Disorders of the Immune Response

Disorders of the Immune Response

First Lines of Defense (Nonspecific)

Mechanical Barriers

  • Definition: Physical obstructions that prevent pathogen entry. These are the body's initial defense.

  • Examples:

    • Skin: Provides a physical barrier.

      • Layers: Epidermis, dermis, and hypodermis.

      • Function: Prevents pathogen penetration.

    • Mucous Membranes: Line body cavities and trap pathogens.

      • Locations: Respiratory tract, digestive tract, urogenital tract.

      • Secretions: Mucus, enzymes, and antibodies.

      • Function: Traps and expels pathogens.

    • Cilia: Hair-like structures that sweep away pathogens.

      • Location: Respiratory tract.

      • Action: Wavelike motion to move mucus and trapped particles.

      • Function: Clears pathogens from the airway.

Chemical Barriers

  • Definition: Substances that create inhospitable environments for pathogens.

  • Enzymes:

    • Antibacterial Agents: Like lysozyme, found in tears and saliva.

    • Function: Degrades bacterial cell walls.

      • Mechanism: Hydrolyzes peptidoglycans in bacterial cell walls.

      • Result: Lysis of bacteria.

  • Acid (pH):

    • Definition: Creates an inhospitable environment.

    • Examples:

      • Stomach Acid: Kills ingested pathogens.

        • pH: Ranges from 1.5 to 3.5.

        • Component: Hydrochloric acid (HCl).

        • Function: Denatures proteins and kills bacteria.

      • Skin pH: Inhibits microbial growth.

        • pH: Ranges from 4.5 to 5.5.

        • Source: Secretions from sweat and sebaceous glands.

        • Function: Inhibits bacterial and fungal growth.

  • Salt:

    • Definition: Inhibits microbial growth through osmotic effects.

    • Example: Sweat.

      • Composition: Water, electrolytes, and urea.

      • Mechanism: Creates a hypertonic environment, causing water to leave bacterial cells.

      • Result: Dehydration and growth inhibition of bacteria.

Biological Barriers

  • Phagocytosis:

    • Definition: Ingestion of pathogens by cells.

    • Cells: Macrophages and neutrophils.

      • Macrophages: Phagocytose pathogens and present antigens to T cells.

      • Neutrophils: Most abundant white blood cell; engulf and kill bacteria.

    • Function: Clearing pathogens and cellular debris.

      • Process: Chemotaxis, adherence, ingestion, digestion, and elimination.

      • Outcome: Removal of pathogens and cellular debris from the body.

  • Fever:

    • Definition: Elevated body temperature.

    • Function: Inhibits pathogen growth and enhances immune responses.

      • Mechanism: Increases metabolic rate and enhances immune cell activity.

      • Regulation: Hypothalamus regulates body temperature.

      • Pyrogens: Substances that induce fever.

  • Inflammation:

    • Definition: Localized response to tissue damage.

    • Characteristics: Redness, swelling, heat, and pain.

      • Redness (Rubor): Increased blood flow to the area.

      • Swelling (Tumor): Accumulation of fluid.

      • Heat (Calor): Increased metabolic activity.

      • Pain (Dolor): Stimulation of nerve endings by chemical mediators.
        -Function: Contains the infection and promotes healing
        -Vasodilation: Increased permeability
        -Recruitment of immune cells
        -Tissue repair

  • "Friendly" Microorganisms:

    • Definition: Compete with pathogens.

    • Example: Gut microbiota.

      • Composition: Bacteria, fungi, viruses, and other microorganisms.

      • Location: Large intestine.

    • Function: Prevent pathogen colonization.

      • Mechanism: Produce antimicrobial substances and compete for nutrients and attachment sites.

      • Result: Inhibition of pathogen growth and maintenance of gut health.

Interferon and Complement Proteins

Interferon Production and Action

  • Activation: Infected cells activate interferon and complement proteins.

    • Interferons: Cytokines that interfere with viral replication.

      • Types: Interferon-alpha, interferon-beta, and interferon-gamma.

      • Function: Induce antiviral state in neighboring cells.

    • Complement Proteins: Enhance antibody and phagocytic cell clearance.

      • Pathways: Classical, alternative, and lectin pathways.

      • Components: C1 to C9, factors B, D, and P.

      • Function: Opsonization, chemotaxis, cell lysis, and inflammation.

  • Interferon Production:

    • Infected Cell (Host Cell 1): Turns on interferon genes.

      • Trigger: Viral nucleic acids.

      • Transcription Factors: Activate interferon gene expression.

    • Result: Produces interferon molecules.

      • Interferon-alpha and Interferon-beta: Major types produced by infected cells.

    • Host Cell 1: Eventually killed by the virus.

      • Mechanism: Viral replication leads to cell lysis.

  • Interferon Action:

    • Interferon Stimulates Nearby Cell (Host Cell 2):

      • Receptor: Interferon binds to interferon receptors on the cell surface.

    • Result: Turns on genes for antiviral proteins.

      • Examples: RNA-dependent protein kinase (PKR) and 2'-5' oligoadenylate synthetase (OAS).

    • Host Cell 2: Protected against the virus by interferon from Cell 1.

      • Antiviral State: Reduced viral replication and spread.

  • Antiviral Proteins: Block viral reproduction.

    • Function: Interferes with various stages of the viral life cycle.

      • Inhibition of viral entry, replication, assembly, and release.

  • Viral Nucleic Acid (mRNA): Genetic material of the virus.

    • Target: Antiviral proteins inhibit viral replication.

      • PKR: Phosphorylates eIF2alpha, inhibiting protein synthesis.

      • OAS: Activates RNase L, degrading viral RNA.

  • New Viruses: Production is inhibited by antiviral proteins.

    • Result: Reduces viral load and spread.

Complement System

  • Pathways of Activation:

    • Classical Pathway: Initiated by antibody-antigen complexes (adaptive immunity).

      • Components: C1q, C1r, C1s, C4, and C2.

      • Trigger: IgG or IgM binding to antigen.

    • Alternative Pathway: Initiated by pathogen surfaces (innate immunity).

      • Components: Factor B, factor D, and properdin.

      • Trigger: LPS, peptidoglycan, and other microbial components.

    • Lectin Pathway: Initiated by mannose-binding lectin (MBL) binding to pathogens (innate immunity).

      • Components: MBL, MASP-1, MASP-2, C4, and C2.

      • Trigger: Mannose residues on microbial surfaces.

  • Outcomes of Complement Activation:

    • Opsonization: Coating pathogens to enhance phagocytosis.

      • Component: C3b.

      • Mechanism: Binds to pathogens and facilitates recognition by phagocytes.

    • Chemotaxis: Attracting immune cells to the site of infection.

      • Components: C3a and C5a.

      • Mechanism: Recruit neutrophils, macrophages, and other immune cells.

    • Cell Lysis: Direct killing of pathogens by forming membrane attack complex (MAC).

      • Components: C5b, C6, C7, C8, and C9.

      • Mechanism: Inserts into the pathogen membrane, creating pores and causing cell lysis.

    • Inflammation: Promoting inflammation to enhance immune responses.

      • Components: C3a and C5a.

      • Mechanism: Induce mast cell degranulation and release of histamine and other inflammatory mediators.

Inflammatory Response

Initiation and Mechanism

  • Trigger: Tissue damage by injury or infection.

    • Causes: Physical trauma, chemical exposure, infection by pathogens.

    • Detection: Damage-associated molecular patterns (DAMPs) and pathogen-associated molecular patterns (PAMPs).

  • Function: Disinfects tissues, limits further infection, and promotes healing.

    • Goals: Eliminate pathogens, remove debris, and repair damaged tissue.

  • Mechanism:

    • Tissue Injury: Release of chemical signals, such as histamine and cytokines (Step 1).

      • Examples of Chemical Signals: Histamine, prostaglandins, leukotrienes, cytokines (TNF-alpha, IL-1, IL-6).

      • Source: Mast cells, macrophages, and damaged tissue cells.

      • Function: Increases blood flow and attracts immune cells.

    • Dilation and Increased Leakiness of Local Blood Vessels (Step 2).

      • Vasodilation: Increased blood flow to the affected area.

      • Increased Permeability: Allows fluid and immune cells to move from blood vessels into the tissues.

      • Endothelial Cell Contraction: Creates gaps between endothelial cells.

    • Result: Immune cells and fluid enter the affected area.

      • Edema: Accumulation of fluid in the tissues.

    • Migration of Phagocytes:

      • Macrophages and neutrophils migrate to the area (Step 2).

      • Chemotaxis: Movement of cells along a chemical gradient.

      • Adhesion Molecules: Help immune cells stick to the blood vessel walls and migrate into the tissues.

      • Examples: Selectins, integrins, and ICAMs.

    • Function: Engulf and destroy pathogens and cellular debris.

      • Phagocytosis: Ingestion and digestion of pathogens and debris.

      • Respiratory Burst: Production of reactive oxygen species (ROS) to kill ingested pathogens.

    • Phagocytes Consume Bacteria and Cell Debris; Tissue Heals (Step 3).

      • Macrophage Activation: Release of growth factors, cytokines, and other mediators to promote tissue repair.

      • Fibroblast Proliferation: Synthesis of collagen and other extracellular matrix components.

    • Resolution of Inflammation: Tissue repair and restoration of function.

      • Angiogenesis: Formation of new blood vessels.

      • Scar Tissue Formation: Replacement of damaged tissue with collagen fibers.

Visible Signs and Components

  • Visible Signs: Swelling, redness, heat, and pain.

    • Swelling (Tumor): Caused by fluid accumulation in the tissues (edema).

    • Redness (Rubor): Increased blood flow to the area (vasodilation).

    • Heat (Calor): Increased metabolic activity and blood flow.

    • Pain (Dolor): Stimulation of nerve endings by chemical mediators (prostaglandins and bradykinin).

  • Components: Chemical signals, white blood cells, phagocytes, and fluid.

    • Chemical Signals: Histamine, prostaglandins, leukotrienes, cytokines (TNF-alpha, IL-1, IL-6).

    • White Blood Cells: Neutrophils, macrophages, basophils, eosinophils, and lymphocytes.

    • Phagocytes: Neutrophils and macrophages.

    • Fluid: Plasma that leaks from blood vessels into the tissues.

Phagocytic System

Definition and Action

  • Definition: Composed of polymorphonuclear leukocytes (neutrophils) and mononuclear phagocytes (monocytes and macrophages).

    • Neutrophils: Most abundant white blood cell; first responders to infection.

    • Monocytes: Circulate in the blood and differentiate into macrophages in tissues.

    • Macrophages: Resident phagocytes in tissues; engulf pathogens and present antigens.

  • Action of Cells:

    • Migrate to the Site of Infection.

      • Mechanism: Chemotaxis.

        • Chemokines: Chemical signals that attract phagocytes.

        • Examples: IL-8 and C5a.

    • Aggregate Around the Affected Tissue.

      • Function: Contain the infection.

        • Mechanism: Form a barrier to prevent the spread of pathogens.

    • Envelope the Invading Microorganisms.

      • Mechanism: Phagocytosis.

        • Steps: Recognition, ingestion, phagosome formation, fusion with lysosome (phagolysosome), digestion, and elimination.

      • Receptors: Toll-like receptors (TLRs) and complement receptors.

    • Generate Microbicidal Substances.

      • Examples: Reactive oxygen species and lysosomal enzymes.

        • Reactive Oxygen Species (ROS): Superoxide, hydrogen peroxide, and hydroxyl radicals.

        • Lysosomal Enzymes: Lysozyme, proteases, and lipases.

    • Function: Kill ingested pathogens.

      • Mechanism: Oxidative stress and enzymatic degradation.

Specific Immunity

Antigens, Active Immunity, and Passive Immunity

  • Antigens: Foreign molecules that elicit an immune response.

    • Examples: Proteins, polysaccharides, or lipids on pathogens.

      • Proteins: Surface proteins on bacteria, viruses, and fungi.

      • Polysaccharides: Capsules of bacteria.

      • Lipids: Lipopolysaccharide (LPS) on Gram-negative bacteria.

    • Epitopes: Specific regions on antigens that bind to antibodies and T cell receptors.

      • B Cell Epitopes: Recognized by antibodies.

      • T Cell Epitopes: Presented by MHC molecules to T cells.

  • Active Immunity: The immune system reacts to antigens.

    • Result: Long-lasting protection.

      • Development of Memory Cells: Provide a rapid and robust response upon subsequent exposure to the same antigen.

    • Acquisition: Infection or vaccination.

      • Infection: Natural exposure to pathogens.

      • Vaccination: Administration of weakened or inactive pathogens or antigens.

  • Passive Immunity: Temporary immunity from another source.

    • Examples: Maternal antibodies or antibody injections.

      • Maternal Antibodies: IgG antibodies that cross the placenta from mother to fetus.

      • Antibody Injections: Administration of pre-formed antibodies (e.g., intravenous immunoglobulin).

    • Benefit: Immediate but short-lived protection.

      • No Development of Memory Cells: Protection lasts only as long as the antibodies are present in the body.

Lymphocyte Development

Stem Cells, T Cell Processing, and B Cell Processing

  • Stem Cells: Located in red bone marrow.

    • Function: Give rise to undifferentiated lymphocytes.

      • Hematopoiesis: The process of blood cell formation in the bone marrow.

      • Lymphoid Progenitor Cells: Give rise to lymphocytes (T cells, B cells, and NK cells).

  • T Cell Processing: Some undifferentiated lymphocytes processed in the thymus gland.

    • Result: Become T cells.

      • Types: Helper T cells (CD4+), cytotoxic T cells (CD8+), and regulatory T cells.

    • Process: Selection and maturation for self-tolerance and functionality.

      • Positive Selection: T cells that recognize self-MHC molecules survive.

      • Negative Selection: T cells that strongly recognize self-antigens undergo apoptosis.

  • B Cell Processing: Some undifferentiated lymphocytes processed in bone marrow.

    • Result: Become B cells.

      • Types: Plasma cells (antibody-secreting) and memory B cells.

    • Process: Selection and maturation.

      • Negative Selection: B cells that recognize self-antigens undergo apoptosis.

  • Transportation: T cells and B cells are transported to lymphatic organs.

    • Organs: Lymph nodes, lymphatic ducts, and spleen.

      • Lymph Nodes: Filter lymph and initiate immune responses.

      • Lymphatic Ducts: Collect lymph and return it to the bloodstream.

      • Spleen: Filters blood and initiates immune responses.

    • Function: Encounter antigens and initiate immune responses.

      • Antigen Presentation: APCs present antigens to T cells and B cells.

Lymphocytes and Immune Response

B Cells, T Cells, and Lymphatic Organs

  • Two Kinds of Lymphocytes: B cells and T cells.

    • B Cells: Responsible for humoral immunity (antibody-mediated).

    • T Cells: Responsible for cell-mediated immunity (direct cell killing and regulation of immune responses).

  • B Cells: Secrete antibodies.

    • Function: Attack antigens (humoral immunity).

      • Antibodies: Bind to antigens and neutralize them, mark them for destruction by phagocytes, or activate complement.

      • Clonal Selection: B cells that bind to specific antigens proliferate and differentiate into plasma cells.

  • T Cells: Attack infected cells.

    • Function: Cell-mediated immunity.

      • Helper T Cells (CD4+): Activate B cells and cytotoxic T cells by releasing cytokines.

      • Cytotoxic T Cells (CD8+): Kill infected cells that display foreign antigens on their surface.

      • Regulatory T Cells: Suppress immune responses to prevent autoimmunity.

  • BONE MARROW: Origin of stem cells and immature lymphocytes.

    • Function: Primary site of hematopoiesis.

      • Red Bone Marrow: Site of blood cell formation.

      • Yellow Bone Marrow: Stores fat and does not actively produce blood cells.

  • THYMUS: Site of T cell maturation.

    • Function: Establishes T cell tolerance and functionality.

      • Thymic Epithelial Cells: Present self-antigens to T cells.

      • Positive and Negative Selection: Ensures that T cells are self-tolerant and functional.

  • Lymphatic Organs: Lymph nodes, spleen, and other lymphatic organs.

    • Function: Final maturation of B and T cells.

      • Lymph Node Structure: Cortex (B cell zones) and medulla (T cell zones).

      • Spleen Structure: Red pulp (filters blood) and white pulp (immune responses).

Cell-Mediated Immunity

Antigen-Presenting Cells and the Process of Antigen Presentation

  • Antigen-Presenting Cell (APC): Displays a foreign antigen and self proteins (MHC molecules).

    • Function: Presents antigens to a helper T cell.

      • Types of APCs: Dendritic cells, macrophages, and B cells.

      • MHC Molecules: Major histocompatibility complex molecules (MHC I and MHC II).

    • MHC Class I: Presents antigens to cytotoxic T cells (CD8+).

    • MHC Class II: Presents antigens to helper T cells (CD4+).

  • Process:

    • Macrophage Processes a Microbe:

      • Function: Engulfs and digests the microbe.

    • Result: Becomes an APC.

      • Presents microbial antigens on its surface in complex with MHC molecules.

    • APC Displays Antigen:

      • Presents nonself molecule (antigen) and self protein (MHC molecule).

    • Helper T Cell Binds to the APC:

      • Mechanism: Via its T cell receptor (TCR).

        • TCR: Recognizes the antigen-MHC complex.

      • CD4: Co-receptor on helper T cells that binds to MHC II molecules.

    • Recognition: Self-nonself complex.

      • T Cell Activation: Leads to the release of cytokines.

    • Binding Site:

      • Self protein (MHC) and antigen.

Helper T Cells and Cytotoxic T Cells

Function of Helper T Cells and Cytotoxic T Cells

  • Main Effectors: Helper T cells and cytotoxic T cells.

    • Helper T Cells (CD4+): Activate B cells and cytotoxic T cells.

    • Cytotoxic T Cells (CD8+): Kill infected cells.

  • Helper T Cell Function: Stimulate humoral responses.

    • Mechanism: Activates B cells.

      • B Cell Activation: Leads to antibody production.

      • Cytokine Release: Activates other immune cells.

    • Production: Cytokines that enhance immune cell activity.

      • Examples: IL-2, IL-4, IL-5.

      • Effects: Promote T cell and B cell proliferation, differentiation, and activation.

  • Overall: T cells mount the cell-mediated defense and aid humoral immunity.

    • Coordination: Helper T cells coordinate the immune response by activating other immune cells.

    • Regulation: Regulatory T cells suppress immune responses to prevent autoimmunity.

Helper T Cell Activation

Recognition, Activation, and Outcomes

  • Recognition: Helper T cell receptors recognize self-nonself complexes on the APC.

    • TCR Binding: TCR on the helper T cell binds to the antigen-MHC II complex on the APC.

    • Co-stimulation: Additional signals from the APC are required for full T cell activation.

      • Examples: B7-CD28 interaction.

  • Activation: Interaction activates the helper T cells.

    • Cytokine Production: Activated helper T cells produce cytokines, such as IL-2, IL-4, and IFN-gamma.

    • T Cell Proliferation: IL-2 promotes the proliferation of activated T cells.

  • Cytotoxic T Cell Activation: Helper T cells activate cytotoxic T cells.

    • Mechanism: Helper T cells secrete IL-2, which activates cytotoxic T cells.

  • Interleukin-2: Stimulates cell division and activates T cells and B cells.

    • Effects: Promotes the clonal expansion of T cells and B cells.

  • Interleukin-1: Activates helper T cell.

    • Effects: Enhances the production of IL-2 and other cytokines.

  • Outcomes:

    • Cell-Mediated Immunity:

      • Mechanism: Attack on infected cells by cytotoxic T cells.

        • Perforin and Granzymes: Cytotoxic T cells release perforin and granzymes, which induce apoptosis in infected cells.

    • Humoral Immunity:

      • Mechanism: Secretion of antibodies by plasma cells.

        • Antibody Functions: Neutralization, opsonization, and complement activation.

Immunological Memory

Memory Cells, Primary Response, and Secondary Response

  • Memory Cells: Confer lifelong immunity.

    • Types: Memory T cells and memory B cells.

      • Memory T Cells: Provide a rapid cell-mediated immune response upon re-exposure to the same antigen.

      • Memory B Cells: Provide a rapid antibody-mediated immune response upon re-exposure to the same antigen.

    • Characteristics: Long-lived and can quickly differentiate into effector cells.

  • Primary Response: First exposure to antigen X.

    • Lag Phase: Time required for antigen processing and lymphocyte activation.

    • Antibody Production: Relatively slow and low levels of antibody production.

    • Cell-Mediated Immunity: Slower and less effective compared to the secondary response.

  • Secondary Response: Second exposure to antigen X, first exposure to antigen Y.

    • Characteristics: Faster and stronger response due to memory cells.

      • Memory Cell Activation: Rapidly differentiate into effector cells.

      • Antibody Production: Higher levels of antibody production and more effective cell-mediated immunity.

    • Specificity: Memory cells are specific for the antigen to which they were previously exposed.

  • Antibody Concentration: Increases more rapidly and reaches a higher level in the secondary response.

    • Isotype Switching: Memory B cells can switch to producing different antibody isotypes (e.g., IgG, IgA, IgE).

Cytotoxic T Cells

Binding, Perforin, and Apoptosis

  • Function: Bind to infected body cells and destroy them.

    • Target Cells: Cells infected with viruses, bacteria, or other intracellular pathogens.

  • Mechanism:

    • Cytotoxic T Cell Binds to Infected Cell (Step 1):

      • Recognition: Antigen on MHC class I molecules.

        • TCR Binding: TCR on the cytotoxic T cell binds to the antigen-MHC I complex on the infected cell.

        • CD8: Co-receptor on cytotoxic T cells that binds to MHC I molecules.

    • Perforin Makes Holes in Infected Cell’s Membrane (Step 2).

      • Perforin: A protein that forms pores in the target cell membrane.

      • Granzymes: Enzymes that enter the target cell and activate apoptosis.

    • Infected Cell Is Destroyed (Step 3):

      • Mechanism: Apoptosis.

        • Activation of Caspases: Initiates a cascade of events that leads to cell death.

  • Perforin Molecule: Creates holes in the infected cell.

    • Function: Allows granzymes to enter the target cell.

  • Foreign Antigen: Displayed on infected cell surface.

    • MHC Class I: Presents the antigen to the cytotoxic T cell.

Cancer and Cytotoxic T Cells

Cancer Cell Alteration and Cytotoxic T Cell Role

  • Cancer Cell Alteration: Surface molecules are altered by the disease.

    • Tumor-Specific Antigens: Antigens that are expressed only on cancer cells.

      • Examples: Mutated proteins, overexpressed proteins, and viral proteins.

    • Immune Evasion: Cancer cells can downregulate MHC I expression to avoid recognition by cytotoxic T cells.

      • Escape Mechanisms: Mutations and epigenetic changes.

  • Cytotoxic T Cell Role: May attack cancer cells and help prevent cancer.

    • Immune Surveillance: Cytotoxic T cells patrol the body and eliminate cancerous cells.

    • Cancer Immunotherapy: Enhancing the ability of cytotoxic T cells to recognize and kill cancer cells.

B Cells and Humoral Immunity

Activation, Effector Cell, and Plasma Cell Function

  • Activation: Triggered by a specific antigen, a B cell differentiates into an effector cell.

    • Antigen Binding: B cell receptor (BCR) binds to the antigen.

    • T Cell Help: Helper T cells provide signals that activate B cells.

      • CD40 Ligand: Binds to CD40 on B cells, providing a co-stimulatory signal.

    • Cytokine Signals: Cytokines from helper T cells promote B cell proliferation and differentiation.

      • Examples: IL-4, IL-5, IL-6.

  • Effector Cell: Plasma cell.

    • Plasma Cell Differentiation: Activated B cells differentiate into plasma cells.

  • Plasma Cell Function: Secretes antibodies.

    • Antibody Production: Plasma cells produce large quantities of antibodies with the same specificity as the BCR.

  • B Cell Role: Main warriors of humoral immunity.

    • Neutralization: Antibodies bind to antigens and prevent them from infecting cells.

    • Opsonization: Antibodies coat pathogens and enhance their uptake by phagocytes.

    • Complement Activation: Antibodies activate the complement system, leading to cell lysis and inflammation.

Antibody Molecules

Structure of Antibody Molecules

  • Light Chain: One of the polypeptide chains that make up an antibody.

    • Types: Kappa (κ) and lambda (λ).

    • Variable Region: Contains the antigen-binding site.

  • Antigen-Binding Sites: Regions on the antibody that bind to specific antigens.

    • Hypervariable Regions: Highly variable sequences within the variable region that determine antigen specificity.

  • Disulfide Bonds: Stabilize the antibody structure.

    • Heavy Chain-Heavy Chain: Connects the two heavy chains.

    • Light Chain-Heavy Chain: Connects each light chain to a heavy chain.

  • Variable Region: Region of the antibody that varies from one antibody to another.

    • Amino Acid Sequence: Determines the antigen specificity.

  • Constant Region: Region of the antibody that is the same for all antibodies of a given class.

    • Isotypes: IgG, IgM, IgA, IgD, and IgE.

    • Effector Functions: Determines the function of the antibody (e.g., complement activation, Fc receptor binding).

Types of Immunoglobulins

IgG, IgA, IgM, IgD, and IgE

  • IgG:

    • Location: Tissue fluid and plasma.

      • Most Abundant: ~75% of serum antibodies.

    • Function: Activates complement, defends against bacteria, viruses, and toxins.

      • Opsonization: Enhances phagocytosis.

      • Neutralization: Blocks viral binding and neutralizes toxins.

      • Complement Activation: Activates the classical complement pathway.

  • IgA:

    • Location: Exocrine gland secretions (breast milk, saliva, mucus).

      • Dimeric Form: Two IgA molecules joined together by a J chain.

    • Function: Defends against bacteria and viruses in mucosal tissues.

      • Neutralization: Blocks pathogen attachment to mucosal surfaces.

Types of Immunoglobulins (Continued)

  • IgM:

    • Location: Plasma.

      • Pentameric Form: Five IgM molecules joined together by a J chain.

    • Function: Reacts with naturally occurring antigens on RBCs, activates complement.

      • First Antibody Produced: During a primary immune response.

      • Agglutination: Effective at clumping pathogens together.

  • IgD:

    • Location: Surface of most B lymphocytes.

      • B Cell Receptor: Acts as a receptor for antigens on B cells.

    • Function: Plays a role in B cell activation.

      • Signaling: Triggers B cell activation when it binds to antigen.

  • IgE:

    • Location: Exocrine gland secretions and bound to mast cells and basophils.

      • Fc Receptors: Binds to Fc receptors on mast cells and basophils.

    • Function: Promotes inflammation and allergic reactions.

      • Mast Cell Activation: Triggers the release of histamine and other inflammatory mediators.

Antibody Actions

Neutralization, Agglutination, Precipitation, Complement Activation, and Enhanced Phagocytosis

  • Neutralization: Blocks viral binding sites; coats bacterial toxins.

    • Mechanism: Antibodies bind to the pathogen, preventing it from infecting cells or exerting its toxic effects.

    • Examples: Neutralizing antibodies against viruses and toxins.

  • Agglutination of Microbes: Clumping of pathogens for easier elimination.

    • Mechanism: Antibodies bind to multiple pathogens, cross-linking them and forming large aggregates.

    • Enhances Phagocytosis: Makes it easier for phagocytes to engulf and destroy the pathogens.

  • Precipitation of Dissolved Antigens: Makes antigens easier to phagocytose.

    • Mechanism: Antibodies bind to soluble antigens, forming insoluble complexes that precipitate out of solution.

    • Removal: These complexes are then phagocytosed by macrophages and neutrophils.

  • Activation of Complement: Leads to cell lysis.

    • Classical Pathway: Antibodies activate the classical complement pathway.

    • Membrane Attack Complex (MAC): Formation of MAC leads to lysis of pathogens.

  • Enhances Phagocytosis: Makes pathogens more appealing to macrophages.

    • Opsonization: Coating pathogens with antibodies and complement fragments.

    • Fc Receptors: Phagocytes have Fc receptors that bind to the constant region of antibodies, facilitating phagocytosis.

Primary and Secondary Immune Responses

Primary Response and Secondary Response

  • PRIMARY RESPONSE (initial encounter with antigen):

    • Antigen Binds to Antigen Receptor on a B Cell.

      • B Cell Activation: Leads to proliferation and differentiation.

    • Cell Growth, Division, and Differentiation into Plasma Cells and Memory B Cells.

      • Plasma Cells: Antibody-secreting cells.

      • Memory B Cells: Long-lived cells that provide immunological memory.

    • Antibody Molecules are Produced by Plasma Cells.

      • IgM: First antibody produced during the primary response.

      • IgG: Produced later in the primary response.

  • SECONDARY RESPONSE (can be years later):

    • Later Exposure to Same Antigen.

      • Memory B Cells: Quickly recognize the antigen and initiate a rapid immune response.

    • Memory B Cell is Activated, Leading to Cell Growth, Division, and Further Differentiation.

      • Effector Cells: Plasma cells and memory B cells.

    • Larger Clone of Plasma Cells and Antibody Molecules are Produced.

      • IgG: Predominant antibody during the secondary response.

      • Affinity Maturation: Antibodies have higher affinity for the antigen.

IgE-Mediated Allergic Reactions

Atopic Disorders, Nonatopic Disorders, and Mechanism

  • Atopic Disorders:

    • Hereditary Predisposition and Production of a Local Reaction to IgE Antibodies.

      • Genetic Factors: Increased susceptibility to allergies.

      • Environmental Factors: Exposure to allergens during early childhood.

    • Examples: Urticaria (hives), allergic rhinitis (hay fever), atopic dermatitis, food allergies, some forms of asthma.

  • Nonatopic Disorders:

    • Lack the Genetic Component and Organ Specificity of the Atopic Disorders.

      • Triggers: Irritants, infections, and other non-allergic factors.

  • Mechanism:

    • Sensitization: Initial exposure to allergen leads to IgE production.

    • Allergen Binding: IgE binds to mast cells and basophils.

    • Mast Cell Activation: Subsequent exposure to allergen triggers mast cell degranulation.

Hypersensitivity Reaction - Type I

Type I Hypersensitivity, Examples, and Phases

  • Type I: Immediate-reaction allergy.

    • IgE-Mediated: Requires sensitization to an allergen.

  • Examples:

    • Hives (Urticaria): Skin rash with itchy, raised welts.

    • Hay Fever (Allergic Rhinitis): Inflammation of the nasal passages.

    • Asthma: Chronic inflammatory disease of the airways.

    • Atopic Dermatitis (Eczema): Chronic, itchy skin condition.

    • Gastric Disturbances: Nausea, vomiting, and diarrhea.

    • Anaphylactic Shock: Severe, life-threatening allergic reaction.

  • Type I Hypersensitivity Reactions: Phases

    • Primary or Initial-Phase Response:

      • Vasodilation: Increased blood flow to the affected area.

      • Vascular Leakage: Fluid leaks from blood vessels into the tissues.

      • Smooth Muscle Contraction: Bronchospasm and constriction of blood vessels.

    • Secondary or Late-Phase Response:

      • More Intense Infiltration of Tissues with Eosinophils and Other Inflammatory Cells.

      • Tissue Destruction: Damage to epithelial cells and other tissue components.

Type I Hypersensitivity Mechanism

Sensitization, Primary Early Response, and Secondary Late Response

  • Sensitization:

    • B Cells are Stimulated by T Helper Cells (TH) and IL-4 to Produce IgE-Secreting Plasma Cells.

      • T Cell Activation: Helper T cells recognize the allergen and activate B cells.

      • Cytokine Production: IL-4 stimulates B cells to switch to IgE production.

    • IgE Antibodies Bind to Mast Cells.

      • Fc Receptors: IgE binds to Fc receptors on mast cells and basophils.

  • Primary Early Response:

    • Antigen Binds to IgE on Mast Cells, Causing Degranulation and Release of Mediators.

      • Cross-Linking: Antigen cross-links IgE molecules on mast cells and basophils.

      • Degranulation: Release of histamine, leukotrienes, prostaglandins, and other inflammatory mediators.

    • Leads to Vasodilation, Vascular Damage, and Smooth Muscle Spasm.

      • Histamine: Causes vasodilation and increased vascular permeability.

      • Leukotrienes: Cause bronchospasm and mucus production.

  • Secondary Late Response:

    • Release of Cytokines Leads to Recruitment and Activation of Inflammatory Cells.

      • Cytokine Production: Mast cells release cytokines that recruit eosinophils, neutrophils, and other inflammatory cells.

    • Causes Mucosal Edema, Mucus Secretion, Leukocyte Infiltration, Epithelial Damage, and Bronchospasm.

      • Eosinophils: Release toxic substances that damage tissues.

    • Membrane Phospholipids are Converted into Arachidonic Acid.

      • Arachidonic Acid: Metabol