DISORDERS OF

IMMUNE SYSTEM

Immune
System

- Ramu G
 Immune system is a complex network of cells, tissues, and organs. Together they help
the body fight infections and other diseases.

 When immune system does not work correctly, it results certain immune system
disorders.

 These problems include:

• Allergies – Overactive immune system

e.g., Asthma, Hay fever

• Autoimmune disorders - Immune system attacks on body’s self cells by mistake.

e.g., Rheumatoid arthritis

• Immunodeficiency disorders – Lack of resistance power & infections may last longer.
e.g., Severe Combined Immunodeficiency (SCID), AIDS.
Allergy
– Over active immune system
 Allergies:
 When you have gone to a new place and suddenly you started sneezing, wheezing for no
explained reason, and when you went away, your symptoms disappeared.

 This is because some of us are sensitive to some particles in the environment.

 Did this happen to you?

 The above mentioned reactions like sneezing, wheezing etc could be because of allergy to
pollen, mites etc.

Pollen Animal dander

Pollen
 The exaggerated response of the immune system to certain antigens present in the
environment is called allergy.

 The substances to which such an immune response is produced are called allergens.
• Common examples of allergens are mites in dust, pollens, animal dander, etc.

 The antibodies produced to these are of IgE type.

• Normal quantity of IgE type = 0.05%
• In allergy cases more IgE type antibodies produced.

 Symptoms of allergic reactions include sneezing, watery eyes, running nose and difficulty in
breathing.

 Allergy is due to the release of chemicals like histamine and serotonin from the mast cells of
connective tissue.

Stimulation of
mast cell by IgE

Release of histamine &

other inflammatory agents
IgE mediated allergic response
 For determining the cause of allergy, the patient is exposed to or injected with very small
doses of possible allergens, and the reactions studied.

 The use of drugs like anti-histamine, adrenalin and steroids quickly reduce the symptoms
of allergy.

Allergy testing
 Somehow, modern-day life style has resulted in lowering of immunity and more
sensitivity to allergens – more and more children in metro cities of India suffer from
allergies and asthma due to sensitivity to the environment. This could be because of
the protected environment provided early in life.

Examples of allergy:
1. Bronchial asthma
2. Hay fever
3. Anaphylactic shock.
Asthma: (allergy of lungs)
 Asthma is an allergy of lower respiratory tract. Caused by allergens like dust or pollen.

 It generally caused due to hypersensitivity of the bronchioles to allergens that enters into
respiratory tract by inhalation.

 When allergen comes in contact with bronchioles, it triggers spasms of the smooth
muscles present in the walls of the bronchiole tube & mucus cells on the wall of air
passage start secreting excess amount of mucus which may close the bronchi and
bronchioles.

• NK cells release cytokines in

response to allergens,
triggering inflammation.
• The air passages become
inflamed, mucus filled and
narrow.
 Symptoms:

 Symptoms includes-
• coughing,
• trouble breathing,
• wheezing mainly during expiration.

Difficulty in
breathing
 Asthma prevention & control

 Avoiding exposure to the allergens.

 Antibiotic therapy to control infection

 Use of bronchodilator drugs, inhalers

for symptomatic relief.
 Hay fever: (allergic rhinitis)

 Hay fever causes cold-like signs & symptoms, such as a runny nose, itchy eyes, congestion,
sneezing and sinus pressure.

 But unlike a cold, hay fever isn't caused by a virus

 Caused by allergens such as dust and mostly pollens.

 Anaphylactic shock

 Anaphylactic shock is a rare but severe allergic reaction that can be deadly if not treat
immediately. (systemic and most severe )

 It's most often caused by an allergy to food, insect bites, or certain medications
(Penicillin injection).

 When penicillin injected into a penicillin sensitive person, penicillin(allergen) stimulates

the secretion of histamine from the mast cells of whole body.

Penicillin
Release of histamine &
other inflammatory agents
 This causes vasodilation and increased permeability of blood vessels. As a result a large
amount of fluid is leaked from blood vessels in to tissue spaces.(decrease in blood volume)

 Due to this blood pressure drops suddenly and airways narrow, blocking breathing. That
may lead to death.

 A shot of a drug called adrenaline or epinephrine is needed immediately.

Normal

Anaphylactic
 Treatment for anaphylaxis:

 A shot of a drug called adrenaline or epinephrine is needed immediately.

Autoimmune disorders
- Immune system attacks on body’s self cells, tissues by mistake
Auto Immunity

 Memory-based acquired immunity evolved in higher vertebrates based on the ability to

differentiate foreign organisms (e.g., pathogens) from self cells. While we still do not
understand the basis of this, two corollaries of this ability have to be understood.

 1. One, higher vertebrates can distinguish foreign molecules as well as foreign

organisms. Most of the experimental immunology deals with this aspect.

 2. Two, sometimes, due to genetic and other unknown reasons, the body attacks self-
cells. This results in damage to the body and is called auto-immune disease.

 Autoimmunity is the immune responses of an organism against its own healthy cells,
tissues and other organs. Any disease that results from such an aberrant immune
response is termed an "autoimmune disease”.

Example:
1. Rheumatoid arthritis
2. Myasthenia gravis. NCERT examples
1. Myasthenia gravis:

 It is an auto immune disorder.

 Due to the formation of auto antibodies against Ach receptors at motor end plate there
by affecting neuromuscular junction leading to fatigue, weakening and paralysis of
skeletal muscle.

 The most commonly affected muscles are those of the eyes, face, and swallowing. It can
result in double vision, drooping eyelids, trouble talking, and trouble walking.

Immune system

Plasma cells
Antibodies
2. Rheumatoid arthritis:

 Rheumatoid arthritis (RA) is an autoimmune disease that can cause joint pain and
damage. The joint damage that RA causes usually happens on both sides of the body. So,
if a joint is affected in one arm, the same joint in the other arm also affected.

 It is due to the presence of rheumatoid factor(IgM type).

 Its primary symptom is inflammation, thickening of synovial membrane. If left untreated,

synovial fluid increases and exerting pressure and that cause pain.

Inflamed synovial membrane

Excess synovial fluid, exerting

pressure & pain.

Loss of cartilage
 The inflamed synovial membrane then starts secreting abnormal granules called
pannus, which causes erosion of articular cartilage.

 As a result, the fibrous tissue are attached with the bones and become ossified,
making the joint immovable.

 Rheumatoid arthritis which affects many people in our society

Treatment:
• Heat treatment
• Physiotherapy.
• Joint replacement therapy in extreme cases
Normal & RA
Other examples of auto immune disorders:
1. Pernicious anemia:
• Antibodies against Castles intrinsic factor, so Vit-B12 can not be absorbed.
• It decreases the blood formation.(Lowers erythropoiesis)

2. Hashimoto disease:
• Antibodies against the thyroid gland, destroy the thyroid gland.
• It leads to hypothyroidism.

3. Addison disease – antibodies against adrenal gland

4. I D D M – Insulin Dependent Diabetes Mellitus (Type I diabetes or Juvenile diabetes):

• Antibodies against the beta cells of pancreas, deficiency of insulin.

5. Multiple sclerosis:
• Antibodies against myelin sheath of nerve cells, neurological dysfunction.

6. Psoriasis:
• Skin disease that causes red, itchy scaly patches, mostly on the knees, elbows, trunk and scalp.
• It is a long-term (chronic) disease with no cure.

7. Vitiligo - When body attacks on its own melanocytes. Loss of pigmentation on skin
 Psoriasis: (autoimmune disorder)

• Skin disease that causes red, itchy scaly patches, most commonly on the knees, elbows, trunk
and scalp.

• Long-term (chronic) disease with no cure.

Red, itchy scaly patches

Vitiligo:
 It is an autoimmune disorder.

 In people with vitiligo, their immune system appears to attack the melanocytes
(pigment cells) in the skin.

 As a result melanocytes do not produce enough melanin in the skin.

 This causes white patches to develop on the skin or hair.

Q. Which of the following is NOT an autoimmune disorder?
1. Psoriasis
2. Rheumatoid arthritis
3. Alzheimer's disease
4. Vitiligo.

Q. Type-I diabetes is:-

1. Insulin dependent
2. Insulin nondependent
3. Aldosterone dependent
4. Glucagon dependent

Q. Autoimmunity against the synovial membrane at joints is called:-

1. Multiple sclerosis
2. IDDM
3. Hashimoto disease
4. Rheumatoid arthritis
Immunodeficiency disorders
– person get sick more often & infections may last longer
Immunodeficiency disorders:
 Immunodeficiency disorder is a medical condition in which body is unable to fight
infectious agents & diseases.

 It is also known as immune-compromisation.

 Caused by mutations and infections

Examples:
1. SCID or ADA deficiency 2. AIDS
• Severe Combined Immune Deficiency • Acquired immune deficiency syndrome

• Caused by mutation in ADA gene. • Caused by HIV infection

• It results deficiency of adenosine • HIV mainly attacks on T-helper cells.

deaminase.
• This causes the decrease count of T-
• This enzyme is very important for normal helper cells to critical low level.
functioning of immune system.
• Person become so immune deficient.
• Treatment – Gene therapy.
Immunotherapy:
 It is a treatment procedure that involves increase or decrease immune responses to
achieve therapeutic effects.( Manipulation of the immune response)

 This is carried out by giving immunomodulators.

 There are two general clinical approaches of immunomodulation.

1. Immunopotentiate therapy:

• Administration of immunopotentiate agents like preformed antibodies or alpha

interferons.
• This strategy augments the immune response.

2. Immunosupressive therapy:

• In case of autoimmune disorders , to suppress the autoimmunity, patients are given

by immumo suppressive agents like steroids, cyclosporine-A and cortisol etc
 Boost your
immunity

Thank you