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 Reading & Goal
‡ Read Chapter 1, Abbas & Lichtman: ã


  
 

 

; Saunders, 2nd Editions 2004
± If you have1st Edition 2001 that is o.k.
‡ Or Chapter 1, Immunology A Short Course,
Benjamini et al

‡ The goal of this lecture is to introduce to you some of

the subjects studied under the umbrella of
Immunology. It is not meant to teach you the whole
Immunology in one hour
 Öhy immunology for pharmacists?
‡ Pharmacists as healthcare providers must
understand the human body and what keeps it
healthy and what causes its disease
‡ Pharmacists might provide vaccines. Therefore you
must know how immunization works
‡ Immunology helps understand mechanisms of
action of some drugs such as:
± monoclonal antibodies
± cytokine analogs or antagonists
± immunosuppressants
± immune modulating drugs
 Overview of the Immune System
1. Innate immunity
2. Adaptive immunity:
1. Humoral and
2. cell-mediated immunity
3. Properties of adaptive immunity:
1. Specificity and
2. memory
4. Phases of the immune response
5. Cells of the immune system: Lymphocytes, antigen-
presenting cells, effector cells
6. Tissues and organs of the immune system: Peripheral
lymphoid organs, lymphocyte circulation
 Learning Objectives
1. Know the protective role of the immune system
2. Differentiate between the !"#
$!% and the
 
3. Know the fundamental role of the discrimination between
! in the work of the immune system
4. Know the major branches of the immune system: the
  and the
 !! immune response
5. Have an idea about the benefits and the harmful effects of
the immune system
6. Recognize 

  as a basis of the
! of the immune response
7. Know that the immune system is usually ! up
and down
 Protective role of the immune system
‡ Immune system evolved to protect us against:
± Intra- and extracellular 


± &
: K
 intracellular
± o
: Extracellular
± 
: Some unicellular protozoa such
as malarial parasites, „

  species, are
intracellular but most are large, extracellular and even
lumen dweller
± Malignant cells
‡ Intracellular pathogens live inside host¶s (patient¶s)
cells
‡ Extracellular pathogens live outside host¶s cells
 Innate Immunity
‡ Synonyms:
± Natural
± None-adaptive
± Nonspecific
‡ Cells involved:
± All white blood cells except B and T lymphocytes
± Phagocytes
‡ Monocytes (mono[á
  ]cytes)/macrophages
‡ PMN (polymorphonuclear) neutrophils
± Natural killer (NK) cells
‡ Humoral or soluble components
± Complement system
‡ Exterior defenses
± Skin, Stomach acidity, Mucus, Cilia, Microflora, Lysozyme in
tears, Flushing of urinary tract by urination
Exterior Innate Defenses
 Adaptive (Acquired) Immunity
‡ Develops " to microorganisms and
other  (Ags)
‡ ' 
± Improves after each encounter with the Ag  has a
 
‡ '! (Abs) = Immunoglobulins (Ig):
± '()(( (
‡ | "
:
± *

± +

 Antibody: A flexible adaptor
‡ Abs specific binding
sites of the o region
bind 's
± As with microbe 1
'
‡ No specific Ag  No
binding
± As with microbe 2 V
C L chain
‡ The o
region of the Ab Papain
binds o

" on H chain
some cells such as
phagocytes
‡ The Ag-Ab complex
can activate the
complement system via
the Fc of the Ab
 Phases of the Immune Response
‡ 
 of Ag:
± Naïve B lymphocytes recognize certain types of Ags
± Naïve T lymphocytes recognize ""! "!'
"
#'
%
± Clonal expansion
‡ '
"
± Differentiation:
‡ B cell  Ab producing cell
‡ T cell  Effector T cell
‡ 
 phase
± Elimination of Ags by:
‡ Humoral immunity
‡ Cell-mediated immunity
‡ 
 (homeostasis)  '""
‡      

 Active & Passive Immunization
‡ '
 immunization
± is acquired in response to Ag administration
‡ All vaccinations
‡  immunization
± acquired through administration of Ab from immunized individual
‡ Hepatitis A
‡ Anti-rabies treatment
‡ Anti-tetanus
‡ '!" transfer:
± Transfer of immunity by transplantation of immunocompetent cells
‡ E.g. bone marrow transplant
 Self and Nonself
‡ Discrimination between self and nonself
Ags is fundamental for the function and
evolution of the immune system
‡ This is the basis of immune response
against pathogens and transplant rejection
‡ Self fanaticism
± Reacting against foreign Ag because it is
foreign
± Not based on beneficial or harmful Ag
 Humoral and Cell-mediated Immunity
‡ '
$!  (soluble) immunity is based on '
made by B cells
‡
 "  and
, may be considered part of
the humoral immunity
‡ '
$!
 !! immunity depends on +
" cells (TH) and
-
+
 (Tc), or
cytolytic T lymphocytes (CTLs)
‡ Other leukocytes are part of the cellular immunity,
including:
± Phagocytes,
± macrophages,
± natural killer cells (NK)
Complement ‡ Complement is a system of  
" that interact with one
Functions another and with other molecules
to generate important effects
 |
‡ The complement system has an
intrinsic ability to  the

  of many bacterial species
.
 -
‡ Complement products released in this
reaction 
"
 to the site
of the reaction
/ "0
‡ Complement components coat the
bacterial surface allowing the
phagocytes to recognize the bacteria
and engulf them
 Cells of the Immune System
‡ Lymphocytes
± T helper cells (TH)
± Cytotoxic T cells (Tc)
± B cells
± NK
‡ PMNs
± Neutrophil
± Basophil & Mast cells
± Eosinophil
‡ Monocytes
± Dendritic cells
± Macrophages

! "
 "
 
#%

Functions of Lymphocytes
 Major histocompatibility complex
(MHC)
‡ MHC is called |'or  
 

‡ Two classes: I & II
‡ Important in " '+ !+



± 
 presents Ag peptides to +

± 
 presents Ag peptides to +
 Cytokines
‡ ""!, synthesized by different cells involved in
the immune system
‡ They are : 
 cells or  cell
functions
‡ Major means of communication among cells of the
immune system and between them and others
‡ Examples:
± ,
‡ IL-2
‡ IL-4
± 
‡ IFNĮ
‡ IFNȖ
 Clonal Selection Theory
1. T and B cells exist with   ! specificities
before any contact with foreign Ags
. '"


"that recognize foreign Ags:
1. Abs are the B cell receptors on the surface of B cell &
2. T-cell receptor (TCR) on T cell
/ 
 "
 has a  "


4. The 
!  ("") on the Ag binds
with lymphocyte (B or T) and triggers their
! and "
1 
 by self Ags  shut off cells that
recognize them during maturation
Clonal Selection

No specialized
receptor

""
.(/(2.
 Benefits of the Immune System
‡ Immunization and defense against
infectious disease
‡ Cancer detection and management
A benefit of immunology (application):
± Organ transplantation and blood
transfusion
 Harmful Effects of the Immune System
‡ Hypersensitivity or allergic reactions:
± Type I, immediate hypersensitivity
± Type II, cytotoxic Ab-mediated reactions
± Type III,immune complex Ab-mediated
± Type IV, delayed-type cell-mediated
‡ Autoimmune diseases
± The immune system attacks body¶s own Ags causing diseases
like rheumatoid arthritis, diabetes mellitus and systemic lupus
erythematosus
‡ Immunodeficiencies
± Occur when one or more components of the immune system fail
to function properly
± This can be result of genetic defect (SCID) or acquired (AIDS)
‡ Graft rejection
± Occurs because of immune response against transplant¶s Ags
 Genetic Recombination & Immune
Response Diversity
‡ 106-107 of antigenic specificities might exist
‡ If 1 gene = 1 response, are 107 genes needed?
± 
‡ )

  ³within ³ a gene that
encodes the Ig proteins is the answer
‡ So, the basic Ab is composed of 2 types of
polypeptides3 
, |
 and each chain
has a
 
á
‡ This mechanism generates Ab & T cell receptor
(TCR) specificity
 Regulation of the immune system
‡ Öhy regulation?
‡ Immune response  proliferation and increased
synthesis of specific molecules that will not be
useful after their job is finished (infection 
response  cure)
‡ Homeostasis or equilibrium must be established
by shutting down the system
‡ Deregulation of the immune system has severe
consequences
‡ Immune response to self Ags  Autoimmunity