General Pathology

1
General Pathology

• Basic Principles of Cellular and Organ Pathology
• Infection II
• Autoimmune Diseases

http//www1.lf1.cuni.cz/jdusk/
Jaroslava Dušková Inst. Pathol. ,1st Med.
Faculty, Charles Univ. Prague
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Inflammation - causes

• nonliving
• physical
• chemical

• living
• prions (?)
• viral
• bacterial
• mycotic
• parasitic
• AUTOIMMUNE

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Infectious Agents of Humans Viruses

• virion
• obligate intracellular
• either DNA (adeno, herpes, pox, cytomegalo, EB,
  papova, HPV, ..
• or RNA (picorna - entero, polio, coxsackie
  arbo, rhino, arbo, myxo, paramyxo, RS, rubeola,
  rabdo, retro,)

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Virion

• capsid
• helical symmetry
• icosaedral symmetry
• genome
• DNA
• RNA

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Host Microorganism Encounter

• General
• Natural defenses
• Inflammation
• Immune status

• Successful transmission
• Site of attack
• Number of microorg.
• Pathogenicity

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Host

• Inflammation
• leucocytes
• macrophages -phagocytosis
• Immune status
• immunity (or lack of it)
• active, passive immunisation, contact
• lymphocytes
• immunoglobulins
• complement

• General
• age, race, nutrition, other diseases (diabetes)
• Natural defenses
• skin, mucose integrity
• mucus, cilliary action, unobstructed flow
• protective secretion (lysosym in tears, gastric
  acid, IgA

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Microorganism

• Successful transmission
• Site of attack
• Number of microorg.
• Pathogenicity invasiveness
• toxin production
• multiplication
• resistence to host
  defence mechanisms
• ability to cause necrosis
• enzyme release

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Virus Host Cell Interaction

• cytocidal
• stabilised (steady state)
• transformation ONCOGENS

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Virus-Induced Injury

• cell entering - surface ligands viral tropism
• translocation of the entire virus
• fusion of the viral envelope with the cell
  membrane
• receptor mediated endocytosis
• intracellular replicative phase forming of
  virions using virus specific enzymes
• virus assembly release extracellular phase

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Virus Organism Interaction

• infected cell
• lysis by antibody and complement
• cell mediated immunity lymphocytes
  macrophages interferon ?

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Virus-Induced Injury

• Host cell responses
• DNA, RNA and protein synthesis
• metabolic derangements
• cell lysis / cell fusion
• multinuclear formation
• viral inclusions

12
Infectious Agents of Humans Viruses

• virion
• obligate intracellular
• either DNA (adeno, herpes, pox, cytomegalo, EB,
  papova, HPV, ..
• or RNA (picorna entero, polio, coxsackie
  arbo, rhino, arbo, myxo, paramyxo, RS, rubeola,
  rabdo, retro,)

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Inflammation

• Definition
• complex reaction of organism to damage
• (aim homeostasis maintenance)

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Inflammation - Causes

• nonliving
• physical
• chemical

• living
• viral
• bacterial
• mycotic
• parasitic
• AUTOIMMUNE

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Inflammation immunity

• Nonspecific antibodies
• imunocomplexes on dendritic cells
• long lasting antigen presentation

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Mechanisms of Immune Response

• antigen specific
• humoral B lymphocytes
• cellular T lymphocytes
• INTERACTION
• B-lymphoTh affinity maturation plasmocyte

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Autoimmunity

• Def.
• lack of self-tolerance

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Autoimmunity

• constant activity in
• organogenesis
• regeneration
• metalaxia

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Autoimmune Diseases

• loss of self-tolerance resulting into damage of
  organ /tissue

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Mechanisms Preventing Antiself Reactivity

• clonal deletion (thymus)
• clonal anergy (thymus)
• peripheral clonal supression by
  Tsupressor cells ( B,T helpers)

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Inflammation autoimmune Systemic autoimmune
diseases

• DISEASE
• SLE
• RA
• Sjögren dis.
• Syst. sclerodermia
• Dermatopolymyositis
• Prim. vasc. syndromes

• ANTIBODY
• ANA, ENA
• collag. II, Fc Ig
• (rheum. factor)
• ANA,ENA
• ENA (Scl70)
• ENA (Jo1)
• ANCA

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Inflammation autoimmune Organ autoimmune
diseases skin

• ANTIBODY
• intercel. epit. matrix
• basal membrane of epidermis

• DISEASE
• pemphigus
• pemphigoid

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Inflammation autoimmune Organ autoimmune
diseases endocrine

• ANTIBODY
• TGB, microsomes
• pancreas ? cells
• insulin
• ins. receptors
• adrenal microsomes
• TSH rec.

• DISEASE
• GB, HT
• DM I
• Ires. DM
• Ires. DM
• Adison dis.
• GB

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Inflammation autoimmune Organ autoimmune
diseases GIT

• ANTIBODY
• mitochondrie
• membr. hct., cytosol
• gliadin

• DISEASE
• prim. bill. cirrhosis
• CAH
• gluten enteropathy

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Inflammation autoimmune Organ autoimmune
diseases CNS

• ANTIBODY
• acetylcholin rec.
• basic myelin protein

• DISEASE
• myasthenia gravis
• disseminated sclerosis