*Our immune system is essential for our survival.

Without an
immune system, our bodies would be open to attack from
bacteria, viruses, parasites, and more. It is our immune system
that keeps us healthy as we drift through a sea of pathogens.
This vast network of cells and tissues is constantly on the
lookout for invaders, and once an enemy is spotted, a complex
attack is mounted. The immune system is spread throughout
the body and involves many types of cells, organs, proteins,
and tissues. Crucially, it can distinguish our tissue from foreign
tissue — self from non-self. Dead and faulty cells are also
recognized and cleared away by the immune system. If the
immune system encounters a pathogen, for instance, a
bacterium, virus, or parasite, it mounts a so-called immune
response. White blood cells White blood cells are also called
leukocytes. They circulate in the body in blood vessels and the
lymphatic vessels that parallel the veins and arteries. White
blood cells are on constant patrol and looking for pathogens.
When they find a target, they begin to multiply and send
signals out to other cell types to do the same. Our white blood
cells are stored in different places in the body, which are
referred to as lymphoid organs. These include the following:
Thymus — a gland between the lungs and just below the neck.
Spleen — an organ that filters the blood. It sits in the upper
left of the abdomen. Bone marrow — found in the center of the
bones, it also produces red blood cells. Lymph nodes —small
glands positioned throughout the body, linked by lymphatic
vessels. There are two main types of leukocyte: 1. Phagocytes
These cells surround and absorb pathogens and break them
down, effectively eating them. There are several types,
including: Neutrophils — these are the most common type of
phagocyte and tend to attack bacteria.Monocytes — these are
the largest type and have several roles.Macrophages — these
patrol for pathogens and also remove dead and dying
cells.Mast cells — they have many jobs, including helping to
heal wounds and defend against pathogens. 2. Lymphocytes
Lymphocytes help the body to remember previous invaders
and recognize them if they come back to attack again.
Lymphocytes begin their life in bone marrow. Some stay in the
marrow and develop into B lymphocytes (B cells), others head
to the thymus and become T lymphocytes (T cells). These two
cell types have different roles: B lymphocytes — they produce
antibodies and help alert the T lymphocytes. T lymphocytes —
they destroy compromised cells in the body and help alert
other leukocytes. The immune system needs to be able to tell
self from non-self. It does this by detecting proteins that are
found on the surface of all cells. It learns to ignore its own or
self proteins at an early stage. An antigen is any substance that
can spark an immune response. In many cases, an antigen is a
bacterium, fungus, virus, toxin, or foreign body. But it can also
be one of our own cells that is faulty or dead. Initially, a range
of cell types works together to recognize the antigen as an
invader.The role of B lymphocytes Once B lymphocytes spot
the antigen, they begin to secrete antibodies (antigen is short
for “antibody generators”). *Antibodies are special proteins
that lock on to specific antigens. Each B cell makes one specific
antibody. For instance, one might make an antibody against
the bacteria that cause pneumonia, and another might
recognize the common cold virus. *Antibodies are part of a
large family of chemicals called immunoglobulins, which play
many roles in the immune response: Immunoglobulin G (IgG)
— marks microbes so other cells can recognize and deal with
them. IgM — is expert at killing bacteria. IgA — congregates in
fluids, such as tears and saliva, where it protects gateways into
the body.IgE — protects against parasites and is also to blame
for allergies. IgD — stays bound to B lymphocytes, helping
them to start the immune response. Antibodies lock onto the
antigen, but they do not kill it, only mark it for death. The
killing is the job of other cells, such as phagocytes. The role of
T lymphocytes There are distinct types of T lymphocytes:
Helper T cells (Th cells) — they coordinate the immune
response. Some communicate with other cells, and some
stimulate B cells to produce more antibodies. Others attract
more T cells or cell-eating phagocytes. Killer T cells (cytotoxic
T lymphocytes) — as the name suggests, these T cells attack
other cells. They are particularly useful for fighting viruses.
They work by recognizing small parts of the virus on the
outside of infected cells and destroy the infected
cells.*Everyone’s immune system is different but, as a general
rule, it becomes stronger during adulthood as, by this time, we
have been exposed to more pathogens and developed more
immunity. an antibody has been produced, a copy remains in
the body so that if the same antigen appears again, it can be
dealt with more quickly. That is why with some diseases, such
as chickenpox, you only get it once as the body has a
chickenpox antibody stored, ready and waiting to destroy it
next time it arrives. This is called immunity. There are three
types of immunity in humans called innate, adaptive, and
passive: Innate immunity We are all born with some level of
immunity to invaders. Human immune systems, similarly to
those of many animals, will attack foreign invaders from day
one. This innate immunity includes the external barriers of
our body — the first line of defense against pathogens — such
as the skin and mucous membranes of the throat and gut. This
response is more general and non-specific. If the pathogen
manages to dodge the innate immune system, adaptive or
acquired immunity kicks in. Adaptive (acquired) immunity
This protect from pathogens develops as we go through life. As
we are exposed to diseases or get vaccinated, we build up a
library of antibodies to different pathogens. This is sometimes
referred to as immunological memory because our immune
system remembers previous enemies. Passive immunity This
type of immunity is “borrowed” from another source, but it
does not last indefinitely. For instance, a baby receives
antibodies from the mother through the placenta before birth
and in breast milk following birth. This passive immunity
protects the baby from some infections during the early years
of their life.*Immunization introduces antigens or weakened
pathogens to a person in such a way that the individual does
not become sick but still produces antibodies. Because the
body saves copies of the antibodies, it is protected if the threat
should reappear later in life.- Immune system disorders
Because the immune system is so complex, there are many
potential ways in which it can go wrong. Types of immune
disorder fall into three categories:* Immunodeficiencies These
arise when one or more parts of the immune system do not
function. Immunodeficiencies can be caused in a number of
ways, including age, obesity, and alcoholism. In developing
countries, malnutrition is a common cause. AIDS is an example
of an acquired immunodeficiency.In some cases,
immunodeficiencies can be inherited, for instance, in chronic
granulomatous disease where phagocytes do not function
properly. Autoimmunity In autoimmune conditions, the
immune system mistakenly targets healthy cells, rather than
foreign pathogens or faulty cells. In this scenario, they cannot
distinguish self from non-self. Autoimmune diseases include
celiac disease, type 1 diabetes, rheumatoid arthritis, and
Graves’ disease. Hypersensitivity With hypersensitivity, the
immune system overreacts in a way that damages healthy
tissue. An example is anaphylactic shock where the body
responds to an allergen so strongly that it can be life-
threatening. in a nutshell The immune system is incredibly
complicated and utterly vital for our survival. Several different
systems and cell types work in perfect synchrony (most of the
time) throughout the body to fight off pathogens and clear up
dead cells. B lymphocytes both originate and mature in the
bone marrow Mature B cells occur mostly outside the lymph
node Germinal centers of lymph nodes, spleen, gut, respiratory
tract; also subcapsular and medullary cords of lymph nodes
The B-cell receptors (BCRs) constitute of membrane
antibodies known as immunoglobulin surface receptors.
Extracellular antigens such as bacteria, free viruses and other
circulating free foreign material. T lymphocytes mature in the
thymus after its origination in the bone marrow Mature T cells
occur mostly inside the lymph node. Parafollicular areas of
cortex in lymph nodes, periarteriolar in the spleen Surface
receptors are called T-cell receptors (TCRs) and differ from
membrane antibodies. The foreign antigen in association with
self-antigen only such as a virus-infected cell. *The function of
MHC molecules is to bind peptide fragments derived from
pathogens and display them on the cell surface for recognition
by the appropriate T cells. The consequences are almost
always deleterious to the pathogen—virus-infected cells are
killed, macrophages are activated to kill bacteria living in their
intracellular vesicles, and B cells are activated to produce
antibodies that eliminate or neutralize extracellular
pathogens. Thus, there is strong selective pressure in favor of
any pathogen that has mutated in such a way that it escapes
presentation by an MHC molecule. Two separate properties of
the MHC make it difficult for pathogens to evade immune
responses in this way. First, the MHC is polygenic: it contains
several different MHC class I and MHC class II genes, so that
every individual possesses a set of MHC molecules with
different ranges of peptide-binding specificities. Second, the
MHC is highly polymorphic; that is, there are multiple variants
of each gene within the population as a whole. The MHC genes
are, in fact, the most polymorphic genes known. In this section,
we will describe the organization of the genes in the MHC and
discuss how the variation in MHC molecules arises. We will
also see how the effect of polygeny and polymorphism on the
range of peptides that can be bound contributes to the ability
of the immune system to respond to the multitude of different
and rapidly evolving pathogens.* Humoral immunity When
foreign material - antigens - is recognized in the body, the
body responds with an antibody-mediated reaction.
Extracellular intruders, such as bacteria, are commonly found
in this foreign material. B cell lymphocytes, a type of immune
cell that makes antibodies after detecting a specific antigen,
are principally responsible for this method. Lymphocytes
known as naive B cells circulate throughout the body via the
lymphatic system. These cells produce antigen-specific
molecules that are necessary for detecting infectious
pathogens in the human body. When naive B cells in the
lymphatic system come into contact with an antigen, they
begin the differentiation process that results in the formation
of memory B cells and effector B cells *Cell-mediated
immunity, unlike humoral immunity, does not rely on
antibodies to perform adaptive immunological activities.
Mature T cells, macrophages, and the production of cytokines
in response to an antigen are the main drivers of cell-mediated
immunity. To recognize intracellular target antigens, T cells
that participate in cell-mediated immunity rely on antigen-
presenting cells that have membrane-bound MHC class I
proteins. The maturation and differentiation of naive T cells
into helper or killer T cells are dependent on the binding
specificity of MHC proteins to external antigens.* Antigens are
large molecules of proteins, present on the surface of the
pathogen- such as bacteria, fungi viruses, and other foreign
particles. When these harmful agents enter the body, it
induces an immune response in the body for the production of
antibodies. For example: When a common cold virus enters
the body, it causes the body to produce antibodies to prevent
from getting sick. Properties of Antigens The antigen should
be a foreign substance to induce an immune response. The
antigens have a molecular mass of 14,000 to 6,00,000 Da. They
are mainly proteins and polysaccharides. The more chemically
complex they are, the more immunogenic they will be.
Antigens are species-specific. The age influences the
immunogenicity. Very young and very old people exhibit very
low immunogenicity. Types of Antigens On the basis of Origin
There are different types of antigens on the basis of origin:
Exogenous Antigens Exogenous antigens are the external
antigens that enter the body from outside, e.g. inhalation,
injection, etc. These include food allergen, pollen, aerosols, etc.
and are the most common type of antigens. Endogenous
Antigens Endogenous antigens are generated inside the body
due to viral or bacterial infections or cellular metabolism.
Autoantigens are the ‘self’ proteins or nucleic acids that due to
some genetic or environmental alterations get attacked by
their own immune system causing autoimmune diseases.*
Tumour Antigens It is an antigenic substance present on the
surface of tumour cells that induces an immune response in
the host, e.g. MHC-I and MHC-II. Many tumours develop a
mechanism to evade the immune system of the body. Native
Antigens An antigen that is not yet processed by an antigen-
presenting cell is known as native antigens. Structure of
Antigens The epitopes or antigenic determinants are the
components of antigen. Every antigen has several epitopes. An
antibody has at least two binding sites that can bind to specific
epitopes on antigens. The antigens combine with the antibody
according to the lock and key mechanism. The ability of the
body to act against the disease-causing agents and antigens by
the immune system is termed as the immunity. This immunity
may be either inborn or acquired from vaccinations. *
Agglutination is the process of clumping of antigens with their
respective antibodies. Agglutination reactions are used to
particulate test antigens that are usually conjugated to a
carrier.The carrier can either be artificial (such as latex or
charcoal particles) or biological (such as red blood cells). The
agglutination process involving red blood cells is termed
hemagglutination, and the process with white blood cells is
termed leukoagglutination. These conjugated particles then
react with the patient’s serum which might or might not
contain antibodies. The result of this test can be collected
based on the observation of clumps resulting from that
antigen-antibody complex formation.*Precipitation is a
process where soluble antigens bind with their specific
antibody at an optimum temperature and pH, resulting in the
formation of an insoluble precipitate. The interaction between
the soluble antigen and antibody results in the formation of
insoluble lattice that forms precipitate out of the solution. The
process of precipitation has some requirements involving the
valency of both the antigen and the antibody. For precipitation
to take place, the antibody must be bivalent, and the antigen
must be either bivalent or polyvalent. Precipitation takes place
in the zone of equivalence, where the concentration of antigen
and antibody is equal. On either side of equivalence,
precipitation doesn’t occur if the concentration of either
antigen or antibody is in excess or deficient.* When
radioisotopes instead of enzymes are used as labels to be
conjugated with antigens or antibodies, the technique of
detection of the antigen-antibody complex is called
radioimmunoassay (RIA). Radioimmunoassay (RIA) is an in
vitro assay that measures the presence of an antigen with very
high sensitivity. RIA was first described in 1960 for the
measurement of endogenous plasma insulin by Solomon
Berson and Rosalyn Yalow of the Veterans Administration
Hospital in New York. It involves a combination of three
principles. An immune reaction i.e. antigen, antibody binding.
A competitive binding or competitive displacement reaction.
(It gives specificity) Measurement of radio emission. (It gives
sensitivity) *Enzyme-linked immunosorbent assay (ELISA)
utilizes an enzyme system to show specific combination of an
antigen with its antibody. It is a method of quantifying an
antigen immobilized on a solid surface. ELISA uses a specific
antibody with a covalently coupled enzyme. The amount of
antibody that binds the antigen is proportional to the amount
of antigen present, which is determined by
spectrophotometrically measuring the conversion of a clear
substance to a colored product by the coupled enzyme. The
ELISA technique was first conceptualized and developed by
Peter Perl ELISA is of 3types. Indirect ELISA: This technique is
used for the detection of HIV. The envelop proteins are
developed by recombinant technology and coated on the
surface of the of microtire plates. Suspects serum is added, and
unbound proteins are washed off. Sandwich ELISA: Used to
detect the presence of Ag in a sample. The well is coated with
Ab specific to the Ag and then suspect serum is added allowed
to react. The wells are washed to remove unbound Ag’s.mann
and Eva Engvall at Stockholm University, Sweden. >
Competitive ELISA: Another variation for measuring amounts
of antigen is competitive ELISA. In this technique, antibody is
first incubated in solution with a sample containing antigen.
*The antigen-antibody mixture is then added to an antigen
coated micro titer well immuno fluorescence: Fluorescence is
the property of absorbing light rays of one particular
wavelength and emitting rays with adifferent wave length.
Fluorescent dyes show up brightly under UV light asthey
convert into visible light. Coons et al (1942) showed that
labeled dyes can be conjugated to Ab’s and these labeled
antibodies can be used to detect Ag’s. Dyes that are commonly
used include:Fluorescein, an organic dye that is the most
widely used label for immunofluorescence procedures,
absorbs blue light (490 nm) and emits an intense yellow-green
fluorescence (517 nm). Phycoerythrin is an efficient absorber
of light (- 30fold greater than fluorescein) and a brilliant
emitter of red fluorescence, stimulating its wide use as a label
for immunofluorescence* Hybridomas are cells formed via
fusion between a short-lived antibody-producing B cell and an
immortal myeloma cell. Each hybridoma constitutively
expresses a large amount of one specific mAb, and favored
hybridoma cell lines can be cryopreserved for long-lasting
mAb production. As a result, researchers usually prefer
generating hybridomas over other mAb production methods
in order to maintain a convenient, never-ending supply of
important mAbs. Hybridoma generation is a five-step process
that takes advantage of a host animal's natural ability to
generate functional, highly specific, high-affinity mAbs. In
brief, the first stage involves the development and
optimization of an immunogenic antigen (Ag)Next, a host
animal is immunized with the Ag to elicit an immune response
and initiate the process of B-cell maturation The third stage
involves the isolation of these B cells from the spleen of the
host animal and their fusion with myeloma cells to generate
hybridomas During the fourth stage, the generated
hybridomas are subject to multiple rounds of screening and
selection in order to identify the hybridomas that produce the
best mAbs for the intended downstream application. The fifth
and final stage is the amplification of these specific
hybridomas and subsequent mAb purification * Oncogenes are
mutated genes that can contribute to the development of
cancer. In their non-mutated state, everyone has genes which
are referred to as proto-oncogenes. When proto-oncogenes
are mutated or increased in numbers (amplification) due to
DNA damage (such as exposure to carcinogens), the proteins
produced by these genes can affect the growth, proliferation,
and survival of the cell, and potentially result in the formation
of a malignant tumor Proto-oncogenes are normal genes
present in everyone's DNA. These genes are "normal" in that
they play an important role in normal cell growth and division,
and are particularly vital for the growth and development of
the fetus during pregnancy. These genes function as a
blueprint that codes for proteins that trigger cell growth. The
problem arises when these genes are mutated or activated
later in life (if they become oncogenes), where they may result
in the formation of a cancerous tumor While the products
(proteins) produced by proto-oncogenes are subject to the
presence of growth factors and other signals to stimulate cell
growth, the products of oncogenes may lead to cell growth
even when these other signals are not present. As a result, the
cells begin to outnumber normal surrounding cells and form a
tumor. Modes of Activation (How Proto-Oncogenes Become
Oncogenes) There are a number of ways in which normal
proto-oncogenes can become activated (changed) so that they
become oncogenes. The process can begin when carcinogens
(cancer-causing agents) in the environment cause a mutation
or amplification of a proto-oncogene. Studies on animals have
shown that chemical carcinogens can cause the mutations that
convert ras proto-oncogenes to oncogenes.This finding is
fitting, as KRAS mutations in lung cancer are more common in
people who have smoked than never smokers. That said, DNA
damage may occur as an accident during the normal growth of
cells; even if we lived in a world free from carcinogens, cancer
would occur. Different types of oncogenes have different
effects on growth (mechanisms of action), and to understand
these it's helpful to look at what is involved in normal cell
proliferation (the normal growth and division of cells). Most
oncogenes regulate the proliferation of cells, but some inhibit
differentiation or promote survival of cells (inhibit
programmed death or apoptosis)..* Many tumor cells produce
antigens, which may be released in the bloodstream or remain
on the cell surface. Any molecule capable of being recognized
by the immune system is considered an antigen. Antigens have
been identified in most of the human cancers, including
Burkitt lymphoma, neuroblastoma, melanoma, osteosarcoma,
renal cell carcinoma, breast cancer, prostate cancer, lung
carcinoma, and colon cancer. A key role of the immune system
is detection of these antigens to permit subsequent targeting
for eradication. However, despite their foreign structure, the
immune response to tumor antigens varies and is often
insufficient to prevent tumor growth (see also Host Response
to Tumors). Tumor-associated antigens (TAAs) are relatively
restricted to tumor cells. Tumor-specific antigens (TSAs) are
unique to tumor cells. TSAs and TAAs typically are portions of
intracellular molecules expressed on the cell surface as part of
the major histocompatibility complex. Suggested mechanisms
of origin for tumor antigens include Introduction of new
genetic information from a virus (eg, human papillomavirus
E6 and E7 proteins in cervical cancer) Alteration of oncogenes
or tumor suppressor genes by carcinogens, which result in
formation of neoantigens (novel protein sequences or
accumulation of proteins that are normally not expressed or
are expressed at very low levels, such as ras or p53), either by
generating the novel protein sequence directly or by inducing
accumulation of these proteins Development of missense
mutations in various genes not directly associated with tumor
suppressor or oncogenes and that cause appearance of tumor-
specific neoantigens on the cell surface Development of
abnormally high levels of proteins that normally are present at
substantially lower levels (eg, prostate-specific antigens,
melanoma-associated antigens) or that are expressed only
during embryonic development (carcinoembryonic antigens)
Uncovering of antigens normally buried in the cell membrane
because of defective membrane homeostasis in tumor cell
Release of antigens normally sequestered within the cell or its
organelles when tumor cells die * Cancer is defined as
uncontrolled growth of a group of cells disregarding the
normal rule of cell division. Such cells are known as cancer
cells. Normal cells are under direct supervision and their
growth, proliferation and cell division are supervised through
signal transduction. However cancer cells develop
autonomous mechanism for its growth and proliferation.
Cancer is diseases which turns the normal cell into cancer cell
by the process called carcinogenesis. Clinically, there are many
types of cancer, but biologically, the origin of cancer is similar,
which is due to defect in gene expression. There are some
factors which are responsible for change of normal cell into
cancer cell. Those factors or agents are known as carcinogens.
It is believed that all cells carry certain cancer producing
oncogenes. Oncogenes are the genes that are responsible for
induction of tumors. Under certain conditions these genes are
triggered to multiply rapidly into malignant neoplasm.
Etiological agents that induce cancer: Environmental factors:
tobacco, smokes, diets, environmental pollutants etc Heavy
smoking cause lung, oral cavity and oesophagus cancer.
Excessive intake of alcohol cause liver cancer. Chemical
carcinogen: Nickel compounds, cadmium, arsenic,
nitrosamines, trichloroethylene, arylamines, benzopyrene,
aflatoxins, reactive oxygen radicals etc Physical carcinogen:
UV rays (ultraviolet), ionizing radiation (x-rays and gamma
rays) Biological carcinogen: Virus: Virus has also been
associated with various types of cancers. These viruses are
called oncoviruses . Rous sarcoma virus (RSV) is the first
discovered retro-virus causing cancer. (Oncovirus); Human
papilloma virus (HPV), Epstein-BarrVirus, (EBV), Hepatitis B
virus, Herpes virus Hepatitis B and C virus is casually related
with hepato-cellular carcinoma.Cytomegalovirus (CMV) is
associated with kaposi’s sarcoma. Human papilloma virus
(HPV) is a chief suspect of cervix cancer. Bacteria; Helicobacter
pylori, Endogenous factors: Mutations, change in DNA
replication, metabolic reactions generating, reactive oxygen
radicals, Immune system defects,  Ageing Cancer
pathophysiology Regardless of difference in types of cancer
histologically and physiologically, there is existence of a
common pathophysiological process of malignant tumors or
cancer development in the organism. The commonly accepted
basis of the pathogenesis of cancer is the damage to the
genetic apparatus of cells (such as mutation, disturbance of
gene expression, activation of tumor promoter gene,
inactivation of tumor suppressor genes, etc.) It is believed
that damage to the genetic apparatus of the cell along with
inactivation of anti-tumor genes takes place and is essential
for the development of malignant tumors. But it should be
noted that the inactivation of tumor suppressor gene is one of
the natural physiological reactions of the organism, and when
this reaction becomes pathophysiological condition of an
organism it results in cancer development. At the cellular
level, the development of cancer is viewed as a multi-step
process involving mutation and selection for cells with
progressively increasing capacity for proliferation, survival,
invasion, and metastasis. First step: Mutation and
tumor initiation Genetic alteration leads to mutation in a single
cell which results into abnormal proliferation of that cell
known as tumor cell. Second step: Cell proliferation and
Tumor progression Tumor progression continues as additional
mutations occur within cells of the tumor population. The
mutated cells have some selective advantage over normal cell
as such cells shows rapid growth and division. The
descendants of a cell bearing such additional mutation will
consequently become dominant within the tumor population
Third step: Clonal selection and malignancy Cell proliferation
of tumor then leads to new clone of tumor cells with increased
growth rate or other properties (such as survival, invasion, or
metastasis) that confer a selective advantage. The process is
called clonal selection. Clonal selection continues throughout
tumor development, so tumors continuously become more
rapid-growing and increasingly malignant. For example: In
colon cancer, the earliest stage in tumor development is
increased proliferation of colon epithelial cells. A clonal
selection occurs in which, a single cell within these
proliferative cell population give rise to a small benign
neoplasm. Further rounds of clonal selection lead to the
growth of benign neoplasm with increase in size and
proliferative potential resulting in malignant carcinoma.
The cancer cells then continue to proliferate and spread
through the connective tissues of the colon wall. Eventually
the cancer cells penetrate the wall of the colon and invade
other abdominal organs, such as the bladder or small intestine.
In addition, the cancer cells invade blood and lymphatic
vessels, allowing them to metastasize throughout the body.
Fourth step: Metastasis Metastasis is a complex process in
which cancer cells break away from the primary tumor and
circulate through the bloodstream or lymphatic system to
other sites in the body. At new sites, the cells continue to
multiply and eventually form additional tumors comprised of
cells that reflect the tissue of origin. The ability of tumors,
such as pancreatic cancer and uveal (iris, ciliary body, or
choroid of eye) cancers, to metastasize contributes greatly to
their lethality. Many fundamental questions remain about the
clonal structures of metastatic tumors, phylogenetic
relationships among metastases, the scale of ongoing parallel
evolution in metastatic and primary sites, how the tumor
disseminates, and the role that the tumor micro-environment
plays in the determination of the metastatic site. Types of
cancer Abnormal proliferation of any of the different kinds of
cells in the body can result in Cancer. So there are more than a
hundred different types of cancer varying on their behavior,
pathophysiology, site of origin and response to treatment or
therapy. A tumor can be either benign or malignant.  Benign
tumor: A tumor that remains confined to its original location,
neither invading surrounding normal tissue nor spreading to
distant body sites is known as benign tumor. For examples;
Skin wart Malignant tumor: A tumor which is capable of both
invading surrounding normal tissue and spreading
(metastasis) throughout the body via the circulatory or
lymphatic systems is known as malignant tumor. Only
malignant tumors are properly referred to as cancer.
Pathologically, cancers are classified into three categories:
Carcinomas, Sarcomas, Leukemia: Carcinomas: This type of
cancer arises from epithelial cells or ectodermal tissues lining
the internal surface of the various organs. For example: breast
cancer, lung cancer, skin cancer, brain cancer, cancer of
pancreas and mouth, oesophagus, stomach and intestine.
Sarcomas: These cancers arise from connective and muscular
tissue derived from mesoderm. For examples: bone tumours,
muscle tumours, muscle tumours, cancer of lymph nodes.
Lymphomas or Leukemia: It is the malignant growth of
leucocytes (WBC). Persons affected with this cancer show the
excessive production of leucocytes (blood cancer) and cancer
of bone marrow. In addition, brain tumor, kidney tumor and
eye tumor is seen in infants and children due to malignant
growth of primitive embryonic tissues. Similarly, cervical
cancer is common in women and prostate cancer common in
men. Cancer Diagnosis (symptoms of disease) The early
infection does not show significant symptom. Possible
symptoms of cancer are as follows: A persistent cough or
hoarseness in a smoker. A persistent change in digestive and
bowel habits. Rapid change in the form, appearance and
growth of a mole or wart. A hard area in the breast. Excessive
loss of blood during monthly period in women. A swelling or
sore throat that does not heal easily. Unexpected loss of
weight. Cancer Treatment Early treatment ensures that the
cancer can be controlled. Some of treatments may control
cancers. Radiation or Radiotherapy: It involves the exposure
the cancerous part of the body to high doses of radiation
which can destroy rapidly growing cells and shrink tumors.
Surgery or  Operation: Generally tumor and cancerous cells are
surgically removed. Chemotherapy: It involves some
anticancer drugs to control cancer. Chemotherapy drugs are
alkalyting agents ( carboplatin, cisplatin, melphalan) and
antibiotics ( actinomycin, mythramycin). Hormone therapy:
Hormone therapy is a treatment that slows or stops the
growth of breast and prostate cancers that use hormones to
grow. Stem cell transplant: Stem cell transplants are
procedures that restore blood-forming stem cells in cancer
patients who have had theirs destroyed by very high doses of
chemotherapy or radiation therapy. Precision medicine:
Precision medicine helps doctors select treatments that are
most likely to help patients based on a genetic understanding
of their disease. Target therapy: Targeted therapy is a type of
cancer treatment that targets the changes in cancer cells that
help them grow, divide, and spread. Herbal- therapy: Certain
medicinal plants have anti- cancer property * Vaccines are
made from dead (inactivated) or modified (attenuated live)
whole microbes, or from inactivated or recombinant parts of
microbes that are responsible for disease (such as toxins or
surface proteins) Although it can take a long time to produce
vaccines, they are not difficult to produce. It is the extensive
testing required to ensure there are no unintended
consequences from them that takes time. The challenge of
producing and rolling out vaccines across the population
depends on the technical, ethical and regulatory hurdles to
overcome. Over past few centuries we have managed to
develop successful vaccines for many diseases, including
yellow fever, rubella and tuberculosis; however the emergence
of new diseases, adaptations of old diseases, and global travel,
means that novel vaccines are increasingly required. Weaken
the virusUsing this strategy, viruses are weakened so they
reproduce very poorly once inside the body. The vaccines
for measles, mumps, German measles (rubella), rotavirus, oral
polio (not used in the U.S.), chickenpox (varicella), and
influenza (intranasal version) vaccines are made this way.
Viruses usually cause disease by reproducing themselves
many times in the body. Whereas natural viruses reproduce
thousands of times during an infection, vaccine viruses usually
reproduce fewer than 20 times. Because vaccine viruses don't
reproduce very much, they don't cause disease, but vaccine
viruses replicate well enough to induce "memory B cells" that
protect against infection in the future. Find out more about
these and other cells of the immune system. The advantage of
live, "weakened" vaccines is that one or two doses provide
immunity that is usually life-long. The limitation of this
approach is that these vaccines usually cannot be given to
people with weakened immune systems (like people with
cancer or AIDS) Using this strategy, viruses are completely
inactivated (or killed) with a chemical. By killing the virus, it
cannot possibly reproduce itself or cause disease. The
inactivated polio, hepatitis A, influenza (shot), and rabies
vaccines are made this way. Because the virus is still "seen" by
the body, cells of the immune system that protect against
disease are generated. Using this strategy, just one part of the
virus is removed and used as a vaccine. The hepatitis
B, shingles, human papillomavirus (HPV), and one of the
influenza vaccines are made this way. The vaccine is
composed of a protein that resides on the surface of the virus.
This strategy can be used when an immune response to one
part of the virus (or bacteria) is responsible for protection
against disease. These vaccines can be given to people with
weakened immunity and appear to induce long-lived
immunity after two doses.* A pathogen is a microorganism
that is able to cause disease in a plant, animal or insect.
Pathogenicity is the ability to produce disease in a host
organism. Microbes express their pathogenicity by means of
their virulence, a term which refers to the degree of
pathogenicity of the microbe. Hence, the determinants of
virulence of a pathogen are any of its genetic or biochemical or
structural features that enable it to produce disease in a host.
The relationship between a host and a pathogen is dynamic,
since each modifies the activities and functions of the other.
The outcome of such a relationship depends on the virulence
of the pathogen and the relative degree of resistance or
susceptibility of the host, due mainly to the effectiveness of the
host defense mechanisms Two broad qualities of pathogenic
bacteria underlie the means by which they cause disease: 1.
Invasiveness is the ability to invade tissues. It encompasses
mechanisms for colonization (adherence and initial
multiplication), production of extracellular substances which
facilitate invasion (invasins) and ability to bypass or overcome
host defense mechanisms. 2. Toxigenesis is the ability to
produce toxins. Bacteria may produce two types of toxins
called exotoxins and endotoxins. Exotoxins are released from
bacterial cells and may act at tissue sites removed from the
site of bacterial growth. Endotoxins are cell-associated
substance.  (In a classic sense, the term endotoxin refers to the
lipopolysaccharide component of the outer membrane of
Gram-negative bacteria).  However, endotoxins may be
released from growing bacterial cells and cells that are lysed
as a result of effective host defense (e.g. lysozyme) or the
activities of certain antibiotics (e.g. penicillins and
cephalosporins). Hence, bacterial toxins, both soluble and cell-
associated, may be transported by blood and lymph and cause
cytotoxic effects at tissue sites remote from the original point
of invasion or growth. Some bacterial toxins may also act at
the site of colonization and play a role in invasion.*sti The five
most common of these are: Pneumocystis carinii pneumonia
HIV wasting syndromeCandidiasis of the esophagus
Tuberculosis Kaposi’s sarcoma Chlamydia Chlamydia, the
most prevalent bacterial STI in the United States, is the result
of the Chlamydia trachomatis bacterium, which can infect the
urethra (bladder opening) and cervix (uterus opening). It is
common in youngsters aged fifteen to nineteen. The disease is
easily treated, but like other sexually transmitted infections,
chlamydia tends to be silent and therefore go undiagnosed
until it becomes more serious than in its early stages. Three in
four women and one in two men have no symptoms. In 40
percent of cases, by the time a girl seeks medical attention, the
disease has progressed to pelvic inflammatory disease (PID,
described below), a major cause of female infertility and pelvic
pain. Gonorrhea Chlamydia infection is sometimes confused
with gonorrhea, another bacterial infection transmitted
through vaginal and anal intercourse, and oral sex. Not only do
they share many of the same symptoms, the two diseases can
occur together. Gonorrhea usually begins in the urethra
(bladder opening) or the cervix. However, the rapidly
proliferating Neisseria gonorrhoea bacterium can migrate to
the uterus and the fallopian tubes, giving rise to pelvic
inflammatory disease (PID). The infection, like chlamydia, may
also involve the rectum. Pelvic Inflammatory Disease (PID) A
number of different microorganisms can cause pelvic
inflammatory disease of the upper female reproductive tract.
The two most common culprits are Chlamydia trachomatis
and Neisseria gonorrhoea, which account for four in five cases.
Sexually active girls aged fifteen to nineteen are the most
vulnerable population, partly because they are more likely
than other age groups to have multiple sex partners. PID from
chlamydia infection typically produces mild symptoms or
none at all, but should be treated promptly. Otherwise, like
other forms of PID, it can inflame and scar the ovaries and the
fallopian tubes. PID from gonorrhea, on the other hand, can
produce what Dr. Meg Fisher of Philadelphia’s St.
Christopher’s Hospital for Children characterizes as “the worst
lower-abdominal pain a girl has ever had. That’s what brings
most of them in to the doctor.” Because PID affects the
fallopian tubes, where conception takes place, if the scarring is
severe enough, the male sperm may be prevented from
reaching the female egg. In other words, sterility can be the
final outcome of PID. Symptoms That Suggest Sexually
Transmitted Infections May Include: HIV/AIDS Headaches
Difficulty swallowing Fever Night sweats Fatigue/weakness
Appetite loss Weight loss Chronic diarrhea Nausea/vomiting
Itchy, rashy skin/skin lesions Chronic coughing
Confusion/delirium Difficulty breathing Chlamydial Infection
Symptoms typically occur one to three weeks after
exposure.Women: Abnormal vaginal discharge Mild pain
when urinating Progression to pelvic inflammatory disease
Men: Penile discharge Mild pain when urinating Progression
to epididymitis, an inflammation of the tubelike structure that
stores and transports sperm Gonorrhea Symptoms typically
occur two to ten days after exposure. Men: Penile discharge
Mild to severe burning sensation when urinating Can progress
to epididymitis Women: Painful or burning sensation when
urinating and/or yellow or bloody vaginal discharge
Abdominal pain Bleeding between menstrual periods
Vomiting Fever Progression to pelvic inflammatory disease
Rectal Infection: Anal discharge Anal itching Painful bowel
movements Pelvic Inflammatory Disease (PID) Lower
abdominal pain Abnormal vaginal discharge Fever Painful
intercourse Irregular menstrual bleeding *A fungal infection
is also known as mycosis. Although most fungi are harmless to
humans, some of them are capable of causing diseases under
specific conditions. Fungi reproduce by releasing spores that
can be picked up by direct contact or even inhaled. That’s why
fungal infections are most likely to affect your skin, nails, or
lungs. Fungi can also penetrate your skin, affect your organs,
and cause a body-wide systemic infectionSome common types
of fungal infection include: Athlete’s footAthlete’s foot is also
known as tinea pedis. It’s a type of fungal infection that can
affect the skin on your feet, as well as your hands and nails.
The infection is caused by dermatophytes, a group of fungi
that can thrive in the warm and humid areas between your
toes.It’s particularly common among athletes and can spread
from one person to another. You can also catch it from
contaminated surfaces, like a public shower or locker room
floors.Symptoms Athlete’s foot can cause an itching, stinging,
or burning sensation between your toes or on other parts of
your foot. Your skin might also crack, peel, or blister. Diagnosis
Your doctor may recognize athlete’s foot by looking at the
symptoms on your skin. If the doctor isn’t sure, a small area of
the skin can be scraped off and tested for the fungus.
Treatment There are several topical over-the-counter (OTC)
antifungal medications you can use to treat athlete’s foot. If
those don’t provide relief, your doctor can prescribe
something stronger. Ringworm Ringworm is a fungal infection
that can affect your skin and scalp. Similar to athlete’s foot and
jock itch, it’s caused by dermatophytes. Ringworm is also part
of a group of fungi that grow on skin, particularly in damp and
humid parts of your body. Symptoms It usually starts as a
reddish, itchy, scaly rash. Over time, patches of ringworm can
spread and form red rings. Other signs include: patches that
get blisters and start to ooze bald patches on the scalp patches
that look like rings with a redder outside edge thick,
discolored, or cracked nails (if the infection is in the nails)
Diagnosis A simple skin examination can find ringworm. The
fungus glows under a black light, so your doctor can tell if you
have it by shining the black light over the affected area. A
small sample of the affected skin can also be scraped off and
sent to a lab for testing. Treatment ringworm is often able to
be successfully treated with OTC antifungal creams, sprays,
gels, or ointments. *Necrotizing Fasciitis (Flesh-eating
Disease) Necrotizing fasciitis is a serious infection most often
caused by Streptococcus pyogenes bacteria. S. pyogenes are
cocci shaped bacteria that typically colonize the skin and
throat areas of the body. S. pyogenes are flesh-eating bacteria,
producing toxins that destroy body cells, specifically red blood
cells and white blood cells. This results in the death of the
infected tissue, a process known as necrotizing fasciitis. Other
types of bacteria that can also cause necrotizing fasciitis
include Escherichia coli, Staphylococcus aureus, Klebsiella, and
Clostridium. Methicillin-resistant Staphylococcus aureus
(MRSA) are bacteria that can cause serious health issues.
MRSA is a strain of Staphylococcus aureus bacteria or Staph
bacteria that have developed a resistance to penicillin and
penicillin-related antibiotics, including methicillin. MRSA is
typically spread through physical contact and must breach the
skin—through a cut, for example—to cause an infection. MRSA
is most commonly acquired as a result of hospital stays. These
bacteria can adhere to various types of instruments, including
medical equipment. If MRSA bacteria gain access to internal
body systems and cause a staph infection, the consequences
could be fatal. These bacteria can infect bones, joints, heart
valves, and the lungs. Bacterial meningitis is an inflammation
of the protective covering of the brain and spinal cord, known
as the meninges. This is a serious infection that can lead to
brain damage and even death. A severe headache is the most
common symptom of meningitis. Other symptoms include
neck stiffness and high fever. Meningitis is treated with
antibiotics. It is very important that the antibiotics start as
soon as possible after infection to help reduce the risk of
death. A meningococcal vaccine can help prevent it for those
who are most at risk of developing this disease. Bacteria,
viruses, fungi, and parasites can all cause meningitis. Bacterial
meningitis can be caused by a number of bacteria. The specific
bacteria that cause bacterial meningitis vary based on the age
of the infected person. For adults and adolescents, Neisseria
meningitidis and Streptococcus pneumoniae are the most
common causes of the disease. In newborns, the most common
causes of bacterial meningitis are Group B Streptococcus,
Escherichia coli, and Listeria monocytogenes.* Blood Group
System Karl Landsteiner, an Austrian scientist discovered the
ABO blood group system in the year 1900. In his experiments,
he mixed different blood types and noted that the plasma from
certain blood type produced agglutinates or formed clusters
which were caused by the absence of molecules on red blood
cells and resulting in antibodies to defeat that molecule. He
then made a note of the agglutination and divided the blood
types into 4 different groups. For the discovery of ABO blood
group, he was awarded the Nobel Prize. The blood grouping
system is pivotal in blood transfusion. Our immune system
recognizes another blood type as foreign and attacks it if
introduced in the body causing a transfusion reaction.  Any
inappropriate match with the Rh and ABO blood types, causes
the most serious and life-threatening transfusion reactions.
Therefore, before blood transfusion, it is suggested to have a
blood group checked.During the blood transfusion, the two
most important group systems examined are the ABO-system
and the Rhesus system. The ABO blood group system consists
of 4 types of blood group – A, B, AB, and O and is mainly based
on the antigens and antibodies on red blood cells and in the
plasma. Both antigens and antibodies are protein molecules in
which antigens are present on the surface of Red Blood Cells
and antibodies are present in the plasma which is involved in
defending mechanisms. On the other hand, the Rh blood group
system consists of 50 defined blood group antigens. In the Rh
system, the most important antigens are D, C, c, E, and e. The
ABO and Rh blood systems are discussed in detail below. 1.
ABO blood Group system The basis of ABO grouping is of two
antigens- Antigen A and Antigen B. The ABO grouping system
is classified into four types based on the presence or absence
of antigens on the red blood cells surface and plasma
antibodies.Group A – contains antigen A and antibody B.
Group B –contains antigen B and antibody A. Group AB –
contains both A and B antigen and no antibodies (neither A
nor B). Group O – contains neither A nor B antigen and both
antibodies A and B. individuals of blood group O are called as
universal donors, whereas individuals of blood group AB are
universal recipients. *Rh Blood Group System In addition to
the ABO blood grouping system, the other prominent one is
the Rh blood group system. About two-thirds of the population
contains the third antigen on the surface of