IMMUNOLOGY AND SEROLOGY

Definition of Terms

Immune State of being well equipped for fighting against diseases or infections in general

Immunology Study of immunity and its processes

Serology Study of serum and its components particularly those associated with immunity

Antigens, antibodies

Antigen Markers

Foreign: may even induce an immune response – production of antibodies

Can be made up of proteins, carbohydrates, lipids

Antibodies Produced to neutralize foreign antigens

Immunogens Antigens that can induce an immune response

Not all antigens are immunogens but immunogens are all antigens

Immunogenicity Protein antigens → carbohydrates → lipids and amino acids

Division of the Immune System

Innate Immunity Characteristics Adaptive Immunity

Present at birth Birth Not present at birth

Commonly shared microbial structures Specificity Specific antigens

Limited Diversity High

None Memory Yes

Epithelium, mucus Physical Barriers None

Lysozymes, complement, defensins, acute Humoral Factors immunoglobulins

phase reactants, interferons (present in plasma or fluids)

Neutrophils, eosinophils, basophils, mast Cells Lymphocytes (NK cells excluded)

cells, NK cells, monocytes, macrophages

Tall-Like Receptors (TLRs) that recognize Key Features Memory cells - activated; resides in the
Pathogen-Associated Membrane lymph nodes; plays a role in secondary
Polysaccharide (PAMPS) response

Lines of Defense

First Line Second Line Third Line

Intact skin Phagocytic Cells - neutrophils, Lymphocytes - T and B cells; B cells turn
Mucous Membranes macrophages into plasma cells
Lysozymes Inflammation
pH - 5.6 Fever - to fight against pathogens since Antibodies
Cilia - respiratory tract they cannot survive in high temperature Memory Cells - helpful in secondary
Normal Flora response
*Anamnestic response - quick response
*There are normal flora that are of the body because the body recognizes
opportunistic – bacteria, fungi the pathogen already
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INNATE IMMUNITY

Stages of Inflammation

Vascular Response Vascular permeability increases: Dilation of blood vessels - a space will appear between the
endothelial cells so that it can go to the site of infection or the affected site

Cellular Response Margination - movement of cells from the center of blood vessels to the periphery of blood
vessels; will initiate rolling

Rolling - mediated by selectins

Transmigration - movement from blood vessels outwards the tissue

*Adhesion - mediated by integrins

Chemotaxis - cells detect where to go due to chemicals released by bacteria; directed

movement of cells towards the source of the detected chemicals

Opsonization - coating; opsonins coat the foreign substance to mark them for phagocytosis

Phagocytosis - elimination of foreign substances through engulfment

Resolution and Repair Mainly mediated by fibroblasts which are abundant in connective tissues

Three Outcomes
● Complete repair and function is restored
● Formation of abscess with some function loss - happens when there is a high
concentration of WBC at the site; pus also contains metabolites, dead cells of the
infectious agent
*Cold abscess - abscess that does not induce an immune response or inflammation

● Formation of granuloma - happens in chronic infections

*-oma - swelling/tumor

Cardinal Signs of Inflammation

Rubor Redness; due to the dilation of blood vessels → release of cellular components

Calor Heat; to kill infective agents that cannot survive in high temperature

Dolor Pain; localized infection (affected nerves)

Tumor Swelling; presence of increased interstitial fluid

*Edema - increased interstitial fluid

Functio Laessa Loss of function; chronic or damaged already

Antigen Presenting Cells

Antigen Presenting Cells Phagocytize, process, present to T cells

(APCs)

Dendritic Cells Most effective APCs

Natural Killer Cells

Natural Killer Cells (NK Cells) Lymphocytes that kills foreign substances

Neither T or B cells

Do not have CD3 marker that can be seen on most lymphocytes

IMMUNOLOGY AND SEROLOGY
Utilizes granzymes and perforins that are too toxic to cells which may induce lysis to cells
*NK cells target cells that do not possess MHC class I marker
CD16 and CD56: associated with NK cells

Phagocytosis

Initiation Initiated by immune response

Chemotaxis Directed movement

*If there’s no foreign substance present, random movement

Job Syndrome / Hyper IgE Syndrome - impaired chemotaxis

Lazy Leukocyte Syndrome - both chemotaxis and random movement of cells are impaired

Engulfment Phagolysosome - phagosome + lysosome

Digestion Oxygen-dependent - NADPH oxidase, catalase, superoxide dismutase; associated with

respiratory burst

Oxygen-independent - lysozyme, lactoferrin, major basic proteins, defensins

Excretion Excretion of waste

Two Types of Phagocytosis

Direct Phagocytosis Phagocytic cell detect or recognize the foreign substance

Indirect Phagocytosis Mediated by opsonins that coat the foreign substance

Steps in Phagocytosis

● Adherence - adherence of macrophage to foreign substance

● Engulfment ingestion of microbe by phagocyte
-

● Formation of phagosome
● Granule contact
● Formation of phagolysosome
● Digestion OF ingested microbe by enzyme
-

● Excretion of debris discharge OF waste materials

-
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Macrophages in Different Tissues

Liver Kupffer cells

CNS Microglia ( central nervous system )

Bone Osteoclasts

Lungs Dust cells, alveolar macrophages

Placenta Hofbauer cells

Spleen Littoral cells

Synovium Type A lining cells (joints)

Humoral Factors Associated with Innate Immunity

● Lysozymes
● Complement
● Defensins
● Acute Phase Reactants
● Interferons

Acute Phase Reactants

Positive Acute Phase Reactants Negative Acute Phase Reactants

CRP - 1000x during inflammation Albumin - usually present in plasma; vascular permeability
Serum Amyloid A - 1000x during inflammation during infection leads to low albumin levels because plasma is
Ferritin, fibrinogen carried to the site of infection
Hepcidin, haptoglobin
Ceruloplasmin, C3 Transferrin
Mannose-binding protein
PAPR N APR
*Positive Acute Phase Reactants - increase during *Negative Acute Phase Reactants - decrease during
inflammatory response inflammatory response

ADAPTIVE IMMUNITY

Cellular Adaptive Immunity

T Cells Mature in thymus

Positive Selection - T cells expressing TCR (T Cell Receptor/CD3) capable of binding self MHC
survive

Negative Selection - T cells expressing TCR with high affinity for self-antigens undergo
apoptosis; T cells undergo apoptosis

Double Negative - no CD4 and CD8

Double Positive - both CD4 and CD8

Mature - either CD4 and CD8

Mature T Cells Cytotoxic T Cells (CD8+) - kill virus-infected and tumor cells; very helpful against intracellular
pathogens

Helper T Cells (CD4+) - orchestrators of the effector mechanism of the immune system;
mastermind of the immune system
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● Th0
● Th1 - intracellular infections; secrete interferon (IFN) gamma
● Th2 - extracellular infections; secrete IL-4, IL-5
● Th17 - extracellular bacteria and fungi; IL-17, IL-22

T Regulatory Cell - CD25

*Adjuvant - Enhances T and B cells by promoting the accumulation and activation of APCs;
present during inflammation

*Mitogen - stimulates cell division (mitosis)

B Cells Mature in the bone marrow

Specializes in making memory B cells; further differentiate in plasma cells which can produce
antibodies

Self Tolerance - to eliminate self reactive B cells

● Clonal deletion - bone marrow
● Clonal anergy - circulation

Development of B Cells

Bone Marrow Lymphoid Stem Cell

Pro-B cell

Pre-B cell - contain cytoplasmic mu chains

Immature B cell - surface IgM

Circulation Mature B cell - surface IgM and IgD

Activated B cell - must contain CD25

Specialized B Cells Plasma cell - cytoplasmic Ig which is specific for certain antigens

Memory B cell - surface IgA, IgG, IgE

IMMUNIZATION

Toxoid Vaccine Inactivated exotoxins from toxigenic bacteria; introduced to the body to form antibodies against
them

Live Attenuated Vaccine Microorganism that lost its pathogenicity but retained ability to proliferate; non-pathogenic
microorganism

Inactivated or Killed Vaccine Killed microorganisms or inactivated

Types of Immunity

Active Immunity Passive Immunity

Definition Individual forms the antibody Preformed antibody

Natural Recovery from illness Maternal, placental transfusion (through

colostrum)

Artificial Vaccination Rhogam

Hepatitis IgG / IgM