The Lymphatic System and

Immunity

Dr. Workneh T.(Asst Prof of G. surgery and

cardiothoracic surgery fellow)
Learning Objectives
 Understand bodies lymphatic vessels and circulation

 Describe the structure and function of lymphoid organs

 List the body’s nonspecific defenses and describe the

components and mechanisms of each

 Define specific resistance and distinguish between cell-mediated

immunity and antibody mediated immunity

 Discuss the role of the T cell, B cell and antibodies in specific

immunity
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Lymphatic system
The lymphatic system consists of:
 Lymph

 Lymphatic vessels

 Lymph nodes

 Lymphoid organs and tissues

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Cont’d…
Functions;
 Protects body against foreign material

 Assists in circulation of body fluids between cells and blood stream

 Transports dietary fats

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Cont’d…
LYMPH
 Lymph is a clear watery fluid that circulates through the lymphatic

vessels.
 Contains more white blood cells than plasma

 Enters node through afferent lymphatic vessels

 Flows through node in one direction

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Cont’d…
 flows through sinuses in lymph

node cortex and then into the

medulla
 exits the lymph node through

efferent lymphatic vessels

 must be returned to blood stream

to maintain blood volume and

pressure

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Cont’d….
Formation of lymph
 As blood circulates through the body, most components of blood

plasma such as nutrients, gases, and hormones filter through blood

capillary walls to form interstitial fluid and reabsorbed back by
venous capillaries.
 The excess filtered fluid (about 3 liters per day) drains into lymphatic

vessels and becomes lymph. ie. the interstitial fluid enters into
lymphatic vessels is called lymph

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LYMPH VESSELS
LYMPH CAPILLARIES
 Lymphatic capillaries, are located in the spaces between cells and are

closed at one end

 Just as blood capillaries converge to form venules and then veins,

lymphatic capillaries unite to form larger lymphatic vessels

 Lymphatic capillaries have greater permeability than blood capillaries

 Lymphatic capillaries are slightly larger in diameter than blood capillaries

 It is made up of Single layer of overlapping endothelial cells

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Cont’d…
 It has unique one-way structure that permits interstitial fluid to

flow into them but not out

 When pressure is greater in the interstitial fluid than in lymph, the

cells separate slightly, like the opening of a one-way swinging

door, and interstitial fluid enters the lymphatic capillary.
 When pressure is greater inside the lymphatic capillary, the cells

adhere more closely, and lymph cannot escape back into

interstitial fluid
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Cont’d…
 The small intesiine contains special types of lymphatic capillaries

called lacteals.
 Lacteals pick up not only interstitial fluid, but also dietary lipids and

lipid soluble vitamins.

 The lymph of this area has a milky color due to the lipid and is also

called chyle.

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LYMPHATIC COLLECTING VESSEL
 Lymphatic capillaries unite to form larger lymphatic vessels, which

resemble small veins in structure

 Three layered wall but thinner than vein

 More numerous valves than in vein

 At intervals along the lymphatic vessels, lymph flows through lymph

nodes which are an encapsulated bean-shaped organs consisting of

masses of B cells and T cells

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LYMPHATIC TRUNKS
 Lymphatic vessels exit lymph nodes and they unite to form lymph

trunks
 The principal trunks are the lumbar, intestinal, bronchomediastinal,

subclavian, and jugular trunks

 The lumbar trunks drain lymph from the lower limbs, the wall and

viscera of the pelvis, the kidneys, the adrenal glands, and the abdominal
wall.
 The intestinal trunk drains lymph from the stomach, intestines,

pancreas, spleen, apart of the liver.

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Cont’d…
 The bronchomediastinal trunks drain lymph from the thoracic wall,

lung, and heart.

 The subclavian trunks drain the Upper limbs.

 The jugular trunks drain the head and neck.

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LYMPHATIC DUCTS
 Lymph passes from lymph

trunks into two main channels,

the thoracic duct (left
lymphatic duct) and the right
lymphatic duct , and then
drains into venous blood.

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Cont’d…
Thoracic Duct (left lymphatic duct)
 about 15-18 inches (38-45 cm) in length

 begins as a dilation called the cisterna chyli

 main collecting duct of lymphatic system

 receives lymph from lower body and upper

left quadrant
 empties into the left subclavian vein

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 Cont’d…
 The cisterna chyli receives lymph from the right and left lumbar

trunks and from the intestinal trunk

 In the neck, the thoracic duct also receives lymph from the left

jugular, left subclavian, and left bronchomediastinal trunks

 Therefore, the thoracic duct receives lymph from the left side of the

head, neck, and chest, the left upper limb, and the entire body
inferior to the ribs
 The thoracic duct in turn drains lymph into venous blood at the

junction of the left jugular vein and left subclavian veins.

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THE RIGHT LYMPHATIC DUCT
 The right lymphatic duct is about 1.2 cm long

 It receives lymph from the right jugular, right subclavian, and right

bronchomediastinal trunks.
 Thus, the right lymphatic duct receives lymph from the upper right

side of the body.

 From the right lymphatic duct, lymph drains into venous blood at the

junction of the right jugular and right subclavian veins

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Cont’d….
Lymph is kept moving by:
- Constriction of vessels
- Skeletal muscle pump
- Respiratory pump

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LYMPHATIC ORGANS AND TISSUES
 The lymphatic organs and tissues are classified into two groups

based on their functions.

- Primary lymphatic organs and tissues

- Secondary lymphatic organs and tissues

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Cont’d…
 The Primary lymphatic organs are the sites where stem cells divide

and become immunocompetent

 The primary lymphatic organs are the red bone marrow and the

thymus.
 The secondary lymphatic organs and tissues are the sites where most

immune responses occur

 They include lymph nodes, the spleen, and lymphatic nodules

(follicles).

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Thymus
 The thymus is a bilobed organ

 Located in the mediastinum

 Reddish appearance

 Outer layer of connective tissue

holds the two lobes closely together

 But inner a connective tissue

capsule separates the two.

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Cont’d…
 Extensions of the capsule is called trabeculae

 Trabeculae penetrate inward and divide each lobe into lobules

 Each thymic lobule consists of a dark colored and a light colored

central medulla
 The cortex is composed of large numbers of

- T cells

- Dendritic cells,

- Epithelial cells,

- Macrophages

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Cont’d…
 Immature T cells (pre-t cells) migrate from red bone marrow to the

cortex of the thymus, where they proliferate and begin to mature.

 Dendritic cells are derived from monocytes and assist in maturation

 The epithelial cells help to “ educate” the pre-t cells in a process

known as positive selection

 Only about 2% of developing T cells survive in the cortex.

 The remaining cells die via apoptosis (programmed cell death).

 Thymic macrophages help clear out the delbris of dead and dying

cells.
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Cont’d…
 The surviving T cells enter the medulla

 The medulla consists of more mature T cells, epithelial cells,

dendritic cells, and macrophages

 Some of the epithelial cells become arranged into concentric layers

of flat cells that degenerate and become filled with keratohyalin

granules and keratin.
 These clusters are called thymic (Hassall’s) corpuscles

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Cont’d…
 Cells that leave the

thmus via the blood

migrate to lymph nodes,
spleen and other
lymphatic tissues

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LYMPH NODES
 Located along lymphatic vessels are about 600 bean-shaped lymph

nodes
 Lymph nodes are 1-25 mm (0.04-1 in.) long

 Like thymus lymph nodes are covered by capsule

 Extensions of the capsule is called trabeculae

 Trabeculae penetrate inward and divide each node into lobules

 Internal to the capsule is a supporting network of reticular fibers and

fibroblasts.

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Cont’d…
 The capsule, trabeculae, reticular fibers, and fibroblast constitute the

stroma (supporting framework of connective tissue) of a lymph node

 The parenchyma (functioning part) of a lymph node is divide into a

superficial cortex and a deep medulla

 The cortex consists of an outer cortex and an inner cortex.

 Within the outer cortex are egg-shaped aggregates of B cells called

lymphatic nodules

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Cont’d…
 There are two types of lymphatic nodules

- Primary lymphatic nodule- consisting chiefly of B cells

- Secondary lymphatic nodules- sites of plasma B cell and memory B

cell formation
 The center of a secondary lymphatic nodule contains a region of light

staining cells called a germinal center.

 In the germinal center are B cells, follicular dendritic cells (a special

type of dendritic cell), and macrophages.

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Cont’d…
 When follicular dendritic cells present an Antigen, B cells proliferate and

develop into antibody-producing plasma cells or develop into memory B

cells
 B cells that do not develop properly undergo apoptosis (programmed cell

death)
 Macrophages clear out the debris of dead and dying cells.

 The inner cortex does not contain lymphatic nodules.

 It consists mainly of T cells and dendritic cells that enter a lymph node

from other tissues.

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Cont’d…
 The dendritic cells present antigens to T cells, causing their

proliferation.
 The newly formed T cells then migrate from the lymph node to areas

of the body where there is antigenic activity

 The medulla of a lymph node contains B cells, antibody producing

plasma cells that have migrated out of the cortex into the medulla,
and macrophages

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Cont’d…
Flow of lymph within l.node
 Lymph flows through a node in one direction only

- It enters lymph node through several afferent lymphatic vessels

- Within the node, lymph enters sinuses, a series of irregular channels

- Efferent lymphatic vessels leave the node at the hilum

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SPLEEN
 Spleen is the largest single mass of lymphatic tissue in the body

measuring about 12 cm (5in.) In length

 It is located in the left hypochondriac region

 The superior surface of the spleen is smooth and convex

 Neighboring organs make indentations in the visceral surface of the

spleen
-The gastric impression (stomach),
- The renal impression (left kidney), and
- The colic impression (left colic flexure of large intestine).
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Cont’d…
 Like lymph nodes, the spleen has a hilum.

 Through hilum pass the splenic artery, splenic vein, and efferent

lymphatic vessels.
 A capsule of dense connective tissue surrounds the spleen

 Extension of capsule is Trabeculae,

 Trabeculae extend inward from the capsule.

 The capsule plus trabeculae, reticular fibers, and fibroblasts

constitute the stroma of the spleen

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Cont’d…
 The parenchyma of the spleen consists of two different kinds of tissue

called white pulp and red pulp

 The White pulp is lymphatic tissue, consisting mostly of lymphocytes

and macrophages arranged around branches of the splenic artery called

central arteries.
 The red pulp consists of blood filled venous sinuses and cords of

splenic tissue called splenic (Billroth’s) cords.

 Splenic cords consist of red blood cells, macrophages, lymphocytes,

plasma cells, and granulocytes.

 Veins are closely associated with the red pulp.
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Cont’d…
 Blood flowing into the spleen through the splenic artery enters the

central arteries of the white pulp.

 Within the white pulp, B cells and T cells carry out immune

functions
 Spleen macrophages destroy blood-borne pathogens by

phagocytosis.

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Cont’d…
 Within the red pulp, the spleen performs three functions related to

blood cells:
 Removal of ruptured, worn out, or defective blood cells and platelets
by macrophages
 Storage of platelets, up to one-third of the body's supply

 Production of blood cells (hemooiesis) during fetal life.

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ISOLATED LYMPHATIC NODULES (B CELLS)
 Lymphatic nodules (follicles) are egg-shaped masses of lymphatic

tissue that are not surrounded by a capsule

 They are scattered throughout the lamina propria of mucous

membranes lining the

- Gastrointestinal tract

- Urinary tract

- Reproductive tract

- Respiratory airways
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Cont’d…
 lymphatic nodules in these areas are also referred to as mucosal

associated lymphatic tissue (MALT)

 when activated by antigens they differentiate into plasma cells and

produce antibodies against specific antigens

 plasma cells secrete IgA antibodies

- provide protection against bacterial and viral infections in lumen of

tracts

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Lymphatic system and immunity
Nonspecific defenses
 Do not distinguish one type of threat from another

Specific defenses
 Protect against particular threats

 Depend upon the activation of lymphocytes

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Nonspecific Defenses
Physical barriers
 Keep hazardous organisms outside the body
 Includes hair, epithelia, secretions of integumentary and digestive
systems

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Cont’d…
Phagocytes
 Remove cellular debris and respond to invasion by foreign pathogens
 Monocyte-macrophage system - Fixed and free
 Microphages – Neutrophils and eosinophils
 Move by diapedesis
 Exhibit chemotaxis

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Cont’d…
NK cell
 Recognize cell surface markers on foreign cells
 Destroy cells with foreign antigens
NK activation
 Recognition of unusual surface proteins
 Rotation of the Golgi toward the target cell and production of
perforins
 Release of perforins by exocytosis
 Interaction of perforins causing cell lysis

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Cont’d…
Complement system
 Cascade of ~11 plasma complement proteins (C)
 Destroy target cell membranes
 Stimulate inflammation
 Attract phagocytes
 Enhance phagocytosis

 interact with one another via two pathways

- Classical
- Alternative

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Specific Defenses
Forms
 Innate immunity
- Genetically determined
- Present at birth
 Acquired immunity
- Not present at birth
- Achieved by exposure to antigen
- Active immunity
- Passive immunity

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Cont’d…
Properties of immunity
 Specificity – activated by and responds to a specific antigen

 Versatility – is ready to confront any antigen at any time

 Memory – “remembers” any antigen it has encountered

 Tolerance – responds to foreign substances but ignores normal

tissues

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Cont’d…
• Antigen triggers an immune response

• Activates T cells and B cells

- T cells are activated after phagocytes exposed to antigen

• T cells attack the antigen and stimulate B cells

• Activated B cells mature and produce antibody

• Antibody attacks antigen

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T cell and Cell-mediated Immunity
Major types of T cells
 Cytotoxic T cells (TC) – attack foreign cells

 Helper T cells (TH) – activate other T cells and B cells

 Suppressor T cells (TS) – inhibit the activation of T and B cells

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Cont’d…
T cell membranes contain CD markers
 CD3 markers present on all T cells

 CD8 markers on cytotoxic and suppressor T cells

 CD4 markers on helper T cells

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Cont’d…
Activation of CD8 cells

• Responds quickly giving rise to other T cells

• Cytotoxic T cells – seek out and destroy abnormal cells

• lymphotoxin

• Memory TC cells – function during a second exposure to antigen

• Suppressor T cells – suppress the immune response

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Cont’d…
Activation of CD4 T cells

• Produces helper T cells and memory T cells

• Activated helper T cells

• Secrete lymphokines that coordinate specific and nonspecific

defenses

• Enhance nonspecific defenses

• Stimulate the activity of NK cells

• Promote activation of B cells

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B Cells and Antibody-mediated Immunity
• TH cells activated by same antigen stimulate B cell

• Active B cell differentiates into Memory B Cell or Plasma cell

• Plasma cells synthesize and release antibody

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Cont’d…
 Antibodies are Y-shaped proteins consisting of:

- Two parallel polypeptide chains

- Heavy chains and light chains
- Constant region and variable region
- Antigen binding site

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Cont’d…
Actions of antibodies;
Neutralization

Agglutination and precipitation

Activation of complement

Attraction of phagocytes

Opsinization

Stimulation of inflammation

Prevention of adhesion
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Cont’d…
Classes of Antibodies (immunoglobins)
 IgG – resistance against many viruses, bacteria and bacterial toxins

 IgE – accelerates local inflammation

 IgD – found on the surface of B cells

 IgM – first type secreted after antigen arrives

 IgA – primarily found in glandular sec

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 Thank you

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