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Immunology and Disease (complete summary)

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Lecture 1 – Innate and Adaptive Immunity
CD: Cluster of Differentiation
Techniques to diagnose and monitor disease
●​ Immunohistochemistry (IHC), Enzyme linked immunosorbent assay (ELISA), Flow cytometry
●​ Immunotherapy: Modulation of immunological effector functions to treat disease. Biologicals,
‘engineered’ antibodies
a.​ Flow cytometer: cell in solution, cell sucked up in small flow of liquid → measuring of cells that
are in fluid stream → cell passes a laser beam, and by the way that the light is spread you will
get size of the cell
b.​ FACS: fluorescence activated cell sorting —> we can sort cells based on the fluorescent colour
they are carrying. Eg. mark t cell green b cell red —> give these cells a charge and those
deflection. plates separate the cells —> separate tubes with different types of cells (sorting
bacteria etc)
Immunity
innate: rapid. TLR 4: recognizes LPS (lipopolysaccharide) on gram -
bacteria
Adaptive: APC presents small peptides in context of MHC to T cells or b
cells —> differentiation and proliferation
●​ generating new b and t cells specificities all the time (repertoire)
—> anticipatory system (wasteful), many of them are killed
(central tolerance prevent autoimmunity) —> evolutionarily
speaking it pays off
HLA (human leukocyte antigen): human specific MHC I & II —> sits
on the surface of human white blood cells
Antigen: structure that can induce antibody dependent response
Spleen: filters RBC due to signal from CD molecules (eat me)
Lymphocytes: B cell & T cell originates in bone marrow, but T cell matures in Thymus

Characteristics of foreign matter:
●​ Life form of infection: extracellular, intracellular
●​ Location of infection: gut, skin, blood
Challenges of immunity
A universe of microorganisms: Different structures, life-forms and size
Threat:
●​ Bacteria and viruses grow exponentially the body must respond in
time once an infection occurs
●​ Rapid evolution of microorganisms adaptable system necessary
●​ The immune system must accomplish this without destroying the
body itself (discrimination self/non-self)
Ineffective immunity: SCID (genetic disorder, absence of functional T
cells, prone to infections) and AIDS (caused by HIV targets immune cells (CD4+ T cells and DC) and
undermines immune function, susceptible to a variety of bacterial, fungal and viral infections)

,Hyperactive/incorrect immunity: asthma/allergies (uncontrolled allergic reactions to innocent
substances/allergens e.g., house dust mites), autoimmunity (immune reaction to self tissues due to
unbalanced immune regulation e.g., T1 diabetes, RA, etc)

Organisation of the immune system
●​ Prevention (barriers)
●​ Fast response (innate immunity)
●​ Extracellular (humoral immunity) and
intracellular (cellular immunity) microbes
●​ Adaption (adaptive immunity)
●​ Specificity (innate and adaptive)

Physical & chemical barriers → prevent infection
Physical barriers: Skin, respiratory tract, GI tract
●​ → Continuous epithelia protect against entry
of microbes
Chemical barriers: antibacterial enzymes in saliva, tears, mucus, plus stomach acid, gut bacteria

Innate immunity: first line of defense
●​ Initial & rapid response (hours)
●​ Limited specificity (PAMP → PRRs) – germline encoded
●​ Components: humoral (complement system, cytokines) & cellular (phagocytes–MP&NP– & NK
cells)
●​ Diversity: limited (fixed variety of PRRs)
●​ No memory → always responds in the same way
2 main functions of innate immunity
1.​ Elimination of insults: phagocytosis, lysis
2.​ Observation of insults: inflammation, activation of
adaptive immunity
Cells of innate immunity:
Functions: phagocytosis, APC, antigen transport, cytotoxicity, cytokine
mediated functions, etc
Components of innate immunity:
1.​ Complement system
●​ Humoral part of innate immunity
●​ Defense against extracellular pathogens
●​ Collection of circulating and membrane-associated proteins
●​ Many of these are proteolytic enzymes → enzymatic cascade
3 pathways: alternative, classical (IgM), lectin (MBL) → MAC
3 functions: inflammation, lysis of microbes, opsonization
2.​ NK cells
●​ are lymphocytes, but has no receptor (no TCR&BCR)
●​ respond to intracellular microbes

, ●​ Kill these cells directly
●​ Respond to IL-12 from macrophages
●​ Produce IFN-γ → IFN-γ activates
macrophages to kill phagocytosed
microbes
Mechanism (activation & inhibition)
●​ do not attack normal cells because of
inhibitory receptors
●​ Inhibitory receptors recognize MHC-I
which is present on all nucleated cell
●​ In infected cells MHC-I expression is
reduced inhibitory receptors are not
engaged cell is killed
3.​ Granulocytes–monocytes
●​ PMN: polymorphonuclear → nucleus can take up diff shapes
●​ Granulocytes: very fragile when taken out of the cell, but they lyse
quite rarely and mess up your whole system
●​ PBMC: peripheral blood mononuclear cells → granulocytes are
absent, present: monocytes, MP, T cells
4.​ The neutrophil
●​ Main cell of innate immunity & acute inflammation
●​ Rapidly recruited to site of infection
●​ In response to phagocytic stimulus undergo an oxidative
burst and degranulation
●​ The most abundant leukocytes in the blood (6k/microliter)
Functions
●​ Find: rolling, adhesion, transmigration (chemotaxis)
●​ Eat: phagocytosis
●​ Kill: ROS, Lysosomal enzymes

, Chemotaxis of neutrophils
Neutrophils follow chemical gradients to SOI
●​ soluble bacterial product (fMLP)
●​ Complement factors (C5a)
●​ Cytokines (IL-8)
●​ Leukotriene B4
Chemotactic factors bind to cell surface receptors
●​ Induce calcium mobilization
●​ Assembly of cytoskeletal contractile elements
EBV: epstein barr virus related to certain cancers. infectious
mononucleosis —> risk of MS (multiple sclerosis) doubles: 1 in 1000

Recognition of microbes
Pathogen associated molecular Patterns (PAMPs) → conserved molecular motifs shared
by classes of microbes e.g
●​ sugar residues (mannose)
●​ lipoproteins (lipopolysaccharide: LPS)
●​ Nucleotides (ssRNA dsDNA unmethylated nucleotides (CpG))

Pattern recognition receptors (PRR) → Diverse receptors to recognize PAMP
●​ e.g. Mannose receptors, toll-like receptors (LPS, CpG, viral DNA, viral RNA)
●​ Each individual has of fixed variety of PRRs (few genes, germline encoded)
●​ Non-clonal: all cells of a lineage express the same receptors
TLR: 3 locations
1.​ TLR on the cell surface membrane → recognises extracellular PAMP
2.​ TLR on the endosomal membrane → deals with viral DNA/RNA (intracellular
viral replication)
3.​ Cytosolic TLR:
●​ (NLR) NOD like receptors: not membrane bound, float in cytoplasm →
another monitoring system for what is going on inside
●​ (RLR) RIG like receptors → recognises viral RNA
only if it has 3 phosphate on it (more specific)
Effects of PRR activation
PAMP recognised by PRR induces kinase interactions which
will lead to transcription factors activation and thereby:
1.​ Enhanced phagocytosis → pathogen elimination
2.​ Cytokines and chemokines → communication
3.​ Co-stimulatory molecules → activation of adaptive immunity
4.​ Antigen presentation molecules → activation of adaptive immunity
5.​ Adhesion molecules → cell-cell interaction
Cytokines
●​ Large group of small molecules (±5-20 kD) important for cell communication and
signaling and cell movement
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