Samenvatting Immunologie
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Inhoud
Thema 1: Inleiding Immunologie .................................................................................................. 5
1.1 Innate en Adaptief ........................................................................................................................ 5
1.2 Linies van afweer .......................................................................................................................... 6
1.3 Cellen van het immuunsysteem.................................................................................................... 7
1.4 Inleiding fagocytose .................................................................................................................... 10
1.5 Lymfoïd weefsel .......................................................................................................................... 11
Thema 2: Aangeboren immuniteit – Complement systeem.......................................................... 14
2.1 Activatie complement systeem: 3 belangrijke functies .............................................................. 15
2.2 Complement activatie via 3 routes ............................................................................................. 16
2.3 Regulering ................................................................................................................................... 21
Thema 3: Aangeboren immuniteit – Ontstekingsreactie .............................................................. 23
3.1 Cytokines ..................................................................................................................................... 23
3.2 Inleiding ontstekingsreacties ...................................................................................................... 27
3.3 Fasen ontstekingsreacties ........................................................................................................... 28
3.4 Fagocytose .................................................................................................................................. 28
3.5 Hyperemie & Exsudatie............................................................................................................... 31
3.6 Diapedese neutrofiel................................................................................................................... 32
Thema 4: Antilichamen en B-cel receptoren ................................................................................ 36
4.1 Inleiding....................................................................................................................................... 36
4.2 Structuur en functie .................................................................................................................... 38
4.3 Effector functies .......................................................................................................................... 40
4.4 Antigeen-antilichaam interactie ................................................................................................. 42
4.5 Immunoassays............................................................................................................................. 44
Thema 5: Diversiteit van B-cel receptoren en antilichamen ......................................................... 46
5.1 Ontwikkeling B-cel ...................................................................................................................... 46
5.2 Allelic exclusion ........................................................................................................................... 47
5.3 Sommatische recombinatie ........................................................................................................ 48
5.4 Nucleotide additie & variabele recombinatie ............................................................................. 50
5.5 Inleiding B-cel differentiatie........................................................................................................ 52
Thema 6: Herkenning van antigeen door T-lymfocyten (TCR en MHC) .......................................... 58
6.1 Antigeen herkenning door TCR ................................................................................................... 59
6.2 Structuur & diversiteit TCR ......................................................................................................... 60
6.3 Structuur & Ag presentatie MHC ................................................................................................ 63
6.4 Peptide belading MHC ................................................................................................................ 65
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6.5 Diversiteit MHC ........................................................................................................................... 69
Thema 7: De ontwikkeling van T-lymfocyten............................................................................... 73
7.1 Rijping Thymus ............................................................................................................................ 73
7.2 Selectie T-lymfocyt ...................................................................................................................... 76
7.3 T-cel homing................................................................................................................................ 78
7.4 Antigeenpresentatie ................................................................................................................... 78
Thema 8: T-cel gemedieerde immuniteit..................................................................................... 81
8.1 De immunologische synaps......................................................................................................... 81
8.2 Activatie Th-cel ............................................................................................................................ 82
8.3 Activatie Tc-cel ............................................................................................................................ 84
8.4 Clonale expansie ......................................................................................................................... 85
8.5 Deactivatie T-cel.......................................................................................................................... 86
8.6 CD40L & effectorfuncties ............................................................................................................ 87
8.7 Cytokine gemedieerde differentiatie .......................................................................................... 87
8.8 Effector Th1 functies ................................................................................................................... 90
Thema 9: B-cel en antistof gemedieerde immuniteit ................................................................... 92
9.1 Activatie B-cel ............................................................................................................................. 92
9.2 Activatie zonder T-cel (alleen antigen activatie)......................................................................... 93
9.3 Activatie met TFH-cel.................................................................................................................... 93
9.4 Clonale deling & somatiche hypermutatie ................................................................................. 95
9.5 Selectie & isotype switch ............................................................................................................ 98
9.6 Primaire & secondaire immuunreactie ..................................................................................... 101
Thema 10: Cellulaire cytotoxiteit .............................................................................................. 104
10.1 Inleiding afweer tegen virussen .............................................................................................. 104
10.2 Cel-gemedieerde cytotoxiteit: Tc-cel ...................................................................................... 105
10.3 Interferonen ............................................................................................................................ 107
10.4 Antistoffen & complement ..................................................................................................... 109
10.5 Cel-gemedieerde cytotoxiteit: NK-cel ..................................................................................... 110
10.6 Slimme virussen ..................................................................................................................... 112
10.7 HIV (human immunodeficiency virus)..................................................................................... 114
Thema 11: Overgevoeligheidsreactie van het immuunsysteem.................................................. 116
11.1 Inleiding overgevoeligheidsreacties........................................................................................ 116
11.2 IgE & worminfecties ................................................................................................................ 117
11.3 Type I reacties ......................................................................................................................... 117
11.4 Basis mechanisme ................................................................................................................... 118
11.5 Symptomen ............................................................................................................................. 120
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10.6 Luchtweg allergieën ................................................................................................................ 122
10.7 Therapie .................................................................................................................................. 123
10.8 Diagnostiek.............................................................................................................................. 124
Thema 12: Autoimmuniteit en autoimmuunziekten .................................................................. 125
12.1 Centrale tolerantie .................................................................................................................. 126
12.2 Perifere tolerantie ................................................................................................................... 127
12.3 Extra mechanismen voor tolerantie ....................................................................................... 128
12.4 Ontstaan van auto-immuunziekten ........................................................................................ 128
12.5 Indeling van auto-immuunziekten .......................................................................................... 130
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Inhoud
Thema 1: Inleiding Immunologie .................................................................................................. 5
1.1 Innate en Adaptief ........................................................................................................................ 5
1.2 Linies van afweer .......................................................................................................................... 6
1.3 Cellen van het immuunsysteem.................................................................................................... 7
1.4 Inleiding fagocytose .................................................................................................................... 10
1.5 Lymfoïd weefsel .......................................................................................................................... 11
Thema 2: Aangeboren immuniteit – Complement systeem.......................................................... 14
2.1 Activatie complement systeem: 3 belangrijke functies .............................................................. 15
2.2 Complement activatie via 3 routes ............................................................................................. 16
2.3 Regulering ................................................................................................................................... 21
Thema 3: Aangeboren immuniteit – Ontstekingsreactie .............................................................. 23
3.1 Cytokines ..................................................................................................................................... 23
3.2 Inleiding ontstekingsreacties ...................................................................................................... 27
3.3 Fasen ontstekingsreacties ........................................................................................................... 28
3.4 Fagocytose .................................................................................................................................. 28
3.5 Hyperemie & Exsudatie............................................................................................................... 31
3.6 Diapedese neutrofiel................................................................................................................... 32
Thema 4: Antilichamen en B-cel receptoren ................................................................................ 36
4.1 Inleiding....................................................................................................................................... 36
4.2 Structuur en functie .................................................................................................................... 38
4.3 Effector functies .......................................................................................................................... 40
4.4 Antigeen-antilichaam interactie ................................................................................................. 42
4.5 Immunoassays............................................................................................................................. 44
Thema 5: Diversiteit van B-cel receptoren en antilichamen ......................................................... 46
5.1 Ontwikkeling B-cel ...................................................................................................................... 46
5.2 Allelic exclusion ........................................................................................................................... 47
5.3 Sommatische recombinatie ........................................................................................................ 48
5.4 Nucleotide additie & variabele recombinatie ............................................................................. 50
5.5 Inleiding B-cel differentiatie........................................................................................................ 52
Thema 6: Herkenning van antigeen door T-lymfocyten (TCR en MHC) .......................................... 58
6.1 Antigeen herkenning door TCR ................................................................................................... 59
6.2 Structuur & diversiteit TCR ......................................................................................................... 60
6.3 Structuur & Ag presentatie MHC ................................................................................................ 63
6.4 Peptide belading MHC ................................................................................................................ 65
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6.5 Diversiteit MHC ........................................................................................................................... 69
Thema 7: De ontwikkeling van T-lymfocyten............................................................................... 73
7.1 Rijping Thymus ............................................................................................................................ 73
7.2 Selectie T-lymfocyt ...................................................................................................................... 76
7.3 T-cel homing................................................................................................................................ 78
7.4 Antigeenpresentatie ................................................................................................................... 78
Thema 8: T-cel gemedieerde immuniteit..................................................................................... 81
8.1 De immunologische synaps......................................................................................................... 81
8.2 Activatie Th-cel ............................................................................................................................ 82
8.3 Activatie Tc-cel ............................................................................................................................ 84
8.4 Clonale expansie ......................................................................................................................... 85
8.5 Deactivatie T-cel.......................................................................................................................... 86
8.6 CD40L & effectorfuncties ............................................................................................................ 87
8.7 Cytokine gemedieerde differentiatie .......................................................................................... 87
8.8 Effector Th1 functies ................................................................................................................... 90
Thema 9: B-cel en antistof gemedieerde immuniteit ................................................................... 92
9.1 Activatie B-cel ............................................................................................................................. 92
9.2 Activatie zonder T-cel (alleen antigen activatie)......................................................................... 93
9.3 Activatie met TFH-cel.................................................................................................................... 93
9.4 Clonale deling & somatiche hypermutatie ................................................................................. 95
9.5 Selectie & isotype switch ............................................................................................................ 98
9.6 Primaire & secondaire immuunreactie ..................................................................................... 101
Thema 10: Cellulaire cytotoxiteit .............................................................................................. 104
10.1 Inleiding afweer tegen virussen .............................................................................................. 104
10.2 Cel-gemedieerde cytotoxiteit: Tc-cel ...................................................................................... 105
10.3 Interferonen ............................................................................................................................ 107
10.4 Antistoffen & complement ..................................................................................................... 109
10.5 Cel-gemedieerde cytotoxiteit: NK-cel ..................................................................................... 110
10.6 Slimme virussen ..................................................................................................................... 112
10.7 HIV (human immunodeficiency virus)..................................................................................... 114
Thema 11: Overgevoeligheidsreactie van het immuunsysteem.................................................. 116
11.1 Inleiding overgevoeligheidsreacties........................................................................................ 116
11.2 IgE & worminfecties ................................................................................................................ 117
11.3 Type I reacties ......................................................................................................................... 117
11.4 Basis mechanisme ................................................................................................................... 118
11.5 Symptomen ............................................................................................................................. 120
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10.6 Luchtweg allergieën ................................................................................................................ 122
10.7 Therapie .................................................................................................................................. 123
10.8 Diagnostiek.............................................................................................................................. 124
Thema 12: Autoimmuniteit en autoimmuunziekten .................................................................. 125
12.1 Centrale tolerantie .................................................................................................................. 126
12.2 Perifere tolerantie ................................................................................................................... 127
12.3 Extra mechanismen voor tolerantie ....................................................................................... 128
12.4 Ontstaan van auto-immuunziekten ........................................................................................ 128
12.5 Indeling van auto-immuunziekten .......................................................................................... 130
