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Physiology: Hematology

Medicine L3

PSL222

Immunity

Lecture 6
Dr. S.Bashir

Lecture objectives

Identify the different type of body defense


mechanisms.
Classify immunity into innate and acquired
(specific).
Describe the different mechanisms of innate
immunity.
Classify acquired immunity into humeral and cell
mediated types.

Dr. S.Bashir

How does the body protect itself


against the different microbes
?found in the environment

Dr. S.Bashir

1. Giardia
2. Influenza
3. Food poisoning.
4. Malaria.
5. Strep throat.
6. AIDS .
7. Tuberculosis.
8. Lyme disease.
9. Hepatitis B.

Dr. S.Bashir

Nonspecific Defenses

There are several categories of nonspecific defenses:


1-Physical barriers: skin & mucus membranes.
2-Secretions & reflexes.
3-Innate immune mechanisms:

Phagocytes
Interferons
Complement
Inflammatory response
Fever
Normal flora.
Dr. S.Bashir

Skin

Most imp barrier. Epidermal epithelium


has multiple layers of dead, keratinized
cells held together by desmosomes.
Can't be penetrated by most organisms
unless there is a cut.
pH (< 7.0) of skin secretions inhibits
bacterial growth
Hair follicles secrete sebum that contains
lactic acid and fatty acids both of which
inhibit the growth of some pathogenic
bacteria and fungi Areas of the skin not
covered with hair, are most susceptible to
fungal infections. such as ?

Dr. S.Bashir

The epithelia linings

In the digestive, respiratory,


reproductive, and urinary tracts .
The epithelial cells are linked by
tight junctions and supported by a
dense fibrous basement membrane.
Mucus traps infiltrating pathogens
Respiratory cilia help move the
mucus upwards away from the
delicate lung tissue.
Reflexes: Coughing, sneezing&
vomiting. Advantages?
Dr. S.Bashir

Defensive Secretions- 2

The stomach contains a very low pH and


proteases that can destroy pathogens.
Urine flushes the urinary tract while glandular
secretions flush the reproductive tract.
Saliva, tears, nasal secretions, and perspiration
contain lysozyme which damage or kill bacteria.
Ear?

Dr. S.Bashir

Role of Normal Flora

Billions of microbes, mostly bacteria,


live in and on the body with, usually,
no harmful effects.
They are found on the skin,
digestive, respiratory , & urogenital
tracts.
They compete and resist
colonization by pathologic bacteria.
What happens if normal flora is
removed e.g. by prolonged use of
antibiotics?
Dr. S.Bashir

.Summary of barriers & Secretions

Dr. S.Bashir

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The role of Fever


in innate immunity:

Pyrogens reset the body's thermostat and


cause a rise in temperature.

Bacterial toxins, antigen-antibody complexes,


and interleukin-1 (a chemical released by
active macrophages) all act as pyrogens.

The rise in temperature causes an increase in


the body's metabolic rate which allows the
WBC to function with greater efficiency.
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3-The cellular innate


immune responses
Involves :
Phagocytic cells (neutrophils, monocytes,
and macrophages).

Cells that release inflammatory mediators


(basophils, mast cells, and eosinophils);

Natural killer cells (NK cells).

Molecules such as complement proteins,


and interferon.
Dr. S.Bashir

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Inflammation

A localized tissue response to


injury that results in:
pain, redness, swelling, and heat.
The goals of inflammation are:
-Prevent additional pathogen
entry.
-Slow the spread of pathogens
away from the area.
-Mobilize defenses that can
overcome the pathogens
- Facilitate permanent repair.

Dr. S.Bashir

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Cells involved in acute


:inflammation

What are the cells


involved in the
inflammation
process , and what
is the role of each
type?

Dr. S.Bashir

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The role of Complement

A set of proteins circulating


in plasma.
Synthesized by the liver.
Complement can be
activated by interacting
with sugars on a
bacterium's surface or by
interacting with an antigenantibody complex.
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Complement activation

Activation of
complement acts
through:
1- Direct lysis of
microbial
membranes.

2- Opsonization
of organisms to
facilitate their
phagocytosis.

3- Enhancing the
inflammatory
process.

Dr. S.Bashir

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The role of Interferon's

Interferons are proteins released by


macrophages, lymphocytes, and tissue
cells infected with a virus.

A cell is infected by a virus interferon.

Interferon diffuses to adjacent cells.


Binds to receptors on the surface of those,
uninfected cells, they begin the production
of a protein that prevents the synthesis of
viral proteins.

This prevents viral spread throughout the


body.
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Dr. S.Bashir

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Acquired (Specific) immune


response

The acquired immune response is classified into


2 types:Humoral immunity: mediated by B- Lymphocytes:
Responds to bacteria, parasites, and any extra
cellular organism.
Cell mediated immunity= T-Lymphocytes.
Responds to viruses, intracellular organism,
malignant cells, transplanted tissues.
Dr. S.Bashir

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Classification into T &


B-Lymphocytes

Depending on
the site of
maturation of
lymphocytes.
T-lymphocytes
mature in?
B-lymphocyte
mature in?
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Specific immunity

T cells and B cells respond to the


molecular structure of a specific antigen.

The antigen's shape/size will determine


which lymphocytes will respond to its
presence..

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?What is an Antigen

Antigens are
macromolecules that
elicit an immune
response in the body.
Antigens can be :
-proteins
-polysaccharides
Rarely:
-lipoproteins
- glycolipids.

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Presentation of foreign
antigens

Macrophages phagocytose an organism partially


or completely
Present some of the organism antigens on its
surface
Lymphocytes recognize the presented antigens
as foreign and respond to it.

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Classification of acquired
:(specific ) immunity

Humoral immunity: mediated by B-lymphocytes,


destroys extra-cellular organisms by producing
antibodies against their specific antigens.

Cell mediated immunity: mediated by


T-lymphocytes. T-lymphocytes are converted into
cytotoxic cells that destroy abnormal or infected
cells.
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Classification of acquired
:(specific ) immunity

Dr. S.Bashir

A type of Tlymphocytes called


T-helper cells
(CD4+ cells) are
activated by
macrophages
presenting
antigens.
T-helper cells
produce cytokines
that stimulate both
types of specific
immunity.
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Thank You

Dr. S.Bashir

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Physiology: Hematology

Medicine L3

PSL222

Immunity

Lecture 6
Dr. S.Bashir

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Lecture objectives

Describe the mechanisms and


characteristics
of:
Humoral immunity.
Cell mediated immunity.

Explain the immunological basis of


vaccination, passive immunization
,allergies , auto-immune disease&
immune-deficiency syndromes.
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MCQ

a. Humoral immunity.

b. Cell mediated
immunity.

c. Acquired immunity.

d. Innate immunity.

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a.

b.
c.
d.

Cells infected by a virus release


substances that diffuse to neighbouring
uninfected cells and help to protect them
from infection by the virus. What are
?these substances
Complement

proteins.
Normal flora.
Pyrogens.
Interferons.

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Cell Mediated Immunity

Dr. S.Bashir

Activated
Tlymphocytes
change into
cytotxic cells &
memory cells.
Cytotoxic cells
destroy any
abnormal body
cells, e.g., tumor
cells , cells infected
by a virus or
foreign cells. 31

?How do Cytotoxic cells act

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Humoral Immunity

Dr. S.Bashir

Activated Blymphocytes form


Plasma cells that
produce
antibodies .
Some of the
activated
lymphocytes remain
in lymph nodes as
memory cells.
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How do antibodies help to


?destroy antigens

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Isotypes of antibodies
:(immunoglobulins)

IgM : is the primary antibody against A


and B antigens on RBC. Largest antibody
& can't cross the placenta.
IgG neutralize toxins and prevent
infections by blocking bacterial and viral
entry into cells can be transported
across the placenta into fetus.
IgA Secreted across epithelial surfaces
into the lumen of the gut, intestines, and
mammary gland.
IgE involved in Allergic reactions &
responses to most parasitic worms.
IgD's function is currently unknown
.
Dr. S.Bashir

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Characteristics of Acquired
immune responses
Acquired immunity ( both types) has
several important properties:
1-Specificity.
2- Clonal expansion.
3-Memory.
4- Tolerance of self antigens.

Dr. S.Bashir

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Specificity-1

T cells and B cells respond to the


molecular structure of a specific
antigen.

The antigen's shape/size will


determine which lymphocytes will
respond to its presence..

Each T cell and B cell has specific


receptors that will bind to one
specific antigen, ignoring all
others.
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Clonal selection-2

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Clonal selection

When antigen exposure occurs, a


lymphocyte specific for that antigen
will divide, producing more
lymphocytes with the same specificity.

This division results in the production


of an army of cells (known as clones)
that will deal with the particular
antigen.
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Memory-3

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Memory:
1ry & 2ndry response

First contact with a


foreign antigen
production of
memory T and B
lymphocytes.
If the same
antigen is
encountered again
, memory cells
produce a faster
and stronger
response called
2ndry response.

Dr. S.Bashir

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Tolerance-4

During their differentiation in the bone


marrow (B cells) and thymus (T cells),
cells that react to antigens normally
present in the body are destroyed.
Thus, mature T and B cells will ignore
normal self-antigens and attack only
foreign non-self antigens.
Abnormalities in this process
autoimmune diseases .
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Summary of Humoral Immunity

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Summary of Cell Mediated Immunity


Specificity

Clonal selection &


proliferation.

Memory .
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Dr. S.Bashir

:Clinical applications

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Active immunization
Vaccination

A weak or dead organism


(antigen) is introduced into
the body.
The immune system imitates
a 1ry response and produces
memory cells.
If the person is exposed to the
real disease , the immune
system responds by a 2ndry
response which is?
Dr. S.Bashir

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Passive immunization

The subject is injected with


serum containing ready
made antibodies formed by
another animal exposed to
the antigen.

Examples : snakes antitoxin, anti-rabies, antitetanus serum.


Dr. S.Bashir

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Auto-immune diseases

The immune system usually distinguishes


"self" from "non-self".
Autoimmune diseases result when the
immune system attacks and destroys
cells and tissues of the body.
Type 1 diabetes mellitus, Grave's disease,
Multiple sclerosis and Rheumatoid
arthritis are some of the autoimmune
diseases.
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Causes of Immunodeficiency

Immunodeficiency may occur


due to:
Congenital abnormalities.
Sever nutritional deficiencies.
Destruction of bone marrow.
Immunosuppressive drugs e.g.
after transplant.
Destruction of lymphocytes e.g.
HIV virus AIDS.
Consequences?
Dr. S.Bashir

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Allergies

Allergies are
excessive and
inappropriate
responses to
(typically)
harmless antigens,
such as the pollen.

Examples :
bronchial asthma,
hay fever. contact
dermatitis

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Mechanism of Allergy

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Thank You

Dr. S.Bashir

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