K2 - Imunologi Kulit

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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

Date post:	07-Aug-2018
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