Cytokines health and disease ppt for pathology resident doctor
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Running Command
mkdir -p /home/daytona/workspace/cytokines-ppt && ls /home/daytona/workspace/
Writing File
~/cytokines-ppt/build.js
const pptxgen = require("pptxgenjs");
const pres = new pptxgen();
pres.layout = "LAYOUT_WIDE";
pres.title = "Cytokines: Health and Disease";
pres.author = "Pathology Resident Education";
// ============================================================
// COLOR PALETTE
// ============================================================
const C = {
deepNavy: "0D1B2A", // dominant dark bg
navy: "1A2F4B",
midBlue: "1E4D8C",
accent: "00B4D8", // cyan-teal accent
accentGold: "F4A261", // warm gold
accentRed: "E63946", // alert red
accentGreen:"2D9D78", // healthy green
white: "FFFFFF",
lightGrey: "D6E4F0",
textLight: "B8D4EA",
textDark: "0D1B2A",
};
// ============================================================
// HELPERS
// ============================================================
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fontSize:42, bold:true, color:C.white, fontFace:"Calibri",
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// ============================================================
// SLIDE 1: TITLE
// ============================================================
let s = pres.addSlide();
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// decorative circles
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s.addText("CYTOKINES", {
x:0.5, y:0.9, w:12.3, h:1.3,
fontSize:54, bold:true, color:C.white, fontFace:"Calibri",
align:"center", charSpacing:6
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s.addText("Health and Disease", {
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fontSize:30, color:C.accent, fontFace:"Calibri",
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});
s.addShape(pres.ShapeType.rect, { x:3, y:3.0, w:7.3, h:0.05, fill:{color:C.accent} });
s.addText("A Comprehensive Overview for Pathology Residents", {
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fontSize:16, color:C.textLight, fontFace:"Calibri", align:"center"
});
s.addText([
{ text: "Sources: ", options:{bold:true, color:C.accentGold} },
{ text: "Henry's Clinical Diagnosis & Management | Cellular & Molecular Immunology | Schwartz's Surgery | Robbins Pathology", options:{color:C.textLight} }
], {
x:0.5, y:6.7, w:12.3, h:0.4,
fontSize:11, fontFace:"Calibri", align:"center"
});
// ============================================================
// SLIDE 2: OVERVIEW / AGENDA
// ============================================================
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s.addText("Lecture Outline", { x:0.3, y:0, w:12.7, h:0.7, fontSize:22, bold:true, color:C.white, fontFace:"Calibri", valign:"middle", margin:0 });
s.addShape(pres.ShapeType.rect, { x:0, y:0.7, w:"100%", h:0.04, fill:{color:C.accent} });
const agenda = [
["01", "What Are Cytokines?", "Definition, history, key properties"],
["02", "Classification & Families", "Structural and functional groupings"],
["03", "Cytokine Receptors", "Five receptor superfamilies"],
["04", "JAK-STAT Signaling", "Central pathway and SOCS regulation"],
["05", "Cytokines in Innate Immunity", "Pro-inflammatory cascade"],
["06", "Cytokines in Adaptive Immunity", "Th1 / Th2 / Th17 / Treg balance"],
["07", "Cytokines in Disease", "Autoimmunity, cancer, sepsis"],
["08", "Cytokine Therapeutics", "Biologics, JAK inhibitors, clinical use"],
["09", "Cytokine Assays in the Lab", "ELISA, multiplex, clinical relevance"],
["10", "Key Takeaways", "High-yield review for pathology practice"],
];
const col1 = agenda.slice(0,5);
const col2 = agenda.slice(5);
col1.forEach((a, i) => {
const yy = 0.95 + i*0.92;
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s.addText(a[0], { x:0.3, y:yy, w:0.48, h:0.48, fontSize:13, bold:true, color:C.deepNavy, align:"center", valign:"middle" });
s.addText(a[1], { x:0.9, y:yy-0.04, w:5.3, h:0.35, fontSize:15, bold:true, color:C.white, fontFace:"Calibri", valign:"bottom" });
s.addText(a[2], { x:0.9, y:yy+0.28, w:5.3, h:0.3, fontSize:12, color:C.textLight, fontFace:"Calibri", valign:"top" });
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const yy = 0.95 + i*0.92;
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s.addText(a[1], { x:7.4, y:yy-0.04, w:5.3, h:0.35, fontSize:15, bold:true, color:C.white, fontFace:"Calibri", valign:"bottom" });
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});
// ============================================================
// SLIDE 3: WHAT ARE CYTOKINES?
// ============================================================
s = pres.addSlide();
contentSlide(s, "What Are Cytokines?", [
{ heading:"Definition:", text:"Small secreted proteins (8–80 kDa) that regulate cell-to-cell communication, immune activation, inflammation, hematopoiesis, and tissue repair" },
{ heading:"Term coined:", text:"Stanley Cohen, 1975 - to describe activities released by epithelial cells. Before this, lymphokines (from T cells) and monokines (from monocytes) were described separately" },
{ heading:"Key properties:", text:"Pleiotropism (one cytokine, multiple effects) | Redundancy (multiple cytokines, same effect) | Synergy & Antagonism | Active at pico- to femtomolar concentrations" },
{ heading:"Modes of action:", text:"Autocrine (acts on secreting cell) | Paracrine (acts on adjacent cells) | Endocrine (rare - systemic action)" },
{ heading:"Producer cells:", text:"T helper cells, macrophages, dendritic cells, NK cells, mast cells, epithelial cells, fibroblasts, vascular endothelium" },
{ heading:"Scope:", text:"Over 100 known members coordinating development, immunity, inflammation, metabolism, aging, and disease pathogenesis" },
]);
// ============================================================
// SLIDE 4: CLASSIFICATION
// ============================================================
s = pres.addSlide();
s.addShape(pres.ShapeType.rect, { x:0, y:0, w:"100%", h:"100%", fill:{color:C.navy} });
s.addShape(pres.ShapeType.rect, { x:0, y:0, w:"100%", h:0.7, fill:{color:C.midBlue} });
s.addText("Classification of Cytokines", { x:0.3, y:0, w:12.7, h:0.7, fontSize:22, bold:true, color:C.white, fontFace:"Calibri", valign:"middle", margin:0 });
s.addShape(pres.ShapeType.rect, { x:0, y:0.7, w:"100%", h:0.04, fill:{color:C.accent} });
// 3x2 grid of boxes
const classBoxes = [
{ label:"Interleukins (ILs)", color:C.midBlue, note:"IL-1 to IL-38+\nMediate leukocyte-to-leukocyte signals\nSubfamilies: IL-1, IL-2, IL-6, IL-10, IL-12, IL-17 families" },
{ label:"Interferons (IFNs)", color:"295E8A", note:"Type I (IFN-α/β): antiviral, ISG induction\nType II (IFN-γ): macrophage activation, Th1\nType III (IFN-λ): mucosal antiviral" },
{ label:"TNF Family", color:"5C4A8A", note:"TNF-α, RANKL, FasL, TRAIL\nSurvival, differentiation, apoptosis, bone remodeling\nKey in inflammation and cancer" },
{ label:"Chemokines", color:"1A6B4A", note:"CXC (IL-8/CXCL8), CC (MCP-1), CX3C, XC\nDirected cell migration, leukocyte trafficking\n~50 members; bind to GPCR receptors" },
{ label:"Colony-Stimulating Factors", color:"6B4A1A", note:"G-CSF, GM-CSF, M-CSF, IL-3\nHematopoiesis, myeloid differentiation\nClinical use: post-chemotherapy neutrophilia" },
{ label:"Growth Factors & Others", color:"5A1A1A", note:"TGF-β, VEGF, FGF, EGF, PDGF\nAngiogenesis, fibrosis, tissue repair\nAdipokines: leptin, adiponectin (metabolic link)" },
];
classBoxes.forEach((b, i) => {
const col = i % 3;
const row = Math.floor(i / 3);
const x = 0.25 + col * 4.35;
const y = 0.9 + row * 3.05;
s.addShape(pres.ShapeType.rect, { x, y, w:4.1, h:2.75, fill:{color:b.color}, line:{color:C.accent,pt:1} });
s.addText(b.label, { x, y:y+0.08, w:4.1, h:0.5, fontSize:14, bold:true, color:C.accent, align:"center", fontFace:"Calibri" });
s.addShape(pres.ShapeType.line, { x:x+0.2, y:y+0.58, w:3.7, h:0, line:{color:C.accent,pt:0.5} });
s.addText(b.note, { x:x+0.1, y:y+0.65, w:3.9, h:1.9, fontSize:11.5, color:C.lightGrey, fontFace:"Calibri", valign:"top" });
});
// ============================================================
// SLIDE 5: CYTOKINE RECEPTORS
// ============================================================
s = pres.addSlide();
s.addShape(pres.ShapeType.rect, { x:0, y:0, w:"100%", h:"100%", fill:{color:C.navy} });
s.addShape(pres.ShapeType.rect, { x:0, y:0, w:"100%", h:0.7, fill:{color:C.midBlue} });
s.addText("Cytokine Receptors – Five Superfamilies", { x:0.3, y:0, w:12.7, h:0.7, fontSize:22, bold:true, color:C.white, fontFace:"Calibri", valign:"middle", margin:0 });
s.addShape(pres.ShapeType.rect, { x:0, y:0.7, w:"100%", h:0.04, fill:{color:C.accent} });
const receptors = [
{ n:"1", name:"IL-1 / TIR Family", detail:"3 Ig-like domains; IL-1, IL-18, IL-33, IL-36 receptors; signals via MyD88 → NF-κB", color:C.accentRed },
{ n:"2", name:"TNF Receptor (TNFR) Superfamily", detail:"Cysteine-rich extracellular domain; 27 members; mediates apoptosis, survival, bone remodeling via TRAF adaptors", color:"E07B00" },
{ n:"3", name:"Class I (Haematopoietin) Receptors", detail:"WSXWS motif; share gp130, γc, or βc subunits; bind IL-2,4,6,7,12, EPO, G-CSF; signal via JAK-STAT", color:C.midBlue },
{ n:"4", name:"Class II (Interferon) Receptors", detail:"Bind IFN-α/β/γ and IL-10 family; signal via JAK1/TYK2-STAT1; induce ISG transcription", color:C.accentGreen },
{ n:"5", name:"Tyrosine Kinase Receptors (RTKs)", detail:"Intrinsic kinase domain; VEGFR, FGFR, PDGFR, SCF receptor; link to Ras-MAPK and PI3K pathways; mutated in cancers", color:"7B2D8B" },
];
receptors.forEach((r, i) => {
const y = 0.9 + i*1.12;
s.addShape(pres.ShapeType.rect, { x:0.2, y:y, w:0.5, h:0.55, fill:{color:r.color}, line:{color:"000000",pt:0} });
s.addText(r.n, { x:0.2, y:y, w:0.5, h:0.55, fontSize:16, bold:true, color:C.white, align:"center", valign:"middle" });
s.addText(r.name, { x:0.85, y:y, w:3.8, h:0.55, fontSize:14.5, bold:true, color:C.accentGold, fontFace:"Calibri", valign:"middle" });
s.addText(r.detail, { x:4.8, y:y, w:8.3, h:0.55, fontSize:13, color:C.lightGrey, fontFace:"Calibri", valign:"middle" });
if (i<4) s.addShape(pres.ShapeType.line, { x:0.2, y:y+0.75, w:12.9, h:0, line:{color:C.accent,pt:0.4,transparency:60} });
});
s.addText("Note: Receptor structural homology drives functional redundancy — a key reason cytokine blockade requires targeting specific nodes", {
x:0.3, y:6.6, w:12.7, h:0.55,
fontSize:12, italic:true, color:C.accent, fontFace:"Calibri", align:"center"
});
// ============================================================
// SLIDE 6: JAK-STAT (with embedded diagram description)
// ============================================================
s = pres.addSlide();
s.addShape(pres.ShapeType.rect, { x:0, y:0, w:"100%", h:"100%", fill:{color:C.navy} });
s.addShape(pres.ShapeType.rect, { x:0, y:0, w:"100%", h:0.7, fill:{color:C.midBlue} });
s.addText("JAK-STAT Signaling – The Central Hub", { x:0.3, y:0, w:12.7, h:0.7, fontSize:22, bold:true, color:C.white, fontFace:"Calibri", valign:"middle", margin:0 });
s.addShape(pres.ShapeType.rect, { x:0, y:0.7, w:"100%", h:0.04, fill:{color:C.accent} });
// Left: diagram placeholder (we'll embed via URL)
const jakStatUrl = "https://cdn.orris.care/cdss_images/1a301f9a0ebd75a75a4a0256c85d98f78560ec431b643d756180223ef43ef181.png";
const jakImages = JSON.parse(require("child_process").execSync(
`node /home/daytona/skills/shared/scripts/fetch_images.js "${jakStatUrl}"`
).toString());
if (jakImages[0] && jakImages[0].base64) {
s.addImage({ data: jakImages[0].base64, x:0.3, y:0.85, w:5.0, h:5.7 });
}
// Right: text
const jakPoints = [
{ heading:"Step 1:", text:"Cytokine binds receptor monomers → receptor dimerization" },
{ heading:"Step 2:", text:"JAK1/2/3 or TYK2 (pre-bound) transphosphorylate each other (P = phosphate activation)" },
{ heading:"Step 3:", text:"Phosphorylated receptor recruits STAT1/2/3/4/5/6 proteins via SH2 domains" },
{ heading:"Step 4:", text:"JAK phosphorylates STATs → STAT dimerization" },
{ heading:"Step 5:", text:"STAT dimers translocate to nucleus → gene transcription (proliferation, differentiation, survival)" },
{ heading:"SOCS proteins:", text:"Negative feedback - SOCS1-7 & CIS terminate JAK/STAT signaling (inhibitory loop)" },
{ heading:"Clinical relevance:", text:"JAK2 mutations → myeloproliferative neoplasms | JAK3 loss → SCID | JAK inhibitors (jakinibs): ruxolitinib, tofacitinib, baricitinib" },
];
const jakItems = jakPoints.map((b,i)=>[
{ text:b.heading+" ", options:{bold:true,color:C.accentGold,breakLine:false} },
{ text:b.text, options:{color:C.lightGrey, breakLine:i<jakPoints.length-1} }
]).flat();
s.addText(jakItems, { x:5.6, y:0.85, w:7.1, h:5.7, fontSize:14.5, fontFace:"Calibri", valign:"top", paraSpaceBefore:4, paraSpaceAfter:4 });
// ============================================================
// SLIDE 7: INNATE IMMUNITY
// ============================================================
s = pres.addSlide();
s.addShape(pres.ShapeType.rect, { x:0, y:0, w:"100%", h:"100%", fill:{color:C.navy} });
s.addShape(pres.ShapeType.rect, { x:0, y:0, w:"100%", h:0.7, fill:{color:C.midBlue} });
s.addText("Cytokines in Innate Immunity", { x:0.3, y:0, w:12.7, h:0.7, fontSize:22, bold:true, color:C.white, fontFace:"Calibri", valign:"middle", margin:0 });
s.addShape(pres.ShapeType.rect, { x:0, y:0.7, w:"100%", h:0.04, fill:{color:C.accent} });
// Flow boxes
const innateFlow = [
{ t:"Pathogen / DAMP", c:C.accentRed },
{ t:"TLR / PRR\nActivation", c:"7A1A1A" },
{ t:"Macrophage /\nDendritic Cell", c:C.midBlue },
{ t:"IL-1β, IL-6\nTNF-α, IL-12", c:"5C4A8A" },
{ t:"Systemic\nEffects", c:C.accentGreen },
];
innateFlow.forEach((f, i) => {
const x = 0.5 + i*2.6;
s.addShape(pres.ShapeType.rect, { x, y:0.85, w:2.3, h:1.1, fill:{color:f.c}, line:{color:C.accent,pt:1} });
s.addText(f.t, { x, y:0.85, w:2.3, h:1.1, fontSize:13, bold:true, color:C.white, align:"center", valign:"middle", fontFace:"Calibri" });
if (i<4) s.addShape(pres.ShapeType.line, { x:x+2.3, y:1.4, w:0.3, h:0, line:{color:C.accentGold,pt:2} });
});
// Key cytokines table
const innateRows = [
["IL-1β", "Macrophages, DCs", "Fever, acute phase, T-cell activation", "IL-1RA, Anakinra"],
["TNF-α", "Macrophages, T cells", "Inflammation, apoptosis, cachexia, NF-κB", "Infliximab, Adalimumab"],
["IL-6", "Macrophages, fibroblasts", "Acute phase (CRP, fibrinogen), B-cell differentiation, fever", "Tocilizumab"],
["IL-12", "DCs, macrophages", "NK and T-cell IFN-γ production, Th1 polarisation", "Ustekinumab (IL-12/23)"],
["IFN-α/β", "Plasmacytoid DCs", "Antiviral ISGs, NK cell activation, Class I MHC upregulation", "IFN-α therapy (HCV, melanoma)"],
["IL-18", "Macrophages", "IFN-γ synergy with IL-12, Th1, NK activation", "Tadekinig alfa (recombinant IL-18BP)"],
];
// Header
const headers = ["Cytokine","Source","Key Actions","Clinical Application"];
const colW = [1.9, 2.7, 5.0, 3.1];
const colX = [0.25, 2.15, 4.85, 9.85];
headers.forEach((h,i) => {
s.addShape(pres.ShapeType.rect, { x:colX[i], y:2.1, w:colW[i], h:0.42, fill:{color:C.midBlue}, line:{color:"000000",pt:0} });
s.addText(h, { x:colX[i], y:2.1, w:colW[i], h:0.42, fontSize:12, bold:true, color:C.white, align:"center", valign:"middle" });
});
innateRows.forEach((r,ri) => {
const rowY = 2.52 + ri*0.76;
const bg = ri%2===0 ? "1A2F4B" : "162640";
r.forEach((cell,ci) => {
s.addShape(pres.ShapeType.rect, { x:colX[ci], y:rowY, w:colW[ci], h:0.73, fill:{color:bg}, line:{color:C.accent,pt:0.3,transparency:60} });
s.addText(cell, { x:colX[ci]+0.05, y:rowY, w:colW[ci]-0.1, h:0.73, fontSize:11, color:ci===0?C.accentGold:C.lightGrey, fontFace:"Calibri", valign:"middle" });
});
});
// ============================================================
// SLIDE 8: ADAPTIVE IMMUNITY / Th BALANCE
// ============================================================
s = pres.addSlide();
s.addShape(pres.ShapeType.rect, { x:0, y:0, w:"100%", h:"100%", fill:{color:C.navy} });
s.addShape(pres.ShapeType.rect, { x:0, y:0, w:"100%", h:0.7, fill:{color:C.midBlue} });
s.addText("Cytokines in Adaptive Immunity – Th Cell Balance", { x:0.3, y:0, w:12.7, h:0.7, fontSize:22, bold:true, color:C.white, fontFace:"Calibri", valign:"middle", margin:0 });
s.addShape(pres.ShapeType.rect, { x:0, y:0.7, w:"100%", h:0.04, fill:{color:C.accent} });
const thCells = [
{ name:"Th1", driver:"IL-12, IL-18, IFN-γ", tf:"T-bet, STAT4", produces:"IFN-γ, TNF-α, IL-2", protects:"Intracellular pathogens, tumors", disease:"Autoimmune: RA, MS, T1DM, IBD", color:"2D5FAF" },
{ name:"Th2", driver:"IL-4, IL-33, TSLP", tf:"GATA3, STAT6", produces:"IL-4, IL-5, IL-13", protects:"Helminths, extracellular parasites", disease:"Allergy: asthma, atopic dermatitis, eosinophilia", color:"B87D1A" },
{ name:"Th17", driver:"TGF-β + IL-6, IL-23", tf:"RORγt, STAT3", produces:"IL-17A/F, IL-22, TNF", protects:"Extracellular bacteria, fungi", disease:"Psoriasis, RA, IBD, MS, ankylosing spondylitis", color:"7B2D8B" },
{ name:"Treg", driver:"TGF-β, IL-2", tf:"FoxP3, STAT5", produces:"TGF-β, IL-10, IL-35", protects:"Self-tolerance, immune homeostasis", disease:"Loss of Treg → autoimmunity; excess → cancer immune evasion", color:C.accentGreen },
];
thCells.forEach((t,i) => {
const x = 0.2 + i*3.3;
s.addShape(pres.ShapeType.rect, { x, y:0.85, w:3.05, h:5.9, fill:{color:t.color+"22"}, line:{color:t.color,pt:1.5} });
s.addShape(pres.ShapeType.rect, { x, y:0.85, w:3.05, h:0.58, fill:{color:t.color}, line:{color:"000000",pt:0} });
s.addText(t.name, { x, y:0.85, w:3.05, h:0.58, fontSize:20, bold:true, color:C.white, align:"center", valign:"middle" });
const fields = [
["Driven by", t.driver],
["TF / STAT", t.tf],
["Produces", t.produces],
["Protects vs", t.protects],
["Disease link", t.disease],
];
fields.forEach(([label,val],fi) => {
const fy = 1.55 + fi*0.97;
s.addText(label, { x:x+0.1, y:fy, w:2.85, h:0.3, fontSize:10, bold:true, color:t.color==="2D5FAF"?C.accent:C.accentGold, fontFace:"Calibri", italic:true });
s.addText(val, { x:x+0.1, y:fy+0.3, w:2.85, h:0.58, fontSize:11.5, color:C.lightGrey, fontFace:"Calibri", valign:"top" });
});
});
// ============================================================
// SLIDE 9: ANTI-INFLAMMATORY CYTOKINES
// ============================================================
s = pres.addSlide();
contentSlide(s, "Anti-Inflammatory Cytokines – Restoring Balance", [
{ heading:"IL-10:", text:"Master anti-inflammatory cytokine; produced by Tregs, macrophages, DCs; suppresses TNF, IL-1β, IL-6, IL-12; critical in IBD and infection tolerance; IL-10 deficiency → colitis" },
{ heading:"TGF-β:", text:"Promotes Treg differentiation; suppresses T-cell proliferation; drives fibrosis in chronic inflammation; TGF-β excess → tissue fibrosis (lung, liver, kidney)" },
{ heading:"IL-1RA (IL-1 receptor antagonist):", text:"Blocks IL-1α/β signaling; naturally produced during inflammation; recombinant form = Anakinra, used in RA, MAS, Still disease" },
{ heading:"IL-35:", text:"Produced by Tregs; suppresses Th1 and Th17; promotes Treg expansion; potential therapeutic target" },
{ heading:"IFN-α/β:", text:"Anti-inflammatory in context of autoimmunity; downregulate cytokine-mediated lethality; used therapeutically in MS, viral hepatitis" },
{ heading:"Balance concept:", text:"In health: pro- and anti-inflammatory cytokines maintain equilibrium. In disease: persistent pro-inflammatory drive overcomes anti-inflammatory counter-regulation → chronic damage" },
]);
// ============================================================
// SLIDE 10: CYTOKINES IN AUTOIMMUNE DISEASE
// ============================================================
s = pres.addSlide();
s.addShape(pres.ShapeType.rect, { x:0, y:0, w:"100%", h:"100%", fill:{color:C.navy} });
s.addShape(pres.ShapeType.rect, { x:0, y:0, w:"100%", h:0.7, fill:{color:C.midBlue} });
s.addText("Cytokines in Autoimmune Disease", { x:0.3, y:0, w:12.7, h:0.7, fontSize:22, bold:true, color:C.white, fontFace:"Calibri", valign:"middle", margin:0 });
s.addShape(pres.ShapeType.rect, { x:0, y:0.7, w:"100%", h:0.04, fill:{color:C.accent} });
const autoimmuneData = [
{ disease:"Rheumatoid Arthritis", cytokines:"TNF-α, IL-1β, IL-6, IL-17A", mechanism:"Synovial inflammation, pannus, cartilage destruction; RANKL-driven bone erosion", therapy:"Anti-TNF (infliximab), anti-IL-6R (tocilizumab), anti-IL-17 (secukinumab)" },
{ disease:"Psoriasis", cytokines:"TNF-α, IL-17A/F, IL-23, IL-22", mechanism:"Keratinocyte hyperproliferation, neutrophil recruitment, dysregulated IL-23/IL-17 axis", therapy:"Anti-IL-17 (secukinumab, ixekizumab), anti-IL-23 (guselkumab), anti-TNF" },
{ disease:"SLE", cytokines:"IFN-α/β, IL-6, IL-10, BLyS/BAFF", mechanism:"IFN signature drives TLR7/9 activation, auto-Ab production, complement activation", therapy:"Anifrolumab (anti-IFN-αR), belimumab (anti-BLyS)" },
{ disease:"IBD (Crohn/UC)", cytokines:"TNF-α, IL-6, IL-12, IL-23, IL-17", mechanism:"Mucosal barrier disruption, macrophage activation, Th1/Th17 dysregulation", therapy:"Anti-TNF (infliximab), anti-IL-12/23 (ustekinumab), anti-IL-23 (risankizumab)" },
{ disease:"Multiple Sclerosis", cytokines:"IFN-γ, IL-17, TNF-α, IL-12", mechanism:"Th1/Th17 myelin attack; IL-17 disrupts blood-brain barrier integrity", therapy:"IFN-β (modulatory), natalizumab, anti-IL-12/23 (usteki...)" },
];
const adCols = ["Disease","Key Cytokines","Pathomechanism","Targeted Therapy"];
const adW = [2.1, 2.4, 4.5, 3.8];
const adX = [0.2, 2.3, 4.7, 9.2];
adCols.forEach((h,i) => {
s.addShape(pres.ShapeType.rect, { x:adX[i], y:0.85, w:adW[i], h:0.42, fill:{color:"2D478A"}, line:{color:"000000",pt:0} });
s.addText(h, { x:adX[i], y:0.85, w:adW[i], h:0.42, fontSize:12, bold:true, color:C.white, align:"center", valign:"middle" });
});
autoimmuneData.forEach((r,ri) => {
const rowY = 1.27 + ri*1.06;
const bg = ri%2===0 ? "1A2F4B" : "162640";
const cells = [r.disease, r.cytokines, r.mechanism, r.therapy];
cells.forEach((cell,ci) => {
s.addShape(pres.ShapeType.rect, { x:adX[ci], y:rowY, w:adW[ci], h:1.03, fill:{color:bg}, line:{color:C.accent,pt:0.3,transparency:60} });
s.addText(cell, { x:adX[ci]+0.05, y:rowY, w:adW[ci]-0.1, h:1.03, fontSize:ci===0?12.5:10.5, bold:ci===0, color:ci===0?C.accentGold:C.lightGrey, fontFace:"Calibri", valign:"middle" });
});
});
// ============================================================
// SLIDE 11: CYTOKINE STORM
// ============================================================
s = pres.addSlide();
s.addShape(pres.ShapeType.rect, { x:0, y:0, w:"100%", h:"100%", fill:{color:C.deepNavy} });
s.addShape(pres.ShapeType.rect, { x:0, y:0, w:"100%", h:0.7, fill:{color:C.accentRed} });
s.addText("Cytokine Storm – Pathological Hypercytokinemia", { x:0.3, y:0, w:12.7, h:0.7, fontSize:22, bold:true, color:C.white, fontFace:"Calibri", valign:"middle", margin:0 });
s.addShape(pres.ShapeType.rect, { x:0, y:0.7, w:"100%", h:0.04, fill:{color:C.accentGold} });
const stormPoints = [
{ heading:"Definition:", text:"Life-threatening dysregulated systemic inflammatory response with massive uncontrolled cytokine release" },
{ heading:"Triggers:", text:"Infections (sepsis, COVID-19, influenza H5N1), hemophagocytic lymphohistiocytosis (HLH/MAS), CAR-T therapy, checkpoint inhibitor therapy" },
{ heading:"Key cytokines:", text:"IL-6, IL-1β, TNF-α, IFN-γ, IL-18, GM-CSF, M-CSF, MCP-1/CCL2 — positive feedback loops amplify response" },
{ heading:"COVID-19 specific:", text:"SARS-CoV-2 triggers plasmacytoid DC and macrophage activation → IL-6 storm → capillary leak syndrome, ARDS, multi-organ failure" },
{ heading:"Sepsis cytokine dysregulation:", text:"Early hyperinflammation (IL-6, IL-8, IL-10 surge) → immunoparalysis phase; disrupted IL-6/IL-8/IL-10 network = poor prognosis" },
{ heading:"HLH/MAS:", text:"Extremely high ferritin, IL-18, IFN-γ; activated macrophages engulf blood cells; triggers: EBV, SLE flare, malignancy" },
{ heading:"Management:", text:"IL-6R blockade (tocilizumab) — approved for COVID-19, CAR-T CRS; anakinra (IL-1RA) for HLH/MAS; dexamethasone (broad suppression); ruxolitinib (JAK1/2 inhibitor)" },
];
const stormItems = stormPoints.map((b,i)=>[
{ text:b.heading+" ", options:{bold:true,color:C.accentGold,breakLine:false} },
{ text:b.text, options:{color:C.lightGrey, breakLine:i<stormPoints.length-1} }
]).flat();
s.addText(stormItems, { x:0.4, y:0.85, w:12.3, h:5.8, fontSize:14.5, fontFace:"Calibri", valign:"top", paraSpaceBefore:3, paraSpaceAfter:3, lineSpacingMultiple:1.2 });
// ============================================================
// SLIDE 12: CYTOKINES IN CANCER
// ============================================================
s = pres.addSlide();
s.addShape(pres.ShapeType.rect, { x:0, y:0, w:"100%", h:"100%", fill:{color:C.navy} });
s.addShape(pres.ShapeType.rect, { x:0, y:0, w:"100%", h:0.7, fill:{color:C.midBlue} });
s.addText("Cytokines in Cancer – Friend or Foe?", { x:0.3, y:0, w:12.7, h:0.7, fontSize:22, bold:true, color:C.white, fontFace:"Calibri", valign:"middle", margin:0 });
s.addShape(pres.ShapeType.rect, { x:0, y:0.7, w:"100%", h:0.04, fill:{color:C.accent} });
// Two columns: Tumor-promoting vs Anti-tumor
const proTumor = [
{ heading:"IL-6:", text:"STAT3 activation → survival, proliferation, angiogenesis; elevated in many cancers; drives cancer cachexia" },
{ heading:"TGF-β:", text:"Immunosuppressive TME; suppresses CTL and NK cells; promotes EMT and metastasis" },
{ heading:"VEGF:", text:"Angiogenesis; therapeutic target (bevacizumab); induced by IL-6, TNF, hypoxia" },
{ heading:"IL-10:", text:"Immunosuppression in TME; promotes tumor evasion of CTL killing" },
{ heading:"TNF-α:", text:"Paradoxically: promotes angiogenesis and NF-κB survival signals in established tumors" },
{ heading:"Adipokines:", text:"Leptin promotes tumor proliferation; resistin drives proinflammatory cancer risk" },
];
const antiTumor = [
{ heading:"IFN-γ:", text:"Activates macrophages, upregulates MHC-I on tumors → CTL killing; impaired in immunosuppressed TME" },
{ heading:"TNF-α:", text:"At high dose: direct tumor cell apoptosis; basis of isolated limb perfusion therapy" },
{ heading:"IL-2:", text:"Approved for metastatic melanoma & RCC (10% response); promotes CTL/NK expansion; limited by vascular leak" },
{ heading:"IFN-α:", text:"Approved for melanoma, hairy cell leukemia, Kaposi sarcoma; inhibits tumor proliferation, upregulates MHC-I" },
{ heading:"GM-CSF/G-CSF:", text:"Post-chemotherapy neutropenia management; stimulates DC differentiation in tumor vaccines" },
{ heading:"IL-12:", text:"Potent anti-tumor in animal models; activates NK and CTL; used in oncolytic virus and CAR-T combinations" },
];
twoCol(s, "", proTumor, antiTumor, "Tumor-Promoting Cytokines", "Anti-Tumor Cytokines", "7A1A1A", C.accentGreen);
// ============================================================
// SLIDE 13: CYTOKINES IN HEMATOPOIESIS
// ============================================================
s = pres.addSlide();
contentSlide(s, "Cytokines in Hematopoiesis & Haematological Disease", [
{ heading:"Colony-Stimulating Factors (CSFs):", text:"G-CSF (IL-3 family) → neutrophil production; M-CSF → monocyte/macrophage; GM-CSF → myeloid DCs; EPO → erythropoiesis; TPO → megakaryocytes/platelets" },
{ heading:"IL-3:", text:"Multi-CSF; promotes expansion of all myeloid and some lymphoid progenitors from HSCs; synergises with SCF and Flt3L" },
{ heading:"IL-7:", text:"Non-redundant for T and B lymphopoiesis; IL-7Rα mutations → SCID; elevated in lymphopenia" },
{ heading:"JAK2 V617F mutation:", text:"Gain-of-function mutation in ~95% of polycythaemia vera, ~50% of ET and MF; constitutive JAK-STAT5 activation → excessive proliferation of myeloid lineage" },
{ heading:"γc chain (CD132) deficiency:", text:"X-linked SCID: affects signaling of IL-2, IL-4, IL-7, IL-9, IL-15, IL-21; absent T and NK cells, non-functional B cells" },
{ heading:"Haematological malignancy cytokines:", text:"IL-6 → myeloma cell survival (via STAT3); IL-2 → CTCL and T-cell leukemia (basis of IL-2 therapy); CXCL12 → marrow homing of leukaemic blasts" },
{ heading:"Therapeutic CSFs:", text:"Filgrastim (G-CSF), pegfilgrastim: post-chemotherapy; sargramostim (GM-CSF): mobilisation of HSCs for transplant" },
]);
// ============================================================
// SLIDE 14: CYTOKINE BIOLOGICS TABLE
// ============================================================
s = pres.addSlide();
s.addShape(pres.ShapeType.rect, { x:0, y:0, w:"100%", h:"100%", fill:{color:C.navy} });
s.addShape(pres.ShapeType.rect, { x:0, y:0, w:"100%", h:0.7, fill:{color:C.midBlue} });
s.addText("Cytokine Therapeutics – Biologics & JAK Inhibitors", { x:0.3, y:0, w:12.7, h:0.7, fontSize:22, bold:true, color:C.white, fontFace:"Calibri", valign:"middle", margin:0 });
s.addShape(pres.ShapeType.rect, { x:0, y:0.7, w:"100%", h:0.04, fill:{color:C.accent} });
const drugs = [
["Infliximab / Adalimumab","Anti-TNF-α mAb","RA, IBD, psoriasis, AS, PsA","Risk: TB reactivation, fungal infections"],
["Tocilizumab / Sarilumab","Anti-IL-6R mAb","RA, COVID-19, cytokine storm, GCA","LFT monitoring; IL-6 level rises (receptor blocked)"],
["Anakinra / Canakinumab","IL-1 blocker","RA, gout, CAPS, HLH/MAS, AOSD","Injection site reactions; renal monitoring"],
["Secukinumab / Ixekizumab","Anti-IL-17A mAb","Psoriasis, PsA, AS","IBD risk (caution); candidasis"],
["Ustekinumab","Anti-IL-12/23 (p40) mAb","Psoriasis, IBD, PsA","Generally well tolerated"],
["Dupilumab","Anti-IL-4Rα (blocks IL-4 & IL-13)","Atopic dermatitis, asthma, CRSwNP","Conjunctivitis; well tolerated"],
["Ruxolitinib / Tofacitinib","JAK1/2 or JAK1/3 inhibitor","MPN, RA, COVID-19, alopecia areata","VTE, infection, lipid changes; avoid in high CV risk"],
["Baricitinib","JAK1/2 inhibitor","RA, COVID-19, alopecia areata","Thrombosis risk; dosing adjustment in renal impairment"],
];
const drugCols = ["Agent","Target/Class","Approved Indications","Key Adverse Effects / Notes"];
const dW = [2.6, 2.6, 3.7, 3.9];
const dX = [0.15, 2.75, 5.35, 9.05];
drugCols.forEach((h,i) => {
s.addShape(pres.ShapeType.rect, { x:dX[i], y:0.85, w:dW[i], h:0.4, fill:{color:"2D478A"}, line:{color:"000000",pt:0} });
s.addText(h, { x:dX[i], y:0.85, w:dW[i], h:0.4, fontSize:11.5, bold:true, color:C.white, align:"center", valign:"middle" });
});
drugs.forEach((r,ri) => {
const rowY = 1.25 + ri*0.77;
const bg = ri%2===0 ? "1A2F4B" : "162640";
r.forEach((cell,ci) => {
s.addShape(pres.ShapeType.rect, { x:dX[ci], y:rowY, w:dW[ci], h:0.74, fill:{color:bg}, line:{color:C.accent,pt:0.3,transparency:60} });
s.addText(cell, { x:dX[ci]+0.05, y:rowY, w:dW[ci]-0.1, h:0.74, fontSize:10.5, color:ci===0?C.accentGold:C.lightGrey, fontFace:"Calibri", valign:"middle", bold:ci===0 });
});
});
// ============================================================
// SLIDE 15: CYTOKINE ASSAYS
// ============================================================
s = pres.addSlide();
contentSlide(s, "Cytokine Assays in the Clinical Laboratory", [
{ heading:"Bioassays (gold standard):", text:"Measure biological activity (e.g., T-cell proliferation assay for IL-2); time-consuming, labour-intensive; mainly research use" },
{ heading:"ELISA (Enzyme-Linked ImmunoSorbent Assay):", text:"Widely available kits for IL-1α/β, IL-4, IL-5, IL-6, IL-10, IFN-γ, TNF-α; single-plex; clinical laboratory standard; sensitivity varies by manufacturer" },
{ heading:"Multiplex / Luminex assays:", text:"Simultaneously measure 20-100+ cytokines from small sample volumes; bead-based immunoassay; high sensitivity; platforms vary (Luminex xMAP, electrochemiluminescence [MSD]); inter-platform variability is a known limitation" },
{ heading:"Flow cytometry intracellular staining:", text:"Cell-level cytokine production analysis; requires brefeldin A blocking; important in research, HLA typing, transplant assessment" },
{ heading:"Clinical applications:", text:"Sepsis monitoring (IL-6, IL-10); CAR-T CRS grading (IL-6, IFN-γ, ferritin); COVID-19 severity (IL-6, IL-8); HLH diagnosis (soluble CD25/IL-2Rα, IFN-γ, IL-18, ferritin)" },
{ heading:"Pathology lab relevance:", text:"Rising serum IL-6 correlates with CRP/acute phase; CSF cytokine panels in CNS inflammation; tumour microenvironment cytokine profiling (research/companion Dx)" },
]);
// ============================================================
// SLIDE 16: ANTI-CYTOKINE COMPLICATIONS
// ============================================================
s = pres.addSlide();
s.addShape(pres.ShapeType.rect, { x:0, y:0, w:"100%", h:"100%", fill:{color:C.navy} });
s.addShape(pres.ShapeType.rect, { x:0, y:0, w:"100%", h:0.7, fill:{color:"7A1A1A"} });
s.addText("Complications of Cytokine Deficiency & Immunopathology", { x:0.3, y:0, w:12.7, h:0.7, fontSize:22, bold:true, color:C.white, fontFace:"Calibri", valign:"middle", margin:0 });
s.addShape(pres.ShapeType.rect, { x:0, y:0.7, w:"100%", h:0.04, fill:{color:C.accentRed} });
const deficiencies = [
{ defect:"IL-12 / IL-12R deficiency", consequence:"Inability to produce IFN-γ → susceptibility to mycobacterial and Salmonella infections (Mendelian susceptibility to mycobacterial disease)" },
{ defect:"IFN-γR deficiency", consequence:"Fatal disseminated mycobacterial infection even with BCG vaccination" },
{ defect:"IL-10 / IL-10R deficiency", consequence:"Very early onset IBD; uncontrolled intestinal inflammation; refractory to conventional therapy" },
{ defect:"γc (CD132) chain deficiency", consequence:"X-linked SCID: absent T and NK cells; profound lymphopenia; fatal without HSCT or gene therapy" },
{ defect:"JAK3 deficiency", consequence:"Autosomal recessive SCID; phenotype identical to X-SCID (shares γc signaling)" },
{ defect:"JAK2 V617F gain-of-function", consequence:"Myeloproliferative neoplasms (PV, ET, MF); constitutive erythropoiesis/megakaryopoiesis" },
{ defect:"STAT1 gain-of-function", consequence:"Chronic mucocutaneous candidiasis with hyperresponsive IFN signaling; impaired Th17" },
{ defect:"TNF hypersecretion", consequence:"Cachexia, systemic inflammation; TNFR1 mutations → TRAPS (periodic fever syndrome)" },
];
deficiencies.forEach((d,i) => {
const y = 0.88 + i*0.77;
const bg = i%2===0 ? "1A2F4B" : "162640";
s.addShape(pres.ShapeType.rect, { x:0.2, y, w:12.9, h:0.73, fill:{color:bg}, line:{color:C.accentRed,pt:0.3,transparency:60} });
s.addText(d.defect, { x:0.3, y, w:3.6, h:0.73, fontSize:12, bold:true, color:C.accentRed, fontFace:"Calibri", valign:"middle" });
s.addShape(pres.ShapeType.line, { x:3.9, y:y+0.1, w:0, h:0.53, line:{color:C.accentRed,pt:0.7,transparency:40} });
s.addText(d.consequence, { x:4.0, y, w:9.0, h:0.73, fontSize:11.5, color:C.lightGrey, fontFace:"Calibri", valign:"middle" });
});
// ============================================================
// SLIDE 17: CYTOKINE NETWORK DIAGRAM (Schematic text-based)
// ============================================================
s = pres.addSlide();
s.addShape(pres.ShapeType.rect, { x:0, y:0, w:"100%", h:"100%", fill:{color:C.deepNavy} });
s.addShape(pres.ShapeType.rect, { x:0, y:0, w:"100%", h:0.7, fill:{color:C.midBlue} });
s.addText("Cytokine Network – Systems View", { x:0.3, y:0, w:12.7, h:0.7, fontSize:22, bold:true, color:C.white, fontFace:"Calibri", valign:"middle", margin:0 });
s.addShape(pres.ShapeType.rect, { x:0, y:0.7, w:"100%", h:0.04, fill:{color:C.accent} });
// Central hub
s.addShape(pres.ShapeType.ellipse, { x:5.4, y:2.4, w:2.5, h:1.6, fill:{color:C.midBlue}, line:{color:C.accent,pt:2} });
s.addText("CYTOKINE\nNETWORK", { x:5.4, y:2.4, w:2.5, h:1.6, fontSize:14, bold:true, color:C.white, align:"center", valign:"middle" });
// Satellite nodes
const nodes = [
{ label:"Innate\nImmunity", x:0.2, y:0.9, color:C.accentRed },
{ label:"Adaptive\nImmunity", x:10.8, y:0.9, color:C.midBlue },
{ label:"Hematopoiesis", x:0.2, y:4.2, color:C.accentGreen },
{ label:"Autoimmune\nDisease", x:10.8, y:4.2, color:"7B2D8B" },
{ label:"Cancer /\nTME", x:5.4, y:5.8, color:C.accentGold },
{ label:"Cytokine\nStorm", x:2.8, y:0.85, color:"8A1A1A" },
{ label:"Therapeutic\nTargets", x:8.3, y:5.5, color:"1A6B4A" },
];
nodes.forEach(n => {
s.addShape(pres.ShapeType.roundRect, { x:n.x, y:n.y, w:2.2, h:1.0, fill:{color:n.color}, line:{color:C.white,pt:0.8}, rectRadius:0.15 });
s.addText(n.label, { x:n.x, y:n.y, w:2.2, h:1.0, fontSize:12, bold:true, color:C.white, align:"center", valign:"middle" });
});
// Connector lines (simplified)
const cx = 6.65, cy = 3.2;
const connectors = [
{x1:2.2, y1:1.4, x2:5.5, y2:2.8},
{x1:11.0, y1:1.4, x2:7.9, y2:2.8},
{x1:2.2, y1:4.7, x2:5.5, y2:3.8},
{x1:11.0, y1:4.7, x2:7.9, y2:3.8},
{x1:6.5, y1:6.3, x2:6.5, y2:4.0},
{x1:4.0, y1:1.35, x2:5.8, y2:2.5},
{x1:9.4, y1:5.95, x2:7.9, y2:3.8},
];
connectors.forEach(c => {
s.addShape(pres.ShapeType.line, { x:c.x1, y:c.y1, w:c.x2-c.x1, h:c.y2-c.y1, line:{color:C.accent,pt:1,dashType:"dash"} });
});
s.addText("Cytokines operate within a highly interconnected signaling web — alterations in one node propagate throughout the network, driving disease states or restoring homeostasis", {
x:0.3, y:6.8, w:12.7, h:0.5, fontSize:11, italic:true, color:C.textLight, fontFace:"Calibri", align:"center"
});
// ============================================================
// SLIDE 18: KEY TAKEAWAYS
// ============================================================
s = pres.addSlide();
s.addShape(pres.ShapeType.rect, { x:0, y:0, w:"100%", h:"100%", fill:{color:C.deepNavy} });
s.addShape(pres.ShapeType.rect, { x:0, y:0, w:"100%", h:0.06, fill:{color:C.accent} });
s.addShape(pres.ShapeType.rect, { x:0, y:7.44, w:"100%", h:0.06, fill:{color:C.accentGold} });
s.addText("Key Takeaways", { x:0.5, y:0.15, w:12.3, h:0.65, fontSize:26, bold:true, color:C.white, align:"center", fontFace:"Calibri" });
s.addShape(pres.ShapeType.rect, { x:2.5, y:0.78, w:8.3, h:0.05, fill:{color:C.accent} });
const takeaways = [
{ n:"1", t:"Pleiotropic & Redundant", d:"No single cytokine = single disease; networks overlap — targeting requires understanding the full system" },
{ n:"2", t:"Families & Receptors", d:"Structural receptor homology explains functional redundancy; receptor mutations = immunodeficiency or malignancy" },
{ n:"3", t:"JAK-STAT is the hub", d:"~60 cytokines signal via JAK-STAT; SOCS proteins self-limit; JAK2 V617F = MPNs; JAK inhibitors are major drugs" },
{ n:"4", t:"Th1/Th2/Th17/Treg balance", d:"Deviation from balance drives autoimmunity (Th1/Th17 excess), allergy (Th2 excess), or cancer immune evasion (Treg excess)" },
{ n:"5", t:"Cytokine Storm = Emergency", d:"IL-6 + IFN-γ + TNF positive feedback → ARDS, MOF; anti-IL-6R (tocilizumab) is first-line for COVID-19 CRS" },
{ n:"6", t:"Biologics have transformed medicine", d:"Anti-TNF, anti-IL-6R, anti-IL-17, anti-IL-12/23 have revolutionised RA, IBD, psoriasis treatment" },
{ n:"7", t:"Cytokine deficiency = immunopathology", d:"IL-12R/IFN-γR defects → mycobacterial disease; γc/JAK3 defects → SCID; IL-10 defects → early IBD" },
];
takeaways.forEach((t, i) => {
const col = i < 4 ? 0 : 1;
const row = i < 4 ? i : i-4;
const x = col === 0 ? 0.3 : 6.8;
const y = 0.9 + row * 1.6;
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s.addShape(pres.ShapeType.rect, { x, y, w:0.6, h:1.45, fill:{color:C.accent+"33"}, line:{color:"000000",pt:0} });
s.addText(t.n, { x, y, w:0.6, h:1.45, fontSize:20, bold:true, color:C.accent, align:"center", valign:"middle" });
s.addText(t.t, { x:x+0.7, y:y+0.1, w:5.3, h:0.45, fontSize:14, bold:true, color:C.accentGold, fontFace:"Calibri" });
s.addText(t.d, { x:x+0.7, y:y+0.52, w:5.3, h:0.85, fontSize:11.5, color:C.lightGrey, fontFace:"Calibri" });
});
// ============================================================
// SAVE
// ============================================================
pres.writeFile({ fileName: "/home/daytona/workspace/cytokines-ppt/Cytokines_Health_Disease.pptx" })
.then(() => console.log("DONE: /home/daytona/workspace/cytokines-ppt/Cytokines_Health_Disease.pptx"))
.catch(e => { console.error(e); process.exit(1); });
Reading File
Running Command
rm /home/daytona/workspace/cytokines-ppt/build.js
Writing File
~/cytokines-ppt/build.js
const pptxgen = require("pptxgenjs");
const pres = new pptxgen();
pres.layout = "LAYOUT_WIDE";
pres.title = "Cytokines: Health and Disease";
pres.author = "Pathology Resident Education";
// ============================================================
// COLOR PALETTE
// ============================================================
const C = {
deepNavy: "0D1B2A",
navy: "1A2F4B",
midBlue: "1E4D8C",
accent: "00B4D8",
accentGold: "F4A261",
accentRed: "E63946",
accentGreen:"2D9D78",
white: "FFFFFF",
lightGrey: "D6E4F0",
textLight: "B8D4EA",
textDark: "0D1B2A",
};
// ============================================================
// SLIDE 1: TITLE
// ============================================================
let s = pres.addSlide();
s.addShape(pres.ShapeType.rect, { x:0, y:0, w:"100%", h:"100%", fill:{color:C.deepNavy} });
s.addShape(pres.ShapeType.rect, { x:0, y:0, w:"100%", h:0.18, fill:{color:C.accent} });
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s.addText("CYTOKINES", {
x:0.5, y:0.9, w:12.3, h:1.3,
fontSize:54, bold:true, color:C.white, fontFace:"Calibri",
align:"center", charSpacing:6
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s.addText("Health and Disease", {
x:0.5, y:2.1, w:12.3, h:0.75,
fontSize:30, color:C.accent, fontFace:"Calibri",
align:"center", italic:true
});
s.addShape(pres.ShapeType.rect, { x:3, y:3.0, w:7.3, h:0.05, fill:{color:C.accent} });
s.addText("A Comprehensive Overview for Pathology Residents", {
x:0.5, y:3.2, w:12.3, h:0.55,
fontSize:16, color:C.textLight, fontFace:"Calibri", align:"center"
});
s.addText([
{ text: "Sources: ", options:{bold:true, color:C.accentGold} },
{ text: "Henry's Clinical Diagnosis & Management | Cellular & Molecular Immunology | Schwartz's Surgery | Robbins Pathology | Fitzpatrick's Dermatology", options:{color:C.textLight} }
], {
x:0.5, y:6.7, w:12.3, h:0.4,
fontSize:11, fontFace:"Calibri", align:"center"
});
// ============================================================
// SLIDE 2: OUTLINE
// ============================================================
s = pres.addSlide();
s.addShape(pres.ShapeType.rect, { x:0, y:0, w:"100%", h:"100%", fill:{color:C.deepNavy} });
s.addShape(pres.ShapeType.rect, { x:0, y:0, w:"100%", h:0.7, fill:{color:C.midBlue} });
s.addText("Lecture Outline", { x:0.3, y:0, w:12.7, h:0.7, fontSize:22, bold:true, color:C.white, fontFace:"Calibri", valign:"middle", margin:0 });
s.addShape(pres.ShapeType.rect, { x:0, y:0.7, w:"100%", h:0.04, fill:{color:C.accent} });
const agenda = [
["01", "What Are Cytokines?", "Definition, history, key properties"],
["02", "Classification & Families", "Structural and functional groupings"],
["03", "Cytokine Receptors", "Five receptor superfamilies"],
["04", "JAK-STAT Signaling", "Central pathway and SOCS regulation"],
["05", "Cytokines in Innate Immunity", "Pro-inflammatory cascade"],
["06", "Th Cell Balance", "Th1/Th2/Th17/Treg regulation"],
["07", "Anti-Inflammatory Cytokines", "Restoring homeostasis"],
["08", "Cytokines in Autoimmunity", "RA, SLE, IBD, psoriasis, MS"],
["09", "Cytokine Storm", "Sepsis, COVID-19, HLH/MAS"],
["10", "Cytokines in Cancer", "TME, anti-tumor, pro-tumor"],
];
const col1 = agenda.slice(0,5);
const col2 = agenda.slice(5);
col1.forEach((a, i) => {
const yy = 0.95 + i*1.1;
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s.addText(a[1], { x:0.95, y:yy, w:5.4, h:0.28, fontSize:15, bold:true, color:C.white, fontFace:"Calibri", valign:"bottom" });
s.addText(a[2], { x:0.95, y:yy+0.3, w:5.4, h:0.28, fontSize:12, color:C.textLight, fontFace:"Calibri", valign:"top" });
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col2.forEach((a, i) => {
const yy = 0.95 + i*1.1;
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});
// Add last items
const last2 = [
["11", "Hematopoiesis & Immunodeficiency"],
["12", "Cytokine Biologics & JAK Inhibitors"],
["13", "Cytokine Assays in the Lab"],
["14", "Key Takeaways"],
];
s.addText("... and more:", { x:0.3, y:6.55, w:13, h:0.3, fontSize:11, color:C.textLight, italic:true, fontFace:"Calibri" });
// ============================================================
// SLIDE 3: WHAT ARE CYTOKINES?
// ============================================================
s = pres.addSlide();
s.addShape(pres.ShapeType.rect, { x:0, y:0, w:"100%", h:"100%", fill:{color:C.navy} });
s.addShape(pres.ShapeType.rect, { x:0, y:0, w:"100%", h:0.7, fill:{color:C.midBlue} });
s.addText("What Are Cytokines?", { x:0.3, y:0, w:12.7, h:0.7, fontSize:22, bold:true, color:C.white, fontFace:"Calibri", valign:"middle", margin:0 });
s.addShape(pres.ShapeType.rect, { x:0, y:0.7, w:"100%", h:0.04, fill:{color:C.accent} });
const defPoints = [
["Definition", "Small secreted proteins (8-80 kDa) that mediate cell-to-cell communication in the immune system, inflammation, hematopoiesis, embryonic development, and tissue repair"],
["History", "Term coined by Cohen (1975) for activities released by epithelial cells. Previously called lymphokines (from T cells) or monokines (from monocytes). Keratinocyte cytokines discovered 1981"],
["Pleiotropism", "One cytokine elicits multiple different effects in different target cell types"],
["Redundancy", "Multiple distinct cytokines share overlapping biological roles in any given bioassay - loss of one is often compensated by others"],
["Synergy / Antagonism", "Cytokines act in complex combinations - synergistic pairs amplify responses (IL-12 + IL-18 for IFN-g); antagonistic pairs limit each other (IL-10 vs TNF-a)"],
["Concentration range", "Active at pico- to femtomolar concentrations; secreted in small quantities; receptor density and cell activation state determine cellular response"],
["Modes of action", "Autocrine (self-signaling) | Paracrine (adjacent cells) | Endocrine (systemic, rare)"],
["Producer cells", "T helper cells, macrophages, DCs, NK cells, mast cells, epithelial cells, fibroblasts, adipocytes, vascular endothelium, many more"],
];
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const y = 0.85 + i*0.82;
const bg = i%2===0 ? "1A2F4B" : "162640";
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// ============================================================
// SLIDE 4: CLASSIFICATION
// ============================================================
s = pres.addSlide();
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s.addShape(pres.ShapeType.rect, { x:0, y:0, w:"100%", h:0.7, fill:{color:C.midBlue} });
s.addText("Classification of Cytokines", { x:0.3, y:0, w:12.7, h:0.7, fontSize:22, bold:true, color:C.white, fontFace:"Calibri", valign:"middle", margin:0 });
s.addShape(pres.ShapeType.rect, { x:0, y:0.7, w:"100%", h:0.04, fill:{color:C.accent} });
const classBoxes = [
{ label:"Interleukins (ILs)", color:"1E4D8C", note:"IL-1 to IL-38+\nMediate leukocyte-leukocyte signals\nSubfamilies: IL-1, IL-2, IL-6, IL-10, IL-12, IL-17 families" },
{ label:"Interferons (IFNs)", color:"295E8A", note:"Type I (IFN-a/b): antiviral, ISG induction\nType II (IFN-g): macrophage activation, Th1\nType III (IFN-l): mucosal antiviral" },
{ label:"TNF Superfamily", color:"5C4A8A", note:"TNF-a, RANKL, FasL, TRAIL, BAFF\nSurvival, differentiation, apoptosis\nBone remodeling; 27 members" },
{ label:"Chemokines", color:"1A6B4A", note:"CXC (IL-8/CXCL8), CC (MCP-1), CX3C\nDirected cell migration, leukocyte trafficking\n~50 members; bind GPCR receptors" },
{ label:"Colony-Stimulating Factors", color:"6B4A1A", note:"G-CSF, GM-CSF, M-CSF, IL-3, EPO, TPO\nHematopoiesis, myeloid differentiation\nClinical: post-chemotherapy neutrophilia" },
{ label:"Growth Factors & Adipokines", color:"5A2A2A", note:"TGF-b, VEGF, FGF, EGF, PDGF\nAngiogenesis, fibrosis, tissue repair\nAdiponectin, leptin: metabolic-immune link" },
];
classBoxes.forEach((b, i) => {
const col = i % 3;
const row = Math.floor(i / 3);
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const y = 0.9 + row * 3.35;
s.addShape(pres.ShapeType.rect, { x, y, w:4.1, h:3.1, fill:{color:b.color}, line:{color:C.accent,pt:1} });
s.addText(b.label, { x, y:y+0.1, w:4.1, h:0.5, fontSize:14, bold:true, color:C.accent, align:"center", fontFace:"Calibri" });
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s.addText(b.note, { x:x+0.1, y:y+0.72, w:3.9, h:2.2, fontSize:12, color:C.lightGrey, fontFace:"Calibri", valign:"top" });
});
// ============================================================
// SLIDE 5: CYTOKINE RECEPTORS
// ============================================================
s = pres.addSlide();
s.addShape(pres.ShapeType.rect, { x:0, y:0, w:"100%", h:"100%", fill:{color:C.navy} });
s.addShape(pres.ShapeType.rect, { x:0, y:0, w:"100%", h:0.7, fill:{color:C.midBlue} });
s.addText("Cytokine Receptors - Five Superfamilies", { x:0.3, y:0, w:12.7, h:0.7, fontSize:22, bold:true, color:C.white, fontFace:"Calibri", valign:"middle", margin:0 });
s.addShape(pres.ShapeType.rect, { x:0, y:0.7, w:"100%", h:0.04, fill:{color:C.accent} });
const receptors = [
{ n:"1", name:"IL-1 / TIR Family", detail:"3 Ig-like extracellular domains; IL-1R, IL-18R, IL-33R, IL-36R; cytosolic TIR domain signals via MyD88 -> NF-kB; IL-1RA is natural antagonist", color:C.accentRed },
{ n:"2", name:"TNF Receptor (TNFR) Superfamily", detail:"Cysteine-rich extracellular domain; 27 members (TNFR1/2, FasR, RANK, DR4/5); mediates apoptosis (FADD/caspase-8) and survival (TRAF adaptor -> NF-kB)", color:"E07B00" },
{ n:"3", name:"Class I (Haematopoietin) Receptors", detail:"WSXWS motif; share gp130 (IL-6 family), gc chain (IL-2,4,7,9,15,21), or bc chain (IL-3,5,GM-CSF); JAK1/2/3 -> STAT3/5 signaling", color:C.midBlue },
{ n:"4", name:"Class II (Interferon) Receptors", detail:"Bind IFN-a/b, IFN-g and IL-10 family; heterodimeric; signal via JAK1/TYK2 -> STAT1/STAT2; ISGF3 complex activates antiviral ISGs", color:C.accentGreen },
{ n:"5", name:"Tyrosine Kinase Receptors (RTKs)", detail:"Intrinsic kinase domain; VEGFR, FGFR, PDGFR, c-Kit (SCF receptor), Flt3; Ras-MAPK and PI3K-Akt pathways; mutation/overexpression common in cancers", color:"7B2D8B" },
];
receptors.forEach((r, i) => {
const y = 0.88 + i*1.28;
s.addShape(pres.ShapeType.rect, { x:0.2, y, w:0.55, h:0.6, fill:{color:r.color}, line:{color:"000000",pt:0} });
s.addText(r.n, { x:0.2, y, w:0.55, h:0.6, fontSize:18, bold:true, color:C.white, align:"center", valign:"middle" });
s.addText(r.name, { x:0.88, y, w:3.9, h:0.6, fontSize:14.5, bold:true, color:C.accentGold, fontFace:"Calibri", valign:"middle" });
s.addText(r.detail, { x:4.9, y, w:8.2, h:0.6, fontSize:12.5, color:C.lightGrey, fontFace:"Calibri", valign:"middle" });
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});
s.addText("Clinical note: Receptor structural homology drives functional redundancy - targeting single cytokines often has limited efficacy; blockade of shared receptor subunits (gp130, gc) is more broadly effective", {
x:0.3, y:7.2, w:12.7, h:0.38,
fontSize:11, italic:true, color:C.accent, fontFace:"Calibri", align:"center"
});
// ============================================================
// SLIDE 6: JAK-STAT (with embedded image)
// ============================================================
s = pres.addSlide();
s.addShape(pres.ShapeType.rect, { x:0, y:0, w:"100%", h:"100%", fill:{color:C.navy} });
s.addShape(pres.ShapeType.rect, { x:0, y:0, w:"100%", h:0.7, fill:{color:C.midBlue} });
s.addText("JAK-STAT Signaling - The Central Cytokine Hub", { x:0.3, y:0, w:12.7, h:0.7, fontSize:22, bold:true, color:C.white, fontFace:"Calibri", valign:"middle", margin:0 });
s.addShape(pres.ShapeType.rect, { x:0, y:0.7, w:"100%", h:0.04, fill:{color:C.accent} });
const jakStatUrl = "https://cdn.orris.care/cdss_images/1a301f9a0ebd75a75a4a0256c85d98f78560ec431b643d756180223ef43ef181.png";
try {
const jakImages = JSON.parse(require("child_process").execSync(
`node /home/daytona/skills/shared/scripts/fetch_images.js "${jakStatUrl}"`,
{timeout: 20000}
).toString());
if (jakImages[0] && jakImages[0].base64) {
s.addImage({ data: jakImages[0].base64, x:0.3, y:0.85, w:4.8, h:5.6 });
}
} catch(e) {
s.addShape(pres.ShapeType.rect, { x:0.3, y:0.85, w:4.8, h:5.6, fill:{color:C.deepNavy}, line:{color:C.accent,pt:1} });
s.addText("JAK-STAT Diagram\n(Schwartz's Surgery, Fig. 2-7)", { x:0.3, y:0.85, w:4.8, h:5.6, fontSize:14, color:C.textLight, align:"center", valign:"middle" });
}
const jakPoints = [
["Step 1", "Cytokine binds receptor monomers -> receptor dimerization"],
["Step 2", "Constitutively associated JAK1/2/3 or TYK2 transphosphorylate each other (P activation)"],
["Step 3", "Phosphorylated receptor recruits STAT1/2/3/4/5/6 via SH2 domains"],
["Step 4", "JAK phosphorylates STATs -> STAT dimerization"],
["Step 5", "STAT dimers translocate to nucleus -> gene transcription (proliferation, differentiation, survival, apoptosis)"],
["SOCS", "Negative feedback: SOCS1-7 & CIS terminate JAK/STAT signaling; induced by JAK-STAT itself (inhibitory loop)"],
["JAK inhibitors", "Ruxolitinib (JAK1/2), Tofacitinib (JAK1/3), Baricitinib (JAK1/2) - approved for RA, MPNs, COVID-19, alopecia"],
["Mutations", "JAK2 V617F -> MPNs (PV, ET, MF) | JAK3/gc loss -> X-SCID | STAT1 GOF -> chronic mucocutaneous candidiasis"],
];
jakPoints.forEach((p, i) => {
const y = 0.9 + i*0.75;
s.addText(p[0] + ": ", { x:5.35, y, w:1.5, h:0.7, fontSize:12.5, bold:true, color:C.accentGold, fontFace:"Calibri", valign:"middle" });
s.addText(p[1], { x:6.8, y, w:6.3, h:0.7, fontSize:12.5, color:C.lightGrey, fontFace:"Calibri", valign:"middle" });
if(i<7) s.addShape(pres.ShapeType.line, { x:5.3, y:y+0.72, w:7.8, h:0, line:{color:C.accent,pt:0.3,transparency:70} });
});
// ============================================================
// SLIDE 7: INNATE IMMUNITY
// ============================================================
s = pres.addSlide();
s.addShape(pres.ShapeType.rect, { x:0, y:0, w:"100%", h:"100%", fill:{color:C.navy} });
s.addShape(pres.ShapeType.rect, { x:0, y:0, w:"100%", h:0.7, fill:{color:C.midBlue} });
s.addText("Cytokines in Innate Immunity", { x:0.3, y:0, w:12.7, h:0.7, fontSize:22, bold:true, color:C.white, fontFace:"Calibri", valign:"middle", margin:0 });
s.addShape(pres.ShapeType.rect, { x:0, y:0.7, w:"100%", h:0.04, fill:{color:C.accent} });
// Flow arrows row
const innateFlow = [
{ t:"Pathogen\n/ DAMP", c:C.accentRed },
{ t:"TLR/PRR\nActivation", c:"8A1A1A" },
{ t:"Macrophage /\nDendritic Cell", c:C.midBlue },
{ t:"IL-1b, IL-6\nTNF-a, IL-12", c:"5C4A8A" },
{ t:"Systemic\nEffects", c:C.accentGreen },
];
innateFlow.forEach((f, i) => {
const x = 0.5 + i*2.65;
s.addShape(pres.ShapeType.rect, { x, y:0.85, w:2.35, h:1.1, fill:{color:f.c}, line:{color:C.accent,pt:1} });
s.addText(f.t, { x, y:0.85, w:2.35, h:1.1, fontSize:12.5, bold:true, color:C.white, align:"center", valign:"middle", fontFace:"Calibri" });
if (i<4) {
s.addShape(pres.ShapeType.line, { x:x+2.35, y:1.4, w:0.3, h:0, line:{color:C.accentGold,pt:2} });
}
});
// Table
const innateRows = [
["IL-1b", "Macrophages, DCs, inflammasome", "Fever, acute phase response, T-cell co-activation, IL-6 induction", "Anakinra (IL-1RA), Canakinumab"],
["TNF-a", "Macrophages, T cells, mast cells", "NF-kB activation, inflammation, cachexia, endothelial activation, apoptosis", "Infliximab, Adalimumab, Etanercept"],
["IL-6", "Macrophages, fibroblasts, endothelium", "Acute phase (CRP, fibrinogen, hepcidin), B-cell differentiation, fever, STAT3 activation", "Tocilizumab, Sarilumab"],
["IL-12", "DCs, macrophages", "NK and Th1 cell IFN-g induction; critical for intracellular pathogen defense", "Ustekinumab (anti-p40, IL-12/23)"],
["IFN-a/b", "Plasmacytoid DCs (pDCs)", "Antiviral ISG induction, NK activation, MHC-I upregulation, STAT1/2 activation", "Pegylated IFN-a therapy (HCV, melanoma)"],
["IL-18", "Macrophages, epithelium", "Synergises with IL-12 to amplify IFN-g; NK and Th1 activation; elevated in HLH", "Tadekinig alfa (recombinant IL-18BP)"],
];
const iH = ["Cytokine","Source","Key Actions","Clinical Application"];
const iW = [1.6, 2.6, 5.3, 3.3];
const iX = [0.2, 1.8, 4.4, 9.7];
iH.forEach((h,i) => {
s.addShape(pres.ShapeType.rect, { x:iX[i], y:2.1, w:iW[i], h:0.42, fill:{color:"2D478A"}, line:{color:"000000",pt:0} });
s.addText(h, { x:iX[i], y:2.1, w:iW[i], h:0.42, fontSize:12, bold:true, color:C.white, align:"center", valign:"middle" });
});
innateRows.forEach((r,ri) => {
const rowY = 2.52 + ri*0.8;
const bg = ri%2===0 ? "1A2F4B" : "162640";
r.forEach((cell,ci) => {
s.addShape(pres.ShapeType.rect, { x:iX[ci], y:rowY, w:iW[ci], h:0.77, fill:{color:bg}, line:{color:C.accent,pt:0.3,transparency:60} });
s.addText(cell, { x:iX[ci]+0.05, y:rowY, w:iW[ci]-0.1, h:0.77, fontSize:10.5, color:ci===0?C.accentGold:C.lightGrey, fontFace:"Calibri", valign:"middle", bold:ci===0 });
});
});
// ============================================================
// SLIDE 8: TH CELL BALANCE
// ============================================================
s = pres.addSlide();
s.addShape(pres.ShapeType.rect, { x:0, y:0, w:"100%", h:"100%", fill:{color:C.navy} });
s.addShape(pres.ShapeType.rect, { x:0, y:0, w:"100%", h:0.7, fill:{color:C.midBlue} });
s.addText("Cytokines in Adaptive Immunity - Th Cell Balance", { x:0.3, y:0, w:12.7, h:0.7, fontSize:22, bold:true, color:C.white, fontFace:"Calibri", valign:"middle", margin:0 });
s.addShape(pres.ShapeType.rect, { x:0, y:0.7, w:"100%", h:0.04, fill:{color:C.accent} });
const thCells = [
{ name:"Th1", driver:"IL-12, IL-18, IFN-g", tf:"T-bet / STAT4", produces:"IFN-g, TNF-a, IL-2", protects:"Intracellular pathogens, tumors", disease:"RA, MS, T1DM, IBD", color:"2D5FAF" },
{ name:"Th2", driver:"IL-4, IL-33, TSLP", tf:"GATA3 / STAT6", produces:"IL-4, IL-5, IL-13", protects:"Helminths, extracellular parasites", disease:"Asthma, atopic dermatitis, eosinophilia", color:"B87D1A" },
{ name:"Th17", driver:"TGF-b + IL-6, IL-23", tf:"RORgt / STAT3", produces:"IL-17A/F, IL-22, TNF", protects:"Extracellular bacteria, fungi", disease:"Psoriasis, RA, IBD, AS, MS", color:"7B2D8B" },
{ name:"Treg", driver:"TGF-b, IL-2", tf:"FoxP3 / STAT5", produces:"TGF-b, IL-10, IL-35", protects:"Self-tolerance, homeostasis", disease:"Treg loss -> autoimmunity; excess -> cancer immune evasion", color:C.accentGreen },
];
thCells.forEach((t,i) => {
const x = 0.2 + i*3.3;
s.addShape(pres.ShapeType.rect, { x, y:0.85, w:3.1, h:6.45, fill:{color:t.color+"20"}, line:{color:t.color,pt:1.5} });
s.addShape(pres.ShapeType.rect, { x, y:0.85, w:3.1, h:0.62, fill:{color:t.color}, line:{color:"000000",pt:0} });
s.addText(t.name, { x, y:0.85, w:3.1, h:0.62, fontSize:22, bold:true, color:C.white, align:"center", valign:"middle" });
const fields = [
["Driven by", t.driver],
["TF / STAT", t.tf],
["Produces", t.produces],
["Protects vs", t.protects],
["Disease link", t.disease],
];
fields.forEach(([label,val],fi) => {
const fy = 1.58 + fi*1.09;
s.addText(label, { x:x+0.1, y:fy, w:2.9, h:0.32, fontSize:10.5, bold:true, color:C.accentGold, fontFace:"Calibri", italic:true });
s.addText(val, { x:x+0.1, y:fy+0.33, w:2.9, h:0.65, fontSize:11.5, color:C.lightGrey, fontFace:"Calibri", valign:"top" });
});
});
// ============================================================
// SLIDE 9: ANTI-INFLAMMATORY CYTOKINES
// ============================================================
s = pres.addSlide();
s.addShape(pres.ShapeType.rect, { x:0, y:0, w:"100%", h:"100%", fill:{color:C.navy} });
s.addShape(pres.ShapeType.rect, { x:0, y:0, w:"100%", h:0.7, fill:{color:C.midBlue} });
s.addText("Anti-Inflammatory Cytokines - Restoring Balance", { x:0.3, y:0, w:12.7, h:0.7, fontSize:22, bold:true, color:C.white, fontFace:"Calibri", valign:"middle", margin:0 });
s.addShape(pres.ShapeType.rect, { x:0, y:0.7, w:"100%", h:0.04, fill:{color:C.accent} });
const antiInfl = [
["IL-10", "Master anti-inflammatory; produced by Tregs, macrophages, DCs; suppresses TNF, IL-1b, IL-6, IL-12 production; critical in IBD tolerance (IL-10 deficiency causes early-onset colitis in mice and humans)"],
["TGF-b", "Promotes Treg (FoxP3+) differentiation and peripheral tolerance; suppresses T-cell and B-cell proliferation; drives fibrosis in chronic states (lung, liver, kidney fibrosis)"],
["IL-1RA", "Natural antagonist of IL-1a and IL-1b; binds IL-1 receptor without signaling; recombinant = Anakinra; approved for RA, MAS, Still disease, CAPS; naturally elevated in obesity"],
["IL-35", "Produced by Tregs and Bregs; suppresses Th1 and Th17; promotes Treg expansion; impaired in inflammatory disease; potential biologic target"],
["IFN-a/b (Type I)", "Anti-inflammatory in some contexts; downregulate cytokine-mediated lethality; upregulate IL-1RA; IFN-b used therapeutically in multiple sclerosis to reduce relapse rate"],
["IL-13", "From Th2 cells; anti-inflammatory at low levels (inhibits macrophage activation); pro-fibrotic at high levels; target in asthma (dupilumab blocks IL-4/IL-13 signaling via IL-4Ra)"],
["Balance principle", "Homeostasis = balance between pro- (IL-1b, TNF-a, IL-6, IL-17) and anti-inflammatory (IL-10, TGF-b, IL-1RA) cytokines. Chronic pro-inflammatory shift leads to tissue damage in autoimmune, metabolic and infectious disease"],
];
antiInfl.forEach((p, i) => {
const y = 0.85 + i*0.97;
const bg = i%2===0 ? "1A2F4B" : "162640";
s.addShape(pres.ShapeType.rect, { x:0.2, y, w:12.9, h:0.92, fill:{color:bg}, line:{color:"000000",pt:0} });
s.addShape(pres.ShapeType.rect, { x:0.2, y, w:1.8, h:0.92, fill:{color:C.accentGreen+"55"}, line:{color:"000000",pt:0} });
s.addText(p[0], { x:0.25, y, w:1.75, h:0.92, fontSize:13, bold:true, color:C.accentGreen, fontFace:"Calibri", valign:"middle", align:"center" });
s.addText(p[1], { x:2.1, y, w:10.85, h:0.92, fontSize:11.5, color:C.lightGrey, fontFace:"Calibri", valign:"middle" });
});
// ============================================================
// SLIDE 10: AUTOIMMUNE DISEASE
// ============================================================
s = pres.addSlide();
s.addShape(pres.ShapeType.rect, { x:0, y:0, w:"100%", h:"100%", fill:{color:C.navy} });
s.addShape(pres.ShapeType.rect, { x:0, y:0, w:"100%", h:0.7, fill:{color:C.midBlue} });
s.addText("Cytokines in Autoimmune Disease", { x:0.3, y:0, w:12.7, h:0.7, fontSize:22, bold:true, color:C.white, fontFace:"Calibri", valign:"middle", margin:0 });
s.addShape(pres.ShapeType.rect, { x:0, y:0.7, w:"100%", h:0.04, fill:{color:C.accent} });
const autoimmuneData = [
{ disease:"Rheumatoid Arthritis", cytokines:"TNF-a, IL-1b, IL-6, IL-17A, IL-18", mechanism:"Synovial inflammation, pannus formation, cartilage/bone destruction; RANKL-driven osteoclastogenesis; IL-6->STAT3->acute phase", therapy:"Anti-TNF (infliximab), anti-IL-6R (tocilizumab), anti-IL-17 (secukinumab), JAK inhibitors (baricitinib)" },
{ disease:"Psoriasis", cytokines:"TNF-a, IL-17A/F, IL-23, IL-22", mechanism:"Dysregulated IL-23/IL-17 axis; keratinocyte hyperproliferation; neutrophil recruitment; impaired skin barrier", therapy:"Anti-IL-17 (secukinumab, ixekizumab), anti-IL-23 (guselkumab, risankizumab), anti-TNF, anti-IL-12/23 (ustekinumab)" },
{ disease:"SLE", cytokines:"IFN-a/b, IL-6, IL-10, BLyS/BAFF, IL-17", mechanism:"pDC-derived IFN-a signature; TLR7/9 activation by immune complexes; auto-Ab (anti-dsDNA) production; complement activation", therapy:"Anifrolumab (anti-IFNAR1), belimumab (anti-BLyS), hydroxychloroquine" },
{ disease:"IBD (Crohn/UC)", cytokines:"TNF-a, IL-6, IL-12, IL-23, IL-17, IL-1b", mechanism:"Mucosal barrier disruption; aberrant Th1/Th17 macrophage activation; dysbiosis-triggered cytokine cascade; IL-10 insufficiency", therapy:"Anti-TNF, anti-IL-12/23 (ustekinumab), anti-IL-23 (risankizumab), vedolizumab, JAK inhibitors" },
{ disease:"Multiple Sclerosis", cytokines:"IFN-g, IL-17, TNF-a, IL-12, lymphotoxin", mechanism:"Th1 and Th17 attack on myelin; IL-17 disrupts blood-brain barrier; activated macrophages drive axonal injury", therapy:"IFN-b1a/b (immune modulation), natalizumab, anti-IL-12/23" },
];
const adCols = ["Disease","Key Cytokines","Pathomechanism","Targeted Therapy"];
const adW = [2.0, 2.5, 4.5, 3.9];
const adX = [0.2, 2.2, 4.7, 9.2];
adCols.forEach((h,i) => {
s.addShape(pres.ShapeType.rect, { x:adX[i], y:0.85, w:adW[i], h:0.42, fill:{color:"2D478A"}, line:{color:"000000",pt:0} });
s.addText(h, { x:adX[i], y:0.85, w:adW[i], h:0.42, fontSize:12, bold:true, color:C.white, align:"center", valign:"middle" });
});
autoimmuneData.forEach((r,ri) => {
const rowY = 1.27 + ri*1.28;
const bg = ri%2===0 ? "1A2F4B" : "162640";
const cells = [r.disease, r.cytokines, r.mechanism, r.therapy];
cells.forEach((cell,ci) => {
s.addShape(pres.ShapeType.rect, { x:adX[ci], y:rowY, w:adW[ci], h:1.25, fill:{color:bg}, line:{color:C.accent,pt:0.3,transparency:60} });
s.addText(cell, { x:adX[ci]+0.05, y:rowY, w:adW[ci]-0.1, h:1.25, fontSize:ci===0?12:10.5, bold:ci===0, color:ci===0?C.accentGold:C.lightGrey, fontFace:"Calibri", valign:"middle" });
});
});
// ============================================================
// SLIDE 11: CYTOKINE STORM
// ============================================================
s = pres.addSlide();
s.addShape(pres.ShapeType.rect, { x:0, y:0, w:"100%", h:"100%", fill:{color:C.deepNavy} });
s.addShape(pres.ShapeType.rect, { x:0, y:0, w:"100%", h:0.7, fill:{color:C.accentRed} });
s.addText("Cytokine Storm - Pathological Hypercytokinemia", { x:0.3, y:0, w:12.7, h:0.7, fontSize:22, bold:true, color:C.white, fontFace:"Calibri", valign:"middle", margin:0 });
s.addShape(pres.ShapeType.rect, { x:0, y:0.7, w:"100%", h:0.04, fill:{color:C.accentGold} });
const stormPoints = [
["Definition", "Life-threatening dysregulated systemic inflammatory response with massive uncontrolled cytokine release, leading to multi-organ failure"],
["Triggers", "Infections (sepsis, COVID-19, H5N1 influenza) | Hemophagocytic lymphohistiocytosis (HLH) / Macrophage Activation Syndrome (MAS) | CAR-T cell therapy (CRS) | Immune checkpoint inhibitors | SCT engraftment"],
["Key cytokines", "IL-6, IL-1b, TNF-a, IFN-g, IL-18, GM-CSF, M-CSF, MCP-1/CCL2 - positive feedback loops amplify and sustain the response"],
["COVID-19", "SARS-CoV-2 -> pDC/macrophage activation -> IL-6 surge -> capillary leak, ARDS, hypercoagulability, MOF; CysLTs co-amplify response; CRP/ferritin/D-dimer markers of severity"],
["Sepsis", "Early phase: IL-6, IL-8, TNF-a surge; concurrent anti-inflammatory IL-10 rise; second phase: immunoparalysis; IL-6 alone is strong independent predictor of mortality"],
["HLH / MAS", "Massively elevated ferritin (>10,000 ug/L), IL-18, IFN-g; activated macrophages engulf red cells and leukocytes; triggers: EBV, SLE flare, malignancy; sHScore for diagnosis"],
["Management", "Tocilizumab (anti-IL-6R): approved for COVID-19 ARDS and CAR-T CRS | Anakinra (IL-1RA): HLH/MAS | Dexamethasone: broad suppression | Ruxolitinib (JAK1/2): salvage in HLH | Emapalumab (anti-IFN-g): primary HLH"],
];
stormPoints.forEach((p, i) => {
const y = 0.85 + i*0.92;
const bg = i%2===0 ? "1A2F4B" : "162640";
s.addShape(pres.ShapeType.rect, { x:0.2, y, w:12.9, h:0.87, fill:{color:bg}, line:{color:"000000",pt:0} });
s.addShape(pres.ShapeType.rect, { x:0.2, y, w:2.0, h:0.87, fill:{color:C.accentRed+"55"}, line:{color:"000000",pt:0} });
s.addText(p[0], { x:0.25, y, w:1.95, h:0.87, fontSize:12.5, bold:true, color:C.accentRed, fontFace:"Calibri", valign:"middle", align:"center" });
s.addText(p[1], { x:2.3, y, w:10.65, h:0.87, fontSize:11.5, color:C.lightGrey, fontFace:"Calibri", valign:"middle" });
});
// ============================================================
// SLIDE 12: CYTOKINES IN CANCER
// ============================================================
s = pres.addSlide();
s.addShape(pres.ShapeType.rect, { x:0, y:0, w:"100%", h:"100%", fill:{color:C.navy} });
s.addShape(pres.ShapeType.rect, { x:0, y:0, w:"100%", h:0.7, fill:{color:C.midBlue} });
s.addText("Cytokines in Cancer - Friend or Foe?", { x:0.3, y:0, w:12.7, h:0.7, fontSize:22, bold:true, color:C.white, fontFace:"Calibri", valign:"middle", margin:0 });
s.addShape(pres.ShapeType.rect, { x:0, y:0.7, w:"100%", h:0.04, fill:{color:C.accent} });
// Left header
s.addShape(pres.ShapeType.rect, { x:0.3, y:0.85, w:6.0, h:0.45, fill:{color:"7A1A1A"}, line:{color:"000000",pt:0} });
s.addText("Tumor-Promoting Cytokines", { x:0.3, y:0.85, w:6.0, h:0.45, fontSize:14, bold:true, color:C.white, align:"center", valign:"middle" });
// Right header
s.addShape(pres.ShapeType.rect, { x:7.0, y:0.85, w:6.0, h:0.45, fill:{color:C.accentGreen}, line:{color:"000000",pt:0} });
s.addText("Anti-Tumor Cytokines", { x:7.0, y:0.85, w:6.0, h:0.45, fontSize:14, bold:true, color:C.white, align:"center", valign:"middle" });
s.addShape(pres.ShapeType.line, { x:6.65, y:0.85, w:0, h:6.6, line:{color:C.accent,pt:1.5} });
const proTumor = [
["IL-6", "STAT3 activation -> survival, proliferation, angiogenesis; elevated in breast, lung, colon, myeloma; drives cachexia"],
["TGF-b", "Immunosuppressive TME; suppresses CTL and NK; promotes EMT, invasion, and metastasis"],
["VEGF", "Angiogenesis; bevacizumab target; induced by IL-6, TNF, and hypoxia"],
["IL-10", "Immunosuppression in TME; promotes tumor evasion of cytotoxic T cells and NK cells"],
["IL-17A", "Promotes angiogenesis and VEGF production; recruits neutrophils to TME"],
["Adipokines", "Leptin -> promotes tumor proliferation; obesity -> chronic low-grade cytokine inflammation"],
];
const antiTumor = [
["IFN-g", "Activates macrophages; upregulates MHC-I on tumors for CTL killing; PDL-1 induction (checkpoint)"],
["TNF-a", "High-dose: direct tumor apoptosis; basis of isolated limb perfusion therapy for melanoma"],
["IL-2", "Approved: metastatic melanoma and RCC; promotes CTL/NK expansion; limited by vascular leak syndrome"],
["IFN-a", "Approved: hairy cell leukemia, melanoma, Kaposi sarcoma; inhibits tumor proliferation, MHC-I upregulation"],
["GM-CSF / G-CSF", "Post-chemo neutropenia (filgrastim, pegfilgrastim); DC differentiation in vaccines"],
["IL-12", "Potent antitumor in animal models; activates NK and CTL; used in oncolytic virus and CAR-T combinations"],
];
proTumor.forEach((p,i) => {
const y = 1.42 + i*1.0;
const bg = i%2===0 ? "1A2F4B" : "162640";
s.addShape(pres.ShapeType.rect, { x:0.3, y, w:6.0, h:0.95, fill:{color:bg}, line:{color:"000000",pt:0} });
s.addText(p[0]+" ", { x:0.35, y, w:1.2, h:0.95, fontSize:12.5, bold:true, color:C.accentGold, fontFace:"Calibri", valign:"middle" });
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antiTumor.forEach((p,i) => {
const y = 1.42 + i*1.0;
const bg = i%2===0 ? "1A2F4B" : "162640";
s.addShape(pres.ShapeType.rect, { x:7.0, y, w:6.0, h:0.95, fill:{color:bg}, line:{color:"000000",pt:0} });
s.addText(p[0]+" ", { x:7.05, y, w:1.4, h:0.95, fontSize:12.5, bold:true, color:C.accentGreen, fontFace:"Calibri", valign:"middle" });
s.addText(p[1], { x:8.45, y, w:4.4, h:0.95, fontSize:11, color:C.lightGrey, fontFace:"Calibri", valign:"middle" });
});
// ============================================================
// SLIDE 13: HEMATOPOIESIS & IMMUNODEFICIENCY
// ============================================================
s = pres.addSlide();
s.addShape(pres.ShapeType.rect, { x:0, y:0, w:"100%", h:"100%", fill:{color:C.navy} });
s.addShape(pres.ShapeType.rect, { x:0, y:0, w:"100%", h:0.7, fill:{color:C.midBlue} });
s.addText("Cytokines in Hematopoiesis & Immunodeficiency", { x:0.3, y:0, w:12.7, h:0.7, fontSize:22, bold:true, color:C.white, fontFace:"Calibri", valign:"middle", margin:0 });
s.addShape(pres.ShapeType.rect, { x:0, y:0.7, w:"100%", h:0.04, fill:{color:C.accent} });
const haemoPoints = [
["CSFs", "G-CSF (IL-3 family) -> neutrophils; M-CSF -> monocytes/macrophages; GM-CSF -> myeloid DCs; EPO -> erythropoiesis; TPO -> megakaryocytes/platelets; IL-3 = pan-hemopoietic stimulus"],
["IL-7", "Non-redundant for T and B lymphopoiesis; IL-7Ra mutations -> T-B+NK- SCID; elevated IL-7 in lymphopenia drives homeostatic proliferation of T cells"],
["JAK2 V617F", "Gain-of-function mutation: ~95% polycythaemia vera, ~50% ET and MF; constitutive JAK-STAT5 activation -> uncontrolled erythropoiesis; therapeutic target for ruxolitinib"],
["gc (CD132) deficiency", "X-linked SCID: loss of common gamma chain shared by IL-2, IL-4, IL-7, IL-9, IL-15, IL-21 receptors -> absent T and NK cells; profound lymphopenia; curative: HSCT or gene therapy"],
["JAK3 deficiency", "Autosomal recessive SCID; JAK3 is the intracellular partner of gc chain; phenotype identical to X-SCID; JAK3 inhibitors (tofacitinib) recapitulate SCID in high doses"],
["Myeloma and IL-6", "IL-6 via STAT3 -> myeloma cell survival, anti-apoptosis; IL-6 level correlates with disease activity; tocilizumab investigational in myeloma"],
["Clinical CSF use", "Filgrastim (G-CSF): post-chemotherapy or autologous HSCT mobilisation; sargramostim (GM-CSF): PBSC mobilisation; EPO analogs: anemia of CKD and cancer; eltrombopag (TPO-Ra) for ITP"],
];
haemoPoints.forEach((p, i) => {
const y = 0.85 + i*0.97;
const bg = i%2===0 ? "1A2F4B" : "162640";
s.addShape(pres.ShapeType.rect, { x:0.2, y, w:12.9, h:0.92, fill:{color:bg}, line:{color:"000000",pt:0} });
s.addShape(pres.ShapeType.rect, { x:0.2, y, w:2.0, h:0.92, fill:{color:C.midBlue+"88"}, line:{color:"000000",pt:0} });
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// ============================================================
// SLIDE 14: BIOLOGICS TABLE
// ============================================================
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s.addShape(pres.ShapeType.rect, { x:0, y:0, w:"100%", h:0.7, fill:{color:C.midBlue} });
s.addText("Cytokine Therapeutics - Biologics & JAK Inhibitors", { x:0.3, y:0, w:12.7, h:0.7, fontSize:22, bold:true, color:C.white, fontFace:"Calibri", valign:"middle", margin:0 });
s.addShape(pres.ShapeType.rect, { x:0, y:0.7, w:"100%", h:0.04, fill:{color:C.accent} });
const drugs = [
["Infliximab / Adalimumab / Etanercept", "Anti-TNF-a (mAb / fusion protein)", "RA, IBD, psoriasis, AS, PsA, JIA", "TB / fungal reactivation; demyelination; CHF exacerbation"],
["Tocilizumab / Sarilumab", "Anti-IL-6 receptor mAb", "RA, COVID-19 ARDS, CRS, GCA", "IL-6 level rises (receptor blocked); LFT monitoring; bowel perforation (rare)"],
["Anakinra / Canakinumab / Rilonacept", "IL-1 antagonists (recombinant IL-1RA; anti-IL-1b mAb)", "RA, gout, CAPS, HLH/MAS, AOSD, cardiovascular inflammation", "Injection site reactions; neutropenia risk; renal dosing adjustment"],
["Secukinumab / Ixekizumab", "Anti-IL-17A mAb", "Psoriasis, PsA, ankylosing spondylitis", "IBD flare risk (avoid in IBD patients); Candida infection"],
["Ustekinumab", "Anti-IL-12/23 (anti-p40 subunit)", "Psoriasis, PsA, Crohn disease, UC", "Generally well tolerated; PRES (rare); infections"],
["Dupilumab", "Anti-IL-4Ra (blocks IL-4 and IL-13)", "Atopic dermatitis, asthma, CRSwNP, EoE", "Conjunctivitis; injection site reactions; well tolerated overall"],
["Ruxolitinib / Fedratinib", "JAK1/2 inhibitor (oral)", "Myelofibrosis, PV, COVID-19, HLH, aGVHD", "Anemia, thrombocytopenia; VTE; herpes zoster reactivation"],
["Tofacitinib / Baricitinib / Upadacitinib", "JAK inhibitors (JAK1/3; JAK1/2; JAK1)", "RA, UC, PsA, alopecia areata, COVID-19", "VTE risk; lipid changes; serious infection; avoid in high CV risk; MACE warning"],
];
const drugCols = ["Agent", "Target / Class", "Approved Indications", "Key Adverse Effects"];
const dW = [2.9, 2.5, 3.5, 3.9];
const dX = [0.15, 3.05, 5.55, 9.05];
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s.addShape(pres.ShapeType.rect, { x:dX[i], y:0.85, w:dW[i], h:0.42, fill:{color:"2D478A"}, line:{color:"000000",pt:0} });
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drugs.forEach((r,ri) => {
const rowY = 1.27 + ri*0.81;
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});
});
// ============================================================
// SLIDE 15: CYTOKINE ASSAYS
// ============================================================
s = pres.addSlide();
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s.addText("Cytokine Assays in the Clinical Laboratory", { x:0.3, y:0, w:12.7, h:0.7, fontSize:22, bold:true, color:C.white, fontFace:"Calibri", valign:"middle", margin:0 });
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const assayPoints = [
["Bioassays", "Gold standard; measure biological activity (e.g., T-cell proliferation for IL-2, antiviral assays for IFN); time-consuming, labour-intensive, not practical for routine clinical labs; mainly research/validation use"],
["ELISA", "Widely available commercial kits for IL-1a/b, IL-4, IL-5, IL-6, IL-10, IFN-g, TNF-a; single-plex; quantitative; sensitivity: 1-10 pg/mL; Gold standard for individual cytokine measurement in serum, plasma, or BAL"],
["Multiplex / Luminex", "Bead-based immunoassay: simultaneously measures 20-100+ cytokines from <100 uL sample; platforms: Luminex xMAP, Meso Scale Discovery (electrochemiluminescence); high sensitivity; inter-platform variability is a known limitation (cross-site standardisation difficult)"],
["Flow cytometry ICS", "Intracellular cytokine staining with Brefeldin A/monensin block; cell-level cytokine analysis; identifies cytokine-producing T cells (IFN-g+ CD8+ = antigen-specific); used in transplant, vaccine response, GVHD monitoring"],
["CRS / CAR-T grading", "IL-6, IFN-g, ferritin, CRP measured serially; ASTCT CRS grading uses fever + hypotension + hypoxia; IL-6 rise precedes clinical CRS; guides tocilizumab timing"],
["Sepsis & COVID-19", "IL-6 strongest predictor of COVID-19 ICU admission; IL-8 correlates with ARDS severity; IL-10 rise indicates immunosuppressive phase; soluble CD163 (macrophage activation marker) elevated in HLH"],
["Pathology relevance", "CSF cytokine profiling (IL-6, IL-8, TNF-a) in CNS vasculitis / autoimmune encephalitis; Tumour microenvironment IHC (IL-6, PD-L1/IFN-g axis); HLH diagnosis: soluble CD25 (sIL-2Ra), ferritin, IL-18"],
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// ============================================================
// SLIDE 16: DEFICIENCY AND IMMUNOPATHOLOGY
// ============================================================
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s.addText("Cytokine Pathway Defects - Clinical Immunopathology", { x:0.3, y:0, w:12.7, h:0.7, fontSize:22, bold:true, color:C.white, fontFace:"Calibri", valign:"middle", margin:0 });
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const deficiencies = [
{ defect:"IL-12 / IL-12Rb1 deficiency", consequence:"Fail to produce IFN-g -> susceptibility to mycobacteria and Salmonella; Mendelian susceptibility to mycobacterial disease (MSMD); BCG vaccine danger" },
{ defect:"IFN-gR1/R2 deficiency", consequence:"Fatal disseminated mycobacterial infection even with BCG vaccination; recurrent non-typeable Salmonella; diagnostic: absent IFN-g binding on flow" },
{ defect:"IL-10 / IL-10R deficiency", consequence:"Very early onset IBD (<2 years); uncontrolled intestinal inflammation; refractory to standard therapy; curative: allogeneic HSCT" },
{ defect:"gc (CD132) / JAK3 deficiency", consequence:"X-linked SCID (gc) or AR SCID (JAK3): absent T and NK cells; B cells present but non-functional; profound lymphopenia; fatal without HSCT or gene therapy" },
{ defect:"JAK2 V617F gain-of-function", consequence:"Myeloproliferative neoplasms: PV (95%), ET (50%), MF (50%); constitutive STAT5 activation; erythrocytosis, thrombocytosis; target: ruxolitinib" },
{ defect:"STAT1 gain-of-function", consequence:"Chronic mucocutaneous candidiasis; hyperresponsive IFN signaling; impaired Th17 responses; brain aneurysms; treated with JAK inhibitors" },
{ defect:"STAT3 gain-of-function", consequence:"Multi-organ autoimmunity; lymphoproliferation; early-onset IBD, cytopenias, diabetes; loss-of-function STAT3 = Job syndrome (Hyper-IgE)" },
{ defect:"TNFR1 mutations (TRAPS)", consequence:"TNF receptor-associated periodic syndrome; periodic fever, serositis, rash; excessive TNF signaling; treated with anakinra or canakinumab" },
];
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// ============================================================
// SLIDE 17: KEY CYTOKINES QUICK REFERENCE
// ============================================================
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const quickRef = [
["IL-1b","Fever, acute phase, NLRP3 inflammasome product; Anakinra target; drives RA and gout flares"],
["IL-2","T-cell growth factor; CTL/NK expansion; high-dose: melanoma/RCC therapy; vascular leak syndrome"],
["IL-4","Th2 master; IgE class switching; inhibits macrophage activation; dupilumab target"],
["IL-5","Eosinophil differentiation and survival; mepolizumab target in eosinophilic asthma"],
["IL-6","Acute phase response, B-cell differentiation, STAT3 cancer survival; tocilizumab target"],
["IL-8 (CXCL8)","Neutrophil chemoattractant; angiogenesis; elevated in ARDS, sepsis, COVID-19"],
["IL-10","Anti-inflammatory master; Treg, macrophage; IL-10 deficiency = early onset IBD"],
["IL-12","Th1 polarisation; NK activation; intracellular pathogen defense; ustekinumab (p40) target"],
["IL-17A","Extracellular defense; psoriasis, RA, IBD; secukinumab, ixekizumab targets"],
["IL-23","Th17 maintenance; p19 subunit unique; risankizumab, guselkumab targets in psoriasis/IBD"],
["TNF-a","NF-kB; inflammation, apoptosis, cachexia; infliximab/adalimumab targets; TB reactivation risk"],
["IFN-g","Macrophage activation; MHC-I/II upregulation; elevated in HLH; emapalumab target"],
["TGF-b","Treg induction; fibrosis; immunosuppression in TME; EMT in cancer metastasis"],
["IFN-a/b","Antiviral ISGs; pDC-derived; type I IFN signature in SLE; anifrolumab target"],
];
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// ============================================================
// SLIDE 18: KEY TAKEAWAYS
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const takeaways = [
{ n:"1", t:"Pleiotropic & Redundant", d:"No single cytokine = single disease; networks overlap - targeting requires understanding the full system" },
{ n:"2", t:"Five Receptor Families", d:"Structural homology drives redundancy; receptor mutations cause immunodeficiency (gc, JAK3) or malignancy (JAK2 V617F)" },
{ n:"3", t:"JAK-STAT is the hub", d:"~60 cytokines signal via JAK-STAT; SOCS proteins provide negative feedback; JAK inhibitors are major immunomodulatory drugs" },
{ n:"4", t:"Th1/Th2/Th17/Treg balance", d:"Th1/Th17 excess -> autoimmunity | Th2 excess -> allergy | Treg excess -> cancer immune evasion" },
{ n:"5", t:"Cytokine Storm = Emergency", d:"IL-6 + IFN-g + TNF positive feedback -> ARDS, MOF; tocilizumab first-line for COVID-19 CRS; anakinra for HLH/MAS" },
{ n:"6", t:"Biologics changed medicine", d:"Anti-TNF, anti-IL-6R, anti-IL-17, anti-IL-23 transformed RA, IBD, psoriasis; adverse effects inform mechanism (TB, IBD, demyelination)" },
{ n:"7", t:"Deficiency = immunopathology", d:"IL-12R/IFN-gR -> MSMD; gc/JAK3 -> SCID; IL-10R -> early IBD; STAT mutations cause gain- or loss-of-function syndromes" },
];
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// ============================================================
// SAVE
// ============================================================
pres.writeFile({ fileName: "/home/daytona/workspace/cytokines-ppt/Cytokines_Health_Disease.pptx" })
.then(() => console.log("DONE: /home/daytona/workspace/cytokines-ppt/Cytokines_Health_Disease.pptx"))
.catch(e => { console.error(e); process.exit(1); });
Running Command
cd /home/daytona/workspace/cytokines-ppt && node build.js 2>&1
Running Command
cd /home/daytona/workspace/cytokines-ppt && sed -i 's/color:C\.accent+"44"/color:"005F6B"/g; s/color:C\.accent+"33"/color:"004F60"/g; s/color:C\.midBlue+"88"/color:"1A4570"/g; s/color:C\.midBlue+"55"/color:"1E4D8C"/g; s/color:C\.accentGreen+"55"/color:"217053"/g; s/color:C\.accentRed+"55"/color:"8C1F22"/g; s/color:t\.color+"20"/color:C.deepNavy/g; s/color:C\.accentGold+"33"/color:"5A3A0A"/g; s/color:C\.accentGold+"44"/color:"6A4A1A"/g; s/+"44"/""/g; s/+"33"/""/g; s/+"88"/""/g; s/+"55"/""/g; s/+"20"/""/g' build.js && node build.js 2>&1 | tail -5
Running Command
ls -lh /home/daytona/workspace/cytokines-ppt/Cytokines_Health_Disease.pptx
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