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Lecture in Immunology

الكلية كلية الطب     القسم  الباطنية     المرحلة 3
أستاذ المادة منعم مكي عبد الرضا الشوك       4/30/2011 8:10:43 AM

 

 

lymphatic system:

 

network of vessels that penetrate every tissue, and   a collection of tissues & organs that produce immune cells

 

it has 3 main functions:

 

      1.fluid recovery

 

      2. immunity

 

      3. fat absorption ( lacteals )

 

lymphoid organs

 

1.primary : thymus , bm

 

2.secondary : ln , tonsils( nodules ), peyer patches( at last segment of small intestine) & spleen

 

have well defined anatomical sites & capscule     

 

3.mucosa associated lymphatic tissue malt

 

lymphoid tissues

 

secondary

 

primary

 

(sites for ag contact and response)

 

(responsible for maturation of ag-reactive cells)

 

 

 

 

 

spleen

 

lymph node

 

bm

 

thymus
(t-cell maturation)

 

similar to lymph nodes but part of blood circulation. collects blood-borne ags

 

(expansion of lymphatic system, separate from blood circulation. deep cortex harbors mostly t-cells, superficial cortex harbors mostly b-cells)

 

(b-cell maturation)

 

(t-cell maturation)

 

 

 

principles

 

·          the immune system defends the body against invading agents, participates in autoimmune and hypersensitivity disorders, and determines transplant tissue reactions.

 

·          the ability to recognise foreign antigens allows destruction and removal of invading organisms by various effector mechanisms.

 

·          inappropriate immune reactions against self-antigens or host cells result in autoimmune disorders.

 

·          overt responses to an antigen result in hypersensitivity disorders.

 

 

 

 

cells of lymphatic system:

 

immune responsive cells can be divided into five groups based on

 

  i) the presence of specific surface components

 

ii) function:

 

  b-cells (b lymphocytes), t-cells (t lymphocytes), accessory cells (macrophages and other antigen-presenting cells), killer cells (nk and k cells), and mast cells.

 

functions

 

surface  components

 

cell group

 

direct antigen recognition differentiation into abproducing plasma cells                     

 

  antigen presentation within class ii mhc

 

surface ig(ag\recognition)                                  immunoglobulinfc,receptor                                                                                                                                        class ii major histocompatability complex (mhc) molecule (ag presentation)

 

b-lymphocytes

 

involved in both humoral and cell-mediated responses

 

cd3 molecule                                                                     

 

t-cell receptor (tcr, ag recognition)

 

t-lymphocytes

 

recognizes antigen presented within class ii mhc                   

 

  promotes differentiation of b-cells and cytotoxic t-cells    activates macrophages

 

cd4 molecule

 

helper t-cells (th)

 

downregulates the activities of other cells

 

cd8 molecule

 

suppressor t-cells (ts)

 

recognizes antigen presented within class i mhc                     

 

kills cells expressing appropriate antigen

 

cd8 molecule

 

cytotoxic t-cells (ctl)

 

phagocytosis and cell killing

 

variable

 

accessory cells

 

bind fc portion of ig (enhances phagocytosis) bind cc  c3b (enhances phagocytosis) antigen presentation within class ii mhc                 

 

secrete il-1 (macrokine) promoting t-c differentiation and proliferation can be "activated" by t-cell lymphokines

 

 

immunoglobulinfc\receptor complement\componentc3b receptor ,

 

class ii mhc molecule

 

macrophages

 

apcwithin class ii mhc

 

class ii mhc molecule

 

dendritic cells

 

bind fc portion of ig (enhances phagocytosis) bind cc  c3b (enhances phagocytosis)

 

immunoglobulin fc receptor complement component c3b receptor

 

polymorphonuclear cells (pmns)

 

direct cell killing

 

variable

 

killer cells

 

kills variety of target cells (e.g. tumor cells, virus-infected cells, transplanted cells)

 

unknown

 

nk cells

 

bind fc portion of ig                                kills antibody-coated target cells (antibody-dependent cell-mediated cytotoxicity, adcc)

 

immunoglobulin fc receptor

 

k cells

 

bind ige and initiate allergic responses by release of histamine

 

high affinity ige fc receptors

 

mast cells

 

 

( 1 ) t cells ( thymus dependent )

 

( 2 ) b cells lymphocytes : changed into plasma cells when activated & produce ab the protective ig in tissue fluids

 

( 3 ) macrophage : derived from monocytes of the blood . ( - phogocyte foreign matter antigens , - “display’’ frogments antigen to certain t cells alerting immune system to the presence of enemy ,

 

works as part of apc with other cells

 

( 4 ) dendritic cells are apcs in the epidermis & mucus membrane and lymphatic organs ( in the skin is called langerhan’s cell )

 

( 5 ) reticular cells : stoma or connective tissue network in lymphoid organs and in the thymus can works as apcs

 

thymus gland

 

a gland that has lymphoid & endocrine functions , house developing lymphocytes and secrete their activating hormones

 

located in the superior mediastinum between the sternum & aortic arch

 

it is large in the fetus & grows slowly during childhood ,when it is most active , after 14 begins to shrink ( involution ) where in adults its very small and in elderly replaced by fibrous and fatty tissues making it indistinguishable from surrounding tissues .

 

  thymus gland structure

 

fibrous capscule sends trabeculae , which divide the parenchyma into several angular lobules each lobule is divided into cortex and medulla that populated by lymphocytes

 

reticular epithelial cells seal off the cortex from the medulla and surrounding blood vessels and lymphocytes cluster in the cortex,( blood – thymus barrier ) which isolates developing lymphocytes from forieng antigens

 

there is no blood – thymus barrier in the medulla and t cells develops in the cortex and leaves the cortex to the medulla & spend during this period 3 weeks .the reticular epithelial form whorl called thymic hassal corpuscles , their function is unknown and serete the hormones thymosin & thymopoitin which promote development & activation of t lymphocytes

 

  spleen

 

the parenchyma divided into white pulp & red pulp ( red pulps are sinuses engorged with concentrated rbcs, and the white pulps are lymphocytes and macrophages that accumulate like a sleeve along the small branches of splenic artery .what is the function of the spleen ?

 

 

  immune resistance & defence

 

immune defences are normally categorised into:

 

1)innate immune response( non specific )which provides immediate protection against an invading pathogen, and

 

2) adaptive or acquired immune response, which takes more time but confers exquisite specificity and long-lasting protection.

 

properties of immune responses

 

innate                                                        adaptive

 

 

immediate                                                  slow, amplification

 

no memory                                                  memory, self recognition

 

                                                           

 

                                   

 

 

 

immuune response:

 

  host defense is present in many forms. overall, the immune response (ir) can be divided into two major classifications humoral and cell-mediated. while these responses are not mutually exclusive, they provide distinctly different avenues for dealing with pathogenic organisms or altered host cells.

 

immune response

 

 

 

 

cmir

 

 

humoral

 

(cytotoxicity)

 

 

(antibody)

 

     

 

 

 

definitions:

 

antigen (ag): a molecule which elicits a specific immune response when introduced into an animal. more specifically, antigenic (immunogenic) substances are:

 

  1. generally large molecules (> 10,000 daltons in molecular weight),

     

  2. structurally complex (proteins are usually very antigenic),

     

  3. accessible (the immune system must be able to contact the molecule), and

     

  4. foreign (not recognizable as "self").

     

antibody (ab): a glycoprotein produced in response to an antigen that is specific for the antigen and binds to it via non-covalent interactions. the term "immunoglobulin" is often used interchangeably with "antibody". we will use the term "immunoglobulin" to describe any antibody, regardless of specificity, and the term "antibody" to describe an antigen-specific "immunoglobulin". immunoglobulins (igs) come in different forms (iga, igd, ige, igg, igm) that reflect their structure. more information can be found here.

 

primary ir1ْ

 

secondary 2ْ ir

 

 

antibody kinetics: the above figure illustrates the production of antibody in response to antigenic substances. in this figure, an animal was injected with antigen a at day 0. antigen a invokes a primary response beginning about day 4, as indicated by a rise in the specific antibody titer (titer = measure of the amount of antibody in the animal s serum per unit volume). initially, this antibody is mostly igm (and some igg). after a peak titer between days 7 and 10, the response decreases rapidly. if the animal is then reinjected with antigen a at day 28, the production of antibody begins almost immediately and reaches a level 1000-fold greater that that seen in the primary response. this is known as the secondary response and the principal antibody produced is igg. if a second antigen (antigen b) is also injected at the same time as the reinjection of antigen a, however, only a primary response to antigen b is observed. these results demonstrate that:

 

  1. the immune response is specific.

     

  2. the immune response has memory.

     

clonal selection hypothesis (jerne and burnet): the clonal selection hypothesis attempts to explain the findings described above by suggesting the following:

 

  1. animals contain numerous cells called lymphocytes,

     

  2. each lymphocyte is responsive to a particular antigen by virtue of specific surface receptor molecules,

     

  3. upon contacting its appropriate antigen, the lymphocyte is stimulated to proliferate (clonal expansion) and differentiate,

     

  4. the expanded clone is responsible for the secondary response (more cells to respond) while the differentiated ("effector") cells secrete

     

 

regulation of the humoral response

 

regulation of the immune response is possibly mediated in several ways.

 

first,  a specific group of t-cells, suppressor t-cells, are thought to be involved in turning down the immune response. like helper t-cells, suppressor t-cells are stimulated by antigen but instead of releasing lymphokines that activate b-cells (and other cells), suppressor t-cells release factors that suppress the b-cell response. while immunosuppression is not completely understood, it appears to be more complicated than the activation pathway, possibly involving additional cells in the overall pathway.other means of regulation involve interactions between antibody and b-cells. one mechanism, "antigen blocking", occurs when high doses of antibody interact with all of the antigen s epitopes, thereby inhibiting interactions with b-cell receptors.

 

a second mechanism, "receptor cross linking", results when antibody, bound to a b-cell via its fc receptor, and the b-cell receptor both combine with antigen. this "cross-linking" inhibits the b-cell from producing further antibody.

 

another means of regulation  that has been proposed is the idiotypic network hypothesis. this theory suggests that the idiotypic determinants of antibody molecules are so unique that they appear foreign to the immune system and are, therefore, antigenic. thus, production of antibody in response to antigen leads to the production of anti-antibody in response, and anti-anti-antibody and so on. eventually, however, the level of [anti]n-antibody is not sufficient to induce another round and the cascade ends

 

         

 

 

immunity & resistance

 

                pathogens are toxins ,living organisms & other agents that can cause damage or disease

 

                body contains 10,000 times bacteria as we do human cells

 

                body’s 3 lines of defence against pathogens include :

 

  1. external barriers

     

  2. anti microbial protein , inflammation , fever & other

     

  3. specific immune mechanism ( humeral & cellular )

     

non specific resistance

 

                skin & mucus membrane ( in skin contains surface keratin and antimicrobials chemical e.g. definsins produced by surface neutrophils and lactic acid as surface coat inhibits bacterial growth )

 

                mucus membrane( cilia , mucus , lysozymes , tears , saliva , urine ,and areolar tissue hyaluronic acid viscous consistency )

 

                microbial growth is inhibited by physiological factors such as low ph and low oxygen tension, and sebaceous glands secrete hydropinghobic oils that further repel water and microorganisms

 

                within the respiratory tract, cilia directly trap pathogens and contribute to removal of mucus, assisted by physical manoeuvres such as sneezing and coughing.

 

                in the gastrointestinal tract, hydrochloric acid and salivary amylase chemically destroy bacteria, while normal peristalsis and induced vomiting or diarrhoea promote clearance of invading organisms.

 

                cells involved in innate resistance ( leucocytes & macrophages ) as phagocytes system in the body can attack pathogens that penetrate the skin and mucus membrane .

 

cells in non specific immunity :

 

                neutrophils highly mobile cells , spending most of their time wandering in tissues & kill bacteria by two ways : ( 1.phagocytosis & digestion  .2. respiratory burst )

 

                eosinophils less phagocytic than neutrophils

 

                basophils secrete products that aids other cell ( heparin ,histamine )

 

                monocytes system & lymphoid – macrophage in various tissues in the body

 

anti microbial proteins in innate system

 

                complements

 

                interferones & other cytokines that play important roles  in regulation of the immune response

 

                these provide short term & non specific resistence to viral & bacterial infections

 

interferon

 

a polypeptide secreted by cells that had been infected by viruses non specific,for,a,particularvirus                                                                                                                                                                          activate nk cells,macrophages& cd8+ t cells also promotes destruction of cancer cells

 

ifn types

 

types

 

sources

 

functions

 

potentialclinical uses

 

inf ?

 

macrophage

 

antiviral

 

hepatitisb& c hcl,cml,kaposi’s sarcomas,

 

inf beta

 

fibroblast

 

antiviral

 

multiple sclerosis

 

inf gama

 

t cells

 

antiviral activate macrophag increase antimycobactericidal activity

 

tb,leprosy , leishmaniasis,cgd ,

 

complement

 

  the complement system is a group of more than 20 tightly regulated, functionally linked proteins  ( beta globulins )that act to promote inflammation and eliminate invading pathogens, proteins are continually present in blood plasma & must be activated by pathogens to exert their effects .

 

three mechanisms by which the complement cascade may be triggered 1 . the classical pathway is initiated when igm or igg antibody binds to antigen, forming immune complexes.this induces a conformational change in the antibody, exposing a binding site for the first protein in the classical pathway, antibodies bind to pathogens then bind a complex of three complement protein c1, c2 ,and c4 – complement fixing .

 

2. the alternative pathway is directly triggered by binding of c3 to bacterial cell wall components such as lipopolysaccharide of gram-negative bacteria and teichoic acid of gram-positive bacteria. it begins with 3 complement proteins factor b ,d & p .   both pathways 1 & 2 converge on step where complement c3 is splits into 2 fragments c3a & c3b

 

3 . the lectin pathway is activated by the direct binding of mannose-binding lectin to microbial cell surface carbohydrates(   mannose binding  – lectine pathway )

 

complement help destruction of pathogens in 3 ways

 

chemotaxis & enhences inflammation :c3a stimulates mast cells & basophils to secrete chemicals that enhence inflammation

 

opsonization : c3b

 

direct cell lysis ( mac )

 

 

references :

 

1.    roitt immunology

 

2.    cecil textbook of medicine 2008

 

3.    kumar & clark

 

4.    pass final carty

 

5.    immunology 4th ed richard hyde

 

6.    immunology a short course eli

 

7.    lecture notes on immunology by gordin

 

8.    immunological disorder by david edger

 


المادة المعروضة اعلاه هي مدخل الى المحاضرة المرفوعة بواسطة استاذ(ة) المادة . وقد تبدو لك غير متكاملة . حيث يضع استاذ المادة في بعض الاحيان فقط الجزء الاول من المحاضرة من اجل الاطلاع على ما ستقوم بتحميله لاحقا . في نظام التعليم الالكتروني نوفر هذه الخدمة لكي نبقيك على اطلاع حول محتوى الملف الذي ستقوم بتحميله .