SECOND WORKSHOP:

2009-02
R. Hugo Martínez Lozano, M.D.
Sept-04-2009
Examples of innate immunity: Forms of adpative immunity:
-External barriers -Humoral
-Phagocytosis -Cellular
-Complement
-TLR
-NK cells
“missing
self”

-Viran inf.
-Neoplasia
-Transplant r.
Lymphocyte
PLASMA CELL
Most prominent
Organelle?
TISSUE?
Adaptive immunity: cells and
tissues
TISSUE? STAINED CELL?
 Immune response
• Cells
• Tissues
• Mechanisms (vgr. HLA systems)
HYPERSENSITIVITY REACTIONS
Bronchial asthma… thick mucus plug… other microscopic
 HYPERSENSITIVITY REACTION II

Opsonins (& C)-mediated phagocytosis

Complement (& Fc R)-mediated inflammation

Anti-Receptor disease
SELECTED EXAMPLES OF H.R.-II
• HEMOLYTIC ANEMIAS
• GOODPASTURE SYNDROME
• PEMPHIGUS V.
• INSULIN-RESISTENT DIABETES
• MYASTHENIA GRAVIS
• GRAVES DISESASE
GOODPASTURE DIS.
PATHOGENESIS:
VASCULITIS
(PHASES)
“GRANULAR” PATTERN
HYPERSENSITIVITY
REACTION IV
CONTACT DERMATITIS: Perforins, granzymes laden T cells
SLE: SKIN… ANTI-B.M. INJURY
IDEM “Wire-loops”
Idem…Diffuse Proliferative glomerulonephritis:
LIBMAN-SACHS
ENDOCARDITIS
Pannus
Sjogren
 Stiffness of
the
skin.

Types of sclero-
dermia…
CREST SX… Meaning?
 Adaptive immunity
• Humoral (Abs.)
-pyogenic bacteria.
-some virus & protozoos (luminal)
• Cellular (cells & cytokines)
-Many fungi
-Many viruses
-Other intracytoplasmic microbs
 IMMUNE DEFICIENCY
SYNDROMES.
II.- PRIMARY:
RECOMMENDED STUDY:
- X-LINKED AGAMMAGLOBULINEMIA
- COMMON VARIABLE IMMUNODEF.
- ISOLATED IgA DEF.
- DiGEORGE SYNDROME
- SEVERE COMBINED IMMUNODEF
- WISKOTT-ALDRICH SYNDROME
GIARDIA
LAMBLIA
CANDIDIASIS
MEASLES’ PNEUMONIA
P.A.S.
“ASPERGILLOMA”
SILVER STAIN
MYCOBACTERIOSIS
CRIPTOSPORIDIASIS
CM
INTRANUCLEAR INCLUSIONS
Kaposi Sarcoma
Idem
Idem
BURKITT LYMPHOMA
 NEOPLASIA
• DEFINITIONS:
- TUMOR
- NEOPLASIA: “New growth”
- CANCER
- ONCOLOGY
 NEOPLASIA I
• BIOLOGY (AND MORPHOLOGY)
B M
- DIFFERENTIATION WELL ANAPLASIA
- CAPSULE (OR PSEUDO) +++ - OR +
- GROWTH RATE + +++
- NUCLEAR ABNORMALITY + +++
- MITOSES - 0R + +++
- ARCHITECTURAL AB. - OR + +++
- METASTASIS NO COMMON

R. HUGO MARTINEZ
Proliferative endometrium… polarity.
ADENOCARCINOMA
Uterine
BREAST CARCINOMA
 NEOPLASIA I
• NEOPLASTIC DISSEMINATION:
I - LOCAL INVASION
II- SPREAD:
1) SEEDING (IN CAVITIES)
2) METASTASIS – LYMPH NODES
- BLOOD-BORN
COLONIC ADENOCARCINOMA: LOCAL INVASION
Peritoneal
Invasion to a lymphatic capillary
BLOOD-BORN METASTASIS ARRIVING TO…
 REGULATORY GENES
• GROWTH-PROMOTING (PO)
• GROWTH-INHIBITING (TSG)
• APOPTOSIS
• DNA REPAIR
 PROTOONCOGENES
• PHYSIOLOGIC REGULATORS OF CELL
PROLIFERATION & DIFFERENTIATON
- GROWTH FACTORS
- GROWTH FACTOR RECEPTORS
- REGULATORY PROTEINS –TRANSDUCER
- NUCLEAR

- ETC. (Table 7-8, p. 295)

- Examples: FGF, TGF, RAS, Abl, etc.
M.M. (PO fgf3/int-2)
Cholangiocarcinoma (K-ras)
 TSG
• RB
• P53
• OTHER… NF
P16
WT-1
WT-X
BRCA
AT (ATM)
COLPOSCOPY
CYTOLOGY: HPV SIGNS
RB GENE &
RETINOBLASTOMA:
“PARADIGM FOR THE
2 HIT HYPOTHESIS”
ADENOMATOUS POLYP
MULTIPLE POLYPOSIS
SEQUENTIAL & CONCURRENT
HPV infection…
DNA REPAIR
DEFECTS
(GENOMIC
INSTABILITY)

XERODERMA
PIGMENTOSUM
AT
Telomeres: Up to 2000 repeats of the 5’TTAGGG3’ sequence
DETACHMENT
VASCULAR DISS.
& HOMING
Pancoast t.

SVC Sx.
IDEM.
FIBROSARCOMA: I-like substance
RENAL CELLS
CARCINOMA
FEMORAL VENOUS THROMBOSIS (TROUSSEAU´S PHENOMENON)
PANCREATIC ADENOCARCINOMA
ACANTHOSIS NIGRICANS
ACANTHOSIS
NIGRICANS

50% OR MORE…

Most likely neop?

CACHEXIA
PrP
 BACTERIOPHAGES, PLASMIDS & TRANSPOSONS

BACTERIOPHAGES &
PLASMIDS = VIRULENCE

PLASMIDS & TRANSPOSONS

= RESISTANCE
Coliphages T-1
Infecting a
bacteria
•TRANSIENT VIRAL INFECTIONS
•CHRONIC LATENT INF (HERPESVIRUS)

•CHRONIC PRODUCTIVE INF.

•TRANSFORMING
 TRANSIENT V.I.

MEASLES
GIANT CELLS PNEUMONITIS
SSPE
Denervation
CHRONIC LATENT INF. ORAL HERPES SIMPLEX
GENITAL HERPES
HERPES: Vesicle due to Acantholisis…a polykarion (arrow)
HERPETIC ENCEPHALITIS
HERPES-
ZOSTER
CHRONIC PRODUCTIVE
“ATYPICAL” LYPMHOCYTES IN BLOOD ETIOLOGIC AGENT? T.I
 MECHANISMS OF BACTERIAL
INJURY
• ADHERENCE TO HOST CELLS
• TOXINS
• ENZYMES
• INTRACELLULAR B. (IMMUNE RESP.)
• VIRULENCE
 IMMUNE EVASION BY
MICROBES
• VARIATION
• SHEDDING
• INHIBITION OF IMMUNITY
MYCOPLASMAS ATACHED TO EPITHELIAL CELL.
CHLAMYDIA BODIES
Ehrlichia
Haemophilus i.