Immune System Review

Immune System Overview

  • The immune system provides resistance to disease.

  • Composed of two intrinsic systems working together to destroy pathogens:

    • Innate immune system (rapid but nonspecific)

    • First and second lines of defense:

      • First line of defense: External body membranes (skin and mucosae)

      • Second line of defense: Antimicrobial proteins, phagocytes, and other cells.

      • Inhibits the spread of invaders; inflammation is the most important mechanism.

    • Adaptive immune system (slower but highly specific)

    • Third line of defense

      • Attacks particular foreign substances and takes longer to react than innate immunity.

  • Innate and adaptive defenses are intertwined, both releasing and recognizing many of the same defensive molecules.

  • Innate responses release proteins that alert cells of the adaptive system to foreign molecules.

Innate Immunity

First Line of Defense: Surface Barriers

  • Surface barriers include skin and mucous membranes, along with their secretions.

    • Functions:

    • Acts as a physical barrier to most microorganisms.

    • Produces protective chemicals that inhibit or destroy microorganisms:

      • Acid: Acidity of skin and some mucous secretions inhibits growth, known as the acid mantle.

      • Enzymes: Lysozyme found in saliva, respiratory mucus, and lacrimal fluid kills many microorganisms; enzymes in the stomach also kill many microorganisms.

      • Mucin: Sticky mucus lines the digestive and respiratory tracts and traps microorganisms.

      • Defensins: Antimicrobial peptides that inhibit microbial growth.

      • Other chemicals: Lipids in sebum and dermicidin in sweat are toxic to certain bacteria.

  • Respiratory system modifications to stop pathogens:

    • Mucus-coated hairs in the nose trap inhaled particles.

    • Cilia in the upper respiratory tract sweep dust- and bacteria-laden mucus toward the mouth.

  • When surface barriers are breached (e.g., nicks or cuts), the internal second line of defense is triggered, protecting deeper tissues.

Components of the Second Line of Defense

  • Phagocytes: White blood cells that ingest and digest foreign invaders.

    • Neutrophils: Most abundant phagocytes that die fighting. They become phagocytic upon exposure to infectious material and are attracted via chemotaxis from the bloodstream to the affected area.

    • Macrophages: Develop from monocytes and are the chief phagocytic cells. Examples:

    • Free macrophages: Wander through tissue spaces (e.g., alveolar macrophages).

    • Fixed macrophages: Permanent residents of specific organs (e.g., alveolar macrophages in lungs, stellate macrophages in the liver, microglia in the brain).

  • Natural Killer (NK) Cells: Nonphagocytic, large granular lymphocytes that police the blood and lymph.

    • Can kill cancer and virus-infected cells before the adaptive immune system is activated.

    • Attack cells lacking "self" cell-surface receptors and induce apoptosis in infected cells, secreting potent chemicals that enhance the inflammatory response.

Inflammation: Tissue Response to Injury

  • Triggered whenever body tissues are injured by trauma, heat, irritating chemicals, or infections by microorganisms.

  • Benefits of inflammation:

    • Prevents the spread of damaging agents.

    • Disposes of cell debris and pathogens.

    • Alerts the adaptive immune system.

    • Sets the stage for repair.

  • Four cardinal signs of acute inflammation:

    1. Redness

    2. Heat

    3. Swelling

    4. Pain

    • Sometimes a fifth sign, impairment of function, may occur if movement or use of the area is hampered.

Stages of Inflammation

  1. Inflammatory chemical release:

    • Inflammatory chemicals flood the extracellular fluid, released by injured or stressed tissues.

    • E.g., mast cells release histamine.

    • Other mediators include kinins, prostaglandins, cytokines, and if pathogens are involved, complement proteins.

    • Induces vasodilation of local arterioles, increased capillary permeability, and attracts phagocytes to the area.

  2. Vasodilation and increased vascular permeability:

    • Brings more immune cells and chemicals to the site of injury, causing redness and heat.

  3. Phagocyte mobilization:

    • Neutrophils flood the area first, followed by macrophages and adaptive immunity elements if needed.

Phagocyte Mobilization

  • Steps for phagocyte mobilization:

    1. Leukocytosis:

    • Injured cells release leukocytosis-inducing factors that trigger the release of neutrophils from the bone marrow into the bloodstream.

    1. Margination:

    • Phagocytes cling to the inner walls of capillaries through cell adhesion molecules (CAMs) that attract passing neutrophils, causing them to slow and stick.

    1. Diapedesis:

    • Neutrophils flatten and squeeze between endothelial cells, entering interstitial spaces.

    1. Chemotaxis:

    • Inflammatory chemicals act as a “honing device” to promote positive chemotaxis of neutrophils toward the injured area, where they begin devouring pathogens and foreign objects.

Antimicrobial Proteins

  • Various antimicrobial proteins enhance innate defenses, notably interferons and complement proteins.

    • Interferons:

    • Released by infected cells to warn nearby uninfected cells, inhibiting viral replication.

    • Act on gene expression in uninfected cells, increasing resistance to infection; also involved in tumor surveillance.

    • Complement Proteins:

    • Group of at least 20 plasma proteins that circulate in inactive states.

    • Major mechanism for destroying foreign substances; activation unleashes inflammatory responses and directly destroys bacteria.

    • Non-specific but complement both innate and adaptive defenses.

Fever

  • A systemic response to invading microorganisms indicating widespread infection.

  • Fever is characterized by an abnormally high body temperature due to pyrogens secreted by leukocytes and macrophages exposed to foreign substances.

  • Benefits of moderate fever:

    • Causes the liver and spleen to sequester iron and zinc (needed by microorganisms).

    • Increases metabolic rate, accelerating repair processes.

Adaptive (Acquired) Immunity

  • The body's specific defense system targeting identified pathogens after recognizing antigens.

  • Involves lymphocytes (B and T cells), which are NOT involved in innate immunity.

  • Characteristics:

    • Specificity: Recognizes and targets specific pathogens initiating an immune response.

    • Systemic: Not restricted to local infection sites.

    • Memory: Mounts a stronger attack after initial exposure.

  • Two overlapping arms of adaptive immune system:

    1. Humoral Immunity

    2. Cellular Immunity

Adaptive Immunity: Humoral vs. Cellular

  • Humoral Immunity:

    • Antibody-mediated immunity controlled by activated B cells and antibodies present in body fluids (humors).

    • Antibodies circulate, binding to extracellular targets and marking them for destruction by macrophages or complement.

  • Cellular Immunity:

    • cell-mediated immunity carried out by T cells targeting intracellular pathogens (infected or cancerous cells).

    • Lymphocytes kill the infected cells or enhance the inflammatory response.

Antigens

  • Antigenic determinants: Parts of an antigen that antibodies or lymphocyte receptors bind to.

  • Naturally occurring antigens can mobilize different populations of lymphocytes and form various antibodies.

    • Self-antigens: Proteins found on cell surfaces that are not antigenic to self but may be to others (e.g., in transfusions).

    • Major Histocompatibility Complex (MHC) proteins: Unique glycoproteins on cell surfaces coded by MHC genes that help the immune system recognize foreign vs. self.

  • Antigens are generally large, complex molecules perceived as foreign intruders by the body.

Lymphocytes and Antigen-Presenting Cells (APCs)

  • Three crucial types of cells in adaptive immunity:

    • B lymphocytes (B cells): Responsible for humoral immunity producing antibodies. Clone themselves upon recognizing a foreign antigen.

    • Most clones become effector cells; few remain as memory cells for faster response to future exposures.

    • T lymphocytes (T cells): Carry out cellular immunity.

    • Antigen-Presenting Cells (APCs): Engulf antigens and present fragments for recognition by T cells. Major types include dendritic cells, macrophages, and B-lymphocytes.

Humoral Immune Response

  • Activation of B cells provokes the humoral immune response.

  • Antibodies specific to the target antigen are produced:

    • B cells activated when antigens bind to surface receptors, leading to proliferation and differentiation into effector cells.

    • Most cloned cells become plasma cells that secrete specific antibodies at 2000 molecules per second for 4 to 5 days before dying.

    • These antibodies circulate, binding to free antigens, marking them for destruction by innate or other adaptive mechanisms.

    • Clone cells that do not become plasma cells become memory cells, providing immunological memory for future infections.

Immunological Memory

  • Primary immune response: Cell proliferation and differentiation occur upon first exposure to antigen, with a 3 to 6 day lag period before peak antibody levels are reached in 10 days, after which levels decline.

  • Secondary immune response: Faster, more prolonged, and effective response upon re-exposure to the same antigen, with memory cells responding within hours:

    • Antibody levels peak in 2 to 3 days at much higher levels and with greater affinity, possibly remaining high for weeks to months.

Active and Passive Humoral Immunity

  • Active humoral immunity: Occurs when B cells encounter antigens and produce specific antibodies, which can be:

    • Naturally acquired: Develops in response to actual bacterial or viral infections.

    • Artificially acquired: Formed in response to vaccines of dead or attenuated pathogens.

  • Passive humoral immunity: Occurs when ready-made antibodies are introduced into the body (e.g., maternal antibodies delivered through the placenta or in milk; serum injections).

    • Immunological memory does not occur as B cells are not challenged by antigens; protection ends when antibodies degrade.

Antibodies

  • Antibodies (Immunoglobulins, Igs): Proteins secreted by plasma cells that detect germs and harmful substances, neutralize them, and attract other immune system cells for assistance.

    • Bind directly to the surfaces of viruses or bacteria, or to their toxins, preventing attachment to body cells and infection.

    • Produced by B lymphocytes, binding only to matching antigens like a key in a lock, inactivating and tagging them for destruction by innate defenses.

  • Form antigen-antibody (immune) complexes.

T-Cells and Cellular Immunity

  • T Lymphocytes (T-cells): Provide defense against intracellular antigens (e.g., virus-infected cells, cancer cells, foreign cells).

    • Respond to processed fragments of antigens displayed on cell surfaces.

    • Types of T cells:

    • Helper T cells: Activate other immune cells, releasing cytokines to enhance both humoral and cellular immune responses.

    • Cytotoxic T cells: Do the destructive work by destroying infected or abnormal cells and can induce apoptosis.

Review: The Second Line of Defense

Innate Cellular and Chemical Defenses

  • Phagocytes: Engulf and destroy pathogens, contributing to adaptive immune responses.

  • Natural Killer (NK) Cells: Promote apoptosis by attacking virus-infected/cancerous cells; recognize general abnormalities.

  • Inflammatory Response: Prevents the spread of injurious agents and promotes healing.

  • Antimicrobial Proteins: Interferons and complement proteins that enhance immune responses.

  • Fever: Systemic response inhibiting microbes and enhancing repairs.

Immunodeficiencies

  • Immunodeficiency: Conditions impairing function/production of immune cells or molecules.

    • Acquired Immune Deficiency Syndrome (AIDS): Caused by Human Immunodeficiency Virus (HIV), which attacks helper T cells, leading to severe infections and complications.

Autoimmune Diseases

  • Occurs when the immune system fails to distinguish self from foreign.

    • Results in the production of autoantibodies that destroy body tissues.

    • Examples include:

    • Rheumatoid arthritis

    • Myasthenia gravis

    • Multiple sclerosis

    • Graves’ disease

    • Type 1 diabetes mellitus

    • Systemic lupus erythematosus (SLE)

Hypersensitivities

  • Hypersensitivities: Immune responses to perceived threats causing tissue damage.

    • Immediate Hypersensitivity: Quick response to allergens causing inflammation/development of allergies by IgE antibodies.

    • Delayed Hypersensitivity: T cell mediated response, takes longer to develop.