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Gerald N. Callahan and Robin M. Yates
Veterinary Clinical Laboratory Immunology chapter by Amy L. Warren

University Press of Colorado


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© 2014 by University Press of Colorado

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Library of Congress Cataloging-in-Publication Data

Callahan, Gerald N., 1946– author.
  Basic veterinary immunology / Gerald N. Callahan and Robin M. Yates ; Veterinary clinical laboratory immunology
chapter by Amy L. Warren.
       p. ; cm.
  Includes bibliographical references and index.
  ISBN 978-1-60732-218-4 (pbk. : alk. paper)
  I. Yates, Robin M. author. II. Title.
  [DNLM: 1.  Animal Diseases—immunology. 2.  Animal Population Groups—immunology. 3.  Immune System
Diseases—veterinary. 4.  Immune System Phenomena. 5.  Veterinary Medicine—methods.  SF 757.2]
Designed and typeset by Daniel Pratt
23 22 21 20 19 18 17 16 15 14 10 9 8 7 6 5 4 3 2 1

Cover illustrations, top to bottom: Thoroughbred horse © pirita/Shutterstock; Viruses, detailed 3D illustration
© nobeastsofierce/Shutterstock; © William Zaun; Chinese shar-pei dog © Waldemar Dabrowski / Shutterstock;
© William Zaun.

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Chapter 1: Overview of Chapter 2: Overview of the

Mechanisms of Defense 1 Innate Immune System 17
Clinical Correlation: Simian Acquired Clinical Correlation: Cyclic
Immune Deficiencies 1 Neutropenia in Gray Collies 17
Learning Objectives 1 Learning Objectives 17
Essential Involvement of Animal Anatomical and Physiological Barriers
Immune Systems in All Aspects of to Microbial Invasion 18
Animal Health 1 Epithelial Barrier 18
Immune System 2 Secretions 18
Cells of Defense 3 Mucus and Mucociliary Clearance 20
Communication between Cells of the Commensal Organisms 21
Immune System 3 Cells of the Innate Immune System 21
Communication through cytokines 3 Hematopoiesis 21
Other cytokines 4 Coordinating Hematopoiesis 23
Communication through other signaling Monitoring Hematopoesis 23
molecules 4 Overview of the Cells of the Innate
Communication through cell–cell Immune System 25
contact 4 Myeloid Innate Immune Cells 25
Innate and Adaptive Immune Systems 5 Neutrophils 25
Innate immune system 5 Eosinophils 26
Adaptive immune system 9 Basophils 27
Clinical Correlation Follow-Up 16 Monocytes 28
Student Considerations 16 Macrophages 29
Possible Explanations 16 Myeloid dendritic cells 30
Mast cells 31

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Lymphoid Innate Immune Cells 31 Chapter 4: The Complement
Natural killer cells 31 System 53
Other Innate Immune Cells 33
Clinical Correlation: C3 Deficiency in
Clinical Correlation: Follow-Up 33
Brittany Dogs 53
Student Considerations 33
Possible Explanations 34 Learning Objectives 53
Complement Activation 54
Classical Pathway 55
Chapter 3: Innate Immune Lectin Pathway 57
Recognition 37 Alternative Pathway 58
Terminal Membrane Attack Pathway 60
Clinical Correlation: Sepsis in
Neonatal Foals 37 Regulation of Complement Activation 60
Learning Objectives 38 Outcomes of Complement Activation 62
Inflammation and Chemotaxis 62
Introduction 38
Enhancement of Phagocytosis
Evolutionarily Conserved Molecular (Opsonization) 63
Patterns 40 Promoting Humoral Immunity 63
Pathogen-Associated Molecular Clearance of Immune Complexes 64
Patterns 40
Clinical Correlation: Follow-Up 64
Pattern-Recognition Receptors 40 Student Considerations 64
Signaling Pattern-Recognition Possible Explanations 64
Receptors 41
Toll-like receptors 42
NOD-like receptors and RIG-like Chapter 5: Acute Inflammation 67
receptors 44
Phagocytic Pattern-Recognition Clinical Correlation: Acute Bovine
Receptors 44 Mastitis 67
Other Pattern-Recognition Receptors 46 Learning Objectives 67
Innate Recognition of Damage- Purposes of Acute Inflammation 68
Associated Molecular Patterns 46 Signs of Acute Inflammation 69
Inflammasome 48
Initiators and Mediators of Acute
Consequences of Danger Signal Inflammation 70
Recognition by Sentinel Cells 50
Vascular Changes in Acute
Activation of Macrophages 50
Inflammation 72
Proinflammatory Mediators 50
Leukocyte Recruitment 75
Clinical Correlation: Follow-Up 50
Leukocyte Extravasation 75
Student Considerations 50
Diversity and Timeline of Leukocyte
Possible Explanations 51
Recruitment 79
Systemic Effects of Acute
Inflammation 80
Clinical Correlation Follow-Up 85
Student Considerations 86
Possible Explanations 86

vi Contents

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Chapter 6: Innate Cellular Organs and Cells of the Adaptive
Effector Mechanisms 89 Immune System 109
Primary Lymphoid Organs and
Clinical Correlation: Rattles in Foals 89 Hematopoiesis 110
Learning Objectives 90 Bone marrow 110
Classification of Innate Cellular Thymus 112
Effector Mechanisms 90 Secondary Lymphoid Organs 114
Lymph nodes 115
Phagocytes and Phagocytosis 91
Spleen 117
Phagocytosis Part I: Recognition and
Mucosa-associated lymphoid tissue 118
Adhesion of Particles on the Plasma
Membrane of the Phagocyte 91 Clinical Correlation: Follow-Up 119
Phagocytosis Part II: Membrane and Student Considerations 120
Cytoskeletal Reorganization to Possible Explanations 120
Mediate Particle Engulfment and the
Creation of a Phagosome 94 Chapter 8: Antigens and
Phagocytosis Part III: Maturation of Antigen Processing 121
the Phagosome into a Microbicidal
and Degradative Phagolysosome 94 Clinical Correlation: Caprine Arthritis
Extracellular Innate Effector Encephalitis 121
Mechanisms 99 Learning Objectives 122
Degranulation by Neutrophils and Stimulators of Adaptive Immunity:
Eosinophils 99 Pathogens, Antigens, and Epitopes 122
Release of Neutrophil Extracellular Major Histocompatibility Complex 124
Traps 100 History of the Major
Histocompatibility Complex 124
Natural Killer Cell–Mediated
Major Histocompatibility Complex
Cytotoxicity 101
Genetics 125
Recognition of Target Cells 101
Structure and Distribution of Major
Activating stimulus 101
Histocompatibility Complex Class I
Inhibitory stimulus 102
and Class II Molecules 129
Targeted Degranulation by Natural
Antigen–Major Histocompatibility
Killer Cells 102
Complex Interactions 131
Antibody-Dependent Cell-Mediated
Cytotoxicity 105 Antigen Acquisition, Processing, and
Presentation 132
Clinical Correlation: Follow-Up 105
Antigen-Presenting Cells 132
Student Considerations 105
Major Histocompatibility Complex
Possible Explanation 106
Class I Antigen Processing and
Presentation 135
Chapter 7: Cells and Organs Major Histocompatibility Complex
Class II Antigen Processing and
of the Adaptive Immune
Presentation 136
System 109
Cross-Presentation 137
Clinical Correlation: Feline Clinical Correlation: Follow-Up 139
Lymphadenopathy 109 Student Considerations 140
Learning Objectives 109 Possible Explanations 140

Contents vii

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Chapter 9: T-Lymphocyte Third Signal and T-Helper Cell
Development 143 Differentiation 168
Effector T Cells 169
Clinical Correlation: Severe Combined
Effector T-Helper Cells: Th1, Th2,
Immunodeficiency Disease in
Tf h, and Th17 Cells 169
Arabian Foals 143
Effector Regulatory T Cells: Treg, Th3,
Learning Objectives 143 and Tr1 Cells 171
T-Cell Receptor Genes 144 Effector Cytotoxic T Cells 173
Structure of the T-Cell Receptor 144 Clinical Correlation Follow-Up 177
T-Cell Receptor Gene Families 145 Student Considerations 177
Gene Rearrangement in the Thymus 145 Possible Explanations 177
T-Cell Selection in the Thymus 150
Products of T-Cell Gene
Rearrangement 150 Chapter 11: B-Cell
Positive Selection of Functional Develop­ment 181
T Cells 153
Clinical Correlation: Equine
CD4, CD8, and Major
Agammaglobulinemia 181
Histocompatibility Complex
Recognition 155 Learning Objectives 181
Negative Selection of Self-Reactive B Cells and the Structure of the B-Cell
T Cells 155 Receptor 182
T-Helper, Cytotoxic T, and B-Cell Genetics, Development, and
T-Regulatory Cells 156 Circulation 183
γ/δ T Cells 156 B-Cell Receptor Gene Families,
Clinical Correlation: Follow-Up 158 Genetic Rearrangement, and
Student Considerations 158 Junctional Diversity 183
Possible Explanations 158 Order and Regulation of B-Cell
Development 186
Immunoglobulin Isotypes 189
Chapter 10: T-Cell Activation 161 Other Populations of B Cells 191
Clinical Correlation: Canine B-1 B Cells 191
X-Linked Severe Combined Marginal-Zone B Cells 194
Immuno­deficiency 161 Clinical Correlation Follow-Up 195
Learning Objectives 162 Student Considerations 195
Possible Explanations 195
Antigen Recognition by T Cells 162
First Signal: T-Cell Receptors and
Major Histocompatibility Complex– Chapter 12: B-Cell Activation
Antigen Interactions 162
and Differentiation 197
Second Signal and Major
Histocompatibility Complex– Clinical Correlation: Selective Immuno-
CD4/8 Interactions 164 globulin A Deficiencies in Dogs 197
Signal Transduction and T-Cell Learning Objectives 197
Activation 166
T-Dependent B (B-2) Cells 199

viii Contents

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Interaction of B Cells with Antigens 199 Memory B Cells 238
B Cells as Antigen-Presenting Cells 203 Memory T Cells 238
Activation of B Cells by T-Helper Clinical Correlation Follow-Up 239
Cells 204 Student Considerations 239
Isotype Switching, Somatic Possible Explanations 239
Hypermutation, and Terminal
Differentiation of B Cells into
Plasma Cells 206Chapter 14: Fetal and
Antibody Effector Functions 213 Neonatal Immunity 241
Pathogen and Toxin Neutralization 213
Clinical Correlation: Failure of Passive
Opsonization and Activation of
Transfer 241
Complement 213
Distribution and Function of Fc Learning Objectives 241
Receptors 214 Fetal Development of the Immune
Clinical Correlation Follow-Up 215 System 241
Student Considerations 215 Maternal Transfer of Immunity 243
Possible Explanations 217 Prenatal Transfer of Immunity 243
Postnatal Transfer of Immunity 245
Chapter 13: Adaptive Immune Neonatal Acquisition of Memory and
Responses to Infections and Immune Capacity 248
Immunological Memory 219 Vaccination of Neonates 249
Clinical Correlation Follow-Up 251
Clinical Correlation: Canine
Student Considerations 251
Parvovirus and the Wolves of Isle
Possible Explanations 252
Royale 219
Learning Objectives 220
Adaptive Immunity: The Big Picture— Chapter 15: Vaccination 253
From Insult to Recovery 221 Clinical Correlation: Animal Vaccines 253
Routes of Infection 223
Learning Objectives 253
Mechanisms of Pathogenesis 223
Innate Response Cells and Cytokines Vaccines 253
of Innate Responses Direct T-Cell Vaccine Characteristics 253
Differentiation 225 Live-Attenuated Vaccines 255
Effector T Cells Home to Sites of Killed Vaccines 259
Infection and Inflammation 226 Component, Toxoid, Conjugate,
Antibody Responses Develop in Recombinant, and Naked DNA
Secondary Lymphoid Tissues 229 Vaccines 259
Importance of Different Adaptive Adjuvants 263
Responses to Clearance of Different Administration 266
Pathogens 233 Frequency 266
Immune Responses in the Gut 233 Passive Immunotherapy 267
Immunological Memory 237 Clinical Correlation Follow-Up 268
Primary and Subsequent Immune Student Considerations 268
Reponses 237 Possible Explanations 268

Contents ix

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Chapter 16: Immune Chapter 18: Veterinary Clinical
Deficiencies and Immune- Laboratory Immunology 295
Mediated Diseases 271 Clinical Correlation: Transfusion
Clinical Correlation: Feline Reactions 295
Immunodeficiency Virus 271 Learning Objectives 297
Learning Objectives 271 Principles of Antibody-Based
Immune Deficiencies 272 Techniques 298
Congenital Immune Deficiencies 272 Generating Antibodies: Polyclonal
Acquired Immune Deficiencies 273 and Monoclonal Antibodies 298
Immune-Mediated Diseases 274 Production of polyclonal antibodies 298
Hypersensitivities Type I, III, and IV 274 Production of monoclonal antibodies 299
Type I hypersensitivities 274 Detecting Antibody–Antigen
Type III hypersensitivities 279 Reactions 300
Type IV hypersensitivities 282 Specific Techniques 300
Type II Hypersensitivities and Enzyme-linked immunosorbent
Auto­immune Diseases 283 assays 300
Immunoblotting 302
Clinical Correlation Follow-Up 284 Immunofluorescent microscopy 303
Student Considerations 284 Precipitation assays 304
Possible Explanations 284 Flow cytometry 305
Immunohistochemistry 306
Chapter 17: The Immune Diagnosis of Blood Type
System and Cancer 287 Incompatibilities 307
Blood Typing 307
Clinical Correlation: Canine Cancer 287 Blood typing cards 308
Learning Objectives 287 Typing gel 308
Background 287 Membrane dipstick 309
Crossmatching 309
Evidence That Mammalian Immune
Systems Affect Tumors 289 Diagnosis of Immunodeficiencies 312
Serum Immunoglobulin
Tumor–Host Interactions 290
Quantification 312
Outcomes 292 Phenotypic Analysis of Lymphocytes 312
Clinical Correlation: Follow-Up 293 Other Immunodeficiency Tests 313
Student Considerations 293 Diagnosis of Autoimmunity 313
Possible Explanations 294 Antinuclear Antibody Test 313
Coombs Test 314
Antiplatelet Antibody Test 314
Antithyroglobulin Autoantibody Test 315
Clinical Correlation: Follow-Up 316
Student Considerations 316
Possible Explanations 316
Glossary 319
Index 327

x Contents

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Gerald N. Callahan and Robin M. Yates

Overview of Mechanisms of Defense Chapter 1


was a retrovirus—simian T-lymphotropic virus

Clinical Correlation: Simian Acquired Immune
III—a retrovirus very similar to the human T-
Deficiencies 1
lymphotropic virus III, the apparent (and later
Learning Objectives 1
confirmed) cause of human AIDS. The monkey
Essential Involvement of Animal Immune
Systems in All Aspects of Animal Health 1 virus was later renamed simian immunodefi-
Immune System 2 ciency virus (SIV).
Cells of Defense 3 Studies of wild African monkeys revealed that
Communication between Cells of the Immune green monkeys had SIV infection rates as high
System 3 as 30 to 50 percent with no overt clinical syn-
Communication through cytokines 3 drome. As with rhesus macaques, however, SIV
Other cytokines 4 infection of pig-tailed and crab-eating macaques
Communication through other signaling almost invariably resulted in a chronic wasting
molecules 4 disease and severe opportunistic infections, such
Communication through cell–cell contact 4 as oroesophageal candidiasis. What was under-
Innate and Adaptive Immune Systems 5 lying this clinical syndrome in these monkeys?
Innate immune system 5
Adaptive immune system 9
Learning Objectives
Clinical Correlation Follow-Up 16
Student Considerations 16 After reading this chapter, you should be able to
Possible Explanations 16
• describe the immune defense system;
• understand how cells of the immune sys-
Clinical Correlation: Simian tem communicate;
Acquired Immune Deficiencies • understand the basic elements of innate
The story probably began almost 32,000 years immune mechanisms;
ago, but the villain was not discovered until • describe the basic elements of adaptive
1985. In that year, M. D. Daniel and his collabo- immune mechanisms.
rators completed their work on four rhesus ma-
caque monkeys. Table 1.1 lists the symptoms of Essential Involvement of
those monkeys (Figure 1.1). Animal Immune Systems in All
Four monkeys seriously ill—at least three of Aspects of Animal Health
them from what appeared to be opportunis-
tic infections—for no apparent reason. Daniel Roughly 4 billion years ago, life on Earth became
and coworkers began searching for the cul- complex. From the primordial ooze, life co-
prit. What they found in the affected monkeys alesced into individual organisms—eubacteria,


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Figure 1.1. Rhesus macaque (© gopause / Shutterstock)

archaebacteria, and likely others. The brown Table 1.1. Symptoms of macaque monkeys at the New

seas turned azure and the pink skies turned England Regional Primate Research Center (adapted from
M. D. Daniel et al., 1985, Science 228: 201)
blue. Soon after, the first parasites appeared.
Animal Symptoms
Parasitism offered an energy-efficient alterna-
tive to survival on one’s own. Hosts provided 251–79 Malignant lymphoma
protection and energy with minimal or no in- 239–82 Macrophage infiltrates in brain, oroesopha-
geal candidiasis, cryptosporidiosis, intestinal
vestment by the parasite.
By the time metazoan life appeared, almost
220–82 Macrophage infiltrates in brain, oroesopha-
3 billion years later, parasitism had become a geal candidiasis, cryptosporidiosis, intestinal
high art. That constant evolutionary pressure, trichomoniasis
those threats to the survival of individual or- 142–83 Diarrhea, facial rash, generalized lymphade-
ganisms, produced immune systems. Both nopathy, splenomegaly
simple and complex mechanisms for defense
against parasites had, almost from the outset,
become essential components of all life, and vidual animals vanish. Because of this critical
still are. Without means for self-defense, no in- involvement of immune systems in all animal
dividual plants or animals would exist on Earth. functions, understanding immunity is essential
The proof of that is apparent in both pri- to understanding animal medicine, including
mary and acquired immune deficiencies in animal behavior.
animals as disparate as sharks and horses. Im-
mune-deficient animals rapidly disappear, and Immune System
in their places communities of other living
things—bacteria, viruses, fungi, and parasites— Animals have evolved numerous strategies to
abruptly arise. Without immune systems, indi- defend themselves against infections. These

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mechanisms range from independently acting All other vertebrates have both white and red
single proteins to highly trained cellular assas- blood cells (RBCs). RBCs, or erythrocytes,
sins that can specifically target infected cells. transport oxygen to animal tissues and deliver
Over evolutionary time, these various mecha- carbon dioxide to animals’ lungs. White blood
nisms have coalesced into unified defense sys- cells, or leukocytes, are, among other things,
tems called immune systems. Collectively, an cells of vertebrate immunity, both innate and
immune system includes the tissues, cells, and adaptive. White blood cells include T and B
molecules that work together to effect an im- lymphocytes (often referred to simply as T and
mune response designed to protect the host B cells and involved primarily in adaptive im-
animal from a given threat. Immune responses mune responses), as well as neutrophils, baso-
do not only secure the immediate survival of phils, eosinophils, NK cells (involved primarily
the infected host, but in many cases also bet- in innate immunity), and monocytes, which be-
ter prepare the animal for later exposures to a come, among other things, macrophages and
particular threat. dendritic cells (DCs; involved in both innate
The immune system is divided into two func- and adaptive immune responses). Neutrophils
tional subsystems: the innate immune system make up about 70 percent of all leukocytes in
and the adaptive (or acquired) immune system. the blood, followed by lymphocytes at around
The innate immune system mediates rapid, 20 percent, but the percentages of the various
early-phase responses to threats. These responses cell types vary among species, as well as with
include molecular and cellular mechanisms that the animal’s age and health. T cells can further
kill a wide variety of potential pathogens. The differentiate into T-helper (Th) and cytotoxic
adaptive immune system provides a delayed but T (Tc) cells. Th cells may differentiate into a
customized, or specific, response to infectious variety of Th cell types, including Th1, Th2,
threats, resulting in the production of antibod- Th17, and regulatory T cells, and each of these
ies, T-cell responses, and immune memory. Th-cell lineages perform specialized functions
For decades, immunologists considered and in adaptive immunity (see chapter 10). B cells
studied the innate and adaptive immune sys- ultimately differentiate into plasma cells that
tems separately. More recently, it has become secrete antibodies.
clear that these subsystems work together in an
overlapping and reciprocating fashion. Gener-
ally speaking, without a functional innate im- Communication between Cells
mune system, an animal is incapable of gen- of the Immune System
erating effective adaptive immune responses. It takes billions of immune cells to achieve
Without a functional adaptive immune system, effective defensive responses. Coordination of
most innate immune mechanisms are less ef- such massive numbers of cells requires a so-
fective. In truth, animal immunity involves a phisticated communication system involving
single collection of cells and their products that multiple cytokines, a variety of other soluble
act synergistically in defense of their host. How mediators, and direct cell-to-cell communica-
is this synergy orchestrated? tion via intercellular contact.

Cells of Defense Communication through cytokines

The only known vertebrate animals without Essentially, all cells use cytokines (soluble
red blood cells (RBCs) are crocodile icefish, proteins or glycoproteins) to communicate
which live in oxygen-rich cold water and ab- with one another. As with hormones, cytokines
sorb gaseous oxygen directly into their blood. may act directly on the cells that produce them

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(autocrine stimulation); on other nearby cells eration of cells in the bone marrow is apparent
(paracrine stimulation); or, via the blood, on as new colonies of cells.
distant cells (endocrine stimulation). Immune
cytokines fall into distinct categories based on
structure, function, and origin. Other cytokines
Interleukins (ILs) are a diverse group of cy- Several other immunologically important cy-
tokines produced predominantly by leukocytes tokines do not fit neatly within the preceding
(white blood cells) and act on other leukocytes categories. These cytokines include transform-
(inter, “between”; leukins, “leukocytes”). Acti- ing growth factor–β (TGF-β; so called because
vated T lymphocytes secrete the majority of it stimulates [among other things] growth simi-
ILs, but many other leukocytes, particularly lar to that seen in tumor cells). TGF-β has roles
macrophages and DCs, also produce cytokines in the regulation of immune reactions and tis-
to communicate with other cells. The abbrevia- sue repair. Other significant cytokines include
tion IL is followed by a number designating the tumor necrosis factors TNF-α and TNF-β (so
specific IL; for example, IL-2 is an IL that stimu- called because under some conditions these fac-
lates T-cell division. ILs have a variety of targets tors can cause tumor cell necrosis), which have
and functions within the immune system. roles in mediating inflammation and its sys-
Interferons (IFNs) are a group of cytokines temic effects. Table 1.2 lists some of the more
that are particularly important in the coordina- common cytokines and their functions.
tion of immune responses to infections, par-
ticularly viral infections. Because they were
first identified as molecules that interfered with Communication through other
signaling molecules
viral infection and replication, scientists com-
bined the word “interfere” with the particle suf- Aside from cytokines, the immune system
fix “-on” to form interferon. They include IFN-α uses several other molecules as messengers.
and IFN-β (released by virus-infected cells) and These molecules include the monoamines his-
IFN-γ, a proinflammatory cytokine produced tamine and serotonin, synthesized and released
predominantly by Th lymphocytes. from mast cells and basophils in response to in-
Chemokines are a group of cytokines that flammatory stimuli or allergens, which mediate
direct movements of immune cells (chemo, vascular changes associated with inflammation.
“chemical”; kines, “kinos or movement”). The Other important groups of immune signal-
movement of leukocytes among various tis- ing molecules derive from cellular lipids. These
sues is essential to all immune responses. Che- signaling molecules include the leukotrienes
mokines released by other immune cells direct and prostaglandins. Although derived from a
the movements of these leukocytes. Some che- common lipid precursor, members of these
mokines can also change the physiology of im- two molecular families have diverse functions,
mune cells so that these cells can perform par- including vascular changes, immune activation,
ticular functions (a process commonly referred chemotaxis, and regulation of inflammation
to as activation). and immunity.
Colony-stimulating factors (CSFs) are cyto-
kines that promote the proliferation and dif-
ferentiation of leukocyte precursors. The ma- Communication through cell–cell contact
jority of CSFs act on bone marrow stem cells Much of the communication between im-
and leukocyte precursors in the bone marrow, mune cells in the adaptive immune system relies
although some CSFs also act in peripheral tis- on direct molecular interactions between pro-
sues. CSFs were so named because the prolif- teins, complexes, and receptors on cell surfaces.

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Table 1.2. Some of the cytokines involved in innate immunity
(kDa) Assembly Source(s) Target(s)
IL-1 17 Monomer Macrophages, endo- Endothelia (h coagulation, h inflammation), hepatocytes
thelia, epithelia (h acute phase proteins), hypothalamus (h fever)
IL-18 17 Monomer Macrophages NK cells (h IFN-γ), T lymphocytes (h IFN-γ)
TNF 17 Homotrimer Macrophages, T Endothelia (h coagulation, h inflammation), hepatocytes
lymphocytes (h acute phase proteins), neutrophils (h activation), hypo-
thalamus (h fever)
IL-6 26 Homodimer Macrophages, endo- Hepatocytes (h acute phase proteins), B lymphocytes
thelia, T lymphocytes (h proliferation)
IL-15 13 Monomer Macrophages NK cells (h proliferation), T lymphocytes (h proliferation)
IL-12 35/40 Heterodimer Macrophages, den- Th1 lymphocytes (h differentiation), Tc lymphocytes
dritic cells (h IFN-γ), NK cells (h IFN-γ)
IL-23 19/40 Heterodimer Macrophages, den- T lymphocytes (h IL-17)
dritic cells
IL-27 28/13 Heterodimer Macrophages, den- Th1 lymphocytes (inhibition and/or differentiation), NK
dritic cells lymphocytes (h IFN-γ)
IL-10 18 Homodimer Macrophages, T Macrophages, dendritic cells (i IL-12)
IFN-α 21 Homodimer Macrophages All cells (h viral immunity, h MHC class I), NK cells (h
IFN-β 25 Homodimer Fibroblasts All cells (h viral immunity, h MHC class I), NK cells (h
Chemo- 8–12 monomer Macrophages, endo- Phagocyte (h migration), B lymphocytes (h migration),
kines thelia, fibroblasts, T lymphocytes (h migration), h wound repair
Note: MHC = major histocompatibility complex.

This type of communication requires intimate humans. In vertebrate animals, the innate im-
cell–cell contact. T lymphocytes in particular mune system represents the first line of defense
often require contact with other cells for acti- against invading pathogens, but in invertebrate
vation and to perform their effector functions. animals it represents the only line of defense.
Over millions of years of evolution, the innate
immune system has become amazingly com-
Innate and Adaptive Immune Systems plex and sophisticated. The key feature of this
Although the innate and adaptive immune immune system is its ability to distinguish be-
systems work together as a functional unit, tween foreign (often microbial) molecules and
there are evolutionary and functional differences molecules normally encountered in healthy
between these two systems (see Figure 1.2). host tissue.
Unlike adaptive immune systems, which have
to learn the differences between self and non-
Innate immune system self, the innate system has evolved to recognize
The innate immune system is an evolu- aspects of non-self immediately and to react
tionarily ancient system present in one form instantaneously, even before birth. This ability
or another in every animal, from mollusks to is the result of evolution of the genes encoding

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Table 1.3. Some cytokines involved in adaptive immunity
(kDa) Assembly Source(s) Target(s)
Lympho- 21–24 Homotrimer T lymphocytes B lymphocytes (h development), T lymphocytes (h develop-
toxin ment), neutrophils (h migration, h activation)
IL-2 17 Monomer T lymphocytes T lymphocytes (h survival, h proliferation, h cytokines),
B lymphocytes (h proliferation, h antibody production),
NK cells (h proliferation, h activation)
IL-4 17 Monomer Th2 lymphocytes B lymphocytes (h isotope switch IgE), Th2 lymphocytes
(h proliferation, h differentiation), macrophages (i IFN-γ
response), mast cells (h proliferation)
IL-5 26 Homodimer Th2 lymphocytes B lymphocytes (h proliferation, h isotope switch IgA),
eosinophils (h proliferation, h activation)
IL-13 13 Monomer Th2 lymphocytes, B lymphocytes (h isotope switch IgE), macrophages (h col-
NK-T lymphocytes, lage), fibroblasts (h collage), epithelia (h mucus)
mast cells
IL-17 35/40 Dimer T lymphocytes Endothelia (h chemokines), macrophages (h cytokines/che-
mokines), epithelia (h G-CSF and GM-CSF)
IFN-γ 40 Homodimer Th1 lymphocytes, B lymphocytes (h isotope switch), Th1 lymphocytes (h dif-
Tc lymphocytes, ferentiation), macrophages (h activation), various cells (h
NK cells antigen processing and h MHC class I)
Note: MHC = major histocompatibility complex.

numerous, highly conserved receptors that rec- that sometimes results in the direct lysis of the
ognize molecular patterns specific to pathogens microbe and always activates numerous sec-
(pattern-recognition receptors [PRRs]) or other ondary innate and adaptive immune responses.
receptors specific to the products of host tissue Specialized groups of cells carry out other
damage and necrosis. Several types of cells ex- innate effector mechanisms. Phagocytes are
press both types of receptors, but they appear a group of cells that can, via a process called
in the highest concentrations on the surfaces of phagocytosis, engulf and degrade microbes.
the sentinel cells of the innate immune system, This ability, plus specific cell-surface receptors,
including the macrophages and DCs found in allows phagocytes to selectively ingest indi-
practically every animal tissue. Once these cell- vidual microbes and, within a cytoplasmic sack
surface receptors bind their ligands, the cells called a phagolysosome, eliminate those invad-
release cytokines and chemokines that engage ing organisms. In this way, phagocytes remove
the rest of the immune system, which leads to and kill microbes without harming host cells.
the activation of antimicrobial effector mecha- The phagocytes of the innate immune system
nisms that find and kill invading microbes and include macrophages, DCs, and neutrophils.
parasites as well as dispose of damaged cells. In some cases, invading pathogens may be
The simplest of the innate antimicrobial too large or too numerous for phagocytes to
mechanisms involve individual secreted pro- handle effectively. In these cases, neutrophils or
teins or groups of them. For example, the eosinophils can also release antimicrobial and
complement system includes a series of plasma antiparasitic products directly into extracellular
proteins, most of which come from the liver. spaces. Although these products can harm by-
Activation of the complement system by invad- stander cells, they also effectively kill microbes
ing microbes initiates a biochemical cascade and large parasites such as worms.

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Figure 1.2. Major differentiating features of the innate and adaptive immune systems

Other innate immune cells, NK cells, defend nize and eliminate threats derives from highly
against intracellular pathogens such as viruses. conserved genes within the germline chromo-
NK cells do this by physically touching host somal DNA of animals. Because these systems
cells to determine whether they are healthy or have been refined over eons of evolution, they
stressed and abnormal (potentially indicating regularly and effectively distinguish microbes
that they may be infected by a virus or are neo- from normal host tissue. However, the innate
plastic). When NK cells detect suspicious cells, system cannot identify subtle differences be-
they induce apoptosis of those cells and limit tween strains of microbes and so may be cir-
viral spread or neoplasia (Figure 1.3). cumvented by evolving pathogens, particularly
The entire repertoire of mechanisms that viruses. Another limitation of the innate im-
allows the innate immune system to recog- mune response is that its efficiency does not

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Figure 1.3. Major innate and adaptive defense mechanisms against extracellular and intracellular
Different aspects of innate and adaptive immunity have evolved to deal with intracellular and ex-
tracellular pathogens. The complement system and phagocytes are especially important aspects of
innate immunity that deal with extracellular pathogens. NK cells of the innate response help to elimi-
nate infected cells. During adaptive immune responses (discussed in the Adaptive Immune System
section), antibodies and some Th cells act most directly in protecting against extracellular infections,
and other Th cells and Tc cells are most effective against intracellular infections.

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improve with repeated exposure to a given mi- immune response. The first time an animal
crobe. Unlike the adaptive immune system, the encounters a pathogen, the adaptive immune
innate immune system has no memory. system generates a primary immune response.
As a result, the innate immune system re- During second and subsequent encounters
sponds in an identical and predictable manner with that same pathogen, adaptive immune re-
to microbes, foreign bodies, and trauma. Also, sponses become more specific, faster, stronger,
innate responses do not improve with repeated and longer lasting (see Figure 1.4).
exposures. To escape these limitations, ver- Those differences between primary and
tebrates have evolved another set of immune sub­sequent immune responses constitute im-
mechanisms that are highly specific and evolve munological memory—the adaptive immune
over time to deal with ever-changing patho- system’s ability to remember it has seen an anti-
gens: the adaptive immune system. gen before and respond differently on a second
encounter with that antigen. Specificity and
memory are the hallmarks of adaptive immune
Adaptive immune system responses.
Beyond innate defenses, vertebrate animals Adaptive immune responses rely on lympho-
can muster a series of additional protective cytes, especially T and B lymphocytes. These
responses. These responses take longer to de- cells are the only ones in an animal’s body that
velop than innate responses, but add several re- specifically recognize and respond to antigens.
markable defense options. Adaptive responses On lymphocytes, antigen recognition occurs
to infection are adaptive because they are not through specific molecules called antigen re-
immediate responses and develop only over ceptors. These molecules are B-cell receptors
time. The adaptive immune response is also re- (BCRs) and T-cell receptors (TCRs; see Figures
ferred to as the acquired immune response be- 1.5 and 1.6).
cause the animal does not directly inherit these BCRs and TCRs are exquisitely specific for
immune responses but acquires them within individual antigens—nearly one BCR or TCR
its lifetime. Molecules that induce adaptive for each potential antigen. Because animals can
immune responses are called antigens. In the respond to essentially any antigen inside of an
natural world, antigens are molecular bits of animal, BCRs and TCRs must exist in nearly
organisms, including pathogens. Some antigens limitless numbers of specificities. That chemi-
may also induce innate responses, but the term cal feat results from a remarkable series of ge-
antigen is reserved for those molecules that netic rearrangements.
stimulate adaptive immune responses (gener- The genes that encode BCRs and TCRs ap-
ally, macromolecules, especially proteins and pear in pieces spread along particular chromo-
glycoproteins, but also carbohydrates as well as somes. During the development of B cells and T
some lipids and nucleic acids). cells, those genetic bits shuffle randomly like a
Innate immune responses, although rapid deck of cards to generate a nearly infinite num-
and powerful, lack fine specificity. For example, ber of possible receptors, including self-reactive
the inflammatory responses (aspects of innate receptors. Subsequent processes identify and
immunity) to type 1 and type 2 parvoviruses destroy self-reactive lymphocytes, minimizing
are the same. Adaptive immune responses are the possibility of autoimmunity. Nonetheless,
much more specific and customized to deal some self-reactive B and T cells can survive se-
with specific pathogens. For example, no mat- lection and may initiate auto­immune disease
ter how many times a dog gets infected with later in the animal’s life.
a parvovirus, the innate immune response re- In spite of their plasticity, specificity, and
mains similar, which is not true of the adaptive memory, adaptive responses lack the speed of

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Figure 1.4. Primary and secondary antibody responses
After injection of antigen A on day 0, an animal produces a primary antibody response to antigen A.
This response lasts for 30–40 days and is dominated by a type of antibody called IgM (pentamers).
When again injected with antigen A plus a new antigen B, the animal produces a robust secondary
antibody response to antigen A but a primary response to antigen B.

innate responses and can take days to weeks to tivated. Once these cells are activated by APCs,
reach measurable levels. This time lag is the re- they begin to divide rapidly and further differ-
sult of a phenomenon called clonal expansion. entiate. Ultimately, these waves of cell division
After a primary immunization or infection, a lead to a dramatic increase in the number of T
special group of cells, called antigen-presenting cells specific for the immunizing or infecting
cells (APCs), ingests and processes pathogens antigens. This process is clonal expansion—the
and then presents pathogen-derived antigens to expansion of a few cells into enormous clones
T cells. At the time of immunization or infec- of the originally activated T cell—resulting in
tion, an animal usually has only a few T cells thousands to millions of cells that all share the
specific for infecting or immunizing antigens. At same antigenic specificity. A similar process oc-
this stage, these T cells are referred to as “naive” curs among B cells. After antigen binding and
T cells because they have not yet encountered interaction with T cells, a few antigen-specific
their specific antigens—they have yet to be ac- B cells rapidly divide to create massive clones

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Figure 1.5. The B-cell antigen-specific receptor Figure 1.6. The T-cell antigen-specific receptor
As B cells mature in the bone marrow, they The antigen-specific portion of the TCR con-
express a complex of molecules called the BCR. tains two chains, either α/β or γ/δ. Together
This complex contains two immunoglobulin they make up the single antigen-binding site
heavy chains (H) and two immunoglobulin light of the TCR. The TCR also includes γ-, δ-, ε-,
(L) chains (essentially an antibody molecule) and ζ-chain molecules that contribute to signal
that, together, make up the antigen-specific transduction during T-cell activation. Ag =
portions of the BCR. In addition, the BCR con- antigen.
tains two other molecules, Igα and Igβ, which
participate in signal transduction and B-cell
activation. Ag = antigen.
through antibodies. After binding antigen and
interacting with certain T cells, B cells differen-
of antigen-specific B cells. Ultimately, these B tiate into plasma cells. Plasma cells secrete an-
cells differentiate into plasma cells and secrete tibodies (essentially a soluble form of the BCR)
antigen-specific antibody. All of this takes time, into lymph and blood. Antibodies are especially
a week to ten days in a primary adaptive im- effective in eliminating extracellular pathogens
mune response. (see Figure 1.8).
Once generated in sufficient numbers, T cells As mentioned earlier, unlike the innate im-
exert their effects directly, especially through mune system, the adaptive immune system re-
destruction of infected host cells and enhance- members its first encounters with antigens. So,
ment of other immune responses (see Fig- in a secondary adaptive immune response, lag
ure 1.7). B cells, however, provide protection times are shorter than primary immune response,

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Figure 1.7. Some of the actions of effector T cells
After activation by APCs, T cells differentiate into a variety of effector cells that drive the progres-
sion of several types of immune responses, including destruction of virus-infected cells (first panel),
activation of macrophages to kill ingested bacteria (second panel), activation of B cells to produce an-
tibodies (third panel), stimulation of inflammation (fourth panel), and maintenance of self-tolerance
(fifth panel). Treg = regulatory T cell; CTL = Tc cells.

tertiary responses are even faster, and so on. Also, although innate immune responses may
Such immune memory results from the cre- occur nearly anywhere, adaptive immune re-
ation of specialized subsets of long-lived B and sponses arise at specialized sites in animals’ bod-
T cells, called memory cells, which remain after ies. Those sites include lymph nodes (see Figure
primary adaptive immune responses. This pro- 1.9), the spleen, and mucosa-associated lym-
cess increases the number of resident antigen- phoid tissue (MALT).
specific cells. The second time an animal en- As mentioned at the beginning of this chap-
counters the same pathogen or antigen, these ter, separating immune responses and immune
memory cells dominate adaptive responses. systems into innate and adaptive components is
The result is that secondary and subsequent primarily a matter of convenience and history.
adaptive immune responses happen much No adaptive response ever occurs in the ab-
faster, are more specific, are stronger, and last sence of an accompanying innate response, and
longer (see Figure 1.4). most innate responses in vertebrate animals in-

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Figure 1.8. Effector mechanisms of antibodies
As shown in the left column, when antibodies bind to toxins (or viruses), the toxins can no longer
bind to specific receptors on host cells and are neutralized. The center column shows how antibody
binding to bacteria (a process called opsonization) enhances phagocytosis of pathogens by macro-
phages. The right column shows a similar process. Once IgM or IgG antibodies have bound to a
pathogen, the complex activates complement. Because macrophages and other phagocytic cells also
have receptors for complement fragments, this process also leads to more efficient phagocytosis of

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Figure 1.10. (facing page) Overview of a typical
immune response
Figure 1.10 is a concept map of a typical im-
mune response involving both the innate
(yellow) and adaptive (blue) immune systems.
These two systems intersect to work together
toward a common goal: control or eradication
of a threat. Following is a chronological descrip-
tion of the typical immune response depicted.
Numbers in parentheses correspond to the
circled numbers in the figure.
(1) After recognition of a threat, sentinel in-
nate immune cells initiate immune responses. (2)
Recognized threats include microbial products in
normally sterile tissues and the products of cellu-
lar injury—hallmarks of infection or potential in-
fection. (3) Even without knowing precisely what
the threat may be, innate sentinel cells can recruit
other innate cells, such as neutrophils, eosinophils,
and monocytes, as well as allow serum proteins,
such as complement, to permeate the affected
tissue through a process called inflammation. (4)
Once recruited to the site of infection, innate cells
Figure 1.9. Canine lymphatics and lymph nodes and serum proteins deploy powerful (albeit non-
Lymphatics (upper portion) are a system of specific) antimicrobial and antiparasitic mecha-
open-ended vessels that return extravascular nisms. (5) During the innate immune response,
fluid from the periphery to the heart and blood. APCs, such as macrophages and DCs, ingest
Distributed throughout the lymphatics are a and process proteins, move to lymph nodes, and
series of small filtering stations called lymph present these proteins to lymphocytes, initiating
nodes. Each node has both cortical (outer) and adaptive immune responses. (6) Adaptive immune
medullary (inner) regions in which different responses rely on the activation of key antigen-
aspects of the immune response occur. specific lymphocytes (around 1 in each 100,000
lymphocytes). Once activated, these cells undergo
rapid replication, expanding a few key lympho-
duce coincidental adaptive immune responses cytes to millions of identical cells (clones), a pro-
cess called clonal expansion. (7) The result is an
(see Figure 1.10).
army of lymphocytes that specifically recognize
Every day, every animal encounters liter-
parts of the invading microbe and effect a targeted
ally trillions of potential threats in the form attack by producing antibodies or by mobilizing
of transmissible pathogens—viruses, bacteria, and coordinating other immune processes. Not
fungi, and parasites. These agents of disease, only do these adaptive immune responses directly
if unchecked, would quickly destroy us all. Im- kill invading microbes or infected cells, but many
mune systems have evolved to help prevent that. of them at the same time enhance the efficiency
To do this, immune systems recognize specific of innate antimicrobial mechanisms already in
pieces of pathogens as foreign and, in response, play. (8) During clonal expansion, a portion of key
induce a series of protective mechanisms that antigen-specific lymphocytes differentiate into
involve both innate and adaptive reactions. The long-lived memory cells—allowing more efficient
ability to generate those reactions is why we are adaptive immune responses on repeat exposure
to the same threat (immunologic memory).
all here. The remainder of this book explores

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animals’ remarkable immune systems and their tic infections apparent in rhesus macaques and
interactions with the infectious world. other monkeys infected with SIV.

Clinical Correlation Follow-Up

Possible Explanations
Student Considerations As shown in this chapter, T cells are essen-
Further investigations of the affected mon- tial components of almost all adaptive immune
keys showed that SIV specifically infected T responses against both intra- and extracellular
cells, particularly Th cells, a type of T cell nec- pathogens. As SIV destroys more and more T
essary for almost all types of adaptive immune cells, these monkeys’ immune systems grow
responses and for amplification of many innate weaker and weaker. Eventually, the total num-
immune responses. ber of T cells drops below the levels needed
SIV is a retrovirus, which means that during to generate effective immune responses. At
infection, viral RNA serves as the template for that point, the monkeys begin to show signs
new complementary DNA that, with the help of of an acquired immunodeficiency syndrome.
an integrase, inserts itself into a host’s chromo- Although the innate immune system is still
somal DNA. This SIV provirus may remain inac- in play, without help from T cells it is quickly
tive for years, but once the host T cell activates— overwhelmed by normally innocuous mi-
for example, during an immune response—viral crobes, such as Candida albicans, that become
DNA becomes active, and those host cells begin opportunistic pathogens and blossom across
to produce infectious SIV, which results in host- mucosal surfaces, causing oroesophageal can-
cell malfunction and often host-cell death. didiasis. These and other opportunistic infec-
After reading this chapter, you should be able tions quickly overwhelm and kill infected
to propose an explanation for the opportunis- monkeys.

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Robin M. Yates

Overview of the Innate Immune System Chapter 2


susceptibility to bacterial infections. Within

Clinical Correlation: Cyclic Neutropenia in
Gray Collies 17 eight to twelve weeks of age, affected puppies
Learning Objectives 17 develop a broad range of symptoms, including
Anatomical and Physiological Barriers to fever, diarrhea, and joint pain as well as eye, re-
Microbial Invasion 18 spiratory, and skin infections. As a result, these
Epithelial Barrier 18 puppies often die before they reach six months
Secretions 18 of age. Monitoring the cell composition of
Mucus and Mucociliary Clearance 20 the collies’ blood over time by means of serial
Commensal Organisms 21 complete blood cell counts reveals an interest-
Cells of the Innate Immune System 21 ing phenomenon. Every twelve to fifteen days,
Hematopoiesis 21 these puppies develop a marked neutropenia
Coordinating Hematopoiesis 23 (lack of circulating immune cells called neu-
Monitoring Hematopoiesis 23 trophils), after which the number of circulating
Overview of the Cells of the Innate Immune neutrophils rebounds. During these periods of
System 25 neutropenia, the animals are extremely suscep-
Myeloid Innate Immune Cells 25 tible to bacterial infections that often result in
Neutrophils 25 illness and dramatically shortened lives. How
Eosinophils 26 does a genetic disorder affect neutrophil num-
Basophils 27 bers when other leukocytes seem unaffected?
Monocytes 28 And if the immune system is so complex, why
Macrophages 29 does the periodic loss of one cell type have such
Myeloid dendritic cells 30 devastating effects?
Mast cells 31
Lymphoid Innate Immune Cells 31
Learning Objectives
Natural killer cells 31
Other Innate Immune Cells 33 After reading this chapter, you should be able to
Clinical Correlation: Follow-Up 33
Student Considerations 33
• describe the anatomical and physical barri-
ers that guard against infection;
Possible Explanations 34
• discuss how leukocytes are generated in the
bone marrow (hematopoiesis);
Clinical Correlation: Cyclic • list the major cells in the innate immune
Neutropenia in Gray Collies system;
An unusual genetic disorder of collies results • list the basic morphological features of the
in gray coat color (Figure 2.1) and increased major innate immune cells;


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• outline the origin and anatomical location
of the major innate immune cells;
• describe the basic functions of the major
innate immune cells;
• list and understand the basic function of
the lymphoid innate immune cells.

Only vertebrates have adaptive immunity; in

Figure 2.1. Gray-coatedcollie pup (photograph
most species in the biome, host defense starts
provided by Michelle Tennis)
and stops with innate immunity. Starfish, for
example, have only innate immune systems, Affected pups are gray (often with a pinkish
yet they can live in some of the world’s most hue) with pale brown noses.
microbe-­rich environments and, for the most
part, successfully avoid infection. It is interest- that coat the exterior surfaces of an animal,
ing that many of the components of the innate including the gastrointestinal, respiratory, and
immune system in starfish are strikingly simi- reproductive tracts. Several features of mucous
lar to those in more complex animals, such as membranes and skin make them ideal barriers
mice, dogs, cats, pigs, horses, and humans. (Figure 2.3A–C). First, the flattened epidermal
For most of the twentieth century, immunol- and epithelial cells adhere to one another, form-
ogists focused on the adaptive immune system; ing tight junctions, which create a continuous
however, the innate immune system is an intri- impermeable shield. Second, in the skin, the
cate and sophisticated system in and of itself. outer layer of the epidermis is made up of dead
In this chapter, we introduce the major cells of cells that are filled with keratin—a mechanically
the innate immune system of animals and dis- strong protein that also repels water. Third, the
cuss their origins. The following chapters focus epithelial cells of the skin and mucous mem-
on how these components function to imme- branes continually grow and shed, repeatedly
diately protect animals from harm and how re-creating a fresh, microorganism-free surface.
the innate and adaptive immune systems work This process is particularly important in the in-
together to form an integrated defense system. testine, where epithelial cells in the colon have
a turnover rate of approximately six days. Dur-
ing intestinal parasitic infections, the intestinal
Anatomical and Physiological
epithelial cell turnover rate dramatically accel-
Barriers to Microbial Invasion
erates to expel the parasites.
Apart from what one normally thinks of as an
immune system, animals have innate anatomi-
cal and physiological barriers that are very effec- Secretions
tive in preventing infection. These barriers are In addition to the barrier role played by epi-
not usually included as bona fide components dermal and epithelial cells, the secretions these
of the innate immune system, but because their cells produce also play a role in innate defense.
contribution to host defense is so immense, we In the skin, specialized sebaceous glands adja-
review them here (Figure 2.2). cent to hair follicles produce sebum. Sebum is
lipid based and water-repellent. Sebum is also
acidic (with a pH of approximately 3 to 5),
Epithelial Barrier which inhibits the growth of many microbes.
The most obvious barrier to microbial inva- Numerous other secretions contain anti­
sion is the skin and the mucous membranes microbial proteins that specifically target un-

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Figure 2.2. Anatomical and physiological barriers in animals

Figure 2.3A–C. Epithelial barriers

Skin: keratinized squamous epithelium (panel A); mucous membrane: nonkeratinized squamous epi-
thelium (panel B); epithelium of the large intestine: columnar epithelium (panel C)

wanted microbes at key sites around an animal’s peptides defensins and cathelicidins, produced
body. Lysozyme is one of these secretions. It is by epithelial cells, also appear in body secre-
found in tears, saliva, milk, and in the mucus in tions. These small, positively charged peptides
the gut. Lysozyme specifically degrades the pep- insert themselves into negatively charged micro-
tidoglycan cell walls of bacteria. The cationic bial membranes and punch holes in them (most

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as hydrochloric acid, which acidifies the gastric
contents to a pH of 2 or less. As food moves
out of the stomach into the duodenum, the pH
is rapidly increased by the addition of bile. Bile
also contains numerous detergents that, along
with the pancreatic enzymes, act to disrupt mi-
crobial membrane integrity.
Aside from the specific antimicrobial actions
of many secretions, the physical flushing of
milk, tears, saliva, and urine removes many mi-
crobes from the mammary glands, eyes, mouth,
and urinary tract. The importance of simple
unidirectional flushing of surfaces is very evi-
dent in animals that cannot fully empty their
urinary bladders (as can happen, e.g., in dogs
with lower spinal cord injury). In the absence
of regular flushing of the lower urinary tract,
microbes can more easily colonize and migrate
up the tract, predisposing these animals to both
Figure 2.4. Proposed mechanism of action of lower and upper urinary tract infections.
These antimicrobial peptides have clusters of
positive charges alongside regions of hydro-
Mucus and Mucociliary Clearance
phobicity that allow them to integrate into Mucosal surfaces (including those lining the
negatively charged membranes. Integration of respiratory and reproductive tracts as well as
several defensins can destabilize the microbial the small and large intestines) secrete large
membrane, creating pores through which water amounts of mucus. This sticky, viscous sub-
and solutes can pass. In sufficient numbers, stance coats epithelial cell layers, providing an
these pores can substantially perturb osmo­
additional mechanical barrier to microorgan-
regulation of microbes and cause them to lyse.
isms by preventing them from binding to the ep-
ithelial surfaces. It also immobilizes microbes,
membranes in animal cells are positively charged making them easier to expel.
and resistant to these peptides; Figure 2.4). Although mucus produced by the intesti-
Some leukocytes also synthesize and secrete de- nal mucosa is cleared along with the intestinal
fensins, as do intestinal crypt Paneth cells. Other contents via peristalsis, mucus in the respira-
antimicrobial proteins can be found in milk, tory tract (along with trapped microbes and
where they help to inhibit microbial growth in debris) is expelled by a process referred to as
the lactating mammary gland. These proteins mucociliary clearance. Cilia are minute, finger-
include lactoferrin, which sequesters iron, mak- like projections on the apical (lumenal) surface
ing it unavailable for microbial growth, and lac- of the respiratory epithelium that move in co-
toperoxidase, which generates reactive oxygen ordinated waves (Figure 2.5). These waves act
compounds that damage microbes. to push mucus out of the airway and into the
The gastrointestinal tract produces multiple esophagus, inducing swallowing. Inactivation
secretions that not only mediate digestion but of mucociliary clearance results in the accumu-
also kill many unwanted microbes. The gastric lation of microbe-laden mucus in the airways.
mucosa secretes degradative enzymes as well In a rare heritable disease in dogs called ciliary

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dyskinesia, affected dogs have an abnormality commensal organisms but inhibits growth of
in the structure of cilia that renders them non- the majority of other microbes.
functional. Because of this abnormality, these A growing body of evidence supports the clin-
dogs are unable to clear mucus and are prone ical benefits of pro-biotic supplementation of
to upper and lower respiratory tract infections. “good” microbes, including protection from gas-
trointestinal disease, reducing the length of gas-
trointestinal infections, and reducing the length
Commensal Organisms of antibiotic-induced diarrhea (a side effect of
The skin and the reproductive, respiratory, antibiotic-mediated destruction of natural flora).
and intestinal tracts of healthy animals are Commensal intestinal bacteria also have a pro-
colonized by an array of commensal organ- found influence on the development of the in-
isms, particularly bacteria. These organisms testine itself and the adaptive immune system.
typically do not cause disease but, among other Overall, the barriers inherent in an animal’s
things, prevent the growth of pathogenic mi- anatomy and physiology effectively prevent
crobes. Prevention is achieved in part by the the invasion of most environmental microbes.
well-adapted commensal organisms’ simply These barriers, however, are not impenetrable.
outcompeting foreign microbes for space and Microbial breach is common. The second line
nutrients but also by creating a chemical mi- of defense faced by invading microbes is the in-
croenvironment that allows some microbes to nate immune system.
flourish while others perish. For example, com-
mensal lactobacilli within the vagina create an
Cells of the Innate
acidic environment that favors the growth of
Immune System
The innate immune system is made up of a
host of immune cells as well as soluble fac-
tors such as complement and acute-phase pro-
teins (APPs, which are discussed in subsequent
chapters). Unlike the adaptive immune system,
which includes recognizable tissues and organs
such as lymph nodes, spleen, and thymus, the
innate immune system is spread throughout
every tissue of every animal. In spite of this dif-
fuse anatomical distribution, innate immune
cells have a common origin in the bone marrow.

The production of immune cells in the bone
marrow is termed hematopoiesis (literally the an-
cient Greek words for blood and to make). As the
Figure 2.5. Scanning electron micrograph of name suggests, hematopoiesis produces not only
ciliated epithelium lining the respiratory tract immune cells but also red blood cells (RBCs) as
These long projections move in coordinated well as platelets. Amazingly, all of these arise
waves that push mucus and ensnared microbes during a highly coordinated and complex pro-
up and out of the respiratory tract. Image by cess that produces as many as 1011–1012 cells per
Charles Daghlian.
day from common hematopoietic stem cells.

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Figure 2.6. An overview of hematopoiesis showing major points of differentiation and anatomical
location in healthy animals

Hematopoiesis has three major lineages: the dedicated immune cells in animals (Figure
erythroid, myeloid, and lymphoid. The ery- 2.6). Most of the cells of the innate immune
throid lineage primarily produces RBCs (eryth- system arise from the myeloid lineage. These
rocytes) and platelets. The remaining two lin- cells include the granulocytes (neutrophils,
eages, myeloid and lymphoid, produce all of eosinophils, and basophils), mast cells, mono-

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cytes, macrophages, and myeloid dendritic cells ets or niches in the bone marrow that favor the
(DCs). The lymphoid lineage predominantly differentiation of particular hematopoietic lin-
produces lymphocytes (T and B cells) that eages, allowing different areas of the bone mar-
function in adaptive immune responses. The row to intensively support different hematopoi-
lymphoid lineage also produces natural killer etic activities (Figure 2.7).
(NK) cells that, unlike most T and B cells, func- Because the majority of innate immune cells
tion in the innate immune system. Other lym- derive from the common myeloid precursor
phoid cells have innate immune function, but stem cell, the activity of each differentiation
they apparently play only minor roles in innate pathway is what determines the final compo-
immune defense, and we consider them only sition of cells released from the bone marrow.
briefly here. Levels of growth factors (regulated by feedback
loops), along with external signals, regulate
these pathways. For instance, IL-5, IL-3, and
Coordinating Hematopoiesis GM-CSF favor eosinophil production; G-CSF,
With so many different bone marrow lin- GM-CSF, and IL-3 favor neutrophil production;
eages, all with quite different roles, it is impor- M-CSF, GM-CSF, and IL-3 favor monocyte pro-
tant that the bone marrow be able to selectively duction; and IL-4 and IL-9, along with GM-CSF,
increase or decrease the production of each of favor basophil and mast-cell differentiation, re-
the lineages in response to the body’s demands. spectively. Of course, other cytokines play roles
It would be wasteful to increase erythrocyte in the differentiation of these cells, but it is easy
production during inflammation and, likewise, to see that by varying the levels of cytokines, it
neutrophil production during anemia. For is possible to achieve a fine balance of lineage
these reasons, animals have evolved hemato- expansion or contraction.
poietic growth factors for specific regulation of At each step in a cell lineage, precursor cells
bone marrow cell differentiation and division. undergo irreversible commitments to fewer
The hematopoietic growth factors include a possible cell types. Expression of cell-specific
family of proteins known as colony-stimulating receptors and effector molecules as well as
factors (CSFs), which include granulocyte– changes in cellular morphology reflect this pro-
monocyte CSF (GM-CSF), granulocyte CSF gressive differentiation.
(G-CSF), and macrophage CSF (M-CSF). In ad- Once mature, the newly formed leukocytes,
dition to mediating inflammatory processes (as erythrocytes, and platelets move from the bone
we discuss in later chapters), several interleukins marrow into the blood through highly fenes-
serve as hematopoietic growth factors (includ- trated capillary networks. Some of the mature
ing IL-1, IL-3, IL-4, IL-5, IL-6, and IL-7). These leukocytic cells (particularly neutrophils and, to
interleukins play important roles in regulating a lesser extent, eosinophils and monocytes) re-
levels of immune cell production to meet the main in the blood, circulating through the body
immediate needs of an animal’s defense system. and exiting into surrounding tissues as needed.
Hematopoiesis in the bone marrow occurs in Other cells, such as mast cells, DCs, and mac-
areas between stromal reticular cells and adipo- rophages, are mostly directed to other tissues.
cytes (fat cells). Stromal reticular cells form a
very fine meshwork of spindled cells that pro-
vide the structural framework of the bone mar- Monitoring Hematopoiesis
row. In addition, stromal reticular cells (along Normally, the bone marrow of healthy ani-
with osteoblasts) produce and bind certain mals releases balanced numbers of mature leu-
hematopoietic growth factors, increasing their kocytes into circulation. But during disease,
local concentration. This process creates pock- when demand is high, increased numbers of

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Figure 2.7. Bone marrow
Representation of localized hematopoiesis in the bone marrow. Hematopoietic precursor cells are
enmeshed in a fine stromal network that creates small niches or pockets where growth factors are
differentially concentrated. This compartmentalization is thought to support localized growth and
differentiation of particular lineages.

certain leukocytes, including their immature

forms, appear in the circulation. Blood counts
and differentials (the identification and propor-
tion of cell types in blood smears) provide evi-
dence of such changes. Large increases in leu-
kocyte counts, particularly neutrophils (termed
neutrophilia), often indicate active inflamma-
tion. When immature neutrophils (band neu-
trophils) appear in large numbers in the blood
(a phenomenon called a left shift), it is usually
indicative of severe, acute inflammation.
In addition, bone marrow aspirates allow Figure 2.8. Monitoring changes to hematopoiesis
practitioners to finely gauge the marrow’s re- can be achieved indirectly through complete
sponse to disease. During inflammation, the blood cell counts or directly by observing
number of cells differentiating into leukocytes changes in bone marrow aspirates.
increases. For example, in allergies, increased
numbers of eosinophil precursors appear in the a cannula directly into the marrow cavity. Be-
bone marrow. Bone marrow aspiration, how- cause of that, it is typically used only when the
ever, requires anesthesia and the insertion of bone marrow is suspected of failing or to diag-

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nose bone marrow neoplasia. More commonly, of producing a variety of antimicrobial toxins.
practitioners exploit changes in circulating Under normal conditions, the majority of neu-
blood leukocytes to diagnose certain diseases. trophils remain in the blood in a resting state
for the entirety of their short lives (a few days).
However, circulating neutrophils have the abil-
Overview of the Cells of ity to swarm in huge numbers into inflamed tis-
the Innate Immune System sues where they unleash a storm of antimicro-
As mentioned earlier, the highly complex he- bial effectors. In these instances, neutrophils die
matopoietic process produces different subsets even more rapidly, often victims of their own
of innate immune cells. Here we provide only effector molecules. The extent of neutrophil
a brief introduction to these innate immune recruitment and death is often apparent as pus,
cells. More details appear in later chapters. which is composed mostly of dead neutrophils.
In their unactivated state in the blood, neu-
trophils are uniformly spherical. On activation,
Myeloid Innate Immune Cells typically accompanied with extravasation (exit
Neutrophils from the bloodstream), the neutrophils as-
These cells make up the majority of circulat- sume amoeboid shapes, allowing the cells to
ing leukocytes in many species and are capable crawl (chemotax) in the interstitial spaces. The

Figure 2.9. Canine neutrophil (mature) in a blood smear stained with Wright’s Giemsa

Name: Neutrophils
Other names: Polymorphonucleocytes; Heterophils (in birds and reptiles)
Classifications: Granulocyte, phagocyte
Lineage: Myeloid
Appearance: Segmented nucleus, granular cytoplasm
Location in health: Blood
Life span in health: Forty-eight to seventy-two hours
Primary function: Antimicrobial effectors, particularly in acute bacterial infection
Mechanism of action: Phagocytosis; Degranulation; Neutrophil extracellular trap formation

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cytoplasm of neutrophils is filled with granules. Second, activated neutrophils can kill extracellu-
These granules fail to stain in common hema- lar microbes by degranulation and secretion of
tology and histology stains, resulting in a neu- antimicrobial proteins and the release of toxic
tral appearance, hence the name neutrophil. metabolites. Third, neutrophils release meshlike
The segmented nuclei of mature neutrophils substances called neutrophil extracellular traps
are unique and hard to miss in a blood smear. (NETs). These NETs, consisting of DNA and
The degree of nuclear segmentation is an indi- certain proteins, can trap and kill extracellular
cator of neutrophil maturation, with the imma- microbes (literally as a fishing net does). In addi-
ture band neutrophils possessing unsegmented tion to killing microbes, neutrophils participate
nuclei and older neutrophils having highly seg- in the coordination of inflammation through
mented nuclei. the release of inflammatory mediators.
As stated earlier, the primary function of
neutrophils is to kill invading microbes. Neu-
trophils achieve this through several effector Eosinophils
mechanisms. First, neutrophils engulf (eat) Eosinophils are especially effective in killing
microbes via phagocytosis and destroy them multicellular parasites such as parasitic hel-
in intracellular vesicles called phagolysosomes. minths (worms). Eosinophils also have some

Figure 2.10. Canine eosinophil in a blood smear stained with Wright’s Giemsa

Name: Eosinophils
Other names: Eosinophil granulocytes
Classifications: Granulocyte
Lineage: Myeloid
Appearance: Characteristic eosinophilic granules (staining red with eosin)
Location in health: Blood and tissues lining gastrointestinal tract and airways
Life span in health: Days to weeks
Primary function: Antiparasitic effectors, particularly in helminthic infection; Some antiviral action; Roles
in allergy
Mechanism of action: Degranulation; Limited phagocytosis

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antiviral capabilities and are active in certain al- Once in the tissue and activated by parasite or
lergic responses (particularly in cats and horses). leukocyte products, resident or newly recruited
Their role in tumor immunity remains unclear. eosinophils kill invading parasites. Because mul-
After release from the bone marrow, mature ticellular parasites are too big to be engulfed by
eosinophils circulate in the blood and make up phagocytosis, eosinophils release antiparasitic
approximately 0.1 percent to 3.0 percent of leu- proteins and toxic metabolites into extracellular
kocytes in most species. In blood smears, their spaces to harm or kill these multicellular invad-
granules stain bright red. The morphology ers. They are also active in certain severe allergic
of eosinophil nuclei can range from round to responses in cooperation with mast cells and ba-
multilobular. Unlike neutrophils, eosinophils sophils and have roles in antiviral responses. For
normally exit the blood after a brief period the most part, however, eosinophils are innate
of circulation and spend most of their lives in granulocytes and specialists in combating para-
healthy tissues, particularly in the connective sitic, particularly helminth, infections.
tissues underlying mucosal surfaces. It is here
that eosinophils are most likely to encounter
multicellular parasites. During parasitic infec- Basophils
tions, eosinophils still circulating in the blood In most domestic species, basophils typically
are specifically recruited to the affected tissue. make up less than 0.5 percent of leukocytes

Figure 2.11. Bovine basophil in a blood smear stained with Wright’s Giemsa
Name: Basophils
Other names: Basophil granulocytes
Classifications: Granulocyte
Lineage: Myeloid
Appearance: Characteristic blue-purple basophilic granules with basic dyes
Location in health: Blood
Life span in health: Days
Primary function: Mediator of inflammation
Mechanism of action: Degranulation

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Figure 2.12. Feline monocyte in a blood smear stained with Wright’s Giemsa

Name: Monocytes
Classifications: Mononuclear phagocytes
Lineage: Myeloid
Appearance: Large round to kidney-shaped nucleus, diffuse pale blue-gray staining cytoplasm com-
monly containing vacuoles
Location in health: Blood
Life span in health: Days (in circulation)
Primary function: Precursors of macrophages and DCs
Mechanism of action: Limited antimicrobial function in blood

circulating in the blood. Although rare, their Monocytes

characteristic dark-staining large cytoplasmic Monocytes are circulating precursors of,
granules (when stained with basic dyes) make among other cell types, macrophages and DCs.
it easy to identify them on a blood smear. Dur- In most species, monocytes make up 2 percent
ing multicellular parasitic infections and late- to 10 percent of circulating leukocytes. In a
phase allergic reactions, basophils migrate into blood smear, these cells appear to be 12–20 µm
inflamed tissues. Here, basophils coordinate in- in diameter with diffusely stained cytoplasm
flammation (in a manner similar to that of mast and large, round, indented, or kidney-shaped
cells) and promote the adaptive immune reac- nuclei. Monocytes typically circulate for a few
tions best suited to combating parasites (called days before exiting the circulation to differen-
a Th-2 response, covered in later chapters). Un- tiate into tissue macrophages or DCs. Under
fortunately, these functions of basophils also normal circumstances, monocytes perpetually
amplify the unwanted effects associated with replenish tissue macrophages and DCs in all
allergies (type I hypersensitivities). Overall, ba- tissues. However, in inflamed tissues, mono-
sophils are mediators of inflammation associ- cytes rapidly exit the blood to quickly populate
ated with parasitic infections and allergies. the area with large numbers of macrophages.

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Figure 2.13. Murine tissue macrophage grown in cell culture and stained with Diff-Quik

Name: Macrophages
Other names: Tissue macrophages; Kupffer cells (macrophages in liver); Splenic macrophages (mac-
rophages in spleen); Microglial cells (macrophage equivalents in the central nervous
system); Alveolar macrophages (macrophages in airways); Peritoneal macrophages
(macrophages in the peritoneal cavity)
Classifications: Mononuclear phagocyte; Sentinel cell; Antigen-presenting cell
Lineage: Myeloid
Appearance: Round nucleus, clear-vacuolated cytoplasm, irregular cell shape
Location in health: Peripheral tissue
Life span in health: Months
Primary function: Immune surveillance, moderate antimicrobial capacity, limited antigen presentation
Mechanism of action: Detection of threats and release of inflammatory mediators; Phagocytosis

Monocytes themselves are phagocytic and pro- As mentioned earlier, macrophages arise from
duce some cytokines but are generally not very monocytes that exit the circulation. Once mono-
proficient at these tasks until they fully differ- cytes are in a tissue, various tissue factors drive
entiate into macrophages or DCs after exiting the monocytes’ maturation into macrophages.
the blood. Because this process occurs in practically every
tissue and organ, different combinations of tis-
sue factors produce numerous organ- or tissue-
Macrophages specific macrophage types. Although different
Within the immune system, macrophages macrophage types may differ in location, ho-
are sentinel cells, antimicrobial effector cells, meostatic function, morphology, and name,
and antigen presenting cells (APCs). During most perform similar functions in the immune
health, macrophages also perform numerous system. Macrophages are generally larger cells
housekeeping functions, such as removal of with copious amounts of membrane. They are
dead and damaged cells and cellular debris, extremely pleomorphic (i.e., they vary greatly
tissue remodeling, and maintenance of iron in their size and shape), adopting spherical, spin-
homeostasis. dle, or amoeboid cellular forms.

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Figure 2.14. Murine DC grown in culture and stained with Diff-Quik
Name: Myeloid dendritic cells
Other names: Inflammatory DCs; Conventional DCs; Langerhaan cells (DCs in skin)
Classifications: Mononuclear phagocyte; Sentinel cell; Antigen-presenting cell
Lineage: Myeloid
Appearance: Round nucleus, clear cytoplasm, irregular shape with long branched projections
Location in health: Tissue
Life span in health: Months
Primary function: Immune surveillance, antigen processing and presentation
Mechanism of action: Detection of threats and release of inflammatory mediators; Endocytosis and

Macrophages are very active sentinel cells, al- Although macrophages are not as microbi-
ways on the lookout for signs of danger. They cidal as neutrophils, they are reasonably adept
commonly crawl around in the extracellular at phagocytosis and killing microbes inside
spaces and have high rates of endocytosis and of phagolysosomes. Unlike most neutrophils,
pinocytosis (two methods of taking up extra- however, macrophages can also keep pieces of
cellular fluid). These activities allow them to protein from the phagocytosed bacteria and, in
constantly patrol the tissue and sample mol- a process called antigen presentation, present
ecules in the extracellular fluid. Detection of these pieces to T cells of the adaptive immune
a threat is achieved using a variety of recep- system (see chapter 8).
tors that recognize microbial products as well
as products of tissue damage. Once activated,
macrophages produce proinflammatory cyto- Myeloid dendritic cells
kines that engage other aspects of the immune The term dendritic cell (DC) has been ap-
system and promote the recruitment of other plied to a number of different cell types with
leukocytes to the area. different origins and functions (see discussion

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of other innate cells). Thus, the term does not out the body (especially the connective tissues
always define a single cell type. However, my- surrounding blood vessels and nerves, as well
eloid DCs (DCs of myeloid origin) are typically as in the lamina propria of mucosal surfaces),
just referred to as DCs (as we do here). where they then differentiate into mature mast
DCs are innate sentinel cells that are highly cells. Because mast cells act as sentinel cells,
efficient at processing and presenting antigens they express a variety of receptors that can de-
to T cells. Because antigen presentation is es- tect innate danger signals. Mast cells also have
sential for T-cell adaptive immunity, DCs func- receptors that recognize IgE, which is impor-
tion at the interface between the innate and the tant in adaptive immune responses to parasites
adaptive immune systems. and allergens.
DCs are present in practically every tissue The cytoplasm of a mature mast cell contains
and organ of the body. Like macrophages, DCs densely packed granules full of proinflamma-
derive from circulating monocytes that have ex- tory mediators. On detection of a threat (either
ited the blood and migrated into tissues. If given directly or through products released by other
the right stimulus, monocytes mature into DCs leukocytes or by complement activation), mast
that take up residence by extending their long cells degranulate and release the proinflam-
branched cellular projections between cells and matory granule contents into the extracellular
connective tissues, which gives the DCs their space. These granule components, together with
intricate shape as well as their name (dendron the lipid mediators and cytokines synthesized
is Greek for “tree”). Within tissues, DCs act as by the mast cells, act on local cells and vascula-
sentinel cells. They express numerous receptors ture, resulting in inflammation (particularly by
that detect tissue damage and infection, and in increasing vascular dilation and permeability).
response they synthesize cytokines that activate This inflammation not only alerts the immune
other immune cells. Similarly to macrophages, system to the threat but also assists in the re-
DCs can also endocytose and phagocytose mi- cruitment of effector cells that can combat the
crobes, but unlike macrophages, DCs are not threat. Mast cells also play important roles in the
very effective in killing the microbes within the coordination of chronic inflammation and tissue
phagolysosome. However, DCs are especially repair. Overall, mast cells are specialized sentinel
efficient at processing protein antigens, display- cells strategically positioned in tissues and, when
ing bits of those antigens on their surfaces, and triggered, quickly promote inflammation.
presenting them to T cells. In fact, DCs are the
only APCs that can effectively initiate T-cell re- Lymphoid Innate Immune Cells
sponses to new antigens. For this reason, DCs
are often referred to as professional APCs. Natural killer cells
NK cells earn their name because of their
ability to innately recognize and kill abnormal
Mast cells host cells without previous sensitization. NK
Mast cells, like macrophages and DCs, are cells do not express either T- or B-cell receptors,
sentinel cells involved in immune surveillance. which distinguishes them from NK T lympho-
On detection of a threat, mast cells rapidly re- cytes, which are named for their similarity to
lease potent mediators of inflammation, which both NK cells and T cells but function in both
are usually protective. Mast cells, however, adaptive and innate immune responses.
also play a major role in allergies (type I hyper­ NK cells arise in the bone marrow from the
sensitivities). lymphoid lineage, but go through a second
Mast-cell precursor cells arise in the bone round of maturation (termed licensing) in sec-
marrow and quickly migrate into tissues through- ondary lymphoid tissues (lymph nodes, spleen).

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Figure 2.15. Canine mast cell from a fine-needle aspirate stained with Wright’s Giemsa

Name: Mast cells

Classifications: Sentinel cells
Lineage: Myeloid
Appearance: Round nucleus, cytoplasm densely packed with granules (purple)
Location in health: Tissue, particularly connective tissue surrounding vasculature and nerves, and the lamina
propria of the mucosa
Life span in health: Weeks to months
Primary function: Immune surveillance, mediator and amplifier of inflammation and allergy
Mechanism of action: Detection of threats and release of inflammatory mediators via degranulation (vasoac-
tive amines) or synthesis of lipid mediators and cytokines

Mature, licensed NK cells then enter the circula- anisms are ineffective against them. Similarly,
tion, where they can account for as much as 2 many tumor cells differ very little from normal
percent to 15 percent of lymphocytes. NK cells host cells. However, both virus-infected and
are larger than most circulating lymphocytes and tumor cells often express abnormal molecules
have cytoplasms that contain azurophilic gran- on their surfaces or lose markers that normally
ules (hence, they are often described as “large identify the host cells as self. NK cells use host
granular lymphocytes”). These granules contain cell–surface proteins to identify normal and ab-
proteins, called granzymes and perforins, that normal cells. If a host cell appears abnormal,
are key to NK cells’ cytotoxic abilities. NK cells the NK cell forms a tight adhesion to the target
also appear in normal tissues, particularly under- cell and precisely delivers cytotoxic molecules
lying mucosal surfaces; however, their function from its granules to the abnormal cell, forcing
in these locations is less well understood. it into apoptosis (programmed cell death). An-
NK cells constitute the first line of defense tibodies, produced during an adaptive immune
against viral infections and possibly some types response, can also trigger NK cell cytotoxicity
of tumor cells. Because viruses replicate inside in a process called antibody-dependent cell-me-
host cells, the majority of innate immune mech- diated cytotoxicity.

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Figure 2.16. Canine NK cell in blood smear stained with Wright’s Giemsa

Name: Natural killer cells

Other names: Null lymphocytes
Classifications: Lymphocyte
Lineage: Lymphoid
Appearance: Large lymphoid cell, round nucleus, azurophilic cytoplasmic granules
Location in health: Blood, spleen
Life span in health: Weeks to months
Primary function: Destruction of virally infected or abnormal host cells (including tumor cells)
Mechanism of action: Recognition of virally infected or abnormal host cells and targeted release of cytotoxic

Other Innate Immune Cells good at presenting antigen, but during viral
infections, they can produce IFN-α, a powerful
In addition to NK cells, B-1 cells and γδ T cells antiviral agent.
are innate immune cells of lymphoid origin. FDCs appear in the B-cell regions of lymph
Because both of these cell types share much in nodes and probably derive from mesenchymal
common with their adaptive immune cousins cells. They function to retain unprocessed an-
B-2 cells and αβ T cells, the specifics of these tigen on their surfaces, which supports B-cell
innate lymphocytes are covered in chapters 10 maturation during a humoral immune re-
and 12. sponse (covered in chapter 12).
As mentioned, DCs also have different sub-
types. In addition to myeloid DCs, there are
plasmacytoid DCs (pDCs) and follicular den- Clinical Correlation: Follow-Up
dritic cells (FDCs).
pDCs, named for their resemblance to Student Considerations
plasma cells, are of lymphoid origin and cir- As described at the beginning of this chap-
culate in the blood. They are not particularly ter, collies with cyclic neutropenia go through

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Figure 2.17A–B. Cyclic neutropenia
Two blood smears (stained with Wright’s Giemsa) taken from a gray collie during (panel A) and after
(panel B) a period of neutropenia. Note the difference in mature neutrophils between smears.

cycles of neutrophil depletion that coincide cause. The mutation disrupts the normal traf-
with increased susceptibility to many types of ficking of granular proteins (such as elastase)
infections, especially bacterial infections. After to cytoplasmic granules during certain stages
reading this chapter, you should be able to in hematopoiesis. This disruption results in a
propose an explanation for the coincidence of cyclic arrest of maturation of myeloid progeni-
neutropenia and susceptibility to opportunistic tor cells in the bone marrow followed by their
bacterial infections. apoptosis—probably the result of buildup of in-
correctly trafficked granule proteins in the cell.
The end result of this mutation is that these
Possible Explanations gray collies have compromised production of
Canine cyclic neutropenia is a genetic disor- early myeloid cells.
der that affects melanocytes (resulting in the The understanding behind the cyclic nature
gray coat color) and bone marrow stem cells. of the defect is less clear, with several conflict-
Affected puppies exhibit cyclic fluctuations in ing theories proposed. However, it is likely that
all their blood cells (RBCs, platelets, and leu- the cyclic nature of the neutropenia is related
kocytes), but because neutrophils have the to feedback loops involving different stages of
shortest life span of these cells, the most char- myeloid precursor cells, which result in oscillat-
acteristic finding is cyclic neutropenia (Figure ing levels of growth factors, apoptosis, or both.
2.17A–B). Nonetheless, because neutrophils are one of
A mutation in the gene encoding the protein the primary innate defenders against bacterial
AP3β1 has been identified as the underlying attack, their depletion in periods of neutrope-

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nia most likely underpins the clinical presenta- bolstering myelopoiesis by increasing the con-
tion of recurrent bacterial infections. centration of the hematopoietic growth factor
An interesting finding is that although these G-CSF through injection of exogenous G-CSF
puppies usually die at a very young age, there or increasing the expression of G-CSF through
has been some success in the treatment of this gene therapy.
lifelong disease. Successful strategies involve

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Robin M. Yates

Innate Immune Recognition Chapter 3


foal’s blood via wounds, such as the umbilical

Clinical Correlation: Sepsis in Neonatal Foals 37
stump, or after ingestion or inhalation of envi-
Learning Objectives 38
ronmental bacteria. The original infection can
Introduction 38
also originate in utero.
Evolutionarily Conserved Molecular Patterns 40
The most common type of bacteria isolated
Pathogen-Associated Molecular Patterns 40
from septic foals is Gram-negative Escherichia
Pattern-Recognition Receptors 40
coli (E. coli), which accounts for 30 percent to
Signaling Pattern-Recognition Receptors 41
60 percent of reported cases. Bacteremic foals
Toll-like receptors 42
typically present with fever, malaise, and gen-
NOD-like receptors and RIG-like receptors 44
eral ill thrift. These symptoms can rapidly
Phagocytic Pattern-Recognition Receptors 44
progress to life-threatening sepsis, also known
Other Pattern-Recognition Receptors 46
as bacteremia-induced systemic inflammatory
Innate Recognition of Damage-Associated
response syndrome (SIRS). SIRS results from
Molecular Patterns 46
a systemwide uncontrolled activation of mul-
Inflammasome 48
tiple pro­inflammatory reactions. If not aggres-
Consequences of Danger Signal Recognition
by Sentinel Cells 50 sively treated, prolonged SIRS and its associated
Activation of Macrophages 50 shock (severe hypotension) can lead to multior-
Proinflammatory Mediators 50 gan failure and death (Figure 3.1).
Clinical Correlation: Follow-Up 50 It is easy to rationalize why bacteria in the
Student Considerations 50 blood (particularly in an immunocompromised
Possible Explanations 50 neonate) could result in severe illness. It is in-
teresting, however, that although the bacteria
themselves may be the instigators, they are not
Clinical Correlation:
the pathogenic force behind the symptoms of
Sepsis in Neonatal Foals
The medical management of septic foals is a What is doing all this damage? SIRS resulting
major challenge for equine practitioners. Sepsis from septicemia is primarily propagated by the
is a systemic inflammatory response to infec- innate immune system that is overactivated by
tion that in foals is a common sequela of bacte- disseminated bacterial products (not necessar-
remia (infection of the blood by live bacteria). ily the bacteria themselves). In the case of sepsis
Neonatal foals are particularly susceptible to from Gram-negative bacteria such as E. coli, one
bacteremia, especially foals of mares that are of the most potent activators of the immune
sick or experience abnormal or difficult par- system is lipopolysaccharide (LPS). LPS is also
turition or foals that fail to suckle soon after commonly referred to as an endotoxin (“inside
birth. Bacteria can gain entry to the neonatal toxin”). In fact, it is not a toxin in the classic sense


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Figure 3.1. A septic neonatal foal undergoing intensive life-supporting therapy (photograph courtesy
of Dr. Michel Levy, University of Calgary)

(such as cholera toxin or botulinum toxin, which • explain the concepts of evolutionarily con-
have evolved to purposefully cause dysfunction) served molecular patterns;
but a structural component of the outer mem- • define the terms PAMPs, DAMPs, and PRRs;
branes of Gram-negative bacteria. However, • give examples of PAMPs and DAMPs and
LPS elicits such a strong inflammatory reaction the PRRs that recognize them;
in animals that it is often viewed as toxic, and the
• list the general functions and cellular loca-
reaction is often referred to as endotoxic shock.
tions of the major PRR families;
Experimentally, SIRS can be induced by the in-
jection of purified LPS in the complete absence
• explain the function and formation of the
of live bacteria. How is a chemically inert mol-
ecule made up of lipid and sugars able to cause • list the consequences of sentinel cell expo-
so much damage? Clearly, in the case of septice- sure to PAMPs and DAMPs.
mia in a neonatal foal, the immune reaction to
LPS is detrimental. What is the advantage to the
animal, if any, of reacting to LPS at all? Introduction
The immune system of an animal cannot be
Learning Objectives fully activated in all tissues at all times. Not only
would this lead to the depletion of immune
After reading this chapter, you should be able to components and energy, but it would also cause
• describe in general terms how the innate tissue and organ damage. Instead, the immune
immune system recognizes threats; system needs to be in a dormant but alert state

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Figure 3.2. The structure of LPS
LPS is a macromolecule consisting of a lipid component (lipid A), a core oligosaccharide, and a vari-
able polysaccharide side chain (O antigen). It is an integral component of Gram-negative bacteria,
conferring structural stability and chemical resistance to the outer membrane. The scanning electron
image of E. coli was created in the Rocky Mountain Laboratories, National Institutes of Health.

and be selectively activated when and where it tween self and non-self antigens (how it does
is needed. So, one of the first and most impor- this has preoccupied the field of immunology
tant functions of an animal’s immune system is for decades). But when an animal is faced with
to differentiate between threatening and non- an entity it has never encountered, it needs to
threatening situations. You are probably aware be able to instantly and instinctively determine
by now that the intricate adaptive immune whether it is a threat and be able to act accord-
system can learn over time to differentiate be- ingly. The innate immune system has evolved

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to innately determine whether something is those species continue to express these specific
potentially hazardous or not without having to molecules.
learn how to make that distinction. It can then
selectively use offensive strategies to fight this
new threat. However, the importance of the in- Pathogen-Associated
nate detection of a threat does not stop with Molecular Patterns
the deployment of innate immune effectors; The basic structures of microbes (bacteria,
the innate responses also direct subsequent fungi, protozoa, and viruses) and mammalian
learned or adaptive immune responses. cells have many key differences. For example,
Animals encounter countless new foreign most bacteria have a particular cell wall struc-
antigens every day but only mount an adaptive ture that is made up of a substance called pepti-
immune response to some. Moreover, the most doglycan (a network of alternating sugars cross-
effective type of adaptive immune response linked by amino acids). Because mammalian
mounted (e.g., humoral vs. cellular) appears cells do not have cell walls, this arrangement of
to be directed by the type of infecting agent. molecules is absent from normal mammalian
For decades, the adaptive immune components tissue, and thus it is a distinguishing molecular
were heralded to be the “brains” making these feature (or pattern) of many bacteria. Hence,
intelligent decisions, but it is now clear that the peptidoglycan is an example of a pathogen-­
innate immune system directs most subsequent associated molecular pattern (PAMP). The term
immune responses. Moreover, the first real ad- PAMP is somewhat misleading because these
vances in this understanding were not achieved molecular patterns are present in nonpathogenic
by studying the more advanced mammalian microbes as well. The term microbe-­associated
system but by looking at the humble fruit fly, molecular patterns (MAMPs) is more accurate
which does not have an adaptive immune sys- but has not been widely adopted.
tem at all. In addition to acting as cues to distinguish
microbial from host material, different combi-
nations of PAMPs can give an animal’s innate
Evolutionarily Conserved
immune system an indication as to what type
Molecular Patterns
of microbe is present (bacteria vs. virus vs. pro-
At the molecular level, viruses, bacteria, fungi, tozoa, etc.), and thus the subsequent immune
parasites, and animals are all made up of the reaction can be crafted to best combat the par-
same elements arranged into similar carbon- ticular type of microbe. Obviously, the ability
based protein, lipid, nucleic acid, and carbohy- of the innate immune system to do this relies
drate building blocks. At numerous points in on its ability to somehow detect these PAMPs.
speciation, however, divergent evolution gen-
erated new arrangements of these molecules
Pattern-Recognition Receptors
and left behind some of the older ones. The
result is that certain molecules are peculiar to In subsequent chapters, you will read much
certain species. These molecules are sometimes about the adaptive immune system’s ability to
so fundamental to the existence of a certain or- learn to differentiate between self and non-self.
ganism that, even if selective pressure against a This ability involves random and nonrandom
particular molecule existed, the species could recombination of key areas of the chromosome
not simply change or eliminate that molecule. of lymphocytes, together with an accelerated
Because of that, even over evolutionary time selection process within an individual animal.
and even in the face of the increasing efficiency In contrast, the innate immune system’s ability
of evolving immune systems, all members of to detect evolutionarily conserved molecular

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Figure 3.3. PAMPs of Gram-positive bacteria
A diagram of a Gram-positive bacterium and associated PAMPs recognized by the innate immune
system of mammals.

patterns such as PAMPs relies on numerous of structure and cellular location, but they can
receptors that are hardwired into the genome also be categorized on the basis of function: sig-
of animals after millions of years of evolution. naling PRRs (usually stimulating proinflamma-
These receptors are termed pattern recognition tory signaling and cytokine release) and phago-
receptors (PRRs) and can be found in organ- cytic PRRs (stimulating uptake of microbes by
isms throughout the biome (they are present endocytosis or phagocytosis).
in animals, plants, and even some microbes).
In essence, PRRs can be considered sensory
receptors, but instead of sensing tastes, smells, Signaling Pattern-
heat, or pain, they detect PAMPs. Numerous Recognition Receptors
PRRs have been identified in mammals. These Signaling PRRs (often also referred to as ac-
PRRs can be divided into families on the basis tivating or proinflammatory PRRs) appear on

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a range of cells within the immune system but
are particularly concentrated in and on the sen-
tinel cells such as macrophages and DCs. The
primary function of these PRRs, after binding
to PAMPs, is to initiate intracellular signaling
pathways that lead to the activation of the host
cell. Activation of sentinel cells by PAMPs usu-
ally results in the release of proinflammatory
cytokines that alert other immune cells to the
presence of microbial products (recall that cy-
tokines are proteins released by cells to commu-
nicate to other cells), which in turn can initiate Figure 3.4. Drosophila flies that are deficient
a range of immune defense mechanisms. The in the toll receptor are susceptible to fungal
three major families of particular note within infections.
this functional category are the toll-like recep- This image is a scanning electron micrograph
tors (TLRs), the NOD-like receptors (NLRs) of an adult Drosophila that has been killed by
Aspergillus (200× magnification). The hairlike
and the RIG-like receptors (RLRs).
structures over the thorax are actually the ger-
minating hyphae of Aspergillus. (Lemaitre et al.,
Toll-like receptors 1996, Cell 86: 973–83)

Mammalian TLRs were actually discovered

because of their similarity to the toll recep-
tors of Drosophila melanogaster (fruit fly). Flies expressed on the plasma membrane of cells
that were deficient in the toll receptor were where they can detect extracellular microbes,
extremely susceptible to fungal infections (par- but some (notably TLR3, TLR7, and TLR9)
ticularly Aspergillus infections) and often died as are expressed on the intracellular endosomal
a result (Figure 3.4). Researchers found that the membranes, where they can detect the PAMPs
toll receptor detected fungal PAMPs and stimu- associated with intracellular bacteria and vi-
lated the release of antimicrobial peptides (sim- ruses (Figure 3.5). Each individual TLR detects
ilar to defensins) that protected fruit flies from a different set of PAMPs. These PAMPs include
fungus. Later, researchers noted that mammals LPS, peptidoglycan, unmethylated DNA (nu-
had genes that were similar to the Drosophila clear DNA from mammals is methylated, but
toll gene, which also mapped to a region of the prokaryotic DNA is unmethylated), single- and
genome that was known to confer sensitivity to double-stranded RNA (some viral genomes are
LPS (later found to be the gene for TLR4). This made of these), flagellin (a protein in bacterial
family of related genes was named TLRs. flagella), profilin-like protein (a protein found
TLRs are a family of numbered, structurally in some protozoan parasites), and various mi-
similar transmembrane proteins that detect a crobial lipoproteins, to name a few. In addition
broad range of PAMPs derived from bacteria, to individual receptor ligands, some TLRs can
viruses, fungi, and protozoa. TLRs are ex- join forces to detect other PAMPs. For example,
pressed predominantly on the sentinel cells of TLR2 can dimerize (form a pair) with TLR1 or
the innate immune system but are also found TLR6 to form a receptor that recognizes micro-
on many other leukocytes, as well as on key bial diacylated lipopeptides. Some TLRs also
areas of the epithelium exposed to the exter- cooperate with non-TLR accessory proteins, al-
nal environment (such as those lining the in- lowing them to bind to PAMPs that they could
testinal and respiratory tracts). Most TLRs are not bind to autonomously. As a family, TLRs

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Figure 3.5. The cellular location and examples of known PAMP ligands for the TLR family
GPI = Glycosylphosphatidylinositol; dsRNA = double-stranded RNA; ssRNA = single-stranded RNA.

collectively detect at least one PAMP from vir- ways initiated by TLRs are also well conserved.
tually any microbe. All TLRs have a cytosolic TIR domain that, after
Although the number of TLRs that have detection of a PAMP, recruits signaling adapter
been identified varies slightly between different molecules (such as MyD88 and TRIF). These
vertebrate species (most mammals have approx- adapter molecules initiate signaling cascades in-
imately thirteen; chickens have approximately volving a slew of kinases, which serve to prop-
ten), the major individual TLRs (e.g., TLR4) agate and amplify the signal. One of the final
are surprisingly well conserved, displaying little steps in the signaling pathway is the release of
variation between species. The signaling path- the rapid-acting transcription factor NFκB from

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its negative regulator (IκB), allowing it to move The PAMPs detected by many of the newly
from the cytoplasm into the nucleus (Figure discovered NLR members are currently un-
3.6). Within the nucleus, NFκB binds specific known. The best characterized NLRs are
sequences of DNA (called response elements) NOD1 (which is expressed in many cell types)
and recruits other transcriptional activators as and NOD2 (which is expressed predominantly
well as RNA polymerase. This process results in the sentinel cells). Both NOD1 and NOD2
in the expression of genes that lead to the ac- detect different patterns within peptidoglycan
tivation of the cell as well as the expression (recall that peptidoglycan is a meshlike com-
of numerous proinflammatory cytokines and ponent of bacterial cell walls). Because certain
chemokines. Aside from NFκB, several other pathogenic bacteria actually invade the cytosol
signaling pathways can be initiated by TLRs, re- of cells (such as Listeria monocytogenes, a major
sulting in the upregulation of a variety of genes problem in dairy and beef cattle), NOD1 and
associated with immune activation. Without a NOD2 have evolved to detect intracellular bac-
doubt, the TLR family is one of the most im- teria that are otherwise hidden from the rest
portant groups of PRRs in vertebrates. But be- of the immune system. After binding pepti-
cause TLRs are all transmembrane receptors doglycan, NOD1 or NOD2 initiates signaling
with their sensing domain always facing out- cascades that result in the activation of NFκB,
ward (detecting extracellular and endosomal leading to cellular activation and the expres-
PAMPs), infectious invaders of the cytosol can sion of pro­inflammatory cytokines and chemo-
escape their detection. kines, similar to TLR activation.
RLRs are a family of three RNA helicases
that sense the presence of viral RNA within
NOD-like receptors and the cytosol and hence are important in the de-
RIG-like receptors tection of certain viruses. The best character-
Two main families of PRRs sense PAMPs ized is RIG-I, which recognizes long double-
within the cytosol of cells: the NLRs, which stranded RNA, as well as single-stranded RNA
sense a variety of bacterial PAMPs (as well as containing a 5´-triphosphate. Although RNA
damage signals, which we discuss later), and the strands are in normal mammalian cytosol, they
RLRs, which detect viral RNA. Although TLRs are usually single stranded with a 5´ cap (no
can sense similar PAMPs, these cytosolic PRRs 5´-triphosphate); hence, RIG-I can differenti-
constitute a second line of detection of bacteria ate between normal host RNA and RNA that
and viruses that make their way into the cyto- is produced during viral replication. On recog-
sol of the cell. nition of viral RNA, RIG-I initiates signaling
As with TLRs, the NLRs encompass an pathways that not only result in the activation
evolutionarily conserved family of PRRs with of NFκB but also lead to the expression of type
more than 20 to 30 members in mammals (sea I interferons (cytokines that specifically elicit
urchins are thought to contain upward of 203 antiviral responses).
different NLR members). NLRs have a com-
mon tripartite structure consisting of a leu-
cine-rich pattern-recognition domain, a NOD Phagocytic Pattern-
domain (that facilitates oligomerization after Recognition Receptors
PAMP detection), and a variable protein–pro- All of the phagocytic cells, such as neutro-
tein interaction domain. NLRs are not mem- phils, macrophages, and DCs, express a collec-
brane bound but float in the cytosol of immune tion of phagocytic PRRs on their surfaces that
cells (although some nonimmune cells can also allows them to autonomously detect microbes
express certain NLRs). and phagocytose them. As you will learn in

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Figure 3.6A–C. Activation of NFκB after binding of PAMPs by PRRs
Panel A: After PRR activation by PAMPs, intracellular signaling
(involving several steps not shown) (1) eventually results in the libera-
tion of NFκB from its inhibitor protein IκB (2), allowing it to move
into the nucleus (3) and turn on proinflammatory genes (4). One
of the outcomes is the synthesis and release of proinflammatory
cytokines (5). Panels B, C: The images show NFκB (green) trapped
in the cytosol before exposure to PAMPs (panel B) and its transloca-
tion to the nucleus after PAMPs have been detected (panel C). NFκB
is green, actin cytoskeleton is red, and nuclear DNA is blue. (Panel B
images reproduced courtesy of Cell Signaling Technology, Inc.

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subsequent chapters, phagocytosis of micro­ and C-reactive protein (CRP). MBL (not to be
organisms can not only lead to their destruc- confused with the membrane-bound MR) is an
tion, but also allow for their protein antigens to acute phase protein synthesized primarily by
be processed and presented to T cells (a critical the liver and released into plasma. Here, MBL
step in the initiation of the adaptive immune specifically binds to mannose residues on the
response). Numerous phagocytic PRRs can surface of microbes and initiates complement
recognize a wide variety of PAMPs. One of the activation, resulting in amplification of several
best-characterized phagocytic PRRs is the man- innate immune mechanisms. We cover com-
nose receptor (MR; CD206). plement activation in greater detail in chapter
The MR is a transmembrane protein ex- 4. CRP (the major acute phase protein in pri-
pressed on the surface of the macrophages and mates, rabbits, dogs, and pigs) is another plasma
DCs of mammals. The extracellular domain protein that can also be considered a secreted
is a C-type lectin (a lectin is a carbohydrate- PRR. It selectively binds microbial polysaccha-
binding protein), which allows it to selectively rides and glycolipids as well as phosphocholine
bind terminal mannose, fucose, and N-acetyl- associated with bacteria or damaged host cells.
glucosamine residues of modified proteins. Once bound, CRP can facilitate complement
These proteins are common on the surface of activation as well as enhance phagocytic clear-
microbes but absent from normal healthy host ance of microbes and dead cells.
cells. As such, the detection of these PAMPs by
the MR provides signals to the cell that stimu-
Innate Recognition of Damage-
late phagocytosis (or endocytosis) of the mi-
Associated Molecular Patterns
crobes that come into contact with phagocytes,
leading to their destruction and the presenta- To this point, we have focused on the innate
tion of their antigens to T cells (Figure 3.7). recognition of microbial products (PAMPs).
Recent research, however, has added a second
set of molecular patterns recognized by the
Other Pattern-Recognition Receptors innate immune system that are not foreign
Several other PRRs do not fit neatly within but endogenously derived (made by the host
the signaling or phagocytic PRR categories. animal). These molecular patterns are associ-
The formyl peptide receptors (FPR) found on ated with cellular and tissue injury, indicating a
the surface of neutrophils and macrophages, al- threat to the animal that may or may not be as-
though somewhat implicated in cellular activa- sociated with microbial invasion. The term that
tion and phagocytosis, primarily direct chemo- has been adopted for these signals is damage-­
taxis. The PAMPs that these receptors detect associated molecular patterns, or DAMPs, although
are N-formylmethionine–containing peptides they have also previously been referred to as
(the amino terminus of bacterial proteins com- alarmins.
monly starts with the modified amino acid for- Irrespective of whether microbes are in­volved
mylmethionine, which is generally absent from or not, the immune system needs to respond to
mammalian proteins). On recognition of these tissue or cellular trauma. Tissues can be physi-
bacterial peptides, these G protein–coupled re- cally damaged (torn, crushed, cut), damaged by
ceptors coordinate movement of the neutro- heat and cold (burns, frostbite), or chemically
phil or macrophage toward the microbes. In damaged (acids, bases, toxins, poisons). Dam-
this way, these phagocytes can detect, locate, aged tissues need to be protected from micro-
and destroy bacteria. bial invasion and tissue repair mechanisms de-
Another category of PRRs is the secreted ployed; thus, the immune system needs to be
PRRs, such as mannose-binding lectin (MBL) alerted. DAMPs are derived from the normal

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Figure 3.7. MRs and phagocytosis
MRs can facilitate phagocytosis of mi-
crobes through recognition of mannose
residues displayed on the microbe’s sur-
face. In this way, phagocytes, such as the
macrophage, can recognize and phagocy-
tose microbes in an autonomous fashion.

proteins and metabolites found in the cyto- have been identified in animals, ranging from
plasm or nucleus of host cells that are released nuclear proteins (e.g., high-mobility group box
after cellular necrosis (Figure 3.8). The extracel- 1 protein [HMGB1]), cytosolic proteins (S100
lular presence of these molecules indicates cel- calcium-binding proteins and heat shock pro-
lular injury in the vicinity. Numerous DAMPs teins), DNA (particularly mitochondrial DNA),

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PRRs that also recognize PAMPs (e.g., HMGB1
is also recognized by the PAMP receptors TLR2
and TLR4).

The presence of PAMPs or DAMPs indicates
that either a microbial invasion or some sort of
tissue damage has occurred, and the immune
system is thus stimulated to give a measured
response. The presence of both PAMPs and
DAMPs indicates both a microbial invasion
(most likely pathogenic) and tissue damage
have occurred—a serious threat. In addition
to the additive effects of PAMPs and DAMPs,
they can synergize through the formation of
the inflammasome—a signaling cascade that
results in the massive production and secretion
of IL-1β and IL-18 (both potent proinflamma-
tory cytokines).
Figure 3.8. Endogenous production of DAMPs Although a variety of inflammasome types
As shown, after injury, host cell necrosis can exist, most require two separate signals from
release DAMPs, often leading to inflamma- PAMPs, DAMPs, or both. The best studied is
tion. Programmed cell death via apoptosis does the NALP3 inflammasome (Figure 3.9). This
not release proinflammatory DAMPs and will large protein complex is formed in macro-
not activate the innate immune system during phages after stimulation by a PAMP, followed
homeostatic cell turnover. by a second signal provided by ATP (a DAMP).
The first signal can originate through the acti-
and purine metabolites (e.g., adenosine triphos- vation of a variety of PRRs (TLRs, NLRs, or
phate [ATP], adenosine, and uric acid) (Table RLRs), resulting in the NFκB-mediated expres-
3.1). In addition to DAMP release from necrotic sion of inactive (pro-forms) of IL-1β and IL-18.
cells, macrophages, neutrophils, and NK cells These proteins accumulate in the cytosol in
can actively secrete DAMPs after activation, their inactive forms. If damage has occurred to
which can act to amplify danger signals in a tis- host cells in the vicinity, released ATP, detected
sue after trauma or microbial invasion. through a purinergic receptor (P2X7 recep-
Numerous PRRs specifically recognize tor), initiates the assembly of a large cytoplas-
DAMPs. For instance, the nuclear protein mic complex, activating the protease caspase 1,
HMGB1, when released from cells, is recog- which efficiently cleaves the inactive IL-1β and
nized by a PRR called the receptor for advanced IL-18 into their active forms. These potent pro-
glycation end products (RAGE), which is ex- inflammatory cytokines are secreted from the
pressed on macrophages and certain endothe- macrophage in large quantities, inciting wide-
lial cells (cells that line blood vessels and lym- spread leukocyte activation and inflammation.
phatics). Detection of HMGB1 by RAGE results Aside from ATP, other DAMPs, such as uric
in signaling pathways that lead to NFκB acti- acid, as well as alum (a common vaccine adju-
vation (similar to activation by many PAMPs). vant), can provide the second signal needed for
Interestingly, some DAMPs are recognized by full inflammasome function.

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Figure 3.9. Intracellular activation of inflammasomes
Full activation of the inflammasome requires activation by a PAMP (e.g., LPS) as well as a DAMP
(e.g., uric acid or ATP). This activation indicates that a microbial invasion and cellular damage have
occurred. The sentinel cell responds by secreting large quantities of the proinflammatory cytokines
IL-1β and IL-18.

Table 3.1. Examples of known DAMPs

DAMP Type Origin PRR
HMGB1 DNA-interacting protein Nucleus and cytoplasm RAGE, TLR2, TLR4
S100 proteins Calcium-binding protein Cytoplasm RAGE, TLR2, TLR4
Serum amyloid A Acute-phase protein Hepatocytes FPR, RAGE, TLR2, TLR4
DNA DNA Nucleus and mitochondria TLR9
Spliceosome-associated Protein Nucleus Mincle
protein 130 (SAP130)
ATP Adenosine derivative Cytosol P2X7 receptor
Uric acid Adenosine metabolite Cytosol NALP3

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Consequences of Danger Signal proinflammatory cytokines that engage several
Recognition by Sentinel Cells other aspects of the immune response (Figure
As covered in chapter 2, every tissue within an
animal contains innate immune sentinel cells
that constitutively express numerous PRRs Proinflammatory Mediators
on their plasma membranes and within their
Activated macrophages have an extremely
cytoplasm. The majority of these cells are de-
high capacity to synthesize and release me-
rived from the monocytic lineage, consisting
diators of inflammation. These mediators are
of blood monocytes, tissue macrophages, DCs,
covered in greater detail in chapter 5. However,
and a variety of tissue-specific monocytic cells,
in brief, they generally include three types of
including microglial cells (central nervous sys-
proinflammatory molecules: cytokines, che-
tem), Kupffer cells (liver sinusoids), and Lang-
mokines, and lipid mediators. The major pro-
erhans cells (skin). These relatively long-lived
inflammatory cytokines produced by sentinel
cells patrol the extracellular spaces of the tissue
cells in response to PAMPs and DAMPs are
in which they reside, constantly on the lookout
IL-1β, IL-6, and TNF-α. These cytokines act
for indicators of danger. In healthy tissue, these
locally by activating nearby leukocytes and en-
sentinel cells exist in an unactivated (resting)
dothelial cells, but when released in large quan-
state. However, binding of PAMPs, DAMPs, or
tities they can also act systemically, producing
both (via PRRs) activates these sentinel cells,
fever, malaise, and ill thrift. Chemokines are
enhancing their abilities to phagocytose and
also released by activated macrophages so that
destroy bacteria, to present antigens to the
additional leukocytes can be recruited to the
adaptive immune system, and to stimulate the
site of danger (recall that chemokines are pro-
synthesis and release of proinflammatory cy-
teins that stimulate directed movement of leu-
tokines and other mediators of inflammation.
kocytes). In addition to proinflammatory pro-
As you will see in later chapters, this step is the
teins, the activation of macrophages induces
first in initiating both the innate and adaptive
enzymes that can synthesize lipid-based proin-
immune responses.
flammatory mediators such as prostaglandins,
leukotrienes, and platelet-activating factor.
Activation of Macrophages These molecules can also assist in the recruit-
ment of leukocytes as well as mediate changes
Detection of PAMPs and DAMPs activates
to the local vasculature, which are essential to
macrophages, which allows these cells to bet-
ter combat microbes. The repertoire of mol-
ecules displayed on the surface of macrophages
changes, including increased numbers of phago- Clinical Correlation: Follow-Up
cytic receptors, adhesion molecules, and molec-
ular complexes that are needed to present anti- Student Considerations
gen to T cells. Antimicrobial effectors (covered After reading this chapter, you should under-
in chapter 6), such as enzyme complexes that stand why LPS, an innocuous bacterial product
produce oxidative products or proteins that kill in and of itself, can cause SIRS in neonatal foals
microbes directly, are also upregulated during with (Gram-negative) septicemia. You should
macrophage activation. As a result, activated also be able to reason why animals have evolved
macrophages more quickly and efficiently find, to recognize and respond to LPS, even though
engulf, and kill microbes in the vicinity. In addi- in cases of septicemia the response itself can be
tion, activated macrophages secrete a variety of life threatening.

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Figure 3.10. Inflammatorymediators produced by macrophages after activation by PAMPs, DAMPs,
or proinflammatory cytokines
Exposure of a sentinel cell to PAMPs, DAMPs, or proinflammatory cytokines activates the cell, lead-
ing to upregulation of cellular antimicrobial defenses as well as release of proinflammatory chemo-
kines, lipid mediators, and cytokines. Many of these proinflammatory products can in turn activate
nearby leukocytes.

Possible Explanations the accessory proteins MD-2 and CD14), which

Infection of the blood by live Gram-negative would then initiate intracellular signaling in
bacteria, such as E. coli, would result in mas- the sentinel cells, resulting in the expression
sive amounts of LPS being liberated and dis- of multiple proinflammatory cytokines, che-
seminated throughout the foal’s body. Sentinel mokines, and enzymes that synthesize other
cells (particularly macrophages) in virtually proinflammatory mediators. The simultane-
every tissue will be exposed to LPS in signifi- ous, widespread release of these proinflam-
cant quantities. This particular PAMP is de- matory products, which can in turn stimulate
tected through the PRR TLR4 (with help from other leukocytes to release the same or similar

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to activate in a focused response to an area of
infection (covered in chapter 5). However, sys-
temwide uncontrolled activation of multiple
proinflammatory reactions—including vascu-
lar changes (see Figure 3.11), clotting and plate-
let activation, production of oxidative radicals,
and leukocyte degranulation—leads to massive
disruption to systemic homeostasis and ulti-
mately SIRS.
Although LPS is the most cited initiator of
SIRS in sepsis, any PAMP from many varieties
Figure 3.11. Oral mucous membranes of a septic
of microbes can trigger SIRS in a septic animal.
foal (photograph courtesy of Dr. Michel Levy,
In fact, DAMPs released after severe trauma to
University of Calgary)
an animal, even in the complete absence of in-
Note the marked hyperemia as a result of
fection, can also initiate SIRS. It is important to
disseminated PAMPs and proinflammatory
bear in mind that SIRS is an extreme example of
unregulated pattern recognition and response.
In a normal, healthy animal and in the majority
mediators, can result in a “cytokine storm” (or of those that are diseased, pattern recognition
hypercytokinemia). Ordinarily, the innate im- is one of the first and one of the most essen-
mune response to inflammatory mediators in tial mechanisms by which the immune system,
small, localized doses is advantageous to the when faced with a threat, can be activated in an
animal, because it allows the immune system appropriate manner.

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Robin M. Yates

The Complement System Chapter 4


when the dogs reached middle age (four to

Clinical Correlation: C3 Deficiency in
seven years old), they developed renal disease
Brittany Dogs 53
involving the glomeruli, which was diagnosed
Learning Objectives 53
as mesangio-proliferative glomerulonephritis.
Complement Activation 54
As a result, many of the affected dogs died from
Classical Pathway 55
renal failure–related illnesses. The dogs in this
Lectin Pathway 57
colony were later discovered to have a geneti-
Alternative Pathway 58
cally determined deficiency in a blood protein
Terminal Membrane Attack Pathway 60
called complement C3. How could a deficiency
Regulation of Complement Activation 60
in this one complement component cause the
Outcomes of Complement Activation 62
Brittany dogs to develop devastating bacterial
Inflammation and Chemotaxis 62
infections and renal disease? In this chapter, you
Enhancement of Phagocytosis (Opsonization) 63
will discover that complement forms a very im-
Promoting Humoral Immunity 63
portant part of the innate immune system and
Clearance of Immune Complexes 64
that C3 in particular is an important player in
Clinical Correlation: Follow-Up 64
the effectiveness of the complement system.
Student Considerations 64
Possible Explanations 64
Learning Objectives
Clinical Correlation: C3 After reading this chapter, you should be able to
Deficiency in Brittany Dogs
• explain in general terms the arrangement of
During the 1980s, a colony of Brittany dogs, bred a biochemical cascade such as the comple-
for research into hereditary canine spinal mus- ment system;
cular atrophy, were noted to have an increased • name the major pathways of the complement
susceptibility to bacterial infections and kidney system in mammals;
disease (Figure 4.1). At a young age (younger • identify the major similarities and differences
than two years old, many only a few months in the classical, lectin, and alternative path-
old), the dogs developed serious bacterial infec- ways of complement activation;
tions, including sepsis, pyometra, pneumonia,
and bacterial myositis at a surgery site. These
• describe the initiation of the classical, lectin,
and alternative pathways of complement
infections were caused by a variety of differ-
ent bacteria, including Pseudomonas, Escherichia
coli, Clostridia, and Klebsiella. With veterinary • identify the major convertases in the classical,
lectin, and alternative pathways of comple-
intervention (principally prolonged courses of
ment activation;
antibiotics), most of the dogs recovered. Later,


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Figure 4.1. A Brittany dog (also referred to as a Brittany spaniel). Photo by Pharaoh Hound.

• describe in general terms the assembly and the innate immune system, certain triggers and
function of the membrane attack complex outcomes of the complement system involve
(MAC); parts of the adaptive immune system (such as
• give an example of how complement acti- antibodies). However, the complement system
vation is regulated; is always present and can act independently as
• list the major outcomes of complement a ready-made, innate immune defense system.
activation and describe the mechanisms The complement system consists of around
leading to them. sixteen different plasma proteins and glycopro-
teins that make up around 10 percent of the
total serum protein of mammals—a significant
investment of energy and resources for an ani-
Complement Activation
mal. As with most proteins found in plasma,
The complement system is made up of a col- the majority of the complement proteins are
lection of plasma proteins that are individually synthesized by the liver, but monocytes, mac-
inert but can interact to create a powerful innate rophages, and certain epithelial cells also con-
immune response. Complement was originally tribute. Many of these complement proteins
discovered in the 1890s as a heat-labile serum circulate in the blood as (inactive) serine prote-
factor that complemented the bactericidal prop- ase proenzymes. Activation of the complement
erties of a heat-stable serum factor (later iden- proenzyme to an active serine protease (usually
tified as antibodies). Like most components of as a result of cleavage by an activated comple-

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ment protein immediately upstream of it in mon terminal pathway (also known as a mem-
the pathway) permits it to, in turn, cleave (and brane attack pathway).
activate) downstream complement proteins. The nomenclature used to describe each
This activation forms a biochemical cascade. complement component typically uses C (for
Activation of the complement cascade results complement) and a number (e.g., C3). To com-
in many outcomes, including release of inflam- plicate matters, the numbers are only loosely
matory and chemotactic mediators, coating of arranged in the order by which they are acti-
microbes with complement proteins that “tag” vated in the pathway because the specific action
them as foreign (a process called opsonization), of some was discovered after the implementa-
and also direct lysis of microbes. tion of the numbering system. Sometimes a
But why is this system so overly complex? letter indicating a subunit or cleavage product
Why not have a few proteins (such as defensins of a complement molecule follows the num-
and C-reactive protein) that can act indepen- ber. For instance, C1 is made up of the proteins
dently and directly on microbes? The answer C1q, C1s, and C1r. When complement proteins
lies in the amplification power of a biochemi- are cleaved into two fragments, the smaller
cal cascade. Innate proteins (such as defensins) cleavage product is typically (but not always)
that act on their own cannot amplify. However, indicated by the letter a and the larger by the
an activated complement protein (although it letter b (e.g., when C3 is cleaved by a C3 con-
may not be able to effect an immune response vertase, the smaller fragment is named C3a
by itself ) can activate several other comple- and the larger is named C3b). When several
ment protein molecules in the next step in the complement proteins or cleavage products
pathway. Each of these activated proteins can form a complex together, the complex is typi-
in turn activate several complement proteins cally named using the complement numbers in
that follow. Thus, a small inciting stimulus can the order in which they join the complex (e.g.,
amplify to a huge response involving billions of cleavage products C4b and C2a form a complex
complement molecules. C4b2a). Complexes can also be referred to by
The complement cascade can be activated their function (e.g., C4b2a is also referred to
through three different pathways that are trig- as the classical pathway C3 convertase—the
gered by different stimuli: (1) the classical path- complex formed in the classical pathway that
way, (2) the lectin pathway, and (3) the alterna- cleaves [converts] C3). Last, other proteins or
tive pathway. cofactors integral to the complement pathways
The classical pathway is initiated by anti- are not named according to this system (e.g.,
bodies (particularly IgM and IgG) complexed factor B). It is easy to get lost in the details of
to antigens and thus occurs as a consequence these pathways, so it is important to focus on
of a humoral immune response (the adaptive the salient features common to each of them,
immune response that produces antibodies to particularly the creation of both a C3 and a C5
antigens). The lectin and alternative pathways, convertase and the initiation of the terminal
however, are triggered directly by microbial membrane attack pathway (Figure 4.2).
products or surfaces and thus are purely innate
responses. Although each pathway is triggered
by different stimuli, they share common fea- Classical Pathway
tures: they all consist of a proteolytic cascade As mentioned earlier, the classical pathway
that allows for signal amplification; they all re- is triggered by the antibody–antigen com-
sult in the creation of a C3 and a C5 convertase plexes produced after an adaptive humoral im-
(which can cleave the complement proteins C3 mune response (covered in chapter 12). So, even
and C5, respectively); and they all end in a com- though all of the complement components that

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make up this pathway are always present, the
activation of this pathway relies on the produc-
tion of specific antibodies that may take several
days to appear after a new infection. It is also
important to note that not all antibody types
can activate the classical pathway (sometimes
referred to as an antibody’s ability to fix com-
plement). In most domestic species, IgM and
certain isotypes of IgG are the most potent ac-
tivators of the classical complement pathway.
When one IgM or several IgG molecules are
bound to an antigen, the Fc (carboxy-­termini
of the H chains) portion of the antibodies can Figure 4.3. Structure of the C1 complex binding
be recognized by the large multimolecular to IgG antibodies
complex named C1 (or C1qr2s2; Figure 4.3). The
backbone of C1 is made up of C1q. C1q itself is
a massive protein complex that has six globu- two copies of C1r and two copies of C1s, both
lar head domains connected by linear tail do- serine proteases. For C1 to become activated,
mains. Associated with tail domains of C1q are at least two globular heads of C1q must rec-
ognize and bind to two adjacent Fc regions of
antibodies bound to an antigen. This recogni-
tion induces conformational change in the C1q
protein, which activates the protease activity of
C1r through autocatalysis (meaning C1r cleaves
itself ). The active C1r subunits then cleave the
adjacent C1s molecules in the complex, which
activates their serine protease activities.
Now activated, C1s of the C1 complex
cleaves the nearby complement protein C4
into C4a and C4b (Figure 4.4), revealing a thi-
olester group on C4b that allows it to cova-
lently attach (through reaction with hydroxyl
or amine groups) to a nearby surface. Because
thiolesters are extremely unstable, lasting only
milliseconds, C4b can only attach to surfaces
in the immediate vicinity of the activated C1
complex (with luck, onto the surface of the
microbe or antigen complex that is being rec-
ognized by the initiating antibodies). The cova-
lently bound C4b can present C2 to C1s, which
Figure 4.2. A
simplified diagram to illustrate the cleaves it into C2b and the larger fragment C2a
common points of complement activation
(note that for historical reasons the naming of
The classical, lectin, and alternative pathways the larger C2 cleavage product C2a goes against
all create a functional C3 convertase and C5 the complement nomenclatural convention of
convertase and initiate the terminal membrane
labeling the larger fragment b). The bound C4b
attack pathway.
can then bind with the C2a fragment, forming

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cleavage of C3 reveals a thiolester group in C3b,
which allows the fragment to covalently attach
to the surfaces in the immediate vicinity. As we
discuss later in the chapter, the covalent attach-
ment of C3b to a microbe or other antigen is
an important objective of the complement
system as it tags (a process called opsoniza-
tion) the object for phagocytosis and removal.
Although the attachment of C3b achieves one
goal of the classical complement pathway, the
next step is to initiate the terminal membrane
attack pathway that can mediate direct lysis of
the microbe. For this, a proportion of C3b will
complex with the C3 convertase C4b2a to form
the classical pathway C5 convertase (C4b2a3b).
This complex now cleaves C5 into C5a and C5b.
C5b remains associated with the C4b2a3b com-
plex and serves as an anchor that coordinates
the assembly of the MAC in the terminal mem-
brane attack pathway (as detailed in the Termi-
nal Membrane Attack Pathway section).

Lectin Pathway
The lectin pathway of complement activa-
tion is not reliant on any products of the adap-
tive immune response; thus, it is an indepen-
dent innate immune response. Lectins are pro-
teins that bind particular carbohydrate (sugar)
residues. The lectin complement pathway is
driven by lectins found in plasma, such as the
mannose binding lectin (MBL) and ficolins that
can recognize microbial-specific carbohydrates
displayed on the surface of various microbes.
MBL is a tetrameric member of the C-type lec-
tin family and shares structural similarities with
C1q. Instead of recognizing bound antibodies
(as does C1q), however, MBL binds mannose,
Figure 4.4. The classical pathway of complement
activation fucose, and N-acetylglucosamine PAMPs that
are commonly present in the cell walls of bacte-
ria and fungi, as well as on some protozoa and
complex C4b2a on the surface of the microbe viruses. Essentially, as mentioned in chapter 3,
or antigen. MBL can be considered an extracellular PRR.
C4b2a is the classical pathway C3 convertase. Binding to a microbial cell wall induces a con-
Its job is to cleave C3 (the most abundant com- formational change in MBL, which promotes
plement protein) into C3a and C3b. As with C4, activation of MBL-associated serine proteases

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(MASPs) via autocatalysis (Figure 4.5). Simi-
larly to C1s, MASPs can in turn cleave C4 and
C2 to create the C3 convertase C4b2a, which is
assembled on the surface of the microbe. From
here on, the lectin pathway resembles the clas-
sical pathway, with C4b2a cleaving C3, leading
to deposition of covalently bound C3b on the
surface of the microbe and the creation of the
C4b2a3b C5 convertase, which initiates the ter-
minal membrane attack pathway. Ficolins are a
family of lectins that, like MBL, bind microbe-
associated carbohydrates and activate MASPs.
In essence, the lectin pathway is homologous
to the classical pathway but uses the innate rec-
ognition of microbial products (PAMPs) and
surfaces using lectins instead of the recognition
of antibodies by C1.

Alternative Pathway
The alternative pathway of complement acti-
vation is unlike the classical and lectin pathways
because it does not require specific recognition
of a microbial surface by antibodies or lectins.
It relies on the nonspecific, low-level hydroly-
sis of C3 (remember, C3 is the most abundant
complement protein and a key player in all path-
ways). In plasma, C3 is inherently slightly un-
stable, with a small portion of it spontaneously
degrading into its C3a and C3b components. As
you recall, this cleavage reveals the reactive thi-
olester group on C3b, which allows it to cova-
lently bind to surfaces in the immediate vicinity.
If C3b binds to a healthy host cell membrane, it
is rapidly degraded to prevent any further com-
plement activation. This degradation occurs
because host membranes are rich in sialic acid
residues that promote binding of C3b to factor
H (a negative regulator of complement activa-
tion; Figure 4.6A). Factor H, along with factor I,
inactivates and degrades inappropriately bound
C3b. Hence, on those surfaces on which comple-
Figure 4.5. The lectin pathway of complement
ment activation is not wanted, spontaneously
bound C3b is destroyed as fast as it is deposited.
However, microbial membranes and cell walls
are typically rich in polysaccharides that do not

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Figure 4.6A–B. The alternative pathway of complement activation
Panel A: In the presence of sialic acid residues, which are abundant on the surface of
host cells, bound C3b preferentially binds factor H and is degraded by factor I. Panel
B: On activating surfaces, bound C3b can bind factor B, which can be cleaved by factor
D, resulting in the activation of the alternative C3 convertase C3bBb. C3bBb can now
catalyze C3 proteolysis into C3a and C3b, eventually leading to more C3bBb, thus
creating an amplification loop.

contain sialic acid. Should C3b happen to cova- complex C3bBb. C3bBb is the alternative C3
lently bind to one of these so-called activating convertase. Now, instead of relying on the low
surfaces, C3b does not bind the regulatory fac- level of spontaneous hydrolysis of C3, this C3
tor H and instead adopts a conformation that convertase efficiently catalyzes the cleavage of
allows it to preferentially bind factor B, forming plasma C3, resulting in the rapid deposition of
the complex C3bB (Figure 4.6B). C3b onto the activating surface. A portion of
Another serum factor, factor D, cleaves the this bound C3b will recruit factor B and, with
factor B component of the C3bB complex, re- the help of factor D, will create more of the
leasing Ba and creating the active proteolytic alternative C3 convertase C3bBb. As you can

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pathways (C4b2a3b), the alternative C5 conver-
tase (C3bBb3b) cleaves C5, which initiates the
terminal membrane attack pathway.

Terminal Membrane Attack Pathway

All complement activation pathways can ini-
tiate the common terminal membrane attack
pathway (Figure 4.7). The goal of this particu-
lar pathway is to construct a protein complex
that essentially punches a hole in the target
membrane and thus can directly lyse and kill
the microbe (Figure 4.8). This protein complex
is aptly named the membrane attack complex
(MAC). The terminal membrane attack path-
way is initiated by the activating pathways’ C5
convertase (C4b2a3b, generated by the classical
and lectin pathways, and C3bBb3b, generated
by the alternative pathway). These C5 conver-
tases cleave C5 into C5a and C5b. C5b recruits
C6 and C7 to the target membrane, forming
the complex C5b67. This complex can bind and
partially unfold C8, exposing a hydrophobic
region of the protein that allows it to wedge
itself deep in the target membrane. With C8
now inserted into the membrane, the complex
can recruit and insert ten to sixteen copies of
Figure 4.7. Theclassical, lectin, and alternative C9 into the membrane to create a cylindrical
pathways of complement activation pore (using C9 much like the wooden staves
that make up a barrel). The completed MAC
breaches the cell membrane of the microbe, al-
see, this process initiates an amplification loop lowing water to rush into the cell. If sufficient
leading to the accelerated deposition of C3b on numbers of MAC form on the membrane, the
the activating surface. (As a side note, because microbe is destroyed by osmotic lysis.
C3b deposition is common to all pathways, the
alternative C3 convertase C3bBb and the am-
Regulation of
plification loop that results are also inherent
Complement Activation
in the classical and lectin pathways.) The C3
convertase C3bBb is itself relatively unstable One downside of an amplifying biochemical
but can complex with a plasma protein called cascade is that it can easily get out of hand.
factor P (also known as properdin), which helps Thus, it is not surprising that the system of
stabilize the complex. The alternative C5 con- complement activation is highly regulated by
vertase is created when an additional C3b mol- an equally complex system of complement
ecule complexes with the C3 convertase C3bBb control proteins (see Table 4.1) that not only
to form C3bBb3b (Figure 4.7). As with the C5 increases the complement system’s selectivity
convertase formed in the classical and lectin for non-self but also limits activated comple-

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C4 and C2. C1 inhibitor can also inhibit MASPs
that have been activated by MBL; hence, it plays
a role in the regulation of the early stages of
both the classical and lectin pathways.
Other complement control proteins found in
plasma include factor H and C4b-binding pro-
tein. As mentioned earlier, factor H enhances
the degradation of C3b bound to membranes
rich in sialic acid and can thus (along with fac-
tor I) directly influence the formation and sta-
bility of the alternative C3 convertase (C3bBb).
The C4b-binding protein, as its name suggests,
preferentially binds C4b. Binding results in the
accelerated degradation of the C3 convertase
C4b2a; hence, it is a regulator of the classical
and lectin activation pathways.
In addition to plasma proteins, many com-
plement control proteins are displayed on the
surfaces of host cells. Decay-accelerating factor
(CD55) is displayed on the surfaces of erythro-
cytes, circulating leukocytes, platelets, and en-
dothelia, where, as its name suggests, it acts to
accelerate the decay of the alternative C3 con-
vertase (C3bBb), thus providing an extra level
Figure 4.8. Assembly
of the MAC by the terminal of security against inappropriate activation
membrane attack pathway of the alternative pathway on host cells that
The final MAC consists mostly of ten to sixteen are continually exposed to plasma. Similarly,
molecules of C9 arranged into a barrel-shaped complement receptor 1 (CR1 or CD35) and
pore within the target membrane. The diameter membrane cofactor protein (CD46) are mem-
of the inner pore is around ten nanometers and brane proteins that can inhibit either the alter-
allows fluid to rush into the target cell. native or the classical and lectin C3 convertase
by interacting with C4b or C3b. Several other
ment cascades from continuing indefinitely. complement control proteins found on the cell
The classical, lectin, alternative, and terminal membranes of host cells also specifically act to
membrane attack pathways can all be stopped prevent formation of the MAC. One of these
or downregulated at key points by soluble or control proteins, protectin (CD59), acts to pre-
membrane-associated complement control vent MAC formation on host cells by binding
proteins. Many of these control proteins func- the C5b678 complex and preventing the bind-
tion by inhibiting the protease activities or fa- ing and oligomerization of C9. Several other
cilitating the degradation of activated comple- host membrane glycoproteins act in a similar
ment complexes or convertases. fashion.
An example of an inhibiting protein is the Together, the complement control proteins
acute phase protein C1 inhibitor. As the name act to prevent the complement innate defense
suggests, the C1 inhibitor inhibits the protease system from acting on inappropriate targets
function of C1 (specifically C1r and C1s), which and also from acting in perpetuity. The inabil-
prevents excessive or inappropriate cleavage of ity of the control proteins to halt complement

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Table 4.1. A summary of known complement control proteins and their function
Complement Pathway
control protein Location regulated Action
C1 inhibitor Plasma, serum Classical and Inactivates C1r, C1s, and MASPs
C4b-binding Plasma, serum Classical and Binds C4b; accelerates decay of
protein lectin the classical and lectin C3 conver-
tase (C4b2a)
Factor H Plasma, serum Alternative Binds C3b and accelerates decay
Decay-accelerating Cell membrane of erythrocytes, neu- Alternative Accelerates decay of C3 conver-
factor (CD55) trophils, lymphocytes, monocytes, tase (C3bBb)
platelets, and endothelial cells
Complement recep- Cell membrane of erythrocytes Classical, lectin, Binds C3b and C4a and inhibits
tor I (CD35) (primates), neutrophils, lymphocytes, and alternative alternative and classical/lectin C3
monocytes, and macrophages convertases
Membrane cofactor Widely expressed on cell membrane Classical, lectin, Binds C3b and C4a and inhibits
protein (CD46) of host cells and alternative alternative and classical/lectin C3
Protectin (CD59) Predominantly expressed on cell Terminal mem- Binds to C5b678 and prevents C9
membrane of erythrocytes, leuko- brane attack recruitment and MAC formation
cytes, and vascular endothelium

cascades can have devastating consequences. Inflammation and Chemotaxis

An interesting fact is that venom from the cobra As you recall, two major points of all com-
snake contains a C3b analogue (called cobra plement activation pathways are the assembly
venom factor) that can complex with factor of C3 and C5 convertases. These convertases
Bb and factor P to form a stable C3 convertase mediate the cleavages of C3 and C5, respec-
(cobra venom factor Bb). This convertase is not tively, resulting in the attachment of the large
recognized by the regulatory proteins factor H fragments C3b and C5b to microbial surfaces.
and I, and thus it will continually hydrolyse C3 It is easy to discount the two smaller frag-
(and C5), leading to complement depletion and ments C3a and C5a as useless by-products,
severe local tissue damage. but they actually play important roles in their
own right. Because both C3a and C5a are small
(around 10 kDa), they readily diffuse away
Outcomes of
from the site of complement activation. Nu-
Complement Activation
merous leukocytes detect local complement
Aside from the direct complement-mediated activation through the recognition of C3a and
lysis of cells by formation of a MAC, numer- C5a by surface complement receptors, which
ous products of complement activation act to alerts these cells to a potential threat in the vi-
enhance immune defense within an animal cinity. Mast cells react to both C3a and C5a by
(see Table 4.2). These products include those degranulating, thus dumping loads of vasoac-
promoting inflammation, chemotaxis of leu- tive amines into the extracellular space, which
kocytes, phagocytic uptake of targets, humoral in turn leads to dilation and increased perme-
immune responses, and the clearance of im- ability of the local vasculature (both hallmarks
mune complexes. of acute inflammation, covered in chapter 5).

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Table 4.2. A summary of outcomes of complement activation
Outcome products Action
Direct target lysis MAC Osmodysregulation and lysis of target cells
Tissue C3a and C5a Activation of mast-cell degranulation leading to release of vasoactive
inflammation amines (histamine and serotonin)
Endothelial C3a and C5a Increased expression of adhesion molecules
Chemotaxis C3a and C5a Promotes migration of neutrophils, eosinophils, and macrophages toward
site of complement activation
Leukocyte C5a (C3a and Upregulation of adhesion molecules, phagocytic receptors, and antimicro-
activation C4a) bial effectors by neutrophils and monocytes
Opsonization C3b and iC3b Enhancement of particle phagocytosis by macrophages and neutrophils
Promotion of C3dg Enhanced B-cell activation, retention of antigen complexes in B-cell follicles
humoral responses
Immune complex C3b (and iC3b) Blocking of growth and facilitation of dissociation of immune complexes;
clearance immobilization and clearance of immune complexes through interaction
with CR1 on erythrocytes

With a small localized response, complement- Enhancement of Phagocytosis

mediated vascular dilation and permeability (Opsonization)
act to enhance the delivery of leukocytes and A major outcome of complement activa-
immune proteins to the site of complement tion is the covalent attachment of C3b to target
activation. C3a and C5a can also help recruit surfaces, which essentially tags these surfaces
circulating leukocytes by prompting endothe- as foreign, hazardous, or simply abnormal.
lial cells lining the local vasculature to express Particles with C3b and its breakdown product
adhesion molecules. But when generated in iC3b on their surfaces are recognized by mac-
large amounts systemically, C3a and C5a can rophages and neutrophils through complement
cause systemic anaphylactic shock. For this rea- receptors (specifically CR1, CR3, and CR4),
son, C3a and C5a are sometimes referred to as which mediate phagocytosis of the particles.
anaphylotoxins. Although microbes can be recognized by mac-
In addition, C3a and C5a in particular stimu- rophages and neutrophils without complement
late the chemotaxis (movement) of many leu- (e.g., via the MR), the presence of C3b and iC3b
kocytes, including neutrophils, eosinophils, and on their surfaces dramatically enhances their
macrophages. Diffusion of C3a and C5a away phagocytosis. This binding of C3b and iC3b to
from the site of complement activation estab- microbial surfaces is termed opsonization (cov-
lishes a chemotactic gradient, up which leuko- ered in greater detail in chapter 6).
cytes can migrate toward the potential threat.
These complement products also activate leu-
kocytes such as neutrophils, allowing these cells Promoting Humoral Immunity
to upregulate their receptors, adhesion mol- Another breakdown product of bound C3b
ecules, and the antimicrobial arsenal needed to is C3dg, which can be recognized by the CR2
find and combat microbes and other threats in expressed on both B cells and follicular den-
the tissue. dritic cells (FDCs). When a B cell recognizes a

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specific antigen through its B-cell receptor, it is infections. You should also be able to derive a
stimulated to activate and proliferate (covered possible explanation for the development of kid-
in chapter 12). Recognition of C3dg by CR2, ney disease in these Brittany dogs (Figure 4.9).
in association with the specific antigen, signifi-
cantly enhances B-cell activation, which in turn
enhances the generation of antibodies directed Possible Explanations
against that antigen. The presence of C3dg in C3 is the most abundant complement pro-
antigen complexes is also thought to help retain tein. It is central to the classical, lectin, and al-
the antigen within the B-cell follicles of lymph ternative complement pathways and is also a
nodes through interaction with CR2 on FDCs. prerequisite for the initiation of the common
This retention promotes prolonged antigen–B terminal membrane attack pathway. So, essen-
cell interaction, which further acts to enhance tially, a deficiency in the C3 component renders
the humoral response to the complement-as- the whole complement system defunct, which
sociated antigen—yet another example of an would result in deficiencies in direct bacterial
innate immune system outcome that enhances killing by MAC, reduced bacterial phagocytosis,
an adaptive immune response. compromised acute inflammatory reactions,
diminished activation and chemotaxis of leuko-
cytes, and perhaps even reductions in humoral
Clearance of Immune Complexes immune responses. All of these would directly
Immune complexes consisting of matrices of compromise the dog’s efficiency in mounting
antibodies and antigen can be generated during effective immune responses to invading bac-
an immune reaction to an abundant antigen. teria, and thus it is easy to understand why an
These complexes, if not cleared, can be depos- animal that is deficient in C3 would succumb to
ited in particular sites in the body of an animal bacterial infection.
(particularly in vessel walls, kidneys, joints, The renal disease that these Brittany dogs de-
and eyes), resulting in a type III hypersensitiv- velop later in life is harder to explain. It is inter-
ity (covered in chapter 16). Attachment of C3b esting to note that human patients with C3 de-
to these complexes (through classical comple- ficiency develop a similar glomerulo­nephritis.
ment cascade) interrupts the antigen–antibody The membrano-proliferative glomerulonephri-
interactions, preventing complex growth and tis that both dogs and humans with C3 defi-
facilitating their dissociation. Integration of ciency develop is thought to be the manifesta-
C3b into the complexes also allows them to be tion of an autoimmune-type disease. As you will
bound to the surface of erythrocytes through discover in chapter 16, glomerulonephritis (lit-
interaction with CR1. Once bound to erythro- erally, inflammation of the glomerulus) is one
cytes, the immune complexes are not inappro- of the more common manifestations of a type
priately deposited and can be safely removed III hypersensitivity, caused by antigen–antibody
by phagocytosis of the erythrocytes in the liver complexes that circulate through the blood and
and spleen. lodge in the maze of capillaries that form the
glomerulus. Once in the glomeruli, these an-
Clinical Correlation: Follow-Up tigen–antibody complexes trigger inflamma-
tory responses that damage the glomeruli. As
Student Considerations you learned in this chapter, deposition of C3b
After reading this chapter, you should be able on circulating immune complexes aids in their
to list the outcomes of complement activation dissociation, immobilization, and removal (via
and reason why a deficiency in C3 would inter- binding to erythrocytes and phagocytic clear-
fere with an animal’s ability to control bacterial ance in the liver and spleen). Without C3, im-

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Figure 4.9. A Brittany dog. Photograph by Lori Branham.

mune complexes that develop during the mul- of a membrano-proliferative glomerulonephri-

titude of adaptive responses in the lives of C3- tis and, eventually, renal failure. Thankfully, and
deficient Brittany dogs lodge in glomeruli and presumably because of the immense selection
incite inflammation. Over a period of years, the pressure over eons of evolution, complete C3
inflammation in the glomeruli results in their deficiency in any animal species is considered
progressive dysfunction and the development to be extremely rare.

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Robin M. Yates

Acute Inflammation Chapter 5


Acute mastitis is the sudden dysfunction of

Clinical Correlation: Acute Bovine Mastitis 67
the mammary gland, accompanied by swelling,
Learning Objectives 67
heat, and obvious pain and discomfort for the
Purposes of Acute Inflammation 68
cow. The milk expressed from the affected quar-
Signs of Acute Inflammation 69
ter often contains clots and debris and is unfit
Initiators and Mediators of Acute
for consumption. A hallmark diagnostic feature
Inflammation 70
of acute mastitis is the presence of leukocytes
Vascular Changes in Acute Inflammation 72
in the milk. Leukocytes, and indeed other so-
Leukocyte Recruitment 75
matic cells, can be detected using a cowside
Leukocyte Extravasation 75
test called the California Mastitis Test (CMT).
Diversity and Timeline of Leukocyte
Recruitment 79
This test uses the agglutination of DNA, which
Systemic Effects of Acute Inflammation 80
forms a gel in the milk, as an indicator of the
Clinical Correlation Follow-Up 85
presence of leukocytes (see Figure 5.2). Nowa-
Student Considerations 86
days, the CMT is gradually being replaced by
Possible Explanations 86
automated cell counting. Sudden onset of clini-
cal signs and a positive CMT or high leukocyte
counts in the milk from a quarter are indicative
Clinical Correlation:
of acute mastitis. They are handy diagnostic
Acute Bovine Mastitis
indicators, but what are the leukocytes doing
Everyone has had experience with acute in- there? How did they get there, and how did
flammation. It is characterized by hallmark fea- they know where to go?
tures and usually indicates that an infection is
present or that the tissue has had some physical Learning Objectives
or chemical damage. Dairy farmers deal with
inflammation on a twice-daily basis in the form After reading this chapter, you should be able to
of mastitis in their milking herds (Figure 5.1). • understand purposes of inflammation and
Mastitis is inflammation of the mammary its roles in immunity;
gland, which is almost always initiated by the
infection of these high-performing glands by
• describe the cardinal signs of acute inflam-
mation and explain the basic underlying
contagious or environmental bacteria. Eco-
pathophysiological processes;
nomically, mastitis is one of the most important
disease syndromes affecting the dairy industry. • list basic groups of mediators in acute
Clinical and subclinical mastitis results in lower inflammation and their origins and targets;
milk production and poor milk quality and ad- • describe the blood vessel changes that
versely affects the welfare of these animals. occur during acute inflammation;


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Figure 5.1. Acute bovine mastitis (photograph courtesy of Dr. Gordon Atkins, University of Calgary)
This photograph is of a four-year-old, mid–second-lactation Jersey cow with severe mastitis of the
right hindquarter caused by Staphylococcus aureus.

• describe the steps of extravasation and urement, why is it inherent—in some form or
chemotaxis of leukocytes in the acute another—to all species in the animal kingdom?
inflammatory process; As we discussed in chapter 3, sentinel cells such
• appreciate the diversity of inflamma- as tissue macrophages and DCs are dispersed
tory processes and timelines of leukocyte throughout every tissue in the body. Although
recruitment; macrophages, by themselves, can phagocytose
• describe the systemic clinical findings that and destroy bacteria as well as clear cellular de-
may be associated with an acute inflamma- bris, in the face of major tissue damage or the
tory process; introduction of a large microbial insult, they
can be quickly overwhelmed. In these cases,
• describe the systemic laboratory find-
macrophages need to enlist the aid of large
ings that may be associated with an acute
numbers of other leukocytes. One of the most
inflammatory process.
well equipped of these leukocytes is the neu-
trophil, but monocytes, eosinophils, and even
Purposes of Acute Inflammation certain lymphocytes can also be recruited to
the affected tissue.
The acute inflammation of a tissue is com- Neutrophils are armed with numerous pow-
monly viewed as an undesirable symptom of erful antimicrobial effector mechanisms to de-
an injury or disease process. If this process fend against major threats. But as you learned
serves only to provide discomfort and disfig- in chapter 2, neutrophils spend most of their

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the influx of leukocytes and plasma proteins to
the site of insult and the changes to the vascula-
ture needed to facilitate the movement of these
immune entities result in the cardinal signs as-
sociated with inflammation (Figure 5.3).

Signs of Acute Inflammation

The first known description of the signs as-
sociated with acute inflammation was found
in an Egyptian papyrus dating back to 3000
BC. However, it was during the period of the
Roman Empire when the encyclopedist Celsus
documented the cardinal signs of inflamma-
tion in the Latin terminology that is still in use
1. rubor (redness);
2. tumor (swelling);
Figure 5.2. California Mastitis Test (CMT) 3. calor (heat);
The CMT pictured was performed on milk ex- 4. dolor (pain);
pressed from a normal quarter of an udder (left) 5. functio laesa (loss of function; added to
and a quarter of the same udder with severe Celsus’s list by the German pathologist
acute mastitis (right). CMT reagent was added Virchow in the late 1800s).
to both milk samples and mixed in a CMT
paddle. The gelatinous material formed in the Many of these signs are consequences of
positive sample is leukocyte DNA, which can be the local vascular changes initiated by inflam-
assessed when the mixture is swirled (top) or mation. Both rubor and calor arise from local
poured out of the paddle (bottom). vasodilation and increased blood flow to the
affected area. It is important to point out that
calor is due primarily to increased conduction
lives inside the circulatory system. To be effec- of core body temperature to the periphery by
tive in infected or damaged tissues, neutrophils increased blood flow to the area of inflamma-
need to rapidly and accurately find infected tion (as a result of vasodilation) rather than
and affected tissues, extravasate (get out of the local metabolic changes or pyrexia (fever).
circulatory system), and travel to the specific Tumor is primarily a result of increased per-
site of insult. In addition to cells, soluble com- meability or leakiness of the local vasculature,
ponents of the immune system (once again, leading to tissue edema. Dolor is attributed to
mostly found in blood), such as complement the release of inflammatory mediators such as
proteins, acute phase proteins, and antibodies, prostaglandins, neuropeptides, and cytokines
need to gain access to affected tissue. Delivery by damaged tissue and activated immune cells.
of cellular and soluble immune components These mediators can act on pain receptors, re-
to the site of injury significantly enhances the sulting in hyperalgesia, although the physical
local immune defenses, which act to eliminate and chemical trauma associated with tissue
microbes, trigger the adaptive immune system, edema and antimicrobial functions of immune
and initiate tissue repair. The culmination of cells undoubtedly contribute. Functio laesa re-

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be debilitating. So when is it appropriate for an
inflammatory process to be initiated, and how
is it triggered?

Initiators and Mediators

of Acute Inflammation
The most common initiator of acute inflamma-
tion is the sentinel cell detection of microbial
or parasitic products within host tissues. Recall
from chapter 3 that the innate immune system
is equipped with numerous PRRs that can rec-
ognize the conserved molecular motifs associ-
ated with microbes—the so-called PAMPs. Sen-
tinel cells, such as macrophages, constitutively
express PRRs that enable them to continually
monitor the local tissue microenvironment
for signs of microbial invasion. The detection
of microbial products via PRRs leads to signal-
ing cascades within the macrophages, which
results in their activation. Once activated, the
macrophages synthesize and release a slew of
proinflammatory cytokines (such as IL-1β, IL-6,
and TNF-α) that act as signals to other inflam-
Figure 5.3. Inflammation of the fetlock of a matory cells and blood vessels in the area. Ac-
foal (photograph courtesy of Dr. Michel Levy, tivated macrophages can also release chemo-
University of Calgary) kines such as CXCL8 (also known as IL-8). As
This foal has a suppurative arthritis. There you have learned, chemokines are chemotactic
is diffuse, moderate swelling (tumor) of the cytokines consisting of small proteins that can
fetlock and reddening of the skin (rubor). If diffuse away from the secreting cell to set up
you were to palpate it, it would feel warmer
a concentration gradient. Using this gradient,
to the touch (calor) and would likely elicit a
leukocytes, such as neutrophils, can move to-
pain response (dolor). Clinically, the foal would
present with an abnormal gait caused by loss ward the particular site of insult by chemokine-
of full function of the limb (functio laesa). Also directed chemotaxis.
note that distal to the fetlock are two puncture Although microbial infections are the most
wounds oozing blood and suppurative material commonly considered triggers of inflammation,
(pus). many other tissue insults can initiate so-called
sterile inflammation. These insults include
trauma, physical and chemical injury, foreign
sults from a culmination of tumor, dolor, and bodies, or inappropriate products of adaptive
tissue damage, leading to general dysfunction immunity. Many of these insults result in the
and the instinctive behavior of the animal to release of DAMPs, which, although endog-
protect the inflamed region. enously derived, can also lead to the activation
Apart from dolor, which may provide a pro- of macrophages.
tective function for the inflamed area, the other Activation of macrophages with PAMPs,
cardinal signs have no obvious benefits and can along with activation by DAMPs, indicates in-

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fection and tissue injury. Together, they com- thesize leukotrienes and prostaglandins from
bine to become a powerful stimulus to activate the normal cellular diacylglycerols or phospho-
assembly of the inflammasome within macro- lipids found in cellular or nuclear membranes.
phages, which dramatically enhances the release The first step is the liberation of a polyunsatu-
of IL-1β and IL-18, both potent proinflamma- rated 20-carbon fatty acid (called arachidonic
tory cytokines. The macrophage-derived pro­ acid) from diacylglycerols or phospholipids
inflammatory cytokines (IL-1β, IL-6, and TNF-­ (Figure 5.4), which is mediated by phospholi-
α) can act directly on endothelial cells in local pases (phospholipase C or phospholipase A2,
vasculature and can additionally act on neigh- respectively). Although leukotrienes and pros-
boring immune cells, often prompting them to taglandins derive from this common precursor
also release proinflammatory mediators. and have overlapping functions, it is important
One cell in particular that can rapidly amplify to differentiate between the two classes of mol-
proinflammatory signals in response to the cy- ecules because of their distinct contributions to
tokines produced by macrophages is the mast clinically important situations.
cell. As mentioned in chapter 2, mast cells are The enzyme lipoxygenase uses the freed
typically situated near blood vessels and nerves, arachi­donic acid to synthesize leukotrienes.
and contain numerous cytoplasmic granules There are several immunologically important
rich in histamine and serotonin, both vasoactive leukotrienes, including leukotriene B4 and leu-
compounds. Mast cells and histamine are com- kotriene D4. These leukotrienes act locally as
monly associated with type I hypersensitivities powerful chemoattractants for neutrophils (B4)
(allergies) in response to an inappropriate hu- and effect changes in the vascular endothelium
moral response to allergens and are discussed (B4 and D4).
in depth in chapter 16. Aside from unwanted Prostaglandins are synthesized from the
degranulation in allergies, however, mast-cell arach­idonic acid pool by cyclooxygenase (COX)
degranulation in response to proinflammatory enzymes. The two major COX isoforms, COX-1
cytokines such as IL-1 acts to rapidly facilitate and COX-2, are expressed at different levels in
the changes to local vasculature needed for in- different tissues. Although COX-1 is needed to
flammation. In addition to macrophage prod- synthesize prostaglandins with homeostatic
ucts, mast cells can be directly induced to de- roles, COX-2 is responsible primarily for pros-
granulate by surface-bound IgE (a specific anti- taglandin synthesis in inflammation. These en-
body isotype associated with allergies) after the zymes become critically important in the phar-
detection of specific antigens. Furthermore, macological management of inflammation
products of complement activation (C3a and because they are the target of the nonsteroidal
C5a), physical or chemical trauma, and even anti-inflammatory drugs (NSAIDs) commonly
extreme temperatures can induce mast-cell used in veterinary medicine (e.g., meloxicam
degranulation. [Metacam®]; phenylbutazone, or “bute”; and
Another group of important mediators of carprofen [Rimadyl®]). The major prostaglan-
acute inflammation is the eicosanoids—in par- din involved in inflammation is prostaglandin
ticular, leukotrienes and prostaglandins. Unlike E2. Prostaglandin E2 is synthesized by both
cytokines, which are proteins, the eicosanoids macrophages and mast cells and acts on local
are oxidized derivatives of fatty acids. These vasculature and endothelium.
compounds typically have a short half-life and Collectively, in response to local noxious or
thus act in an autocrine or paracrine capacity in microbial stimuli, macrophages, in concert
an inflamed tissue. Within minutes of detecting with other immune cells such as mast cells,
an inflammatory stimulus (e.g., cytokines or can rapidly release proinflammatory cytokines
trauma), both macrophages and mast cells syn- and other mediators such as histamine. These

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Figure 5.5. Vascular changes in acute
This figure shows the major changes to vas-
culature in response to inflammatory signals
detected within a tissue. In brief, indicators of
infection or trauma can be detected by sen-
Figure 5.4. Eicosanoid synthesis
tinel cells, such as macrophages, resulting in
Leukotrienes, and prostaglandins are synthe- the release of inflammatory mediators, which
sized from arachidonic acid released from is often amplified by neighboring mast cells.
membrane lipids. Pools of arach­idonic acid can These inflammatory mediators act on local
be acted on by lipoxygenase or cycloxygenase vasculature to effect vasodilation, expansion of
enzymes to produce a variety of leukotrienes capillary beds, increased vascular permeability,
and prostaglandins, respectively. Cycloxygenases and decreased blood velocity in the postcapil-
can be inhibited by NSAIDs, which decrease lary venules.
prostaglandin synthesis and prostaglandin-
induced inflammatory sequelae.
1. vasodilation and local stasis of blood flow;
2. increased vascular permeability;
3. expression of cell-adhesion molecules on
mediators can act on local vasculature to initi-
vascular endothelium.
ate the vascular changes needed for the infiltra-
tion of cellular and plasma-derived immune Vasodilation occurs through the action of
mediators (see Table 5.1). inflammatory mediators on the arteriole and
the postcapillary venule smooth muscle. De-
creasing the tone of the periarteriolar muscu-
Vascular Changes in
lature acts to widen the lumen of the vessels,
Acute Inflammation
which in turn opens new capillary beds in the
Three main changes to local blood vessels occur affected tissue (Figure 5.5). As mentioned ear-
in response to inflammatory mediators: lier, these expanded capillary beds contribute

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Table 5.1. A summary of the major mediators of inflammation
Inflammatory mediator Primary source Inflammatory action
Cytokines and chemokines
IL-1β, IL-6, and TNF-α Macrophages Leukocyte and endothelial activation; systemic
CXCL8 (IL-8) Leukocytes Leukocyte activation and chemotaxis

Plasma proteins
C3a Complement activation Mast-cell degranulation; smooth-muscle contraction
C5a Complement activation Leukocyte chemotaxis; mast-cell degranulation;
smooth-muscle contraction; vascular permeability
Bradykinin Kinin–kallikrein system Vasodilation; vascular permeability; pain

Vasoactive amines
Histamine Mast-cell degranulation Vascular permeability; smooth-muscle contraction
Serotonin (5-hydroxytryptamine) Mast-cell degranulation Vascular permeability; smooth-muscle contraction

Leukotriene B4 Leukocytes Leukocyte activation and chemotaxis; vascular
Leukotrienes B4, D4, and E4 Leukocytes (particularly Smooth-muscle contraction; vascular permeability
mast cells)
Prostaglandin E2 Leukocytes (particularly Vasodilation; vascular permeability; pain
mast cells)

to both rubor and calor by increasing the vol- ity also contributes to the local stasis of blood
ume of blood in the area. By widening the ve- flow; akin to the flow of water in a pipe with
nules, vasodilation also acts to slow the veloc- numerous holes in it, the more water that leaks
ity of the blood in these postcapillary vessels, out, the slower the flow of water in the pipe.
akin to water current in a river—the wider and In healthy tissue, endothelial cells lining the
deeper the river is, the slower and less turbu- microvasculature typically prevent the move-
lent the water flow. Coupled with the “leaki- ment of protein-rich fluid out of the blood
ness” of endothelium, vasodilation contributes vessels. They do this by creating a continuous
to the local stasis of blood flow. Slower velocity barrier on the inside of vessels through inter-
or stasis of blood flow is important to decrease cellular tight junctions, which is critical for the
the shear force on the leukocytes during the maintenance of fluid homeostasis. However,
process of extravasation, which we discuss in within minutes of the detection of infectious or
depth later. noxious stimuli by sentinel cells, inflammatory
Increased vascular permeability or leakiness mediators can act on endothelial cells (typically
is another important vascular change associ- in postcapillary venules) and trigger confor-
ated with inflammation. It permits the move- mational changes in these cells, leading to the
ment of fluid and plasma proteins—including breakdown of the endothelial barrier (Figure
complement, antibodies, and acute phase pro- 5.6A–D). Mediators such as histamine and IL-1
teins (discussed later in this chapter)—into the stimulate endothelial cells to contract or rear-
affected interstitial tissue. The protein-rich fluid range their cytoskeletons, which decreases
that escapes from vasculature is known as exu- their surface areas, creating gaps between en-
date. As mentioned earlier, vascular permeabil- dothelial cells and allowing protein-rich fluid

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Figure 5.6A–D. Mechanisms that increase vascular permeability during inflammation
Four mechanisms are thought to contribute to the increase in vascular permeability during inflamma-
tion: endothelial contraction (panel A), active transcytosis (panel B), direct physical or chemical injury
to the vasculature (panel C), and injury to the vasculature after leukocyte extravasation or activation
(panel D).

(exudate) to leak out of these vessels and into cytosis is the active transport of fluid and mac-
the surrounding tissue. romolecules across the cytoplasm through a se-
Another mechanism by which increased vas- ries of separate or interconnected cytoplasmic
cular permeability is thought to be induced in vesicles. These vesicles effectively form tunnels
inflammation is through the upregulation of or channels through the cells, allowing protein-
transcytosis in venule endothelial cells. Trans- rich fluid to pass directly through the activated

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endothelial barrier. Finally, aside from purpose- first to respond. Unlike macrophages, how-
ful changes to endothelial cells in postcapillary ever, before inflammation, neutrophils appear
venules induced by inflammatory mediators, almost exclusively in the blood. To be useful,
inadvertent injury to vasculature can also con- neutrophils need to find the general area of in-
tribute to vascular permeability after injury or flamed tissue, exit the circulation, and migrate
inflammation. Injury can include direct physi- within the tissue to the specific locale of insult.
cal or chemical injury to vascular beds by the They achieve this in four stages of extravasation
inciting insult (e.g., a heat or chemical burn) (Figure 5.7):
or collateral damage associated with leukocyte
1. tethering (margination) and rolling;
extravasation and the subsequent antimicrobial
effector function. 2. firm adhesion (pavementing) and crawling;
In addition to promoting vascular permeabil- 3. transmigration (diapedesis);
ity, the activation of vascular endothelium by 4. chemotaxis through tissue.
cytokines (such as IL-1 and TNF-α) induces the
Even though vascular changes help to slow
expression of cell-adhesion molecules. These
the blood flow in an inflamed region, normal
cell-adhesion molecules are displayed in high
neutrophil velocity in the circulation, coupled
numbers on the lumenal membranes of the
with the shear forces on stationary objects
endothelial cells that line postcapillary venules,
within blood vessels, makes the task of ex-
where they act to snag circulating leukocytes.
travasation difficult. Tethering and rolling of
This process serves to slow and tether use-
neutrophils on activated endothelium are nec-
ful leukocytes and also to signal to them that
essary to marginalize and slow down the oth-
a threat is in the vicinity and that they should
erwise fast-moving cells. As mentioned earlier,
IL-1 and TNF-α activate vascular endothelial
Overall, the changes to vasculature in the vi-
cells in venules to express and display cell-
cinity of a detected proinflammatory threat act
adhesion molecules. An important family of
to deliver more blood to the vasculature beds in
cell-adhesion molecules is the selectins, named
the area (vasodilation); slow the velocity of the
because they function as selective lectins (recall
blood flow (vasodilation and vascular perme-
that lectins are carbohydrate-binding proteins).
ability); allow protein-rich fluid into the tissue
Selectins are expressed on activated endothe-
(vascular permeability); and select, tether, and
lium, where they function to marginalize and
concentrate circulating leukocytes (cell-adhe-
slow down circulating leukocytes. E-selectin
sion molecule expression). Vascular changes are
binds to sialylated Lewis X–modified glyco-
important steps in the early process of inflam-
proteins that are displayed on the surface of
mation and account for many of the cardinal
circulating neutrophils and eosinophils. P-se-
signs (rubor, calor, and tumor), but they are just
lectin, which is also is displayed on activated
the beginning of the inflammatory process.
endothelium, binds platelet selectin glycopro-
tein ligand 1, which is a glycoprotein found
Leukocyte Recruitment on all circulating leukocytes. The interactions
between the selectins on activated endothelia
Leukocyte Extravasation and their glycoprotein ligands on leukocytes
As mentioned earlier, one of the major pur- are relatively low affinity. Through numerous
poses of inflammation is to recruit additional low-affinity selectin and ligand interactions,
leukocytes to the site of a detected threat. In however, leukocytes can loosely adhere to ac-
acute inflammation, neutrophils—well equipped tivated endothelium, causing them to be mar-
with an antimicrobial arsenal—are usually the ginalized within the vasculature and roll along

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Figure 5.7. Leukocyte extravasation (video courtesy of Dr. Paul Kubes, University of Calgary)
Diagram (top) and video micrograph (bottom) showing the four stages of leukocyte extravasation.
The bottom panel is a sequential montage taken from a video micrograph of neutrophils extravasat-
ing from a postcapillary venule in the cremaster muscle of a mouse after experimental induction of
local acute inflammation. Endothelial cells and their tight junctions are highlighted in red. Neutro-
phils are green. From left to right, arrows indicate neutrophils undergoing (1) tethering and rolling,
(2) firm adhesion, (3) transmigration, and (4) chemotaxis. The video was taken using a mulitphoton
confocal microscope.

the endothelial surface. Through this process of chemokines, such as CXCL8, further slows
involving multiple weak interactions with pass- the neutrophils and induces conformational
ing leukocytes, the endothelium slows but does changes in a second group of neutrophil pro-
not stop the cells in the high-shear environment teins called integrins. These structural changes
of the blood vessel. switch the integrins from low- to high-affinity
Being tethered and rolled gives the leukocyte receptors. Lymphocyte function–associated an­
time to detect local proinflammatory chemo- ti­gen 1 (LFA-1) is one such integrin found on
kines at the endothelial surface. The detection the surface of lymphocytes, monocytes, and

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neutrophils. LFA-1 binds to intercellular adhe- typically occurs in the thin-walled postcapillary
sion molecule 1 (ICAM-1), which is another venules; however, transmigrating neutrophils
cell-adhesion molecule that endothelial cells must still penetrate the endothelial barrier and
express in response to proinflammatory media- the underlying basement membrane. Although
tors. In its low-affinity state, LFA-1 on neutro- neutrophils have been reported to exit the ves-
phils does not bind endothelial ICAM-1, but the sel by moving through intact endothelial cells,
conformational switch to its high-affinity state adhered neutrophils usually crawl to the junc-
quickly enables LFA-1 to bind ICAM-1 with tions between these cells to transmigrate. Here
great strength, allowing the rolling neutro- neutrophils, in cooperation with the endothe-
phil—if given the right chemokine stimulus— lial cells, break down the tight junctions of the
to slow its rolling down to a complete stop and endothelium, creating small gaps between the
to firmly adhere to the activated endothelium. endothelial cells. The neutrophils then attempt
Once stopped, the shear force on the adhered to squeeze through these gaps and digest the
neutrophil causes it to spread out from a spheri- underlying basement membrane through local-
cal shape to a flattened morphology. This stage ized secretion of collagenases. Using another
of firm adhesion is also referred to by patholo- series of cell-adhesion molecules, the leading
gists as pavementing, because the local endo- edge of each neutrophil adheres to the extra-
thelium starts to resemble a tiled pavement cellular matrix, allowing the neutrophils to pull
as more neutrophils adhere and flatten out. themselves out of the vasculature. It is not sur-
With the advent of sophisticated microscopic prising that by breaching the endothelial and
techniques, we now know that adhered neu- basement membrane barriers, the process of
trophils are not stationary on the endothelium transmigration additionally increases the per-
but crawl in their flattened state to try to find a meability (leakiness) of the vessel. Microscopic
suitable area to transmigrate. studies have also shown that the hole left by
The importance of the ability of neutrophils transmigrating neutrophils is commonly used
to firmly adhere to the endothelium is demon- by other transmigrating leukocytes, increasing
strated by the clinical manifestations of bovine the efficiency of extravasation. Now out of the
leukocyte adhesion deficiency (BLAD). BLAD circulation, the neutrophils must migrate to the
is an autosomal recessive disease that affects specific location of the potential threat.
Holstein cattle as a result of a mutation in the The recruitment of leukocytes to a spe-
gene that encodes β2-integrin (CD18). An ani- cific site of insult relies on the establishment
mal that is homozygous for this mutation has of chemical gradients of chemoattractants.
impaired expression of LFA-1 on its neutro- These chemoattractants can be endogenously
phils. Because LFA-1 is required to form a firm derived from activated macrophages and other
adhesion with activated endothelium (through immune processes or can be exogenously de-
interaction with ICAM-1), tethered and rolling rived microbial products diffusing away from a
neutrophils cannot stably adhere to the endo- site of infection. As mentioned earlier, sentinel
thelium and are thus unable to extravasate. cells such as macrophages, once activated by
Without the ability to mobilize its first respond- PAMPs, DAMPs, or both, produce proinflam-
ers to a site of inflammation, the animal suffers matory mediators. These mediators include
frequent and recurrent bacterial infections that chemo­attractants, for example lipid-derived me-
result in premature death. diators such as leukotriene B4 and chemokines
Transmigration, commonly referred to as such as CXCL8. These endogenous chemoat-
diapedesis, is the movement of leukocytes tractants diffuse away from activated macro-
from the lumen of the blood vessel through phages at the site of insult, setting up a concen-
the vessel wall and into the interstitium. It tration gradient. Another powerful endogenous

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Figure 5.8. Leukocyte chemotaxis (photograph courtesy of Dr. Paul Kubes, University of Calgary)
Diagram (left) and video micrograph (right) showing leukocyte chemotaxis up a chemoattractant gra-
dient. The micrograph is a sequential montage taken from a video of an activated neutrophil migrat-
ing up a concentration gradient of the chemoattractant of N-formylmethionine–containing peptide in
a petri dish. Note the neutrophil morphology, particularly the leading edge and trailing tail between
which the neutrophil can detect minute differences in concentration of the chemoattractant. The four
sequential photos are taken approximately 60 seconds apart using a phase-contrast microscope.

chemoattractant is a small protein by-product though, does the neutrophil detect a chemotac-
of complement activation, C5a. Recall from tic gradient and move in the right direction?
chapter 4 that following classical, alternative, When clinicians think of neutrophils, they
or lectin pathways of complement activation, usually picture a snowball-shaped cell with a
C5 is cleaved by the C5 convertases to produce segmented nucleus in blood smears. However,
a large C5b fragment (which is involved in ini- once out of the circulation, the neutrophil can
tiation of the MAC) and a small, often forgot- take on an amoeboid-like morphology with an
ten C5a fragment. C5a diffuses away from the extending pseudopod leading edge and a trail-
site of complement activation and establishes a ing tail (Figure 5.8). Using receptors for che-
chemoattractant gradient around complement- moattractants dispersed on its plasma mem-
activating surfaces. brane, the neutrophil extends its pseudopod in
Exogenously derived chemoattractants (such the region of the greatest chemotactic recep-
as microbial products—PAMPs) can also be tor activation and then pulls the rest of itself
used by neutrophils to navigate toward a nidus toward the stimulus. Clearly, these migrating
of infection. One particular chemotactic PAMP leukocytes can actually detect the very small
is N-formylmethionine–containing peptides. difference in concentration of a chemoattrac-
Because N-formylmethionine is common in tant between its leading edge and trailing tail
proteins of bacterial origin (but not common (some 8–12 µm apart). During the journey to
in host proteins), a neutrophil that migrates the site of injury or infection, stimulated by
up a gradient of N-formylmethionine pep- local proinflammatory mediators, the neutro-
tides should be moving toward its target. How, phil activates, making it much more efficient at

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Figure 5.9. Eosinophilic inflammation
Histopathological section of the intestinal mucosa of a horse with a strongyle infection (arrow)
showing an acute inflammatory reaction with recruitment eosinophils. Note that a high proportion
of the cells have the bright red cytoplasmic granules characteristic of eosinophils.

locating, ingesting, and destroying pathogens sion molecules displayed on the endothelium,
(covered in chapter 6). and the types of adhesion molecules and che-
Once at the site of inflammation, the neu- mokine receptors on the surface of the circulat-
trophil is short-lived; thus, a constant stream of ing leukocytes. For instance, acute inflamma-
new neutrophils needs to be recruited. In many tion associated with parasitic infections (such as
bacterial infections, the neutrophils infiltrate strongyle infection in horses) is associated pri-
and die in such large numbers that they visibly marily with eosinophil recruitment (recall from
manifest as pus or suppuration. chapter 2 that eosinophils are best equipped to
fight helminthic infections; Figure 5.9). The re-
cruitment of eosinophils is mediated by release
Diversity and Timeline of of the chemokine CCL11 (also called eotaxin),
Leukocyte Recruitment which promotes the extravasation and che-
Although neutrophils are the most com- motaxis of eosinophils (as opposed to CXCL8,
mon early cells in many acute inflammatory which attracts primarily neutrophils).
conditions, other leukocytes (such as mono- Circulating monocytes are a common sec-
cytes, eosinophils, and lymphocytes) can also ond responder in acute inflammation, with the
be recruited to the site of inflammation. The majority being recruited one to two days after
mechanisms of extravasation and chemotaxis the initial insult, as the neutrophil recruitment
for these other leukocytes are similar to those wanes. As soon as they extravasate, these mono-
described earlier for neutrophils. Which leuko- cytes mature into macrophages, which further
cytes are recruited and the timing of their re- activate as they migrate toward the site of in-
cruitment are dependent on the type and extent flammation. As mentioned in chapter 2, macro-
of the tissue insult. Coordination of the type phages are moderately proficient at killing mi-
and timing of leukocyte recruitment to an in- crobes, but they also have the ability to phago-
flammatory site is achieved through a complex cytose and break down debris, as well as present
combination of chemotactic molecules and cy- antigen. Hence, these new macrophages start
tokines released in the area, the types of adhe- the task of cleaning up the dead neutrophils,

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Figure 5.10. Phases of leukocyte recruitment in persisting inflammation
Although neutrophils are a common first responder in acutely inflamed tissue, mononuclear cells
and lymphocytes are often recruited in later stages of inflammation. This figure shows the phases of
leukocyte recruitment in a typical site of inflammation that persists over several weeks.

debris, and remaining microbes, which is not are dependent on the pathogen and tissue in-
only important in the fight against infection, but volved and the nature of the adaptive immune
a necessary step in the resolution of inflamma- response (e.g., Th1 vs. Th2 responses; covered
tion, wound healing, and tissue repair. in later chapters). Invariably, the neutrophil
In most instances, local acute inflammation plays a diminished role in chronic inflamma-
is self-limiting and quickly resolves without fur- tion, but macrophages, Th cells, Tc cells, and
ther sequelae. However, infection with a bona even B cells play major roles (Figure 5.10).
fide pathogen that is adapted to resist anti­
microbial mechanisms of the innate immune
Systemic Effects of
system may cause persistent inflammation. In
Acute Inflammation
these instances, the adaptive immune system is
brought into play, and the acute inflammation Aside from the local effects of acute inflam-
may evolve into chronic inflammation. Chronic mation (rubor, tumor, calor, dolor, and functio
inflammatory processes are very diverse and laesa), significant localized inflammation or

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Figure 5.11. Systemic effects of acute inflammation
Certain proinflammatory cytokines generated at the site of acute inflammation can be distributed
throughout the body of an animal, resulting in systemic inflammatory responses involving many
organs. ACTH = adrenocorticotropic hormone; CSF = colony-stimulating factors.

disseminated acute inflammation can have sys- 3. lethargy;

temic effects on the animal that may be clini- 4. muscular wasting (cachexia);
cally apparent. These effects become important 5. hemodynamic changes (shock);
indicators of an acute inflammatory process in
6. fever (pyrexia);
tissues or organs not immediately visible in a
7. leukocytosis (commonly neutrophilia);
clinical examination (e.g., pyothorax or prosta-
titis). In these situations, it is common for ani- 8. metabolic acidosis (lowered blood pH);
mals to be presented for these systemic symp- 9. alterations to acute phase proteins.
toms rather than for the inflamed tissue itself. The majority of the systemic effects of acute
Systemic effects of acute inflammation inflammation are mediated by the systemic re-
include lease of TNF-α, IL-1, and to a lesser extent IL-6
1. loss of appetite (anorexia); by activated leukocytes at the site of inflamma-
2. altered sleep patterns (increased slow-wave tion (Figure 5.11). These proinflammatory cyto-
sleep); kines can rapidly disseminate throughout the

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body and mediate responses in many organs, extraordinarily conserved (even reptiles display
including the hypothalamus, liver, and bone fever in response to inflammation), and thus it
marrow. Generally speaking, many of these presumably offers some survival advantage to
systemic effects serve to conserve energy and the host.
mobilize resources (particularly protein) to aid Leukocytosis is the increased number of leu-
in the resource-expensive process of inflamma- kocytes circulating in the blood. Leukocytosis
tion. These systemic effects include anorexia, in response to acute inflammation is primarily
altered sleep patterns, lethargy, and cachexia a neutrophilia (increased numbers of circulat-
(which contributes to metabolic acidosis)— ing neutrophils), which is due to the increased
most of which are directed by TNF-α. Other release of neutrophils from the bone marrow
systemic effects, however, perform specific in response to IL-1 and TNF-α that provides
functions in the acute inflammatory process. greater numbers of these short-lived leuko-
Fever (pyrexia) is the elevation of the core cytes so that more can extravasate and contrib-
body temperature as a result of a higher-than- ute to the immune defense at the site of inflam-
normal thermoregulatory set point within the mation. Prolonged release of neutrophils from
anterior hypothalamus. This set point is raised the bone marrow will deplete its store of the
(typically between 1° and 5°C [~2° and 9°F]) mature cells, prompting increased synthesis
above the normal body temperature of the ani- of CSFs such as granulocyte CSF (products of
mal in response to pyrogens. Pyrogen is a term inflammation such as C3a also lead to eleva-
used for any substance that induces fever and tions in G-CSF). This increased synthesis in
can be exogenously or endogenously derived. turn enhances granulocyte differentiation from
Immunologically speaking, exogenous pyrogens myeloid precursor cells, and the release of the
(typically PAMPs or DAMPs such as LPS and ad- less mature band neutrophils. As mentioned in
enosine) can induce leukocytes to produce en- chapter 2, band neutrophils can be identified by
dogenous pyrogens, which are pro­inflammatory their unsegmented band nuclei. Clinically, this
cytokines such as TNF-α and IL-1 (Figure 5.12). release of less mature band neutrophils is re-
These endogenous pyrogens can be released ferred to as a neutrophilia with a left shift (more
into the circulation to act on the vascular en- circulating neutrophils that are on average less
dothelial and perivascular cells of the anterior mature) and is commonly associated with acute
hypothalamus. Here, they can stimulate the inflammation. It is one of the most important
synthesis of prostaglandins (particularly pros- clues a veterinarian has in gauging whether the
taglandin E2), which will then act on neurons animal’s clinical signs stem from an inflamma-
in the preoptic nucleus involved in thermoregu- tory process (especially if the site of inflamma-
lation. Nonsteroidal anti-inflammatory drugs tion is not immediately apparent). The degrees
(such as meloxicam) are often antipyretic as well of neutrophilia and left shift are also important
as anti-inflammatory because they block cyclox- diagnostic indicators of the severity of the in-
ygenase enzymes, thus reducing the production flammatory response occurring in the animal
of prostaglandins at the site of inflammation (Figure 5.14).
(anti-inflammatory) as well as in the anterior Another common laboratory finding in
hypothalamus (antipyretic). acute inflammation is the change to the acute
Fever in response to acute inflammation is phase protein (APP) profile of the serum.
well accepted, but what are the functions of APPs are serum proteins whose abundance is
fever? Surprisingly, it is poorly understood. altered in response to an acute inflammatory
There are many theories, but no one theory process. They can be divided into positive and
can explain the benefits of fever to everyone’s negative APPs, with serum levels of positive
satisfaction (Figure 5.13). Nevertheless, fever is APPs increasing, and those for negative APPs

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Figure 5.12. Induction of fever
Exogenous and endogenous pyrogens stimulate the release of prostaglandins (prostaglandin E2) in the
anterior hypothalamus that act on the thermoregulatory neurons that control the body’s temperature
set point. Increasing the set point promotes metabolic and behavioral changes in the animal that serve
to increase heat production and minimize heat loss.

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Figure 5.13. Proposed functions of fever
The true function of fever is nebulous. Over the years, numerous reports have shown immunological
benefits of fever to the host animal. This diagram attempts to summarize these possible benefits of

decreasing, in response to acute inflammation. onset of inflammation) and can reach levels
Positive and negative APPs in various species ten to one hundred times their normal serum
and their relative association with acute in- concentrations. Veterinarians exploit this fea-
flammation can be found in Table 5.2. APPs ture by using increased APP concentrations
are named as such because they are indicative as an indicator of inflammation, well before
of an inflammatory process taking place in the classic blood leukocyte concentration changes
animal, not necessarily because they have com- (such as neutrophilia). The use of APPs in di-
mon functions or are proinflammatory. In fact, agnostic medicine has received a great deal of
the reported actions of different positive APPs attention in recent years as an aid in the diag-
include a wide range of homeostatic, proin- nosis of a broad range of diseases, including
flammatory, and anti-inflammatory actions. bovine respiratory syncytial virus infections,
APP concentrations rise very quickly in the prostate cancer, bronchopneumonia, multiple
serum of animals with inflammation (peak- myeloma, mastitis, Streptococcus suis infection,
ing within twenty-four to forty-eight hours of starvation, and lymphoid neoplasia.

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Figure 5.14. Neutrophilia left shift
As bone marrow stores of mature neutrophils diminish during the course of acute inflammation, less
mature neutrophils will be released into circulation, which is termed a left shift of the population of
circulating neutrophils. This figure shows the range of maturation in states of normal, left-shifted,
and severely left-shifted neutrophil populations.

Many of the positive APPs are produced by ment activation). Thus, CRP acts as a secreted
the liver in response to cytokines such as IL-6, PRR that enhances the clearance of microbes
although the gastrointestinal tract, kidney, and damaged host cells during periods of acute
heart, adipocytes, and even leukocytes them- inflammation. Numerous other pro- and anti-
selves have been shown to synthesize various inflammatory roles of CRP have been reported,
APPs. One of the more prominent positive including the induction of various cytokines,
APPs in dogs, rabbits, pigs, and primates is C-re- attenuation of neutrophil chemotaxis and de-
active protein (CRP). CRP is a pentameric pro- granulation, and promotion of tissue repair.
tein produced by hepatocytes and adipocytes in
response to IL-6. It contains domains that can
Clinical Correlation: Follow-Up
bind phosphocholine as well as certain poly-
saccharides and glycolipids that are commonly As we discussed at the start of this chapter,
found on the surface of bacteria, parasites, and acute mastitis is an acute inflammatory reac-
damaged cells. Other domains can bind cer- tion in the mammary gland, leading to its dys-
tain Fc (antibody) receptors on macrophages function (Figure 5.15). Lactating dairy herds
(enhancing the phagocytosis of microbes and are highly susceptible to mastitis, which is com-
dead cells) or can bind C1q (initiating comple- monly initiated by contagious or environmental

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Table 5.2. Acute-phase proteins in domestic species
APP Immunologic function Species variability
C-reactive protein Binds to bacteria Major APP in dog and pig (increases 10 to
(CRP) Promotes complement binding and opsonization 100 times)
Induces cytokine production Not seen in cats
Modulates monocytes and macrophages
Serum amyloid A Chemotactically recruits leukocytes Major APP in dogs, cats, cattle, and pigs
Downregulates inflammatory response (increases 10–100 times)
Has an inhibitory effect on fever, oxidative burst
of neutrophils, and immune response
Involved in lipid metabolism and transport (e.g.,
cholesterol from dying cells)
Plays a pathological role in systemic (reactive)
Haptoglobin Binds hemoglobin; reduces tissue toxicity and Major APP in pigs, cattle, and sheep
sequesters iron from microbe (increases 10–100 times)
Inhibits granulocyte chemotaxis and phagocytosis Moderate APP in dogs and cats (increases
2–3 times)
Alpha-1-acid Antineutrophil and anticomplement activity Major APP in cats (increases 10–100 times)
glycoprotein Increases macrophage IL-1R antagonist secretion Increases in feline infectious peritonitis and
inflammatory peritonitis in cats
Moderate APP in dogs (increases 2–3
Minor APP in cattle
Ceruloplasmin Transports copper for wound healing, collagen Moderate APP in dogs (increases 2–3
formation, and maturation times)
Antioxidant Minor APP in cattle
Hepcidin Sequesters iron in anemia of chronic disease
Fibrinogen Coagulation Important indicator of acute inflammation
in horses and cattle
Albumin (negative) Decreases inflammation
Transferrin Iron binding, so reduced concentration sequesters
(negative) iron from bacterial use

bacteria. Hallmark characteristics of acute mas- Possible Explanations

titis include redness, heat, swelling and pain in High-performing mammary glands such as
the udder, and the presence of leukocytes in the those of a lactating dairy cow are highly suscep-
milk. tible to microbial infection with contagious or
environmental bacteria. These bacteria can pass
through the streak canal, particularly after milk-
Student Considerations ing, and proliferate in the gland. The proliferat-
After learning about the onset and develop- ing microbes release PAMPs (such as endotoxin
ment of acute inflammation, you should be in the case of coliform mastitis), which are de-
able to describe the sequence of events that tected by sentinel cells (such as macrophages)
leads to acute mastitis and outline the key clini- resident in the gland’s tissue. These cells release
cal and laboratory findings that would aid a vet- proinflammatory cytokines, including TNF-α,
erinarian in his or her diagnosis. IL-1, and IL-6, and other mediators such as pros-

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Figure 5.15. Acute bovine mastitis (photograph courtesy of Dr. Gordon Atkins, University of Calgary)
This photograph is of a five-year-old, mid–third-lactation Holstein cow with severe mastitis of the left
front quarter caused by Klebsiella bacteria.

taglandins and leukotrienes that, together with touch. When a milk sample is taken, increased
mediators from other cell types such as hista- numbers of infiltrated neutrophils along with
mine, result in changes to the local vasculature. sloughed epithelial cells can be detected by milk
These changes allow serum proteins containing smear, CMT, or automated cell counting. The
complement and antibodies into the tissue and cow may be febrile and show signs of lethargy,
also promote the tethering and adhesion of cir- anorexia, and altered behavior resulting from
culating neutrophils. Sensing chemokines ema- the systemic release of TNF-α and IL-1. Blood
nating from within the tissue, the tethered and samples would reveal a neutrophilia with left
rolling neutrophils extravasate and migrate up shift and, if measured, increased serum con-
a proinflammatory chemoattractant gradient. centrations of APPs, including haptoglobin and
Here, they can bolster the local macrophage serum amyloid A (the major APPs in cattle).
defense against the invading microbes by using To the dairy farmer, acute mastitis signifies a
their potent antimicrobial effector mechanisms. loss of income and considerable effort and time
The details of these mechanisms are discussed lost in both individual treatment (often intra­
in the next chapter. gland antibiotic preparations) and herd preven-
Clinically, these changes manifest in a mam- tion. To the cow, acute mastitis is painful and
mary quarter that is swollen, red, and hot to the uncomfortable and is often accompanied by

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systemic ill thrift. Nonetheless, as illustrated by tally important process of the innate and adap-
deficiencies such as bovine leukocyte adhesion tive immune systems and is essential for the
deficiency, acute inflammation is a fundamen- survival of animals in this microbe-rich world.

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Robin M. Yates

Innate Cellular Effector Mechanisms Chapter 6


report as having “rattling breath” and “being

Clinical Correlation: Rattles in Foals 89
off feed.” Unfortunately, the filly dies before
Learning Objectives 90
the veterinarian arrives. On postmortem of
Classification of Innate Cellular Effector
the foal, the veterinarian discovers tuberculo-
Mechanisms 90
sis-like granulomas throughout the lungs and
Phagocytes and Phagocytosis 91
tentatively attributes the filly’s death to pneu-
Phagocytosis Part I: Recognition and
Adhesion of Particles on the Plasma
monia caused by a disease known as rattles
Membrane of the Phagocyte 91 (Figure 6.1).
Phagocytosis Part II: Membrane and Rattles, so named because of its presenting
Cytoskeletal Reorganization to Mediate sign of rattly breathing, is a severe form of
Particle Engulfment and the Creation of a bacterial pneumonia that commonly affects
Phagosome 94 foals. It is caused by the Gram-positive bacte-
Phagocytosis Part III: Maturation of the rium Rhodococcus equi, which is related to My-
Phagosome into a Microbicidal and
cobacterium tuberculosis (the etiological agent
Degradative Phagolysosome 94
of tuberculosis). R. equi is found in soil and is
Extracellular Innate Effector Mechanisms 99
endemic on certain horse farms. The majority
Degranulation by Neutrophils and
Eosinophils 99 of cases occur in hot, dry summers when con-
Release of Neutrophil Extracellular Traps 100 ditions are dusty. It is thought that foals inhale
Natural Killer Cell–Mediated Cytotoxicity 101 the bacteria in the dust, which are then depos-
Recognition of Target Cells 101 ited in terminal bronchi and alveoli. Here the R.
Activating stimulus 101 equi microbes are engulfed by resident alveolar
Inhibitory stimulus 102 macrophages. These specialized macrophages
Targeted Degranulation by Natural are the primary immune cells defending these
Killer Cells 102 respiratory surfaces. They are extremely profi-
Antibody-Dependent Cell-Mediated cient at recognizing and phagocytosing inhaled
Cytotoxicity 105 debris and microbes and very effective at killing
Clinical Correlation: Follow-Up 105 them. R. equi bacteria, however, are not typi-
Student Considerations 105 cally killed by alveolar macrophages in foals.
Possible Explanation 106 In fact, they can thrive within the macrophage.
Macrophages infected with R. equi quickly re-
Clinical Correlation: cruit other immune cells through the release of
Rattles in Foals proinflammatory cytokines, eventually form-
ing granulomas. How is the macrophage able
A veterinarian is called out to examine a four- to kill most microbes easily but unable to kill
month-old thoroughbred filly that the owners R. equi?


callahan text.indd 89 3/11/14 1:45 PM

some that mediates the killing and diges-
tion of microbes;
• describe the process of degranulation of
neutrophils and eosinophils and list the
major products released by these cells;
• describe the formation and composition of
NETs and explain their proposed function;
• explain in general terms the recognition of
target cells by NK cells;
• explain how NK cells kill target cells;
• explain the augmentation of the innate effec-
tor mechanisms by the adaptive immune

Classification of Innate
Cellular Effector Mechanisms
Thus far, you have learned that innate immune
cells can recognize microbes and parasites,
alert neighboring cells, and coordinate recruit-
ment of specific innate immune cells to a site
of infection. But what do these cells do when
Figure 6.1. Lung granulomas found at necropsy they get there, and how do they control infec-
in a five-month-old foal infected with tion? The mechanisms of microbial killing are
Rhodococcus equi (photograph courtesy of Dr. as diverse as the microbial threats to an animal.
Rachel Peters, Takeda Pharmaceuticals) These mechanisms depend on the type of in-
fection (particularly location and physical size
of the invader) and which innate immune cell
Learning Objectives responds to the infection.
Generally, the killing mechanisms can be cat-
After reading this chapter, you should be able to
egorized as
• explain in general terms the effector mecha-
nisms of the innate immune system; 1. phagocytosis by phagocytes and killing of
microbes within the phagosome;
• identify which innate immune effectors are
most efficient at controlling 2. release of antimicrobial products to kill
extracellular microbes and parasites;
»» small extracellular threats, such as bacteria,
3. targeted destruction of infected host cells
»» large extracellular threats, such as multicel-
by NK cell–mediated cytotoxicity.
lular parasites,
»» intracellular infections, such as viruses; Together, these mechanisms can defend
• list the major professional phagocytes and against pathogens large or small, intracellular
describe how they recognize, ingest, and or extracellular, often without any help from
kill target microbes; the adaptive immune system. The response to
• describe the process of phagosomal matu- a given infection may use effector mechanisms
ration and list attributes of the phagolyso- in just one, two, or all three of these categories.

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Although these cellular effector mechanisms ized PRRs and opsonic receptors on the surface
are considered part of the innate immune sys- of the phagocyte. As you recall from chapter 4,
tem (because they can be immediately deployed PRRs are immune receptors that can recognize
without previous exposure to the threat), these certain evolutionarily conserved molecular pat-
mechanisms also play an important role in the terns that are unique to foreign material such
elimination of infection after an adaptive im- as microbes (PAMPs) but are absent in normal
mune response has been mounted. In many healthy host tissue. In many circumstances, li-
cases, adaptive immune responses (such as the gation of these PRRs (e.g., by TLRs) leads to
production of antibodies) specifically act to en- proinflammatory signaling and activation of
hance the efficiency of these innate cellular ef- the cell. In addition to proinflammatory PRRs,
fector mechanisms. phagocytes express phagocytic PRRs. These re-
ceptors bind to PAMPs displayed on the surface
of microbes and instigate phagocytosis.
Phagocytes and Phagocytosis
Table 6.1 lists several known PRRs that can
As mentioned in chapter 2, both macrophages initiate phagocytosis. As covered in chapter 3,
and neutrophils (and to a lesser extent DCs) the best-characterized phagocytic PRR is the
have the ability to engulf small particles by a mannose receptor (MR, CD206). This recep-
process called phagocytosis. In fact, these cells tor is found on the surface of macrophages and
are so adept at “eating” particles that they are binds terminal sugar residues on proteins that
often collectively referred to as professional are common on the surface of microbes (but
phagocytes (i.e., professional eating cells). Once absent on healthy host tissues). When microbes
these phagocytes have phagocytosed microbes come into contact with the membrane of
and other material, they can kill and digest the phagocytes, the MR (along with other phago-
phagocytosed products within an intracellular cytic PRRs) binds to molecules on the microbe’s
vacuole called a phagolysosome, which allows the surface. The ligated receptors then initiate in-
cell to kill microbes, using high concentrations tracellular signaling pathways that coordinate
of toxic compounds and enzymes, while mini- phagocytosis of the microbe. Thus, through
mizing collateral damage to neighboring host phagocytic PRR, phagocytes can directly recog-
cells. nize and selectively engulf foreign particles but
The process of microbial killing via phago- leave normal healthy host cells alone. Similar
cytosis can be broken down into three stages: receptors, however, can recognize molecules
on the surface of host cells that have been dam-
1. recognition and adhesion of particles on
aged or have gone through apoptosis (such as
the plasma membrane of the phagocyte;
phosphatidyl serine). These receptors facilitate
2. membrane and cytoskeletal reorganization phagocytosis of dead and dying host cells (a
to mediate particle engulfment and the process often referred to as efferocytosis), which
creation of a phagosome; is necessary for homeostasis, wound repair, and
3. maturation of the phagosome to a microbi- removal of cells that have been killed by an in-
cidal and degradative phagolysosome. tracellular infection such as a virus. These recep-
tors, some of which are listed in Table 6.1, per-
mit professional phagocytes to recognize a wide
Phagocytosis Part I: Recognition range of particles from microbes to apoptotic
and Adhesion of Particles on the host cells and to stimulate their phagocytosis.
Plasma Membrane of the Phagocyte Although macrophages and neutrophils can
The recognition and adhesion of particles autonomously recognize and phagocytose for-
destined for phagocytosis involve both special- eign objects using their phagocytic PRRs, this

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Figure 6.2A–H.Phagocytosis of an IgG-opsonized particle (yellow arrow) by a tissue macrophage
(images acquired at the Live Cell Imaging Facility, University of Calgary)
This series of micrographs was taken over a period of 30 minutes and illustrate the three stages
of phagocytosis: recognition and adhesion of particles on the plasma membrane of the phagocyte
(panels A–B), membrane and cytoskeletal reorganization to mediate particle engulfment and creation
of a phagosome (panels C–E), and maturation of the early phagosome that will eventually become a
microbicidal and degradative phagolysosome (panels F–H).

process is dramatically enhanced by a process molecules essentially tag the microbe for phago-
known as opsonization. Opsonization is the cytosis (making it more tasty to phagocytes).
process whereby particles destined for phago- Phagocytes can strongly adhere to microbes
cytosis are coated with a protein-binding en- coated with the C3b and IgG opsonins through
hancer known as an opsonin (derived from the receptors for C3b (CR1 and CR3) and recep-
Greek opson, which is a condiment such as rel- tors that recognize the constant or Fc portion
ish that is added to food to make it more tasty, of IgG (Fcγ receptors) (Table 6.1). These recep-
hence opsonin). Mammals have two major op- tors also provide a powerful stimulus to initi-
sonins—complement (specifically C3b) and ate phagocytosis of the bound, opsonized mi-
antibodies (particularly certain IgG isotypes). crobes (Figure 6.2). Phagocytosis of opsonized
C-reactive protein (the major acute-phase pro- particles occurs with much greater efficiency
tein in many animal species) can also act as an than phagocytosis initiated through phagocytic
opsonin. These proteins are found in the serum PRRs alone (see Figure 6.3). Hence, although
and can bind to microbes. C3b covalently binds phagocytosis by macrophages and neutrophils
to microbes after initiation of the complement is considered an innate immune response,
cascade (recall from chapter 4). IgG noncova- the production of certain antibodies after the
lently, but very specifically, binds to antigens stimulation of an adaptive immune response
on the surface of microbes after a humoral im- acts to significantly enhance this innate effector
mune response (covered in chapter 12). These process.

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Table 6.1. Examples of pattern recognition and opsonic phagocytic receptors that can be found on professional
Phagocytic receptor type Receptor example Ligand Major target
Direct PRR MR (CD206) Terminal mannose and Bacteria, fungi, viruses
fucose residues
Direct PRR Dectin-1 β-glucan residues Fungi
Direct PRR Scavenger receptor A I Polyanionic ligands (e.g., Diverse (e.g., foreign) particles,
LPS) microbes, and lipoproteins
Direct PRR Phosphatidyl serine receptor Phosphatidyl serine Apoptotic cells
Opsonic receptor CR 3 (CD11b–CD18) C3b Any surface labeled with C3b
Opsonic receptor Fcγ receptor 1 (CD64) Fc portion of IgG Any IgG-bound surface

Figure 6.3. A hypothetical representation of the rate of clearance of invading bacteria from an animal
in the presence or absence of opsonization
Bacteria alone could eventually be cleared from the body by phagocytosis via the direct recognition
by phagocytic PRRs (e.g., MR). However, the rate of clearance would be enhanced with the addition
of the complement- and Ig-based opsonins through more efficient bacterial recognition by phagocytic

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results in tight adhesion of the particle to the
plasma membrane and also serves to cluster
the receptors together. This process of recep-
tor clustering is often enough to initiate re-
gional signals that orchestrate the cytoskeletal
rearrangement necessary for the engulfment of
the particle at the plasma membrane. Several
models of phagocytosis exist, depending on the
size of the particle and the type of phagocytic
receptors engaged, but this process essentially
results in involution of the plasma membrane
to which the particle is bound (Figure 6.5). This
inversion creates an inward-facing pouch of
plasma membrane that is eventually pinched
off, resealing the plasma membrane and creat-
ing a cytoplasmic vacuole (sac) containing the
Figure 6.4. Phagocytosis of bacteria by particle. This vacuole is called the phagosome,
neutrophils and for the first few seconds after being formed,
Neutrophil (yellow) in the process of engulfing it contains only the particle and the extracellu-
anthrax bacteria (orange) via phagocytosis. This lar fluid that was brought in with it—but all of
image was taken by Volker Brinkman using a this changes rapidly.
scanning electron microscope (reprinted from
Brinkman, 2005, PLoS Pathogens 1[3]: cover).
Phagocytosis Part III: Maturation of
the Phagosome into a Microbicidal
Phagocytosis Part II: Membrane and Degradative Phagolysosome
and Cytoskeletal Reorganization The interior of the phagosome—potentially
to Mediate Particle Engulfment containing living microbes—quickly evolves
and the Creation of a Phagosome from an innocuous environment with a neu-
The actual process of phagocytosis refers tral pH to an acidic, oxidative, degradative,
to the physical engulfment of particles bound anti­microbial chamber. This cellular process
to the plasma membrane, resulting in their is aptly named phagosomal maturation (Figure
being trapped in an intracellular vacuole called 6.6). For it to occur, the newly formed phago-
a phagosome. Macrophages and neutrophils some begins to fuse with endosomes and lyso-
can easily phagocytose irregularly shaped par- somes within the cytoplasm of the phagocyte.
ticles and particles as much as 5 µm in diameter Initially, the phagosome preferentially fuses
(about half the size of the phagocytes them- with the relatively immature early endosomes;
selves; Figure 6.4). Moreover, macrophages however, over a period of several minutes, the
and neutrophils can engulf numerous particles maturing phagosome starts to fuse with late
within minutes, and it is not uncommon to see endosomes and eventually with fully formed
these cells laden with upward of twenty mi- lysosomes. In neutrophils, the azurophilic gran-
crobes. Obviously, this level of phagocytosis re- ules—which are essentially modified lysosomes
quires significant alteration of the cytoskeleton that are densely packed with high concentra-
and membrane of the phagocyte. tions of antimicrobial proteins—also fuse with
Recognition of the particle by phagocytic the phagosome. This process of fusion be-
receptors on the surface of the phagocytes tween the phagosome and the endosomal and

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Figure 6.5. Stepsof phagocytic
engulfment of a bacterium
Recognition of a bacterium by phago-
cytic receptors tightly binds the bacte-
rium to the plasma membrane and leads
to intracellular signaling that initiates
engulfment by phagocytosis. During the
process of phagocytic engulfment, the
cytoskeleton is remodeled to allow invo-
lution of the plasma membrane and the
creation of a new intracellular vacuole
called the phagosome.

lysosomal compartments results in the delivery actively pump protons into its interior, making
of hydrolytic enzymes and other antimicrobial it acidic (around pH 4–5). This acid not only
molecules (such as antimicrobial peptides) to serves to help kill any microbes directly but also
the phagosome. The phagosome also starts to activates many of the antimicrobial enzymes
accumulate complexes in its membrane that that have been delivered to the phagosome.

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Figure 6.6. Maturation of the phagosome into a mature phagolysosome
After phagocytosis of a microbe, proton pumps are quickly assembled on the phagosomal membrane,
which serve to acidify its interior. In addition, endosomal and lysosomal compartments containing
hydrolytic enxymes and antimicrobial products progressively fuse with the nascent phagosome dur-
ing its maturation. These events rapidly remodel the newly formed vacuole into an acidic, digestive,
anti­microbial phagolysosome.

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After extensive fusion with endosomes and ly- not generate an oxidative burst in phagocytes
sosomes, the mature phagosome is considered and thus suffer recurrent bacterial infections in
a hybrid vacuole called a phagolysosome. a condition called chronic granulomatous dis-
Another extremely effective strategy used ease. Although no naturally occurring NADPH
by the phagosome to kill ingested microbes oxidase deficiencies have been reported in vet-
is the generation of reactive oxygen species, erinary species, they undoubtedly exist but go
often referred to as the oxidative or respira- undiagnosed.
tory burst. This strategy is achieved by a mul- The phagosome can also produce another
tisubunit complex called NADPH oxidase oxidative radical group called the reactive ni-
that is assembled on the phagosomal mem- trogen intermediates (RNI). Using the amino
brane. This complex transfers unpaired elec- acid arginine as a substrate, inducible nitric
trons from NADPH to molecular oxygen (O2), oxide synthase (iNOS) produces the RNI nitric
generating the free radical superoxide (O2-) oxide (NO). Nitric oxide is produced by many
within the phagosome (Figure 6.7). Having cells as an important signaling molecule, but
an unpaired electron, superoxide is extremely at the high concentrations generated in the
reactive (and damaging) to molecules in its phagosomes of activated phagocytes (activa-
vicinity. If it does not react with an organic tion increases expression of iNOS—hence in-
compound, it typically reacts with hydrogen ducible nitric oxide synthase), the nitric oxide
ions and water to produce hydrogen peroxide free radical is antimicrobial, reacting with DNA
(H2O2) in a chemical reaction called dismuta- and microbial enzymes. Nitric oxide can also
tion. Although hydrogen peroxide is not a free combine with superoxide to produce a highly
radical per se, it is a powerful oxidant—par- unstable isomer of nitrate called peroxynitrite.
ticularly at a low pH, as in the phagosome. Peroxynitrite and its downstream products are
In the phagosome, hydrogen peroxide can be extremely damaging to the lipids, DNA, and
further converted into hydroxyl radicals (OH-), protein contained within the phagosome.
particularly in the presence of ferrous ions. Aside from a low pH and the production of
Similar to superoxide, these free radicals are oxidative compounds, fusion with lysosomes
extremely damaging to virtually all macromol- and granules delivers a variety of digestive
ecules within the phagosome. However, these enzymes and antimicrobial peptides to the
reactions do not necessarily stop here. phagosome. Because lysosomes function as the
Neutrophils make a heme-containing en- garbage disposal system of the cell, they con-
zyme called myeloperoxidase (MPO) in large tain numerous acid hydrolases that can break
amounts and store it in their granules. (An in- down a variety of macromolecules, includ-
teresting fact is that the heme group in MPO ing lipids, carbohydrates, proteins, and nucleic
has a green hue. It is this pigment that gives acids. Within their phagosomes, macrophages
pus, which is made up of dead neutrophils, its use these enzymes to digest and recycle com-
green tinge.) When these granules fuse with ponents of quiescent cells and debris in their
the phagosome, MPO can combine hydrogen normal homeostatic tasks. These enzymes,
peroxide with a chloride ion to make the hypo- though, also serve to help kill and digest phago-
chlorite ion (ClO-). (ClO- is the active ingredi-
cytosed microbes during infection. One ex-
ent in bleach, a powerful disinfectant.) tremely important set of hydrolases delivered
Hence, the oxidative burst in phagosomes to the phagosome is the proteases. As you will
generates numerous reactive oxygen species, learn in chapter 8, these enzymes function in
which serve to kill phagocytosed microbes the phagosomes of macrophages and DCs to
through oxidation. Humans and mice deficient break down protein antigens into small pieces
in parts of the NADPH oxidase complex can- that can be recognized by T cells. This process

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Figure 6.7. Interaction of oxidative chemistries within the phagosome
Superoxide (O2-), hydrogen peroxide (H2O2), hydroxyl radicals (OH-), nitric oxide (NO), peroxynitrite
(ONOO-), and hypochlorite ion (ClO-), although not all free radicals, can all damage biologically
important molecules within the phagosome.

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Extracellular Innate
Effector Mechanisms
Degranulation by Neutrophils
and Eosinophils
To defend against threats that are too big or
too numerous to phagocytose, neutrophils and
eosinophils can release their arsenals of gran-
ules into the extracellular space in a process
called degranulation. Unlike mast-cell degranu-
lation, which releases mostly vasoactive amines
such as histamine, degranulation by neutrophils
and eosinophils releases cytotoxic and degrada-
tive proteins and peptides. Although the aim is
to kill the foreign invader, a high amount of col-
Figure 6.8. The
environment within the lateral damage occurs to the host tissue.
phagolysosome In the face of significant proinflammatory
After minutes to hours, the newly formed stimulation and the presence of high levels of
phagosome is matured into an acidic, oxida- microbial products, neutrophils can induce de-
tive, digestive, antimicrobial compartment. granulation by fusing certain granules to the
Micrograph shows three tissue macrophages, cells’ plasma membranes. All of the granule
two of which have phagocytosed IgG-opsonized products are then released into the extracellular
particles (green). Nuclei are stained blue. space (many of these products are the same as
those delivered to the controlled environment
within the phagosome after phagocytosis).
These products include numerous proteases
is called antigen processing and is essential for (many of which degrade connective tissue),
the development of T-cell–mediated adaptive MPO, and antimicrobial peptides (such as de-
immunity. fensins and cathelicidins). In addition to the
Hence, professional phagocytes, such as release of these granule components, NADPH
macrophages and neutrophils, can recognize oxidase can form on the plasma membrane of
microbes (especially ones that have been opso- the neutrophil and generate superoxide in the
nized), engulf them by the process of phago- extracellular space. The very same dismutation
cytosis, entrap them in an intracellular vacuole reactions that occur in the phagosome can thus
called a phagosome, and then proceed to pump occur in the extracellular space. Hence, the out-
acid, toxic chemicals, and digestive enzymes wardly directed respiratory burst also generates
into the compartment (Figure 6.8). By carefully hydrogen peroxide, hydroxyl radicals, and (be-
selecting what to phagocytose and by contain- cause MPO is released by degranulation) hy-
ing the majority of the cytotoxic components pochlorite ion (ClO-). Although some of these
used to kill internalized microbes, phagocyto- products released by neutrophils are somewhat
sis is a relatively precise antimicrobial effector selective toward microbes (such as defensins),
mechanism that limits collateral damage to most (including proteinases, oxidative radicals,
neighboring host cells. But what happens if the etc.) are just as toxic to host cells as the targeted
invading threat is too big to phagocytose (such microbes. Excessive degranulation by neutro-
as a worm), or there are just too many threats phils can be life threatening to an animal and is
to handle? common in acute lung injury and septic shock.

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plasma membrane and generate extracellular
super­oxide and hydrogen peroxide during a re-
spiratory burst. Products released by activated
eosinophils, although antiparasitic, are also
extremely damaging to bystander host cells.
Eosinophil degranulation also triggers mast-
cell degranulation and is commonly associated
with allergies.

Release of Neutrophil
Extracellular Traps
More recently, researchers have discovered
that, when faced with high levels of proinflam-
matory stimulus, neutrophils can extrude a
sticky, meshlike substance into the extracellu-
lar space to which bacteria and yeast stick and
Figure 6.9. Acanine eosinophil in the process of
are killed. These substances are named neutro-
phil extracellular traps (NETs). With the use
Note the release of the red granules from the
of NETs, neutrophils can efficiently trap and
eosinophil’s cytoplasm.
kill many microbes while minimizing collat-
eral damage to host tissue. NETs are formed
in the final stages of active neutrophil death,
Eosinophils, as mentioned in chapter 3, are in the presence of cytokines such as IL-8 and
specialist antiparasite leukocytes. Although PAMPs such as LPS in inflamed tissue. The
they often play roles in defending against cer- fibers of the NETs are actually strands of the
tain bacterial and viral threats, they are best neutrophils’ own DNA. Both nuclear and gran-
equipped to fight multicellular parasites—those ule membranes break down during the pro-
that are too big to phagocytose. As such, in cess of NET release, allowing antimicrobial
an acute inflammatory response to parasites, granule proteins (such as elastase, defensins,
the eosinophils are often the major recruited and MPO), along with nuclear histones (which
leukocyte. After activation by proinflamma- surprisingly also have antimicrobial proper-
tory stimuli, eosinophils can release their cy- ties), to stick to the negatively charged DNA
totoxic granule contents into the surrounding fibers. Decorated with antimicrobial proteins,
area via degranulation. Eosinophil granules these sticky networks of DNA fibers can not
contain several cytotoxic proteins, including only trap bacteria and yeast, but also kill them
major basic protein (a cytotoxin with antihel- directly (Figure 6.10). NET formation has also
minthic properties), eosinophil cationic protein been shown to occur in the blood, particularly
(a pore-forming protein that punches holes in in the capillaries of the lung and in liver sinu-
cell membranes; it is also reported to be a ribo- soids during periods of sepsis. Although these
nuclease that digests RNA), eosinophil-derived NETs may function to ensnare microbes in
neurotoxin (ribonuclease that has antiviral the blood, they may have detrimental conse-
properties), and eosinophil peroxidase (facili- quences to the animal. Not surprisingly, the
tates oxidative damage by generation of hydro- breakdown of the nucleus and the extrusion of
gen peroxide). As with neutrophils, eosinophils DNA during NET formation results in death of
can also assemble NADPH oxidase on their the short-lived neutrophil.

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lies of conserved surface receptors that recog-
nize sick and stressed host cells, as well as those
cells that are not correctly displaying their self-
markers because they are most likely harboring
infectious agents (such as viruses) or are possi-
bly transformed (neoplastic) cells. In response,
NK cells can kill infected host cells, helping to
contain intracellular infectious agents while the
Tc lymphocyte arm of the adaptive immune
system prepares an antigen-specific response.

Recognition of Target Cells

The exact mechanisms by which NK cells
recognize potentially infected or transformed
host cells are largely unknown. Generally, the
killing of a particular host cell relies on the bal-
ance of the activating and inhibitory signals
from the surface receptors of the NK cells that
make contact with the host cell. These surface
receptors belong to two structural families: the
Figure 6.10. NETs
killer lectin-like receptors (KLRs; receptors that
This is a scanning electron microscope image of resemble the C-type lectins such as the MR)
a bacterium (Klebsiella pneumoniae) ensnared in a
and the killer cell immunoglobulin-like recep-
NET in an infected lung of a mouse. The image
tors (KIRs; receptors with domains that share
has been pseudocolored to differentiate the bac-
terium (pink) and the NET (green and white).
homology with parts of Igs). To make things
Image from “The tangled NETs of the immune more confusing, activating and inhibitory re-
system.” © Klaus Wilhelm, 2011. Originally ceptors belong to both families of receptors.
published in MaxPlanckReasearch 1:11, 72–78.

Activating stimulus
Receptors that provide activating stimulus
Natural Killer Cell–
in NK cells sense a variety of ligands that indi-
Mediated Cytotoxicity
cate abnormality on the surfaces of the target
Although phagocytes and granulocytes can cells. In some cases, NK cell–activating recep-
identify and destroy extracellular threats, threats tors can directly detect conserved viral proteins
that exist within host cells (such as virus and cer- on the surface of infected cells. Infection with
tain bacteria and parasites) are generally hidden certain members of the herpes virus family, for
from the majority of innate effectors. Identify- instance, can be directly detected by NK cells
ing potentially infected host cells, without prior through this type of receptor. Aside from these
exposure to the infective agent, is the specialty specific examples, most activating receptors are
of NK cells. As covered in chapter 2, NK cells thought to detect ill-defined ligands that indi-
are actually lymphocytes. Unlike most T and B cate an altered cellular state, which may arise
cells, however, they do not possess the receptor through infection with viruses, intracellular bac-
diversity generated by recombination of their teria or parasites, or a state of malignancy. These
chromosomal DNA. Instead, NK cells use fami- activating ligands are derived from alterations

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to surface glycoproteins induced by metabolic unrecognizable MHC I, do not trigger inhibi-
stress or altered posttranslational modification tory signaling within the NK cell, and activating
of normal surface proteins. Metabolic stress receptors can fully activate the NK-cell killing
and altered protein processing are commonly mechanism (Figure 6.11).
found in virally infected cells (whose synthe-
sis machinery has been hijacked by viruses).
Transformed cells, which are replicating at an Targeted Degranulation by
abnormal rate, also show metabolic stress and Natural Killer Cells
altered protein expression. The major mechanism by which NK cells kill
their target cells is very similar to that used by
Tc cells (covered in chapter 10). Once an NK
Inhibitory stimulus cell detects a host cell that triggers its activat-
Even if host cells display surface ligands that ing receptors without triggering its inhibitory
indicate ill thrift, these cells are not killed by receptors, changes occur within the NK cell
NK cells if the cells are also displaying normal that allow it to kill the target cell with great
self-markers. This sort of inhibition is achieved precision. NK cells possess cytoplasmic gran-
through inhibitory receptors on the NK cell ules termed lytic granules. These lytic granules
that detect the normal expression of major contain cytotoxic molecules that can kill target
histocompatibility complex class I (MHC I) cells after degranulation. Unlike degranulation
molecules on host cells. MHC I molecules are by neutrophils and eosinophils, which results
usually expressed on every nucleated cell, and in widespread collateral damage, NK-cell de-
because they differ between individual animals, granulation is restricted to killing target cells,
they constitute an important marker to differ- but not neighboring normal cells. NK cells do
entiate self cells from non-self cells. They are this by forming a tight area of adhesion with
also a critical element in the adaptive immune the target cell through which degranulation can
response to intracellular infections because they occur without the cytotoxic components leak-
display samples of proteins that are present ing into the surrounding tissue. This adhesion
within the cell’s cytoplasm and “show” them complex, termed an NK immunological synapse,
to Tc cells. The details on MHC molecules are consists of a collection of adhesion molecules
covered in chapter 8. The presence of normal carefully arranged into a ring by the NK cyto-
levels of MHC I on the surface of target cells skeleton (Figure 6.12). This ring—almost like
indicates that, although they might be slightly a suction cup—acts to “dock” NK cells onto
altered, these cells are behaving relatively nor- target cells and form a tight seal within which
mally. This indication triggers inhibitory signals granule components may be released into the
that override the activating stimulus, thus pre- target cell while being fully contained between
venting activation of the NK-cell killing mecha- both cells. Figure 6.12 shows the NK immuno-
nism. However, altered levels or unrecogniz- logical synapse between an activated NK cell
able MHC I expression indicate that the host and a target cell and the beginning of the polar-
cell’s metabolism has significantly changed or ized degranulation.
that there is covert inhibition of MHC I expres- Degranulation within the NK immunologi-
sion. Purposeful downregulation of the surface cal synapse releases cytotoxic molecules that
expression of MHC I is a common strategy can act on the target cell. Two of these cyto-
used by many viruses to hide from Tc cells. toxic molecules are the proteins perforin and
Many transformed neoplastic cells also have de- granzyme. When released into the NK im-
creased levels of MHC I on their plasma mem- munological synapse, perforin inserts itself
branes. Hence, decreased levels of MHC I, or into the plasma membrane of the target cells

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Figure 6.11. NK cell–mediated killing of target cells
Activation of the cytotoxic function of NK cells requires the presence of activating ligands and the
absence of inhibitory ligands on the target cell surface. The top panel depicts inhibition of NK killing
through recognition of normal MHC I on the surface of the target cell. Despite displaying activating
ligands, the host cell is spared by the NK cell. The lower panel depicts a target cell displaying both an
activating ligand and altered MHC I expression, which triggers the NK-cell killing mechanism, result-
ing in the death of the host cell via forced apoptosis.

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Figure 6.12. NK cell degranulation
NK cells carefully degranulate into an NK immunological synapse (NKIS) formed with the target cell.
This series of micrographs depicts the NKIS between the NK cell (top) and the target cell (bottom).
The actin cytoskeleton (blue) and adhesion molecule CD2 (green) form a ring through which the
perforin (red) and granzyme can be delivered to the target cell. (From Orange et al., “The Mature
Natural Activating Killer Cell Immunologic Synapse Is Formed in Distinct Stages,” PNAS 100 (24): fig.
1, © 2003, National Academy of Sciences, USA)

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Figure 6.13. Antibody-dependent, cell-mediated cytotoxicity
NK cells can recognize surface-bound antibodies (such as IgG) through the receptors that recognize
the Fc portion of the antibody (Fc receptors), thus providing a powerful activating stimulus to initiate
the NK cell’s cytotoxic function.

(perforating the membrane, as its name sug- tive immunity. Specifically, akin to opsoniza-
gests), forming pores. Granzymes are a family tion for phagocytosis, antibody-dependent cell
of serine proteases that can gain access to the cytotoxicity is a process through which the
target cell’s cytoplasm via the pores created by humoral immune system can augment NK cell–
perforin. Here granzymes can act on caspases, mediated cytotoxicity. After the production and
activating pathways that force the target cell to binding of antibodies to cell-associated viral or
go through apoptosis and die. The NK cell is re- neoplasm-associated antigens on the surface
sistant to its own perforin and granzymes and, of abnormal cells, NK cells can more readily
thus, after the directed apoptosis of the target identify these antibody-coated cells as targets.
cell, it can disengage and seek another abnor- Recognition of antibodies on the surface of a
mal cell for destruction. cell is achieved through the Fc receptors on the
NK cell, which serve to provide a very power-
Antibody-Dependent Cell- ful activating stimulus to initiate the NK cell’s
Mediated Cytotoxicity cytotoxic function (Figure 6.13).
As with many innate effector mechanisms,
NK cell–mediated cytotoxicity does not sim- Clinical Correlation: Follow-Up
ply serve to contain infection between expo-
sure and the more specific yet slow-reacting Student Considerations
adaptive immune response. It also acts in an After reading through this material, you
enhanced capacity after the induction of adap- should be able to list the ways in which macro-

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Figure 6.14. R. equi and phagosome maturation
The R. equi bacterium actively arrests the maturation of the phagosome. The arrested phagosome
fails to fully acidify or fuse with the hydrolytic lysosomes, allowing the bacterium to survive within
the macrophage.

phages are able to kill ingested microbes. You ity of the bacterium to avoid being destroyed
should also be able to think of several points in by the macrophage after its phagocytosis in
that arsenal at which R. equi is able to hijack this the pulmonary alveolus. R. equi is thought to
machinery and avoid destruction. achieve this by blocking the maturation of the
phagosome that is created around these bacte-
ria. Without phagosomal maturation, the inte-
Possible Explanation rior does not acidify, and lysosomal products
R. equi is a well-adapted pathogen that has (such as digestive enzymes and antimicrobial
evolved several means for circumventing host products) are not delivered to the phagosome.
immune responses. One of these is the abil- The R. equi bacterium also has the ability to

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prevent the assembly of the NADPH oxidase recruits other mononuclear cells, thus creat-
complex on the membrane of the phagosome, ing a local inflammatory reaction. If not given
which reduces the oxidative stress placed on the the correct stimulus, these monocytes-turned-­
bacterium. It is thought that the phagosomes macrophages cannot kill the R. equi bacteria
containing R. equi bacteria maintain some fu- either but instead become infected themselves,
sion capability with early and recycling endo- further recruiting other immune cells, and so on,
somes, which can bring nutrients to the inhab- which eventually creates a chronic focal immune
iting microbe. Hence, the bacterium survives reaction and the formation of a granuloma.
and replicates within this intracellular niche and An interesting fact is that the macrophage
for the most part is protected from the majority does have the ability to kill R. equi within its
of immune effectors. The exact mechanism by phagosomes, but it cannot do it alone. It needs
which R. equi arrests phagosomal maturation is to be activated by the correct cytokines that
still debated, but certain lipid and protein prod- can be provided by the Th1 cells of the adaptive
ucts produced by the bacterium have been im- immune system (covered in subsequent chap-
plicated in this pathogenic feature. ters). Foals are particularly susceptible to R. equi
The infected macrophage, detecting the pres- because they do not generate a strong Th1 cell
ence of the microbe through PRRs such as the response. Adult horses, however, do generate a
TLRs, releases proinflammatory cytokines robust Th1-type adaptive immune response to
and chemokines into the surroundings, which R. equi and therefore rarely develop rattles.

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Gerald N. Callahan

Cells and Organs of the

Chapter 7
Adaptive Immune System

lymph nodes swell during infections and auto-

Clinical Correlation: Feline Lymphadenopathy 109
immune reactions is essential to understanding
Learning Objectives 109
animals’ responses to and recovery from these
Organs and Cells of the Adaptive Immune
System 109
Primary Lymphoid Organs and Hematopoiesis 110
Bone marrow 110 Learning Objectives
Thymus 112
After reading this chapter, you should be able to
Secondary Lymphoid Organs 114
Lymph nodes 115 • understand the location, structure, and func-
Spleen 117 tion of the bone marrow, thymus, lymph
Mucosa-associated lymphoid tissue 118 nodes, spleen, and MALTs;
Clinical Correlation: Follow-Up 119 • know the origins, characteristics, and physi-
Student Considerations 120 cal properties of T lymphocytes, B lympho-
Possible Explanations 120 cytes, macrophages, and DCs;
• understand the organization and function of
Clinical Correlation: the lymphatics.
Feline Lymphadenopathy
A five-year-old intact male cat presents at a Organs and Cells of the
small-animal clinic. The owner states the cat is Adaptive Immune System
lethargic and will not eat or drink. A quick ex- In 1966, Roy Grist—a pathologist working with
amination of the cat reveals that the animal has a mouse colony in Glasgow, Scotland—discov-
a fever (>40°C, 104°F) and swollen superficial ered a very odd-looking mouse in one of his
cervical and mandibular lymph nodes. Lymph- cages. It was puny, hairless, and short-lived.
adenopathy (especially swollen lymph nodes) is After Dr. Grist made a brief report of his find-
a common presenting symptom for several dis- ing, an Edinburgh researcher asked Dr. Grist
eases of cats (see Table 7.1). if his Edinburgh group could try to establish
With cats, it seems obvious why neoplastic a line of these mice. Grist agreed and shipped
diseases of lymphocytes might lead to swol- a few mice off to the researcher. Because they
len nodes: uncontrolled proliferation of lym- were hairless, the mice became known as nude
phocytes. For the most common causes of mice (see Figure 7.2).
feline lymphadenopathy, however—all of the Beyond their lack of hair, closer examina-
infectious diseases and autoimmune diseases— tion revealed a much more remarkable finding:
the reasons are less clear. Understanding why these nude mice had no thymuses. In the early


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Table 7.1. Causes of lymphadenopathy in cats
I. Proliferative and inflammatory lymphadenopathies
A. Infectious
1. Bacterial
a) Actinomyces app.
b) Corynebacterium
c) Mycobacteria
d) Nocardia app.
e) Streptococci (contagious streptococcal
f ) Yersinia pestis
g) Localized bacterial infection
2. Septicemia
3. Rickettsial
Figure 7.1. Domestic cat (© Pashin Georgiy /
a) Feline ehrlichiosis
b) Hemobartonellosis
4. Fungal
a) Blastomycosis
1970s, no one had any idea what thymuses did, b) Coccidioidomycosis
and these mice seemed to offer an avenue for c) Cryptococcosis
greater insight into the role of this organ. d) Histoplasmosis
One set of experiments involved transplant- e) Phaeohyphomycosis
ing skin from other species onto nude mice. f ) Phycomycosis
Normally, skin grafts elicit a powerful immune g) Sporotrichosis
response and do not survive longer than a few 5. Parasitic
days. Nude mice accepted skin grafts from a) Cytauxzoonosis
chickens, humans, cats, chameleons, fence liz- b) Demodicosis
c) Toxoplasmosis
ards, and frogs. Immunologically, nude mice
6. Viral
(unlike mice with thymuses) could not distin-
a) Feline immunodeficiency virus
guish between themselves and chickens, liz-
b) Feline infectious peritonitis
ards, humans, cats, or frogs (see Figure 7.3A–F). c) Feline leukemia virus
Clearly, the thymus was critical to develop- B. Noninfectious
ing any immunological sense of self. That dis-
1. Dermatopathic lymphadenopathy
covery added the final piece to the puzzle of
2. Idiopathic
the immune system. The thymus, the bone a) Distinctive peripheral lymph node hyperplasia
marrow, the lymph nodes, the spleen, and the b) Plexiform vascularization of lymph nodes
MALT somehow combine to produce the adap- 3. Immune-mediated disorders
tive immune response. a) Immune-mediated polyarthritides
b) Other immune-mediated disorders
4. Localized inflammation
Primary Lymphoid Organs
5. Postvaccinal
and Hematopoiesis
Bone marrow
By the forty-fifth day of gestation, the bone the circulating blood cells. Perinatally, nearly all,
marrow in fetal cats already provides 50 percent if not all, bones contain marrow, the jellylike ma-
of the blood cells. By birth, a cat’s bone marrow terial where all the cells of the blood originate
(as in most mammals) will supply 100 percent of in a process called hematopoiesis (see Figure 7.4).

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Figure 7.2. Nude mouse (photograph by Armin Kübelbeck)
This phenotype is the result of a gene mutation involving hair growth and thymus development.

Recall from chapter 2 that all white blood the remarkable specificity and memory aspects
cells, RBCs, and platelets arise from a single plu- of the adaptive immune response.
ripotential bone marrow stem cell. Early in he- The myeloid lineage produces the remaining
matopoiesis, two distinct cell lineages appear: cells of the blood, many of which participate
the lymphoid lineage and the myeloid lineage. in innate immune responses, as discussed ear-
The lymphoid lineage ultimately produces lier. After they migrate out of the blood vessels
two major types of lymphocytes: T cells and B and into the surrounding tissues, monocytes
cells (recall from chapter 2 that the lymphoid differentiate into macrophages—phagocytic
lineage also produces NK cells that contribute to cells found throughout the body—that are of
innate defense). The T lymphocytes play critical critical importance to innate defense. Other
roles in all adaptive immune responses through phagocytic cells, the DCs, are specialists in ac-
release of essential cytokines and through di- quiring and presenting antigens. Once a DC has
rect killing of pathogen-infected cells. The B acquired antigen, the cell moves through the
cells produce antibodies found throughout the lymphatics to the nearest lymph node and pres-
body. These antibodies provide a major part of ents that antigen to T lymphocytes.
mammalian defense against infections. The B Mast cells begin in the marrow and move
and T lymphocytes are also the only cells with into the circulation and from there into the sur-
antigen-specific receptors—the BCR (a special rounding tissues, where they play major roles
form of antibody) and the TCR (see Figure in innate responses, especially inflammation.
7.5A–B). Together, T and B cells also produce Granulocytes—so named because they contain

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Figure 7.3A–F. Skin grafts on nude mice
Panel A shows human (mammal) skin after 60 days. Panel B shows cat (mammal) skin at 51 days.
Panel C shows chicken (bird) feathers at 32 days; the feathers were already present when the graft
was made. Panel D shows chameleon (reptile) skin at 41 days. Panel E shows fence lizard (reptile) skin
at 28 days. Panel F shows tree frog (amphibian) skin at 40 days. © 1973 Rockefeller University Press.
(Originally published in Manning, Reed, and Shaffer, 1973, J. Exp. Med. 138:488–494.)

cytoplasmic granules (active in inflammatory neutrophils are clearest, but all play important
and other pathways)—include neutrophils, baso- roles in innate defense. (See chapters 2–6.)
phils, and eosinophils. Neutrophils (also known
as polymorphonuclear leukocytes because their
nuclei come in many shapes and sizes) are the Thymus
most numerous of all white blood cells in mam- Although all lymphocytes originate in the
mals. Of the three granulocytes, the functions of bone marrow, only B lymphocytes mature there

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Figure 7.4. Bone marrow and hematopoiesis
A single pluripotential bone marrow stem cell gives rise to all of the cells of the blood. Among these
are the cells most important to the adaptive immune response, particularly B and T lymphocytes and
monocytes, which differentiate into macrophages and DCs.

or in other specialized organs such as the bursa the bone marrow to the thymus, where these
of Fabricius in fowl. In vertebrates, another set cells become T lymphocytes. This step is essen-
of lymphocytes migrates, via the blood, from tial in developing a functional immune system,

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Figure 7.5A–B. Antigen-specific receptors on T and B cells
T (panel A) and B (panel B) lymphocytes—essential components of immune responses—are the only
antigen-specific cells in animals. Distinct antigen-specific receptors on each of these cell types allow
for direct interactions with pathogens and their antigens. The left panel shows the TCR embedded in
the membrane of a T cell. The right panel depicts the BCR embedded in the membrane of a B cell.
Ag = antigen.

and if it does not happen (as in nude mice), ani- Secondary Lymphoid Organs
mals lack any sense of immunological self or Because the thymus generates T lympho-
non-self. cytes and the bone marrow (and the bursa of
The mammalian thymus lies right above the Fabricius) generates B lymphocytes, these or-
heart and is largest shortly after birth; it then gans are sometimes referred to as the primary
decreases significantly in size and function after lymphoid organs. The secondary lymphoid
sexual maturity. However, the thymus func- organs are the sites where the cells of the im-
tions in all mammals throughout adult life. mune system and pathogens meet and immune
The outer or cortical region of the thymus responses occur. In animals’ bodies, infections
contains many lymphocytes called thymocytes may begin in three major places: the intersti-
(while they are in the thymus; see Figure 7.6). tial fluid between the cells, the blood, and mu-
The inner or medullary region of the thymus cosal surfaces. Specialized lymphoid tissues or
contains mostly epithelial cells. Somehow, in- organs have evolved to deal with each. Lymph
side this organ, T cells acquire the ability to nodes screen interstitial fluid (lymph) draining
react with non-self. from peripheral tissues, the spleen screens the

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Figure 7.6. Structure of the mammalian thymus
The thymus contains several lobules, each of which can be divided into cortical (outer) and medullary
(central) regions. The cortex contains immature dividing cells, and the medulla contains more mature
cells. Many of these cells (thymocytes) are in the process of becoming T lymphocytes. In addition,
thymic epithelial cells populate both cortical and medullary regions. Finally, the medulla also contains
both macrophages and DCs that originated in the bone marrow.

blood, and the MALT monitors the mucosal beds—a lot of fluid leaks out into the tissues
tissues. that surround the blood vessels. This fluid—
which is a lot like plasma, minus some of the
big proteins—is called lymph. The total volume
Lymph nodes of lymph that forms every day in most animals
All mammals have two circulatory systems: is nearly equal to the total plasma volume.
cardiovascular and lymphatic. The cardiovas- Some means for collecting lymph and return-
cular system is a closed system of arteries and ing it to the circulation is essential, and that is
veins that moves blood through the body to the the function of the lymphatics (see Figure 7.7).
heart, to the lungs, to the heart, and back to the Each of the vessels of the lymphatics termi-
body. Along the way—especially in the capillary nates in a fingerlike projection with inward-

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Figure 7.7. Canine lymphatics and lymph nodes
Lymphatics (upper portion) are a system of open-ended vessels that return extravascular fluid from
the periphery to the heart and blood. Distributed throughout the lymphatics are a series of small
filtering stations called lymph nodes. Each node has both cortical and medullary regions where dif-
ferent aspects of immune responses occur. The medullary regions contain B cells, DCs, T cells, and
macrophages. The cortical regions contain structures called lymphoid follicles. During an immune
response, germinal centers form inside of the lymphoid follicles. Germinal centers contain T cells,
FDCs, and other DCs and some resting as well as rapidly dividing B cells. Each lymph node connects
to the lymphatics via multiple afferent (inflowing) and one efferent (outflowing) lymphatic vessel as
well as to the circulatory system by an arteriole and a venule.

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Figure 7.8. Canine spleen
The spleen (in green) is the site of most immune responses against blood-borne pathogens.

opening valves. Lymph flows out of the cap- paracortical areas (between the cortex and the
illaries, into the interstitial tissue spaces, and medulla), however, contain mostly T cells.
through the valves into the lymphatics. Once
inside the lymphatics, lymph (driven by the con-
traction of skeletal muscles) moves ultimately Spleen
to the thoracic duct and to the right subclavian Although spleen size varies considerably
vein and into the heart. Along the way, many among mammals, the basic structures of all
small nodes appear; these lymph nodes (see spleens are the same. Immunologically, the
Figure 7.7) are filtering stations. During infec- spleen does for blood-borne antigens what
tions, DCs from the periphery deliver antigens lymph nodes do for lymph-borne antigens (see
to the lymph nodes. Blood delivers T cells and Figure 7.8). In addition, with the help of resi-
B cells to lymph nodes. dent macrophages, the spleen recycles some se-
Inside of lymph nodes, T and B cells as well nescent RBCs.
as macrophages and DCs interact to produce Within the spleen, the white pulp contains
immune responses. The cortical regions of the lymphoid tissues. Here, T-cell–rich regions
lymph nodes contain lymphoid follicles and surround the splenic arterioles to form a struc-
germinal centers where B cells proliferate. The ture called the periarteriolar lymphoid sheath.

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Figure 7.9. Structure of lymphoid tissue in the mammalian spleen
PALS = periarteriolar lymphoid sheath

Nearby are B-cell–rich areas that also contain lymph nodes, germinal centers develop in the
germinal centers (see Figure 7.9). spleen when immune responses occur.
The red pulp areas are sites of red blood cell
destruction; the white pulp areas contain the
lymphoid tissues in the periarteriolar lymphoid Mucosa-associated lymphoid tissues
sheaths. As in lymph nodes, the T and B cells The epithelial mucosa of all animals are,
are unevenly distributed between germinal throughout their lives, constantly exposed to
centers and the surrounding tissues. Also as in and colonized by potentially infectious agents,

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especially bacteria. The largest of these surfaces
are the lungs and the gut. All mucosal tissues
contain specialized lymphoid aggregates called
Gut-associated lymphoid tissues (GALT)—a
part of MALT—include Peyer’s patches in the
small intestine and the cecal tonsils. The lym-
phoid tissues of the Peyer’s patches are the
most organized and possibly most important
of these tissues (see Figure 7.10A–B). In the in-
testine, specialized epithelial cells called M cells
transport antigens from the gut lumen into the
lymphocyte-rich areas of the Peyer’s patches.
Approximately thirty to forty groups of Peyer’s
patches appear in an animal’s intestine as elon-
gated areas without villi.
These lymphoid tissues monitor the patho-
gens in the gut and deal with pathogenic organ-
isms, usually without harming the normal gut
flora. Mucosal immunology remains relatively
poorly understood, but it is unquestionably one
of the keys to understanding animals’ immune
systems and animal health.
Bronchus-associated lymphoid tissues—an-
other part of MALT—are not as structured as
GALT. However, the process by which they deal
with inhaled pathogens is very similar to what
occurs in GALT. Somewhat similar lymphoid
tissues also appear on other mucosal surfaces
Figure 7.10A–B. Lymphoid tissues in the small
such as the urethral and vaginal epithelia.
Despite their structural differences, the
Panel A is a diagram of a thin section of small
lymph nodes, spleen, and MALT—with few ex-
intestine. Within this section, the dark purple–
ceptions—all deal with antigens in very similar rimmed ovoid areas represent specialized
ways using the same types of cells. lymphoid tissue called Peyer’s patches—sites of
immune responses in the intestine. Panel B is
a diagrammatic representation of the interac-
Clinical Correlation: Follow-Up tion between the cells of a Peyer’s patch and an
During discussions, the cat’s owner shared that enteric pathogen. M cells carry antigens from
the gut lumen into the Peyer’s patch where DCs
about a week before the cat’s bout of lethargy
process and present these antigens to the im-
and fever, the cat had killed and partially eaten a mune system. As with splenic lymphoid tissues,
small feral rabbit. Wild rabbits are known reser- there are discrete T-cell–rich and B-cell–rich
voirs for tularemia, a sometimes fatal infectious areas where immune responses begin. From
disease in cats. The examining veterinarian re- these areas, cells enter the lymphatics and
quested a lymph node biopsy and a serum titer eventually the blood. From the blood, immune
for Francisella tularensis, the causative agent for B and T cells return to mucosal tissues and
tularemia. mediate protection.

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The biopsy revealed areas of focal necrosis and into the lymph nodes. Much more com-
and lymphoid hyperplasia, whereas the serum monly, lymphadenopathy is the result of pro-
exhibited a titer of 1/80 for F. tularensis. Ap- tective immune responses against infectious
parently, the observed lymphadenopathy was agents. Once antigens (pathogens or pieces of
lymphadenitis, a result of the bacterial infection pathogens), T cells, and B cells arrive inside
as well as the cat’s immune response to the bac- of lymph nodes, immune responses develop.
terium. After antibiotic treatment, the lymph- Each of these immune responses involves mas-
adenopathy resolved, and the cat recovered. sive proliferation of lymphocytes or lymphoid
hyperplasia. These expanding cell popula-
tions cause lymph nodes to swell well beyond
Student Considerations their normal size, as with human mandibular
After having read this chapter and considered nodes during respiratory infections. This swell-
the nature, distribution, and function of lymph ing is a reflection of the essential role of the
nodes, you should be able to offer at least two lymph nodes in immunity and defense against
possible explanations for the symptoms ob- infections.
served in the patient described at the beginning Regardless of the cause, antibiotic therapy
of this chapter. would be the appropriate course of action for
the attending veterinarian. In this case, the na-
ture of tularemia and the fact that the mandib-
Possible Explanations ular and cervical nodes showed areas of focal
The association of lymphadenopathy with necrosis suggested that lymphadenitis was the
infectious diseases occurs for at least two rea- cause of the swollen lymph nodes. The pres-
sons. First, it is possible for the nodes them- ence of antibody against F. tularensis indicates
selves to become infected, resulting in inflam- the cat had eaten an infected tick while killing
mation (lymphadenitis). This lymphadenopa- or feeding on the rabbit, and the presence of
thy results from the inflammation and the this bacterium in the lymph nodes was the un-
movement of cells and fluid out of the blood derlying cause of the lymphadenitis.

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Gerald N. Callahan

Antigens and Antigen Processing Chapter 8


infections, several nations will not accept goats

Clinical Correlation: Caprine Arthritis
from countries where CAEV is enzootic, such
Encephalitis 121
as the United States.
Learning Objectives 122
Genetic studies of symptomatic and asymp-
Stimulators of Adaptive Immunity: Pathogens,
Antigens, and Epitopes 122
tomatic goats have yielded some of the most
Major Histocompatibility Complex 124
significant insights into the pathogenesis of
History of the Major Histocompatibility
CAEV. Genetically, a major difference exists
Complex 124 between unaffected and affected goats. That
Major Histocompatibility Complex Genetics 125 difference maps onto a particular region of the
Structure and Distribution of Major caprine genome known as the major histocom-
Histocompatibility Complex Class I and patibility complex, or MHC.
Class II Molecules 129 Goats that develop arthritis, encephalitis, or
Antigen­–Major Histocompatibility Complex both are more likely to carry one or both of
Interactions 131 two MHC alleles, Be1 and Be14. This finding
Antigen Acquisition, Processing, and suggests that the products of these MHC genes
Presentation 132
play major roles in the pathogenesis of CAEV.
Antigen-Presenting Cells 132
Associations between diseases and MHC al-
Major Histocompatibility Complex Class I
leles are not unique to goats. The first of these
Antigen Processing and Presentation 135
associations was identified in humans, and it
Major Histocompatibility Complex Class II
Antigen Processing and Presentation 136 showed a clear link between expression of a
Cross-Presentation 137 particular MHC class I allele, human leukocyte
Clinical Correlation: Follow-Up 139 antigen–Bw27, and ankylosing spondylitis, a
Student Considerations 140 debilitating autoimmune disease. Other stud-
Possible Explanations 140 ies soon uncovered similar associations in most
species of mammals. Table 8.1 shows MHC al-
leles associated with various diseases in cattle.
Clinical Correlation: Caprine
The MHC alleles of cattle are also called bovine
Arthritis Encephalitis
leukocyte antigen alleles.
When caprine arthritis encephalitis virus (CAEV) Today, it is clear that MHC genes play a role
infects a herd of goats (Figure 8.1), most animals in a variety of diseases in many mammalian
remain healthy even if infected. An unfortunate species. But how MHC genes affect disease
few, however, develop untreatable, debilitating processes remains murky. A more complete un-
diseases that manifest as polyarthritis and oc- derstanding of the relationship between MHC
casionally in kids as encephalomyelitis. Because and disease is likely to offer new insights into
CAEV infection is common and causes lifelong disease prevention and therapy.


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ecules that bind to antibodies, MHC molecules,
or TCRs. The two antigen subcategories are im-
munogens—substances capable of stimulating
an immune response—and haptens—substances
that will not by themselves produce an immune
response but can do so when complexed with a
larger molecules, such as a host protein.
Despite these different ways of speaking
about molecules that interact with immune
systems, in practice most immunologists refer
to all immunogens and haptens simply as an-
Figure 8.1. SouthAfrican goat herd (© WOLF tigens. In the remainder of this book, we con-
AVNI/ Shutterstock)
sider antigens to be any molecules that can
stimulate adaptive immune responses.
Because of their roles in defense, immune
Learning Objectives
systems are generally thought to focus on non-
After reading this chapter, you should be able to self—things foreign to hosts. But not all foreign
things are antigenic, and sometimes parts of
• distinguish among pathogens, antigens, self may be antigenic. How do molecules that
immunogens, and epitopes;
are antigenic and those that are not differ?
• know the properties that make a molecule To be capable of stimulating an adaptive im-
mune response a substance must be
• know the general character of the mam-
malian MHC; • complex,
• distinguish between class I and class II MHC • organic,
genes and molecules; • degradable,
• understand how MHC molecules bind anti- • large.
gens and the differences between antigens
bound by class I or class II molecules; These properties are necessary for a mol-
• know the different classes of APCs and ecule to be antigenic, but not all complex,
their distributions; organic, degradable, large molecules are anti-
• understand how APCs process and present genic in any given animal. For example, bovine
antigens and the roles of MHC class I and
serum albumin fulfills all of these conditions
class II molecules in this process;
and is, thus, antigenic in mice, but under nor-
mal conditions bovine serum albumin is not
• explain why certain MHC genes may pre- antigenic in cattle. So, often (but not always),
dispose animals to some diseases.
an antigenic molecule must, in addition to all
of the preceding properties, be recognizably
Stimulators of Adaptive
All living things carry unique chemical sig-
Immunity: Pathogens,
natures, which is what separates one animal or
Antigens, and Epitopes
even one bacterium from another. Among those
The word antigen apparently arose as a conden- chemical signatures, proteins are the most indi-
sation of the words antibody generator, but that vidually distinct. Among the biological macro-
is not exactly what all antigens are. More accu- molecules, no other group so finely differenti-
rately, antigens are molecules or pieces of mol- ates individual organisms.

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Table 8.1. Cattle MHC alleles and disease susceptibility
Bovine major histo-
Disease Breed compatibility system Effect
Enzootic bovine leukosis
Seroconversion Holstein A14 Late
Holstein A15 Rapid
Guernsey A21 Late
Guernsey DA6.2, A12 Rapid
Peripheral lymphocytes and B-cell Shorthorn DA7 Resistance
Shorthorn DA12.3 Susceptibility
I. Shorthorn A6, EU28R Susceptibility
I. Shorthorn A8 Resistance
Holstein A12 and A15 Susceptibility
Holstein A14 and A13 Resistance
Holstein DRB22A Resistance
Holstein DRB21C Susceptibility
Holstein DRB3(ERmotif ) Resistance
Holstein DRB3(ERmotif ) Resistance

Clinical mastitis Norwegian Red A2 Resistance
Norwegian Red A16 Susceptibility
Swedish Red & White DQ1A Susceptibility
Holstein A11 Resistance
Holstein CA42 Susceptibility
Subclinical mastitis (cell count) Icelandic A19 Susceptibility
Simmental (S) or S × Red Holstein A15 High
Danish Black Pied A11, A30 Low
Danish Black Pied A21, A26 High
California Mastitis Test Holstein A14 Low

Nematodes Belmont Red A7, CA36 Resistance
Africander × Hereford A9 Susceptibility

Theileria parva Bos indicus Class I Parasite entry

Boophilus Microplus Brahman × Shorthorn A6, CA31 Susceptibility
Posterior spinal paresis Holstein A8 Susceptibility
Ketosis Norwegian Red A2, A13 Resistance
Retained placenta Dutch Friesian Compatibility Susceptibility

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Proteins make all life possible. Proteins are, all pathogen parts are equally antigenic, not
of course, strings of amino acids linked by pep- even all the proteins. Beyond that, not all parts
tide bonds. But unlike carbohydrates or nucleic of pathogen-derived antigenic proteins are
acids, at every position in a protein there are equally antigenic (see Figure 8.2). Some pieces
twenty possible amino acids to choose from. of the pathogen’s proteins stimulate strong re-
That makes proteins unique identifiers—mark- sponses, whereas others go unrecognized. For
ers that set each animal apart from all the example, Figure 8.2 shows antigenic portions
rest. Adaptive immune systems exploit those of proteins that stimulate immune responses
differences. (red or yellow) and other portions that fail to
Proteins are the most potent of all antigens, stimulate immune responses (green).
and the antigenicity of most pathogens de- The parts of proteins that stimulate immune
pends on their protein components. Whether responses are called antigenic epitopes (or sim-
a protein stimulates an immune response, how- ply epitopes) and come in at least two forms—
ever, depends on the properties of that protein. continuous and discontinuous. A continuous
Artificial proteins constructed from a single epitope is the product of the contiguous amino
amino acid—for example, homoalanine—elicit acids in the primary sequence of the protein. A
no immune responses. Complexity appears to discontinuous epitope involves noncontiguous
be an absolute requirement for antigenicity. amino acids and results from the secondary, ter-
Similarly, a protein constructed from D-amino tiary, or quaternary structure of the protein, as
acids will not stimulate an immune response in shown in Figure 8.2. Because of the manner in
any animal. All naturally occurring amino acids which they acquire antigens, MHC molecules
are L-amino acids. Because of that, all naturally bind only continuous antigenic epitopes. Only
occurring proteases have evolved to focus on B-cell receptors and antibody molecules (see
L-amino acids and cannot split peptide bonds chapters 11 and 12) recognize and bind to dis-
formed between D-amino acids. To be antigenic, continuous antigenic epitopes.
a protein must be complex and degradable by
naturally occurring proteolytic enzymes.
Enzymatic degradation of proteins is essen- Major Histocompatibility
tial, because T cells—essential components of Complex
all immune responses—cannot recognize in-
History of the Major
tact proteins. Before an immune response can
Histocompatibility Complex
begin, antigenic proteins must be chopped into
pieces and presented by an MHC molecule, and Nearly as long as people have known about
MHC molecules only bind to peptide bits of the origins of cancers, scientists have been
protein antigens. interested in the role of immunity in defense
Small proteins (<2,500 molecular weight) against tumors. As discussed further in chapter
make poor antigens, and inorganic molecules— 17, in the early 1960s Sir MacFarlane Burnet and
unless coupled to proteins—generally do not Lewis Thomas even went so far as to propose
elicit immune responses. Inorganic molecules that a primary role of mammalian immune
are not usually major parts of the pathogenic systems was to detect and destroy tumors. This
world. Also, of course, immune systems have proposal came to be called the theory of im-
evolved to focus on pathogens—transmissible mune surveillance.
agents of disease: viruses, bacteria, fungi, and To investigate this theory, scientists began
parasites. studying mouse tumors. Initially, those studies
Almost all pathogens induce a wide range of focused on transplanting tumors from mouse
immune responses. Interestingly, though, not to mouse. Some transplanted tumors grew well

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lografts depended on the similarity or dissimi-
larity of only a few genes. Because these genes
had a major effect on tissue (or histo-) compat-
ibility, they were called the major histocompat-
ibility complex, or MHC.
Each species has its own set of MHC genes
and, within each species, a unique name for the
MHC. Because these molecules were originally
found on white blood cells, almost every MHC
name contains the words leukocyte antigen. The
MHC in humans is also called the HLA (human
leukocyte antigen) complex, in monkeys it is
also called the RHA (rhesus leukocyte antigen)
complex, in cattle it is BLA (bovine leukocyte
antigen) complex, and so on. Only mice and
rats depart from this general rule. The MHC of
mice is called H-2 and the MHC of rats is called
Although they were discovered during trans-
plantation experiments, these genes did not
evolve simply to frustrate transplant surgeons.
Instead, the products of MHC genes bind and
Figure 8.2. Antigenic
epitopes of an present antigens to T cells, and those T cells
immunogenic protein direct immune responses. Sometimes those im-
Not all portions of a protein activate the host’s mune responses cause graft rejection, but more
immune system. Those segments that do stimu- often they help to protect animals from the
late immunity are antigenic epitopes. They can pathogenic world.
be of two types: continuous epitopes involving
adjacent amino acids (shown in red) or discon-
tinuous epitopes formed by the secondary or Major Histocompatibility
tertiary structure of the protein (shown in yel- Complex Genetics
low). Here, each ball represents an amino acid.
The basic structure of the MHC is similar in
all mammals. Figure 8.3A–C shows the MHCs
in some mice, but not in others. For this reason, of horses, humans, and mice.
some investigators thought they had discov- Within each MHC are three distinct gene
ered tumor-specific factors that might be ma- types: MHC class I, MHC class II, and several
nipulated for cancer treatment. But in similar other genes called MHC class III. Also, the
experiments using normal tissues, scientists got products of DM, DN, and DO genes in humans
the same results. Instead of something unique and H-2M in mice, although structurally ho-
to tumors, what these scientists had discovered mologous to other MHC class II molecules, are
was a group of genes whose products deter- much less variable and function differently than
mined the immunological compatibility of tis- other MHC class II gene products.
sues (malignant and otherwise) transplanted From end to end, the MHC in mice and hu-
from one mouse strain to another. mans spans about 4 × 106 base pairs. Each MHC
Studies with other mammalian species yiel­ contains multiple genes encoding class I MHC
d­ed similar results: the success or failure of al- molecules and multiple genes encoding class

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Figure 8.3A–C. Diagrammatic representation of the chromosomal organization of MHCs of horses,
humans, and mice
MHC class I genes are shown in red, and MHC class II genes are shown in yellow. All mammalian MHCs
contain additional genes (sometimes called class III genes) that are involved in some immune and non-
immune functions unrelated to the roles of MHC class I and II genes (shown in green and blue).

II MHC molecules. In the mouse MHC, three rate loci encode four distinct MHC class I mol-
separate loci code for three different MHC class ecules, and five separate regions produce five
I molecules, and two distinct regions code for separate MHC class II molecules. Expression of
MHC class II molecules. In horses, four sepa- MHC class I and II genes is codominant, mean-

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Figure 8.4. MHC gene polymorphism
Except for the DRα locus, each MHC class I and MHC class II locus has many possible alleles, which
means that among populations of mammals enormous variety is present in the genetic characteristics
of the MHC.

ing that each animal expresses the alleles on animal’s immune system. Up to a point, the
both parental chromosomes. more MHC molecules an animal has, the more
MHC proteins, as mentioned earlier, bind pathogens it can effectively present to its im-
bits of protein antigens and present them to T mune system. Therefore, multiple loci help to
cells. If that does not happen—if some patho- protect each mammal from a diverse and evolv-
gen escapes MHC molecules—the host animal ing pathogenic world.
is more likely to succumb to that infection. To Beyond multiple loci, the genes of the MHC
deal with this potential problem, each MHC are the most polymorphic genes in mammals.
molecule has evolved to bind a variety of an- Thus, at every locus that encodes an MHC
tigens, but in spite of that evolutionary pres- molecule, there are many possible alleles. For
sure, no one MHC molecule can bind all po- example, humans have six loci involved in pro-
tential antigens. Instead, over time, the MHC ducing MHC class II molecules—DPα, DPβ,
of mammals has grown to include multiple loci DQα, DQβ, DRα, and DRβ. Every human has
encoding class I and II MHC molecules. Those all of these loci, but not all humans have the
additional loci add another level of protection. same allele at each locus. The human popula-
Multiple loci encoding MHC class I and class tion has at least 20 different alleles possible at
II molecules reduce the chance of an animal’s the DQα locus, 89 at the DPβ locus, 45 at the
encountering a pathogen that can escape the DQβ locus, 20 at the DQα locus, 323 at the

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DRβ locus, and 2 at the DRα locus (see Figure
As a result, in addition to multiple MHC loci
in each individual, there are multiple alleles at
each MHC locus in the population at large. So,
although every human being has a DRβ locus,
it is rare for two unrelated people to have the
same allele at that locus, meaning that among
humans, as with most other animal popula-
tions, finding two human beings with the same
set of genes in their MHCs is extremely im-
probable (except for identical twins). Because
the products of these genes also play a role in
graft rejection, MHC polymorphism is a major
reason for the difficulties in finding compat-
ible kidney, heart, or liver donors for identified
recipients. Much more important, MHC poly-
morphisms offer essential protection for both
individuals and species.
Usually, when an infectious disease strikes a
population of animals, some individuals will
die and others will survive. One significant dif-
ference between survivors and fatalities is often
the complement of MHC molecules present
in each individual. Some animals will have the Figure 8.5. African
MHC molecule needed to present the critical (© Anna Omelchenko / Shutterstock)
antigenic epitope or epitopes to the immune African cheetahs are genetically very homoge-
system and neutralize the pathogen, and others neous and at risk for decimation by infectious
will not. pathogens.
Thus, species-wide MHC polymorphisms
dramatically reduce the likelihood that a single
infectious agent will destroy an entire popula- an infectious disease kills one animal, it is likely
tion of animals. Some notable exceptions to this that it will kill every animal.
include African cheetahs, Florida panthers, and For the lions of the Ngorongoro crater, geo-
the lions of Ngorongoro crater in Tanzania. graphical isolation led to genetic bottleneck-
Between 10,000 and 20,000 years ago, the ing. The result, however, was the same. In 1962,
cheetah population dwindled to one or two an infestation of biting flies and their parasites
mating pairs. All of the cheetahs alive today killed all but ten or so of these lions.
came from those mates. Because of this, chee- Much more recently, genetic bottlenecking
tahs are now genetically nearly identical. This happened in the Florida panther. All of the
sort of event is called genetic bottlenecking. Florida panthers alive in the twentieth century
Cheetahs are now so similar, they do not re- appear to have come from a single female. Dis-
ject skin grafts from one another, their MHCs ease and human pressures nearly destroyed this
are nearly identical, and when their hides are population. In 1995, five Texas pumas were in-
stacked atop one another, all of the spots line troduced into panther habitat, and the result-
up perfectly. In a population such as this one, if ing hybrids appear to be doing well. However,

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Figure 8.6A–C. MHC class I structure
Approximate representations of MHC class I molecules. Panel A shows a ribbon diagram of the MHC
class I α chain (MHC derived) and β2-microglobulin. The tertiary structure of the class I α chain
contains three separate structural domains: α1, α2, and α3. The α1 and α2 domains form a cuplike
groove near the N-terminal region of the molecules and form the peptide–antigen binding site. Flat
ribbons ending in arrows indicate regions of β-pleated sheet, and the helical ribbons indicate regions
of α-helix. Panel B shows a top view of the MHC class I peptide–antigen binding site. Note how the
α-helical regions frame the flat segments of β-pleated sheet to form the binding site. Panel C shows
a diagrammatic representation of an MHC class I molecule including the transmembrane domain of
the α chain. The purple band across the figure bottom represents the lipid-bilayer outer membrane of
a eukaryotic cell. (Panels A and B adapted from C. Janeway, P. Travers, M. Walport, and M. Shlom-
chik, 2006, Immunobiology, 122)

because of the MHC homogeneity in these spe- tide chains. MHC class I molecules contain an
cies, some scientists predict that none of these MHC-encoded α chain and a smaller molecule
populations will survive the next few decades. called β2-microglobulin. Both of the two chains
of MHC class II molecules, α and β, come from
genes within the MHC (see Figure 8.6A–C).
Structure and Distribution of Although MHC class I and II molecules have
Major Histocompatibility Complex similar tertiary and quaternary structures,
Class I and Class II Molecules these MHC molecules are chemically distinct.
Both MHC class I and II molecules are cell- Those chemical distinctions result in some im-
surface glycoproteins composed of two polypep- portant structural differences at the antigen-

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Figure 8.7A–C. MHC class II structure
Approximate representations of MHC class II molecules. Panel A shows a ribbon diagram of the
MHC class II α chain and β chain. Each chain contains three separate structural domains: α1, α2, and
α3, as well as β1, β2, and β3. The α1 and α2 domains, along with the β1 and β2 domains, form a cuplike
groove near the N-terminal region of the molecules and form the peptide–antigen binding site. Panel
B shows a top view of the MHC class II peptide–antigen binding site. Panel C shows a diagrammatic
representation of an MHC class I molecule including the transmembrane domain of the α and β
chains. The purple band across the figure bottom represents the lipid-bilayer outer membrane of a
eukaryotic cell. (Panels A and B adapted from C. Janeway, P. Travers, M. Walport, and M. Shlomchik,
2006, Immunobiology, 123)

binding site. For this reason, MHC class I and binding grooves. Only the α chain spans the
class II molecules bind distinct sets of antigenic lipid bilayer. β2-microglobulin binds noncova-
peptides. In addition, the biosynthetic pathways lently to the MHC class I α chain and is mono-
of MHC class I and class II molecules differ (dis- morphic. Two short stretches of α-helix above
cussion follows). Because of that difference, a relatively flat plane of β-pleated sheet (all part
class I and II molecules bind antigenic peptides of the MHC class I α chain) frame the antigen-
in different intracellular compartments and binding groove of MHC class I proteins (see
present these antigens to distinct subsets of T Figure 8.6A–C).
cells. Both the α and β chains of MHC class II mol-
In MHC class I molecules, only the α chains ecules come from the MHC region, both span
are encoded in the MHC. The first and second the cell membrane, and both contribute to the
domains of these α chains—where all of the al- antigen-binding groove of the molecule. Again,
lelic polymorphisms reside—form the antigen- two coils of α-helix above a plane of β-pleated

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sheet create the groove itself. In MHC class II
molecules, however, the ends of the α-helices
are further apart than in MHC class I mol-
ecules, leaving open ends to the groove. Be-
cause of this, MHC class II molecules can bind
slightly larger peptides than those bound by
MHC class I molecules. However, the peptides
bound by MHC class I or II molecules are not
large enough to have significant secondary or
tertiary structure. As a result, only linear, con-
tinuous antigenic epitopes bind to MHC mol-
ecules. Together, the binding cleft of MHC
molecules and their bound peptides create the
ligands recognizable to T lymphocytes. Figure 8.8. Antigen binding by MHC class I
Still, MHC class I and class II molecules play molecules
very different roles in developing immune re- This ribbon diagram shows an approximation
sponses, and the tissue distribution of MHC of an MHC class I molecule–peptide complex
class I and class II molecules reflects their from above. Two stretches of α-helix near the
unique roles. MHC class I antigens appear on N-terminal portion of the α chain form the
all or nearly all nucleated cells, whereas MHC boundaries of the binding cleft. The antigenic
class II molecules appear only on APCs. Recall peptide lies in the binding cleft of the MHC
from earlier chapters that macrophages and class I molecule. The diagram also shows the
noncovalent interactions (in red) between
DCs are APCs, as are B cells and other cells such
amino acid side chains of the MHC α chain and
as astrocytes in the central nervous system and
the peptide. (Adapted from C. Janeway,
thymic epithelial cells. P. Travers, M. Walport, and M. Shlomchik, 2006,
Immunobiology, 125)
Antigen–Major Histocompatibility
Complex Interactions
As mentioned, each MHC molecule will bind the MHC molecule, but the rest of the peptide
multiple (but not all) antigenic peptides, which is irrelevant to MHC binding. That degenerate
means the interactions between antigens and specificity allows MHC molecules to bind many
MHC molecules have some specificity. That different antigenic peptides. As a result—using
specificity comes from noncovalent interac- a relatively small amount of DNA—mammals
tions between certain amino acids in the bind- are capable of defending themselves against
ing cleft and amino acids in the antigenic pep- most pathogens.
tide (see Figure 8.8). MHC class II molecules bind peptides of
MHC class I molecules bind eight- to ten- varying lengths (typically from twelve to twenty-
amino-acid-long peptides (see Figure 8.8 and four amino acids). Because the binding cleft of
Figure 8.9), but not all of the amino acids MHC class II proteins is open at both ends, the
in each peptide are equally important to the absolute length of the peptide is less important
binding affinity. Instead, MHC class I–peptide than is the position of certain amino acids rela-
interactions depend on as few as two amino tive to one another (see Figures 8.10 and 8.11).
acids. The spacing of those two amino acids Again, not all of the amino acids in the pep-
is critical, because they must line up with cor- tide bind to the MHC class II molecule, and
responding amino acids in the binding cleft of as few as two amino acids may determine the

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Figure 8.9. Molecular
properties of peptides
bound by MHC class I molecules Figure 8.10. Antigen binding by MHC class II
Upper and lower panels show the amino acid molecules
sequence of peptides that bind to two different This ribbon diagram shows an approximate
MHC class I alleles. Although all of the peptides representation of an MHC class II molecule–
differ, the green amino acids indicate the fea- peptide complex from above. Two stretches of
tures they share. In the first set of peptides, the α-helix—one from the N-terminal portion of
amino acid found at position 5 must be either the α chain and the other from the N-terminal
phenylalanine (F) or tyrosine (Y), and the amino portion of the β chain—form the boundaries of
acid found at the C-terminal position must be the binding cleft. The antigenic peptide lies in
leucine (L). Similarly, peptides that react with the binding cleft of the MHC class II molecule.
the second MHC class I allele must contain In addition, the diagram shows the noncovalent
tyrosine at position 2 and a C-terminal valine interactions between amino acid side chains of
(V), leucine, or isoleucine (I). In addition, the the MHC α and β chains and the peptide in red.
length of the peptides is critical. For the first (After C. Janeway, P. Travers, M. Walport, and
MHC class I allele, each peptide must be exactly M. Shlomchik, 2006, Immunobiology, 127)
eight amino acids long, whereas for the second
allele, each peptide must be exactly nine amino
acids long. The critical points of interaction for MHC class I and II molecules also routinely bind
the first allele are the amino group at the pep- and present self peptides. MHC molecules bind
tide’s N-terminus, amino acids 5 and 8, and the and present almost all intracellular and extracel-
hydroxyl group at the C-terminus. The amino lular proteins—self or non-self. For a variety of
acids at all of the other positions in these pep- reasons (discussed in subsequent chapters), this
tides are irrelevant to the peptide’s MHC class does not routinely result in autoimmune de-
I binding affinity. This specificity is relatively struction of self tissues. As you will see, though,
degenerate, meaning that any given MHC class in type II hypersensitivities and other disorders,
I allele will bind many peptide antigens, but not self-presentation and autoimmunity are at the
all. (Adapted from C. Janeway, P. Travers, M.
root of many animal diseases.
Walport, and M. Shlomchik, 2006, Immunobiol-
ogy, 126)
Antigen Acquisition,
Processing, and Presentation
capacity of a peptide to bind to an MHC class
II molecule. Antigen-Presenting Cells
It is important to recognize that, although this The function of MHC class I and class II mol-
discussion focuses on the antigens of pathogens, ecules is to present peptide antigens to T lym-

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Figure 8.11. Antigen-binding motif of MHC class II molecules
Because the ends to the antigen-binding cleft of MHC class II molecules are open, the molecules bind
peptides of varying lengths (typically twelve to twenty-four amino acids). The gray regions represent
the portion of the peptide containing the anchor residues—the amino acids actually within the binding
site of the MHC class II molecule. The peptides that bind to this particular MHC class II molecule range
from thirteen to nineteen amino acids long. However, among all of these peptides, only amino acids 4
and 9 appear critical for binding to this MHC class II allele. Amino acid 4 must be aspartic acid (D) or
glutamic acid (E). Amino acid 9 must usually be a hydrophobic or uncharged amino acid—tyrosine (Y),
isoleucine (I), proline (P), threonine (T), phenylalanine (F), asparagine (N), or glutamic acid. As with
MHC class I molecules, this specificity is relatively degenerate (especially compared with the specificities
of B- and T-cell receptors). So, each MHC class II molecule can bind many different, but not all, peptides.
(Adapted from C. Janeway, P. Travers, M. Walport, and M. Shlomchik, 2001, Immunobiology, fig. 3.26)

Table 8.2. Distribution and properties of APCs

Macrophage DC B cell
MHC-II expression Low levels; induced by PAMPs, Always expressed Always expressed; inducible
DAMPs, and cytokines on activation
Antigen type and pre- Extracellular antigens: presen- Intracellular & extracellu- Extracellular antigen binds to
sentation by MHC tation via MHC II lar antigens: presentation specific Ig receptors: presenta-
via MHC I & MHC II tion via MHC II
Location Lymphoid tissue Lymphoid tissue Lymphoid tissue
Connective tissue Connective tissue Blood
Body cavities Epithelium

phocytes. The cells that use MHC class I and of antigens (see Table 8.2), and each APC has
class II molecules to perform this function are a unique distribution in peripheral tissues and
APCs. Outside the primary lymphoid organs secondary lymphoid organs. In addition, these
and the central nervous system, macrophages, cells differ in how they acquire antigen and
DCs, and B cells are the major APCs (see Fig- what they do with it (see Figures 8.12, 8.13, and
ures 8.12–8.14). 8.14).
All of these cells share certain characteristics, There are several important DC subsets, in-
but each excels at acquisition of certain types cluding lymphoid, plasmacytoid, myeloid, and

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Figure 8.12. Macrophage photo and drawing
The large cell in the center is a macrophage with pseudopodia. Macrophages acquire antigens by
phagocytosis and endocytosis.

Figure 8.13. DC: photo and drawing

This cell is called a DC because of the long processes. These cells also acquire antigens through
phagocytosis or endocytosis.

follicular. Each differs in location and effective- Macrophages and DCs acquire antigens in
ness as an APC. In peripheral tissues, myeloid several ways—through fluid-phase macropino-
DCs seem to be most common. We focus pri- cytosis, endocytosis, and phagocytosis of whole
marily on myeloid DCs. pathogens. Endocytosis and phagocytosis can

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Figure 8.14. B cells
Graphic representation of mammalian B cell (right panel) and micrograph of a B cell (labeled “lym-
phocyte” in left panel). This mononuclear cell is one of two types of white blood cells called lympho-
cytes, a B lymphocyte or B cell. It is the ultimate source of antibody molecules. B cells use BCRs to
specifically bind antigen, endocytose it, and process it.

occur via PRRs such as the MR and scavenger I molecules mostly present intracellular anti-
receptor (see chapters 3 and 6). Simple high- gens, and MHC class II molecules mostly pre­
mannose glycoproteins are present in greatest sent antigens from outside of the cell (extracel-
quantities on prokaryotic organisms, because lular antigen).
these organisms do not have Golgi apparati A subset of all proteins produced in the cyto-
where most complex sugar modifications occur sol of eukaryotic cells includes misfolded, mu-
in eukaryotes. tant, damaged, and excess proteins. To maintain
B cells acquire antigens only through recep- cellular homeostasis, the cell needs to divest it-
tor-mediated endocytosis. For this purpose, B self of these proteins. For this purpose, eukary-
cells use a unique receptor—the BCR. The anti- otic cells have evolved specialized cellular struc-
gen-binding part of that receptor is, of course, tures called proteasomes—large barrel-shaped
the same as the antigen-binding region of an protein complexes in the cytosol of eukaryotic
antibody molecule. B cells are the only APCs cells. Proteolysis (the breakdown of proteins)
that acquire antigens in an antigen-specific occurs within the core of proteasomes. Each
manner. proteasome core contains one α ring at each
end and two β rings in between (see Figure
Major Histocompatibility Beta rings have three enzymatically active
Complex Class I Antigen sites with three separate specificities. B1 cleaves
Processing and Presentation on the C-terminal side of hydrophobic resi-
Inside animals are two spaces where infec- dues; B2 cleaves on the C-terminal side of basic
tious agents may proliferate—inside of cells (in- amino acids; and B3 cleaves on the C-terminal
tracellular) and outside of cells in fluid spaces side of acidic residues. As a result, intact pro-
(extracellular). For an immune system to be teins enter one end of the proteasome, and
protective, it must have information about peptides of various lengths exit the other end
events in both of those two spaces. MHC class of the proteasome. Although they all perform

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ER. As each MHC protein assembles, the prod-
uct extrudes into the lumen of the ER. Inside
the ER, nascent MHC class I molecules, as-
sociated with chaperone proteins, bind β2-
microglobulin, acquire peptide antigens, and
assume their final configurations. Because of
TAP transporters, the peptides available to
MHC class I molecules include not only those
present in the ER but also those created in the
cytosol (see Figures 8.16 and 8.17).
As MHC class I α-chain proteins extrude off
ribosomes and into the ER, they associate with
a series of molecular chaperones. These mol-
ecules, along with β2-microglobulin, force the
α-chain–β2-microglobulin complex into an an-
tigen-binding form. After antigen binding, the
MHC α-chain–β2-microglobulin complexes,
Figure 8.15. Mammalian proteasome along with the bound antigen, move from the
Proteasomes are cellular structures that digest
ER to the Golgi complex and finally to the cell
intracellular proteins into short stretches of surface. This process occurs inside most mam-
linear polypeptides and are essential to normal malian cells. For this reason, most cells present
antigen processing. an exterior image of internal events. As you will
see, a particular T-cell subset—CD8+ T cells—
takes advantage of this image to find and de-
similar functions, not all proteasomes are alike. stroy infected cells.
At least two proteasome subtypes have been
identified—immunoproteasomes and thymo-
proteasomes. How these subtypes affect im- Major Histocompatibility
mune responses remains unclear. Regardless, Complex Class II Antigen
one end of cellular proteasomes collects rep- Processing and Presentation
resentatives of all intracellular proteins (self What about extracellular infections, microbes
or non-self ) and digests them into smaller pep- that never reside in a cell’s cytosol, or organ-
tides. Mammalian immune systems use those isms such as leishmania that grow inside of in-
peptides and transporters associated with anti- tracellular vesicles? Monitoring for extracellular
gen presentation (TAPs) to deliver those pep- and intravesicular infections is the function of
tides into the endoplasmic reticulum (ER). MHC class II molecules. As with MHC class I
In the absence of infection, the proteins en- molecules, class II molecules are also synthe-
tering and the peptides leaving proteasomes are sized on and extruded into the lumen of the
all parts of self. As we discuss later, immune rough ER (see Figures 8.18 and 8.19).
systems—for the most part—ignore self. How- Unlike class I molecules, as soon as MHC
ever, if an intracellular virus or bacterium is class II α and β chains associate inside the ER,
actively assembling itself inside of a host cell, a protein called the invariant chain (Ii) binds to
the proteasomes will also be delivering peptides and blocks the antigen-binding cleft. Because
derived from that virus or bacterium. of this, no antigenic peptide inside of the ER
The first phase of MHC class I molecule as- can bind to an MHC class II molecule. Also, un-
sembly occurs on the ribosomes of the rough like MHC class I molecules, after MHC class II

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Figure 8.16. Antigen processing and presentation by MHC class I molecules
As with all proteins destined for the cell surface, MHC class I molecules, as they are synthesized,
insert their N-termini into the ER but remain anchored in the ER membrane (A). Inside the ER, the
body of MHC class I α chains interact with a series of chaperone proteins (shown here in gray) that,
along with β2-microglobulin (purple), force the α chain into its final configuration (B). A subset of all
proteins made in the cytosol collects in proteasomes where enzymes cleave the proteins into small
peptide fragments. The TAP moves these peptides into the lumen of the ER (C). Once inside the ER,
the peptides encounter MHC class I molecules. Under the right conditions, the peptides bind into the
antigen-binding groove of MHC class I molecules. The chaperone proteins detach (D), and the MHC
class I–peptide complex continues on to the Golgi complex and then to the cell surface (E).

molecules pass through the Golgi complex, CLIP dissociates. Removal of CLIP leaves the
they move—via the trans-Golgi network—into antigen-binding groove empty so that exog-
acidic vesicles that fuse with lysosomes. enously acquired antigenic peptides can bind to
Pathogens and other antigens acquired by the MHC class II molecule. All of this ensures
macropinocytosis, phagocytosis, or receptor- that most MHC class II molecules bind antigens
mediated endocytosis end up in endosomes that came from outside of the APCs.
or phagosomes that eventually fuse with ly- From the endolysosome–phagolysosome
sosomes. So in the end, endosomes and lyso- com­­partment, MHC class II molecules, along
somes contain extracellular antigens and MHC with bound antigens, move to the surface of
class II molecules. the APCs, where they present an antigenic pic-
Recall from chapter 6 that lysosomes are ture of what is happening in the extracellular
acidic compartments filled with proteolytic en- space near the APC and within vesicles inside
zymes. As endosomes or phagosomes carrying the APC. A T-cell subset—CD4+ T cells—mon-
exogenously acquired antigens (which may in- itors MHC class II molecules and their con-
clude pathogens) fuse with lysosomes, protein tents and, when appropriate, initiates immune
antigens are quickly chopped into peptides. The responses.
enzymes in lysosomes also remove most of the
Ii from MHC class II molecules. The last piece
of Ii—the CLIP—remains bound to the bind- Cross-Presentation
ing groove until the very last, when an MHC As we have discussed, generally MHC class
class II surrogate molecule (human leukocyte II molecules present extracellular antigens, and
antigen-M in humans) alters the structure of MHC class I molecules present intracellular an-
MHC class II molecules in such a way that the tigens, which allows for presentation to specific

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viruses). These cells recognize antigens bound
by MHC class I molecules and destroy infected
However, many effective immune responses
require antigen presentation to both Th and Tc
cells. For example, effective immune responses
to virus infections often require both antibody
and Tc cells. Antibody production usually in-
volves CD4+ Th cells that require antigen pre-
sentation via MHC class II molecules. CD8+ Tc
cell activation, however, requires antigen pre-
sentation in the context of MHC class I mole-
cules. Thus, the virus would have to both infect
the DC cell (entering the cytosol, a traditional
pathway for MHC class I presentation) and
enter the endosomal pathway through phago-
cytosis for MHC class II presentation. Phagocy-
tosis of viral particles by DC cells occurs regu-
larly and efficiently. However, virus infection of
DC cells is a relatively rare event.
To deal with this, DCs have evolved cross-
presentation, a process that allows extracellular
antigen to be processed and displayed in MHC
class I molecules (in addition to MHC class II
molecules). When a DC phagocytoses a dead
Figure 8.17. Overview
of antigen processing and cell containing viral particles, the DC can shut-
presentation by MHC class I molecules
tle viral antigens into both the MHC class II and
As antigens are synthesized inside of cells (A), a the MHC class I processing pathway and pre­
portion of the antigenic proteins (B) enter cel-
sent to both CD4+ and CD8+ T cells.
lular proteasomes (C). Those organelles digest
The cellular mechanisms by which DCs
these antigenic proteins into peptides. TAPs (D)
deliver these peptides into the ER.
cross-present extracellular antigens to MHC
(E) There, antigenic peptides bind with MHC class I molecules are still obscure. Some anti-
class I molecules, and endosomes (F) transport gens appear to be simply exported from the
them to the cell surface (G), where they present phagolysosome to the cytoplasm where protea-
these peptides to T cells. somes process them. The TAP moves the result-
ing peptides into the ER lumen for loading onto
MHC class I molecules. Other antigens seem to
T-cell subtypes best equipped to respond to be cross-presented without the involvement of
antigens, based on whether a given antigen is the proteasome and TAP. In this case, it may
extracellular or intracellular. be that MHC class I molecules interact with
For instance (discussed in later chapters), antigens in specialized endosomes. Regardless,
CD4+ T (Th) cells are most effective against cross-presentation is an important process by
extracellular pathogens. These cells recognize which APCs can monitor antigens within the
antigens bound by MHC class II molecules. cytoplasm of other host cells and potentially
However, CD8+ T cells (Tc cells) are most ef- stimulate T-cell responses that most effectively
fective against intracellular pathogens (such as deal with intracellular infections.

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Figure 8.18. Antigen presentation by MHC class II molecules
MHC class II molecules are also synthesized on ribosomes and extruded into the lumen of the ER.
However, as MHC class II proteins arrive inside the ER, another molecule—the invariant chain, or Ii
(shown here in orange)—binds to them (A). The Ii covers the antigen-binding site and prevents MHC
class II molecules from presenting the same set of peptides bound by MHC class I molecules. The
MHC class II–Ii complex then enters the endolysosomal pathway (B) and eventually ends up inside of
endolysosomes. There, a protease removes all but a small piece of Ii from MHC class II molecules.
That small remaining piece is called class II–associated Ii peptide (CLIP). As APCs acquire pathogens
from their surroundings via phagocytosis and endocytosis, the resultant phagosomes and endosomes
containing extracellular antigens eventually fuse with lysosomes to form phagolysosomes and endoly-
sosomes. Inside of these compartments, proteolytic enzymes cleave the pathogen’s proteins into pep-
tides (C). At the same time, the CLIP leaves the antigen-binding site of the MHC class II molecules,
which allows for binding of antigenic peptides in the endolysosome. Portions of the endolysosome
along with MHC–antigen complexes then return to the cell surface via recycling endosomes, which
fuse with the cell membrane (D).

The end result of antigen acquisition, pro- MHCs. Goats that develop arthritis or en-
cessing, and presentation within MHC mol- cephalitis often carry one or both of two MHC
ecules is a cell-surface representation of ev- genes—Be1 and Be14—and disease-free goats
erything occurring in and around host cells. have a higher incidence of Be7.
Mammalian immune systems rely on this infor- Among infectious diseases of goats, CAEV is
mation to detect and respond to infectious non- one of the most common. As with other ret-
self and sometimes to mutant self. roviruses, these infections are lifelong, and re-
crudescence or transmission of the virus may
occur at any time. Goats most commonly pass
Clinical Correlation: Follow-Up
the virus to kids in the colostrum and milk of
As we said at the beginning of this chapter, infected dams. Goats exposed to CAEV often
only a few goats infected with CAEV develop develop persistent infections, slowly developing
disease. Exactly why remains unclear. A major arthritis of their carpal joints and mastitis. Only
factor seems to be the makeup of the goats’ rarely do adult goats develop encephalitis.

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sort of association is not unique to goats. So far,
it appears that MHC–disease associations occur
in all mammals.

Student Considerations
Why might a particular MHC allele make an
animal more or less susceptible to a certain dis-
ease? From what you have just learned about
the function of MHC molecules, you should
be able to offer one or two explanations for the
association between CAEV and MHC genes—
explanations that apply to any association be-
tween a disease and an MHC allele.

Possible Explanations
The exact reasons for these associations re-
main unknown, but at least two possibilities
seem obvious. Because of the roles of MHC
class I and class II molecules in antigen bind-
ing and presentation, a disease might arise in an
animal that was unable to present a critical anti-
gen and mount a protective immune response.
For example, a protective immune response
Figure 8.19. Overview
of antigen processing and against pathogen X occurs only if the host ani-
presentation by MHC class II molecules
mal recognizes antigenic epitope Y. If an animal
APCs ingest extracellular antigens (A) and expresses MHC alleles whose protein products
enclose them in endosomes or phagosomes.
do not bind and present antigen Y, then that ani-
These phagosomes and endosomes eventually
mal will succumb to the infection.
fuse with lysosomes (creating hybrid organ-
elles—phagolysosomes and endolysosomes—
Alternatively, the disease might result from
where proteases digest the antigens into an overreaction or cross-reaction of the im-
peptides. These phagolysosomes and endoly- mune system. Let’s say pathogen X also carries
sosomes then fuse with endosomes containing an antigenic epitope Z that looks a lot like a pro-
MHC class II molecules (E). At this point the tein on synovial cells. If an animal infected with
CLIP is removed from the MHC class II mol- pathogen X carries a certain MHC allele and
ecules and replaced with antigenic peptides. the product of that allele binds to the antigenic
MHC class II–antigen complexes then return epitope Z, then when this animal’s immune sys-
to the cell surface, where they present these tem reacts to epitope Z on pathogen X, it may
peptides to T cells. inadvertently also strike the synovial cells and
cause a progressive arthritis. Although one usu-
Genes Be1, Be14, and Be7 all encode MHC ally thinks of immune responses as being pro-
class I proteins. Goats carrying either Be1 or tective—the ultimate defense against infectious
Be14 genes are more likely to develop arthritis diseases—under certain circumstances, immune
after CAEV infection, and goats carrying the responses can harm host animals. Goats might
Be7 gene are less likely to develop disease. This also develop CAEV because their immune re-

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bind and present the critical CAEV epitope are
Be1 and Be14. If that is true, then goats with ei-
ther or both of these alleles would mount inef-
fective immune responses, the infection would
go unchecked, and these goats would develop
arthritis and sometimes encephalitis.
One more observation about CAEV points,
however, toward an alternative explanation
for the observed differences in susceptibility.
In one study in which goats were intentionally
infected with CAEV, researchers found that im-
munosuppression of goats reduced the likeli-
hood that these goats would develop arthritis.
Although the pathogenesis of CAEV remains
largely unknown, this finding suggests that, in
addition to the virus, an inappropriate immune
Figure 8.20. Domesticgoats (© Mircea response plays a role in the pathogenesis of
Bezergheanu / Shutterstock)
Of the two possibilities discussed, the immu-
sponses against CAEV cross-react with and nosuppression studies have pointed toward over-
damage host tissues. active immune responses as the probable cause
MHC class I and class II gene products bind of CAEV. The association of this disease with
wide varieties of (but not all) antigenic epitopes MHC class I alleles Be1 and Be14 demonstrates
derived from pathogens. In goats, it could be the importance of these genes and their protein
that among the possible MHC class I alleles at a products in antigen presentation and protective
particular MHC locus, the only ones that fail to immunity or destructive autoimmunity.

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Gerald N. Callahan

T-Lymphocyte Development Chapter 9


necropsy, severe atrophy of their thymuses and

Clinical Correlation: Severe Combined
lymph nodes.
Immunodeficiency Disease in Arabian
Foals 143
The only antibodies found in SCID foals
Learning Objectives 143
are remnants of those maternally transferred
T-Cell Receptor Genes 144
through colostrum. Breeding studies have
Structure of the T-Cell Receptor 144
shown that among Arabian foals, SCID is due
T-Cell Receptor Gene Families 145
to an autosomal recessive mutation, meaning
Gene Rearrangement in the Thymus 145
that the sire and the dam have both contributed
T-Cell Selection in the Thymus 150
one defective gene to an afflicted foal. More re-
Products of T-Cell Receptor Gene
cently, studies have identified the relevant gene
Rearrangement 150 as a DNA-dependent phosphokinase. How does
Positive Selection of Functional T Cells 153 such a mutation make these foals so susceptible
CD4, CD8, and Major Histocompatibility to infection?
Complex Recognition 155
Negative Selection of Self-Reactive T Cells 155
Learning Objectives
T-Helper, Cytotoxic T, and T-Regulatory Cells 156
γ/δ T Cells 156 After reading this chapter, you should be able to
Clinical Correlation: Follow-Up 158
Student Considerations 158
• understand the structure and function of
the TCR and the CD3 complex;
Possible Explanations 158
• describe the unique arrangement of TCR
Clinical Correlation: Severe • understand the process and products
Combined Immunodeficiency of genetic rearrangement of TCR gene
Disease in Arabian Foals families;
Every year, about 3 percent of U.S.-born Ara- • describe the process and outcome of positive
bian foals (Figure 9.1) exhibit a devastating and and negative selection of T cells in the thymus;
uniformly fatal affliction. This disease—called • understand the origins of double-positive
severe combined immunodeficiency disease and single-positive T cells and the roles of
(SCID)—manifests as repeated and eventually CD4 and CD8 molecules on T cells;
fatal opportunistic respiratory infections, in- • describe the characteristics of naive T
cluding adenovirus, Pneumocystis carinii, and cells that emigrate from the mammalian
assorted bacterial infections, especially strepto- thymus;
cocci. Clinical analyses of these foals indicate • explain the nature of and evidence for cen-
dramatically low lymphocyte counts and, at tral and peripheral tolerance.


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Figure 9.1. Arabian foal (© Pictureguy / Shutterstock)

T-Cell Receptor Genes termine the antigen specificity of the receptor.

Also, both α/β and γ/δ chain pairs associate
Structure of the T-Cell Receptor
with CD3—a complex of four different poly-
Immunity—the ability to detect and respond peptides (g, δ, ε, and ζ) that together form the
to potentially pathogenic microorganisms—de- signal-transduction machinery of TCRs. Be-
pends on an animal’s ability to distinguish self yond this, the similarities between α/β and γ/δ
from non-self—a critical distinction that keeps TCRs are few.
us all alive. The α/β TCRs recognize antigens only after
Among all the cells of the body, only lym- processing and presentation inside of MHC
phocytes have antigen-specific receptors. On T class I or II molecules. The γ/δ TCRs recognize
cells, these molecules are the TCRs (see Figure intact antigens in the absence of classical MHC
9.2). In their functional state, the N-termini of class I or II molecules. The structural variabil-
these molecules project into T cells’ surround- ity among α/β TCRs is much greater than that
ings, and the C-termini extend into the cytosol. among γ/δ TCRs. Also, γ/δ TCRs seem to have
These receptors contain two polypeptide evolved to recognize a relatively narrow range
chains—either α and β or γ and δ—that to- of specialized antigens, including the lipids of
gether form the antigen-binding site at their mycobacteria, some phosphorylated ligands,
membrane-distal N-termini. Both the α and β and heat-shock proteins. Here, we focus pri-
chains and the γ and δ chains span the plasma marily on α/β TCRs, the most common form
membrane with their C-termini extending into in most mammals, although species variations
the cytosol. Together, α and β or γ and δ de- can be substantial.

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species can respond to essentially every poten-
tial pathogen. Considering the enormity of
the antigenic universe, that means that every
animal must be able to make a nearly unlimited
number of TCRs—literally trillions upon tril-
lions of TCRs. How is that possible?

T-Cell Receptor Gene Families

The essentially unlimited diversity among
mammalian TCRs is the result of a unique ge-
netic mechanism that operates only inside of
T and B lymphocytes: the random rearrange-
ment of germline gene segments. Most of
the original insights into gene rearrangement
came from studies of genes inside of B cells.
However, T cells use the same mechanisms for
generation of diversity. T-cell DNA-sequencing
studies revealed the remarkable finding that
Figure 9.2. T-cell α/β antigen-specific receptor TCR genes are not in contiguous segments of
The complete TCR includes an α and a β chain DNA. Rather, the DNA that eventually encodes
or a γ and a δ chain that together form the an- a TCR is in segments strung out along the DNA
tigen-binding complex. In addition, functional strand. Moreover, for each of the final pieces of
TCRs include a series of associated molecules
a TCR, there are multiple possible segments on
collectively called CD3. These include the γ, δ,
the chromosome (see Figure 9.3).
ε, and ζ chains that transduce activation signals
after antigen binding. Ag = antigen.
Gene Rearrangement in the Thymus
The N-terminal (antigen-binding) regions of The assembly of a TCR α chain begins with
α and β chains have highly variable amino acid a genetic rearrangement that randomly brings
sequences, whereas the C-terminal regions are together one Vα segment and one Jα segment.
invariant. These chemical differences reflect the The intervening DNA loops out and is excised.
functional differences in these two regions of Then ligases join the V and J segments. This VJ
TCRs—antigen binding versus membrane an- segment is then joined to the Cα constant re-
choring and signal transduction. gion segment (see Figure 9.4). After transcrip-
Amino acid sequence analyses of these re- tion, spliceosomes remove all of the excess
ceptors have revealed three clusters of variabil- RNA from the nuclear transcript, and the mes-
ity in the N-termini of α and β chains and γ and senger RNA encodes a single α chain from N-
δ chains. These regions are called hypervariable to C-terminus, including the constant region.
regions 1, 2, and 3, or—more commonly— The assembly of a β-chain gene is slightly
complementarity-determining regions (CDRs) more complicated. This process begins with a
1, 2, and 3 because these regions determine the genetic rearrangement that loops out interven-
complementarity of the fit between TCR and ing DNA and randomly brings together one Dβ
antigen, like a lock and a key. segment and one Jβ segment. The resulting DJ
TCRs are highly specific—nearly one TCR segment then randomly combines with one
for each antigen. In spite of that, most animal Vβ segment to generate a VDJ segment that

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Figure 9.3. Arrangement of TCR genes on mammalian chromosomes
The genetic material that encodes TCR α and β chains is not contiguous. Instead, it exists in seg-
ments. These segments include variable (V), joining ( J), diversity (D), and constant (C) region seg-
ments. The numbers above each gene segment indicate the total number of distinct segments found
in each region of each animal. This figure shows human α (upper panel) and β (lower panel) gene
families. Each species has a unique number of each gene segment.

encodes the variable region of a TCR β chain, the mathematical power of random combina-
which is then joined to a Cβ gene segment to tion, it dramatically increases the number of
form a complete gene. Again, spliceosomes re- possible TCRs that a T cell can generate from
move intervening RNA and convert the nuclear a fixed amount of DNA. In addition, it appears
transcript into messenger RNA that encodes a that any TCR α chain can pair with any TCR β
complete β chain from its variable N-terminus chain, which creates even more diversity.
to its constant C-terminus. By themselves, though, genetic rearrange-
As with all molecules destined for the cell sur- ment and random pairing of α and β chains can-
face, the synthesis of TCR chains begins on the not account for the astronomical array of TCRs
surface of the rough ER. As they grow, these inside of every mammal. The real secret to
polypeptides extrude into the lumen of this or- TCR diversity lies in the ways in which the gene
ganelle. Inside the ER, disulfide bonds join the segments join during genetic rearrangement—
two chains. Later, inside the Golgi complex, en- a process called junctional diversification.
zymes add sugars to these glycoproteins, which Physically, rearrangement of TCR gene seg-
then move to the surface of T cells and join ments occurs after looping out and excision of
with the CD3 complex to form the TCR. intervening DNA to join randomly selected
This random association of V and J or V, gene segments (as with TCR α chain in Figure
D, and J gene segments allows for a variation, 9.5).
similar to shuffling a large deck of cards and The products of two genes—RAG1 and
selecting two or three cards at a time. Using RAG2—drive this process. The protein products

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Figure 9.4. Assembly of an α/β TCR
Formation of an α/β TCR begins with rearrangement of β-chain genes (lower half of figure) with
the random joining of a Dβ and a Jβ gene segment. The gray areas between the lines indicate the
excised segments of DNA. Enzymes then randomly link this new DJβ segment with a Vβ segment to
form the variable region of a β chain. Spliceosomes convert this nuclear RNA transcript into messen-
ger RNA encoding a complete β chain. Once a complete β-chain polypeptide appears, rearrangement
of α-chain gene segment begins (upper half of figure). First, a randomly selected Vα and a Jα pair of
gene segments are joined to form complete α-chain variable region. Then, the VJ segment is joined
with a Cα constant region segment. After splicing, a complete α-chain message forms. After transla-
tion, the α-chain polypeptide joins the β-chain polypeptide and the α/β TCR appears on the cell
surface. (Note: For clarity, only a few gene segments are shown in this drawing.)

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Table 9.1. TCR diversity (adapted from C. Janeway, P. Travers, M. Walport, and M. Shlomchik, 2006, Immunobiology, 151)

Immunoglobulin α:ß receptors

Element H L ß α
Variable segments (V) 65 70 52 ~70
Diversity segments (D) 27 0 2 0
D segments read in 3 frames rarely — often —
Joining segments ( J) 6 5(κ) 4(λ) 13 61
Joints with N- and P-nucleotides 2 50% of joints 2 1
Number of V gene pairs 3.4 × 10 6
5.8 × 10 6

Junctional diversity ~3 × 107 ~2 × 1011

Total diversity ~1014 ~1018

of these genes combine to form the lymphoid- cannot recognize and respond to. However,
specific components of the VDJ recombinase. that incredible diversity comes at a price. Also
This enzymatic complex—along with sev- shown in Figure 9.6, during joint assembly, en-
eral other enzymes, including essential DNA-­ zymes add or remove nucleotides randomly.
dependent protein kinases—accomplishes the At least two-thirds of the time, this results in a
rearrangement steps shown in Figure 9.5A–D. frameshift mutation and no TCR. Only when a
First, complexes of RAG1 and RAG2 bind near full codon appears or disappears will the rear-
relevant gene segments. The RAG proteins ranged gene produce a functional TCR.
then bind to one another, looping and excising As we show later, T cells that do not form
the intervening DNA. functional TCRs die. If instead the cell assem-
During joint formation, enzymes, including bles and expresses a functional TCR, TCR gene
DNA-dependent protein kinases, cut away the rearrangement ceases, which means that all the
hairpin loop and leave single-stranded DNA TCRs on a given T cell have exactly the same
ends behind. The enzyme, terminal deoxy- antigenic specificity. No T cell ever expresses
nucleotidyl transferase (TDT), then randomly more than one TCR or more than one antigenic
adds complementary nucleotides to both specificity.
strands, and DNA polymerases fill the resultant Similar to those of the gene families of α/β
gaps. During the process, at least one-third of TCRs, the gene families used to produce γ/δ re-
the time, TDT creates new codons that code ceptors appear in the genome as a series of frag-
for new amino acids at the VJ and VJD joints ments (see Figure 9.8). In fact the δ-chain gene
(see Figure 9.6A–D). In the final tertiary struc- family nests within the family of gene segments
ture of the TCR, the VJ and VDJ joints form that encode the α chain of the α/β TCR. All
CDR3, one of the most variable regions of the of the processes that operate in the generation
TCR and the region that directly contacts an- of α/β TCRs also operate in the generation of
tigenic peptides during antigen presentation to γ/δ TCRs. As mentioned, though, γ/δ T cells
T cells. Thus, as a result of junctional diversifi- are much less diverse and recognize antigens in
cation, the diversity of possible TCRs increases a distinct manner.
exponentially, and the number of TCRs with The human TCR γ locus resembles the TCR
unique antigenic specificities inside one animal β locus: it has two C genes, each with its own
appears to be effectively limitless (see Table 9.1). set of J gene segments. The mouse γ locus (not
Because of this, an animal will rarely encoun- shown) has a more complex organization and
ter a pathogen or an antigen that the animal three functional clusters of γ gene segments.

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Figure 9.5A–D. DNA rearrangement during TCR α-chain formation
Alpha-chain gene family (panel A); attachment of recombination activating gene (RAG) protein enzy-
matic complexes (panel B); looping out intervening DNA (panel C); and excision of intervening DNA
and formation of DNA hairpin loops (panel D).
Panel A shows a representative α-chain gene family with V segments from 1 to n and a J segment.
Panel B shows the attachment of RAG complexes—the initiation of rearrangement. Panel C shows
how the RAG complexes bind to one another and loop out intervening DNA between randomly
selected V and J segments. Panel D shows how enzymes, including DNA-dependent protein kinase,
excise the intervening DNA. The space with the two dots indicates an indeterminate amount of DNA.

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Figure 9.6A–D. Junctional diversification
Cleavage of DNA hairpins (panel A); random deletion of nucleotides and activation of terminal de-
oxynucleotidyl transferase (TDT) (panel B); junctional diversification (panel C); and DNA ligation and
formation of VJ joint (panel D).
During the final steps of gene rearrangement, a process called junctional diversification introduces
additional diversity into the TCR α-chain gene. Panel A shows the final excision of the loop of inter-
vening DNA, the formation of singled-stranded DNA ends with a final hairpin loop, and enzymatic
cleavage of the hairpin. In Panel B, the enzyme TDT binds into the remaining gap in the DNA and,
in Panel C, begins to randomly add nucleotides, completing the DNA gap between V and J. Finally, as
shown in Panel D, DNA ligases join the now double-stranded DNA ends and complete the VJ joint.

Each contains V and J gene segments and a C gene segments as well as at the V–D and D–J
gene. Rearrangement at the γ and δ loci oc- junctions.
curs in the same way as in the other TCR loci,
with the exception being that during TCRδ T-Cell Selection in the Thymus
rearrangement, both D segments can be used
in the same gene. The use of two D segments Products of T-Cell Receptor
greatly increases the variability of the δ chain, Gene Rearrangement
mainly because extra N-region nucleotides can Beyond the potential frameshift inefficiency,
be added at the junction between the two D random rearrangement and insertion and dele-

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Figure 9.7. γ/δ gene segment families
The TCR γ and TCR δ loci—as with the TCR α and TCR β loci—have discrete V, D, and J gene seg-
ments and C genes. In humans, the locus encoding the δ chain is entirely within the α-chain locus.

tion of nucleotides has another downside: the leaves the bone marrow and migrates to the
specificity of the resultant TCR is unpredict- thymus (see Figure 9.8).
able. Because these processes are random, they When these lymphocytes arrive in the thy-
may generate T cells with no functional TCRs, mus, the thymic stroma delivers a signal that
T cells with self-reactive TCRs, or T cells with activates the Notch 1 gene, and TCR gene
non-self-reactive TCRs. The first group is use- rearrangement begins. Because these early-
less, the second dangerous, and only the third stage thymocytes lack CD4 and CD8, they are
can be safely expanded and exposed to the tis- double-negative cells. Three TCR gene fami-
sues of an animal’s body. lies begin rearranging simultaneously—the
In most mammals, T-cell development be- β-chain, the γ-chain, and the δ-chain families.
gins well before birth. During the last one-third If the cell successfully rearranges and synthe-
of gestation, a large population of lymphocytes sizes a complete β chain first, the cell goes on to

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Figure 9.8. T-cell development
All lymphocytes originate in the bone marrow.
Some of these lymphocytes emigrate from the
bone marrow and travel—via the blood—to the
thymus. Whether these cells are identifiably dif-
ferent from other lymphocytes in the bone mar-
row is unclear. Once inside the thymus (prob-
ably through activation of the Notch 1 gene),
most of the newly arrived lymphocytes begin
to differentiate, which results in the activation
of gene rearrangement among the β, γ, and δ
gene families. Depending on the outcomes of
these rearrangements, the cells begin to express
α/β and CD4 and CD8 cell-surface proteins or
γ/δ TCRs. After positive selection, α/β T cells
no longer express either CD4 or CD8 and dif-
ferentiate along two independent lines as either
CD4+ Th cells or CD8+ Tc cells.

become an α/β T cell. If γ- and δ-chain genes

successfully rearrange first, the cell goes on to
become a γ/δ T cell.
Inside the thymus, gene rearrangement pro-
ceeds one allele at a time; that is, it begins on
only one of the two parental chromosomes. If
rearrangement at the first allele fails, only then
does gene rearrangement begin at the second
allele. Because of this, TCRs always represent
the products of only one parental allele. How-
ever, the opportunity to rearrange gene seg-
ments on both parental chromosomes means
that each lymphocyte has two opportunities to
produce a functional gene rearrangement of
each of the chains of the TCR.
Obviously, the success of this whole process
is essential to an animal’s survival—useless T ment event has to be detectable at the surface
cells have to be disposed of, self-reactive T cells of the T cell. With α/β T cells, rearrangement
have to be destroyed, and somehow non-self- begins with the β-chain gene family. Even if the
reactive T cells have to be identified and pre- T cell manages to successfully rearrange a β
served. To meet these needs, mammals have chain, TCR β chains by themselves cannot in-
evolved a means to monitor TCR gene rear- sert into the cell’s membrane. Only α/β pairs
rangement. Ultimately, the thymic stroma is arrive at the cell surface, but α-chain gene re-
responsible for this monitoring. arrangement cannot begin until it is clear that
For monitoring to be successful throughout a functional β chain exists. Somehow, the de-
T-cell development, each successive rearrange- veloping T cell has to signal the thymic stroma

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that it has successfully rearranged a β-chain
To provide that signal, T cells use an α-chain
surrogate called pre-Tα. When pre-Tα joins
with an assembled β chain, the complex in-
serts into the developing cell’s membrane and,
along with the CD3 complex, forms the pre-
TCR. The appearance of the pre-TCR signals
the thymic stroma that the cell has created a
functional β-chain molecule. In turn, the thy-
mic stroma delivers a signal that ends β-chain
gene rearrangement and initiates α-chain gene
rearrangement. Once the cell has assembled a
functional α chain, the full TCR appears on the
cell surface along with two other molecules—
CD4 and CD8. CD4 and CD8 are cell-surface
proteins that interact with constant regions of
MHC class II and class I molecules during anti-
gen presentation (see Figure 9.9).
Figure 9.9. The fully assembled α/β TCR
C-termini of the α and β chains both span the
Positive Selection of cell membrane while the membrane-distal N-
Functional T Cells termini form the MHC–antigen (Ag) binding
site. In addition, all α/β T cells express CD4
At this point in thymocyte development, the
and CD8 before positive selection. These cell-
thymocyte has on its surface an α/β TCR (or
surface molecules bind to constant regions of
not, because many rearrangements go wrong), MHC molecules: CD4 binds MHC class II, and
the CD3 complex, and CD4 as well as CD8. Be- CD8 binds MHC class I. In the T-cell mem-
cause these thymocytes now express both of brane, the α/β heterodimer associates with
the markers of mature T cells (CD4 and CD8) another group of molecules collectively called
they are called double-positive cells. CD3. These include the γ, δ, ε, and ζ molecules,
Ultimately, this complex of molecules is des- either alone or in pairs.
tined to interact with the MHC–antigen com-
plex on the surface of APCs. To be useful, this
newly formed TCR must show signs that it is with the MHC–antigen complex on the surface
capable of detecting those complexes. Because of an APC (see Figure 9.10).
the processes of gene rearrangement and nu- Positive selection tests whether a newly cre-
cleotide deletion and insertion all occur ran- ated TCR can bind to the MHC class I or MHC
domly, this newly formed TCR might be use- class II molecules on thymic cortical epithelial
less, dangerous, or potentially protective. It is cells (these cells are also APCs). This binding is
the job of the thymus and its components to likely a low-affinity interaction between MHC
sort out the useless and dangerous T cells and and TCR. Most (maybe as much as 96 percent
destroy them. This sorting or selection process of ) thymocytes fail positive selection and un-
occurs in two steps—positive selection and neg- dergo apoptosis. Remember, genetic rearrange-
ative selection. ment and reassembly are not only random but
To be of use, the T cell must express a func- perhaps as much as two times more likely to
tional TCR: a TCR that can recognize and react generate no or nonfunctional TCRs.

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Figure 9.10. T-cell selection in the thymus
Once formed, the α/β TCR must react with MHC molecules present on APCs (including thymic epi-
thelial cells) in the thymic stroma. The first of these tests, positive selection, determines whether the
new TCR can bind with low affinity to the MHC portion of an MHC–antigen complex on thymic epi-
thelial cells. If a T cell fails positive selection, it dies by apoptosis. If it survives positive selection, the
T cell must pass a second test—negative selection—a test for self-reactivity. If the new TCR strongly
binds to an MHC–antigen complex presented on bone marrow–derived macrophages or DCs in the
thymus, those T cells also undergo apoptosis. Only non-self-reactive cells emigrate from the thymus.

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Figure 9.11. The roles of CD4 and CD8 molecules
By binding to a constant region found on all MHC class II proteins, CD4 molecules on Th cells
increase the TCR’s avidity for the MHC class II–antigen complex on the APC (A). By binding to a con-
stant region found on all MHC class I proteins, CD8 molecules on Tc cells increase the TCR’s avidity
for the MHC class I–antigen complex on the APC (B). Once a TCR has bound to an MHC class I
molecule, that T cell ceases to express CD4. Likewise, once a TCR has bound to an MHC class II mol-
ecule, that T cell ceases to express CD8. Neither CD4 nor CD8 contributes to the antigenic specificity
of the TCR, but the combination of TCR and CD4 or CD8 binding leads to activation of the T cell via
signals transduced through the CD3 complex of molecules.

CD4, CD8, and Major only CD4. CD4+ T cells recognize antigens
Histocompatibility only in the context of MHC class II molecules.
Complex Recognition CD4 is a cell-surface protein that binds to the
Also during positive selection, thymocytes constant region of MHC class II molecules (see
transform from double-positive cells to single- Figure 9.11). CD4+ T cells are also known as Th
positive cells. This transformation occurs dur- cells, because they assist several other cell types
ing the interaction of the newly formed TCR during immune responses.
with an APC. If the TCR has an affinity for an
MHC class I molecule, the thymocyte turns off
the CD4 gene and begins to express solely CD8. Negative Selection of Self-
That cell then commits for life to MHC class Reactive T Cells
I molecules and their antigens. CD8 is a cell- Through the preceding process, positive se-
surface protein dimer that binds to constant lection eliminates thymocytes that either have
regions of MHC class I molecules (see Figure failed to assemble a TCR or have assembled a
9.11). For reasons that will become apparent useless TCR and seals a T cell’s fate, commit-
later, CD8+ T cells are also called Tc cells. ting it to a CD4+ or a CD8+ lineage. However,
Conversely, if the newly formed TCR has af- even after positive selection, the remaining thy-
finity for MHC class II molecules, that lympho- mocytes are as likely to have self-reactive TCRs
cyte switches off the CD8 gene and expresses as they are to have non-self-reactive TCRs.

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Because of their potential danger, the process lytic anemia in dogs and cats. The reasons for
of negative selection has evolved to eliminate this are not clear.
these self-reactive T cells.
Inside the thymus, if a T cell’s TCR binds
with high affinity to an MHC-antigen com- T-Helper, Cytotoxic T, and
plex present on an APC, the T cell usually dies T-Regulatory Cells
through apoptosis (see Figure 9.11). Because a Those T cells that survive positive and nega-
blood–thymus barrier keeps non-self out of the tive selection leave the thymus via the blood.
thymus, any reactive T cell in the thymus is a Along with NKT-lymphocyte cells (an innate
self-reactive T cell. The process of negative se- subgroup of T cells), these T cells include at
lection eliminates most thymocytes that react least three populations of cells: α/β Tc, α/β
with self as represented in the thymus. Th, and α/β Treg cells, as well as γ/δ T cells.
On the surface, although this process seems Tc cells express CD8 molecules on their sur-
to be an effective means for eliminating useless faces and react with antigens in the context of
and dangerous T cells, it also seems as though MHC class I. These cells are largely responsible
it might eliminate only those cells reactive with for the destruction of pathogen-infected cells.
self presented in the thymus, which might rep- After leaving the thymus, and reaction with
resent only a small portion of the total variety their specific antigens, CD4+ Th cells differenti-
of self molecules. ate into several distinct subsets, including Th1,
To deal with this, the thymus has evolved Th2, Th17, and probably some types of regula-
a genetic mechanism that allows for a much tory cells (see chapter 10). Th cells are active in
broader representation of self on APCs in the almost all aspects of every immune response.
thymus. A gene known as the autoimmune Th1 cells activate macrophages, sometimes as-
regulator, or AIRE, gene allows thymic epithe- sist Tc cells, and activate some NK cells and B
lial cells to express many of the proteins usually cells. Th2 cells drive the proliferation and dif-
found on other tissues of the body (see Figure ferentiation of B cells into antibody-secreting
9.12). The result is that most cells leaving the plasma cells. Th17 cells promote inflammation,
thymus are tolerant of (will not react to) self and Th3 cells probably help suppress auto­
antigens. This form of tolerance is called cen- immunity. Some T-regulatory cells differentiate
tral tolerance, and it results from the process of in the thymus but operate outside the thymus
negative selection in the thymus. to help suppress self-reactive T cells that leave
Although negative selection on APCs ex- the thymus.
pressing the AIRE gene eliminates most self-re-
active T cells, a subset of these cells (T-regula-
tory [Treg] cells) survives and differentiates into γ/δ T Cells
a group of cells expressing FoxP3 molecules. The γ/δ T cells make up only a small fraction
Ultimately these cells, and probably at least a of the T-cell population in mice and humans.
few other cell types, help maintain some as- In ruminants and chickens, however, the major-
pects of self-tolerance beyond the thymus. Tol- ity of T cells are γ/δ T cells. In some species,
erance maintained outside the thymus is called γ/δ T cells line the epithelia of the gut and the
peripheral tolerance. reproductive system, whereas in other species,
Despite central and peripheral tolerance, it most γ/δ T cells are at the same sites as α/β
is obvious—because of autoimmune disease— T cells. The majority of γ/δ T cells express
that some self-reactive cells do escape and, neither CD4 nor CD8 molecules. In addition,
under the right circumstance, can attack self most γ/δ T cells use very few V gene segments
and create diseases such as autoimmune hemo- during assemblies of TCRs and may, therefore,

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Figure 9.12. Expression of self in the mammalian thymus and the role of the AIRE gene
Because of the AIRE gene, APCs in the thymus express and present many peptides derived from non-
thymic tissues.

have a significantly narrower diversity than that cal MHC class I molecules but are monomor-
seen in α/β T cells. However, because of fre- phic in animal populations, are not encoded
quent and substantial nucleotide deletion and by genes within the MHC, and do not seem to
addition during gene rearrangement, the CDR3 be involved in classical antigen presentation.
region of the δ chain is the most diverse of all These MHC class Ib proteins present some
the antigen-specific receptors in mammals. unprocessed antigens, such as certain phos-
The γ/δ T cells recognize unprocessed anti- phoproteins present on cell surfaces. After in-
gens, including intact pathogens, and classical teraction with their target antigens, γ/δ T cells
MHC class I and II molecules are not involved respond in the same ways as CD8+ α/β cells.
in presentation of antigens to γ/δ T cells. Only That is, both cell types secrete cytokines and in-
a few of the antigens that γ/δ T cells recognize duce apoptosis in the cells bearing their target
have been identified, and the role of these an- antigens. Because γ/δ T cells are widespread
tigens in disease processes is not always clear. in the animal kingdom, and because—in some
For example, one subset of γ/δ T cells recog- species—these T cells make up a significant
nizes a group of molecules called MHC class part of the T-cell population, γ/δ T cells must
Ib molecules. These molecules resemble classi- be important to immune-mediated protection,

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Figure 9.13A–D. The role of DNA-dependent kinases in gene rearrangement
Cleavage of DNA hairpins (panel A); random deletion of nucleotides and activation of TDT (panel B);
junctional diversification (panel C); and DNA ligation and formation of VJ joint (panel D). Note the
essential role the DNA-dependent protein kinase plays in excision of intervening DNA and formation
of the new DJ joint. (For a complete description of these events, see Figure 9.6.)

but the exact nature of that importance is only should be able to offer a complete explanation
beginning to appear. for the clinical laboratory and necropsy findings
with SCID foals and the reason they all die so
Clinical Correlation: Follow-Up young.

Student Considerations
SCID in Arabian foals manifests as severe re- Possible Explanations
peated infections, often respiratory infections. During genetic rearrangement of TCR V, D,
These foals invariably die from these infections and J segments, a DNA-dependent phospho­
by age five months. SCID results from an auto- kinase aids in cleaving the intervening DNA
somal recessive mutation in a gene encoding a and ligating the new joint between the rear-
DNA-dependent phosphokinase. Knowing this, ranged segments (see Figure 9.13A–B). Without
and the material covered in this chapter, you that enzymatic event, rearrangement is impos-

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sible, and functional TCRs cannot be assembled penia and atrophy of both thymus and lymph
(see Figure 9.13A–D). nodes.
During maturation in the thymus, thymo- The reason that some of these foals survive
cytes without functional TCRs die during posi- for as long as five months is that antibody-con-
tive selection, which means that in affected Ara- taining colostrum—transferred from mare to
bian foals, no functional T cells ever emigrate foal shortly after birth—provides temporary
from the thymus. Also (as you will see in chap- protection against infection. Because these
ter 11), the same enzymes drive the rearrange- antibodies have a limited half-life in the foals’
ment of BCRs. In the absence of functional blood, protection wanes by five months. Left
receptors, B cells die. The inability to produce defenseless, these foals rapidly succumb to
either B or T cells explains the marked lympho- infections.

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callahan text.indd 160 3/11/14 1:45 PM
Gerald N. Callahan

T-Cell Activation Chapter 10


worsened. About three weeks later, one of

Clinical Correlation: Canine X-Linked Severe
these pups developed signs of a systemic infec-
Combined Immunodeficiency 161
tion, and the owner took the dog to the hospi-
Learning Objectives 162
tal. The animal was small and underweight and
Antigen Recognition by T Cells 162
exhibited a large papular–pustular dermatitis,
First Signal: T-Cell Receptors and Major
Histocompatibility Complex–Antigen
and the examining veterinarian could find no
Interactions 162 peripheral lymph nodes. More antibiotics were
Second Signal and Major Histocompatibility prescribed as well as adjunctive therapy, but at
Complex–CD4/8 Interactions 164 eight weeks old, the pup died, apparently from
Signal Transduction and T-Cell Activation 166 pneumonia. At about the same time, the other
Third Signal and T-Helper Cell Differentiation 168 pup that had early symptoms of an infection
Effector T Cells 169 worsened and began to show the same symp-
Effector T-Helper Cells: Th1, Th2, Tfh, and toms as the first pup. Antibiotic therapy had no
Th17 Cells 169 effect, and a suppurative otitis developed. After
Effector Regulatory T Cells: Treg, Th3, and vaccination with a canine distemper–hepatitis
Tr1 Cells 171 live-virus vaccine, this pup developed symp-
Effector Cytotoxic T Cells 173 toms of hepatitis, became hypothermic and
Clinical Correlation Follow-Up 177 icteric, eventually slipped into a coma, and was
Student Considerations 177 euthanized.
Possible Explanations 177 Later, the same breeding pair of hounds
produced a second litter of eight pups—seven
males and one female. All appeared normal at
Clinical Correlation: Canine
birth. By age two weeks, one male pup exhib-
X-Linked Severe Combined
ited skin lesions, and two more male pups de-
veloped similar symptoms at age three weeks.
In 1978, a local breeder brought a litter of basset All the lesions resolved after antibiotic treat-
hound pups (Figure 10.1) to the Genetics-Pedi- ment. None of these pups had palpable lymph
atrics Clinic of the University of Pennsylvania nodes or a detectable thymus gland. Between
Veterinary Teaching Hospital. The litter in- twelve and sixteen weeks, all three of the af-
cluded five males and five females. At about age fected pups developed canine distemper and
three weeks, two of the male pups developed were euthanized. Even though all were unvac-
superficial pyoderma—a bacterial infection of cinated, none of these pups’ littermates devel-
the skin common in dogs—over their hind- oped canine distemper.
quarters. The attending veterinarians began At necropsy, all the affected pups showed
antibiotic therapy, but over time the infections signs of extensive infections, including canine


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Table 10.1. B and T cells in dogs with X-linked SCID (adapted from Felsberg, Somber, Harnett, Henthorn, and Carding,
1988, Immunologic Research, 17: 63)
<4 Week >8 Week
Cells Normal XLSCID Normal XLSCID
B Cells 14.3 ± 15.9a 66.3 ± 4.6 12.9 ± 2.5 49.7 ± 15.1
T Cells 58.2 ± 4.6 1.4 ± 1.9 68.1 ± 5.8 23.7 ± 21.4
CD45RA*+ T cellsb 92.5 ± 2.6 88.1 ± 4.6 90.6 ± 3.2 8.0 ± 0.6
a Percentage ± SD.
b Percentage of T cells that are CD45RA+.
* CD45RA+ represents naive T cells.

distemper, hepatitis, and pneumonia. The thy- Learning Objectives

muses of all affected animals were severely at-
After reading this chapter, you should be able to
rophied and mostly acellular. (See thymocyte
cell counts from affected animals in Table 10.1.) • describe the nature of the first, second, and
Overall, T-cell counts were dramatically third signals necessary for T-cell activation;
lower in affected littermates. An interesting • explain the consequences of each of these
finding was that affected animals had higher- signals on the process and direction of
than-normal B-cell counts. On the basis of T-cell differentiation;
these and other data, it appeared that the af- • describe the role of the CDR1, CDR2, and
fected pups’ thymocytes had some sort of de- CDR3 regions of the α/β TCR in binding
fect that prevented their normal proliferation to MHC–antigen complexes;
during thymic development.
Further investigations have confirmed that
• list differences and similarities in the activa-
tion signals for activation of Th and Tc
this, in fact, is the case. Because the relevant
gene is on the X chromosome of these dogs,
and the mutation results in a broad-spectrum • describe the differences in the requirements
immunodeficiency, this disease—which has for naive T-cell and effector and memory
counterparts in other species—is known as T-cell activation;
X-linked severe combined immunodeficiency • explain the origins and functions of the
(XLSCID). major classes of effector Th cells, including
More recent studies have shown that the af- Th1, Th2, Th17, Tf h, and Treg cells;
fected gene encodes a protein known as the cy- • explain the actions of Tc cells on infected
tokine receptor common γ chain, or simply γc. target cells.
Receptors for several distinct IL receptors, in-
cluding IL-2R, IL-4R, IL-7R, IL-9R, IL-15R, and Antigen Recognition by T Cells
IL-2R, contain γc (or CD132). Furthermore, γc is
also among the family of molecules called type First Signal: T-Cell Receptors
I cytokine receptors and is expressed on most and Major Histocompatibility
lymphocytes. The gene for γc is on the X chro- Complex–Antigen Interactions
mosome of mammals. Somehow, the effects of Inside of the thymus, T cells acquire a TCR,
the XLSCID mutation in dogs result in a pro- a CD4 or CD8 molecule, and the CD3 complex
found immunodeficiency as well as dramatic (see Figure 10.2). The TCR contains an α and β
atrophy of the thymus and near to complete chain or a γ and δ chain that together form the
absence of lymph nodes. antigen-binding site. Once the TCR has bound

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Figure 10.1. Basset hound (© caimacanul / Figure 10.2. T-cell antigen-specific receptor

cific antigen–MHC target. It now appears that

antigen, signal transduction occurs via the CD3 both of these populations of naive T cells can
complex, which includes γ, δ, ε, and ζ chains. only be activated by antigen–MHC complexes
Mature T cells also express either CD4 or CD8 on DC APCs (most commonly in secondary
(not shown here), molecules that are not part lymphoid tissues). Once activated, however,
of the TCR but do help determine whether a both Th and Tc cells respond to other types of
T cell will react with antigen in the context of APCs, including B cells, macrophages, and in-
MHC I or II molecules. fected self cells. Also, activated T cells, includ-
Each of these molecules has an important ing effector and memory T cells, react more
function, but only the α and β chains (or γ and rapidly during antigen presentation, require
δ chains) directly interact with both antigen and fewer antigen–MHC complexes, and require
MHC molecules in MHC–antigen complexes. less or no costimulation. For now, we focus on
Thus, the α and β chains (or γ and δ chains) activation of mature naive T cells.
determine all of the antigenic specificity of a As mentioned in chapter 9, the N-terminal
TCR. (membrane-distal) regions of the TCR α and
After differentiation in the thymus, two pop- β chains contain most of the chemical varia-
ulations of mature, naive T cells emigrate to tion seen between TCRs of differing antigenic
the thymus—CD4+ Th cells and CD8+ Tc cells. specificity. Within those N-terminal regions,
Naive T cells are those T cells that have left the the greatest variation lies in the so-called CDRs.
thymus but have not yet encountered their spe- Each TCR chain has three CDRs, designated

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CDR1α, CDR2α, and CDR3α for the α chain
and CDR1β, CDR2β, and CDR3β for the β
chain. Together, these CDRs form the antigen–
MHC contact face of the TCR (see Figure 10.3).
Crystallographic studies of TCR and MHC–
antigen complexes revealed first that the TCR
interacts simultaneously with both the MHC
molecule and the antigenic peptide. Further-
more, during this interaction each of the CDRs
of the α and β chains plays a different role.
During binding, CDR1α, CDR2α, CDR1β, and
CDR2β bind to the α-helical portions of the
antigen-binding cleft of either MHC class I or
II molecules. Remember that positive selection
of T cells inside the thymus relies on the TCRs’
Figure 10.3. Interaction of TCR and antigen–MHC
ability to bind to MHC molecules. Different
T cells have affinities for different MHC mol-
The N-terminal (membrane-distal) regions of
ecules. These affinities result from the interac-
both the α and β chains of the TCR directly
tions of CDR1α, CDR2α, CDR1β, and CDR2β interact with the antigen–MHC complex.
with either MHC class I or II molecules. From crystallographic studies, it is apparent
However, CDR3α and CDR3β bind di- that CDR1α and CDR2α as well as CDR1β and
rectly to the antigenic peptides in MHC mol- CDR2β interact most directly with the MHC
ecules’ binding clefts. As described in chapter molecule, whereas the CDR3 regions of both
9, CDR3α and CDR3β are the most variable chains interact most directly with the antigenic
portions of TCR α and β chains. An animal peptide in the MHC binding cleft.
must generate TCRs reactive with relatively
few MHC molecules. Those MHC molecules,
though, may hold a nearly infinite number of least two other interactions must occur be-
antigenic peptides. So it makes sense that the tween T-cell and APC cell-surface molecules.
most variable parts of TCRs would be those The first of these involves two molecules dis-
that bind directly to antigens. cussed in chapter 9: CD4 and CD8.
The binding of TCRs to antigen–MHC com- As T cells undergo positive selection in the
plexes is as specific as antigen–antibody inter- thymus, they switch from being double positive
actions but of lower affinity, which means that (expressing both CD4 and CD8) cells to express-
nearly one TCR exists for every possible anti- ing only CD4 (MHC class II–specific) or CD8
gen. The lower affinity means that TCRs by (MHC class I–specific) molecules. CD4 and
themselves are not enough to anchor a T cell CD8 molecules strengthen the bond between
to its target. TCRs and MHC molecules by binding to a con-
stant region (the same regardless of encoding
allele) of an MHC molecule. Overall, this bond
Second Signal and Major with the constant region of the MHC molecule
Histocompatibility Complex– increases the avidity of the TCR for the APC
CD4/8 Interactions but has no effect on the antigenic specificity
Interactions between a TCR and an antigen– of the TCR (see Figure 10.4A–B). All Th cells
MHC complex are essential but not sufficient express CD4 molecules that bind to antigen–
(by themselves) to activate a naive T cell. At MHC class II complexes. All Tc cells express

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Figure 10.5. T-cell costimulation
The initial phase of T-cell activation requires
two signals; a primary signal CD3 delivers after
the TCR has bound to the MHC–antigen com-
plex on an APC and a secondary signal CD28
delivers after it has bound to B7 on the APC.

CD28 on the T-cell surface and B7 molecules

on the APC surface. Although we focus only on
T-cell activation, it is also possible for APCs to
deliver negative or inhibitory signals to T cells,
which may be important in both downregula-
tion of immune responses and self-tolerance.
Complete activation of T cells is a two-step
process. In the first step, after TCR binding of
Figure 10.4A–B. Interactions between CD4 and
antigen–MHC complex, CD3 delivers a pri-
CD8 molecules with APCs
mary signal to the T-cell nucleus. In the second
The CD4 molecule on the surface of Th cells
step, B7 (CD80 and 86) on the APC delivers a
binds MHC class II molecules and strengthens
secondary signal through CD28 on the T cell
the interaction between Th cells and DC APCs
(upper panel). The CD8 molecule on the surface
(see Figure 10.5). Only after both interactions
of Tc cells binds MHC class I molecules and occur successfully will a T cell respond.
strengthens the interaction between DC APCs Because inappropriate activation of T cells
or target cells and Tc cells (lower panel). may pose a threat to self, as with MHC class II
molecules, B7 molecules appear only on APCs.
Moreover, until pathogens, cytokines, or T cells
CD8 molecules that bind to antigen–MHC class activate them, most APCs express fairly low lev-
I complexes. els of B7.
Beyond CD4 and CD8, T-cell activation re- If a T cell receives only signal 2, nothing hap-
quires one more interaction between molecules pens. But when a T cell receives signal 1 alone,
on T cells and APCs. This interaction involves that T cell becomes anergic (unreactive) to

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further antigenic stimulation (see Figure 10.6A–
B). This requirement further guards against T-
cell activation by non-APCs or APCs that have
not been previously activated by danger signals
(PAMPs, DAMPS, or both), because these cells
are likely presenting only self antigen.

Signal Transduction and

T-Cell Activation
The first lymphocytes activated during most
adaptive immune responses are Th cells. Once
a Th cell receives both signals from an APC, a
series of events follows.
Through a series of phosphorylations and
dephosphorylations inside the T cell, as well as
the activation of enzymes and nuclear factors
such as NFAT and NF-κB, nuclear gene expres-
sion changes. The pivotal role of these steps
is most apparent after treatment with cortico-
steroids, which inhibit the activation of NF-κB
and result in marked immunosuppression.
Under normal circumstances, though, T-cell
activation induces several Th-cell genes to cease
or begin producing proteins. One particularly
important change is induction of expression of
the high-affinity IL-2 receptor and the cytokine
IL-2 (see Figure 10.7A–D).
Naive T cells express an IL-2 receptor (IL-2R)
composed of only β and γ chains (a γ chain is
common to many IL receptors). This form of
the IL-2R has only moderate affinity for IL-2,
and the resultant interaction between receptor
and ligand is too weak to push the naive T cells
into cell division. After a specific interaction
with its cognate antigen (the antigen–MHC
complex that specifically reacts with the cell’s
TCR) and costimulation, a T cell begins to ex-
Figure 10.6A–B. T-cell
responses to only primary
press the third (or α) chain of the IL-2R. Once
or only secondary signal
the α chain joins with the β and γ chains, the
By itself, interaction of B7 and CD28 (second
complete IL-2R develops high affinity for IL-2.
signal) elicits no T-cell response (upper panel).
At the same time, the newly activated T cell Interaction of TCR with antigen–MHC com-
begins to express IL-2. The interaction of IL-2 plex (primary signal) without the second signal,
with the high-affinity IL-2R causes the T cell to however, renders the T cell unresponsive to this
begin dividing rapidly, which results in a process antigen (lower panel).
called clonal expansion (the rapid expansion of

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Figure 10.7A–D. T-cell activation and the appearance of the high-affinity IL-2 receptor
After antigen presentation and costimulation (A), T cells begin to express both the α chain of the IL-2
receptor and IL-2 (B). When the completed receptor binds IL-2, a signal is transmitted to the nucleus
(C) and the activated T cells begin to proliferate and eventually differentiate into either effector or
memory T cells (D).

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a single antigen-specific T cell into a clone of
millions of identical T cells, all specific for the
same antigen). This process is ultimately re-
sponsible for the exquisite specificity of adap-
tive immune responses.

Third Signal and T-Helper

Cell Differentiation
After activation, Th cells may follow any one
of several paths of differentiation. Understand-
ing this process is essential to understanding
animals’ immune responses and how to ma-
nipulate those responses for maximum ben-
efit—either through vaccination or immune
Ultimately, DC APCs determine the final di-
rections of naive Th-cell differentiation through
selective cytokine secretion (third signal). Dur-
ing interactions with Th cells, APCs secrete spe-
cific cytokines that react with specific receptors
on Th cells, altering gene expression inside the
Th cells and pushing the Th cells down one dif-
ferentiation pathway or another.
When, during antigen presentation, DCs se-
crete IL-12, Th0 cells become Th1 cells. When
APCs induce Notch-receptor signaling, Th0
cells develop into Th2 cells. When APCs pro-
duce IL-6 and TGF-β, Th0 cells become Th17
cells. Some regulatory T cells (in particular,
Treg cells) develop in the thymus and become
Figure 10.8A–B. Directactivation of Tc cells by
active in the periphery, but other Treg cells de-
highly effective APCs
velop from Th0 cells outside the thymus, in-
APCs (like DCs) that constitutively express high
cluding Th3 and TR1 cells. The formation of
levels of B7 can provide both first (MHC–anti-
these cells requires DC-derived IL-10, TGF-β, or
gen) and second (B7) signals to Tc cells (panel
both. No one knows exactly what induces the A). In response, the T cells begin to express the
APC or the Th cell to produce a particular set high-affinity IL-2R and to produce IL-2 (panel
of cytokines, but it depends, at least in part, on B), which leads to activation.
the nature of the innate response that precedes
T-cell activation. Different innate responses can
alter APCs in several ways, and they direct the II) molecules. Second, APCs can activate CD8+
Th-cell response down different pathways. cells in more than one way. Highly effective
The pathways to Tc-cell activation differ APCs, in particular DCs, that express abundant
from those leading to Th-cell activation. First, MHC–antigen complexes and B7 molecules can
interactions between APCs and CD8+ T cells deliver first and second signals and directly acti-
involve antigens bound by MHC class I (not vate Tc cells (see Figure 10.8A–B).

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Activation of naive CD8+ cells by other APCs
(e.g., macrophages) expressing lower amounts
of B7, however, often requires the participation
of a Th cell. Constitutively, macrophages ex-
press lower levels of B7. After antigen-specific
interactions between macrophages and Th
cells, macrophage APCs express much higher
levels of B7, allowing for effective delivery of
the second signal and activation of Tc cells (see
Figure 10.9A–B). Regardless of the activation
pathway, in the end, the activated Tc cells begin
to express the high-affinity IL-2R and IL-2, re-
sulting in rapid expansion of antigen-reactive
clones of Tc cells.
The third signal for Tc-cell activation comes
from the APC in the form of IL-12. This cyto-
kine strongly directs immune responses toward
CD8+–Tc-cell responses, also known as adaptive
cellular immune responses.
As you may have noticed, throughout this
Figure 10.9A–B. Th cell–assisted activation of Tc
description—from antigen processing and pre-
sentation to final activation of T cells—none
of the processes distinguish between self and APCs expressing lower levels of B7 may first
have to interact with Th cells. That interaction
non-self. APCs are, in fact, just as effective at
induces activation of the APC and higher levels
presenting self antigens as they are at present-
of expression of B7 and MHC (panel A), which
ing non-self antigens. Clearly, two factors that increases the efficiency of the APCs, provides
help to reduce the likelihood of self-reactivity additional IL-2, and leads to activation of the Tc
are central and peripheral tolerance. But even cell (panel B).
beyond that, antigen presentation—self or non-
self—fails to activate T cells in the absence of
danger signals. Such signals arise when host mentioned earlier, effector T cells have signifi-
cells bind to PAMPs and DAMPs from patho- cantly different minimal requirements for acti-
gens and the ensuing inflammation. In the vation, including lower or no requirement for
absence of danger signals and the resulting ex- costimulation via B7.
pression of costimulatory ligands on the APCs, All Th cells begin their lives as naive Th cells
antigen presentation not only may fail to acti- (sometimes called Thn cells); after activation,
vate T cells but may even render them tolerant they become Th0 cells. These Th0 cells have
of the presented antigen. the potential to become many other types of
Th cells (see Figure 10.10).
Effector T Cells As shown in the first set of arrows in Figure
10.10, APC- and Th-cell–derived cytokines di-
Effector T-Helper Cells: Th1, rect Th0 differentiation toward one of many
Th2, Tfh, and Th17 Cells possible subsets of Th cells. Despite all the pos-
After activation, naive T cells become effec- sible outcomes of Th-cell differentiation, all Th
tor T cells capable of mediating their effects in cells continue to express CD4 and α/β TCRs
immune responses and other host defenses. As and recognize only antigen in the context of

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Figure 10.10. Th-cell activation and differentiation
After interaction with a DC APC, Th cells may differentiate into several different cell types, including
Th1, Th2, Tf h, Th17, Treg, Th3, and Tr1 cells. The pathway of Th-cell differentiation depends on the
cytokines produced during antigen presentation (arrows). Each Th-cell type secretes a characteristic
set of cytokines (far right) and participates in a unique way in the immune response.

MHC class II molecules. But the similarities most is known about Th1, Th2, and Th17 cells.
end there. The Th1 cells participate in inflammatory re-
Most immunological studies generally recog- sponses and in the production of certain types
nize four products of Th0-cell differentiation: of antibodies, and the Th2 cells mostly direct
Th1, Th2, Th17, and Treg cells. Of these, the B-cell differentiation and antibody responses.

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Th17 cells play their largest roles in inflamma- and IL-25. IL-4 and IL-5 stimulate Th2-cell di-
tory responses. Differences in the cytokines the vision, as well as B-cell activation and division,
cell types produce make this possible. and direct B cells toward the production of spe-
The largest numbers of Th1 cells develop cific antibody types, including IgGs and IgE.
after infections with intracellular bacteria and IL-4 and IL-5 also activate eosinophils (along
viruses. Activated Th1 cells produce a series of with IgE, also important in some parasitic in-
proinflammatory cytokines, including γ-IFN, fections) and mast cells (see Figure 10.12). Also,
IL-2, TNF-α, TNF-β, Fas ligand (FasL), and IL-4 and IL-13 activate an alternative set of mac-
others (see Figures 10.11A–D and 10.12). These rophages important for immune response to
cytokines affect many different aspects of pro- parasites and tissue repair.
tective responses, especially innate effector re- IL-5 stimulates production of granulocytes in
sponses. Together, Th1 cytokines (particularly the bone marrow, and IL-13 stimulates produc-
IFN-γ and IL-2) activate macrophages, increase tion of TGF-β—a cytokine that stimulates cel-
inflammation, stimulate B-cell proliferation lular proliferation and differentiation—whereas
and differentiation, and accelerate T-cell pro- IL-25 is another proinflammatory cytokine. At
liferation. The Th1-cell–activated macrophages sites of inflammation, IL-5 also serves to acti-
express higher levels of B7 and MHC class II vate eosinophils, allowing them to more effec-
molecules, more effectively destroy ingested tively degranulate and mount antihelminthic
bacteria (particularly through upregulation of responses.
oxidative radical-generating machinery), more Beyond Th1 and Th2 cells, several additional
efficiently activate additional T cells (especially types of CD4+ T cells play various roles in stim-
Tc cells), and secrete additional TNF-α—a pow- ulating or inhibiting immune responses. Other
erful stimulator of inflammation. The Th1-cell– products of Th0 cells, Th17 cells, produce sev-
activated macrophages and inflammation are eral cytokines (including IL-17, the source of the
major players in protective responses against designation Th17) that favor inflammation. The
bacteria. After secretion, IL-3 induces increased cytokine IL-17 has multiple effects on events re-
production of macrophages in the bone mar- lated to inflammation (see Figure 10.13).
row. TNF-β further contributes to inflamma- In immune reactions to several types of
tion and emigration of monocytes from the pathogens, this inflammatory enhancement
blood and, along with FasL, helps to destroy is essential for control and elimination of the
chronically infected cells and release their con- pathogen. The cytokines IL-6 and IL-23, from
tents to fresh macrophages. In addition, Th1 APCs, favor development of Th17 from Th0
cells secrete macrophage chemotactic protein cells (see Figure 10.10).
1. This cytokine brings more macrophages to
sites of inflammation. Th1 cells and their cyto-
kines also favor production of specific antibody Effector Regulatory T Cells:
types and suppress activation of Th2 cells and Treg, Th3, and Tr1 Cells
some B cells. The last generally recognized group of CD4+
In addition, Th1 cells are effective activators T cells is the regulatory T cells. Some regula-
of B cells and induce isotype switches to partic- tory T cells, specifically Treg cells, arise in the
ular Ig isotypes (especially those isotype types thymus from populations of self-reactive CD4+
that are the best opsonins; see chapter 11) and T cells that survive negative selection and emi-
suppress activation of Th2 cells. grate to the periphery (see chapter 9). Other
Activated Th2 cells participate most di- regulatory T cells appear to arise after induc-
rectly in antibody-mediated adaptive immune tion outside of the thymus; these cells may be
responses. These cells secrete IL-4, IL-5, IL-13, descendants of Th0 cells. The Treg cells play a

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Figure 10.11A–D. Actions of
effector Th1 cells
Activated Th1 cells secrete
unique sets of cytokines.
Panel A depicts the original
activation that leads to the
production of IFN-γ, and the
other cytokines represented
in panels B, C, and D activate
macrophages, enhance the
killing of bacteria, and induce
B-cell differentiation (panel
A), kill chronically infected
cells (panel B), induce T-cell
proliferation (panel C), and
activate vascular endothelium
to enhance exit of monocytes
from blood into inflamed and
infected tissues (panel D).

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major role in the suppression of autoimmunity Three additional regulatory T-cell categories
through peripheral tolerance. (Th3, Tr1, and Th9) may also be important in
To maintain self-tolerance, Treg cells inter- prevention of autoimmunity. But recent evi-
fere with the normal activation of effector cells dence has indicated that all three cell types may
or destroy them, but exactly how Treg cells do arise from one of the four major types of Th
this is unclear. It now appears that many auto- cells, depending on which cytokines are present.
immune diseases result from dysregulation of, In summary, Th cells act at many points
or imbalances among, Treg-cell populations. while innate and adaptive responses are devel-
Beyond the four generally recognized Th-cell oping. In addition, Th cells help prevent some
subtypes, other CD4+ T cells seemingly par- destructive autoimmune and inflammatory
ticipate in certain types of immune responses responses. But despite their importance in im-
or immune suppression. The relationships munity, the exact number of T-cell lineages and
of these cells to commonly recognized Th their mechanisms of action are not known. It is
cells are unclear. Among them are T-follicular clear that Th cells come in many forms and par-
helper cells (Tf h). These T cells reside in the ticipate in essential ways in all aspects of adap-
follicles inside of lymph nodes and appear to tive immune responses.
play a role in directing Th-cell differentiation.
Because much of Th-cell differentiation occurs
after antigen presentation in the lymph nodes, Effector Cytotoxic T Cells
Tf h cells probably play important roles in the In the final steps of CD8+-cell activation,
lives of Th cells. Whether Tf h cells represent APCs provide first signal in the form of anti-
a T-cell lineage distinct from Th1 and Th2 cells, gen presentation in the context of MHC class I
however, is not clear. molecules and second signal through the inter-

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Figure 10.12. Actions of activated Th2 cells
Th2 cells secrete several cytokines, including IL-4 and IL-5. These cytokines stimulate proliferation
and differentiation, activate mast cells and eosinophils, and stimulate proliferation and differentiation
of B cells.

action of B7 and CD28. Once activated, Tc cells They can extravasate at sites of inflammation
no longer require costimulation for further and look for infected cells exhibiting the same
activation. Activated Tc cells migrate from the MHC class I–antigen complex the APCs first
lymph nodes and circulate in blood and lymph. presented to these Tc cells.

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Figure 10.13. Effects of Th17-derived IL-17
During responses against bacteria, fungi, and parasites, IL-17 attracts neutrophils and macrophages
(derived from monocytes) to sites of inflammation. Once there, this cytokine stimulates mucin secre-
tion and interacts with several other proinflammatory cytokines to enhance and maintain the inflam-
matory state.

The interaction between effector Tc cells and antigen-1 (LFA-1) and I-CAM-1. Only after these
potential target cells does not begin with MHC– adhesion molecules anchor a Tc cell is there an
antigen and TCR. Instead, effector Tc cells opportunity for TCR interactions with specific
browse through potential target cells using intra- MHC–antigen complexes. If no TCR binding
cellular adhesion molecules (I-CAMs or simply occurs, Tc cells detach from this potential target
CAMs) such as leukocyte function-associated and resume their searches for infected cells.

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Figure 10.14A–C. Effector Tc cell function
Tc cells first attach to target cells using CAM (panel A). Then TCR interacts with antigen–MHC com-
plexes, and a shift occurs in the cellular architecture. The Golgi apparatus (GA) aligns between Tc and
target cells, the microtubule organizing center (MTOC) realigns the cellular architecture, and lytic
granules (LG) appear between effector and target cells (panel B). The release of the lytic granules as
well as the interaction between FasL on the Tc cell and Fas on the target cell induce apoptosis in the
target cell (panel C).

When a specific interaction occurs between infectious contents. Macrophages then safely
the T cell’s TCR and MHC–antigen complexes clean up the remains of the apoptotic cells, and
on the target cell, though, several changes occur no inflammatory response follows.
inside of the Tc cell (see Figure 10.14A–C). The By these means, Tc cells effectively rid an ani-
Tc cell’s Golgi apparatus aligns at the point of mal’s body of infected cells and bring infectious
cellular contact, and lytic granules accumulate diseases to a healthy conclusion. In summary (see
in the Tc cell near contact points with the tar- Figure 10.15), APCs activate Tc cells in secondary
get cell. The cellular architecture shifts as the lymphoid tissues. Activated Tc cells may become
Tc cell focuses its weapons on the target cell. At effector Tc cells or memory Tc cells. Effector T
this point, the Tc cell releases both perforins and cells migrate to areas of inflammation and kill
granzymes (a series of serine proteases) and ex- infected cells. Memory Tc cells are long-lived and
presses FasL. Perforins open small pores in the are the first to respond in secondary and subse-
target cells’ surfaces. When entering through quent immune responses. After infection, T cells
those pores, the granzymes initiate apoptosis develop into a formidable array of weaponry
in the target cells. When FasL reacts with Fas (see Figure 10.16). Each of these T cells plays a
on the target cell, it also induces apoptosis, and vital role in the developing immune response as
infected cells die without releasing all of their well as in the prevention of autoimmunity.

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Figure 10.15. Life cycle of a Tc cell
APCs activate Tc cells in lymphoid tissues. Activated cells differentiate into memory or effector Tc cells.

Clinical Correlation Follow-Up this and previous chapters you should know
why the absence of IL-2 receptors might result
As we said at the beginning of this chapter,
in thymic atrophy. In addition, you should be
XLSCID in basset hounds (Figure 10.17) re-
able to offer a plausible explanation for the dra-
sults in severe atrophy of the thymus and the
matically reduced numbers of T cells.
lymph nodes as well as SCID. Affected animals
have dramatically fewer T cells but a normal
to above-normal number of B cells. The muta- Possible Explanations
tion responsible for XLSCID occurs in the gene There is no simple explanation for all of the
that encodes the common γ-chain receptor—a symptoms of XLSCID in basset hounds, but
molecule that forms a requisite part of many some of the contributing factors seem obvious.
different IL receptors, including IL-2R, IL-4R, The γc chain is an essential component of re-
and IL-7R. How could alterations in the γc gene ceptors for IL-2, IL-4, IL-7, IL-9, IL-15, and IL-21.
account for the XLSCID? IL-2 and IL-4 play essential roles in lympho-
cyte proliferation. Both inside and outside of
the thymus, T-cell division depends absolutely
Student Considerations on IL-2. Outside the thymus, naive Th cells re-
On the basis of the material presented in quire IL-2 for proliferation and differentiation.
this chapter, you should be able to propose a In addition, IL-4 stimulates proliferation and
reason why the absence of IL-2 and IL-4 recep- differentiation of Th2 cells and B cells.
tors would result in severely atrophied lymph A complete lack of IL-2R and IL-4R would
nodes. Also, on the basis of information from result in no lymphocyte proliferation in either

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Figure 10.16. Effector T cells
After activation by MHC–antigen complexes on APCs, T cells differentiate into a variety of effector
cells that drive the progression of a variety of types of immune responses.

the thymus or the lymph nodes and a complete with the limited number of T cells, explains the
absence of mature B cells. These factors would absence of mature B cells.
result in severe atrophy of both primary and Beyond IL-2 and IL-4, another factor is at
secondary lymphoid organs, as seen in these play here: IL-7. This cytokine plays a major
dogs. However, these factors would not explain role in the development of lymphoid progeni-
the continued presence of roughly 30 percent tor cells in the bone marrow. When pluripotent
of normal T-cell numbers by age eight weeks lymphoid stem cells lack receptors for IL-7, few
old. or no lymphocytes develop in the bone mar-
In addition, there is the problem of the row. As a consequence, none go to the thymus,
above-normal B-cell numbers in dogs with and none leave the thymus to populate the
XLSCID. Interestingly, all of the B cells in dogs secondary lymphoid tissues. This, too, could
with XLSCID are immature B cells (they only explain the absence of palpable lymph nodes
express IgM). Maturation of B cells (see chapter and the thymic atrophy in dogs with XLSCID.
11) requires interaction with Th cells and cyto- However, a complete lack of receptors for
kines produced by Th cells, such as IL-4. The IL-7 seems inconsistent with the numbers of
absence of functional receptors for IL-4, along lymphocytes remaining in basset hounds with

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Figure 10.17. Tan and white basset hound (© Ewa Studio / Shutterstock)

XLSCID—especially B cells. A complete expla- molecules; reduced affinity of these molecules;

nation for this disorder will probably involve or both, but it seems likely that other factors
reduced numbers of IL-2R, IL-4R, and IL-7R contribute as well.

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callahan text.indd 180 3/11/14 1:46 PM
Gerald N. Callahan

B-Cell Development Chapter 11


tology testing of these animals shows normal

Clinical Correlation: Equine
numbers of lymphocytes, but no B cells, no
Agammaglobulinemia 181
IgM or IgA antibodies, very low concentrations
Learning Objectives 181
of IgG and Ig(T) (an isotype peculiar to horses)
B Cells and the Structure of the B-Cell
Receptor 182
antibodies, and normal T-cell responses in vitro
B-Cell Genetics, Development, and
and in vivo. Because shortly after birth most
Circulation 183 foals receive large amounts of Ig in their dams’
B-Cell Receptor Gene Families, Genetic colostrum, the immunodeficiencies of the foals
Rearrangement, and Junctional Diversity 183 become apparent only as maternal Ig disap-
Order and Regulation of B-Cell Development 186 pears from their blood. At this point, these foals
Immunoglobulin Isotypes 189 often succumb to persistent bacterial infections
Other Populations of B Cells 191 and die.
B-1 B Cells 191 Because of the similarities of this disease to
Marginal-Zone B Cells 194 X-linked agammaglobulinemia in humans, the
Clinical Correlation Follow-Up 195 underlying cause is likely a defect in a molecule
Student Considerations 196 called Bruton’s tyrosine kinase (BTK), an en-
Possible Explanations 196 zyme essentially involved in the function of the
BCR and other surface receptors. These foals’
illness is apparent, but what is less apparent is
Clinical Correlation: Equine how a protein-kinase defect could lead to a se-
Agammaglobulinemia vere immunodeficiency.
Antibody deficiencies, which may be selective
or complete, are among the most frequently Learning Objectives
diagnosed immune deficiencies in mammals.
One of these, equine X-linked agammaglobu- After reading this chapter, you should be able to
linemia, provides a useful insight into the na- • describe the structure of the BCR;
ture of B-cell development in horses and prob-
ably all other mammals. Among thoroughbred,
• explain the genetic mechanisms responsible
for the essentially unlimited diversity of
standard bred, and quarter horses, some af-
BCRs, including genetic rearrangement and
flicted males begin to develop severe bacterial
junctional diversification;
infections at about two to six months of age.
These infections include pneumonia, enteritis, • describe the mechanisms and the order of
B-cell development, including B-cell selection;
and dermatitis. Antibiotics and, interestingly,
plasma transfusions provide temporary relief • explain the differences between Ig isotypes
from symptoms and further infections. Hema- and their importance in defense;


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B cells are the ultimate source of antibod-
ies, the end products of adaptive humoral im-
mune responses—humoral because physicians,
such as Galen in the second century BC, once
believed that all maladies arose as a result of
an imbalance in the humors (black bile, yel-
low bile, phlegm, and blood) of the circulating
fluids. Because of that, factors that appeared
in blood were called humoral factors. Because
scientists first discovered antibodies in serum,
this type of response came to be known as the
humoral immune response. B cells come in two
forms, B-1 and B-2. In mammals, B-2 B cells are
the most numerous and produce the largest va-
riety of antibodies.
Like TCRs, antibodies come in almost limit-
less forms, each with a unique antigenic speci-
ficity, but BCRs contain four polypeptide chains
and react with native antigen—that is, with
unprocessed antigens and no involvement with
MHC molecules (Figure 11.2)
The most common form of mammalian
Figure 11.1. Americanquarter horse (© BCRs contains four Ig chains—two H chains
Lenkadan / Shutterstock) and two L chains—all held together by disul-
fide bonds. This part of the BCR is essentially
an antibody molecule with an added mem-
• describe the nature of B-1 and marginal- brane anchor. Each of the four chains contains
zone (MZ) B cells and discuss the relevance a C-terminal constant region and an N-terminal
of these cells to defense against infections. variable region. Within these variable regions
of both H and L chains (just as with TCR α and
β chains) are three regions of hypervariability
B Cells and the Structure
called CDR1, CDR2, and CDR3. Together these
of the B-Cell Receptor
regions of one H chain and one L chain form an
In mammals, B cells—like all lymphocytes— antigen-binding site—two per BCR.
originate in the bone marrow. Unlike T cells, Unlike TCRs, antibodies exist in two forms,
though, all of the maturation of naive mam- as the cell membrane–bound BCR and as se-
malian B cells occurs in the bone marrow; no creted antibodies (see the Order and Regulation
other organ contributes to the first phases of of B-Cell Development section) that circulate
B-cell development. In birds, however, B-cell in blood, extravascular fluids, and lymph. These
development (along with some hematopoiesis) secreted forms were discovered first and named
occurs in the bursa of Fabricius, an organ on immunoglobulins or antibodies.
the dorsal wall of the cloaca. In the teleost fish, In addition, BCRs associate with two other
the kidneys are the major sites of B-cell devel- membrane-bound proteins—Igα and Igβ. To-
opment, and in amphibians B cells develop at gether, these extra two molecules function in
several sites, including spleen, bone marrow, signal transduction much as the CD3 complex
and kidney. on T cells. Also like CD3, Igα and Igβ have

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Unlike TCRs, during its lifetime a B cell may
express several different forms of the BCR, all
with the same antigenic specificity. Different
forms of BCRs and secreted antibodies are
called Ig isotypes (see Immunoglobulin Iso-
types section). The differences between iso-
types are all found in the constant regions of
the H chains. The first BCR expressed by devel-
oping mammalian B cells is always IgM.

B-Cell Genetics, Development,

and Circulation
B-Cell Receptor Gene Families,
Genetic Rearrangement,
and Junctional Diversity
Once Igs were discovered, it was soon obvi-
ous that the chemical diversity among Igs out-
stripped that of any other animal protein. But
only after many years of study was the genetic
basis of this structural diversity unraveled.
These discoveries actually predated understand-
ing of the genetics of TCRs by a few decades.
Figure 11.2. The common mammalian BCR
The essentially unlimited diversity among
The BCR contains four polypeptide chains—
the common mammalian BCRs within one ani-
two identical H chains and two identical L
chains. The L chains are bound to the H chains
mal arises much as does the diversity of mam-
by disulfide bonds, as the H chains are bound malian TCRs. Inside the genome of mammals,
to one another. The C-terminal (membrane- sequences that encode BCR H and L chains ap-
proximal) portions of the H chains span the pear in segments or families of genes. H chains
cell membrane and are identical for each Ig have one gene family, and L chains have one or
isotype, and the N-terminal (membrane-distal) more. As with the TCR gene families, one BCR
portions of the H chains are highly variable. gene family (H chain) contains variable (V), di-
Similarly, the C-terminal regions of the L chains versity (D), and joining ( J) segments, and the
are constant within a given type of L chains, other gene family (L chain) contains only V and
and the N-terminal portions are highly variable. J segments (Figure 11.3). Camelids (camels and
Together, the N-termini of the H and L chains
llamas) are the one known exception to this. Ca-
make up the two membrane-distal antigen-
melid antibodies (not shown) have no L chains.
binding sites. Igα and Igβ molecules associate
with the antigen-binding portion of the recep-
The H chains by themselves form the antigen-
tor and are involved with signal transduction. binding sites of these antibodies. The Ig gene
Ag = antigen. families of camels and llamas, therefore, do not
include L-chain gene segments.
In mammals, bony fish, and amphibians, BCR
nothing to do with the antigenic specificity of gene rearrangement begins when the bone
the BCR. That specificity resides completely marrow stroma signals a developing B cell to
within the N-termini of the H and L chains. start rearranging H-chain genes, which results

B-Cell Development 183


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Figure 11.3. BCR gene families
The BCR H-chain gene family resides on a single chromosome and contains multiple variable (VH),
diversity (DH), and joining ( JH) segments. The number of these segments and their arrangements
varies between species. The lowercase n indicates varying numbers. The Greek letter ψ indicates
pseudogenes (incomplete genes), and the numbers under brackets indicate the total number of germ-
line V, D, J, and C complexes. IgW and Ig new antigen receptor (IGNAR) are Ig isotypes unique to
cartilaginous fish. BCR L-chain gene families are on separate chromosomes and contain only V, J, and
C segments.

in looping out of intervening DNA and juxta- chain, L-chain rearrangement begins when a
position of randomly selected DH and JH seg- randomly selected VL gene segment associates
ments. Just as with TCR gene rearrangements, with a randomly selected JL segment. Then, fol-
enzymes excise the looped-out DNA and, as the lowing the processes of excision of intervening
DH and JH segments join, additional diversity DNA and junctional diversification, an L-chain
arises from the process of junctional diversifica- variable gene complex appears. Enzymes then
tion—the random addition and subtraction of transcribe these L-chain and H-chain genes,
nucleotides as the DH–JH joint forms (see Figure along with their C segments, into nuclear, or
9.6). Next, this DJ segment, through a similar, primary, RNA. Then spliceosomes convert
random process, joins with a VH segment to cre- these transcripts into messenger RNA (mRNA),
ate an H-chain variable-region gene complex which are translated into proteins that join to
(Figure 11.4). form a BCR (Figure 11.4).
After a successful H-chain gene family rear- A final L chain requires one VL, one JL, and one
rangement and production of a functional H CL segment. The gene rearrangement process

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Figure 11.4. Assembly of L chains and H chains

B-Cell Development 185


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first randomly couples one VL and one JL. The result of somatic hypermutation driven by for-
newly formed VJ segment, along with interven- eign antigen. But regardless of the underlying
ing DNA and a CL segment, are transcribed into mechanisms, the end result is enormous diver-
a nuclear RNA transcript. Splice­osomes con- sity among BCRs and the ability to react with a
vert this nuclear transcript in mRNA, and ribo- nearly unlimited variety of antigens.
somes create the final protein. Similarly, a sin-
gle H-chain gene begins when rearrangement
randomly couples a single DH segment with a Order and Regulation of
JH segment. This complex then randomly rear- B-Cell Development
ranges to join a VH segment. The newly created Just as with T cells, the development of BCRs
VDJ complex, along with intervening DNA and is a complex and random process with an equal
a CH segment, produce a nuclear RNA tran- or greater potential for generating useless or
script that is converted to mRNA and translated self-reactive molecules over protective BCRs.
into an H chain. Two identical H and two iden- So the question remains, how is all of this regu-
tical L chains join to form a BCR. lated and controlled during B-cell development?
The final products are mammalian BCRs, In most mammals, bony fish, and amphib-
each with a unique antigen-binding specific- ians, B-cell development begins in the fetal liver,
ity. The nearly unlimited diversity and anti- spleen, and bone marrow. In chickens, rabbits,
genic specificity of these BCRs is the result of and sheep, it begins in the GALT. However, the
random gene rearrangement and junctional steps in the developmental processes are similar.
diversification. First, the bone marrow or other stroma deliv-
Other species use very different mechanisms ers a signal that initiates genetic rearrangement
to generate BCR diversity. For example, in chick- in the pre–B cells. These cells begin rearrang-
ens, BCR diversity arises from an entirely differ- ing H-chain genes, which starts (as mentioned
ent process called gene conversion (Figure 11.5). earlier and shown in Figure 11.4) with random
Chickens have only one VH, DH, and Cm (con- association of DH and a JH segment. This DJ
stant region for the H chain) gene segment. In- complex then randomly associates with a VH
side the bursa of Fabricius, genetic rearrange- segment, enzymes transcribe the VDJ complex
ment results in the appearance of the same along with a CH segment—in most cases, a Cυ
BCR on all B cells. In addition to the functional segment—into nuclear RNA, spliceosomes re-
gene segments in chicken Ig gene families, how- form this transcript into mRNA, and ribosomes
ever, are multiple pseudogenes—inactive partial make H chains from the message.
genes. During further development in chicken Pre–B cells that fail to successfully rearrange
B cells, additional rearrangement randomly H-chain genes and express a functional H chain
inserts pieces of these pseudogenes into the V are of no further use, so animals have evolved a
segments of both H- and L-chain genes, which means to test for a functional H-chain polypep-
dramatically increases the variety of BCRs and tide. Just as with T cells, B cells have evolved
the capacity for antigen recognition in chickens. a special gene to deal with this, a gene called
Cartilaginous fish have their H and L genes Vλ5 that produces a surrogate L chain. If the
already connected in the germline genetic con- newly formed H chain is functional, it will bind
figuration (Figure 11.3) and use still another to Vλ5, and the complex will move to the cell
means for diversification. Although structurally surface where stromal receptors test for the
unique (no L chains), camelid Ig genes diversify pre-BCR (pBCR). On one hand, if the receptor
via genetic recombination just as do Ig genes does not appear, then further rearrangement
in most other mammals. On the other hand, in on that particular chromosome is shut down,
sheep and cattle, antibody diversity arises as a and H-chain gene rearrangement begins on the

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Figure 11.5. Diversification of chicken BCRs
Initially, all chicken B cells express the same BCR—the product of only one VH, one DH, and one JH as
well as one VL and one JL segment. After these cells enter the bursa of Fabricius, they begin to prolif-
erate, and during cell division, pieces of adjacent pseudogenes (normally inactive genes) are inserted
into the active H-chain and L-chain genes, adding to the diversity of expressed BCRs.

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Figure 11.6. B-cell development
Gene rearrangement begins as B cells divide in the bone marrow. Cells that fail to produce a func-
tional H chain along with a surrogate L chain die. B cells that produce self-reactive BCRs undergo
further rearrangement, called receptor editing. If, after a second gene rearrangement, these B cells
still react with self, these cells die.

other chromosome of the parental pair. At the pears, rearrangement of L-chain genes begins
end of that process, the stroma again tests the on the other parental chromosome. If again no
pre–B cell for the appearance of a pBCR. If at BCR appears, the cell dies. But if a functional
this point the cell expresses no pBCR, the cell BCR does appear, the cell is immediately tested
dies (see Figure 11.6). for self-reactivity. Once identified, self-reactive
On the other hand, if the receptor appears, B cells are stimulated to undergo further rear-
the stroma stimulates the initiation of L-chain rangement, a process called receptor editing. If
gene rearrangement. VL and JL segments ran- these B cells either fail further productive rear-
domly recombine, and a nuclear transcript of rangement or again produce self-reactive BCRs,
this VJ segment, along with a CL segment, ap- these cells also die.
pears. Spliceosomes convert this transcript into Beyond this level of selection, one other pro-
mRNA, and ribosomes begin to make L chains. cess helps to ensure that self-reactive B cells do
If this rearrangement is successful and a func- not attack self outside of the bone marrow. For
tional L chain appears, it associates with the H a B cell to become activated, more than one
chain and moves to the cell surface as a fully BCR must bind to an antigen at the same time,
formed antigen receptor (BCR). The stroma and these BCRs must become cross-linked to
monitors this process as well. If no BCR ap- one another to generate the appropriate intra-

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cellular signals. That process requires particu- ten antigen-binding sites (Figure 11.9). Secreted
late antigen with a repetitive antigenic epitope, IgA antibodies may appear as monomers or as
so that two or more BCRs can bind to the same dimers (Figure 11.8). The dimeric form of IgA
antigen at the same time and induce cross-link- appears predominantly on mucosal epithelia,
ing. So, all B cells that react with soluble pro- so it is sometimes also called secretory IgA.
teins (which lack repetitive antigenic epitopes), The feature that distinguishes one Ig isotype
such as serum albumin, become anergic, or un- from another is the amino acid sequence of
reactive to any further stimulation. the constant region of the H chain. Because of
As a result, in a process somewhat similar to that, different Ig isotypes expressed by single B
T-cell selection, most self-reactive B cells die or cells will all have the same antigenic specificity.
are switched off before they can do any dam- How is it possible for one B cell to produce
age. B cells with functional BCRs are called several different isotypes with the same antigenic
naive or immature B cells—naive until they en- specificity? The answer is through a combination
counter their particular antigens. These B cells of selective RNA splicing and genetic rearrange-
exit the bone marrow or bursa of Fabricius and ment. In addition to V, D, and J segments, every
enter the blood. B-cell differentiation does not, H-chain gene family has multiple C segments—
however, end in the bone marrow. For all B Cm, Cδ, Cγ (one or more), Cε, and Cα (one or
cells, many steps remain on the way to becom- more)—corresponding to the H chains for IgM,
ing antibody-secreting plasma cells. After enter- IgD, IgG, IgE, and IgA (Figure 11.9).
ing the blood, most B cells will eventually make Two distinct genetic mechanisms result in
their way into secondary lymphoid tissues, and expression of distinct Ig isotypes by developing
it is here, especially within the lymphoid fol- B cells. All B cells first express IgM, which re-
licles, that much of the remainder of B-cell de- sults from a simple read-through from the VDJ
velopment occurs (see chapter 12). complex to the first two C gene segments, Cm
and Cδ. During production of mRNA, splice­
osomes remove the RNA encoding the IgD H-
Immunoglobulin Isotypes chain C region. Thus, the newly developed B
As mentioned earlier, antibodies come in cells express only IgM.
two physical forms—a membrane-bound form At a later stage in their development, most
as part of the BCR and a soluble form known as B cells briefly express both IgD and IgM. This
antibodies. In addition, both membrane-bound expression results from an alternative mRNA
forms and soluble forms of antibodies come splice (one splice removes Cm and the other re-
in chemically distinct forms known as isotypes moves Cδ), resulting in the simultaneous pro-
(Figure 11.7). duction of both isotypes and both types of
The numbers and characters of Ig isotypes BCRs. As you will see in chapter 12, at a still
vary markedly between species. Placental mam- later stage in B-cell development, B cells will
mals express IgM, IgD, IgG, IgA, and IgE. Also, often switch from expressing IgM and IgD to
most species that express IgG express multiple expressing another isotype—IgG, IgE, or IgA.
forms, or subtypes, of IgG. The same is often This process is called isotype switching. It is im-
true for IgA subtypes. In addition, both IgM portant to note that isotype switching to IgG,
and IgA appear in multiple structurally distinct IgE, and IgA occurs only after B-cell activation
forms (Figure 11.8). As BCRs, both IgM and IgA and expansion, which occurs only if the BCR
appear in their monomeric forms (shown in recognizes an antigen and, usually, receives fur-
Figure 11.7). When secreted, however, IgM ap- ther signals from Th cells. Exactly how a cell
pears as pentamer with ten H chains and ten chooses one isotype over another is not clear,
L chains creating five antibody monomers and but Th cells and their products appear to direct

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Figure 11.7. Ig isotypes
Variations in the constant regions of Ig H chains result in multiple forms of antibodies called Ig iso-
types. The number of isotypes, their form, and their designations vary among animal species.

the process. The process of Ig–isotype switch Occasionally, B cells will make more than
beyond IgM and IgD results not from alterna- one class switch, but these secondary and later
tive RNA splicing, but from further genetic switches must involve downstream constant re-
rearrangement. For example, inside a cell des- gion genes because all of those upstream of the
tined to express IgG, the DNA that encodes Cm first switch were excised.
and Cδ loops out, and enzymes excise it. From The advantage of multiple Ig isotypes is
this DNA, these B cells then begin to make IgG. that each antibody isotype appears at varying
Because this rearrangement results in changes concentration and distributes differently inside
to the H-chain constant region only, no change animals’ bodies, and each can perform distinct
occurs in the antigenic specificity of the BCR. functions after binding to antigen (Figure 11.10
The same holds for switches to IgA or IgE. and 11.11).

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terial and other infections (see chapter 4). Only
IgE binds to mast cells, a critical aspect of aller-
gies and defense against parasites. In addition,
each isotype has a unique distribution inside an
animal’s body (Figure 11.11).

Other Populations of B Cells

B-1 B Cells
In all mammals so far investigated, there
exists a distinct population of B cells called
B-1 B cells. The origins and function of these
cells are distinct from the B cells discussed so
far (sometimes called B-2 B cells or follicular B
cells because they are most commonly found
in lymphoid follicles). These novel B-1 B cells
arise early during fetal development (which is
the reason for the B-1 designation) in fetal liver,
whereas B-2 B cells arise later, mostly in fetal
bone marrow.
Often, but not always, B-1 B cells also express
a novel cell-surface molecule called CD5, so B-1
B cells are also called CD5+ B cells. The percent-
age of the total B-cell population accounted for
by B-1 B cells varies among species, from about
5 percent in primates and rodents to the major-
Figure 11.8. Polymeric forms of IgM and IgA
ity of B cells in rabbits and ruminants.
As a soluble antibody, IgM always appears as B-1 B-cell Ig gene segments do rearrange dur-
a pentamer with ten H and ten L chains and
ing development, but because these cells lack
ten antigen-binding sites. This process may or
TDT, there is no junctional diversification. In
may not require the participation of another
polypeptide called the J chain (unrelated to addition, B-1 B cells use only a few DJ and VDJ
JH segments). Also, as a soluble antibody, IgA combinations. Together, these two factors re-
appears in two forms, monomeric and dimeric, sult in a much lower BCR diversity among B-1
also with a coupling J chain. B cells than among regular, or B-2, B cells. Also,
after maturation in fetal liver, most B-1 B cells
migrate to the peritoneal and pleural cavities,
Each Ig isotype appears at different concen- not to lymphoid follicles. In the peritoneal and
trations in the serum, with IgG at the highest pleural cavities, it appears that further develop-
concentrations. The exact plasma concentra- ment of B-1 B cells is driven by encounter with
tions of each isotype vary among species. For a narrow range of specific antigens. The exact
example, numbers for horse Ig isotypes are ap- nature of these antigens is not always clear, but
proximately 1.96 mg/ml for IgA, 27 mg/ml for the most common appear to be bacterial poly-
IgG, 4.19 mg/ml for Ig(T), and 0.7 mg/ml for saccharides and lipids, as well as some auto­
IgM. antigens (self molecules).
Only IgM and IgG activate complement, an After activation, B-1 B cells establish self-
essential element in innate defense against bac- renewing populations of active B cells, and

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Figure 11.9. Ig H-chain constant genes
H-chain gene families contain V, D, and J gene segments that encode the variable region of the H
chain. In addition, each H-chain gene family contains multiple C-region gene segments corresponding
to multiple Ig isotypes.

Figure 11.10. Properties of primate Ig isotypes

Each mammalian Ig isotype has slightly different properties. These structural differences allow for
differences in distribution and function. The data shown in the upper half of this chart were derived
from humans and vary among species. IgG crosses the placenta in significant amounts only in mam-
mals with hemochorial (e.g., primates and rodents) or endotheliochorial placentation (e.g., dogs and

they constitute the majority, if not all, of the mals generate B-1 B cells in fetal liver. These B
B-1 B cells present in adult animals. That is, cells then migrate to the peritoneal and pleu-
early during fetal development, most mam- ral cavities, where they establish self-renewing

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Figure 11.11. Distribution of Ig isotypes in animals’ bodies
Both IgG and IgM appear in the blood, but extracellular fluid contains mostly IgG and monomeric
IgA. Dimeric or secretory IgA is the major isotype on mucosal secretions of epithelia and appears
in breast milk. IgE is mostly found bound to mast cells, and mast cells appear in greatest numbers
beneath the epithelial surfaces of the respiratory tract, the gut, and the skin. The blood–brain barrier
normally partitions Ig from the brain.

populations of B-1 B cells that persist through- that some B-1 B cells can, even in the absence
out adult life; these are the only B-1 B cells in of antigen, differentiate into antibody-secreting
adults. plasma cells and are responsible for so-called
B-1 B cells do not require interactions with natural antibodies that appear even in germ-
Th cells to become fully active and differenti- free animals. Most B-1 B cells express only IgM
ate into antibody-producing plasma cells (as do and never switch to another isotype, nor do
B-2 B cells; see chapter 12). So the antigens that they further diversify their BCRs in spleen or
activate B-1 B cells are called thymus-indepen- lymph nodes through the process of somatic
dent antigens (see Figure 11.12). It also appears hypermutation (as do B-2 B cells; chapter 12).

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Figure 11.12. B-1 B cells and thymus-independent antigens
In comparison with traditional or B-2 B cells, B-1 B cells and MZ B cells recognize distinct sets of
antigens called thymus-independent antigens because no T cells are involved in activation of B cells in
response to these antigens.

From all of this, it appears that B-1 B cells have sinuses and returning to the circulation. Obvi-
evolved to recognize and respond to commonly ously, then, the MZ B cells are well positioned
encountered antigens, such as the components to deal with antigens circulating in the blood
of bacteria. Because bacteria are among the and, as it turns out, especially well suited to
most numerous of all pathogens, it seems rea- deal with circulating encapsulated bacteria.
sonable that a rapid response element—such MZ B cells have a greater BCR diversity than
as B-1 B cells—would provide a considerable B-1 B cells, but not as great as that of B-2 B cells.
evolutionary advantage to animals that at birth MZ B cells produce mostly IgM, are longer-
must unavoidably and immediately deal with a lived than B-2 B cells, do not require T-cell help,
host of bacterial pathogens. The role of B-1 B and appear to have evolved to most effectively
cells in autoimmunity is also evident, but the deal with circulating pathogens, especially bac-
mechanisms and evolutionary significance of teria (see Figure 11.12). From a defense perspec-
this aspect of B-1 B cell function are much less tive, this is another relatively rapid response
clear. mechanism targeted toward bacteria, particu-
larly bacteria in the blood.
To summarize, three distinct populations of
Marginal-Zone B Cells B cells have evolved in most mammals to deal
Inside the marginal sinus of the white pulp with particular infectious threats. B-1 and MZ
of the spleen is yet another population of B B cells have relatively limited antigenic reper-
cells, the MZ B cells. These cells are physically toires and appear to have arisen to protect ani-
and functionally distinct from either B-1 or B-2 mals from commonly encountered pathogens,
B cells. The marginal sinus is the site where especially bacteria. B-2 B cells, however, have
blood exits the circulation, then traverses a re- an almost limitless capacity for BCR diversity
gion called the MZ before entering the venous and take somewhat longer to respond. But B-2

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Figure 11.13. Thoroughbred horse (© pirita / Shutterstock)

B cells can do something that B-1 B and MZ B ment. The transduction of that signal depends
cells cannot, and that is, deal effectively with on active functional BTK.
constantly evolving pathogens of all sorts. As mentioned, the bone marrow stroma ini-
tiates and directs rearrangement of BCR genes.
Clinical Correlation Follow-Up
Tyrosine kinases are important components of Student Considerations
many signal transduction pathways, and BTK On the basis of the material presented in this
happens to play an especially important role in chapter, you should be able to offer an explana-
signal transduction in B cells (see Figure 11.14). tion for the observation that horses with defec-
All B cells arise from a common hemato- tive BTK enzymes might exhibit a pronounced
poietic stem cell. Early on, the B-cell lineage agammaglobulinemia, have severely atrophied
diverges from the T- and NK-cell lineages. The lymph nodes, and, by age six months, uniformly
first recognizable B-cell precursor is the pre–B succumb to bacterial infections.
cell. Gene rearrangement begins inside of this
cell. The first outward sign of successful gene
rearrangement is the appearance of the new H Possible Explanations
chain along with Vλ5 in the form of the pBCR— As mentioned earlier, B cells (even B-1 B cells)
the pre–B-cell. For further rearrangement to that express the pBCR must receive and deliver
occur, the bone marrow stroma must deliver a another message before L-chain gene rearrange-
signal through the pBCR to the nucleus of the ment can begin. That signal depends on BTK. In
pre–B-cell to initiate L-chain gene rearrange- the absence of a second rearrangement signal,

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Figure 11.14. The role of BTK in equine X-linked agammaglobulinemia (EXLA)
To ensure that each step proceeds normally, B cells have evolved means for signaling the stroma at
each major step of development. Rearrangement and production of H-chain genes occurs first, but H
chains by themselves cannot assume proper configurations and insert themselves into the cell mem-
brane. Because the cell membrane is the only surface accessible to the bone marrow stroma, B cells
have evolved a means to express isolated H chains using a surrogate L chain called Vλ5. Together, H
chain and Vλ5 form the pBCR at the surface of developing B cells. Normally, the pBCR interacts with
stromal receptors and, in return, the stroma delivers a signal through the BCR to pre–B cells’ nuclei.
The delivery of this signal depends on a complex set of second-messenger molecules. One of these
is BTK. In the absence of BTK, further Ig gene rearrangement ceases. These B cells never produce L
chains and eventually die via apoptosis.

B  cells fail to initiate L-chain gene rearrange- no B cells and no antibodies. Without B cells,
ment. As a result, these cells never express a lymph nodes atrophy, and no lymphoid follicles
functional BCR that will deliver a second signal or germinal centers appear. As a result, as soon
to the bone marrow stroma and allow the pre–B as the maternally transferred antibodies disap-
cells to survive a second round of selection. As a pear from the foal’s blood, massive infections
result, animals without functional BTK produce ensue and the animal dies.

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Gerald N. Callahan

B-Cell Activation and Differentiation Chapter 12


normal levels of IgG and IgM but depressed lev-

Clinical Correlation: Selective Immuno­-
els of IgA. The degree of the suppression varies
globulin A Deficiencies in Dogs 197
from no IgA to a less-than-normal level of IgA.
Learning Objectives 197
T-Dependent B (B-2) Cells 199
Interaction of B Cells with Antigens 199 Learning Objectives
B Cells as Antigen-Presenting Cells 203
After reading this chapter, you should be able to
Activation of B Cells by T-Helper Cells 204
Isotype Switching, Somatic Hypermutation, • describe the manner in which B cells interact
and Terminal Differentiation of B Cells into with antigens and pathogens;
Plasma Cells 206
Antibody Effector Functions 213
• understand the role of B cells in antigen
presentation to Th cells;
Pathogen and Toxin Neutralization 213
Opsonization and Activation of Complement 213
• describe the signals necessary for B-cell
activation and their consequences;
Distribution and Function of Fc Receptors 214
Clinical Correlation Follow-Up 215 • describe the driving forces for Ig isotype
Student Considerations 215 switch and the roles of the various Ig
Possible Explanations 217 isotypes;
• understand the mechanisms, consequences,
and importance of somatic hypermutation;
Clinical Correlation:
Selective Immunoglobulin
• explain the final differentiation of B cells
into plasma cells and the secretion of
A Deficiencies in Dogs
As many as 80 percent of Chinese shar peis • explain the process of affinity maturation;
(see Figure 12.1) develop recurrent dermatitises • describe the differences between primary
(staphylococcal), demodectic mange (see Fig- and secondary humoral immune response
ure 12.2), thyroid disease, otitis externa, flea and the reasons for these differences;
allergies, cystitis, food intolerance, bronchi- • explain the effector actions of antibodies and
tis, and atopy. Similar disorders also appear in their importance in defense;
(among others) German shepherds, beagles,
Irish wolf hounds, and cocker spaniels.
• explain the various roles of Fc receptors in
immune responses and protection.
Most of the symptoms apparent in Chinese
shar peis share two features: they involve body Two of the most striking features of the im-
surfaces and appear to result from some sort of mune system and immune responses are anti-
inherited immune deficiency. Clinical labora- gen specificity and immunologic memory (see
tory analyses of serum from affected dogs reveal Figure 12.3).


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Figure 12.1. Chinese shar pei dog (© Waldemar Dabrowski / Shutterstock)

After a primary immunization of an animal, levels of antibodies persist for very long peri-
no detectable change occurs in blood levels of ods of time—often years or even decades. The
antibodies for the first seven to ten days. This immune response to antigen B, injected at the
phase is called the lag phase, and it occurs be- same time as antigen A, exhibits features char-
cause it takes time to develop an adaptive im- acteristic of a primary immune response.
mune response. After the lag phase, IgM anti- Clearly, at day 28 some aspect of the im-
bodies begin to appear in the animal’s serum. mune system has changed, and it now carries
The amount of antigen-specific serum IgM a memory of the previously seen antigen A.
continues to rise for about another seven days Because of this memory, the animal’s immune
and then gradually falls off over the next two system now does something very different: it
weeks to near 0 by day 28. After a secondary produces more antibody, it produces a differ-
immunization with antigen A and antigen B, ent type of antibody, it produces it faster, and
the lag phase drops to about three days for an- the antibody persists in the serum for a much
tibodies to antigen A, followed by a dramatic longer time. Also, the antibodies produced dur-
rise of antibodies to a much higher level than ing secondary immune responses have a much
seen in the primary response. In most immune higher affinity for antigen and that affinity con-
responses, nearly all of these antibodies are tinues to increase as the secondary response
IgG (although they could also include IgE and continues. This progressive increase in affinity
IgA). Also, after secondary immunization, high is known as affinity maturation, and it occurs in

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Figure 12.2. Dog with severe demodectic mange (© Robert Adrian Hillman / Shutterstock)
Demodectic mange is also known as demodicosis or red mange. A persistent infestation with Demodex
canis, a mite, causes this mange. It comes in two varieties: localized and generalized. Localized mani-
fests at four or fewer spots of mange. Most normal dogs are not susceptible to demodectic mange.

most immune responses and generates highly quence variability among BCRs lies within the
antigen-specific antibody. Memory and speci- CDRs of the H and L chains (Figure 12.5), the
ficity are the hallmarks of adaptive immunity part of the antibody molecule in direct contact
and result from the characteristics of T and B with antigen.
lymphocytes. As the H and L chains fold into their final
conformations, CDR1, CDR2, and CDR3 of
T-Dependent B (B-2) Cells both chains come to reside in the antigen-bind-
ing site—that is, the portion of the BCR that
Interaction of B Cells with Antigens interacts most directly with antigen.
The BCR contains not only two H and two Unlike T cells, B cells do not require antigen
L chains, but signal-transduction molecules as processing before antigen binding, nor is there
well. Igα and Igβ are the same in all BCRs and any involvement of MHC class I or II molecules
do not contribute to an antibody’s antigen-bind- in antigen binding by BCRs. BCRs bind intact
ing properties. The only parts of the BCR that antigens, whether that antigen is a whole bacte-
interact directly with antigens are the variable rium or virus or clumps of denatured proteins,
regions of the L and H chains (see Figure 12.4). such as the toxoid in tetanus vaccines.
As discussed in chapter 11, within the N- Also, because the regions between the mem-
terminus, variable regions of H and L chains brane-distal and membrane-proximal regions
are three hypervariable regions, CDR1, CDR2, of the H chains (sometimes called the hinge
and CDR3. Essentially, all of the amino acid se- regions) are very flexible, antibody and BCR

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Figure 12.3. Primary and secondary humoral immune responses
At day 0, an animal received an injection of antigen A. On day 28, the same animal received an injec-
tion of both antigen A and antigen B. From day 0 on, the serum levels of antibodies to antigens A and
B were monitored and appear in arbitrary units on the y-axis.

molecules can open wide to reach and bind multiple bonds. The advantage to multiple
identical antigenic epitopes. That is, antibodies interactions between antigens and antibodies
can go from being Y shaped to being T shaped is that it makes the interaction highly specific.
to accommodate the span between epitopes. Hydrogen bonds, electrostatic interactions, Van
The chemistry of antigen–antibody interac- der Wahl’s forces, and hydrophobic interactions
tions is complex and involves multiple types of act over only very short distances, which means
bonds, including hydrogen bonds, electrostatic that the fit between an antibody and an anti-
interactions, Van der Wahl’s forces, and hydro- gen must be exact or these bonds simply will
phobic interactions. Two things all of these not form. When the fit is right, though, despite
types of bonds share is that they are noncova- low affinity of individual interactions, the sum
lent and individually weak interactions. of these bonds results in very high overall af-
The most important of these chemical inter- finities between antibodies and their antigens.
actions varies between antibodies and their anti- When the fit is imperfect, the affinity decreases
gens, but all antigen–antibody binding involves (see Figure 12.6)

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Figure 12.4. The common mammalian BCR
This form of the BCR contains four signal-
transduction molecules—two Igα chains and
Figure 12.5. Therole of the CDRs in antigen (Ag)
two Igβ chains. However, all of the interactions
binding by the BCR
between BCR and antigen (Ag) occur at the
N-termini (membrane-distal) portions of the H The N-terminus regions (membrane-distal
and L chains. portions) of H and L chains contain all of the
variability found among BCRs of different
specificity. Within these variable regions of the
H and L chains, the greatest variability lies in
As a result, a given antibody may bind (with three discrete regions called CDR1, CDR2, and
CDR3. In the final quaternary confirmation
varying affinities) to more than one antigen.
of the BCR, CDR1, CDR2, and CDR3 regions
For example, a rabbit immunized with bovine
of the H and L chains make up the bulk of the
serum albumin may produce antibodies with antigen-binding sites and make direct contact
high affinity for bovine serum albumin, but with antigens.
these same antibodies may also bind (with a
much lower affinity) to equine serum albu-
min—an antibody cross-reaction. In spite of
their remarkable specificity, essentially all an- Regardless of affinity—high or low—all anti-
tibodies have some potential for cross-reactiv- gen–antibody interactions are noncovalent and
ity. This consideration is especially important reversible, meaning that antigens are always
when using antibodies for immunotherapy or moving on and off antibody-binding sites at a
in clinical analyses (see chapter 17). given rate—simple equlibria determined by

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Figure 12.7. The B-cell coreceptor
Besides BCRs, B cells express another com-
plex of molecules called the B-cell coreceptor.
Together, these molecules bind to fragments of
complement proteins and deliver an additional
signal to the B-cell nucleus.

As with CD4 and CD8 on T cells, B cells ex-

press another group of molecules besides the
BCR that are important to B-cell activation—
the B-cell coreceptor (see Figure 12.7). The B-
cell coreceptor is a complex of molecules that
bind a complement protein fragment and trans-
duce a second singal from the B-cell surface
to the nucleus to initiate the process of B-cell
Figure 12.6. The affinity of antibodies for antigens
As discussed in chapter 4, several pathogens
results from the complementarity of fit
activate complement directly, which results in
When antigens fit properly within an antibody- opsonization of pathogens with complement-
binding site, the maximum number of interac-
derived proteins, especially C3b. IgG or IgM op-
tions can occur between the two, generating the
sonization of pathogens also activates comple-
highest affinity possible (upper panel). If the fit
is less good, fewer specific bonds form (indi-
ment and leads to deposition of complement
cated in different colors), and the interaction is fragments on the pathogen. Binding of the
of lower affinity (lower panel). coreceptor to these complement fragments on
the antigen, along with the binding of the BCR
the Keq of the reaction. This fact is important to antigen, significantly enhances the strength
to remember in the later discussion of affinity of the binding between B cell and pathogen,
maturation. leading to more efficient B-cell activation. After

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Figure 12.8. B cells as APCs
B cells acquire antigen through the Ig portion of their BCRs. After binding antigen and BCR cross-
linking (not shown), B cells internalize the antigen–antibody (Ag–Ab) complexes, and process both
antigen and antibody into peptides. MHC class II molecules bind these peptides and present them on
B-cell surfaces.

binding of the BCR to antigen and of the B-cell cess, the antigen–antibody complexes enter the
coreceptor to complement fragments, B cells endosomal pathway, are chopped into pieces,
begin to express high levels of MHC class II and are bound by MHC class II molecules as de-
molecules and B7, making them much more ef- scribed in chapter 8. After this processing step,
ficient APCs. the MHC class II–antigen complexes move to
So, BCRs can directly bind to native antigen, the surface of B cells, where the complexes be-
sometimes with very high affinities, but antigen come accessible to the TCRs of Th cells (see
binding alone (not even antigen binding by the Figure 12.8).
B-cell coreceptor along with BCR binding to The same processing and presentation clearly
antigen) is not enough to activate a B cell and occur with BCR fragments. Because most self-
push it into proliferation and differentiation. All reactive T cells die in the thymus, though, there
B cells, except for B-1 B cells and possibly some are usually no Th cells in the periphery that
MZ B cells, require other signals beyond BCR react with self Ig. In fish and amphibians, B
and coreceptor binding to antigen before acti- cells (as do macrophages and DCs) also directly
vation to proliferation and differentiation. Most phagocytose antigens for presentation to Th
of those signals come from Th cells activated cells.
by B cells acting as APCs. After antigen and coreceptor binding, B cells
begin to express higher levels of B7 and MHC
class II molecules. As a consequence, these B
B Cells as Antigen-Presenting Cells cells transform into highly effective APCs. After
After a B cell’s BCRs bind to antigen and antigen-induced activation, B cells also begin
cross-link to one another, some of the antigens, to express another molecule called CD40. Ulti-
along with some of the BCRs themselves, are mately, this molecule will also make B cells bet-
taken into the B cells in a process known as re- ter APCs through interaction with CD40 ligand
ceptor-mediated endocytosis. During this pro- (CD40L) on Th cells. CD40 molecules, in fact,

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appear on all APCs, but CD40 plays an espe-
cially important role in B-cell activation. Dur-
ing interactions between macrophages or DCs,
CD40 binding to CD40L causes these APCs to
secrete cytokines. In the interaction between B-
cell APCs and Th cells, CD40 binding to CD40L
provides a costimulatory signal for the B cells
and promotes growth, differentiation, and iso-
type switching (further described in the Isotype
Switching section).
B cells may encounter antigen in the pe-
riphery or in secondary lymphoid tissues. But
regardless of where the antigen-induced activa-
tion begins, B-cell development finishes in sec-
ondary lymphoid tissues. In our discussion, we
focus on lymph nodes.

Activation of B Cells by T-Helper Cells

The final stage of differentiation for most B
cells requires the participation of a Th cell that
has undergone clonal expansion and further
differentiation after activation by an APC other
than a B cell, usually a DC. Although the BCR
on the B cell binds an antigenic epitope distinct
from the one bound by the TCR on the Th
cell, the antigen–MHC complex on the B cell
must bind to the Th cell’s TCR. For all of this
to occur properly, T cells, B cells, antigens, and
other APCs must all somehow come together
inside of lymph nodes.
After antigen binding or ingestion, DCs and
some macrophages arrive, along with antigen,
in lymph nodes via the lymphatics. Th cells
leave the thymus, and B cells leave the bone
marrow via the blood. The arterial circulation
and the lymphatics have no direct connection,
but inside of lymph nodes (and other second- Figure 12.9. B cells and Th cells enter lymph
ary lymphoid tissues), the endothelia of some nodes through HEVs and interact to effect
of the venules have a unique high-columnar B-cell activation
structure and are called high endothelial ve- Specialized venules inside of lymph nodes and
nules (HEVs). Because of specific interactions Peyer’s patches called HEVs have receptors
between lymphocytes and HEVs, lympho- for cell-surface proteins on T and B cells. This
cytes can move through HEVs from blood into interaction allows the T and B cells to exit the
blood and enter lymph nodes. Inside, Th cells
lymph nodes, allowing for the direct interaction
encounter antigen-presenting DCs.
among B cells, T cells, and antigen (see Figure

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Figure 12.10. B-cell migration
Naïve B cells leave the bone marrow via the blood. From there, these B cells may encounter antigen
in the blood, lymph, or lymph node. If the B cells fail to bind antigen or fail to find the appropriate Th
cell inside a lymph node, they leave nodes via the efferent lymphatics and move on to the next node.

12.9). If, after the antigen-activated B cell enters vides the next signal needed to stimulate B-cell
the lymph node, it does not encounter a T cell division and differentiation (see Figure 12.11).
with the appropriate TCR, the B cell leaves the After interactions with specific antigens pre-
node via the efferent lymphatic and moves on sented on APCs, T cells divide, differentiate,
to the next node (see Figure 12.10). If, instead, and provide necessary, additional signals to B
a B cell binds antigen and encounters a Th cell cells that ultimately trigger B-cell division and
reactive with that same antigen, the Th cell pro- differentiation. These additional signals come

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of eosinophils. Similarly, IL-13 stimulates B-cell
division and affects Ig class switch, and IL-25 in-
duces production of more IL-4, IL-5, and IL-13
and appears to help protect against certain par-
asitic worms.
Th1 cells produce IFN-γ, TNF, IL-2, and IL-
10. In some species, at least, IFN-γ stimulates
B-cell growth and Ig class switching. TNF stim-
ulates inflammation and B-cell differentiation.
IL-2 stimulates further T-cell division and also
affects class switching. IL-10 has multiple effects
on both inflammation and B-cell differentiation.
During primary immune responses, almost
all of the available B cells express IgM (as do all
naive B cells). After interaction with Th cells,
antigen-activated B cells move to the medul-
lary cords of the lymph nodes, differentiate in
plasma cells, and begin to secrete IgM—the
predominant antibody of primary immune re-
sponses (see Figure 12.12). As B cells differenti-
ate into plasma cells, the switch from the mem-
Figure 12.11. Antigen processing and brane-bound form of Ig (the BCR) to the secre-
presentation by B cells inside of a lymph node tion of soluble Ig is the result of an alternative
Mammalian B-cell BCRs bind to antigen and RNA splice that removes the membrane anchor
then, via receptor-mediated endocytosis, from the Ig H chains and creates a soluble form
internalize the antigen–antibody complexes
of the Ig molecule.
(upper portion of figure). The newly formed
Late in the primary response to a persistent
endosomes fuse with lysosomes that contain
both proteolytic enzymes and MHC class II
antigen and in all secondary immune responses,
molecules. The antigenic peptides bind to the most B cells will switch to another antibody
MHC molecules and the MHC–antigen com- isotype.
plexes return to the surface for presentation to
Th cells.
Isotype Switching, Somatic
Hypermutation, and Terminal
in the form of cytokines secreted by Th2 or Th1 Differentiation of B Cells
cells (see Figure 12.11). into Plasma Cells
Perhaps most important among the Th2- Some Th cell–activated B cells do not go to
derived cytokines is IL-4, which (among other the medullary cords. Instead, this population
things) stimulates B-cell division and induces of B cells moves into the lymphoid follicles.
clonal expansion of B cells. As a result, in a rela- There, these B cells interact with additional
tively short period of time after exposure, the Th cells and begin to divide, forming germi-
number of pathogen-specific B cells increases nal centers (see Figure 12.13A–C). As the B cells
to protective levels. IL-4 also plays a role in Ig divide in the germinal centers, Th-cell–derived
class switch (see Isotype Switching section). cytokines induce isotype switching from IgM
In addition, Th2-derived IL-5 stimulates B-cell to IgG or IgA or, occasionally, IgE (see Figure
division, antibody production, and the growth 12.14).

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Figure 12.12. The primary immune response
After the initial interaction between antigen-activated B cells and Th cells, the B cells begin to divide,
migrate to the medullary cords, and differentiate into IgM-secreting plasma cells.

After switching isotype, B cells must continue the mutated BCR may be the same, better, or
to interact with Th cells that stimulate further worse than that of the original BCR.
divisions, or the B cells will die. During these To deal with this, animals have evolved a pro-
divisions, mutations begin to accumulate in the cess of selection to eliminate those B cells with
B cells’ Ig genes at a very high rate—hypermu- unchanged or lower antigen affinity to ensure
tation. Because hypermutation occurs beyond that the end result of somatic hypermutation
the B cells developing in the bone marrow, it is antibody with greater affinity for the immu-
is called somatic hypermutation. Protein-se- nizing antigen. Overall, somatic hypermutation
quencing studies have shown that these muta- and selection result in the affinity maturation
tions do not occur randomly throughout the seen during secondary and subsequent im-
sequence of the Ig molecule. Instead, they are mune responses.
concentrated into the CDR1, CDR2, and CDR3 As mentioned earlier, germinal centers also
regions of the L and H chains (Figure 12.15). contain cells called FDCs. These cells play a
CDR1, CDR2, and CDR3 regions of the L crucial role in affinity maturation. On the sur-
and H chains are, of course, the segments that face of FDCs are receptors that bind to antigen–
make up the antigen-binding sites and directly antibody complexes. As antigen–antibody com-
contact antigen. So mutations that arise as a re- plexes begin to accumulate during the primary
sult of somatic hypermutation have dramatic immune responses, some are trapped on the
effects on the antigen-binding affinity of a B surface of FDCs in the germinal centers. The
cell’s BCR. Because somatic hypermutation is a antigens in these complexes serve as a reservoir
random process, the antigen-binding affinity of for B-cell selection.

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Figure 12.13A–C. B cells proliferate in lymph node
germinal centers
After activation in the medulla, a significant
population of B cells moves to the lymphoid
follicles (panel A), proliferates, and forms
germinal centers (panel B). Dividing B cells are
called centroblasts, and resting B cells are called
centrocytes. Germinal centers also contain Th
cells and FDCs (cells distinct from the antigen-
presenting DCs). In the germinal centers, B
cells undergo isotype switching and somatic
hypermutation, then emigrate the lymph node
and differentiate into plasma cells that migrate
to the bone marrow (panel C).

Each time a B cell interacts with a Th cell, division. If it fails to reacquire antigen, the B
the B cell is induced to divide. As that B cell cell will die by apoptosis.
comes out of the division cycle—goes from The only significant source of antigen in the
being a centroblast to being a centrocyte—it germinal center is the antigen–antibody com-
must again acquire antigen for presentation to plexes on the FDCs. As we have mentioned, all
another Th cell and enter another round of cell bonds between antigen and antibody are non-

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Figure 12.14. Cytokine control of isotype switching in germinal centers
In the upper left corner, a B cell first encounters antigen. Inside of a germinal center in secondary
lymphoid tissue, this B cell interacts with a Th cell (upper right). Depending on the cytokines pro-
duced by the Th cell, the B cell switches from expressing IgM to expressing IgG, IgE, or IgA.

covalent and reversible. If, as the B cell comes once again, present that antigen to a Th cell and
out of cycle, its BCR has a higher affinity for enter a new round of division. If, however, the
antigen than the antibody on the FDC, the new affinity of new, hypermutated BCR is no better
hypermutated BCR can acquire antigen from or worse than the affinity of the antibody in the
the complexes on the FDCs and process and, antigen–antibody complexes on the FDCs, the

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Figure 12.15. Somatic hypermutation
Late in primary immune responses and throughout secondary and subsequent immune responses
against a given antigen, mutations (shown here as colored vertical bars) rapidly arise in B-cell genes
encoding Ig molecules. These mutations fall mostly within the CDR1, CDR2, and CDR3 regions of
the L and H chains.

B cell will not be able to reacquire antigen, and or booster immunization, quickly differentiate
it will die (see Figure 12.16). Because most muta- into plasma cells producing isotypes other than
tions would result in a BCR that has lower or the M and very high-affinity antibody. These are the
same affinity for the antigen, it is not surprising cells that dominate secondary and subsequent
that many B cells die in this process of negative immune responses and, along with memory
selection. Macrophages in the germinal centers Th and Tc cells, are responsible for immuno-
remove dead B cells by phagocytosis. These logical memory. Figure 12.18 shows a summary
macrophages are often referred to as tingible- of these processes and how they relate to the
body (stainable-body) macrophages because differences between primary and secondary re-
their cytoplasm contains B-cell chromatin frag- sponses that we discussed at the beginning of
ments undergoing degradation and is character- this chapter.
istic of active germinal centers in a lymph node. After primary immunization (or infection),
Some of these high-affinity B cells emigrate naive B cells must acquire antigen, migrate to
from the lymph nodes via the efferent lymphat- the secondary lymph nodes, and find T-cell
ics, enter the blood, and home back to the bone help. Then, the first of these cells to be acti-
marrow. Along the way, these B cells differen- vated remains in the secondary lymphoid tis-
tiate into long-lived plasma cells and secrete sue and secretes IgM antibodies. These cells are
higher-affinity antibody from the bone marrow usually short-lived. This process takes seven to
(or sometimes from sites of inflammation) for ten days, and during that time antibody levels
months to years (see Figure 12.17). begin to rise in the serum. Late in the primary
Also in the germinal center, other B cells be- response, another group of B cells moves into
come long-lived memory B cells and remain in the lymphoid follicles and, after interactions
secondary lymphoid tissues. These cells persist with Th cells and FDCs, undergoes isotype
for a long time and, after secondary infection switch, somatic hypermutation, and selection.

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Figure 12.16. Affinity maturation through somatic hypermutation and selection
Inside of lymph nodes, as they undergo the process of somatic hypermutation, B cells must repeat-
edly bind antigen through their BCRs to survive. The major source of antigen in germinal centers is
in the form of antigen–antibody complexes bound directly or indirectly (through C3b and C3d recep-
tors, CR1 and CR2) to FDCs. To bind that antigen, hypermutated BCRs must have greater affinity for
antigen than the antibody on the FDCs. When this happens, B cells survive and continue as high-
affinity B cells.

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Figure 12.17. Life cycle of B cells
In most animals, B cells begin life in the bone marrow. They migrate from there, via the blood, to
secondary lymphoid tissues, where they interact with Th cells. Some B cells immediately become
plasma cells and secrete Ab from the medullary cords of the lymph nodes. Other B cells move to the
lymphoid follicles and, after interactions with Th cells and FDCs, switch isotypes, undergo somatic
hypermutation and selection, and become either long-lived memory B cells or antibody-secreting,
long-lived plasma cells at sites of inflammation, in the bone marrow, or in secondary lymphoid tissue.

Some of these high-affinity B cells migrate to process, another group of long-lived memory B
bone marrow. Along the way, they differenti- cells arises and remains in secondary lymphoid
ate into long-lived plasma cells secreting high- tissues awaiting another antigenic insult.
affinity antibodies specific for the immunizing In species such as chickens, rabbits, and sheep,
antigen. In the germinal centers of the lymph in which most B-cell development occurs in the
nodes, another group of high-affinity, isotype- GALT, the process is a little different (see Figure
switched B cells become long-lived memory B 12.19). Also, B-cell maturation does not involve
cells. After secondary immunization (or infec- germinal centers in all species, nor is it entirely
tion), memory B cells dominate the immune clear whether all species are capable of somatic
response. These B cells, again after interactions hypermutation (see Figure 12.20).
with Th and FDCs, generate mostly IgG or IgA On the surface, these species’ variations
of even higher affinity. From these B cells come might suggest that some species would be at
more long-lived plasma cells secreting high-af- greater risk of infection because of lower po-
finity antibody in the bone marrow. During the tential antibody diversity. In fact, some scien-

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Figure 12.18. Primary versus secondary immune responses

tists have argued that the apparent low diversity host-cell molecules co-opted by bacteria and
among bony and cartilaginous fish might re- viruses) on host cells and either destroy those
flect the greater homogeneity of their environ- host cells or pathologically alter host-cell func-
ment compared with land species—a reduced tions. Antibodies bound either to the surfaces
need for highly diverse BCRs. No hard evidence of viruses or to bacterial toxins prevent interac-
exists for either fewer pathogenic threats or tion with host-cell receptors (see Figure 12.21).
greater susceptibility to infection among these
species. Regardless, it is apparent that at consid-
erable energetic and genetic expense, all mam- Opsonization and Activation
mals and several other species have evolved very of Complement
sophisticated means for generating astounding Antibodies can also bind to the surfaces of
amounts of antibody diversity. bacteria and coat them with antibody molecules,
all with the C-termini of their H chains facing
Antibody Effector Functions out. This process is opsonization, and the end
result is more efficient destruction of bacterial
Pathogen and Toxin Neutralization pathogens (see Figure 12.21). Recall from chap-
During pathogenesis, viruses and bacterial ter 6 that macrophages, neutrophils, and other
toxins both bind to specific receptors (normal cells have receptors, called Fc receptors, that

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Figure 12.19. Acomparison of B-cell development in species in which that development takes place
in bone marrow (and often fetal liver) or GALT
In the so-called GALT species, such as rabbits, chickens, and sheep, Ig gene variability arises differ-
ently. Although the non-GALT species rely largely on genetic rearrangement and junctional diversi-
fication for generation of BCR diversity, GALT species use mechanisms such as gene conversion and
somatic hypermutation before B-cell contact with antigen to generate Ig diversity. In both GALT and
non-GALT species, final B-cell maturation occurs in secondary lymphoid tissues and involves somatic
hypermutation, selection, and affinity maturation. GALT species may also use further gene conver-
sion events and selection to enhance antibody affinity.

bind to the C-termini of Ig H chains. After bind- in more efficient interactions between phago-
ing antigens, the conformation of the C-termini cytic cell surfaces and pathogens and in turn
of Ig H chains changes slightly. Aggregation of leads to more rapid and more effective destruc-
Ig adds to these changes and to the antibodies tive of pathogens, especially bacteria. Activa-
reactive with Fc receptors. As a result, once bac- tion of the terminal membrane attack pathway
teria have been opsonized, macrophages, via Fc also leads to direct lysis of the pathogen.
receptors, bind, phagocytose, and destroy these
bacteria much more efficiently.
Similarly, after antigen binding, changes in Distribution and Function
the C-termini of the H chains of IgG and IgM of Fc Receptors
molecules activate complement via the classical Fc receptors actually appear on a variety of
complement cascade (discussed in chapter 4). cells and perform several functions beyond sim-
Complement activation results in the deposi- ply enhancing phagocytosis. For example, Fc
tion of complement fragments, especially C3b, receptors on FDCs (FcγRIIB) capture antigen–
onto pathogen surfaces. Macrophages, neutro- antibody complexes for selection after somatic
phils, and other phagocytic cells also have re- hypermutation. Also, mast cells, cells that play
ceptors for C3b. Thus, bound C3b also results critical roles in inflammation and allergies, have

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Figure 12.20.The forms of antibody and the use of hypermutation, Ig class switch, and germinal
center formation in various classes of chordates

Fc receptors for IgE (Fcε). When the IgE bound Clinical Correlation Follow-Up
to the Fc receptor interacts with antigen, the
Student Considerations
mast cell releases histamine and several of the
mediators of inflammation. This inflammation Selective Ig deficiencies are the most com-
is sometimes protective (perhaps in parasitic mon immune deficiencies of dogs. As men-
infections) and sometimes causes allergic reac- tioned at the outset of this chapter, as many
tions (see chapter 16). as 80 percent of Chinese shar peis have selec-
Because of antibodies and Fc receptors, the tive IgA deficiencies. Their symptoms include
humoral immune response is very effective at recurrent dermatitises (staphylococcal), demo-
dealing with and defending against extracellu- dectic mange, otitis externa, flea allergies, cys-
lar pathogens. Also, investigators have very re- titis, food intolerance, and bronchitis. On the
cently found that some antibodies do get inside basis of this chapter and the preceding one, you
of cells as well. It still appears, however, that should be able to offer an explanation for why
cellular immune responses and Tc cells deal an animal with an IgA deficiency might have
most effectively with intracellular pathogens. the symptoms seen in these dogs. You should
also be able to offer one or more plausible

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Figure 12.21. Effector mechanisms of antibodies
As shown in the left column, when antibodies bind to toxins (or viruses), the toxins can no longer
bind to specific receptors on host cells and are neutralized. The center column shows how antibody
binding to bacteria (a process called opsonization) allows macrophages to adhere more readily and
facilitate phagocytosis. The right column shows a similar process. Once IgM or IgG antibodies have
bound to a pathogen, the complexes activate complement. Macrophages and other phagocytic cells
also have receptors for complement fragments.

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Figure 12.22. Adult German shepherd and puppy (© Lenkadan / Shutterstock)
Selective Ig deficiencies have also been reported in German shepherds.

explanations about how an IgA deficiency pathogens. It may also be that in the absence
might arise and how it could produce the ob- of IgA, responses dominated by IgE might be
served symptoms. more common and lead to flea and food al-
lergies. Clearly, the majority of the symptoms
seen in these dogs result from a deficiency of
Possible Explanations IgA antibodies.
As the result of specific transport mecha- Just how an animal might come to have a se-
nisms that have evolved to deliver IgA anti- lective IgA deficiency is less clear. Several pos-
bodies to epithelial surfaces, as described in sible explanations exist. It could be that these
chapter 11, IgA—especially dimeric IgA—is the animals have an inherited genetic defect in the
predominant antibody at body surfaces, includ- C-gene segment encoding IgA H chains. In this
ing mucosal and other epithelia. No similar case, it would be impossible for B cells to switch
mechanism transports any other isotype across from IgM to IgA under any circumstances. Also,
epithelial surfaces. Furthermore, infections that as shown in Figure 12.14, Th-cell–derived cyto-
occur at epithelial surfaces induce primarily IgA kines (such as TGF-β) direct isotype switches,
antibody responses. including the switch to IgA. A deficiency or de-
In the absence of normal levels of IgA, epi- fect in any one of these cytokines or their re-
thelia are at much greater risk of primary and ceptors on B cells could also lead to a selective
recurrent infections such as dermatitis, de- IgA deficiency. Similarly, defects in the signal
modectic mange, otitis externa, cystitis, and transduction machinery associated with any
bronchitis and are unable to make protective of these cytokine-specific receptors on B cells
IgA antibody responses against the infecting could lead to a selective IgA deficiency.

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Gerald N. Callahan

Adaptive Immune Responses to

Chapter 13
Infections and Immunological Memory

Clinical Correlation: Canine Parvovirus and

the Wolves of Isle Royale 219
Learning Objectives 220
Adaptive Immunity: The Big Picture—From
Insult to Recovery 221
Routes of Infection 223
Mechanisms of Pathogenesis 223
Innate Response Cells and Cytokines of Innate
Responses Direct T-Cell Differentiation 225
Effector T Cells Home to Sites of Infection and
Inflammation 226
Antibody Responses Develop in Secondary
Lymphoid Tissues 229
Importance of Different Adaptive Responses
to Clearance of Different Pathogens 233
Immune Responses in the Gut 233
Immunological Memory 237
Primary and Subsequent Immune Reponses 237
Memory B Cells 238
Memory T Cells 238 Figure 13.1. Gray wolf (© Dennis Donohue /
Clinical Correlation Follow-Up 239 Shutterstock)
Student Considerations 239
Possible Explanations 239
work and animal populations react to different
In about 1900, moose migrated across an ice
Clinical Correlation:
bridge onto Isle Royale. Around 1940, a wolf
Canine Parvovirus and the
(Figure 13.1) pack, also via an ice bridge, ar-
Wolves of Isle Royale
rived on Isle Royale. Both wolves and moose
Isle Royale National Park is an island in Lake prospered until the early 1970s (see Figure 13.2).
Superior. The island is roadless, covers about About then, the wolf population began to de-
544 square kilometers (338 square miles), and plete the moose herd.
sits 25 kilometers (15.5 miles) from Ontario. Be- And that was how things continued—increas-
cause of its usual isolation from the mainland, ing wolf population, decreasing moose popula-
ecologists have studied the island for nearly a tion—until 1981. In that year, the wolf popula-
century to learn more about how ecosystems tion fell precipitously, from nearly fifty wolves


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Figure 13.2. Wolf and moose populations on Isle Royale, 1955–2010

to fourteen, and the moose herd began to re- Parvovirus infections occur most frequently
cover. By 1985, the moose population reached when dogs ingest food or other things con-
an all-time high, but the wolf population never taminated by feces from an infected animal.
fully recovered. Many people offered theories Figure 13.3 shows the pathogenesis of canine
about the cause of the wolf population’s crash, parvovirus.
but nothing seemed consistent with all the Approximately 70 percent of dogs infected
facts. Then veterinarians completed a series of with canine parvovirus will die from their in-
wolf necropsies in the early 1980s. Essentially, fections. At necropsy, these dogs exhibit leuko-
every necropsied wolf had died as a result of penia, extensive necrosis of the intestinal epi-
a parvovirus infection. Canine parvovirus was thelium and secondary lymphoid tissues, and
unknown until 1978. By 1979, the virus had severe dehydration.
spread around the globe and ravaged dog and
coyote populations, especially pups. The virus
Learning Objectives
is very similar to feline panleukopenia virus and
some viruses of raccoons and foxes and may After reading this chapter, you should be able to
have evolved from one of them.
Isle Royale National Park was established
• describe mammalian adaptive immune
responses from beginning to end;
in 1940, and among its regulations was the ex-
clusion of domestic dogs (the most common
• understand how the effectiveness of these
responses may vary depending on the nature
reservoir for parvovirus). That means the only
of the pathogen;
plausible explanations for the appearance of
parvovirus on Isle Royale all involve humans.
• understand how and why adaptive immune
responses may fail to provide protection;
Among the possibilities, it seems most likely
that this parvovirus outbreak originated when • describe the unique nature of adaptive
immune responses that arise in the gut;
humans carried the virus onto Isle Royale,
probably stuck to the soles of their boots. Be- • understand the nature of immunological
cause parvovirus is a nonenveloped virus that memory and describe the cells involved;
persists for long periods outside of host cells, • describe how immunological memory arises
this explanation seems entirely plausible. and is maintained.

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Figure 13.3. Pathogenesis of canine parvovirus
Canine parvovirus infections occur when canids (especially puppies) ingest food or other material
contaminated with feces from another parvovirus-infected canid. The virus then spreads from the
mouth to the lymph nodes and the gastrointestinal tract. Often, but not always, the virus then causes
a massive bloody diarrhea, leucopenia, gastrointestinal necrosis, dehydration, and death.

Adaptive Immunity: The Big nisms. Until the past decade, most immunolo-
Picture—From Insult to Recovery gists ignored the potential of these innate
defenses and focused on adaptive immunity;
After most encounters with pathogens, a race however, outside of chordates, adaptive im-
ensues—a race between the host animal’s de- mune responses are nonexistent. Because most
fenses and the pathogen. The progress and the animals are not chordates (insects being the
outcome of that competition determine which single largest population of animals), most ani-
survives and which dies. mals, including humans, rely solely on innate
The race begins when the pathogen enters defenses to survive the millions of daily patho-
the host and triggers innate defense mecha- genic assaults they encounter.

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Figure 13.4. Acute infection
Infections always result in a race between the host defenses and the replicating pathogen. After initial
contact with the pathogen, two things begin to happen: the host’s innate responses engage and the
pathogen begins to replicate. When numbers of pathogens exceed a certain threshold and move
beyond the innate defenses, adaptive responses follow. Over a period of days to weeks, these adaptive
responses usually reach protective levels, and the pathogen disappears from the infected animal.

Clearly, innate immunity can provide a pow- alone. Plus, adaptive immune responses make
erful weapon against infectious agents, and possible one of the greatest achievements in the
even among animals that possess adaptive im- battle against infectious diseases—vaccination.
mune capabilities, innate defenses are terri- It is likely that innate defensive responses to
bly important. First, innate immune responses some pathogens fully control infections. Just
occur much more rapidly than adaptive re- how many is not known. First, innate responses
sponses. Because this is a race between patho- occur so rapidly that clinical signs of infection
gen and host defense, speed is of the essence. may not appear before the pathogen is gone.
Second, few—if any—adaptive responses can Deficiencies in innate defense mechanisms are
develop without some assistance and direction rarer (perhaps an indication of the animals’ ab-
from early innate responses. solute dependence on them) than deficiencies in
Beginning with sharks, however, adaptive adaptive responses. So, fewer opportunities have
immune responses often dominate immune arisen to directly assess the importance of innate
responses. An adaptive immune response pro- defense to overall protection. Regardless, many
vides some things innate immunity cannot, pathogens multiply so rapidly that they outstrip
namely, specificity, memory, and affinity matu- innate defenses. When this happens, adaptive
ration. In a world of evolving pathogens, these immune responses engage (see Figure 13.4).
aspects of adaptive immunity add a level of pro- Most immune responses appear to involve
tection unattainable through innate immunity both innate and adaptive aspects, but all begin

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Figure 13.5. Replication of pathogens in various compartments within animals
Different pathogens thrive in different compartments inside of infected animals.

with innate responses. As shown in Figure 13.4, disease. The possible routes of transmission
it appears that once a pathogen replicates be- include inhalation, ingestion, and injection (by
yond the defensive power of innate mecha- mosquitoes or other blood-sucking arthropods);
nisms, adaptive immunity becomes involved. during mating; and through wounds.
Time frames may vary between species and
among individuals, but innate mechanisms gen-
erally engage within seconds to hours, and the Mechanisms of Pathogenesis
development of a primary, full-blown adaptive Once pathogens gain access beyond the bar-
immune response takes a week or longer. riers of skin and mucosal epithelia, they can
thrive and replicate in different compartments
inside of animals (see Figure 13.5). All patho-
Routes of Infection gens exist as either intracellular or extracellular
Infectious agents (i.e., prions, viruses, bac- infections. Extracellular infections may occur in
teria, fungi, and parasites) are also known as any of the body fluids—blood, lymph, intersti-
transmissible agents of disease because, when tial fluid, and urine. Bacteria, protozoa, fungi,
transmitted from an infected to an uninfected and worms are the most common extracellu-
animal, these agents will again induce the same lar pathogens. Pathogenic microorganisms can

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Figure 13.6. Mechanisms of pathogenesis
Various microorganisms cause diseases in various ways. Bacteria produce exotoxins and endotoxins as
well as directly infect cells and alter normal cell function. Viruses infect cells and kill or interfere with
normal host-cell activities. Fungi grow on tissue surfaces and can enzymatically degrade underlying
cells. Protozoan parasites also often infect host cells and alter these cells’ abilities to perform their
normal functions. Worms can cause diseases in a variety of ways.

also grow intracellularly. Bacteria and viruses LPS is present systemically (as in Gram-neg-
are the most common intracellular pathogens. ative sepsis), however, it can cause endotoxic
Each of these different locations presents par- shock and death (described in chapter 3).
ticular problems for immune systems. Trans- Both Gram-negative and Gram-positive bac-
missible agents also cause diseases in different teria can also produce other types of toxins
ways (see Figure 13.6). called exotoxins. Living bacteria produce exo-
On the basis of their abilities to retain toxins, and unlike endotoxins, there are many
Gram stain, bacteria can be split into two large types of exotoxins with very different sorts of
groups—Gram-negative and Gram-positive. effects on host animals. To exert their effects,
Recall from chapter 3 that the defining feature exotoxins can bind directly to specific mole-
of Gram-negative bacteria is that they have a cules on host cells.
thick outer coat of LPS—a powerful PAMP— For example, as they grow, Clostridium botuli-
on their cell walls. Gram-negative bacteria re- num bacteria release botulinum toxin, possibly
lease LPS into their surroundings, particularly the most potent toxin known (a median lethal
when they die. LPS is endotoxin, and endotoxin dose is about 1 ng/kg). When an animal ingests
causes disease by activation of macrophages botulinum toxin, the toxin moves quickly into
and inducing inflammation. When this same and out of the blood where it binds receptors in

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Figure 13.7. Initiation of an adaptive immune response
Antigen gains access to host cells after a break in the skin. DCs ingest this antigen, process it, trans-
port it to the nearest lymph node, and present the antigen to T cells. Adaptive immune responses
begin here and eventually culminate at the site of infection.

neuromuscular junctions. There, it inhibits the Protozoan parasites commonly cause disease
release of acetylcholine from presynaptic nerve by infecting host cells and interfering with nor-
terminals. The neurotransmitter acetylcholine mal host-cell function. Multicellular parasites
is essential for normal muscle activation. In the can cause disease in many different ways—from
presence of botulinum toxin, muscle contrac- simple mechanical obstruction of fluid flow (as
tion becomes impossible, and respiratory and in canine heartworm) to inflammation (as in
cardiovascular systems fail rapidly. sarcoptic mange).
All viruses and some bacteria such as Chla-
mydia grow inside of host cells. The pathogenic
effects of these infections result from the tissue Innate Response Cells and
tropism of the infectious agent and the damage Cytokines of Innate Responses
these pathogens do to those host cells as well Direct T-Cell Differentiation
as from host inflammatory responses. For ex- Adaptive immune responses begin when pro-
ample, in infectious canine hepatitis, the virus fessional (dedicated) APCs ingest antigens and
enters the body through the mouth or nose, transport them to secondary lymphoid tissues
or both, and infects the tonsils and the cervical (see Figure 13.7). Along the way, these APCs
lymph nodes. From there, the virus moves into process the acquired pathogen into pieces, in-
the blood and spreads to (among other places) sert those pieces into MHC class II and MHC
the liver. Here, the virus infects hepatocytes. class I molecules, and relocate these MHC–an-
Some of these hepatocytes die, which stimu- tigen complexes to the surface of the APCs,
lates a host inflammatory response that results where they become available for interaction
in hepatitis. with T cells (see Figure 13.8A–B).
Fungi cause diseases by attachment to host Circulating T cells arrive in lymph nodes via
tissue surfaces and enzymatic degradation of specific interactions with receptors on HEVs.
the underlying host cells. Most often, this at- Initially, in the medullary regions of the nodes,
tachment and degradation occur on the skin. these T cells encounter APCs displaying anti-

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Figure 13.8A–B. APCprocessing and presentation of antigen in MHC Class I molecules (panel A) and
APC processing and presentation of antigen in MHC class II molecules (panel B)
Panel A: A represents an infectious agent reproducing in the cytosol of the cell. B is antigen being
synthesized in the cytosol of the cell. C is the proteosome where the protein products of A are
digested into small peptides. D shows the peptides being transported into the lumen of the ER. E
shows the peptides being bound by newly formed MHC class I molecules. F shows the movement of
the MHC–Ag complexes inside an endosome. G shows the MHC–Ag complexes on the cell surface for
presentation to T cells. Panel B: A represents exogenous antigen that is ingested by an APC via phago-
cytosis and confined inside of a phagosome (B and C). That phagosome then fuses with a lysosome
to form a phagolysosome. D and E show how, inside of the phagolysosome, enzymes cleave antigenic
proteins into small peptides that bind to MHC II molecules and return to the cell surface as Ag–MHC
complexes (F) for presentation to T cells.

gens they have acquired locally or from remote Effector T Cells Home to Sites
sites. For a few days, antigen-specific T cells of Infection and Inflammation
remain in the lymph node, where at least two Tc effector cells express several different cell-
types of interactions occur. Naive Tc cells in- surface markers. Among these are molecules
teract with MHC class I–antigen complexes on that interact specifically with receptors on vas-
APCs and, with or without Th-cell help, these cular endothelial cells at sites of infection and
naive Tc cells become antigen-activated effector inflammation. Because of this, activated Tc
Tc cells (see Figure 13.9A–B). cells home to sites where these cells are most

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Figure 13.10. Effector
Tc-mediated destruction of
pathogen-infected cells
Figure 13.9A–B. Direct activation of Tc cells by After specific recognition of MHC–antigen
highly effective APCs complexes, Tc cells release lytic granules that
After exposure to PAMPs, DAMPs, or both, induce apoptosis in infected host cells.
APCs (like DCs) will express high levels of
MHC classes I and II as well as B7. This, along
with processed antigen, can provide both the
first (MHC–antigen) and the second (B7) signals Also, in secondary lymphoid tissues APCs
to Tc cells (panel A). In response, the T cells
present MHC class II–antigen complexes to Th
begin to express the high-affinity receptor IL
cells. A combination of (1) the nature of the
and produce IL-2 (panel B), which leads to
APC, (2) the nature of the innate responses, (3)
the cytokines the APC produces, and (4) the
affinity and frequency of TCR binding to the
likely to find pathogen-infected cells, especially MHC–antigen complex determines what hap-
virus-infected cells, and destroy them (see Fig- pens to the Th cell beyond this point (see Figure
ure 13.10). 13.11).

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Figure 13.11. Alternative pathways of Th-cell differentiation
After interaction with an APC, Th cells may differentiate into several different cell types, including
Th1, Th2, Tf h, Th17, Treg, Th3, and Tr1 cells. The pathway of Th-cell differentiation depends on
what the cytokines produce during antigen presentation (arrows). Each Th cell type secretes a charac-
teristic set of cytokines (far right) and participates in a unique way in the immune response.

Some of these Th effector cells, particularly protective adaptive immune responses (as de-
Th1 and Th17 cells (because of cell-surface scribed in chapter 10), often enhancing inflam-
changes), also home to areas of infection and mation and macrophage-mediated destruction
inflammation. They also bind to receptors of extracellular and intracellular pathogens.
on the vascular endothelium and engage in Other Th cells remain in the lymph nodes and

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Figure 13.12. B cells as APCs
B cells acquire antigen through the immunoglobulin portion of their BCRs. After binding antigen
and BCR cross-linking, B cells internalize the antigen–antibody (Ag–Ab) complexes and process both
antigen and antibody into peptides. MHC class II molecules bind these peptides and present them on
B-cell surfaces.

interact with B cells or aid in the activation of germinal center. During these divisions, two
Tc cells. things happen: isotype switching and somatic
Inside of lymphoid follicles, B cells undergo
Antibody Responses Develop in further genetic rearrangements that couple
Secondary Lymphoid Tissues new H-chain constant-region genes with the
B cells, usually after acquiring antigen, also variable regions generated in the bone marrow,
arrive in the lymph nodes via the HEVs. B-cell which results in a switch from IgM to some
interaction with antigen through the BCR and other isotype, usually IgG or IgA but some-
the B-cell coreceptor activates B cells. After ac- times IgE (see Figure 13.13).
tivation, B cells express more MHC class II and Also during B-cell division inside of lym-
B7 molecules. At the same time, BCR–antigen phoid follicles, mutations rapidly accumulate
complexes enter B cells via receptor-mediated in genes encoding L- and H-chain variable re-
endocytosis, are processed, and are presented gions, a process called somatic hypermutation.
on the surfaces of the B cells in MHC class II With antibody H- and L-chain variable regions,
molecules. All of this makes B cells very effec- most of the variability appears in three CDRs—
tive APCs (see Figure 13.12) CDR1, CDR2, and CDR3. Somatic hypermuta-
After interaction with Th cells, B cells fol- tion generates much of that hypervariability in
low one of three differentiation pathways. The these CDRs (see Figure 13.14).
first wave of B cells (all expressing IgM BCRs) When the B cell exits the cell cycle after so-
migrates to the medullary cords, differenti- matic hypermutation, that B cell must again
ates into plasma cells, and secretes pentameric acquire antigen for presentation to another Th
IgM. A second set of activated B cells migrates cell. If a B cell fails to once again bind antigen,
to the lymphoid follicles, once again interacts that B cell dies. A ready source of antigen in-
with Th cells, and begins to divide, creating a side of lymph nodes is in the form of antigen–­

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Figure 13.13. Cytokine control of isotype switching in germinal centers
In the upper left corner, a B cell first encounters antigen. Inside of a germinal center in secondary
lymphoid tissue, this B cell interacts with a Th cell (upper right). Depending on the cytokines pro-
duced by the Th cell, the B cell switches from expressing IgM to expressing IgG, IgA, or IgE.

antibody complexes on the surface of FDCs. as the immune response progresses, only B cells
For the newly mutant B cell to acquire this an- with increasingly higher-affinity BCRs survive,
tigen, its new BCR must have a higher affinity resulting in affinity maturation: a continuing
for antigen than the antibody on the FDC. So increase in antibody affinity for antigen during

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Figure 13.14. Somatic hypermutation during B-cell division inside of lymphoid germinal centers
Late in primary immune responses and throughout secondary and subsequent immune responses
against a given antigen, mutations rapidly arise in B-cell genes encoding Ig molecules. These muta-
tions fall mostly within the CDR1, CDR2, and CDR3 regions of the L and H chains, shown here as
colored vertical bars.

secondary and subsequent immune responses opsonize bacteria and enhance macrophage-
(see Figure 13.15). mediated destruction of these bacteria. By
These newly formed isotype-switched, high- blocking specific molecules, antibodies can also
affinity B cells follow one of two paths. Some neutralize bacterial toxins as well as viruses.
of them migrate out of the lymph nodes and Antibodies also facilitate NK cell–mediated
eventually arrive in the bone marrow as long- destruction of infected host cells via antibody-­
lived plasma cells, where they secrete IgG, IgA, dependent cellular cytotoxicity. Finally, it ap-
or IgE. Another group of isotype-switched, pears that some antibodies can have effects in-
high-affinity B cells remain in the secondary side of host cells.
lymphoid tissues as memory B cells (see Mem- By these means, adaptive immune responses
ory B Cells section). have evolved to deal with each of the compart-
Antibodies secreted by B cell–derived plasma ments mentioned at the outset of this chapter
cells enter the blood, the lymph, and interstitial and provide protection from a variety of patho-
tissues and arrive on epithelial surfaces to par- gens. The final results are primary, secondary,
ticipate in several ways in adaptive immune re- etc., adaptive immune responses. The unique
sponses against extracellular pathogens. In par- features of those responses are their specificity,
ticular, IgM and IgG antibodies, after antigen memory, and affinity maturation (see Figure
binding, can activate complement. Comple- 13.16).
ment components aid in protection in several Low-affinity IgM antibodies dominate the pri-
ways, including the direct lysis of microbes, mary immune response, whereas high-­affinity
opsonization of pathogens—which enhances IgG antibodies derived from memory B cells
ingestion and destruction by macrophages and dominate most secondary immune responses.
neutrophils—and enhancement of protective After repeated exposures to antigen, the affinity
inflammatory responses. Also, IgM and IgG can of the antibody for its specific antigen continues

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Figure 13.15. Affinity maturation through somatic hypermutation and selection
Inside of lymph nodes, as they undergo the process of somatic hypermutation, B cells must repeat-
edly bind antigen through their BCRs to survive. The major source of antigen in germinal centers is
in the form of antigen–antibody (Ag–Ab) complexes bound directly or indirectly (through C3b and
C3d receptors) to FDCs. To bind that antigen, hypermutated BCRs must have greater affinity for anti-
gen than the antibody on the FDCs. When this happens, B cells survive as high-affinity B cells.

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Figure 13.16. Primary and secondary adaptive immune responses

to increase. All of these arise because of the tective. Generally, antibody responses are most
unique characteristics of B and T cells and their effective against extracellular infections, and
antigen-specific receptors. Th1 and Tc cells are most effective against intra-
cellular infections (see Figure 13.17).
Different antibody isotypes may provide
Importance of Different Adaptive greater or lesser protection against a given
Responses to Clearance of pathogen. Also, antibodies can provide effec-
Different Pathogens tive protection against intracellular pathogens
As mentioned earlier, pathogens arrive inside by neutralizing the pathogens before they can
animals via different routes, multiply in vari- infect their target cells.
ous spaces, and cause disease in various ways.
Because of this, different classes of pathogens
present different challenges to animals’ immune Immune Responses in the Gut
systems, which is important for several reasons. All of the material presented so far in this
First, understanding the process and outcome chapter is most directly relevant to immune re-
of infections depends on understanding how sponses occurring in the lymph nodes and the
particular types of responses protect against or spleen and, therefore, most relevant to antigens
exacerbate diseases caused by different patho- and pathogens in lymph, interstitial fluids, and
gens. Second, effective vaccination must elicit blood. As mentioned at the outset, though,
protective immune responses. With different there are even larger spaces where animals reg-
pathogens, vaccines may have to induce very ularly encounter pathogens—the epithelia and,
different types of immune responses to be pro- specifically, the gut mucosa.

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Figure 13.17. Different types of immune effector mechanisms are effective against various pathogens
Plus signs indicate the probable importance of different effector mechanisms to protect immunity
against viruses, bacteria, fungi, and parasites. In general, cellular mechanisms are most effective
against intracellular pathogens, and antibodies are most effective against extracellular pathogens. FIV
= feline immunodeficiency virus; SIV = simian immunodeficiency virus.

Scientists have estimated that there are ap- how to completely avoid infection. Instead,
proximately 1029 bacteria on this planet. The each species exists because life requires a com-
mass of that number of bacteria is equivalent promise with bacteria in the form of commen-
to enough aircraft carriers to cover the United sal and mutualistic relationships. Bacteria, espe-
States three deep—that’s seventy stories high. cially the gut bacteria, are essential to animal
No living species exists because it has learned health. Interestingly, in some species (if not all)

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Figure 13.18A–B. Mammalian Peyer’s patches
and lymphoid tissues in the small intestine
Panel A shows a diagram of a thin section of
small intestine. Within this section, the dark
purple–rimmed ovoid areas represent special-
ized lymphoid tissue called Peyer’s patches—
sites of immune responses in the intestine.
Panel B shows a diagrammatic representation
of the interaction between the cells of a Peyer’s
patch and an enteric pathogen. Multifenestrated
or microfold (M) cells carry antigens from the
gut lumen into the Peyer’s patch, where DCs
process and present these antigens to the im-
mune system. As with splenic lymphoid tissues,
the patches have discrete T-cell–rich and B-cell–
rich areas.

the composition of the normal flora is as dis-

tinctive as the animal itself. No two are alike.
The other consequence of the enormous
biological success of bacteria is that all natural
foods are teeming with bacteria and fungi as
well as viruses and perhaps a parasite or two.
One of the most important transitions a newly
born animal makes is moving from a sterile gut
to one carrying much of the normal flora. If an
animal fails to acquire these bacteria, that ani-
mal fails to develop normal gastrointestinal and
immune systems. For all animals, bacterial col-
onization is an essential part of early life. Some-
how, the gut immune system, meaning GALT, of the follicle-associated epithelium of Peyer’s
must deal with all the potential threats and, at patches. Unlike enterocytes, these cells have
the same time, maintain healthy normal flora. no glycocalyx and do not secrete mucus. In-
Because of this, gut immune mechanisms stead, M cells have evolved to interact directly
differ some from the immune mechanisms op- with the antigens of the gut. Using phagocy-
erative in lymph and spleen. Perhaps for differ- tosis and endocytosis, M cells take up antigens
ent reasons, the same appears to be true of im- from the gut lumen and transfer these antigens
mune responses in or on respiratory epithelia across the gut epithelium and deliver them into
and the epithelia lining the major body cavities. the extracellular space on the opposite side of
The gut has several specialized lymphoid the epithelium. Here, APCs acquire these an-
tissues, including tonsils and adenoids. At the tigens, process them, and present them to T
moment, we focus on Peyer’s patches, found cells (see Figure 13.19). Beyond M cells, gut-
mostly in animals’ small intestines (see Figure associated DCs have evolved the ability to in-
13.18A–B). sert pseudopodia (or dendrites) between gut
Specialized cells called multifenestrated or epithelial cells and sample the contents of the
microfold (M) cells make up a significant part gut lumen.

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Figure 13.19. Antigen transfer across the gut epithelium by M cells
M cells acquire antigens by phagocytosis and endocytosis. The basal surfaces of M cells wrap around
lymphocytes and DCs. As antigens cross the gut epithelia, DCs acquire them, process them, and pre­
sent them as MHC–antigen complexes. DCs also extend long dendrites into the gut lumen to sample
and present gut contents.

In addition to Peyer’s patches, foci of plasma them to individual epithelia. In addition to

cells and lymphocytes appear scattered along the conventional α/β T cells expressing CD4+
the length of the small intestine. These are the or CD8+, MALTs contain type b lymphocytes,
effector cells of gut immunity. As with all T and which include CD4−, CD8− γ/δ T cells, T cells
B cells, these cells originate in the bone marrow with γ/δ TCRs, T cells with α/β TCRs, and
and the thymus. Because of specific receptors CD8+ T cells with α:α TCRs. These unique
on their surfaces, however, these B and T cells T-cell subsets do not recognize conventional
home to the gut mucosal epithelia and move MHC–antigen complexes on APCs. Instead,
into the Peyer’s patches. Once there, if these these cells react with several different sorts of
cells find their specific antigens, the B and T molecules and with MHC class IB molecules.
cells become active effector cells and migrate— MHC class IB molecules structurally resemble
via the lymphatics—to the mesenteric lymph classical MHC class I molecules; however, MHC
nodes, and from there to the thoracic duct and class IB molecules do not come from genes in
the blood. Using specialized blood vessels that the MHC.
line the MALT and specific surface receptors, Because several classes of type b lympho-
these effector cells return from the blood to the cytes are present in athymic mice, it is clear
lamina propria and the epithelium of the gut that these lymphocytes do not develop in the
and other mucosa. As a result, an immune re- thymus. Also, type b lymphocytes exhibit little,
sponse that began in an isolated area of the in- if any, gene rearrangement. These cells may
testine spreads to the mucosa, throughout the represent an aspect of innate immunity and not
body, and back to the gut. adaptive immunity, or they may function at the
Similar processes occur within many epithe- boundary of both.
lia, and specialized groups of lymphocytes have A variety of unique cells and immune mech-
evolved specific cell-surface markers to target anisms have evolved to deal with the intimate

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and intricate relationship between the gut mu- Intestinal epithelial cells have surface recep-
cosa and the gut flora. As you will see, this rela- tors for pathogens (e.g., TLRs), but only on
tionship somehow makes possible normal gut their basal surfaces. For recognition to occur,
activity and normal lives for most animals. the pathogen must somehow first breech the
As we have explained, the predominant anti- defense of the epithelium. In response to a
body found at mucosal surfaces in most mam- detected infection, gut epithelial cells secrete
mals is IgA and in particular dimeric IgA. The several chemokines that attract a variety of
variety of IgA isotypes can vary a lot, with immune cells (in particular, macrophages and
rabbits expressing thirteen different subclasses neutrophils). These recruited cells, after activa-
of IgA. In amphibians, IgX appears to perform tion by pathogen and cytokines, can stimulate
functions similar to IgA in mammals. Reptiles inflammation, antigen presentation, and innate
use a modified form of IgG at mucosal surfaces, and adaptive immune responses.
and chicken IgA looks more like mammalian Beyond that, it is also clear that the gut flora
IgM than IgA. In spite of these variations, it is themselves provide protection from infection.
clear that all species have evolved special types For example, after treatment with wide-spec-
of antibodies to deal with immunity at mucosal trum antibiotics, animals may succumb to se-
surfaces. This specialization is essential because rious infections with Clostridium difficile. C. dif-
each species faces the same dilemma—an abso- ficile produces two exotoxins that interfere with
lute requirement for gut colonization and con- normal water resorption in the gut, resulting in
stant contact with gut microbes, some of which life-threatening diarrhea and sometimes death
could be potential pathogens. In general, muco- from hypovolemic shock. Usually, the normal
sal immunity is a complex mixture of innate and flora occupy most of the available space in the
innate-like mechanisms along with adaptive im- gut and use most of the available nutrients in
mune responses and a touch of benign neglect. the gut, and some normal flora even produce
The gut immune system, interestingly, not antimicrobial compounds. So, even though C.
only fails to react to most ingested antigens, it difficile is a common inhabitant of animal gas-
often becomes permanently tolerant of those trointestinal tracts, it usually causes no prob-
antigens—a thing called oral tolerance. For ex- lem. When antibiotics strip the protective flora,
ample, if one injects a rabbit with ovalbumin however, the gut epithelia become very suscep-
(the major protein in hen-egg whites), the rab- tible to colonization by the normally innocuous
bit will usually make a powerful adaptive im- C. difficile.
mune response to the foreign antigen. How-
ever, if one first feeds a rabbit hen-egg whites
for a period of time and then injects the animal Immunological Memory
with ovalbumin, the rabbit makes no response
Primary and Subsequent
to the foreign protein. It appears that all ani-
Immune Responses
mals have evolved means to suppress immune
reactions to the food they eat. Biologically, this One of the most remarkable features of
makes sense, because it allows for tolerance to adaptive immune responses is memory (see
most food. Figure 13.16). A second encounter with a
Clearly, though, animals can make immune pathogen is rarely as dangerous as the first. In
responses against gut pathogens, including in- secondary and subsequent infections or vacci-
gested gut pathogens. How is this possible in nations, the immune system responds faster;
the face of the overwhelming tendency toward produces higher-affinity, isotype-switched anti-
tolerance? Infection of gut epithelial cells and body; and maintains higher levels of antibod-
inflammation appear to be key. ies and effector cells much longer. All of this

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is possible because of memory T and B cells.
In essence, immune systems remember things
they have seen before, and when those same
things appear again, immune systems react
very differently—memory.
Up to now, we have focused most closely on
the nature and events of primary adaptive im-
mune responses, and although memory cells
do begin to appear during primary responses,
their effects are most apparent in secondary and
subsequent immune responses.
Memory cells arise as T and B cells undergo Figure 13.20. Comparison of B cells and antibody
multiple divisions (clonal expansion) after anti- from naive and immunized animals (adapted
gen- and cytokine-driven activation. Just what from C. Janeway, P. Travers, M. Walport, and M.
makes a B or T cell a memory cell is unclear, but Shlomchik, 2001, Immunobiology, fig. 10.24)
several changes occur as cells become memory
cells. These changes are mostly very different be-
tween B and T cells. But one thing seems com- frequency of antigen-specific B cells in immu-
mon to all memory lymphocytes: they have very nized animals increases between 10- and 100-
long lives. Trying to explain this, scientists have fold (see Figure 13.20).
proposed very long-lived memory cells, long- In addition, most B cells from immunized
term persistence of antigen, regular reinfection mice express isotypes other than IgM, and the
with the same pathogen, regular reactivation by antibodies they produce show evidence of hy-
cross-reactive pathogens, and cross-­activation by permutation and selection, resulting in much
cytokines produced during unrelated primary higher affinities for antigen (see chapter 12).
and secondary immune responses. Generally, these cells seem to follow the same
Presently, the most likely explanations in- circulation patterns as naive B cells. That is,
volve some aspects of the first and last of these memory B cells travel throughout the circula-
hypotheses. Memory T and B cells do appear tion, the spleen, mucosal epithelia, and the lym-
to have unusually long lives, but not as long as phatics. When their antigens reappear, these
immunological memory may last—sometimes B cells settle into lymph nodes and other sec-
decades or more. Recent studies have shown ondary lymphoid tissues, where they undergo
that memory cells, though mostly found in rest- multiplication and differentiation inside of lym-
ing states, do occasionally divide. Scientists do phoid follicles (see chapter 12).
not understand the stimulus for these divisions,
but certain cytokines, such as IL-15 and IL-7,
seem to prolong memory. So it appears that, Memory T Cells
in addition to their very long lives, occasionally During primary immune responses, after
as cells respond to unrelated antigens, cytokine activation T cells follow two distinct pathways
production may drive infrequent memory cell of differentiation. One group becomes effector
division and expansion. T cells, and the other group becomes memory
T cells (see Figure 13.21).
Several cell-surface changes accompany the
Memory B Cells transition from naive to memory T cell. It may
In vitro, memory B cells differ both quantita- be that among memory T-cell populations are
tively and qualitatively from naive B cells. The several subpopulations. Because of that, al-

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immune responses. Memory B and T cells exist
in much higher numbers in previously immu-
nized or infected animals, memory B cells have
higher affinities for antigen than naive B cells,
and memory B and T cells respond faster than
naive cells. For all of these (and probably a few
other) reasons, naive T and B cells do not par-
ticipate significantly after a primary response to
their specific antigen.

Clinical Correlation Follow-Up

Student Considerations
In 1981 and 1982, the wolf population on Isle
Royale in Lake Superior fell from nearly fifty
animals to fourteen. Parvovirus, carried in by
humans, was the apparent cause. Canine par-
vovirus is highly contagious and often leads to
severe diarrhea and fatal hypovolemic shock.
What aspects of these wolves’ adaptive im-
mune responses could have been relevant to sur-
vival? Why did fourteen animals survive? What
factors may have contributed to the large die-off
Figure 13.21. Encounterwith specific MHC– of wolves after exposure to canine parvovirus?
antigen generates both effector T cells and
memory T cells
Possible Explanations
Because all of the wolves on Isle Royale were
though the changes described here seem to be and are descendants of one wolf pack with few
characteristic of many memory T cells, they breeding pairs, it is likely that these wolves are
may not be characteristics of all of them. highly inbred. As we discussed in chapter 8 re-
The observed cell-surface changes include garding African cheetahs and Florida panthers,
the loss of receptors for molecules present on inbreeding may have dramatically reduced not
HEVs and the acquisition of receptors for vas- only the MHC variety among these wolves
cular endothelia in inflamed and infected areas (markedly limiting their antigen-presenting di-
of an animal’s body. In addition, effector and versity) but also the amount of genetic varia-
memory T cells have reduced requirements for tion available for the diversification of BCRs
the second signal normally delivered through and TCRs. Any one or all of these might explain
B7 to CD28. As a result, many memory T cells the large number of wolf deaths after exposure
can respond more rapidly to a secondary in- to parvovirus. However, death rates among do-
fection, generate higher numbers of cells in mestic dogs are in the range of 70 percent, so
shorter periods of time, and more quickly elim- it is difficult to evaluate the contribution of in-
inate these secondary challenges. breeding to these wolf deaths.
Because of their characteristics, memory cells As with most, if not all, viruses, parvoviruses
mediate almost all secondary and subsequent are obligate intracellular parasites. To reproduce

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themselves, parvoviruses must enter the host BCRs, isotype switch signals, or abnormalities
cell. As discussed earlier, Tc cells deal with most in somatic hypermutation and selection might
intracellular parasites, especially viruses. Acti- have prevented the development of specific an-
vation of T cells requires presentation of spe- tibodies to control the infection.
cific antigenic fragments inside of MHC class I With viruses especially, all antiviral antibod-
molecules. To respond appropriately, a Tc cell ies are not equal. Often, a single critical anti-
must have a TCR reactive with that specific genic epitope is involved in virus attachment to
MHC class I–antigen combination. host cells. When host animals produce antibod-
For these reasons, MHC class I homogene- ies to that critical epitope, they survive because
ity could be a problem, as could relative TCR their antibodies neutralize the virus’s ability to
homogeneity. Because death rates in dogs are infect host cells. Because of that, these antibod-
similar to those in the Isle Royale wolf popula- ies are called “neutralizing” antibodies and are
tion, though, it seems more probable that the the most important target of vaccination.
difference between surviving and dead wolves The generation of a protective adaptive im-
was simple genetic variation. Survivors may mune response is a complex process that de-
have expressed MHC class I molecules that pends, at many stages, on the genetic back-
presented the critical parvovirus epitope, and ground of the infected animal. For this reason,
the MHC molecules of the wolves that died the efficiency of these responses varies among
could not. Alternatively, because of genetic dif- individuals. Identifying the critical gene or
ferences, critical TCRs may have been present genes is rarely possible, but understanding how
only among the survivors. Also, because anti- adaptive immune responses develop and pro-
bodies likely play important roles in controlling tect is a critical step in the process of under-
the spread of viruses from cell to cell, critical standing diseases and their therapies.

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Gerald N. Callahan

Fetal and Neonatal Immunity Chapter 14


involved bacteria most commonly include Esch-

Clinical Correlation: Failure of Passive
erichia coli (most common), Salmonella spp., Lis-
Transfer 241
teria monocytogenes, Pasturella spp., Streptococcus
Learning Objectives 241
spp., Leptospira spp., and Actinobacillus spp.
Fetal Development of the Immune System 241
Untreated, many of these calves, foals, lambs,
Maternal Transfer of Immunity 243
and piglets will die. In comparison, other ani-
Prenatal Transfer of Immunity 243
mals from the same sire and dam will flourish
Postnatal Transfer of Immunity 245
and be infection free. What is the difference be-
Neonatal Acquisition of Memory and
Immune Capacity 248
tween the affected and unaffected animals?
Vaccination of Neonates 249
Clinical Correlation Follow-Up 251 Learning Objectives
Student Considerations 251
Possible Explanations 252
After reading this chapter, you should be able to
• describe, in general terms, the fetal develop-
Clinical Correlation: Failure ment of immune competence;
of Passive Transfer • describe species differences in maternal trans-
fer of immunity and the underlying causes of
Currently, veterinarians estimate that as many
these differences;
as 35 percent of dairy calves suffer from at least
one serious and sometimes life-threatening • describe the routes of maternal transfer of
bacterial infection during the neonatal period.
Similar infections occur regularly, although less • explain the rationale for neonatal vaccine
frequently, in beef calves, lambs, piglets, foals, protocols;
and likely manatees (Figure 14.1), making these • understand how neonatal immunity is
infections a major biological and economic measured.
issue for the livestock industry. In foals, the
symptoms of these bacterial infections include Fetal Development of
infections of the navel, the joints, and the lungs the Immune System
and septicemia. Animals will also often have
high fevers and be “off suck,” and when the For many animals, immune system develop-
joints are involved, the animals suddenly be- ment is complete, or very nearly complete, at
come lame. Diarrhea is also common. birth, but the prenatal times at which various
For all neonates, the routes of infection for aspects of immune systems mature vary consid-
bacterial invasion include ingestion, inhalation, erably among species. However, some animals
umbilical infection, and in utero infection. The develop immune competence only after days or


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Figure 14.1. Nursing manatee calf (© Liquid Productions, LLC / Shutterstock)
Placentation in manatees, as with that in other sirenians, is endotheliochorial. As a result, transfer of
antibodies across the placenta is limited, and the timely transfer of colostrum is essential for protec-
tion of the calf.

weeks of life. For example, opossums give birth agents such as bovine viral diarrhea virus do in-
to young after only fifteen days of gestation, duce immune responses. Shortly before birth,
and the newborn joeys have no functional im- as cortisol production rises, the cells of the
mune tissues or organs. Only after seven days adaptive immune system (including lympho-
of life do these animals begin to make antibod- cytes, macrophages, and neutrophils) decrease
ies. The opossum is an example of surprisingly considerably.
rapid immune development, but all of it occurs Although immunocompetent, at birth calves
postpartum. As examples of fetal immune de- are mostly protected by maternally transferred
velopment, we focus on the calf and the chick. immunity and innate immune responses—
Other animals are generally similar, but time of rapid and effective reactions to environmental
appearances and completion dates can all vary pathogens. Innate immunity in calves develops
considerably. late during gestation, but just as with adults, it
The gestation period in cattle is approxi- provides first-line, rapid responses to a variety
mately 285 days, or about nine months. Figure of infectious agents, especially bacteria. Figure
14.2 shows a general outline of immune devel- 14.3 shows a more detailed picture of immune
opment in calves. Sometime before birth, fetal development in cattle.
calves acquire the ability to generate adaptive The thymus and bone marrow appear early,
immune responses to antigens. This ability is and lymphocytes and B cells are present after
apparent because some in utero infections by about sixty days of gestation. Granulocytes and

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Figure 14.2. The developing immune system of calves
Passive immunity refers to immunity acquired from the mother. Active immunity refers to the calves’
ability to develop adaptive humoral and cellular immune responses as well as memory cells. (Adapted
from C. L. Christopher et al., 2008, Veterinary Clinics of Northern America: Food Animal Practice, 24: 87)

other cells of innate immunity do not appear cause of this, animals have evolved means for
until later. The mucosal lymphoid tissues are transferring immune capacity from mother to
among the very last to appear and are not fully offspring in utero, immediately after birth, or
active until sometime after birth, which is also both.
true of some of the other elements of innate
Maternal Transfer of Immunity
The process in chicks is quite different. Incu-
bation time for domestic chicks is about twenty- The process of maternal transfer of immunity
one days. By five to seven days, stem cells have involves physical translocation of elements and
migrated to the thymus and the bursa. Lym- products of the mother’s immune system into
phoid follicles appear in the bursa by about the developing animal. This process varies con-
twelve days. IgM-positive B cells appear by siderably among species.
about fourteen to sixteen days, and inoculated
chick embryos can produce specific antibodies.
In ovo vaccination for diseases such as Marek’s Prenatal Transfer of Immunity
disease is very effective by seventeen days. IgY- In precocial chickens, maternal antibodies
positive B cells appear at twenty-one days, but are transferred across the follicular epithelium
IgA-positive B cells appear in the gut only about into the yolk during oogenesis. As described
a week after hatching. As with cattle, the innate earlier, chickens produce three classes of anti-
immune functions of chicks are not fully active bodies: IgY, IgM, and IgA. IgY (the equivalent
at birth. It is not until sometime after birth that of mammalian IgG) antibodies cross into the
calves and chickens attain immune competence egg yolk at the highest concentrations. The egg
levels approaching those of adult animals. white contains the greatest concentrations of
So in cattle and chickens, as in most other IgA and IgM. Shortly before hatching, all ma-
animals, neonates’ immune systems are active ternal IgY and some IgM move into the embry-
but not yet fully protective. That leaves newly onic circulation. There, they provide protection
born animals at very high risk for infection be- to the newborn (and immunologically imma-
tween birth and full immune development. Be- ture) chick.

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Figure 14.3. Timeline for development of cells and organs of the immune system in neonatal calves

Maternal antibodies persist in these chicks for nineteen days. Studies have shown that immu-
fourteen to twenty-one days. During that time nization before day seventeen reduces viable
(by three to seven days), the newborns begin to hatching about 1 percent to 2 percent com-
produce their own antibodies. However, they pared with vaccination on day eighteen. The
do not achieve full immunological maturity site of vaccination is also important (see Figure
until about the time maternal antibodies finally 14.4). For embryonic turkey chicks, it appears
disappear from the chicks’ circulation. that vaccine injection into the amniotic fluid is
The timing varies considerably among bird the most efficient route, but injection into the
species. For example, the half-life of maternal embryo itself is also very effective. Targeted in
antibodies in precocial chickens is somewhere ovo vaccination might seem like a difficult and
from three to ten days, whereas in altricial pas- time-consuming approach to chicken protec-
serine birds, such as house sparrows, the re- tion, but in reality, machines routinely perform
ported half-life of maternal antibodies is closer the task at rates exceeding 50,000 eggs per hour.
to two days. Placental mammals exhibit a range of ana-
The optimum time for vaccinating embry- tomical relationships among the placenta, the
onic chicks is when the stalk of the yolk sac be- mother, and the fetus. There are three types
gins its ascent into the abdomen and the head of mammalian placentas: endotheliochorial,
is nestled under the wing until external pipping epitheliochorial, and hemochorial (see Fig-
(near hatching), which occurs at seventeen to ure 14.5A–B). The character of the placenta

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Figure 14.4. Effectiveness of vaccination of chick embryos at various sites
Marek’s disease vaccine (a live, attenuated, viral vaccine) was injected into turkey embryos at the
indicated sites on day seventeen or eighteen. At five days posthatch, the chicks were challenged with
Marek’s disease virus (based on data from P. Wakenell et al., 2002, Avian Diseases, 46: 274).

ultimately determines the routes of maternal Here, there is one less cell layer between the
transfer of immunity. mother’s circulation and the fetus’s circulation
In primates and rodents—because the cho- than in animals with endotheliochorial placen-
rionic villi themselves have eroded through tas and one more cell layer than in animals with
the maternal vascular endothelium—the fetal hemochorial placentas. In dogs and cats, some
chorionic epithelium is in direct contact with placental transfer of immunity occurs, but not
maternal blood. As a result, IgG antibodies as much as in primates. As with other species, in
move freely from mother to fetus in these spe- dogs and cats maternal transfer continues after
cies. Therefore, in primates and rodents, much birth through milk.
maternal transfer of immunity occurs before
birth, but transfer of IgG and IgA continues
after birth through the mother’s milk. Postnatal Transfer of Immunity
Three layers of cells separate the maternal Postnatal transfer of immunity occurs dur-
circulation in the fetuses of horses, cattle, pigs, ing nursing, first with colostrum and later with
and others. In these species, no cross-placental milk. Colostrum is the first milk that accumu-
transfer of maternal immunity occurs. For this lates in the udder, and it is rich in proteins, fats,
reason, all maternal transfer of immunity must and carbohydrates. A few weeks before birth—
occur during nursing. as colostrum forms—antibodies begin moving
In between these species are animals (such as from the blood into the cow’s udder. At the same
cats and dogs) with epitheliochorial placentas. time, mammary-associated lymphoid tissues

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Figure 14.5A–B. Mammalian placentation
Scientists classify mammalian placentas on the basis of the
number of maternal layers retained in the placenta. The
more layers there are, the more restricted the movement of
blood elements between mother and