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Chapter 22: The Lymphatic System and Immunity
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Three Parts or Sections
Lymphatics in general Innate or nonspecific immunity Adaptive or specific/memory immunity 2/18/2009
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Immunity or Resistance
Ability to ward off damage or disease through our defenses 2 types of immunity Innate or nonspecific immunity – present at birth No specific recognition of invaders, no memory component 1st and 2nd line of defenses Adaptive or specific immunity Specific recognition of invaders with a memory component 2/18/2009
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Lack of resistance is also known as:
Pathogenic Innate Specific Susceptibility Lymphatic 2/18/2009
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I. Lymphatic system structure and function
Consists of lymph, lymphatic vessels, structures and organs containing lymphatic tissue, red bone marrow Functions of the lymphatic system Drain excess interstitial fluid Transport dietary lipid and lipid soluble vitamins (K, E, D, and A) Carry our immune responses 2/18/2009
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Which of the following is not a function of the lymphatic and immune system?
Draining excess interstitial fluid Maintaining water homeostasis in the body Transporting dietary lipids Carrying out immune responses 2/18/2009
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What is the major difference between lymph and interstitial fluid?
Composition of electrolytes White blood cells are present in lymph Location Types of proteins present Red blood cells are present in interstitial fluid 2/18/2009
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Components of the Lymphatic System
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Lymphatic vessels and lymph circulation
Vessels begin as lymphatic capillaries Closed at one end Unite to form large lymphatic vessels Resemble veins in structure but thinner walls and more valves Passes through lymph nodes Encapsulated organs with aggregates of B and T cells Lymphatic capillaries are found throughout the body except in avascular tissue, the CNS, portions of the spleen, and red bone marrow. 2/18/2009
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Lymphatic capillaries
Slightly large diameter that blood capillaries Unique one-way structure Permits interstitial fluid to flow in but not out Anchoring filaments pull openings wider when interstitial fluid accumulates Small intestine has lacteal for dietary lipid uptake Chyle is lymph with lipids 2/18/2009
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What causes lymph from the small intestines to appear white?
Proteins WBC RBC Lipids Fats This is known as ________________. 2/18/2009
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Lymphatic Capillaries
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Describe how lymphatic capillaries are one-way only vessels.
Ans: The ends of the endothelial cells in the wall of the lymphatic capillary overlap. When pressure is higher in the interstitial fluid than in the lymph, the cells separate slightly allowing interstitial fluid into the vessel. When pressure is greater inside, the cells are tightly packed, not allowing the lymph to cross back into the interstitial fluid. 2/18/2009
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Lymph trunks and ducts Vessels unite to form lymph trunks
Principal trunks are the lumbar, intestinal, bronchomediastinal, subclavian and jugular Passes from lymph trunks into 2 main channels (thoracic and right lymphatic ducts) before draining into venous blood (subclavian veins) 2/18/2009
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Routes for drainage of lymph
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The left subclavian vein receives lymph from
Left axillary vein Lumbar trunk Jugular trunk Thoracic duct Right lymphatic duct 2/18/2009
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Formation and flow of lymph – Starling’s Law
More fluid filters out of blood capillaries than returns to them by reabsorption Excess filtered fluid – about 3L/day – drains into lymphatic vessels and become lymph Important function of lymphatic vessels to return lost plasma proteins to blood stream Contain valves Same 2 “pumps” aiding venous return also used Skeletal muscle pump – milking action Respiratory pump – pressure changes during breathing 2/18/2009
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What is/are important function(s) of the lymphatics?
Drain excess interstitial fluid Transport dietary lipid Carry our immune responses Important function of lymphatic vessels to return lost plasma proteins to blood stream 2/18/2009
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How is lymph moved? Valves Skeletal muscle pump Respiratory pump
Venoconstriction 2/18/2009
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The skeletal muscle and respiratory pumps are used in
Lymphatic system Cardiovascular system Immune system Lymphatic and Immune systems only Lymphatic, Immune and Cardiovascular systems 2/18/2009
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85% of interstitial fluid is reabsorbed by the capillaries.
Define Starlings Law: More fluid filters out of blood capillaries than returns to them by reabsorption Excess filtered fluid – about 3L/day – drains into lymphatic vessels and become lymph 85% of interstitial fluid is reabsorbed by the capillaries. 2/18/2009
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The lymph from the right foot empties into the
Left axillary vein Lumbar trunk Jugular trunk Thoracic duct Right lymphatic duct 2/18/2009
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Describe how edema can form.
Ans: Edema can form by obstruction to lymph flow or increased capillary blood pressure causing interstitial fluid to form faster than it is reabsorbed. 2/18/2009
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Relationship of the Lymphatic System to the Cardiovascular System
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Lymphatic tissues and organs
2 groups based on function Primary lymphatic organs Sites where stem cells divide and become immunocompetent Red bone marrow and thymus Secondary lymphatic organs Sites where most immune response occurs Lymph nodes, spleen, lymphatic nodules 2/18/2009
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Define primary lymphatic organ: List primary lymphatic organs:
Sites where stem cells divide and become immunocompetent List primary lymphatic organs: Red bone marrow and thymus Define secondary lymphatic organ: Sites where most immune response occurs List secondary lymphatic organs: Lymph nodes, spleen, lymphatic nodules 2/18/2009
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Thymus Thymus Outer cortex composed of large number of T cells Medulla
Immature T cells migrate here from red bone marrow where they proliferate and begin to mature - THYMOSIN Dendritic cells derived from monocytes assist in T cell maturation Specialized epithelial cells help educate T cells through positive selection – only about 25% survive – HASSALLS CORPUSCLES Macrophages clear out dead and dying cells Medulla More mature T cells migrate here from cortex More epithelial cells, dendritic cells and macrophages Thymus shrinks with age from 70g in infants to 3g in old age 2/18/2009
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Thymus 2/18/2009
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Which of the below produces the hormone that promotes maturation of T cells?
Spleen Lymph node Red bone marrow Thymus Pancreas What is the hormone? 2/18/2009
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In the thymus, where is it speculated that T cells die?
Capsule Trabeculae Epithelial cells Hassall’s corpuscles T cells do not die in the thymus 2/18/2009
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Lymph nodes Located along lymphatic vessels Scattered throughout body
Stroma – supporting connective tissue Capsule, trabeculae, reticular fibers and fibroblasts Parenchyma – functional part Outer cortex – aggregates of B cells called lymphatic nodules (follicles) – site of plasma cell and memory B cell formation Inner cortex – mainly T cells and dendritic cells Medulla – B cells, antibody producing plasma cells from cortex, and macrophages; some follicles 2/18/2009
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Structure of a Lymph Node
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This portion of the lymph node does not contain any lymphatic nodules.
Inner cortex Outer cortex Medulla Sinuses Trabeculae 2/18/2009
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Lymph Lymph flows through a node in 1 direction only
Enters through afferent lymphatic vessels Directs lymph inward Lymph enters sinuses (irregular channels) Into medulla Medullary sinuses drain into efferent lymphatic vessels Conveys lymph, antibodies and activated T cells out of the node Lymph nodes function as a filter Foreign substances trapped Destroyed by macrophages or immune response of lymphocytes 2/18/2009
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Spleen Largest single mass of lymphatic tissue in the body
Stroma – capsule, trabeculae, reticular fibers, and fibroblasts Parenchyma White pulp – lymphatic tissue (lymphocytes and macrophages) B cells and T cells carry out immune function Red pulp 2/18/2009
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Red Pulp Red pulp – blood-filled venous sinuses and splenic (Bilroth’s) cords – red blood cells, macrophages, lymphocytes, plasma cells, and granulocytes Macrophages remove ruptured, worn out or defective blood cells Storage of up to 1/3 of body’s platelet supply Production of blood cells during fetal life 2/18/2009
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Structure of the Spleen
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Which of the following is a function of the spleen?
Removes worn out blood cells Circulates lymph Cleanses interstitial fluid Cleanses lymph Traps microbes with mucus List the other functions of the spleen. (Don’t forget white pulp!) 2/18/2009
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Lymphatic nodules Not surrounded by a capsule
Scattered throughout lamina propria of mucous membranes lining GI, urinary, reproductive tract Mucosa-associated lymphatic tissue (MALT) Most small and solitary Some larger – tonsils, Peyer’s patches, appendix 2/18/2009
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What is a lymphatic nodule? List sites of lymphatic nodules:
Not surrounded by a capsule List sites of lymphatic nodules: Scattered throughout lamina propria of mucous membranes lining GI, urinary, reproductive tract What is MALT? Mucosa-associated lymphatic tissue (MALT) List the large or prominent lymphatic nodules: Some larger – tonsils, Peyer’s patches, appendix 2/18/2009
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II. Innate immunity First line of defenses: Skin and mucous membranes
Provide both physical and chemical barriers Physical barriers Epidermis – closely packed, keratinized cells Periodic shedding Mucous membranes Mucus traps microbes and foreign substances Nose hairs trap and filter Cilia of upper respiratory tract propel trapped particles up and out 2/18/2009
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Innate Immunity Fluids Chemicals Lacrimal apparatus of eye
Washing action of tears Lysozyme breaks down bacterial cell walls – also present in saliva, perspiration, nasal secretions, and tissue fluids Saliva washes mouth Urine cleanses urinary system Vaginal secretions, defecation and vomiting Chemicals Sebaceous (oil) glands secrete sebum – protective film, acid Perspiration, gastric juice, vaginal secretions – all acidic 2/18/2009
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Second line of defenses: Internal defenses
Antimicrobial substances Interferons Produced by lymphocytes, macrophages, and fibroblasts infected by viruses Prevents replication in neighboring uninfected cells Complement Proteins in blood plasma and plasma membranes “complement” or enhance certain immune reactions Causes cytolysis of microbes, promotes phagocytosis, contributes to inflammation 2/18/2009
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These anti-microbial substances promote cytolysis, phagocytosis and inflammation.
Transferrins Perforins Complement proteins Defensins Interferons 2/18/2009
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Which of these does NOT provide a physical or chemical barrier?
Macrophages Saliva Urine Mucus Stratified squamous epithelium 2/18/2009
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Describe the barriers used in innate defense.
Ans: Barriers used by the innate defense include epidermis, mucus, hairs, cilia, lacrimal apparatus, saliva, urine, vaginal secretions, sebum, perspiration and gastric juices. 2/18/2009
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These anti-microbial substances will diffuse to uninfected cells and reduce production of viral proteins. Transferrins Perforins Complement proteins Defensins Interferons 2/18/2009
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Internal Defenses Iron-binding proteins Antimicrobial proteins (AMPs)
Inhibit growth of bacteria by reducing available iron Antimicrobial proteins (AMPs) Short peptides that have a broad spectrum of antimicrobial activity Can attract dendritic cells and mast cells that participate in immune responses 2/18/2009
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Internal Defenses Natural Killer (NK) cells Phagocytes
Lymphocyte but not a B or T cell Ability to kill wide variety of infected body cells and certain tumor cells Attack any body cell displaying abnormal or unusual plasma membrane proteins Can release perforin (makes perforations) or granzymes (induce apoptosis) Phagocytes Neutrophils and macrophages (from monocytes) Migrate to infected area 5 steps in phagocytosis 2/18/2009
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Phagocytosis of a microbe
1 Microbe CHEMOTAXIS Lysosome Digestive enzymes Pseudopod Phagocyte ADHERENCE INGESTION Plasma membrane DIGESTION KILLING Residual body (indigestible material) Digested microbe in phagolysosome 2 3 4 5 Phases of phagocytosis 1 Microbe CHEMOTAXIS Phagocyte Phases of phagocytosis 1 Microbe CHEMOTAXIS Lysosome Digestive enzymes Pseudopod Phagocyte ADHERENCE INGESTION Plasma membrane DIGESTION 2 3 4 Phases of phagocytosis 1 Microbe CHEMOTAXIS Lysosome Pseudopod Phagocyte ADHERENCE INGESTION 2 3 Phases of phagocytosis 1 Phases of phagocytosis Microbe CHEMOTAXIS Pseudopod Phagocyte ADHERENCE 2 2/18/2009
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These are mainly used to kill infectious microbes and tumor cells.
Natural killer cells Perforins platelets Mucus Antimicrobial proteins 2/18/2009
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Which of these provides a non-specific cellular disease resistance mechanism?
Macrophages T lymphocytes B lymphocytes Memory B cells Stratified squamous epithelium 2/18/2009
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Inflammation Nonspecific, defensive response of body to tissue damage
4 signs and symptoms – redness, pain, heat and swelling Attempt to dispose of microbes, prevent spread, and prepare site for tissue repair 3 basic stages Vasodilation and increased blood vessel permeability Emigration Tissue repair 2/18/2009
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Vasodilation and increased permeability of blood vessels
Increased diameter of arterioles allows more blood flow through area bringing supplies and removing debris Increased permeability means substances normally retained in the blood are permitted to pass out – antibodies and clotting factors Histamine, kinins, prostaglandins (PGs), leukotrienes (LTs), complement 2/18/2009
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Emigration of phagocytes
Depends on chemotaxis Neutrophils predominate in early stages but die off quickly Monocytes transform into macrophages More potent than neutrophils Pus – pocket of dead phagocytes and damaged tissue 2/18/2009
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Which of the following is NOT a sign of inflammation?
Redness Pain Heat Mucus production Swelling 2/18/2009
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Which of the following intensifies the effect of interferons and promotes the rate of repair?
Complement proteins Perforin Fever Macrophages Natural killer cells 2/18/2009
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Which of the below do NOT induce vasodilation and permeability (increased fluid flow to an infection site. Histamines Kinins Perforin Leukotrienes Complement 2/18/2009
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III. Adaptive immunity Ability of the body to defend itself against specific invading agents Antigens (Ags) – substances recognized as foreign and provoking an immune response Distinguished from innate immunity by Specificity Memory 2/18/2009
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This induces production of a specific antibody.
Phagocytosis Antigen Antibody Defensin Imunnoglobulin 2/18/2009
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2 types of adaptive immunity
Cell-mediated Cytotoxic T cells ( CD 8 or T8) directly attack invading antigens Particularly effective against intracellular pathogens, some cancer cells and foreign tissue transplants Antibody-mediated B cells transform into plasma cells making antibodies (Abs) or immunoglobulins Works against extracellular pathogens in fluids outside cells Helper T cells ( CD4 or T4) aid in both types 2 types of immunity work together 2/18/2009
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Maturation of T cells and B cells
Both develop from pluripotent stem cells originating in red bone marrow B cells complete their development in red bone marrow T cells develop from pre-T cells that migrate from red bone marrow to the thymus Helper T cells (CD4 T cells) and cytotoxic T cells (CD8 T cells) Immunocompetence – ability to carry out adaptive immune response Have antigen receptors to identify specific antigen 2/18/2009
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When B and T cells are fully developed and mature, they are known to be
Immunocompetent Pluripotent stem cells Primary lymphatic cells Specifically promoted Germ cells 2/18/2009
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Cell-mediated and antibody-mediated immunity
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Clonal selection Process by which a lymphocyte proliferates and differentiates in response to a specific antigen Clone – population of identical cells all recognizing the same antigen as original cell Lymphocyte undergoes clonal selection to produce Effector cell – active helper T cell, active cytotoxic T cell, plasma cell, die after immune response Memory cell – do not participate in initial immune response, respond to 2nd invasion by proliferating and differentiating into more effector and memory cells, long life spans 2/18/2009
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Antigens Antigens have 2 characteristics
Immunogenicity – ability to provoke immune response Reactivity – ability of antigen to react specifically with antibodies it provoked Entire microbes may act as antigen Typically, just certain small parts of large antigen molecule triggers response (epitope or antigenic determinant) 2/18/2009
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This can only stimulate an immune response if attached to a large carrier molecule.
Epitope Antigen Hapten MHC CD8 2/18/2009
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Diversity of antigen receptors
Human immune system able to recognize and bind to at least a billion different epitopes Result of genetic recombination – shuffling and rearranging of a few hundred versions of several small gene segments Major Histocompatibility Complex Antigens MHC or human leukocyte antigens (HLA) Normal function to help T cells recognize foreign or self Class I MHC (MHC-I) – built into all body cells except RBCs Class II MHC (MHC-II) – only on antigen presenting cells 2/18/2009
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Pathways of antigen processing
B cells can recognize and bind to antigens T cells must be presented with processed antigens Antigenic proteins are broken down into peptide fragments and associated with MHC molecules Antigen presentation – antigen-MHC complex inserted into plasma membrane Pathway depends on whether antigen is outside or inside body cells 2/18/2009
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Which of the following is responsible for diversity in the immune system?
Antigen receptors MHC Hapten MHC and antigen receptors Epitopes 2/18/2009
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Exogenous and Endogenous Antigens
Exogenous antigens – present in fluid outside body cells Antigen-presenting cells (APCs) include dendritic cells, macrophages and B cells Ingest antigen, process, place next to MHC-II molecule in plasma membrane, and present to T cells Endogenous antigens – antigens inside body cells Infected cell displays antigen next to MHC-I 2/18/2009
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This class of cells includes macrophages, B cells and dendritic cells.
Antigen presenting cells Primary lymphocytes T cells RBC Epitope cells 2/18/2009
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Exogenous Antigens Phagocytosis or endocytosis of antigen Digestion of
antigen into peptide fragments Antigen peptide fragments bind to MHC-II molecules Phagosome or endosome APCs present exogenous antigens in association with MHC-II molecules Antigen- presenting cell (APC) Vesicles containing antigen peptide fragments and MHC-II molecules fuse Packaging of MHC-II molecules into a vesicle Synthesis of MHC-II molecules MHC-II self-antigen Antigen peptide fragments Key: Endoplasmic reticulum 1 5 6 4 3 2 Exogenous Phagocytosis or endocytosis of antigen Digestion of antigen into peptide fragments Antigen peptide fragments bind to MHC-II molecules Phagosome or endosome APCs present exogenous antigens in association with MHC-II molecules Antigen- presenting cell (APC) Vesicles containing antigen peptide fragments and MHC-II molecules fuse Packaging of MHC-II molecules into a vesicle Synthesis of MHC-II molecules MHC-II self-antigen Antigen peptide fragments Key: Endoplasmic reticulum Vesicle undergoes exocytosis and antigen–MHC-II complexes are inserted into plasma membrane 1 5 6 7 4 3 2 Exogenous Phagocytosis or endocytosis of antigen APCs present exogenous antigens in association with MHC-II molecules Antigen- presenting cell (APC) MHC-II self-antigen Antigen peptide fragments Key: Exogenous 1 Phagocytosis or endocytosis of antigen Digestion of antigen into peptide fragments Phagosome or endosome APCs present exogenous antigens in association with MHC-II molecules Antigen- presenting cell (APC) Vesicles containing antigen peptide fragments and MHC-II molecules fuse Packaging of MHC-II molecules into a vesicle Synthesis of MHC-II molecules MHC-II self-antigen Antigen peptide fragments Key: Endoplasmic reticulum 1 5 4 3 2 Exogenous Phagocytosis or endocytosis of antigen Digestion of antigen into peptide fragments Phagosome or endosome APCs present exogenous antigens in association with MHC-II molecules Antigen- presenting cell (APC) MHC-II self-antigen Antigen peptide fragments Key: 1 2 Exogenous Phagocytosis or endocytosis of antigen Digestion of antigen into peptide fragments Phagosome or endosome APCs present exogenous antigens in association with MHC-II molecules Antigen- presenting cell (APC) Synthesis of MHC-II molecules MHC-II self-antigen Antigen peptide fragments Key: Endoplasmic reticulum 1 3 2 Exogenous Phagocytosis or endocytosis of antigen Digestion of antigen into peptide fragments Phagosome or endosome APCs present exogenous antigens in association with MHC-II molecules Antigen- presenting cell (APC) Packaging of MHC-II molecules into a vesicle Synthesis of MHC-II molecules MHC-II self-antigen Antigen peptide fragments Key: Endoplasmic reticulum 1 4 3 2 Exogenous 2/18/2009
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Endogenous Antigens 2/18/2009
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Cell-mediated immunity
Activation of T cells First signal in activation T-cell receptors (TCRs) recognize and bind to a specific foreign antigen fragments that are presented in antigen-MHC complexes CD4 and CD8 proteins are coreceptors Second signal required for activation Costimulation – 20 known substances (cytokines, plasma membrane molecules) May prevent immune response from occurring accidentally Anergy – recognition without costimulation (in both B and T cells) leads to prolonged state of inactivity 2/18/2009
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This can only become activated when bound to a foreign antigen and simultaneously receiving costimulation. B Cell T Cell Interferon MHC Antigen presenting cell 2/18/2009
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Activation and clonal selection of helper T cells
Most that display CD4 develop into helper T cells (CD4 T cells) Recognize exogenous antigen fragments associated with MHC-II molecules on the surface of an APC After activation undergoes clonal selection Makes active helper T cells and memory helper T cells Active helper T cells secrete variety of cytokines Interleukin-2 (IL-2) needed for virtually all immune responses Memory helper T cells are not active cells – can quickly proliferate and differentiate if the antigen appears again 2/18/2009
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These display CD 4 in their membrane and are associated with MHC class II molecules.
Cytotoxic T cells Helper T Cells Memory T Cells MHC B cells 2/18/2009
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Activation and clonal selection of a helper T cell
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Activation and clonal selection of cytotoxic T cells
Most that display CD8 develop into cytotoxic T cells (CD8 T cells) Recognize antigens combined with MHC-I Maximal activation also requires presentation of antigen with MHC-II to cause helper T cells to produce IL-2 Undergoes clonal selection Active cytotoxic T cells attack body cells Memory cytotoxic T cells do not attack but wait for a antigen to appear again 2/18/2009
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Activation and clonal selection of a cytoxic T cell
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Elimination of invaders
Cytotoxic T cells migrate to seek out and destroy infected target cells Kill like natural killer cells Major difference is T cells have specific receptor for particular microbe while NK cells destroy a wide variety of microbe-infected cells 2 ways to kill cells Granzymes cause apoptosis Perforin and/ or granulysin causes cytolysis Immunological surveillance Tumor antigens displayed on cancerous cells targeted by cytotoxic T cells, macrophages and natural killer cells 2/18/2009
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Activity of cytoxic T cells
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Antibody-mediated immunity
Activation and clonal selection of B cells During activation, antigen binds to B cell receptor (BCRs) Can respond to unprocessed antigen Response much more intense when B cell processes antigen Antigen taken into B cell, combined with MHC-II, moved to plasma membrane, helper T cell binds and delivers costimulation (interleukin-2 and other cytokines) B cell undergoes clonal selection Plasma cells secrete antibodies Memory B cells do not secrete antibodies but wait for reappearance of antigen 2/18/2009
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Activation and clonal selection of B cells
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Antibodies (Ab) Can combine specifically with epitope of the antigen that triggered its production Belong to group of glycoproteins called globulins Ab are immunoglobulins (Igs) 4 polypeptide chains – 2 heavy (H) chains, 2 light (L) chains Hinge region – antibody can be T shape or Y shape Variable (V) region at tips of each H and L chain 2 antigen-binding sites - bivalent Constant (C) region – remainder of H and L chain Same in each 5 classes – determines type of reaction 2/18/2009
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Chemical structure of the immunoglobin (IgG) class of antibody
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Antibody actions Neutralizing antigen Immobilizing bacteria
Agglutinating and precipitating antigen Enhancing phagocytosis Activating complement Defensive system of over 30 proteins Destroy microbes by causing phagocytosis, cytolysis, and inflammation Acts in a cascade – one reaction triggers another Activate C3 C3 then begins cascade that brings about phagocytosis, cytolysis, and inflammation 2/18/2009
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Immunological memory Thousands of memory cells exist after initial encounter with an antigen Next time antigen appears can proliferate and differentiate within hours Antibody titer measure of immunological memory Amount of Ab in serum Primary response Secondary response faster and stronger 2/18/2009
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List the five actions of antibodies.
Ans: Antibodies can act as a neutralizing agent, they can immobilize bacteria, agglutinate and precipitate the antigen, activate the complement and enhance phagocytosis. 2/18/2009
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This class of antibodies is mainly found in sweat, tears, breast milk and GI secretions.
IgG IgA IgM IgD IgE 2/18/2009
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This will lead to inflammation, enhancement of phagocytosis and bursting of microbes.
Classical complement system Alternative complement system Apoptosis Classical and Alternative complement systems Hapten activation 2/18/2009
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This action makes microbes more susceptible to phagocytosis.
Opsonization Cytolysis Inflammation Complement Hybridoma 2/18/2009
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Self-recognition and self-tolerance
Your T cells must have Self-recognition – be able to recognize your own MHC Self-tolerance – lack reactivity to peptide fragments from your own proteins Pre-T cells in thymus develop self-recognition via positive selection – cells that can’t recognize your own MHC undergo apoptosis Self-tolerance occurs through negative selection in which T and B cells that recognize self peptide fragments are eliminated Deletion – undergo apoptosis Anergy – remain alive but are unresponsive 2/18/2009
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This is a self-responsive cell that is inactive.
Deleted cell Hybridoma cell Epitopic cell Anergy cell Natural killer cell 2/18/2009
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This is characterized by the inability of the immune system to protect the body from a pathogen.
immunodeficiency diseases allergy autoimmune disease transplantations graft
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A natural exposure to an infectious agent leads to:
A. Passive immunity B. Active immunity Both a and b None of the above 2/18/2009
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This class of antibodies is produced after an initial exposure to antigens.
IgA IgE IgM IgD IgG 2/18/2009
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Of the following which is considered the body’s second major defense.
Mucous cells Germ cells Lymphocytes Natural killer cells None of the above 2/18/2009
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An acute allergic response can lead to:
transplantation retroviruses anaphylactic shock passive immunity active immunity 2/18/2009
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This is a small hormone that can stimulate or inhibit many normal cell functions.
Enzyme Kinins Cytokine MHC Leukocyte 2/18/2009
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DISORDERS: HOMEOSTATIC IMBALANCES
Discuss AIDS in terms of epidemiology, pathogenesis of the HIV virus, signs and symptoms, progression to AIDS, and treatment. Discuss the basic types of allergic reactions. Discuss the causes and symptoms of infectious mononucleosis. Discuss the causes and treatments of autoimmune diseases. Discuss the two basic types of lymphomas. Discuss the causes and treatments of systemic lupus erythematosus. 2/18/2009
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End of Chapter 22 Copyright 2009 John Wiley & Sons, Inc. All rights reserved. Reproduction or translation of this work beyond that permitted in section 117 of the 1976 United States Copyright Act without express permission of the copyright owner is unlawful. Request for further information should be addressed to the Permission Department, John Wiley & Sons, Inc. The purchaser may make back-up copies for his/her own use only and not for distribution or resale. The Publishers assumes no responsibility for errors, omissions, or damages caused by the use of theses programs or from the use of the information herein. 2/18/2009
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