MODULE 5.

1
REVIEW OF IMMUNOLOGY

IMMUNITY

Immunity is the balanced state of multicellular organisms having adequate biological defenses
to fight infection, disease, or other unwanted biological invasion, while having adequate tolerance to
avoid allergy, and autoimmune diseases.

The immune response is how your body recognizes and defends itself against bacteria, viruses,
and substances that appear foreign and harmful.

A. INNATE, OR NONSPECIFIC, IMMUNITY

is the defense system with which you were born. It protects you against all
antigens. Innate immunity involves barriers that keep harmful materials from entering
your body. These barriers form the first line of defense in the immune response.

Examples of innate immunity include:

• Cough reflex
• Enzymes in tears and skin oils
• Mucus, which traps bacteria and small particles
• Skin
• Stomach acid

First line of defense

The body's most important nonspecific defense is the skin, which acts as a physical
barrier to keep pathogens out. Even openings in the skin (such as the mouth and eyes) are
protected by saliva, mucus, and tears, which contain an enzyme that breaks down bacterial cell
walls.

1. Skin
 The skin is the largest organ of your body. It 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. Tears, mucus and saliva

Nose, mouth and eyes are obvious entry points for pathogens. However, tears, mucus
and saliva contain an enzyme that breaks down the cell wall of many bacteria. Those that are
not killed immediately are trapped in mucus and swallowed. Special cells line and protect the
nose, throat and other passages within your body. The inner lining of your gut and lungs also
produces mucus to trap invading pathogens.

3. Cilia

Very fine hairs (cilia) lining your windpipe move mucus and trapped particles away from
your lungs. Particles can be bacteria or material such as dust or smoke.

4. Stomach acid

Stomach acid kills bacteria and parasites that have been swallowed.

5. Urine flow

Urine flow flushes out pathogens from the bladder area.

6. Normal Flora ‘Friendly’ (beneficial) bacteria

Normal flora are growing on the skin, in the bowel and other places in the body (such as
the mouth and the gut) that stop other harmful bacteria from taking over.

Second line of defense

If a pathogen does make it into the body, there are secondary nonspecific defenses that
take place.

Inflammatory response. Image from OpenStax, CC BY 4.0

 An inflammatory response begins when a pathogen stimulates an increase in blood flow
to the infected area. Blood vessels in that area expand, and white blood cells leak from the
vessels to invade the infected tissue. These white blood cells, called phagocytes engulf and
destroy bacteria. The area often becomes red, swollen, and painful during an inflammatory
response.

When a pathogen has invaded, the immune system may also release chemicals that
increase body temperature, producing a fever. Increased body temperature may slow or stop
pathogens from growing and helps speed up the immune response.

IMMUNE ORGANS
1. Thymus
• Only clearly individualized 1⁰ lymphoid organ
• Primary function:- production of thymic lymphocytes
• A major organ for proliferation of lymphocytes in body.
• Plays key role in determining the differentiation of T cell
2. Bone marrow
• Hematopoiesis
• B cell maturation
• B cell selection
• Puts out mature, naive B cells
3. Lymph nodes
• 1st line of response to antigens
• Secondary follicle (Germinal center) is site of B cell proliferation, mutation,
differentiation
• Specificity is high
• >90% of B cells die through apoptosis
• After Ag stimulation lymphocyte numbers up by 50X in efferent lymphatic vessel
4. Tonsils
• Filters out older RBCs
• Responds to Ag in circulatory system
• Produces activated B cells
5. Appendix
• Responds to Ag
• Role in GI immune response
6. Mucosa-Associated Lymphoid Tissue (MALT)
• Lymphoid tissues below epithelium
• Presence of B cells
• Ag presented through unique cell (M cell)
• Preferentially responds with IgA antibody
B. SPECIFIC DEFENSE: THE ADAPTIVE IMMUNE SYSTEM

When pathogens are able to bypass innate immune defenses, the adaptive
immune system is activated.

Cells that belong in the body carry specific markers that identify them as "self"
and tell the immune system not to attack them.
 Once the immune system recognizes a pathogen as "non-self," it uses cellular
and chemical defenses to attack it. After an encounter with a new pathogen, the
adaptive immune system often "remembers" the pathogen, allowing for a faster
response if the pathogen ever attacks again.

Specific immune responses are triggered by antigens. Antigens are usually found
on the surface of pathogens and are unique to that particular pathogen. The immune
system responds to antigens by producing cells that directly attack the pathogen, or by
producing special proteins called antibodies. Antibodies attach to an antigen and attract
cells that will engulf and destroy the pathogen.

The main cells of the immune system are lymphocytes known as B cells and T
cells. B cells are produced and mature in bone marrow. T cells are also produced in bone
marrow, but they mature in the thymus.

B.1. Humoral immunity

Humoral immunity relies on the actions of antibodies circulating

through the body.
 The humoral response (or antibody‐mediated response) involves B cells
that recognize antigens or pathogens that are circulating in the lymph or blood
(“humor” is a medieval term for body fluid).

The response follows this chain of events:

1. Antigens bind to B cells.

2. Interleukins or helper T cells co-stimulate B cells. In most cases,
both an antigen and a co-stimulator are required to activate a B cell
and initiate B cell proliferation.
3. B cells proliferate and produce plasma cells. The plasma cells bear
antibodies with the identical antigen specificity as the antigen
receptors of the activated B cells. The antibodies are released and
circulate through the body, binding to antigens.
4. B cells produce memory cells. Memory cells provide future
immunity.

B.2. Cell-mediated immunity

Antibodies alone are often not enough to protect the body against
pathogens. In these instances, the immune system uses cell-mediated immunity
to destroy infected body cells.

The cell‐mediated response involves mostly T-cells and responds to any

cell that displays aberrant MHC markers, including cells invaded by pathogens,
tumor cells, or transplanted cells. The following chain of events describes this
immune response:

1. Self cells displaying foreign antigens bind to T cells.

2. Interleukins (secreted by helper T cells) co-stimulate activation
of T cells.
 3. If MHC‐I and endogenous antigens are displayed on the plasma
membrane, T cells proliferate, producing cytotoxic T cells.
Cytotoxic T cells destroy cells displaying the antigens.
4. If MHC‐II and exogenous antigens are displayed on the plasma
membrane, T cells proliferate, producing helper T cells. Helper T
cells release interleukins (and other cytokines), which stimulate
B cells to produce antibodies that bind to the antigens and
stimulate nonspecific agents (NK and macrophages) to destroy
the antigens.

NATURAL IMMUNITY

• occurs through contact with a disease-causing agent, when the

contact was not deliberate.
• immediately activate the rest of your immune system to
prevent you from getting sick.
• A. Natural Passive immunity
o Passive immunity develops after you receive antibodies
from someone or somewhere else. This type of
immunity is short-lived, because it doesn’t cause your
immune system to recognize the pathogen in the
future.
o Example:
o Maternal antibodies are antibodies that transfer from a
mother to child. This usually happens across the
placenta or through breast milk, especially in the first
few days after birth.
o Ig can be transferred by breastfeeding as it is the most
abundant Ig found in human milk
o placental transfer of IgG or milk transfer of IgA
molecules specific for microbial antigens and have
demonstrated their role in infectious disease prevention
• B. Natural Active Immunity
o occurs when the person is exposed to a live pathogen,
develops the disease, and becomes immune as a result
of the primary immune response. Once a microbe
penetrates the body’s skin, mucous membranes, or
other primary defenses, it interacts with the immune
system. B-cells in the body produce antibodies that help
to fight against the invading microbes. The adaptive
immune response generated against the pathogen
takes days or weeks to develop but may be long-lasting,
or even lifelong. Wild infection, for example with
hepatitis A virus (HAV) and subsequent recovery, gives
 rise to a natural active immune response usually leading
to lifelong protection.
o ARTIFICIAL IMMUNITY
o Artificial immunity is a mean by which the body is given
immunity to a disease by intentional exposure to small
quantities of it.
o A. Artificial Passive Immunity
▪ is short lived, and usually lasts only a few months
▪ Artificially-acquired passive immunity is an
immediate, but short-term immunization provided
by the injection of antibodies, such as gamma
globulin, that are not produced by the recipient’s
cells. These antibodies are developed in another
individual or animal and then injected into another
individual. Antiserum is the general term used for
preparations that contains antibodies.
▪ Artificial passive immunization is normally
administered by injection and is used if there has
been a recent outbreak of a particular disease or as
an emergency treatment for toxicity, as in for
tetanus. The antibodies can be produced in animals,
called ” serum therapy,” although there is a high
chance of anaphylactic shock because of immunity
against animal serum itself. Thus, humanized
antibodies produced in vitro by cell culture are used
instead if available.
o Artificial Active Immunity
▪ lasts much longer and is sometimes life-long lasting.
▪ Artificial active immunization is where the microbe, or
parts of it, are injected into the person before they are
able to take it in naturally. If whole microbes are used,
they are pre-treated, attenuated vaccines. This vaccine
stimulates a primary response against the antigen in the
recipient without causing symptoms of the disease.
▪ Example:
▪ Tetanus Toxoid, DPT, BCG

INFLAMMATORY RESPONSES

The inflammatory response (inflammation) occurs when tissues are injured by

bacteria, trauma, toxins, heat, or any other cause.

The damaged cells release chemicals including histamine, bradykinin, and

prostaglandins. These chemicals cause blood vessels to leak fluid into the tissues,
causing swelling. This helps isolate the foreign substance from further contact with body
tissues.
 The chemicals also attract white blood cells called phagocytes that "eat" germs
and dead or damaged cells. This process is called phagocytosis. Phagocytes eventually
die. Pus is formed from a collection of dead tissue, dead bacteria, and live and dead
phagocytes.

The simplest definition of inflammation is best stated in Latin:

a. calor -heat
b. dolor- pain
a. rubor- redness
b. tumor-swelling