Professional Documents
Culture Documents
Immunocytology, Immunophysiology
and Intro to Immunopathology
Marc Imhotep Cray, M.D.
BMS and CK Teacher
http://www.imhotepvirtualmedsch.com/
Clinical:
e-Medicine Article
Acute Respiratory Distress
Syndrome
• External:
– Skin:
• Protective barrier to resist infection.
– GI tract:
• Gastric juice acidity.
– Respiratory tract:
• Mucus and cilia.
– Urinary tract:
• Urine acidity.
– Reproductive tract:
• Vaginal acidity.
• Diapedesis:
– Neutrophils and
monocytes are
able to squeeze
through tiny
gaps between
adjacent
endothelial cells.
– Particle becomes
surrounded by
pseudopods.
– Forms vacuole.
• Vacuole fuses with
lysosomes which digest
the particle.
– If lysosomes are released
into the infected area
before vacuole is
completely fused:
• Contribute to the
inflammation.
• Humoral immunity:
– Most of the lymphocytes that are not T cells are B
lymphocytes (B cells).
• Processed in the bone marrow.
– Function in specific immunity.
– B cells combat bacterial and some viral infections.
• Secrete antibodies into the blood and lymph.
– Provide humoral immunity as blood and lymph are body fluids
(humors).
– Stimulate production of memory cells:
• Important in active immunity.
• Classic pathway:
• Antibodies of IgG and IgM attach to antigens on invading
cell membranes.
– Binding to C1 activates the process.
• Activated C1 hydrolyzes C4 into C4a and C4b.
• C4b binds to the cell membrane and becomes an active
enzyme.
• C4b splits C2 into C2a and C2b.
• C2a attaches to C4b and cleaves C3 into C3a and C3b.
– Alternate pathway converges with classic pathway.
• Fragment C3b becomes attached to the complex in the cell
membrane.
• C3b converts C5 to C5a and C5b.
IVMS USMLE Step 1 Prep. 29
Fixation of Complement Proteins
• Chemotaxis:
– C5a acts as a cytokine to attract neutrophils and
monocytes to the site.
• Attract phagocytes.
• Opsinization:
– Phagocytes have receptors for C3b.
• Form bridges between phagocyte and victim cell.
• C3a and C5a stimulate mast cells to secrete
histamine:
– Increase blood flow and capillary permeability.
• Bring in more phagocytes.
• Secrete granzymes:
– Enter the victim cell
activating caspases:
• Enzymes involved in
apoptosis.
• Destruction of
victims cell’s DNA.
• Identified by CD4
coreceptor.
• Indirectly
participate by
regulating the
response of both
T killer and B cells.
• B cells must be
activated by
helper T cells
before they
produce
antibodies.
IVMS USMLE Step 1 Prep. 35
Interaction of Macrophages,
Helper T and Killer T cells
• Interleukin-1:
– Secreted by macrophages and other cells.
• Activates T cells.
• Interleukin-2:
– Released by helper T cells.
• Activates killer T cells.
• Interleukin-3:
– Serves as a growth factor.
• Activates killer T cells.
• Interleukin-4:
– Secreted by T cells.
• Required for proliferation and clone development of B cells.
• G-CSF and GM-CSF:
– Promote leukocyte development.
IVMS USMLE Step 1 Prep. 38
Subtypes of Helper T Cells
• TH1:
– Produces interleukin-2 and gamma interferon.
• Promotes cell mediated immunity and activates killer T cells.
• Stimulates NO production.
– Interleukin-12:
• Changes “uncommitted” helper T cells into TH1 cells.
• TH2:
– Secretes interleukin-4, interleukin-5, and interleukin-10.
• Promotes humoral immunity and stimulates B lymphocytes.
– Activates mast cells.
• MHC class-1:
– Produced by all cells but RBCs.
– Picks up cytoplasmic peptides and transports
to membrane.
• Killer T cells (cytotoxic) interact with
antigens.
– Coreceptor CD8 permits each type of T cell to
interact only with a class-1 MHC molecules.
• MHC class-2:
– Produced only by antigen-presenting cells and B cells.
• Present class-2 MHC together with antigens to helper T
cells.
• Activates T cells.
– Helper T cells react with antigens.
• Promotes B cell response.
– Appear only on cell membrane when cell is
processing antigens.
– Coreceptor CD4 interacts with only a specific class of
MHC molecule.
• Foreign antigens
attach to
immunoglobulins on
B cells.
• B cells can present
the antigen with
class-2 MHC
molecules to helper T
cells.
– Stimulate B cell
production,
conversion to plasma
cells, and antibody
production.
IVMS USMLE Step 1 Prep. 47
Destruction of T Lymphocytes
• Primary response:
– First exposure to pathogen, immune response insufficient
to combat disease.
– Latent period of 5-10 days before measurable amounts of
specific antibodies appear in blood.
• Secondary response:
– Subsequent exposure to same antigen.
– Antibody production is much more rapid.
• Maximum antibody concentration reached in < 2 hrs.
– Maintained longer period of time.
• Commercially prepared.
• Exhibit specificity for one antigenic determinant only.
• Results in more sophisticated clinical laboratory
tests.
– May aid in the diagnosis of cancer.
• May result in production of drugs combined with
monoclonal antibodies against specific tumor
antigens.