM1: L mt cu t gn quan trng nht d vi cc integrin CD lla, CD18 hoc LFA-1. N nhanh chng to cm ng
trn cc t bo ni m b nhim v c vai tr quan trng trong
p ng vim.
ICAM2: Lin tc bc l mc thp ni m.
ICAM3: Ch bc l cc t vo bch cu v c vai tr quan
trng trong s kt dnh gia cc t bo T v cc APC, c bit vi
t bo c tua.
Im m unoglobulin: Cc globulin min dch.
Iccosomes: L cc mnh nh ca mng c bao bc bng cc
phc h min dch, trong phn b cc qu trnh tin trin ca
cc t bo nang c tua ca cc nang lympho.
ICOS: L mt protein c quan h vi CD28. C mt cc t
bo T hot ha c th gip tng cng p ng min dch qua
trung gian t bo T. Protein ny lin kt vi mt cu t gn khc
l LICOS phn vit vi cc phn t B7.
Idiotopes: c coi l mt epitop ca mt dng khng th
ring bit. Mi phn t Ig u c kh nng lin kt vi hng hot
khng th hng ti nhng c im duy nht v c gi l cc
idiotype (mt typ khng th ring bit, idio: c tnh c bit). Mt
idiotyp c to ra t hng lot cc idiotope.
Idiotypic n etw ork: Mng li idiotyp, l tp hp cc th th
nhn bit khng nguyn ca cc t bo lympho hoc ca khng
th c hnh thnh do s tng tc nhn bit min dch ln
nhau gia chng.
Iga, IgP: Th th ca t bo B hoc CD79a, CD79b.
IL: Interleukins.
I m m a tu r e B Cells: Cc t bo B cha chn l nhng t bo
ch mi sp xp li cc gen chui nng, chui nh v vng V v
mi ch bc l IgM b mt (mlgM cha bc l y mlgD).
Im m e d ia te h y p e rs e n s itiv ity reactions: Cc phn ng qu
mn tc th, l nhng phn ng qu mn xy ra tnh theo pht
p ng li khng nguyn l.
Im m u n e clearance: S "khai quang" min dch l hin tng
loi b nhanh chng khng nguyn l xm nhp nh kh nng
tng hp nhanh khng th hnh thnh phc h khng nguyn
- khng th.
301
302
303
protein khng nguyn ho tan hoc protein mng tan trong cht
ty ra (detergent) dc nh du, sau d s dng tip k
thut in di SDS - PAGE pht hin bng phng x t ghi
(autoradiography).
I m m u n o r e c e p to r tyrosine - b ased a c tiv a tio n motifs
(ITAMS): Cc hnh thc hot ha th th min dch da vo tyrozin. Cc th th ca t bo T v t bo B lun lin kt vi cc
loi phn t xuyn qua mng c hot tnh Tyrosinekinase. Mi
mt hnh thc ITAM bao gm mt cp YXXL to ra mt khong
trng nh khong 10 axit amin. Chng l cc v tr phot
phoryl ha tyrozin v lm kt hp tysosine kinase vi cc phn
lin kt phot photirozin khc, tham gia vo qu trnh truyn tn
hiu ca th th.
Im m u n o reg u latio n : S diu ha min dch.
I m m u n o su p p re s s iv e drugs: Cc thuc km hm min dch,
c dng hn ch s thi b mnh ghp v cha bnh t
min c tnh.
Im m unotoxin: c t' min dch.
Mt dng khng th c kt hp v ha hc (cng hdp) vi cc
phn t cht c c ngun gc thc vt hoc vi sinh vt c kh
nng nhn bit v lin kt vi khng nguyn dc hiu ca t bo
ung th dit khi u, cng c th di dng thuc km hm
min dch.
304
dch ti ch. Hin tng ny c gi l p ng vim (in lammatory response), khi cc t bo c chc nng min dch xm
nhp vo m b vim c gi l s thm nhim vim (inflammtory infiltrate).
Influenza: Bnh thng hn.
I n n a te im m unity: Tnh min dch bm sinh, l tnh min
dch c sn ngay sau khi mt c th ra i, c mt mi thi im
v khng c kh nng p ng p hn bit c hiu.
305
306
307
308
309
62
L .
Lyme disease: Bnh nlim trng mn tnh xon khun Borrelia burgdorferi, xoan khun ny c th trn thot s p ng
Tiin dch.
Lymph: Dch ngoi bo c tch ly trong cc m v c
vn chuyn theo mch lympho tr v h thng bch huyt i qua
ng ngc vo mu.
Lym ph nodes: Hch bch huyt, c quan lympho th cp
hoc ngoi vi.
L y m p h a tic system: H tlg lympho, bao gm cc knh
lympho v m t bo gm cc hch lvmpho, m Pcyer v nhng
thnh phn lvmpho c t chc trong lch.
L y m p h a tic vessels hoc lymphatics: Cc mao mch lym
pho cha dch lympho vn chuyn vo h thng lympho.
Lym phoblast: Mt dng t bo lympho kch thc ln c qu
trnh tng hp ARN v protein mnh m.
Lym phocytes: Cc t bo lympho bt ngun t ty xng v
c bit ha thanh 2 dng lympho B v lympho T.
L ym p hocyte function-associated antigens: Xem Leuko
cyte functional antigens.
L ym ph ocy te r e c e p to r rep erto ire: Kho d tr th th ca
t bo lympho, l tng th tt c cc th th khng nguyn nm
trn t bo B v T ca c th.
L ym phocytic ch o rio m en in g itis virus (LCMV): L mt
dng virus gy bnh vim mng no chut v i khi xy ra
ngi. Vi khun ny c dng trong nghin cu thc nghim.
L ym p hoid d e n d r it ic cells: Nhng t bo bch cu c tua bt
ngun t cc m lympho, khi bt ngun t cc t bo myeloid th
dc gi l t bo tua dng tu myeloid d e n d r itic cells.
L ym ph oid organs: Cc c quan lympho.
Lym phokine: L nhng xitokin c sn xut t cc t bo
lympho.
Lym phom as: Cc khi u (ung th) ca cc t bo lympho,
nm trong cc m lympho hoc trong cc m t bo khc nhng
khng i vo mu. C rt nhiu kiu lymphomas biu hin s
bin dng cc giai on phat trin khc nhau ca cc dng t bo
lympho B v T.
310
311
312
313
314
315
316
MHC.
P ro tectin: (CD59) l mt protein b mt t bo, gip cho t
bo vt ch bo v khi tc dng gy tn thng ca b th. N
ngn cn vic hnh thnh phc h tn cng mng (MAC) bng
cch km hm s lin kt ca C8 v C9 vo phc h C5b, C6, C7.
P ro te c tiv e Im m unity: Trnh min dch, l s khng
chng li nhim trng c hiu, gy nhim trng hoc tim
chng.
P r o te i n A: Mt loi protin ca thnh t bo t cu vng
(Staphylococcus aureus), lin kt c hiu VI Fe ca IgG, gip
cho vi khun khi tc ng opsonin ha ca IgG v ngn cn con
ng hot ha b th.
P r o te i n k in a se C: (PKC) l mt h enzym serine/ thereonine
kinase c hot ha bng diacylglycerol v ion canxi. Qu trnh
hot ha ny l kt qu ca s truyn tn hiu nh nhiu th th
khc nhau.
P r o te i n tiro sin e kinase: L enzym lm kt hp nhm pht
pht vo cc gc tyrosine, c vai tr quan trng trong qu trnh
truyn tn hiu v iu ha s sinh trng t bo. Hot ng ca
protein tyrosine kinase li c iu ha bng protein tyrosine
phosphatase.
P ro to oncogene: Gen tin ung th, l cc gen kim sot v
iu ha qu trnh sinh trng. Khi cc gen ny b t bin s
gy bin dng c tnh t bo, dn n ung th (xem thm onco
gene).
P ro viru s: L mt dng ADN ca retrovirus khi ci vo genom
ca vt ch, n c th gi li s bt hot phin m lu di.
P-selectin: Xem selectin.
P-Ta: xem pre - T - cell receptor.
P u lm o n a r y s u rf a c to m t A a n d D proteins: Cc protein b
mt A v D ca phi l nhng lectin h pentraxin c vai tr quan
trng trong p ng min dch pha c'p.
Purin nucleotide phosphorylase (PNP) deficiency: S
thiu ht purin nucleotit photphprylaza, s thiu ht ny gy ra
thiu ht min dch c dnh, gy ra s tch ly purin nucleotit
gy c cho s pht trin t bo T.
31 7
318
319
320
:V2\
322
324
bo )ch cu khc.
S tro m a l cells: T bo nn s pht trin ca cc t bo lympho
H v cc t bo lympho rr din ra di s tng tc vi cc t bo
nn c vai tr cung cp cc tn hiu khc nhau c tnh cht tan
v lin kt t bo i vi s p h t trin t bo lympho.
326
.327
328
329
330
331
332
333
334
335
336
rm
c (lap ng IgM cng khng (lu nhifntf lng IgM trong huyt
hanh li thng ( mc cao. Bnh ny lion quan n thiu st
338
1.
2.
3.
4.
5.
6.
7.
8.
9
10.
11.
12
13.
14.
339
15.
16
17.
18
19
20.
21
22.
23.
24
25.
26.
27.
28.
29
C h iu tr c h n h i m x u t bn:
Quc
Gim c:
PHNG
NGUYN b t h n h
BO
C h u tr c h n h i m ni d u n g :
Bin tp:
MNH CNG
Bin tp ti bn:
QUC THNG
Ch bn:
NG TH H
Trnh by ba:
NGC ANH
MIN DCH
HC
cd S
1-----------
______________________________________________________
---------------------------------
M s: 1K-63H2008
In 1.000 cun, kh 16 X 24 cm ti Cng ty In & Vn ho phm
S' xut bn: 106 - 2008/CXB/120 - 14/HQGHN, ngy 23/1/2008
Quyt nh xut bn s: 63 KH-TN/XB
In xong v np lu chiu qu IV nm 2008.