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Far  Eastern  University  –  Nicanor  Reyes  Medical  Foundation  

Microbiology  –    Basic  Immunology  

Mary  Joyce  M.  Saborrido-­‐Teoxon,  M.D.    

IMMUNOLOGY  

− Study   of   body’s   protective   and   defensive   mechanisms   against   foreign  substances    

− Discriminate  self  vs.  non  self   − Antigen-­‐antibody  reaction  

− Eliminate  non-­‐self  (infectious  agents)      

Immune  System  

− Collection   of   organs,   tissues,   cells   and   soluble   factors   that   allow   individuals   to   defend   against   harmful   agents   such   as   viruses,   bacteria,  fungi,  parasitic  organisms,  and  tumor  cells  

 

Two  (2)  Important  Roles  of  the  Immune  System:  

1. Provides  defense  mechanism.  

2. Identification  and  destruction  of  abnormal  cells.    

HISTORY  

Louis  Pasteur  –  father  of  immunology;  actually  the  one  who  discovered  

the  rabies  vaccine  

Edward  Jenner  –  discovered  “small  pox”  vaccine  from  cowpox  

 

Innate  vs.  Adaptive  

 

 

First  Line  of  Defense  

a.  Physiologic  Barriers   − Skin  

• Hookworms  can  penetrate  skin   • Tinea  corporis  

• Dermatophytes   b.  Chemica  Barriers  

− Lysozymes:   chemical   barrier/enzyme   that   dissolves   some   bacterial   cell  wall  

− Gastric  pH  of  the  stomach   c.  Biologic  Barrier  

− Nomal  flora  (Lactobacillus  acidophilus)    

Second  Line  of  Defense  

− Phagocytes:  effective  only  for  extracellular  pathogens   − Anti-­‐microbial  proteins  and  inflammatory  response  

 

ThirdLine  of  Defense  

− Lymphocytes:    can  kill  intracellular  pathogens;  memory  cells  

 

Acquired  Immunity:  Active  vs.  Passive  

Active  –  actively  producing  antibody  after  an  exposure  to  an  antigen;  

life-­‐long  protection  

Passive   –   antibody   from   other   source;   immediate   but   short   term  

protection  

Natural  –  naturally  made;  can’t  be  produce  by  humans   Artificial  –  immunoglobulins;  commercially  availabe  

Passive  Immunity  

Natural   Artificial  

→ Placental  transfer  of  IgG   → Colostral  transfer  of  IgA  

    → Antibodies   or   immunoglobulins   → Immune  cells         Active  Immunity   Natural   Artificial  

→ exposure   to   sub-­‐clinical  

infections     → Vaccination  

 

Professional  Phagocytic  cells  

− These  cells  have  enzymatic  constituents  in  their  granules  to  oxidize,   kill,  digest,  and  destroy  particulate  material  that  they  ingest.   − Part  of  2nd  line  of  defense  

   

1. Mononuclear  phagocytes  (formerly  RES)  

A.  Monocytes  (in  the  blood)   B.  Tissue  Macrophages  

a.  Liver  

à

Kupffer  cells  

b.  Lungs  

à

Alveolar  macrophages/  Dust  cells   c.  Kidney  

à

Mesangial  macrophages   d.  CNS  

à

Microglial  cells  

e.  Lymph  nodes  

à

Dendritic  cells   f.  Skin  

à

Langerhan’s  cells   g.  Spleen  

à

Spleenic  macrophages    

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h.  Connective  tissue  

à

Histiocytes   i.  Bone  

à

Osteoclast   j.  Peyer’s  pathches   k.  Tonsils       Functions  of  MØ   a. Phagocytosis  

− Ingestion  &  killing  of  microbes   − Mostly  for  extracellular  pathogens   −  STEPS:  

•  Chemotaxis  (C5a,LTB4,IL-­‐8,N-­‐formyl  methionine)   •  Diapedesis  

•  Adherence  

•  Engulfment/  Opsonins  (C3b,  IgG)   •  Phagosome  formation  

•  Fusion  

•  Digestion/Destruction  

   

b. Antigen  Presentation  

− Presentation   of   antigen   in   association   with   class   II   MHC   proteins  to  CD4  =  helper  T  cells  

−  APCs:   •  MØ   •  B  cells   •  Langerhans  cells   •  Dendritic  cells       c. Cytokine  Production  

− Synthesis   and   release   of   cytokines   such   as   IL-­‐1   &   TNF,   and   chemokines  such  as  IL-­‐8  

   

2. Polymorphonuclear  leukocytes  (PMNs)  

a. Neutrophils  (most  aggressive  phagocyte)   b. Eosinophils  (antiparasitic  phagocyte)   c. Basophils  (secretory  cells)  

    NK  cells  

− LGL  /  Null  cells  

− Lack  T  cell  receptor,  CD3  proteins,  and  surface  IgM  &  IgD   − Thymus  are  not  required  for  development  

−  Activity  not  enhance  by  prior  exposure   −  Associated  w/  ADCC  

−  CD56  &  CD16  

   

Functions  of  NK  cells  

− Kill  virus-­‐infected/  Cancer  cells   − Killing    

• Non-­‐specific  

• Not   dependent   on   foreign   antigen   presentation   by   class   I   or   II   MHC  proteins  

• Activated  by  the  failure  of  a  cell  to  present  self  antigen  

• Produce   perforins   &   granzymes,   w/c   cause   apoptosis   of   target   cell  

   

 Adaptive  Immunity  

− Antigen  –  Antibody  reaction   − Cells:  

•  B  cells   •  T  cells  

   

Antigens  &  Immunogens   Antigens  

→ molecules  that  react  w/  Abs  

→ compound  that  does  not  necessarily  elicit  an  immune  response  

 

Immunogens  

→ molecules  that  induce  an  immune  response  (antibody)   → at  least  2  antigenic  determinant  

*All  immunogens  are  antigens,  but  not  all  antigens  are  immunogens.  

 

Two  properties  of  Antigens:  

− Immunogenecity:   ability   to   induce   specific   immune   response   resulting  to  formation  of  antibodies  or  immune  lymphocytes   − Antigenecity/   Specificity:     the   ability   to   react   specifically   with   the  

antibody  or  cell  that  caused  it  to  be  produced    

Parts  of  AG:  

− Carrier  portion  

• The  bigger  part  that  is  responsible  for  the  MW  of  antigen   • >10000  dalton  more  immunogenic  

−  Epitome/  Antigenic  determinant  

• Determines   specificity   of   antigen,   therefore,   an   antigen   w/out   epitope  is  said  to  be  nonspecific.  

• Reactive  sites  (Ab/  TCR)    

HAPTENS  

− Molecule  that  is  not  immunogenic  by  itself  but  can  react  w/  specific   antibody  

• Incomplete  Ag  

•  Small  molecules  (<10,000D)   •  univalent  

•  HMW  nucleic  acids   •  Drugs  (e.g.  Penicillin)   •  Cathechol  (plant  oak)  

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 CARRIER  

− A   molecule   that   when   coupled   to   a   hapten,   renders   hapten   immunogenic.   − E.g:     •  Albumin   •  Globulin   •  Synthetic  polypeptides      

Features  of  molecules  that  determine  immunogenicity  

− Foreignness   − Molecular  size  

− Chemical-­‐Structural  Complexity   − Antigenic  Determinants  (Epitopes)  

 

 Lymphoid  System   A. Primary/  Central  

 

− are   the   sites   for   generation   and   early   maturation   of     lymphocytes   (B  and  T  cells)  

 a.  Bone  Marrow  (Bursa  of  Fabricus  equivalent)  

→ Hematopoeisis   •  RBC   •  Platelets   •  Monocytes   •  Granulocytes   →  Lymphopoeisis   •  B  cells   •  T  cell  precursors   •  NK  cells   •  Dendritic  cells   •  Mast  cells   b.  Thymus  

→ Maturation  &  Differentiation  of  T  cells  

   

B.  Secondary/  Peripheral  

−  T  &  B  cells  

à

 Central  L.T.  

à

 Migrate  

à

 Peripheral  L.T.  

à

  Respond  to  foreign  antigens  

  a.  Lymph  nodes  

− Major  antigen-­‐trapping  sites  of  the  body  

− Filters  foreign  substances  from  the  tissue  fluids  and  lymph   − Central  organ  for  lymphocyte  traffic  and  circulation   − PARTS:  

 CORTEX  (Germinal  center)  à  B  cells    PARACORTEX  (Juxtamedullary)  à  T  cells  

 

Flow of lymph To thoracic

duct

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b.  Spleen  

− Filters  foreign  substance  from  the  blood   − Critical  line  versus  blood  borne  infections   − Eliminates  dead  worn-­‐out  RBCs  

− 2  pulps  Red  pulp  and     − White  pulp  

•  Marginal  zone   •  Germinal  center   •  PALS  (mostly  T  cells)  

•  Primary  follicles  (mostly  B  cells)  

 

Mucosa-­‐associated  Lymphoid  Tissue  (MALT)  

− GUT-­‐associated  lymphoid  tissue  (GALT)   − Bronchus-­‐associated  lymphoid  tissue  (BALT)  

  BALT  

− L.T.  beneath  the  respiratory  mucosa  and  the  aggregates  of  nodular   lymphatic  tissues  called  Tonsils.  

− Tonsils  à  nodular  aggregates  of  B  cells  &  diffuse  areas  that  contain   mostly  of  T  cells  

                             à  for  airborne  and  alimentary  tract  pathogens      

   T  cells  

− Responsible   for   foreign   antigen   recognition   or   cellular   immune   response,  which  include:  

•    rejection  in  organ  transplantation   •    regulation  of  antibody  production   •    secretion  of  soluble  mediators  

− It  has  the  ability  to  bind  with  sheep’s  RBC  forming  rosette.  

 

Subsets  of  T  cells  

1. T  helper  cell  (CD4  marker)  

• Recognize  Ag  in  association  w/  MHC  class  II   • Collaborate  w/  B  cells  to  produce  Abs   • Th1/Th2  

2. T  cytotoxic  cell  (CD8  marker)  

• Has  killer  function  

3. T  effector  cell  

• Also  called  as  TdTh  cell  

• Responsible  for  delayed  type  of  HPS  

4. T  suppressor  cell  (CD8  marker)  

• Involved  in  presenting  autoimmunity  activated  by  Ag  

   

B  cells  

− Have  shorter  life  span  (5-­‐7  days)  

−  Precursors,  regulators,  and  effectors  of  immunity.  

−  May   transform   or   differentiate   into   plasma   cell   to   produce   immune  antibodies.  

−  CD19,  CD20,  CD21,  CD22,  CD35  

   

Comparison  of  T  &  B  cells  

   

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Complement  

− Composed  of  several  proteins  found  in  human  serum  (other  animal   serum)  

− Synthesize  in  the  liver  (main)  

− Heat  labile  (inactivated  by  heating  serum  at  56  C  for  30  mins)   − 3  Pathways:  

• Classic   (activated   by   Ag-­‐Ab(IgM   &   IgG   only!);   for   IgM   w/   1pentameric  structure  and  IgG  w/  2  monomeric  structure)   • Alternative   • Lectin                                                                                       Classic    

− Activator:   Ag-­‐Ab(IgM   &   IgG   only!);   for   IgM   w/   1pentameric   structure  and  IgG  w/  2  monomeric  structure  

→ 1st  complement  protein  will  be  activated  C1,  usually  attached   to  the  FC  portion  of  Ab  is  C1q.  

• C1r  surrounds  C1q  and  C1s.  

• C1s  is  the  most  active  portion  stimulating  C4.   → C4  will  then  be  cleaved  into  two  (C4a  &  C4b).  

• C4a   will   serve   as   the   anaphylatoxin   (assoc.   w/   hypersensitivity   reaction   resulting   to   increase   vascular   permeability  stimulating  swelling  and  inflammation).   • C4b  is  the  active  part  and  will  continue  the  process.   → After  C4  activation,  C2  will  be  activated  by  C1s  also.   → C2  will  be  then  cleaved  into  C2a  and  C2b.  

• Either   C2a   or   C2b   will   bind   to   C4b   to   become   C3  

convertase  that  will  activate  C3.  

→ C3  will  then  be  cleaved  into  C3a  and  C3b.  

• C3a  (anaphylatoxin)  and  C3b  is  the  active  portion  that  will   have  a  separate  action  as  the  opsonin  or  can  bind  to  C3   convertase   forming   C5   convertase   that   would   then   activate  C5.    

→ C5   will   be   cleaved   into   C5a   that   will   act   as   the   anaphylatoxin/chemotaxin  and  C5b  will  be  the  active  portion   and  will  stimulate  C6C7C8C9  (Membrane  attack  complex).  

  Lectin  

− Activator:  MBP  (found  in  the  cell  wall  of  gram  +  bacteria);  doesn’t   involve   Ab,   also   called   as   “Antibody   Independent   Complement   Pathway”  

− No  C1  activated,  but  MASP  (Mannose  Associated  Serine  Protease)   will  act  as  C1  that  will  activate  C4  and  so  on…  

 

Alternate  

− Activator:  Microbial  surfaces  

− Also  “Antibody  Independent”,  alternate  or  shortcut,  bypassing  C1,   C4,   and   C2.   Automatically   activates   C3   that   will   split   into   C3a   (anaphylatoxin)  and  C3b  (active  portion).  

− Factor  B,  a  unique  component  produced  only  in  this  pathway  that   will  be  cleaved  into  Ba  (no  biologic  significance)  and  Bb  will  attach   to  C3b  producing  C3  convertase  activating  C3.  

− C3   will   be   cleaved   to   C3a   (anaphylatoxin)   and   C3b   will   bind   to   C3   convertase   of   alternative   pathway   producing   C5   convertase   that   will  then  stimulate  C5.  

− C5   will   be   cleaved   into   C5a   (anaphylatoxin)   and   C5b   stimulate  

C6C7C8C9  (MAC).    

Functions  of  complement:  

• Anaphylatoxins  –  C3a,  4a,  5a  

• Chemoattractants-­‐  C5a,  LTB4,  IL-­‐8,  bacterial  products   • Opsonins  –  C3b,  IgG  

• Bacterial  cell  lysis  –  C5b,  6,  7,  8,  9  

      CLASSIC Ag-­‐Ab C1  q,  r,s C4 C2 C4b2a/  C4b2b (  C3  Convertase) C3   C4b2a3b/  c4b2b3b    (C5  Convertase)   C5 C5bC6C7C8C9   (Membrane  Attack   Complex)   MBP LECTIN

 

MASP ALTERNATIVE Microbial   surface   C3 B C3bBb (C3  Convertase)

 

C3bBb3b (C5  Convertase)

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Complement  Regulatory  Proteins  

   

Complement  Deficiencies  

¡ C1sINH  à  Hereditary  Angioedema  

¡ C2  à  Increased  incidence  of  Connective  tissue  d/o  (SLE)  

¡ C1/C4/C2  à  Opsonization  not  efficient  (LAD)  

¡ C3  à  Increased  susceptibility  to  pyogenic  infection              

References

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