 Immune system - is the complex  INFECTIOUS DISEASE AND CANCER –

collection of cells and organs that from errors in non-self-recognition.

destroys or neutralizes pathogens that o E.g.: In eyeball: fluid in between
would otherwise cause disease or cornea separates cornea from
death. self, if fluid is loss, self will
 Lymphatic system is the system of attack cornea.
vessels, cells, and organs that carries
BASED ON SPECIFICITY
excess fluids to the bloodstream and
filters pathogens from the blood INNATE IMMUNITY ADAPTIVE IMMUNITY
(drainage and filtration).
Natural, nonspecific Acquired, specific
General View of Immune System immunity immunity
- Present at birth - Not present at birth
SELF: - Defense mechanism that - Stimulated by microbes
are present even before and capable of
 Unique set of molecules expressed by
infection recognizing non-microbial
our cells (MHC).
- First line of defense substances (Antigens)
 Identifies every cell of our body as - Develop after exposure
“normal, non-harmful”. to microbes
 Immune system will NOT ATTACK CELLS - More powerful defense
IDENTIFIED AS SELF.
 TOLERANCE – outcome of self-
recognition. INNATE ADAPTIVE
 AUTOIMMUNE DISEASES – from errors 1ST LINE OF 2ND LINE OF 3RD LINE OF
DEFENSE (outer DEFENSE DEFENSE
in self-recognition.
surface) (Neutrophils)
o Sytemic Lupus Erythematosus –
- Skin and - Phagocytosis - T cells
most common autoimmune mucous - Inflammation - B cells – plasma
disease membrane and fever cells
▪ Signs: “butterfly cheek” - Secretions (defense - Antibodies
o Rheumatoid arthritis – inability (Lysozyme); mechanism)
to tolerate self-antigen sweat, oil - Natural
- Acidity of GIT antimicrobial
NON-SELF: and vagina substances
 A wide set of molecules not normally - Cilia of (MPO –
expressed by our cells (ANTIGENS). respiratory tract neutrophils)
(goblet cells also - Complement
 Identifies the cells which harbor them
release - Interferons
as “non-normal, potentially harmful”
lysozyme)
 Immune system WILL ATTACK CELLS
IDENTIFIED AS NON-SELF.
 SURVEILLANCE – out of non-self-
recognition.
o Attacks non-self.
o E.g.: TB
o Warts = cervical cancer, HPV

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BASED ON WHAT IS USED: Vaccines:

CELLULAR-MEDIATED HUMORAL-MEDIATED 1. Live organisms – small pox

2. Attenuated or weakened organisms –
“CELLS” “FLUID”
BCG (Bacillus Calmette and Guerin)
Innate Immunity: Adaptive Immunity:
vaccine
- Neutrophils, - Complement,
3. Dead/Killed organisms – cholera,
Monocytes, Basophils, Interferons, Lysozymes
Eosinophils, NK cells (1st and 2nd) typhoid (oral)
(viral) 4. Toxoids – tetanus
Innate Immunity: Adaptive Immunity: 5. Modified Virus – poliovirus
- T and B cells (plasma - Antibodies (IgA) from
cells) plasma cells (B cells)  If oral/intranasal = stronger vaccine
- Lymphokines from T  If through blood = will cause sickness
cells  If through muscle = weaker

TYPES OF ADAPTIVE IMMUNITY

ORGANS OF THE IMMUNE SYSTEM
1. Active Immunity
 Antibody is produced by the body. 1. Primary lymphoid organs (production
E.g.: chicken pox and maturation)
 Advantage: LONG TERM immunity.  Bone marrow
 Disadvantage: SLOW immune o Consists of:
response. o Red marrow – blood cell production
2. Passive Immunity o Yellow marrow – site for fat reserve
 Antibody is NOT produced, but it o Children have more red marrow;
provided. E.g.: RIG (Rabies Adults have more yellow marrow
Immunoglobulin) o Production and maturation of B cell
 Advantage: IMMEDIATE immune o Production of T cell
response.  Thymus
 Disadvantage: SHORT TERM o No longer present after 13 years
immunity. old, causes auto immunity if it stays
after 13.
TYPE MODE OF o Becomes fatty deposits after 13.
ACQUISITION o Maturation of T cell
ACTIVE Natural Infection o Located in between heart and
Artificial Vaccination sternum
PASSIVE Natural Transfer in vivo 2. Secondary lymphoid organs
(mother to fetus)  Lymph node
Colostrum o “Filter of the lymph”
Artificial Immune serum o Lymph ENTERS lymph node through
(prepared
AFFERENT lymphatic vessel
immunoglobulin)
o Lymph LEAVES lymph node through
EFFERENT lymphatic vessel
o 2 regions:

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 1. Cortex – where B cells are
located.
1. Macrophage:
2. Paracortex – where T cells are
 Function as APCs
located.
 Predominant in Cell mediated Immunity
 Spleen (left side near last rib)
1. Kupffer cells – liver
o “Filter of the blood”
2. Sinus histiocytes – lymph nodes
o Consists of:
3. Alveolar macrophages (dust cells, heart
o Red pulp – filtration is via
failure cells) – lungs
nonspecific response
4. Microglia – Brain
o White pulp – filtration is via
5. Mesangial Cells – kidneys
adaptive T and B cell responses
6. Osteoclasts – Bones
o Breaks down hemoglobin from
7. Hofbauer cells – Placenta
senescent RBCs.
o Hematopoiesis in fetal life.
2. Dendritic cells:
 Lymphoid nodules
 Located in epithelium and interstitial
o Located in respiratory tract (Tonsils)
tissues (lymph nodes).
and digestive tract (MALT,
 Presents antigen to T cells by going
Appendix)
from site of exposure to the lymph
o Tonsils (6)
node.
▪ Tonsillar crypts –
accumulation of foreign
3. Natural Killer cells:
bodies.
 Targets:
o Mucosal Associated Lymphoid
o tumor cells/cancer
Tissue (MALT) – GIT and
o virally infected cells
reproductive system
 part of innate immune system
▪ Peyer’s patches – type
 CD 16 & CD 56 (+) – (identifying
of MALT located in
characteristic) MUST KNOW!
ILEUM.
4. B Lymphocytes 5. T Lymphocytes
o Appendix
▪ Characterized by Production and Produced from BM;
presence of GERMINAL maturation in BM Maturation in thymus
centers. 10-20% 60-70% of lymphocytes
▪ Parasitism – in children Recognizes Ag thru B- Recognize peptides
▪ Fecalith – stoned feces. cell Ag receptor presented by MHC of
complex Antigen presenting cells
CELLS OF THE IMMUNE SYSTEM Form plasma cells that Differentiate into:
secrete • T-helper cells
1) Macrophages
immunoglobulin • T-suppressor/T-
2) Dendritic cells regulator cells
3) Natural killer cells • Cytotoxic T cells
4) B lymphocytes
5) T lymphocytes B Lymphocytes markers:

 CD 19, 20, 21, 40 – located in CORTICAL

region of lymph node.

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 3. Engulfment – through AMEBOID
motion.
T Lymphocytes markers:
a. Engulfment is enhanced
 CD 2, 3, 4, 8 – located in through OPSONIZATION.
PARACORTICAL region of lymph node. b. Opsonization is a process of
coating of particles with factors
that speed up phagocytosis. (Ex.
C3b)
4. Digestion - starts when lysosome
approach the phagocyte, forming the
phagolysosome.
 Destruction is through:
o Lysozymes – targets cell wall
o Nitric oxide
o NADPH oxidase – produces ROS
(Reactive Oxygen Species –
fights antioxidants, first
destroys eyes) which is
cytotoxic.

INFLAMMATION

 Tissue reaction to injury.

 Cardinal signs:
o Rubor – redness
o Calor – heat
o Tumor – swelling
o Dolor – pain (caused by
cytokines)
o Functio laesa – loss of function
DN = no markers  Stages of Inflammation:
DP = with markers 1. Vascular Response – mainly
VASODILATION, due to
Mature T cells – should only use 1 marker histamine.
Increased blood flow = Calor
and Rubor
PHAGOCYTOSIS Increased capillary permeability
= Dolor and Tumor
Stages:
2. Cellular Response
1. Initiation – through tissue damage or  Neutrophils – first to
multiplication of microorganisms. migrate, short-lived.
2. Chemotaxis – migration of cells to a (ACUTE inflammation)
certain direction through chemical  Monocytes/Macrophag
stimulation (ex. C5a) es – second to migrate,

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 long-lived (CHRONIC ➢ Oncogene – turns on cancer (prevented
inflammation) by TNF)
3. Resolution and Repair –
DIFFERENCES:
initiated by FIBROBLASTS
(forms scar tissue or ➢ Antigen – substance with the ability to
granuloma). combine with an antibody.
 GRANULOMA ➢ Immunogen – substance that is capable
formation is the of inducing an immune response.
definitive characteristic
of tissue repair. “All immunogens are antigens, but not all
antigens are immunogens.”
MAJOR HISTOCOMPATIBILITY COMPLEX
➢ Hapten – molecule that can bind to
➢ AKA Human Leukocyte Antigen (HLA) antibody but cannot initiate immune
➢ Located at chromosome 6 response.
➢ Important in the antigen recognition by
T-cells FACTORS AFFECTING IMMUNOGENICITY:
➢ Bind peptide fragments of foreign  Size:
proteins for presentation to Ag specific o Potent antigen = MW >10,000
receptors Daltons
➢ Products of genes that evoke rejection o Albumin – MW 40,000
of transplanted organs = high possibility o Blood = less than 10000 MW
of rejection if related.  Chemical Composition:
➢ Associated with many autoimmune o Proteins (most foreign)>>
disease Polysaccharides >> Lipids,
CLASS I MHC CLASS II MHC nucleic acids
Bind endogenous Bind exogenous  Presence of Adjuvants (Substances that
proteins & present to proteins and present enhances immune response)
CD8+ cytotoxic T to CD4+ helper T  Foreignness:
cells cells Classification of antigens:
Encoded in the Encoded in HLA-D: 1. Auto-antigen – from same
genetic loci: HLA-A, HLA-DP, HLA-DQ, individual
HLA-B, HLA-C HLA-DR 2. Allo-antigen – from same
Has α-chain and β2- Has-α chain & β- species
microglobulin chain 3. Hetero-antigen – from different
Expressed on all Expressed on: species
nucleated cells & –Dendritic cells Transplantation/Graft:
platelets –Macrophage (APCs) 1. Auto-graft – from same
–B-cells
individual
–Activated T-cells
2. Iso-graft/Syn-graft – from
MHC CLASS III
IDENTICAL TWIN
➢ Encoded in HLA-C2 and HLA-C4 3. Allo-graft – from same specie
➢ Involved in Factor B and Tumor Necrosis 4. Hetero-graft/Xeno-graft – from
Factor (TNF) different species

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COMPLEMENT SYSTEM:  MAC – C5b6789

 This is activated by microbial CYTOKINES:

macromolecules or by antibodies bound
 Messenger molecules which regulate
to them.
and activate immune system.
 Characteristics of Complement:
 Example:
1. Heat-unstable serum
o Mediate innate immunity
2. Lyse foreign molecules when incubated
▪ IL-1, IL-12, TNF, type I
at 37°C
IFN, chemokines, IFN –
3. Destroyed when incubated at 56 ° C for
gamma
30 minutes
o Adaptive responses
 Membrane Attack Complex (MAC) is
▪ IL-2,4,5,17; IFN-gamma
composed of C5b6789.
o Stimulate hematopoiesis
o Structure allowing water to
▪ CSFs – colony
enter into the microbes and kill
stimulating factors
them by osmotic lysis.
HYPERSENSITIVITY:

 Over-reaction of effector mechanisms

of immune response and under-
reaction of control mechanisms
 TYPES:

1. Allergic hypersensitivity (type I)

2. Cytotoxic hypersensitivity (type II)

3. Immune complex mediated (type III)

4. Cell mediated (type IV)

Alternative pathway – C3(H2O)

Lectin pathway – MBL

Classical pathway – C1qr2s2

4 Effects of Complement Activation:

1. Inflammation
2. Chemotaxis (attraction of phagocytosis)
 C3a, C5a
3. Opsonization (enhancement of
phagocytosis)
 C3b
4. Cell membrane destruction

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 TYPE I TYPE II TYPE III TYPE IV

Reaction Anaphylactic Cytotoxic Immune Cell-mediated

complex

Antibody IgE IgG, IgM IgG, IgM None

Complement No YES YES No

fixation

Process Release of Antibody- Antibody- T-Cell

mast cell dependent, antigen dependent,
granules, complement complexes delayed
immediate –mediated

Tissue injury Allergy or Blood cell Immune Chronic

anaphylactic lysis, complex Inflammation,
reaction cytotoxicity deposition granuloma
formation

DISORDERS:

TYPE I: Type III

1. Atopy 1. Serum sickness

2. Anaphylaxis 2. Rheumatoid arthritis
3. Asthma 3. Arthus reaction
4. Churg-Strauss Syndrome 4. Systemic Lupus Erythematosus
5. Hay fever 5. Post-Streptococcal glomerulonephritis

Type II: Type IV:

1. Autoimmune hemolytic anemia 1. Contact Dermatitis

2. Rheumatic Heart disease 2. Mantoux test
3. Goodpasture’s syndrome 3. Multiple sclerosis
4. Grave’s disease 4. Hashimoto’s thyroiditis
5. Myasthenia gravis
6. Erythroblastosis fetalis

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