CHAPTER 10
IMMUNITY
International Medical School (IMS)
Learning Outcome
Subtopic 1 : Concept of Immunity
At the end of this subtopic, student will be able to :
1. Define Immunity and differentiate types of immunity.
2. Describe the general structure of antibodies and state the classes based on its structure.
3. Briefly describe roles of lymphoid organs in immunity.
4. Explain the various types of antigen and antibody interactions.
Learning Outcome
Subtopic 2 : Development of Immunity
At the end of this subtopic, student will be able to :
1. State types of adaptive immunity.
2. Explain the mechanisms of humoral and cell mediated immunity againts infection.
3. Briefly Explain the primary and secondary immune responses, transplantation and
diseases related to immune disorder.
What is Immunity
• The ability of the body to fight with foreign antigens
or pathogens that caused disease.
• Immunity can be divided into :
i. Innate Immunity (Non-specific Immunity)
ii. Adaptive Immunity (Specific Immunity)
Innate Immunity
• Innate immunity is non-specific immunity. It does not involve specific recognition of
a microbe and acts against all microbes in the same way
• Innate immunity can be divided into :
First line defense
❖ Include physical and chemical barriers. Example: Skin, mucous membrane, lacrimal
apparatus, urine, saliva, vaginal secretion, sebum, gastric juice etc.
Second Line defense
❖ Include internal antimicrobial substances, phagocytes, natural killer cells,
inflammation and fever.
Adaptive (Acquired) Immunity
• Innate immunity is specific immunity. It involve specific recognition of a microbe
once it has breached the innate immunity defenses. Involved lymphocytes
• Adaptive immunity can be divided into :
Humoral Immunity
❖ Involved antibodies, plasma cells and B cells
Cell mediated immunity
❖ Involved T-cells ( Cytotoxic T cells & Helper T cells)
Antibodies & its structure
• Antibodies or also known as immunoglobulins are produced by
plasma cells. Plasma cells is derived from B- cells (Lymphocytes)
• Antibodies have 4 Polypeptide chains which divided into :
i. 2 Heavy chain (H) (450 a.a)
ii. 2 Light chain (L) (220 a.a)
• Heavy chain and Light chain are bonded/ linked by disulfide
bond.
• Each Heavy chain and Light chain have 2 distinct regions :
i. Variable region (V)
ii. Constant region (C)
Classess of antibodies
Mechanisms of antigen-antibody interactions
Neutralizing
antigens
Enhancing Immobilizing
Phagocytosis bacteria
Activating Agglutination
complement and precipitating
system antigens
Lymphoid organs and its roles
Lymphoid organs are organs associated with formation or site of immune responses take
place
It can be divided into :
Primary Lymphoid organs Secondary Lymphoid organs
• Organs where stem cell divided and • Organs where immune response
become immunocompetent. take place.
• Example are Red bone marrow and • Example are lymph node, spleen
thymus. and lymphatic nodules.
• Bilobed organ.
• Located in the mediastinum between the sternum and the aorta.
• Site where T cell matured due to hormone called “ thymosin”.
• Macrophages, dendritic cell and epithelial cells also can be found here.
• Mass of thymus in infant (70 g). When reached to puberty, the mass
reduced (3g).
• Located at bones (within spongy bone tissue).
• Main site production of all types of blood cells.
• Pluripotent stem cells differentiate into myeloid stem cells and
lymphoid stem cells.
• Myeloid stem cells - erythrocytes, platelet, granulocytes WBC,
monocytes.
• Lymphoid stem cells - form lymphocytes ( immature B and T cells).
• Bean shaped structure and located thoughout of the body.
• smallest lymphoid organs (1–25 mm).
• There is around 600 lymph nodes and found in groups.
• various immune cells found here including T cells, B cells,
Dendritic cells, macrophages.
• Acts as filter and purifies lymph before it reaches the veins.
• Located within the mucus membranes that line the gastrointestinal, respiratory,
reproductive, and urinary tracts.
• Also referred as Mucosa associated Lymphatic Tissue (MALT).
• These nodules contain lymphocytes and macrophages which defend against
invading bacteria and other pathogens that enter these passages along with
food, air or urine.
• These nodules can be solitary or grouped together in clusters.
• Major clusters of lymphatic nodules include tonsils and peyer’s patches
• Oval shape organ and the largest single mass of lymphatic tissue in the
body.
• Located in the left hypochondriac region between the stomach and
diaphragm.
• Consist of 2 types of tissues : White pulp & Red pulp
• White pulp - Lymphatic tissue. consist of lymphocytes and
macrophages
• Red Pulp - consist of splenic cord and venous sinuses.
• Function as :
• Removal by macrophages of ruptured, worn out, or defective
blood cells and platelets
• Storage of platelet
• Production of blood cells (During fetal life)
DEVELOPMENT OF IMMUNITY
• As mentioned earlier, adaptive immunity is a spesific mechanism in which it will be activated if the
pathogen/foreign antigens can pass through innate immunity.
• adaptive immunity is slow process but long lasting effect against pathogen/foreign antigens
• There are 2 main branches of adaptive/Acquired immunity :
• Cell mediated immunity
• Humoral immunity / antibody mediated immunity
Cell mediated immunity
Humoral Immunity
effective against :
• intracellular pathogens, which include
effective against
any viruses, bacteria, or fungi that are
• extracellular pathogens, which include
inside cells
any viruses, bacteria, or fungi that are in
• some cancer cells
body fluids outside cells.
• foreign tissue transplants.
ANTIGENS &
MAJOR HISTOCOMPATIBILITY (MHC)
Antigens MHC
• Any substances that can stimulate immune • Self antigen produced in human body.
response by stimulating production of • also known as Human Leukocyte antigen (HLA)
antibody or proliferation of T cells or both. • MHC helps T cells to recognized the antigen is
• Antigens have 2 important characteristics : foreign or not
• Immunogenicity & Reactivity • There are 2 types :
• There are 2 main types of antigens • MHC I : Found in all human cell except RBC
• Endogenous antigens • MHC II : Found on the surface of APC
• Exogenous antigens
ANTIGEN PROCESSING
• In order for adaptive immune response to occur, B cells and T cells need to recognized the foreign
antigens.
• B cells can recognized antigen that circulate in lymph, blood plasma and intersitial fluid.
• T cells can recognized the fragment of antigenic proteins that has been process in certain way.
• This antigen will be breakdown into fragment via antigen processing.
Activation and mechanism of cell-mediated
immunity (Helper T cell /CD4 Cells)
Once activated, Helper T cell
At the same time, Secretion
Antigen-MHC II complex of will undergo clonal selection
of cytokines (IL1) from APC
APC bind with TCR of (Proliferation &
will acts as costimulation to
Inactivated Helper T cells differentiation) to produce
activate Helper T cells
more clone Helper T cells.
There are 2 types of Helper Active Helper T cells will
T cells produced : produce more cytokines,
mainly IL2 which important
Active Helper T - cells
to initiate activation of
Memory Helper T cells Cytotoxic T cells and B cells
Activation of Cytotoxic T cell (CD8 Cells)
TCR of Inactivated Cytotoxic At the same, IL2 secreted Once activated, cytotoxic T
T cells bind with antigen- from Helper T cells will acts cells undergo clonal
MHC I antigen complex of as costimulation to activate selection in which it will
infected cells cytotoxic T cells. proliferate and differentiate.
Active cytotoxic T cells will
It will produce more clone attacks infected cells by 2
cytotoxic T cells. 2 types of ways
cytotoxic T cells i. Release granzyme - cells
Active cytotoxic T cells. become apoptosis.
Memory cytotoxic T cells ii. Release perforin &
granulysin - cause cytolysis.
Activity of Cytotoxic T cell (CD8 Cells)
Activation and mechanism of Antibody-mediated
immunity
Inactivated B- cells bind A the same time, Cytokines B- Cells become activated
with antigen that circulate (IL3,IL4,IL5) produced by and undergo clonal
in lymph, blood plasma Helper T cells will selection (proliferation &
and intersitial fluid. costimulate B cells. differentiation).
Produced 2 types of clone
B cells Active B cells differentiate
into plasma cells. Plasma
i. Active B cells
cells produce antibodies.
ii. Memory B cells.
Primary and Secondary immune response
Primary Immune Response
• Occur when body get infected for the first time.
• After an initial contact with an antigen, no antibodies are present for a period of several days.
• Then, a slow rise in the antibody titer occurs, first IgM and then IgG, followed by a gradual decline in
antibody titer .
• There is also production of memory cells.
Secondary Immune Response
• Occur when body get infected again with same antigens.
• Production of antibody mainly IgG increase quickly than primary immune response.
• Antibodies produced during a secondary response have an even higher, affinity for the antigen than
those produced during a primary response, and thus they are more successful in disposing of it.
Primary immune response
• Low concentration of antibodies produced at early stage and peak up one to two weeks after exposure (test
on antibody titer).
• Has lag time: slow reaction during 3- 6 days after the exposure.
• B cells specific for that antigen multiply and develop into plasma cells.
• Takes 3-14 days to produce enough antibodies to be effective against antigen.
• Meantime, individual usually develops disease symptoms because the antigen has had time to cause tissue
damage.
• Plasma cells secrete antibody. Antibody concentration rise and reach the peak in 10 -12 days.
• IgM is the first antibody produced and later other classes of antibodies are produced as well.
• Primary response lasts several days or weeks. Concentration of antibodies decrease because plasma cell
dies. Memory B cell left in the body.
Secondary immune response
• The response of immune system to the second infection for same antigen.
• Memory cell recognize the same antigen faster.
• Within hours after second exposure: memory B cells proliferate & differentiate rapidly
into plasma cells to produce antibody. IgG mainly antibody produced.
• Within 2-3 days, antibody rises steeply, higher than in primary response and remain high
for weeks to months.
• Plasma cells functioning for much longer than in primary response.
• Memory B cell able to recognize antigen for longer period; may persist for many years
and probably for life or the immunity is long lasting.
Ways to Acquire Adaptive Immunity
Transplantation and tissue rejection
• Transplantation is the process of moving cells, tissues, or organs, from one site to
another, either within the same person or between a donor and a recipient.
• The purpose of this process is to replace or repair damaged or diseased organs and
tissues.
• However, immune response plays significant barrier to successful organ
transplantation when tissues/organs are transferred from one individual to another.
• This is because, immune cells might identify new tissues/organs as foreign antigen and
tend to destroy them. it is called as tissue rejection.
Types of Transplant Tissue
IMMUNE DISORDER : SLE
• A chronic autoimmune, inflammatory disease that affects
multiple body systems.
• most oft en develops between ages 15 and 44 and is 10–15 times
more common in females than male.
• The cause is unknown but genetic predisposition to the disease
and environmental factors trigger this problem
• Common sign : butterfly-shaped rash over your cheeks and nose.
• Reference :
Systemic Lupus Erythematosus [Link]
IMMUNE DISORDER : Allergic Reaction
TUTORIAL
i. What is immunity and state TWO (2) types of immunity.
ii. Briefly describe first line and second life of innate immunity.
iii. State TWO (2) types of adaptive immunity.
iv. What are the first and second signals in activation of a helper T cell?
v. State TWO (2) ways on how cytotoxic T cell destroyed infected cells.
vi. Name the immunoglobulin that circulate abundantly at lymph and blood plasma? State spesific functions of
this Ig.
vii. Name the “self antigen” that formed and found on the surface of APC ? State THREE (3) example of APC.
viii. What is the additional function of spleen during fetal life ?
ix. Name the type of transplantation where tissue/organ from different species is transferred to another species?
x. What is primary immune response ? Name the Ig that formed during this response.