Immunology

Nigarish Ehsan
PharmD, Mphil
Lecturer Gulab Devi institute of Pharmacy
Basic Concepts
Traditional concept
Immunity refers to protection against
infectious diseases.
Modern concept
Immunity is a function of which an individual
recognizes and excludes antigenic foreign
substances. It is normally beneficial, but
sometimes, it is injurious.
 immune system
 The cells and molecules responsible for immunity
constitute the immune system.
 immune response
 their collective and coordinated response to
foreign substances is called the immune response.
 immune tissues.
 The immune system is organized into several
special tissues, which are collectively termed
lymphoid or immune tissues.
 Immunology
 It is the study of the components and function of the
immune system.
Immunity
 It is a natural or acquired resistance of the body to a
certain disease or pathogenic microorganism. OR

 The ability to ward off disease caused by microbes

or their products and to protect against
environmental agents such as pollens, drug, food and
chemicals is called immunity.
Types of Immunity
 The main function of the immune system is to
prevent or limit infections by pathogenic
microorganisms, such as bacteria, viruses, parasites,
and fungi.
 The recognition of microorganisms and foreign
substances is the first event in immune responses of a
host.
 The body’s defense mechanisms can be divided into:
 (a) innate (non specific / natural ) immunity and
 (b) acquired (specific/ adaptive) immunity.
Types of Immunity
INNATE IMMUNITY/
NON-SPECIFIC
IMMUNITY
Innate Immunity/ non-specific
Immunity
 Itis the natural or non-specific resistance of the
body against infections by a number of mechanical
and chemical stimuli. It is called as nonspecific
because it exist in all humans and present from the
earliest time of life (since birth). Lack of such type
of resistance is called as susceptibility
Components of Natural Immunity
There are two components of natural or innate
immunity.
 First Line of Defense
 Second Line of Defense
 First Line of Defense
 This type of defense is provided by certain mechanical
and chemical barriers. These barriers include :
 Dermis and Epidermis
 Mucous Membrane
 Hair
 Mucus
 Lacrimal Fluid
 Gastric acidity
 Saliva
 Urine
 Defecation
 Vomiting
 Vaginal Secretions
 Second Line of Defense
 Once the microorganisms succeed in passing the first
line of defense and enter the deeper tissues, they are
attacked by specific cells(such as blood monocytes,
neutrophils, and tissue macrophages.) which may
ingest or destroy them. These cells are called as
phagocytes and form the second line of defense.
 This process is called phagocytosis
Features of Innate Immunity
 Innate immunity shows the following features:
 It is due to the genetic and constitutional makeup of an
individual. Prior contact with microorganisms or their
products is not essential.
 It acts as the first line of defense of the host immune
system.
 The mechanisms involved in innate immunity are present
in place even before exposure to the foreign agent.
 They are not specific to any infectious agent and do not
seem to improve response on repeated exposures.
 Phagocytic cells (e.g., macrophages and
neutrophils), barriers (e.g., skin and mucous
membrane), and a variety of antimicrobial
compounds synthesized by the host, all play
important roles in innate immunity.
Adaptive (Acquired) Immunity/
specific Immunity
Adaptive (Acquired) Immunity/
specific Immunity
It is an acquired resistance of the body against
infections. It involves the formation of antibodies as a
result of stimulation by foreign particles i.e. antigens.
They are specific and provide specific resistance.
COMPONANTS OF Adaptive
(Acquired) Immunity
 The cells involved in the adaptive immune
responses are
 (a) lymphocytes, ( T- Lymphocytes , B
Lymphocytes )
 (b) antigen-presenting cells (APCs), and
 (c) effector cells that function to eliminate
antigens.
Features of adaptive immunity
 Adaptive immunity shows the following features:

 It is the resistance acquired by an individual during life.

 It occurs after exposure to an agent and is mediated by antibodies as

well as T lymphocytes.

 It has immunologic memory and a remarkable capability of

discriminating between self and non self antigens.

 Once an antigen has been recognized by the cells of acquired immune

system, the response to it is specific and can be repeated. In most
cases, the acquired immune response improves with repeated exposure
 The immune response to the second challenge
occurs more quickly than the first, is stronger, and
is often more effective in neutralizing and clearing
the pathogen.
TYPES OF INNATE IMMUNITY
Acquired immunity is of two types.
 Active immunity
 Passive immunity
Active Immunity
It is produced by introducing antigenic substances i.e. vaccines
from outside to stimulate antibodies . it is of two types:

Naturally Acquired Active Immunity

 It occurs when exposure to antigens is unintentional e.g. it often
follows a disease ;mumps.

Artificially Acquired Active Immunity

 It occurs when exposure to antigens is intentional. It is often
followed by immune response. Vaccines and toxoids produce
such type of response.
Passive Immunity
It is produced by injecting preformed antibodies from external
to the body e.g. immunoglobulins.
It is of two types.
Naturally Acquired Passive Immunity (Congenital
Immunity )
It develops when antibodies pass into the foetal circulation
from mother blood via placenta, unintentionally.
Artificially Acquired Passive Immunity
It develops from the intentional injection of antibody rich
serum into the circulation. Passive immunization is used both
for prophylaxis and therapeutic purposes.
 For prophylaxis …Immunoglobulins , Rabies Antiserum
 For therapeutic … Diptheria Antitoxin
 Antigen
 The word antigen is a shortened form of the words
“antibody generator”.
 Antibodies
 Antibodies are globulin proteins
(immunoglobulins) that are synthesized in serum
and tissue fluids, which react specifically with
the antigen that stimulated their production.
Antibodies
 Antibodies are globulin proteins
(immunoglobulins) that are synthesized in serum
and tissue fluids, which react specifically with the
antigen that stimulated their production.
Types of immunoglobulins
 There are five classes of immunoglobulins:
(GAMED)
 (i) immunoglobulin G (IgG),
 (ii) immunoglobulin M (IgM),
 (iii) immunoglobulin A (IgA),
 (iv) immunoglobulin E (IgE), and
 (v) immunoglobulin D (IgD).
Immunological Tolerance
 Immunological tolerance is a state of
unresponsiveness to a particular antigen to which a
person has been exposed earlier.
 The immune tolerance prevents the body to
provide immune response against the self-antigen.
Self Tolerance Failure leads to autoimmune
response
Antigen–Antibody
Reactions
 The interactions between antigens and antibodies
are known as antigen–antibody reactions.
 The reactions are highly specific, and an antigen
reacts only with antibodies produced by itself or
with closely related antigens.
Clinical and Diagnostic Applications
of Antigen-Antibody Reaction
 These reactions are essentially specific, they have
been used in many diagnostic tests for the
detection of either the antigen or the antibody in
vitro.

 The antigen and antibody reactions also form the

basis of immunity against microbial diseases in
vivo.
 Serological tests are widely used for detection of
antibodies or antigens for diagnosis of a wide
variety of infectious diseases.
 These serological tests are also used for diagnosis
of autoimmune diseases.
 They also help in typing of blood and tissues
before transplantation.
IMMUNE RESPONSE
 The immune system is developed in a host
primarily to protect the host from harmful effects
of pathogens and other foreign substances.
 The response can be
 antibody- mediated (humoral),
 cell-mediated (cellular), or both.
 An encounter with a microbial or viral agent
usually elicits a complex variety of responses.
 Humoral immunity acts mainly against
extracellular pathogens,
 Cell-mediated immunity (CMI) acts against
intracellular pathogens
 HYPERSENSITIVITY
 “Hypersensitivity reaction denotes an immune response
resulting in exaggerated or inappropriate reactions harmful
to host.”
 “It is a harmful immune response in which tissue damage is
induced by exaggerated or inappropriate immune responses
in a sensitized individual on re-exposure to the same
antigen”
 Both the humoral and cell-mediated arms of the immune
response may participate in hypersensitivity reactions.
Components of Hypersensitivity
 Hypersensitivity essentially has two components.
 First priming dose (first dose) of antigen is
essential, which is required to prime the immune
system,
 followed by a shocking dose (second dose) of the
same antigen that results in the injurious
consequences
TYPES OF
HYPERSENSITIVITY
 Depending on the time taken for the reactions and the
mechanisms that cause the tissue damage,
 hypersensitivity has been broadly classified into:
 immediate type.
 delayed type.
 Types I, II, and III are antibody-mediated and are known
as immediate hypersensitivity reactions.
 Type IV is cell-mediated (i.e., mediated by cell-mediated
immunity) and is known as delayed hypersensitivity
reactions.
Four Types of Hypersensitivity
 Type I
  IgE-mediated
  e.g.most common allergies

 Type II
  IgG-mediated
  e.g.ABO transfusion reaction
 Type III
  Immune-complex mediated
  e.g. serum sickness

 Type IV
  T cell-mediated; delayed type
  e.g.tuberculin reaction
ALLERGY
 Type I hypersensitivity reaction is commonly called
allergic or immediate hypersensitivity reaction or
anaphylactic hypersensitivity.
 This reaction is always rapid, occurring within 15 to 30
minutes of exposure to an antigen, and always involves
IgE-mediated.
 IgE is responsible for sensitizing mast cells and
providing recognition of antigen for immediate
hypersensitivity reactions.
 Begin with a feeling of uneasiness, followed by
tingling sensations and dizziness.
 Rapidly develop severe symptoms such as,
generalized itching and hives , wheezing and
difficulty breathing, fainting, or a combination of
these and other allergy symptoms
 ALLERGEN:
 The initiator of type I reaction is known as allergen.
 Typical allergens include:
 Plant pollen, proteins (e.g., foreign serum and
vaccines),
 Certain food items (e.g., eggs, milk, seafood, and
nuts),
 Drugs (e.g., penicillin and local anesthetics),
 Insect products (venom from bees, wasps, and ants),
 Dust mites, mould spores, and
 Animal hair and dander.
 Exposure may be ingested, inhalation, injection or direct
contact.
 Type I hypersensitivity reactions can be systemic (e.g.,
systemic anaphylaxis) or localized to a specific target
tissue or organ (e.g., allergic rhinitis, asthma).
DRUG ALLERGY
MECHANISM
 On exposure to the antigen((drug/ allergen) , TH2
cells specific to the antigen are activated, leading
to the stimulation of B cells to produce IgE
antibody .
 The IgE then binds to Fc portion of mast cells and
basophils with high affinity.
 On reexposure to the antigen, the allergen cross-
links the bound IgE, followed by activation of IgE
and degranulation of basophils and mast cells to
release pharmacologically active mediators within
minutes.
 Binding of IgE to the mast cells is also known as
sensitization, because IgE-coated mast cells are
ready to be activated on repeat antigen encounter.
 Study and explain mechanism of typeII, type
III, Type IV
Immunization
 Immunization is defined as the procedure by
which the body is prepared to fight against a
specific disease. It is used to induce the immune
resistance of the body to a specific disease.
 Immunization is of two types:
 1. Passive immunization (inject anibodies)
 2. Active immunization.(inject antigen/vaccines)
Vaccine
 Vaccine is a substance that is introduced into the
body to prevent the disease produced by certain
pathogens.
 Vaccine consists of dead pathogens or live but
attenuated (artificially weakened) organisms.
 The vaccine induces immunity against the
pathogen, either by production of antibodies or by
activation of T lymphocytes.
 Edward Jenner produced first live vaccine.
 He produced the vaccine for smallpox from
cowpox virus.
 Nowadays, vaccines are used to prevent many
diseases like measles, mumps, poliomyelitis,
tuberculosis, smallpox, rubella, yellow fever,
rabies, typhoid, influenza, hepatitis B, etc.
 Vaccination:
 The process of distributing and administrating vaccines is referred
to as Vaccination.
 Types of vaccine:
 1. Live-attenuated (weakened) vaccines
 2.Heterologous vaccines
 3. Killed-inactivated vaccines
 4. Sub-unit vaccines
 5.DNA Vaccine
 6.RECOMBINANT VECTOR VACCINES
 7.TOXOID VACCINES:
 1. Live-attenuated (weakened) vaccines
 These vaccines contain modifed strains of a pathogen
(bacteria or viruses) that have been weakened but are
able to multiply within the body and remain antigenic
enough to induce a strong immune response.
 The varicella-zoster vaccine,
 Oral poliovirus (OPV) vaccine,
 yellow fever virus vaccine are some examples of this
type of vaccine.
 2.Heterologous vaccines
 Heterologous vaccines are a sub-group of live
attenuated vaccines produced from strains that are
pathogenic in animals but not in humans.
 It is a vaccine that confers protective immunity
against a pathogen that shares crossreacting
antigens with the microorganisms in the vaccine.
 example cowpox virus that protects against
smallpox in humans.
 3. Killed-inactivated vaccines:
 To produce this type of vaccines, bacteria or
viruses are killed or inactivated by a chemical
treatment or heat.
 This group includes for example the inactivated
poliovirus (IPV) vaccine, pertussis vaccine, rabies
vaccine, or hepatitis A virus vaccine.
 4. Sub-unit vaccines
 Instead of the entire microbe, subunit vaccines include
only the antigens that best stimulate the immune system.
 In some cases, these vaccines use epitopes—the very
specific parts of the antigen that antibodies or T cells
recognize and bind to.
 Because subunit vaccines contain only the essential
antigens and not all the other molecules that make up
the microbe, the chances of adverse reactions to the
vaccine are lower.
 5.DNA Vaccine
 When the genes for a microbe’s antigens are introduced
into the body, some cells will take up that DNA.
 The DNA then instructs those cells to make the antigen
molecules. The cells secrete the antigens and display
them on their surfaces.
 In other words, the body’s own cells become vaccine-
making factories, creating the antigens necessary to
stimulate the immune system.
 6.RECOMBINANT VECTOR VACCINES
 Recombinant vector vaccines are experimental
vaccines similar to DNA vaccines, but they use an
attenuated virus or bacterium to introduce
microbial DNA to cells of the body. “Vector”
refers to the virus or bacterium used as the carrier.
 7.TOXOID* VACCINES:
 These vaccines are used when a bacterial toxin is
the main cause of illness.
 When the immune system receives a vaccine
containing a harmless toxoid, it learns how to fight
off the natural toxin. The immune system produces
antibodies that block the toxin. E.g Vaccines
against diphtheria and tetanus.
Routes of Administration
 Deep subcutaneous or intramuscular route (most
vaccines)
 Oral route (oral BCG vaccine)
 Intradermal route (BCG vaccine)
 Scarification (small pox vaccine)
 Intranasal route (live attenuated influenza vaccine)
Scheme of immunization
 Primary vaccination
 One dose vaccines (BCG, measles, mumps,
rubella, yellow fever)
 Multiple dose vaccines (polio, DPT, hepatitis B)
 Booster vaccination
 To maintain immunity level after it declinesafter
some time has elapsed (DT, MMR
 * Toxoids
 Toxoid is a substance which is normally toxic and
has been processed to destroy its toxicity but
retains its capacity to induce antibody production
by immune system.
 Toxoid consists of weakened components or
toxins secreted by the pathogens.
 Toxoids are used to develop immunity against
diseases like diphtheria, tetanus, cholera, etc.
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