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The immune system

⬧ Aim: To introduce course members to the
concept of immunity

The Immune System ⬧

⬧ Outcomes:
⬧ outline non specific (innate, born with) body
defence mechanisms
Dr Terry Ferns
⬧ explain inflammation and fever and their role
in disease
⬧ Describe cell level deterioration linking biology
and chemistry
⬧ describe the adaptive immune system (T- & B-
cells)

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Field specific relevance

⬧ More people die from severe sepsis than lung cancer,
or bowel cancer or breast cancer combined.
⬧ People with severe and enduring mental illness such
as schizophrenia and bipolar disorders are at
increased risk for a range of physical illnesses and
conditions including coronary heart disease, diabetes,
infections, respiratory disease and greater levels of
obesity.
⬧ Respiratory disease is the main cause of death in
people with learning disabilities. They are at risk of
respiratory tract infections caused by aspiration or
reflux if they have swallowed difficulties, and they
are less likely to be immunised against infections.
⬧ Many medical/nursing/midwifery procedures carry a
risk of developing infection

⬧ Both the very young and very old are susceptible to

infection due to compromised immune systems.

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UK Quality Code
for Higher Education QAA Immunity
⬧ Holders of a bachelor's degree with honours will have
developed an understanding of a complex body of
knowledge, some of it at the current boundaries of ‘Immunity or resistance is the bodies
an academic discipline.
ability to ward off damage or disease
through body defenses’
⬧ An appreciation of the uncertainty, ambiguity and
limits of knowledge

⬧ The ability to manage their own learning, and to

make use of scholarly reviews and primary sources

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Definition of terms Immunity

Antigen Foreign molecule that generate antibody Innate Immunity: defenses present at birth /
production in the body nonspecific / no memory
1. Physical and Chemical barriers of the body
Antibodies Used by the immune system to
identify and destroy foreign objects 2. Antimicrobial substances, natural killer cells
phagocytosis, inflammation and fever
Toxin Harmful chemical produced by
microorganisms Adaptive Immunity: acquired immunity, specific,
slow to respond / memory
Pathogen Disease causing antigen 3. Specific immunity - T cells & B cells

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Innate Immunity
A major defensive barrier is the skin, which is the largest
1st Line of defense impermeable organ in the body

Skin and Mucous membranes

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Every square cm of skin may contain in

the region of 125 sweat glands, 25
sebaceous glands, 250 nerve endings, I
meter of blood vessels, 50 receptors for
pain, heat and cold
and millions of assorted cells

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Corynebacteria species

Norma skin Flora (example) C. parvum (propionibacterium acnes) this bacteria

causes acne when trapped in a hair follicle. But it also
produces fatty acids that prevent the growth of fungi
and yeast on the skin

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Innate Immunity
1st Line of defense
Anatomical Barriers
Skin - many layers of skin within the epidermis
provides a physical barrier
Cilia - with the upper respiratory tract trap inhaled
microbes
Lacrimal apparatus - tears in your eyes
Urethra - urine retards microbial colonisation
Defecation / vomiting - expel microbes

Physiological Barriers
Temperature - high temp inhibits growth of some pathogens
Low PH - acidity of the stomach

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Copyright Daniel Kunkel

Innate Immunity
2nd Line of defense
When pathogens penetrate the physical and chemical
barriers of the body

⬧ Antimicrobial substances
⬧ Phagocytes
⬧ Natural killer cells
⬧ Inflammation and fever

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⬧ Monera is a kingdom that contains unicellular

organisms without a nucleus, such as bacteria
⬧ Protista is a kingdom that includes all unicellular
eukaryotes (membrane containing) organisms such
as diatom, ciliates, slime moulds, sporozoans etc
⬧ Plantae is a kingdom that contains multi cellular
organisms which produce their food by
photosynthesis
⬧ Fungi is a group of simple plants that have no
chlorophyll
⬧ Animalia is a kingdom to which all animals belong

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Innate Immunity
2nd Line of defense
Antimicrobial substances

Interferons: Set of proteins produced by a virally

infected cell that limit the spread of infection by
inducing a state of resistance in a healthy cells.

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Innate Immunity
2nd Line of defense
Antimicrobial substances

Complement:

⬧ Set of 30 proteins found in the plasma that are

activated by infection.

⬧ Complicated series of reactions that lead to the

bursting of viruses or bacteria.

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Innate Immunity
2nd Line of defense
Phagocytes
‘Phago’ = eat ‘cytes’ = cells

Two main phagocytes are Neutrophils and ⬧ http://youtu.be/7VQU28itVVw

Macrophages

Attracted to a site of infection due to

chemicals released by injured cells
(chemotaxis)

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Innate Immunity
2nd Line of defense
Natural Killer Cells

http://youtu.be/HNP1EAYLhOs

Attack any body cells that look unusual or abnormal

Bind to the abnormal cell and release toxic substances

that either burst the cell or cause the cell to self
destruct

Apoptosis - self destruct

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⬧ Inflammation and fever

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Inflammatory Response
1. Vasodilation and increased
permeabiltiy of blood vessels due to
histamine release
2. Emigration of phagocytes from the
blood into the area of injury
3. Tissue repair

http://youtu.be/_bNN95sA6-8

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Redness

Loss of Function Heat

Infection
Shape, depth and Oedema/Swelling
odour

Pus and Exudate Pain

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⬧What happens if this

defensive strategy
fails?

https://youtu.be/T49Drk9QUW0

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REVISION
The Oxygen
Journey
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⬧Then what happens?

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⬧ What is produced with

aerobic cellular
respiration? Why is adenosine triphosphate
(ATP) so important?

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A normal ECG complex

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⬧ You use ATP to generate action

potentials and therefore ATP is required
for a normal heart rate, rhythm and
amplitude

⬧ Without ATP…………..

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⬧ Aerobic respiration ⬧ Anaerobic respiration

⬧ 36 ATP`s ⬧ 2 ATP`s

⬧ No lactic acid ⬧ lactic acid production

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Physiological progression (1) Physiological progression (2)

⬧ Anaerobic glycolysis-the breakdown of carbohydrate in the ⬧ The lysosme is an important cell structure containing enzymes
absence of oxygen in the cells-leads to a rapid accumulation of that beak down cell waste
lactic acid

⬧ Lactic acid reduces the ability of cells to generate energy in the ⬧ Due to a lack of oxygen and ATP the lysosomal membrane
form of adenosine triphosphate (ATP) starts to use its structural phospholipids as a nutrient source

⬧ A reduction in ATP reduces the amount of energy available for

cellular work-resulting in disrupted cell membrane function
⬧ Sodium accumulates inside the cell, as there is limited ATP to
pump it out, this draws in water making the cell swell and
contributing to cell death
⬧ The lysosomal membrane becomes increasingly permeable,
ruptures and releases digestive enzymes resulting in cell self
ingestion, compromised cell integrity and contributing to cell
death

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Innate Immunity
2nd Line of defense
Inflammation and fever

Fever: An abnormally high body temperature that

occurs because the hypothalamic thermostat is
reset .

It’s a defense mechanism!

A high temperature speeds up body reactions that aids

repair

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Pyrexia
⬧ How can we physiologically explain pyrexia?

⬧ Temperature helps maintain optimal enzyme functioning

for effective cell metabolism

⬧ As living cells metabolise energy sources, such as sugars

into Adenosine Triphosphate (ATP), a chemical needed
for cell function-heat is released

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Pyrexia
⬧ Pyrexia inhibits bacterial growth and mobilises
immune defences damaging the membranes of both
the body`s and bacterial cells
⬧ At the cellular level pyrexia is generated when
infective agents such as bacteria or viruses invade
body cells
⬧ These trigger a release of a variety of proteins from
the host cells
⬧ These proteins (referred to as pyrogens) are also
released when a cell is damaged through trauma
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Dendritic Cells
⬧ Their main function of Dendritic cells is to
process antigen material and present it on
the cell surface to the T cells of the immune
system
⬧ Dendritic cells are present in those tissues
that are in contact with the external
environment
⬧ They act as messengers between the innate
and the adaptive immune systems.
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The Third line of defense:
Adaptive Immune System
Specific immunity involving lymphocytes and
antibodies
Requires the presence of a functional immune
system capable of recognising and
selectively eliminating organisms
Properties:
1. Specific to particular antigens
2. Memory of encountered antigens
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Pyrexia
⬧ Pyrogens travel in the blood to the
hypothalamus where they act either directly or
via the generation of prostaglandins to alter the
hypothalamus temperature set point
⬧ Once the set point in the hypothalamus is reset
to a higher position, the blood flowing through
the hypothalamus is perceived as being below
the correct temperature and heat conservation
and generation mechanisms are initiated
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The Third line of defense:
Adaptive Immune System
⬧ Adaptive immunity refers to antibody
responses and cell mediated immune
responses by Lymphocytes called:
⬧ B cells
⬧ T cells
⬧ which we acquire following contact with
microorganisms
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Adaptive immune system
⬧ Lymphocytes
B lymphocytes –mature in Bone marrow
lymphatic tissue, especially spleen and lymph
nodes
T lymphocytes –mature in the Thymus
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B lymphocytes (B-cells)
Antibody Mediated Immunity T-lymphocytes (T-cells)
⬧ Made in the bone marrow
⬧ B – lymphocytes produce antibodies
Cell Mediated Immunity
⬧ http://youtu.be/nA3pUFEJ0R4 ⬧ Millions of T-cells specific to an antigen
Process
1. Naïve B cell comes into contact with antigen for the first
time Process
2. Rapid dividing into memory B cells and effector B
cells (plasma cells) ⬧ T-cell binds to a specific antigen
3. Plasma cells produce antibody in mass amounts which ⬧ Complex chemical process becomes activated
bind specifically to foreign antigens
4. The binding of antibodies inactivates viruses and ⬧ T cells kill virus-infected host cells by lysing it
microbial toxins by blocking their ability to bind to
receptors on host cells with perforin
5. Antibody binding also marks invading pathogens for ⬧ http://youtu.be/tqjhMHG7J08
destruction, mainly by making it easier for phagocytic
cells of the innate system to ingest them

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Elevated white cell count

Elevated white cell count
(lymphocyte)
⬧ Normal variations ⬧ Lymphocytes develop and mature when you are an infant
or very young child
⬧ Newborns-adult levels are reached in 2
weeks. ⬧ Lymphocytes remain dormant until activation
⬧ Pregnancy, where the white blood cell
count is higher but has no pathological ⬧ This activation is called lymphocyte proliferation
significance. ⬧ The body has only a few lymphocytes that recognise
invading organisms but hundreds of thousands are
needed to fight infection
⬧ How do we explain elevated white
cell count? ⬧ When phagocytosis takes place a warning system is set up

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How does the body gain

immunity?
⬧ Exposure to the antigen

⬧ Immunisation

⬧ Maternal immunity passes across

the placenta in infants

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⬧ A vaccine is a type of medicine that trains the

body’s immune system to fight a disease it
has not come into contact with before. References
⬧ http://www.templejc.edu/dept/ems/docum
⬧ Vaccines work by teaching the body to recognise
ents/Presentations/1stSemesterParamedic/P
specific dangerous pathogens, so the immune
athophysiology/ImmuneResponsePat ho.ppt
system is prepared to fight off that infection in
the future. ⬧ http://highered.mcgraw-
hill.com/sites/0072437316/student_view0/c
hapter48/animatio ns.html
⬧ Vaccines introduce small parts of germs that are
weakened or dead, (collectively called antigens), ⬧ http://www.cellsalive.com/mac.htm
to trigger/optimize the body’s natural immune
response but without causing the actual
infection/illness.

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