4 IMMUNOLOGY -MODULE 1: INNATE IMMUNITY

GENOVE, ERICKA 09/24/20

BMLS III-2G1 Immunology and Serology Lecture

IMMUNOLOGY–SEROLOGY
MODULE 1 - INNATE IMMUNITY
INTRODUCTION:
Something to think about:
• Why is healthy skin important?
- Our skin, also known as the cutaneous membrane, covers the external surface of our
body and is the largest organ of the body in weight. Although its location makes it
vulnerable to damage from trauma, sunlight, microbes, and pollutants in the
environment, the skin’s protective features ward off such damage. Because of its
visibility, skin reflects our emotions (frowning, blushing) and some aspects of normal
physiology (such as sweating). Changes in skin color may also indicate homeostatic
imbalances in the body.
- A healthy skin, primarily an unbroken skin is our structural barrier that serves as our
external defense system that prevents us from acquiring most infectious agents and it
entering our body. This primarily shows how vulnerable are victims of severe burns are
to infection. Not only does the skin serve as a major structural barrier, but also the
presence of several secretions discourages the growth of microorganisms. Lactic acid
in sweat, for instance, and fatty acids from sebaceous glands maintain the skin at a pH
of approximately 5.6. This acid pH keeps most microorganisms from growing.

• How do you keep your skin healthy?

- Our skin is the first line of defense against the outside world. While others take care of
their skin, most are still neglecting it. Daily washing and taking a bath help me ward
away pathogens and certain microorganisms in the surface of my skin. Of course, taking
care of one’s skin does not just involve care on the outside, eating healthy foods and
daily hydration keeps your skin hydrated and glowing. Although sometimes it might be
a pain in the pocket, it’s also important buying skin care products such as moisturizers,
and serums that will help your skin get the nutrients that it needs on a daily basis. As
much as possible it is also necessary for us to avoid maintain a skin that is free from
scratches and open wounds since a broken skin might serve as a portal of entry for
microorganisms to enter our body. What I also keep in mind is avoiding too much
sunlight exposure that might expose my skin to too much UV rays that can cause
detrimental effects on my skin. Lastly is that I also take in vitamin C capsules, with the
antioxidant properties of vitamin C (ascorbic acid) and its role in collagen synthesis
make vitamin C a vital molecule for skin health.

• Does the color of the skin have something to do with its protective ability?
- Yes the color of the skin actually have something to do with its protective ability,
Melanin is a yellow-red or brown-black pigment that contributes to skin color and
absorbs damaging ultraviolet (UV) light. Once inside keratinocytes, the melanin
granules cluster to form a protective veil over the nucleus, on the side toward the skin

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surface. In this way, they shield the nuclear DNA from damage by UV light. Although
their melanin granules effectively protect keratinocytes, melanocytes themselves are
particularly susceptible to damage by UV light.
Write something on:
➢ ICHTHYOSIS
Ichthyosis is the term used to describe continual and widespread scaling of the skin. It
may be inherited (genetic) or acquired during life. The inherited forms are rare, generally
present from infancy, and are usually lifelong conditions. Acquired ichthyosis can develop
at any age due to a number of medical problems, such as kidney disease. Most varieties of
ichthyosis are relatively rare, affecting only one person in several tens of thousands.
However, ichthyosis vulgaris is one exception; this form is estimated to affect one in every
250 people. Ichthyosis vulgaris is also the mildest form of ichthyosis and frequently goes
undiagnosed or misdiagnosed as simply “dry skin.”

Types of Ichthyosis
Epidermolytic Ichthyosis (EI)
- EI is characterized by thick, blistering, warty hardening of the skin over most of the body,
particularly in the skin creases over the joints. Scales tend to form in parallel rows of spines
or ridges. The skin may be fragile and may blister easily following injury. Babies with EI
are usually born with red, blistering, and denuded skin with visible skin thickening. Over
time there is a gradual decrease in the blistering, but an increase in the severity of the
thickness and scaling. A generalized redness of the skin (erythroderma) is present in some
individuals. Skin infections and heat intolerance cam be common problems.

Autosomal Recessive Congenital Ichthyosis – CIE type

- In CIE, there is an overproduction of skin cells in the epidermis. These cells reach the
stratum corneum (the outermost layer of skin) in as few as four days, compared to the
normal fourteen. New skin cells are made faster than old cells are shed and build up in the
stratum corneum and underlying layers. The severity and scaling of CIE varies. The scales
on the face, scalp and torso are usually fine and white, but the scales on the legs can be
large and plate-like (like the scales of lamellar ichthyosis). The skin is often quite reddish
beneath the scales.

Netherton Syndrome
- Netherton syndrome is a rare syndrome characterized by red, scaly skin, short brittle hair
and a predisposition to allergies, asthma and eczema. Newborns with Netherton syndrome
have reddened skin (erythroderma) and, occasionally, a thick shell-like covering of skin
(collodion membrane). They may also be born prematurely. Trouble gaining weight during
infancy and childhood is common. Atopic dermatitis (red, itchy patches of skin) may be
present, and a cradle cap-like scale and redness may appear on the face, scalp and eyebrows.

Autosomal Recessive Congenital Ichthyosis - lamellar type

-Autosomal Recessive Congenital Ichthyosis (ARCI) – lamellar type (or classical lamellar
ichthyosis) is one of the more commonly seen types of ichthyosis. In lamellar ichthyosis,
the skin cells are produced at a normal rate, but they do not separate normally at the surface
of the stratum corneum (the outermost layer of the skin) and are not shed as quickly as they
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should be. The result is a build-up of scales. The entire body is covered with broad, dark,
plate-like scales separated by deep cracks. People with lamellar ichthyosis may experience
a condition called ectropion (a turning out of the eyelids to expose the red inner lid). People
with lamellar ichthyosis may also have thickened nails and hair loss due to the thickness of
the scales on their scalp. They may also have reddened skin (erythroderma), thickened skin
on the palms of the hands and soles of the feet, and decreased sweating with heat
intolerance.

X-Linked Ichthyosis
- X-linked ichthyosis is one of the more commonly seen forms of ichthyosis. It occurs in 1
in approximately 6,000 births, can range from mild to severe, and occurs only in males. In
X-linked ichthyosis, the skin cells are produced at a normal rate, but they do not separate
normally at the surface of the stratum corneum (the outermost layer of the skin) and are not
shed as quickly as they should be. The result is a buildup of scales. The scales of X-linked
are often dark and usually cover only a portion of the body. Typically the face, scalp, palms
of the hands and soles of the feet are unaffected, while the back of the neck is almost always
affected. X-linked ichthyosis frequently improves in the summer.

Ichthyosis Vulgaris
- Ichthyosis vulgaris is one of the more commonly seen types of ichthyosis. Sometimes
called common ichthyosis (“vulgar” means “common” in Latin), it appears in
approximately 1 in 250 individuals. Ichthyosis vulgaris often goes undiagnosed because
people who have it think they have simple “dry skin” and never seek treatment. In
ichthyosis vulgaris, the skin cells are produced at a normal rate, but they do not separate
normally at the surface of the stratum corneum (the outermost layer of skin) and are not
shed as quickly as they should be. The result is a buildup of scales. Usually only a portion
of the body may be involved (scaling is most common and most severe over the lower legs),
and the scale is usually fine and white. Scaling on the torso is usually less severe and the
face is usually unaffected. When the face is affected, the scaling is usually limited to the
forehead and cheeks.

➢ PHAGOCYTE BACTERICIDAL DYSFUNCTION (DISEASES)

-Phagocyte disorders: Conditions characterized by recurrent bacterial infections that can
involve the skin, respiratory tract, and lymph nodes. Evaluation of phagocytosis should
include tests of motility, chemotaxis, adhesion, intracellular killing (respiratory burst),
enzyme testing, and examination of the peripheral blood smear. Phagocyte disorders
include the following conditions: chronic granulomatous disease; myeloperoxidase
deficiency; Job syndrome (hyperimmunoglobulin E syndrome); Chèdiak–Higashi
syndrome; leukocyte adhesion deficiency, together with less common disorders.

• Job's syndrome: Refers to cold staphylococcal abscesses or infections by other agents

that recur. There is associated eczema, elevated levels of IgE in the serum, and
phagocytic dysfunction associated with glutathione reductase and glucose-6-
phosphatase deficiencies. The syndrome has an autosomal recessive mode of
inheritance.

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• Lazy leukocyte syndrome: A disease of unknown cause in which patients experience

an increased incidence of pyogenic infections such as abscess formation, pneumonia,
and gingivitis which is linked to defective neutrophil chemotaxis in combination with
neutropenia. Random locomotion of neutrophils is also diminished and abnormal. This
is demonstrated by the vertical migration of leukocytes in capillary tubes. There is also
impaired exodus of neutrophils from the bone marrow.

• Chronic granulomatous disease (CGD): A disorder that is inherited as an X-linked

trait in two-thirds of the cases and as an autosomal recessive trait in the remaining one-
third. Clinical features are usually apparent before the end of the second year of life.
There is an enzyme defect associated with NADPH oxidase. This enzyme deficiency
causes neutrophils and monocytes to have decreased consumption of oxygen and
diminished glucose utilization by the hexose monophosphate shunt. Although
neutrophils phagocytize microorganisms, they do not form superoxide and other oxygen
intermediates that usually constitute the respiratory burst.

• Chèdiak-Higashi syndrome: A childhood disorder with an autosomal recessive mode

of inheritance that is identified by the presence of large lysosomal granules in
leukocytes that are very stable and undergo slow degranulation. Multiple systems may
be involved. Repeated bacterial infections with various microorganisms, partial
albinism, central nervous system disorders, hepatosplenomegaly, and an inordinate
incidence of malignancies of the lymphoreticular tissues may occur.

• Leukocyte adhesion deficiency (LAD): A recurrent bacteremia with staphylococci or

Pseudomonas linked to defects in the leukocyte adhesion molecules known as integrins.
These include the CD11/CD18 family of molecules. CD18 β chain gene mutations lead
to a lack of complement receptors CR3 and CR4 to produce a congenital disease marked
by recurring pyogenic infections. Deficiency of p150,95, LFA-1, and complement
receptor 3 (CR3) membrane proteins leads to diminished adhesion properties and
mobility of phagocytes and lymphocytes. There is a flaw in synthesis of the 95 kD β
chain subunit that all three of these molecules share. The defect in mobility is
manifested as altered chemotaxis, defective random migration, and faulty spreading.
Particles coated with C3 are not phagocytized and therefore fail to activate a respiratory
burst. The CR3 and p150,95 deficiency account for the defective phagocytic activity.

• Chemotactic disorders: Conditions attributable to abnormalities of the

complex molecular and cellular interactions involved in mobilizing an appropriate
phagocytic cell response to injuries or inflammation. This can involve defects in either
the humoral or cellular components of chemotaxis that usually lead to recurrent
infections. The process begins with the generation of chemoattractants. Among these
chemoattractants that act in vivo are the anaphylatoxins (C3a, C4a and C5a),
leukotriene B4 (LTB4), IL-8, GM-CSF, and platelet activating factors. Once exposed to
chemoattractant, circulating neutrophils embark upon a four-stage mechanism of
emigration through the endothelial layer to a site of tissue injury where phagocytosis
takes place.

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➢ PRINCIPLE OF NBT (TEST)

- The tétrazolium salts are easily reduced by a number of enzymes into formazan and, since
this reduction often is accompanied by a change in colour, they are widely used in
histochemistry (Glenner, 1969}. Phagocytosis and intracellular killing of microorganisms
by normal leucocytes are accompanied by increased oxidative metabolic activity in the cells
(Johnston & Baehner, 1971) and under these conditions the presence of tétrazolium salts
results in intracellular formazan production.
-The nitroblue tetrazolium (NBT) assay is used to determine the ability of cells to produce
reactive oxygen species, giving insight into their oxidative metabolism. During this assay,
NBT is reduced and precipitates, resulting in dark blue granules (formazan). Phorbol
myristate acetate (PMA) in this assay acts as a stimulant, inducing the reduction of NBT to
form formazan.
[To be submitted. Due date depending on the section. 10 points]

INTENDED LEARNING OUTCOMES (Topic objectives)

At the end of the module, the students will be able to:
1. summarize the characteristics and mechanisms of the natural body defense.
2. describe the importance of intact skin and mucous membranes in body defense by
relating to the acquisition of some bacterial or parasitic infections.
3. cite other physiologic factors which protect the body from infection
4. describe the activity of cells in the blood and tissues which contribute to innate
body defense.

At the end of the module, the students will be able to:

1. present in summary the flow of phagocytosis
2. describe the mechanism of oxidative cytopepsis
3. enumerate the humoral factors contributing to non-oxidative cytopepsis4. describe
an example of a disease where there is a failure of phagocytosis.
5. describe the principle of the NBT test

- Our human body has 2 MAIN MECHANISMS to protect itself from harm
1. Innate/natural resistance
2. Adaptive/specific immune responses
- Natural immunity - Natural immunity (inborn or innate resistance) is one of the ways that
the body resists infection after microorganisms have penetrated the first line of defense.
Acquired resistance, which specifically recognizes and selectively eliminates exogenous or
endogenous agents. Natural immunity is characterized as a nonspecific mechanism. If a
microorganism penetrates the skin or mucosal membranes, a second line of cellular and
humoral defense mechanisms becomes operational. The elements of natural resistance
include phagocytic cells, complement, and the acute inflammatory reaction
- Characteristics:
1. Non-specific
2. Non-adaptive
3. Non-selective

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4. No prior exposure
5. No change in response to subsequent exposures
6. Affected by the state of nutrition, age, fatigue, and stress, etc.

- 2 Components of defense mechanisms

1. External – prevents the entry of the pathogen into the body
2. Internal - designed to clear/destroy the pathogen in the body

- EXTERNAL defense mechanisms – *Anatomical barriers

1. Skin and its appendages
• Sweat glands- coiled tubular structures vital for regulating human body
temperature. Humans have three different types of sweat glands: eccrine,
apocrine, and apoeccrine. Eccrine sweat glands are abundantly distributed all
over the skin and mainly secrete water and electrolytes through the surface of the
skin. Apocrine glands secrete oily substances containing lipids, proteins, and
steroids through hair canals and are found only in skin containing hair (restricted
to the armpits, mammary, anal, and genital areas). Rather than responding to
temperature, apocrine glands often respond to emotional stimuli including
anxiety and fear. Under these circumstances, sweating is often observed in the
armpits, palms, and soles of the feet. For decades it was believed that these are
the only two types of sweat glands. In 1987, however, apoeccrine glands were
identified in areas of apocrine glands but secreted watery fluids similar to eccrine
glands
• Nails- Both fingernails and toenails protect the soft tissues of the fingers and toes
from injury. Fingernails also serve to enhance sensation and precise movements
of the fingertips through the counter-pressure exerted on the pulp of the fingers
by the nails.
• sebaceous glands- normal function of sebaceous glands is to produce and secrete
sebum, a group of complex oils including triglycerides and fatty acid breakdown
products, wax esters, squalene, cholesterol esters and cholesterol. Sebum
lubricates the skin to protect against friction and makes it more impervious to
moisture.
• hair follicles- Hair follicles produce hair fibers in a regular cycle. As part of their
hair-producing role, hair follicles retain stem cells, promote cell growth and
tissue invasion and induce angiogenesis. However, hair follicle function involves
more than just hair fiber production.
• the hair- Hair is one of the characteristic features of mammals and has various
functions such as protection against external factors; producing sebum, apocrine
sweat and pheromones; impact on social and sexual interactions;
thermoregulation and being a resource for stem cells.

2. Mucous membranes
- layer of cells that surrounds body organs and body orifices. It is made from
ectodermal tissue. Mucous membranes can contain or secrete mucus, which is a thick
fluid that protects the inside of the body from dirt and pathogens such as viruses and
bacteria. Many different mucous membranes exist, such as mucous membranes in the
respiratory system, digestive system, and reproductive system.

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*Physiological mechanisms. Name these mechanisms

1. Skin- acts as a barrier between invaders (pathogens) and your body. Skin forms a waterproof
mechanical barrier. Microorganisms that live all over your skin can’t get through your skin
unless it’s broken.
2. Mucus membranes- Some mucous membranes secrete mucus, a thick protective fluid. The
function of the membrane is to stop pathogens and dirt from entering the body and to prevent
bodily tissues from becoming dehydrated.
3. Nasal hair-Nasal hair or nose hair, is the hair in the nose. Adult humans have hair in the
nostrils. Nasal hair functions include filtering foreign particles from entering the nasal cavity,
and collecting moisture.
4. Cilia- 'Motile' (or moving) cilia are found in the lungs, respiratory tract and middle ear.
These cilia have a rhythmic waving or beating motion. They work, for instance, to keep the
airways clear of mucus and dirt, allowing us to breathe easily and without irritation. They also
help propel sperm.
5. Saliva -Saliva has a role to play in maintaining the health of the oral cavity and for carrying
out physiological functions like mastication, taste perception, speech etc.
6. Tears- One of the major functions of tear proteins including the enzyme lysozyme appears
to be protection of the eye from microorganisms. Tears prevent dryness by coating the surface
of the eye, as well as protecting it from external irritants.
7. Good gut bacteria- The microbiota offers many benefits to the host, through a range of
physiological functions such as strengthening gut integrity or shaping the intestinal epithelium,
harvesting energy, protecting against pathogens and regulating host immunity.
8. Stomach acid- Stomach secretions are made up of hydrochloric acid, several enzymes, and
a mucus coating that protects the lining of your stomach. Hydrochloric acid helps your body
to break down, digest, and absorb nutrients such as protein. It also eliminates bacteria and
viruses in the stomach, protecting your body from infection.
9. Oil and sweat from sebaceous glands- normal function of sebaceous glands is to produce
and secrete sebum, a group of complex oils including triglycerides and fatty acid breakdown
products, wax esters, squalene, cholesterol esters and cholesterol. Sebum lubricates the skin to
protect against friction and makes it more impervious to moisture.
10. Earwax- Earwax is produced by the ear to clean and protect itself. It's secreted by glands
in the skin that line the outer half of your ear canals. The wax and tiny hairs in these passages
trap dust and other foreign particles that could damage deeper structures, such as your eardrum.
11. Vaginal bacteria- A healthy vaginal flora protects the body against urogenital infections.
It is made up of many different types of bacteria, the predominant bacteria being lactobacilli.
These beneficial or “good” bacteria play a key role in defending against infection.
12. Dead skin cells- These cells are dead, contain a lot of keratin and are arranged in
overlapping layers that impart a tough and waterproof character to the skin's surface. Dead skin
cells are continually shed from the skin's surface. This is balanced by the dividing cells in the
basal cell layer to produce a state of constant renewal.
13. Urinary flow- During normal urination, the initial urine stream starts slowly. But it speeds
up until the bladder is nearly empty. The urine flow then slows again until the bladder is empty.
In people with a urinary tract blockage, this pattern of flow is changed, and increases and
decreases more slowly.
14. Body temperature- Thermoregulation is a process that allows your body to maintain its
core internal temperature. All thermoregulation mechanisms are designed to return your body
to homeostasis. This is a state of equilibrium. Body temperature is regulated by the
hypothalamus much as the temperature in your home is controlled by a thermostat: The

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hypothalamus responds to internal and external stimuli and makes any necessary adjustments
to keep your body within a few degrees of 98.6.

INTERNAL defense mechanisms – designed to recognize, uptake, and destroy Cells:

1. Neutrophils
- The neutrophil, or polymorphonuclear neutrophilic (PMN) leukocyte, represents
approximately 50 to 70 percent of the total peripheral white blood cells. These are around
10 to 15 μm in diameter, with a nucleus that has between two and five lobes (Fig. 1–1).
They contain a large number of neutral staining granules, which are classified as primary,
secondary, and tertiary granules. Primary granules, also called azurophilic granules,
contain enzymes such as myeloperoxidase; elastase; proteinase 3; lysozyme; cathepsin G;
and defensins, small proteins that have antibacterial activity. Secondary granules are
characterized by the presence of collagenase, lactoferrin, lysozyme, reduced nicotinamide
adenine dinucleotide phosphate (NADPH) oxidase, and other membrane proteins normally
associated with the plasma membrane. Newly discovered tertiary granules contain
gelatinase and plasminogen activator. Acid hydrolases are found in separate compartments
called lysosomes.

2. Eosinophils
- Eosinophils are approximately 12 to 15 μm in diameter, and they normally make up
between 1 and 3 percent of the circulating white blood cells in a nonallergic person. Their
number increases in an allergic reaction or in response to many parasitic infections. The
nucleus is usually bilobed or ellipsoidal and is often eccentrically located. Primary granules
contain acid phosphatase and arylsulfatase, while eosinophil-specific granules contain
several different proteins: major basic protein, eosinophil cationic protein, eosinophil
peroxidase, and eosinophil-derived neurotoxin.25 These cells are capable of phagocytosis
but are much less efficient than neutrophils because of the smaller numbers present and
their lack of digestive enzymes. Their most important role is neutralizing basophil and mast
cell products and killing certain parasites.

3. Basophils
- Basophils are found in very small numbers, representing less than 1 percent of all
circulating white blood cells. The smallest of the granulocytes, they are between 10 to 15
μm in diameter and contain coarse, densely staining deep-bluish-purple granules that often
obscure the nucleus. Constituents of these granules are histamine, a small amount of
heparin, and eosinophil chemotactic factor-A, all of which have an important function in
inducing and maintaining immediate hypersensitivity reactions. Histamine is a vasoactive
amine that contracts smooth muscle, and heparin is an anticoagulant. IgE, the
immunoglobulin formed in allergic reactions, binds readily to basophil cell membranes,
and granules release their constituents when they contact an antigen. The granules lack
hydrolytic enzymes, although peroxidase is present. Basophils exist for only a few hours
in the bloodstream.

4. Mast cells
- Tissue mast cells resemble basophils, but they are connective tissue cells of
mesenchymal origin. They are widely distributed throughout the body and are larger than
basophils, with a small round nucleus and more granules. Unlike basophils, they have a
long-life span of between 9 and 18 months. The enzyme content of the granules helps to

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distinguish them from basophils, as they contain acid phosphatase, alkaline phosphatase,
and protease. The mast cell, like the basophil, plays a role in hypersensitivity reactions by
binding IgE.

5. Monocytes/macrophage
- Monocytes, or mononuclear cells, are the largest cells in the peripheral blood, with a
diameter that can vary from 12 to 22 μm; they have an average size of 18 μm. One
distinguishing feature is an irregularly folded or horseshoe-shaped nucleus that occupies
almost one-half of the entire cell’s volume. The abundant cytoplasm stains a dull grayish
blue and has a ground-glass appearance due to the presence of fine dust-like granules. These
granules are actually of two types, one of which contains peroxidase, acid phosphatase, and
arylsulfatase; this indicates that these granules are similar to the lysosomes of neutrophils.
The other type of granule may contain β-glucuronidase, lysozyme, and lipase, but no
alkaline phosphatase. Digestive vacuoles may also be observed in the cytoplasm. These
make up between 4 and 10 percent of total circulating white blood cells; however, they do
not remain in the circulation for long. They stay in peripheral blood for up to 70 hours, and
then they migrate to the tissues and become known as macrophages.

6. Dendritic cells
- Dendritic cells are so named because they are covered with long membranous
extensions that make them resemble nerve cell dendrites. Their main function is to
phagocytose antigen and present it to helper T lymphocytes. While their actual
developmental lineage is not known, they are believed to be descendents of the myeloid
line. They are classified according to their tissue location, in a similar manner to
macrophages. Langerhans cells are found on skin and mucous membranes; interstitial
dendritic cells populate the major organs such as the heart, lungs, liver, kidney, and the
gastrointestinal tract; and interdigitating dendritic cells are present in the T lymphocyte
areas of secondary lymphoid tissue and the thymus. After capturing antigen in the tissue by
phagocytosis or endocytosis, they migrate to the blood and to lymphoid organs, where they
present antigen to T lymphocytes to initiate the acquired immune response. They are the
most potent phagocytic cell in the tissue.

7. Natural killer cells

- NK cells destroy target cells through an extracellular nonphagocytic mechanism
referred to as a cytotoxic reaction, MHC-unrestricted cytolysis. Target cells include tumor
cells, some cells of the embryo, cells of the normal bone marrow and thymus, and microbial
agents. NK cells will actively kill virally infected target cells and, if this activity is
completed before the virus has time to replicate, a viral infection may be stopped. Natural
killer (NK) cells are essential mediators of virus immunity. Their deficiency in humans
lead to uncontrolled iral replication and poor clinical outcome. MHC class I (MCH I) is
essential to NK and T cell effector and surveillance functions. A total of 70% to 80% of
NK cells have the appearance of large granular lymphocytes (LGLs). Up to about 75% of
LGLs function as NK cells and LGLs appear to account fully for the NK activity in mixed
cell populations.

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Mechanisms:
1. Phagocytosis
Steps:
a. Adherence
b. Phagosome
c. Phagolysosome
d. Digestion/ cytopepsis
e. Exocytosis
Opsonization – defined as enhanced phagocytosis
Examples of opsonins:
- IgM antibodies
- IgG antibodies
- C3b proteins
- C4b proteins
- C1q proteins
- Pentraxins
- Collectins
- Ficolins
- Mannose-binding lectin (MBL)

Cytopepsis – digestion of pathogen Two

mechanisms:
a. Oxidative: oxygen-dependent
- myeloperoxidase
- hydrogen peroxide
- superoxide anion
- singlet oxygen- hydroxyl radicals
b. Non- oxidative: oxygen-independent
- lactoferrin
- proteinases
- lysozymes
- cationic proteins

2. Inflammation Major events:

a. increased blood supply
b. increased permeability
c. chemotaxis → phagocytosis
d. tissue healing
Chemical mediators of inflammation: a. histamine
b. chemotaxins
NON- ANTIBODY FACTORS contributing to innate immunity:
1. chemotactic factors
2. properdin
3. beta lysis
4. interferons
5. lactoferrin
6. lactoperoxidase
7. Lysozymes

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8. *acute-phase reaction proteins

- CRP
- serum amyloid
- complement proteins
- mannose =binding proteins
- alpha-1-antitrypsin
- haptoglobin
- fibrinogen
- ceruloplasmin
- alpha-1-glycoprotein

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