Immunology Body defense may be:- Non-specific resistance specific resistance 1st line 2nd line 3rd line of defense Skin & mucos . Phagocytosis Membrane B, T lymphocytes . Inflammation & fever antibodies. - Phagocytes are neutrophiles & monocytes. - Chemotaxis is the chemical attraction of phagocytes towards the site of infection through chemotactic factors. - Infection increase the number of leukocytes "leukocytosis" - Fever is the systemic response of the body to infection or injury. - The complement system:- is a group of 20 or more proteins present in blood. - Complement system increase the action of antibodies in killing microorganism. - Classical pathway activation of complement :- Ag-Ab complex activate C1 - Alternative pathway activation of complement :Activation doesn't involve Abs but occur through polysaccharides. - The complement system remove Ag – Ab complex from the circulation as if Ag – Ab complex ppt in the kidney it will cause glomeruloneohritis. - C-reactivate protein "C-RP" :- it is one of the acute phase proteins, synthetized in liver, can activate complement system so kill m.o. .it's a marker of inflammation. And reach its peak after 24 hour. - Antistreptolysino "ASO": It is antibody produce by the body as defense mech. against streptolysin which is an enzyme produced by the invading streptococci. 1 :. ASO in case of streptococci & if untreated Aso react W the heart muscle tissue causing "rheumatic fever" - Interferon α, B, Ϫ α,B produced from the infected cells. Ϫ produced from T-lymphocytes. .IFN has an antiviral activity. .IFN is host cell specific but not virus specific as human IFN has only activity in human but against all viruses. When the cell is infected with a virus, the cell process the virus into small protein fragments that move to the surface of the infected cell acting as antigens these antigens are present in association with MHC which act as presenters for those antigens so these antigens are well marked and highly lighted for t-cells. . ͘ . MHC major histocom patibility cpx ) لكى تتعرف عليها ونقوم بقتلهاTc( ) لviral parts)و هى تعمل مثل الصينيه لتقديم ال Immunity Naturally acquired artificially acquired Active passive Ag enter the readymade Abs pass Blood so freely from the mother Body from Ab. To the baby during Pregnancy or during Colostrums "lactation" active passive pathogen is given in ready made Ab injection e.g. vaccine e.g. serum Serology is the study of reactions between Ags and Abs. Abs separated from serum by Gel-electrophores is Antibody ≡ Ϫ globulin ≡ Immunoglobulin ≡ Ig. 2 Antigen "Ag": material that induces production of antibodies when injected Into the body. Has large M.WT ≥ 10,000 Dalton. Mainly proteins or large Polysaccharides . Ag may be the whole bacterial cell, capsule, flagella, viral coats, Toxins, pollen grains, dust or egg white. Epitopes is a specific regions on Ags which the Ab recognize it and bind to it. Haptens: - foreign substance having low M.WT it's not immunogenic, Can't stimulate the immune system to produce Abs. Hapten + carrier Ag "immunogenic" Example of haptens is penicillin. Antibodies"Abs" are proteins made in respone to antigen And it can recognize it and bind with it. Most of Abs are bivalent "have 2 antigen binding site" Ab structures 4 protein chains 2 light "L". 2 heavy "H". Intra disulfide links bet. 2H but inter sulfide bond bet bet. H and L. Ab has a Y shape and the lower parts of the Y shape is the constant Region "C" Fc region composed of the 2 heavy chains "The lower part". 3 The end of the two arms of the Y-shape are called variable Region "V" which is the antigen binding sites. The real form of Ab is the Y-shape structure in which the amino acid Forming the chains exist in form of domains. L has 2 domains VL and CL H has 4 domains VH and 3 CH Constant region of heavy chain has many different amino acid sequences resulting in 5 different classes of Ig (s). IgA, IgG, IgE, IgM, IgD. IgM is the first Ab secreted due to initial infection. I9G structure monomer I9M I9A pentamer Diamer I9D monomer I9E monomer % of total Abs serum 80% 5-10% 5-10% 0.2% 0.002% Complement fixation Placental transfer yes yes No No No Yes No No No No location function Blood, lymph, and intestine Blood, Secretions lymph, B-cell "salvia, mucus, surfaces milk, blood, lymph" phagocytosis 1 ˢᵗ Ig Protection on secreted mucosal surface 4 B-cell surface Bound to mast cell Immune responce Allergic Rx. Humoral immunity (Ab –mediated immunity) :Through circulating Abs W are secreted from B-cells. B-cells activation activated B-cells differentiated into plasma cells Specific Ab produce + Memory cells Cell-mediated immunity: - depend on t-cells And act against pathogen intracellular not Circulating. And fight cancer cells. Stem cells Produce present in bone Marrow in adult and In liver of foetus. Immature immature B-cells T-cells Maturation maturation In bone marrow in thymus gland Mature B-cell mature t-cell. Activation by Ag(s) on pathogen Activated B-cells activated Differentiation cytotoxic (tc) 5 Plasma cells +memory cell form attack cancer cells and Ab(s) specific for intracellular , The Ag viruses , Bacteria. Every single B-cell can be activated only by one specific Ag "Key and lock". Each B-cell can bind only to one Ag using the Ag Receptor (Igd, IgM) Which are bound to the surface of B-cell then the B-cell is activated. Activated B-cells plasma cells + memory cells "Long term immunity". The human body make 100 million lymphocytes each day so an equivalent No. of other lymphocytes must die otherwise leukemia occur. So Apoptosis is a programmed cell death. The 1ˢᵗ Ab formed IgM followed by IgG. Experianent in rabbit. B-cells cancerous B-cell cant produces Abs but contine "Myelomas" Hybrid cell In in grouth in cultne. B-cells + myeloma fusion selective medium hybridoma Produce monoclonal Ab. 6 Cytokines is the chemical messengers of immune cells. Interleukins are cytokines that serve as chemical messenger between leuckocytes. The cells that introduce the Ag on its surface are called "antigen presenting cells"APC(s)". CD4 types:- TH and TD. Types of t-cells CD8 types: - Tc and Ts. TH "helper": - activate the cytotoxic T cells Activate the macrophage Help B-cells to produce Ab(s). TD "delay hypersensitivity t cells": Involve in allergic reaction Involve in rejection of transplanted tissue. Fight intracellular Ag. Tc "cytotoxic": - attack infected host cells and Destroy them by secreting perforins and Lytic enzymes. 7 Ts "suppressor": - regulate the immune response by turning it off when Ag is no longer present. TC bind to MHC-antigen cpx on infested cell surface, Tc release perforins W lyse cell. Vaccines: 1-Live attenuated: - make the organism immunogenic but not pathogenic E.g. Sabine vaccine. 2-Killed: - the organism is killed by formalin or phenol E.g. Rabies vaccine, salk vaccines and cholera, influenza. 3-Toxoid: -toxin inactivated toxoid E.g. tetanus and Diphtheria. 4- Subunit vaccine "recombinant vaccine". E.g. hepatitis B. Hypersensitivity Rx: - Anaphylactic cytotoxic Type 1 type 2 immune cpx type 3 cell-modiated or delay type Type 4 8 1-type 1 "anaphylactic" IgE produced on the 1ˢᵗ exposure to the allergen and attach to mast cells or basophiles so on the 2ⁿᵈ Exposure mast cell degradation and releasing of histamine and leukotrienes and vasodilatation, mucous secretion B.V permeability and bronchoconstriction. E.g. pollen grains, eating fish, nuts, strawberry, Hay fever, urtecaria, asthma. In non-allergic people, igG produced. 2- Type TT "cytotoxic": involve the activation of the complement. E.g. blood transfusion, Type O lack A and B Ag(s), Type AB has A and B Ag (s),but lack Ab(s) to them. Blood type O is universal donor. And blood type AB is universal recipient. RH factor: Father+Rh Child +RH mother-ve RH RBCs of child + Ve through to the placenta mother –Rh IgG 2ⁿᵈ pregncy IgG Pass to the +ve RH child "antiRh" hemolytic disease of newborn. 3- Type 3 which is Drug hypersensitivity. 4- Type 4 : cell mediated Rx "delayed type" TD cells are involved. 9 E.g. allergic contact dermatitis soap,Gloves "latex one" Poison ivy. And tuberculin Rx by mycobacterial Ag Autoimmune disease the production of Ab(s) against the persons own tissue Ag(s). 1-Graves disease: due to Ab(s) called long acting thyroid stimulators. "TSH receptor" Ab binds to receptors on thyroid gland so thyroid hormones amount so hyperthyroidism. 2- Myasthenia gravis: gradual loss of muscular tone caused by the Ab(s) that Coat the Ach receptor at the NMJ "neuromuscular junction". So the muscle controlling the diaphragm don’t receive the Nerve signals Respiratory death. 3- Pernicious anemia: - vit B₁₂ need intrinsic factor to be absorber And her there are Ab(s) to the intrinsic factor so vit B₁₂ can't bind to the Intrinsic factor so Vit B₁₂ deficiency. 4- Rheumatoid arthritis: - immune cpx of IgM and IgG are deposited in joints affect females> male. 5- Systemic lupus erythromatous (SLE): Ab(s) against DNA are formed . ͘ . Ab-self AgDNA cpx deposit in much tissue causing glomerulonephritis. 6- hashimotoo thyroditis : T-cell attack thyroid gland cell and causing hypothyroidism. 10 7- IDDM t-cell attack and destroy B-cell of lengerhans. 8- Good pasture syndrome: Abs against capillary absement membrane (GMB) . ͘ . nephritis and these Abs may pass to the Pulmonary capillary basement membrane causing Pulmonary hemorrhage. 9-Multiple sclerosis (MS): T-cell attack the basic protein myelin Leading to CNS demylination with sclerotic plaque. 10-sojorin syndrome: Abs against salivary gland antigens and exocrine glands of the eye, GIT and RT and vagina so no exocrine gland secretion. Autoimmune diseases Type 2 Autoimmune type 3 type 4 autoimmune hashimotos Disease disease thyroditis Pernicious Anemia SLE IDDM Graves's disease Rheumatoid Myasthenia gravis. Arthritis Tolerogens cpds are broken by the body and have specific no responsiveness. 11 TTT of type 1 hypersensitivity reaction: 1-H₁ blocker. 2-EPi. 3-cromolyn Na⁺. 4-topical steroids. 12