General Pathology for Lecture 8 Dr. Mukhallad A.

Ramadhan
College of Dentistry

Diseases of the Immune System

THE NORMAL IMMUNE RESPONSE

Immunity: refers to protection against infections. The immune system is the

collection of cells and molecules that are responsible for defending the body
against the countless pathogens that individuals encounter.

Defense against pathogens consists of two types of reactions:

1. Innate immunity: the major components of innate immunity are:-

A. Epithelial barriers that block the entry of microbes.
B. Cells: phagocytic cells, dendritic cells, natural killer cells.
C. Plasma proteins: includes complement system.

• Receptors of Innate Immunity: these are

A. Toll-Like Receptors: these are present in the plasma membrane which is
responsible for detection of the bacterial products such as
lipopolysaccharide (LPS), and endosomal TLRs recognize viral and
bacterial RNA and DNA.
B. NOD-like receptors (NLRs): are cytosolic receptors. They recognize a
wide variety of substances, including products of necrotic cells (e.g., uric
acid and released ATP), ion disturbances (e.g., loss of K+), and some
microbial products.
C. Inflammasome: which activates an enzyme that activate cytokine
interleukin-1 (IL-1).

• Reactions of Innate Immunity:

A. Inflammation.
B. Anti-viral defense.

2. Adaptive immunity: The adaptive immune system consists of lymphocytes

and their products, including antibodies.

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General Pathology for Lecture 8 Dr. Mukhallad A. Ramadhan
College of Dentistry

There are two types of adaptive immunity:

a) Humoral immunity: mediated by soluble proteins called antibodies those

are produced by B lymphocytes (also called B cells). Antibodies provide
protection against extracellular pathogens in the blood, mucosal surfaces,
and tissues.

b) Cell-mediated (or cellular) immunity: mediated by T lymphocytes (also

called T cells).T lymphocytes are important in defense against intracellular
microbes. They work by either directly killing infected cells (accomplished
by cytotoxic T lymphocytes) or by activating phagocytes to kill ingested
microbes, via the production of soluble protein mediators called cytokines
(made by helper T cells).

• CELLS AND TISSUES OF THE IMMUNE SYSTEM

1. Cells of the immune system:

a. Lymphocytes: Lymphocytes are present in the circulation and in various
lymphoid organs ,these are of two types; T lymphocytes mature in the thymus,
whereas B lymphocytes mature in the bone marrow.

 T lymphocytes:
 Thymus-derived T lymphocytes develop into the effector cells of cellular
immunity and “help” B cells to produce antibodies against protein antigens.
 Tcells constitute 60% to 70% of the lymphocytes in peripheral blood and are
the major lymphocyte population in splenic periarteriolar sheaths and lymph
node interfollicular zones.
 T cells cannot recognize free or circulating antigens; instead, the vast majority
(>95%) of T cells sense only peptide fragments of proteins displayed by
molecules of the major histocompatibility complex (MHC).
 There are two distinct types of T lymphocytes; CD4+ called T helper that help
B cells to produce antibodies and responsible about processing of peptides
which expressed on MHC II. The second is CD8+ which is called cytotoxic
cell that kill the tumor cells and virally infected cells through interaction with
MHC class I.

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General Pathology for Lecture 8 Dr. Mukhallad A. Ramadhan
College of Dentistry

 B Lymphocytes:
 B (bone marrow–derived) lymphocytes are the cells that produce antibodies,
the mediators of humoral immunity.
 B cells make up 10% to 20% of the circulating peripheral lymphocyte
population.
 B cells recognize antigen by means of membrane-bound antibody of the
immunoglobulin M (IgM) class, expressed on the surface together with
signaling molecules to form the B-cell receptor (BCR) complex.
 B cells recognize and respond to many more chemical structures, without a
requirement for the MHC.
 After stimulation, B cells differentiate into plasma cells, which secrete large
amounts of antibodies.

 Natural Killer Cells and Innate Lymphoid Cells

 NK cells are lymphocytes that arise from the same common lymphoid
progenitor that gives rise to T lymphocytes and B lymphocytes.
 NK cells are innate immune cells, as they are functional without prior
activation and do not express highly variable receptors for antigens.
 NK cells have two types of receptors—inhibitory and activating.
 Inhibitory receptors recognize self class I MHC molecules, which are
expressed on all healthy cells,
 Activating receptors recognize molecules that are expressed or upregulated on
stressed or infected cells.
 NK cells also secrete cytokines such as interferon-γ (IFN-γ), which activates
macrophages to destroy ingested microbes, and thus NK cells provide early
defense against intracellular microbial infections.

b. Antigen-Presenting Cells: The immune system contains several cell types that
are specialized to capture antigens and display these to lymphocytes, these cells
include: -
I. Dendritic Cells: Dendritic cells (DCs) are the most important antigen-presenting
cells for initiating T-cell responses against protein antigens. These cells have
numerous fine cytoplasmic processes that resemble dendrites, from which they
derive their name. Several features of DCs account for their key role in antigen
capture and presentation:

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General Pathology for Lecture 8 Dr. Mukhallad A. Ramadhan
College of Dentistry

I.a. These cells are located under epithelia, the common site of entry of microbes
and foreign antigens, and in the interstitia of all tissues. DCs within the epidermis
are called Langerhans cells.
I.b. In response to microbes, DCs are recruited to the T- cell zones of lymphoid
organs, where they are ideally positioned to present antigens to T cells.
I.c. DCs express high levels of MHC and other molecules needed for antigen
presentation and activation of T cells.

II. Macrophages: ingest microbes and display peptides for recognition by T

lymphocytes.

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General Pathology for Lecture 8 Dr. Mukhallad A. Ramadhan
College of Dentistry

2. Major Histocompatibility Complex Molecules (MHC):

The human MHC, known as the human leukocyte antigen (HLA) complex. It is
present in two types :
A. MHC class I: display the peptide antigen to CD8+ T lymphocytes.
B. MHC class II: display the peptide antigen to CD4+.

3. Lymphoid Tissues: The tissues of the immune system consist of:

A. Primary, or central lymphoid organs, in which T lymphocytes and B

lymphocytes mature and become competent to respond to antigens.
I. Thymus.
II. Bone marrow.
B. Peripheral (or secondary) lymphoid organs, in which adaptive immune
responses to microbes are initiated, this include:
I. Lymph nodes.
II. The spleen.
III. The cutaneous and mucosal lymphoid systems.

THE END

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