Post on 07-Aug-2018
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DMS
Skin Immunology Ageng Brahmadhi
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Integumentum layers
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Functions
Protection against injury, bacterialinvasion, and desiccation
Regulation of body temperature
Reception of continual sensations from the
environment (e.g., touch, temperature, andpain
Excretion from sweat glands
Absorption of ultraviolet radiation from thesun for the synthesis of vitamin D.
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Epidermis
Mainly composed by Stratifed squamous keratinizedepithelium another cells population:
Keratinocytes
Langerhans cells
Melanocytes Merkel cells
ased on epidermis layer skin divided into ! class" #hick skin"
soles of feet, palms of hands
$ layer of epidermis
#hin skin Most skin
% layer of epidermis
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Dermis (Corium)
The layer o skin immediately deep to theepidermis
Divided into two layers papillary layer
reticular layer
&ontains all the cells of connective tissue proper
'ccessory organs "hair follicles and sweat glands,
etworks of blood vessels, lymph vessels, andnerve )bers
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Hypodermis
ot a part of skin Mostly adipose tissue
(some areolar* +besity due to
accumulation ofsubcutaneous fat
'bout - thicker inwomen than men
unctions" inds skin to underlying
tissue /nergy reservoir (fat* #hermal insulation 0adding1cushioning
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Skin’s Defense System
2nherent 3kin 2mmune 3ystem
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Inherent (Non-immune) Skin Defenses
0hysical 4esistance to mechanical trauma
4elatively water impermeable
0hysical separation between self and nonself
&hemical ree fatty acids
ree radical trapping
'ntimicrobial peptides
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Inherent Skin Defenses (cont’d)
0hotoprotective Melanin as a 56 chromophore
2njury repair
Microbiological
3ebum production
7ome for coloni8ing, nonpathogenic bacteria
that" &ompete for nutrients
&ompete for attachment
0roduce antibacterial substances
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Skin Immune System
Components9. &ells" '0&s, 0hagocytes, lymphocytes,
endothelial cells, keratinocytes
!. 7umoral components
:. Draining regional lymph vessels and nodes
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Innate Immune Features of the Skin
o speciali8ation for skin &ellular component
0hagocytes" Macrophages, neutrophils, K cells
Mast cells
7umoral" &omplement
&ytokines, histamine
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Cells of the Cutaneous Adaptive Immune Response
Langerhans; cell Dermal dendrocytes
Keratinocytes
#
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Some cellular components of the skin immunesystem
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Keratinocytes
0rime role
make the protective horny layer
support to the outermost epithelium of the body
immunological functions
0roduce large numbers of cytokines &an be induced by =press 7L'
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Cytokines produce by kertainocytes
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Langerhans cells
one marrow
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Langerhans cells
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Dermal dendritic cells
poorly characteri8ed cells found around the tiny blood vessels of the
papillary dermis.
M7& &lass 22 antigens
probably function as antigen presenting cells
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Mast cells
present in most connective tissues,predominantly around blood vessels
granules contain inCammatory mediators
3timuli"
2mmunologic " 2g/ binding antigen onimmunologic" 0hysical, drugs,
complement
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Mast Cells
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Endothelial Cells
2ncrease permeability hen activated, endothelial cells
cell surface e>pression of 0 and /pression of 6&'M
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γδ T-Cells
2ntraepidermal lymphocytes
4esident in epitheliaF do not recirculate
4estricted γδ− #&4
0resence and function in human skin are stillcontroversial
May play a role in combating antigens thatenter through the skin
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'nother cells types" T lymphocytes T-helper (TH)/inducer cells
T-cytotoic (TC) cells
L cells/null (non-T, non-! cells !atural killer cells
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"olecular components of the s#inimmune system 'ntigens and haptens
3uperantigens
'ntibodies (immunoglobulins* &ytokines
'dhesion molecules &ellular adhesion molecules (&'Ms*
7istocompatibility antigens
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Response Patterns of the Skin
Immune System
Example...
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Skin immunopathology
"echanism $isease %mmunecomponentsin&ol&ed
6iral infection 6aricella 1herpes
8oster7369 E 736!
&lass 2 M7&
molecules&ytoto>ic # cell
#ype 26hypersensitivity
#uberculin test&ontact dermatitis
&ell mediatedimmunity
#ype 27ypersensitivity 5rtikaria (wheal andCare* Mast cell, #h!, 2g/
acterialinfection
M. Leprae(intracellular*3taphylococcalinfection
#h9 E #h!response'ntibody, #h!,complement
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The keratinocyte and wound healing
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T-lymphocyte activation
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Type I: immediate hypersensitivity reactions
5rticaria" an immediate (type 2* hypersensitivity reaction
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Type II: humoral cytotoxic reactions
ullous pemphigoidF a humoral cytoto>ic (type 22* reaction against a basementmembrane 8one antigen.
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Type III: immune complex-mediated reactions
2mmune comple>
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Type IV: cell-mediated immune reactions
%nduction phase of allergic
contact dermatitis
Elicitation phase of allergic
contact dermatitis
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Response to intracellular antigens
2ntracellular fungi or viruses and tumourantigens presented to cytoto>ic # cells (&DG* by theM7& &lass 2 molecule to destruction bycytoto>ic # lymphocytes or K cells.
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Summary...
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Further readings
3kin 2mmune 3ystemF &utaneous 2mmunologyand &linical 2mmunodermatology Third "dition
&linical Dermatology