Ahfad University for Women School of Medicine Basic and Applied Immunology Course Dr Rayan Gamal Goda 2nd Year Registrar Soba University Hospital Clinical Immunology and Allergy MD Programme Sudan Medical Specialization Board Member of Sudanese society for clinical immunology and allergy Member of sudanese Association of Rheumatology

Course Objectives Offer a quick revision of basic immunology, and covers important topics in clinical immunology. Emphasize the role of immunology in current medical practice Walk you through important, difficult topics. More importantly to help you understand immunology and simplify this very interesting subject.

This course will be... Key point guided, interactive tutorials All is encouraged to participate If no one participates; ..... ?? Hello!!! Write down a list of all topics you want to be covered. SLE, RA, Primary immunodeficiency...etc Basically: a tailored course to your needs.

This course is for you; please... Ask and don’t be afraid to know Participate actively. Help me help you.

What do we know? Where do we stand? ...etc. Basic Immunology What do we know? Where do we stand? ...etc.

What is ... Immunology Immune Response Components of the immune system Innate immunity Adaptive immunity Tolerance and autoimmunity Tumour Immunology Transplantation Clinical immunology

Immune Response The reaction that occurs in response to the introduction of foreign substances. Most of medicine and medical practice revolves around this point. Foreign substances; microbes, cancer cells, chemical substances, ...etc.

The Immune Response Innate/ natural or native immunity Components: Skin Mucosal Epithelia Chemical Barriers: e.g. Defensins. Others: plasma proteins; complement, cytokines, acute phase reactants. Cells: DCs, phagocytes, NK cells, T& B cells, Mast cells.

Adaptive immunity Components: Cell mediated immunity Humoral immunity Lymphocytes Antibodies

Immune Response

Organs of the Immune System What are the organs of the immune system? Bone Marrow Liver Spleen Thymus Lymph nodes Lymphatic vessels

The lymphatic system

INNATE IMMUNE RESPONSE Receptors: e.g. Pathogen Associated Molecular Patterns, Death Associated Molecular Patterns, ... NOD Like receptors, RIG like receptors, ...etc Cellular components: Epithelial barriers, Phagocytes, Dendritic Cells, Natural killer cells (NK Cells), B and T lymphocytes with limited specificity, and Mast Cells.

Pathogen Associated Molecular Patterns (PAMPs) Soluble components: Natural antibodies, acute phase reactants, complement. Natural Antibodies: e.g. IgM. Acute Phase Reactants: e.g. IL-8. Defensins and Cathelicidins. Soluble Receptors: complement, Pentraxins, , Collectins, and Ficolins.

Death Associated Molecular Patterns (DAMPs) They play a role in the natural homeostasis of the immune system. They recognize endogenous molecules that are produced from damaged or dying cells. Can be: stress induced proteins Heat Shock Proteins (HSPs) Crystals: Monosodium urate Nuclear Proteins: HMGB1.

Mechanisms Physical barriers Chemical barriers Cellular mechanisms: PHAGOCYTOSIS ( MACROPHAGES, DCs, B CELLS,...ETC) NK CELLS: including Natural Killer T cells. T & B CELLS including ᵞᵟ T cells MAST CELLS < < WHY? - Eosinophils, and basophils.

CELLS OF THE IMMUNE SYSTEM Phagocytes: Dendritic cells Monocytes /Macrophages Neutrophils Mast cells Eosinophils Basophils

Dendritic cells These are the guru cells, everything in immunology begins with the dendritic cells. Also known as the best Antigen Presenting Cells.

PHAGOCYTOSIS

Cytokines of Innate Immunity

Complement It is a group of plasma proteins, work to opsonize microbes, promote the recuitment of phagocytes to the site of infection, and sometimes directly kill the microbe. It is composed of 3 different pathways: Classical , alternative and Mannose- binding Lectin pathways. All these pathways meet at C3, to form c5,c6,c7,c8,c9 ... Membrane Attack Complex (MAC). It can also help to activate B cells, in adaptive immunity.

NATURAL KILLER CELLS

Inflammation

Case study

In reflection to what we discussed: how did these problem occur? How was the immune system involved? Questions..??

THANK YOU!! If you have a questions, problems, feel free to contact me at any time: Email: rayangoda@gmail.com Maybe a group google hangout?!!