Royal College of Surgeons in Ireland - Medical University of Bahrain

MCP 08.14 Immune system I

LEARNING OUTCOMES
• Describe defense barriers and their protective function.
• Describe internal defenses and their role in the innate immune
system.
• Distinguish between the innate and adaptive immune system.
• Define a complete antigen, hapten and antigenic determinant.
• Describe self-antigens MHC-I and II.
• Distinguish between humoral and cell medicate immunity and
the functions of the cells involved.
THE IMMUNE SYSTEM
The immune system protects the body from most infectious
microorganisms, cancer cells and transplanted organs or grafts.
INNATE DEFENSE SYSTEM –
FIRST LINE OF DEFENSE

External body membranes, skin and mucosa

• Keratinized epithelial membrane of the skin; keratin is resistant
to most weak acids and bases and to bacterial enzymes and
toxins.
• Intact mucosa within the body. Mucous membranes line all body
cavities that open to exterior.
INNATE DEFENSE SYSTEM –
FIRST LINE OF DEFENSE
• Epithelial membrane produces protective chemicals
1. The acidity of skin (pH 3 – 5) inhibits bacterial growth,
sebum contains chemicals toxic to bacteria
2. Stomach mucosa secrets HCl
3. Cilia in the upper respiratory tract
4. Saliva & lacrimal fluid contains lysozyme which destroys
bacterial walls
5. Mucus of organ system passageways traps microbes
6. Skin secretes defensins; antimicrobial peptides
INNATE DEFENSE SYSTEM –
SECOND LINE OF DEFENSE
Cells

Phagocytes (WBC)
Engulf foreign particles/cells
Includes macrophages, neutrophils and dendritic cells

Natural killer cells (NK) cause target cells to undergo cell death
INNATE DEFENSE SYSTEM –
SECOND LINE OF DEFENSE

Fever is a systemic response to invading microbes.

• Body temperature is elevated in response to pyrogens
• Increased temp increases repair
• Liver and spleen take up iron and zinc during fever, which
bacteria need to multiply.

Normal body
temperature is 37°C
INNATE DEFENSE SYSTEM –
SECOND LINE OF DEFENSE
Inflammation is the localized response to infection which occurs
when body tissues are injured by physical trauma, heat, chemicals
and infections.
• Functions to prevent the spread of damaging agents, disposes
cell debris and pathogens, and sets the stage for repair.
• Acute (short term) inflammation has four cardinal signs
• Redness
• Heat
• Swelling
• Pain
• Some include impairment of function
INFLAMMATION
INNATE DEFENSE SYSTEM –
SECOND LINE OF DEFENSE
Antimicrobial proteins - Interferons (IFNs)
• Non-specific proteins
• Secreted by viral infected cells
• Interfere with viral replication in healthy
cells
• Also activate macrophages and
mobilize NK cells.
INNATE DEFENSE SYSTEM –
SECOND LINE OF DEFENSE
Complement
• About 30 plasma proteins
• Circulate in the blood
• Activation amplifies all aspects of inflammation as well
as cell lysis for invading cells
QUESTION
If a salmonella species of bacteria were to infect a person,
which of the following innate system responses would be
part of the second line of defense?

A. Mucus membrane
B. Skin
C. Tears
D. Phagocytes
E. Cilia
ADAPTIVE DEFENSE SYSTEM –
THIRD LINE OF DEFENSE
The adaptive immune system recognizes something as foreign
and acts to either immobilize, neutralize or remove it.

It must first be primed by an initial exposure to a specific foreign

substance.

Three important aspects;

1. It is specific
2. It is systemic
(not restricted to the
initial infection site)
3. It has memory
ADAPTIVE DEFENSE SYSTEM –
THIRD LINE OF DEFENSE Two separate but
overlapping arms

Humoral immunity or antibody mediated immunity

Antibodies (produced by lymphocytes) bind to
microbes, inactivating them and acting as
markers for destruction.

Cellular or cell mediated immunity

lymphocytes act against target cells either
• directly - by killing them
• indirectly - by releasing chemical mediators
that enhance inflammation, or activate
other lymphocytes or macrophages
ANTIGENS – THE TRIGGER
• Mobilizes the immune system and provokes an immune
response
• Large complex molecules (including synthetic) that are not
normally present in the body (nonself).
Complete – large proteins, polysaccharides, lipids and nucleic
acids.
1. Immunogenicity – stimulate production of specific
lymphocytes and antibodies
2. Reactivity – react with activated lymphocytes and antibodies
via immunogenic reactions
Incomplete (hapten) – small molecules that, unless attached to
protein carriers, do not cause an immune response. They have
reactivity but not immunogenicity.
ANTIGENIC DETERMINANTS
• Parts of an antigen that are immunogenic
• Most antigens possess a variety of antigenic determinants or
epitope, the more complex the molecule the greater the number.
ADAPTIVE DEFENSE SYSTEM –
THIRD LINE OF DEFENSE
Cells - Lymphocytes;
B- antibody producing (humoral immunity)
T- non-antibody producing (cell medicated immunity)
• Possess unique receptors
• Receptors recognize and bind to specific antigenic determinants
• All the receptors on a single cell are identical
SELF–ANTIGENS: MHC PROTEINS
Major histocompatibility complex (MHC) are glycoproteins that are
self antigens. Each MHC protein has a deep groove that holds a
peptide.

MHC - I
• Found on the surface of all body cells.

MHC - II
• Less widespread.
ADAPTIVE DEFENSE SYSTEM –
THIRD LINE OF DEFENSE
Cells - Antigen-Presenting Cells (APCs)
• Do not respond to specific antigens

• Engulf antigens and then present fragments on their

surface, where they can be recognized by T cells.

• The major types of cells acting as APCs are dendritic cells,

macrophages and B lymphocytes.
QUESTION
Assume a patient has a disorder where their B lymphocytes
are not functioning normally. Which one of the following
functions will be affected most directly?

A. Antibody production
B. Antigen presentation
C. Phagocytosis
D. Viral elimination
E. Hapten formation
LEARNING OUTCOMES
• Describe defense barriers and their protective function.
• Describe internal defenses and their role in the innate immune
system.
• Distinguish between the innate and adaptive immune system.
• Define a complete antigen, hapten and antigenic determinant.
• Describe self-antigens MHC-I and II.
• Distinguish between humoral and cell mediated immunity and
the functions of the cells involved.