Microbiology: A Systems Approach, 2nd ed. Chapter 15: Host Defenses IISpecific Immunity and Immunization 15.1 Specific Immunity: The Third and Final Line of Defense • Not innate, but adaptive • Acquired only after an immunizing event such as an infection • Immunocompetence: the ability of the body to react with myriad foreign substances – Development of B and T lymphocytes – The lymphocytes become specialized for reacting only to one specific antigen or immunogen • Antigens stimulate a response by T and B cells • Two characterizing features of the third line of defense – Specificity – Memory 5 Main Stages of Immunologic Development and Interaction • Lymphocyte development and differentiation • The presentation of antigens • The challenge of B and T lymphocytes by antigens • B lymphocytes and the production and activities of antibodies • T lymphocyte responses Figure 15.1 15.2 An Overview of Specific Immune Responses • Development of the Dual Lymphocyte System – All lymphocytes arise from the same basic stem cell type – Final maturation of B cells occurs in specialized bone marrow sites – Maturation of T cells occurs in the thymus – Both cell types then migrate to separate areas in the lymphoid organs Entrance and Presentation of Antigens and Clonal Selection • Foreign cells cross the first line of defense and enter the tissue • Phagocytes migrate to the site • Macrophages ingest the pathogen and induce an inflammatory response if appropriate • Dendritic cells ingest the antigen and migrate to the nearest lymphoid organ – Process and present antigen to T lymphocytes • Pieces of antigen drain into lymph nodes – Activate B cells Activation of Lymphocytes and Clonal Expansion • When challenged by antigen, B and T cells proliferate and differentiate • This creates a clone (group of genetically identical cells) • Some become memory cells Products of B Lymphocytes: Antibody Structure and Functions • Progeny of dividing B-cell clone are called plasma cells • Programmed to synthesize and secrete antibodies into tissue fluid and blood • When antibodies attach to antigen, the antigen is marked for destruction or neutralization • Humoral immunity How T Cells Respond to Antigen: CellMediated Immunity (CMI) • When activated by antigen, T cell gives rise to one of three different types of progeny – TH1 cells- activate macrophages and help activate TC cells – TH2 cells- assist B-cell processes – TC cells- lead to the destruction of infected host cells and other “foreign” cells Receptors on Cell Surfaces Involved in Recognition of Self and Nonself • Major functions of immune system receptors: – Attachment to nonself or foreign antigens – Binding to cell surface receptors that indicate self, such as MHC molecules – Receiving and transmitting chemical messages to coordinate the response – Aiding in cellular development Major Histocompatibility Complex • Set of genes that codes for human cell receptors • Gives rise to a series of glycoproteins (MHC molecules) found on all cells except red blood cells • Also known as human leukocyte antigen (HLA) system • Three classes of MHC genes identified: – Class I genes- code for markers that display unique characteristics of self – Class II genes- code for immune regulatory receptors found on macrophages, dendritic cells, and B cells; and are involved in presenting antigens to T cells during cooperative immune reactions – Class III genes- encode proteins involved with the complement system Figure 15.2 Lymphocyte Receptors and Specificity to Antigen • B cells have receptors that bind antigens • T cells have receptors that bind processed antigens plus MHC molecules on the cells that present antigens to them The Origin of Diversity and Specificity of the Immune Response • The Clonal Selection Theory and Lymphocyte Development – Early undifferentiated lymphocytes in the embryo, fetus, and adult bone marrow undergo a continuous series of divisions and genetic changes – Generates hundreds of millions of different types of B and T cells Figure 15.3 Summary of the Mechanism • Stem cells in bone marrow can become granulocytes, monocytes, or lymphocytes • Lymphocytic cells become either T cells or B cells • Cells destined to become B cells stay in bone marrow • T cells migrate to the thymus where they build their unique antigen receptor • B and T cells then migrate to secondary lymphoid tissues Figure 15.4 Proliferative Stage of Development • Does not require the actual presence of foreign antigens • By the time T and B cells reach the lymphoid tissues, each one is equipped to respond to a single unique antigen • This diversity is generated by rearrangements of the gene segments that code for the proteinaceous antigen receptors on the T and B cells • Each genetically unique line of lymphocytes arising from these recombinations Clonal Selection and Expansion • Second stage of development • Requires stimulation by an antigen • Antigen contact with a lymphocyte stimulates the clone to undergo mitotic divisions Two Important Generalities From the Clonal Selection Theory • Lymphocyte specificity is preprogrammed, existing in the genetic makeup before an antigen has ever entered the tissues • Each genetically distinct lymphocyte expresses only a single specificity and can react to only one type of antigen Preventing Reactions to Self • Any clones that react to self are destroyed during development through clonal deletion • Autoimmune diseases are thought to be caused by the loss of immune tolerance to self The Specific B-Cell Receptor: An Immunoglobulin Molecule • The receptor genes that undergo recombination are those governing immunoglobulin (Ig) synthesis • Igs: large glycoprotein molecules that serve as the antigen receptors of B cells and as antibodies when secreted • Y-shaped arrangement • Ends of forks contain pockets called the antigen binding sites – Can be highly variable in shape to fit a wide range of antigens – Variable regions (V) Figure 15.5 T-Cell Receptors • Belongs to the same protein family as the Bcell receptor • Relatively small and never secreted Figure 15.6 15.3 The Lymphocyte Response System in Depth • Specific Events in B-Cell Maturation – Bone marrow sites harbor stromal cells – Stromal cells nurture the lymphocyte stem cells and provide chemical signals that initiate B-cell development – B cells circulate through the blood, “homing” to specific sites in lymph nodes, spleen, and GALT – Adhere to specific binding molecules where they come into contact with antigens Specific Events in T-Cell Maturation • Directed by the thymus gland and its hormones • Mature T lymphocytes express either CD4 or CD8 coreceptors – CD4 binds to MHC class II, expressed on T helper cells – CD8 binds to MHC class I, found on cytotoxic T cells • Constantly circulate between the lymphatic and general circulatory system, migrating to specific T-cell areas of the lymph nodes and spleen Entrance and Processing of Antigens and Clonal Selection • Antigen (Ag): a substance that provokes an immune response in specific lymphocytes • Antigenicity: the property of behaving as an antigen • Immonogen: another term for an antigen • Characteristics of Antigens – It is perceived as foreign – Complex molecules are more immunogenic – Categories • • • • • Proteins and polypeptides Lipoproteins Glycoproteins Nucleoproteins Polysaccharides Figure 15.7 Effects of Molecular Shape and Size • Substance must be large enough to initiate an immune response from the surveillance cells • Lymphocyte recognizes and responds to only a portion of the antigen molecule- the epitope • Mosaic antigens- very complex with numerous component parts, each of which elicit a separate lymphocyte response • Haptens: small foreign molecules that consist of only a determinant group – Too small to elicit an immune response on their own – If linked to a larger carrier molecule, then the combination develops immunogenicity Figure 15.8 Other Types of Antigens • Alloantigens: cell surface markers and molecules that occur in some members of the same species but not in others • Superantigens: bacterial toxins, potent stimuli for T cells • Allergens: antigens that evoke allergic reactions 15.4 Cooperation in Immune Reactions to Antigens • The Role of Antigen Processing and Presentation – Antigen-presenting cells (APCs): cells that act upon and formally present antigens to lymphocytes • Macrophages • B cells • Dendritic cells – Engulf the antigen and modify it so it is more immunogenic and recognizable – After processing, the antigen is bound to the MHC receptor and moved to the surface of the APC so it is accessible to T lymphocytes Figure 15.9 Presentation of Antigen to the Lymphocytes and Its Early Consequence • APCs activate CD4 T helper cells in the lymph nodes – This class of T cell has an antigen-specific T-cell receptor • Binds to MHC class II • Binds to a piece of the antigen • Binds to a piece of the CD4 molecule (which also binds to MHC class II) • Once identification has occurred, a molecule on the APC activates the T helper cell • TH produces interleukin-2 (IL-2) • The T helper cells can now help activate B cells 15.5 B-Cell Response • Activation of B Lymphocytes: Clonal Expansion and Antibody Production – Clonal selection and binding of antigen – Antigen processing and presentation – B-cell/T-cell recognition and cooperation – B-cell activation – Clonal expansion – Antibody production and secretion Figure 15.10 The Structure of Immunoglobulins Figure 15.11 Antibody-Antigen Interactions and the Function of the FAb Figure 15.12 Principal Activity of an Antibody Figure 15.13 Functions of the Fc Fragment • Fc end contains an effector protein that can bind to receptors on the membranes of cells • The effect of this binding depends upon that cell’s role Classes of Immunoglobulins Evidence of Antibodies in Serum Figure 15.14 Monitoring Antibody Production over Time: Primary and Secondary Response to Antigens Figure 15.15 15.6 T-Cell Response • Cell-Mediated Immunity (CMI) – Require the direct involvement of T lymphocytes throughout the course of the reaction – T cells require some type of MHC recognition before they can be activated – T cells stimulate other T cells, B cells, and phagocytes The Activation of T Cells and Their Differentiation into Subsets • Mature T cells in lymphoid organs are primed to react with antigens that have been processed and presented to them by dendritic cells and macrophages • Recognize an antigen only when it is presented in association with an MHC carrier • CD4 receptors recognize endocytosed peptides on MHC-II • CD8 receptors recognize peptides on MHC-I • T cell is sensitized when an antigen/MHC complex is bound to its receptors • The activated T cells then transform in preparation for mitotic divisions and differentiate into one of the subsets T Helper (TH) Cells • Play a central role in regulating immune reactions to antigens • Also involved in activating macrophages – Directly by receptor contact – Indirectly by releasing cytokines like interferon gamma • Secrete interleukin-2 – Stimulates the primary growth and activation of many types of T cells • Some secrete interleukins-4, -5, and -6 – Stimulate various activities of B cells • When stimulated by antigen/MCH complex, differentiate into either TH1 or TH2 cells Cytotoxic T (TC) Cells: Cells that Kill Other Cells • Cytotoxicity: the capacity of certain T cells to kill a specific target cell • CD8 killer T cell becomes activated when it recognizes a foreign peptide complexed with self MHC-I presented to it • After activation the TC cell severely injures the target cell – This involves the secretion of perforins and granzymes • Target cells that TC cells can destroy include: – Virally infected cells – Cancer cells – Cells from other animals and humans Figure 15.16 Figure 15.17 Other Types of Killer Cells • Natural killer (NK) cells – Related to T cells – Lack specificity for antigens – Circulate through the spleen, blood, and lungs – Probably the first killer cells to attack cancer cells and virus-infected cells 15.7 A Practical Scheme for Classifying Specific Immunities • • • • Active Immunity Passive Immunity Natural Immunity Artificial Immunity Figure 15.18 15.8 Immunization: Methods of Manipulating Immunity for Therapeutic Purposes • Passive Immunization – Immune serum globulin – Specific immune globulin – Antisera and antitoxins of animal origin • Artificial Active Immunity: Vaccination Immune Serum Globulin (ISG), aka Gamma Globulin • Contains immunoglobulin extracted from the pooled blood of at least 1,000 human donors • Processing concentrates the antibodies to increase potency and eliminates potential pathogens • Method of choice for preventing measles and hepatitis A and in replacing antibodies in immunodeficient patients • Injected intramuscularly • Protection lasts 2-3 months Specific Immune Globulin (ISG) • Derived from a more defined group of donors • Serum is obtained from patients who are in a hyperimmune state after infections (ex. pertussis, tetanus, chickenpox, hepatitis B) • Contain higher titers of specific antibodies from a smaller pool of patients than ISG Antisera and Antitoxins of Animal Origin • Can be used when a human immune globulin is not available • Example: sera produced in horses for diphtheria, botulism, and spider and snake bites Artificial Active Immunity: Vaccination • Vaccination: exposing a person to material that is antigenic but not pathogenic • Stimulate a primary and secondary anamnestic response to prime the immune system for future exposure to a virulent pathogen Principles of Vaccine Preparation Figure 15.19 Development of New Vaccines • Difficult to design vaccines for latent or persistent viral infections – Host’s natural immunity can’t clear the infection – Artificial immunity must then outperform the host’s response to a natural infection • Difficult to choose vaccine antigens that are safe and that properly stimulate immunity • Research focused on newer strategies for vaccine preparation using antigen synthesis, recombinant DNA, and gene cloning technology Genetically Engineered Vaccines • Recombinant DNA technology • Trojan horse vaccine – Genetic material from an infectious agent is inserted into a live carrier microbe that is nonpathogenic – The recombinant microbe multiplies and expresses the foreign genes – The vaccine recipient will be immunized against the microbial antigens • DNA vaccines Figure 15.20 Route of Administration and Side Effects of Vaccines • Most vaccines are injected by subcutaneous, intramuscular, or intradermal routes • Only a few oral vaccines available, even though they have advantages • Some vaccines required the addition of an adjuvant • Common side effects – Local reactions at the injection site – Fever – Allergies • Some patients experience reactions to the medium rather than the antigens To Vaccinate: Why, Whom, and When? • Not only confers protection to the individual receiving the vaccine, but it also protects public heath • Herd immunity – Collective immunity through mass immunization confers indirect protection on the nonimmune members – Important force in preventing epidemics