IMMUNOLOGY FLASH POINTS BY DR EJAZ WARIS

1. HAPTENS are atoms or small molecules that elicit an immune response when, and only when,
they are bound to a larger carrier molecule, generally a protein.
2. T-cells are the center-piece of the immune system. T-cells of various sorts are predominant
throughout the lymph nodes except in and around germinal centers. They also make up most of
the white pulp of the spleen, and occupy the thymus gland. Around 80% of circulating
Lymphocytes are T cells.
3. B-lymphocytes, when activated produce freely circulating immunoglobulins
4. B-cells predominate in the follicles (germinal centers) of the lymph nodes and are more
common than T-cells in the red pulp of the spleen and in the bone marrow.
5. 5. "Natural killer lymphocytes" (NK-cells) are bigger than other lymphocytes, and have
cytoplasmic granules (i.e., you can pick them out on a smear; they make up around 10% of the
circulating cells).
6. 6. An antibody, also known as an immunoglobulin, is a large Y-shaped protein produced by B-
cells that is used by the immune system to identify and neutralize foreign objects such as bacteria
and viruses.
7. Each tip of the "Y" of an antibody contains a paratope (a structure analogous to a lock) that is
specific for one particular epitope (similarly analogous to a key) on an antigen, allowing these
two structures to bind together with precision.
8. There are 5 isotypes of antibodies that are found in different locations and perform different
specific functions.
9. IgG: Has four different forms, and provides the majority of antibody-based immunity against
invading pathogens, because it is the best opsonin of any type of antibody. This is because it
expresses a tail for Fc receptors on phagocytes to bind to, which activates phagocytosis. It is the
only antibody capable of crossing the placenta to give passive immunity to fetus, and can
activate the classical complement system.
10. IgM: Expressed on the surface of B cells (monomer) and in a secreted pentamer with very
high avidity. Eliminates pathogens in the early stages of B cell mediated (humoral) immunity
before there is sufficient IgG. Like IgG, it can also activate the classical complement system.
11. IgE: Found in circulation, and binds to allergens and triggers histamine release from mast
cells and basophils, and is involved in allergy. Also protects against parasitic helminthes worms
12. IgD: Functions mainly as an antigen receptor on B cells that have not been exposed to
antigens. It has been shown to activate basophils and mast cells to produce antimicrobial factors.
13. IgA: A dimer that is secreted into mucosal surfaces, such as the gut, respiratory tract, and
urogenital tract, and prevents mucosal invasion into the body by pathogens. It is resistant to the
proteolytic enzymes found in the gastrointestinal mucosae.
14. That part of a biomolecule (such as a protein) that is the target of an immune response
15. That part of the molecule of an antibody that binds to an antigen
16. A marker corresponding to an antigen found in all members of a subclass of a specific class
of immunoglobulins.
17. Type I hypersensitivity is the mechanism underlying the classic allergic response. Its also
called immediate hypersensitivity, which makes sense to any allergy sufferer .It is caused by
an antigen binding to IgE antibodies that are bound to the surface of mast cells. The antigen
bridges the IgE antibodies, triggering release of nasty mediators (like histamine) from the mast
cell. The end result: vessels dilate, smooth muscle contracts, and inflammation comes in and
makes itself at home. Bronchial asthma, anaphylaxis, allergic rhinitis, hay fever.
18. Type II hypersensitivity is also called antibody-mediated hypersensitivity. In this type of
hypersensitivity antibodies bind to antigens on a cell surface (any cell surface). Macrophages
come in and eat up the cells Complement gets activated, inflammation comes in (harming tissue)
and cells end up dying. Examples of this type of hypersensitivity include: autoimmune hemolytic
anemia, pemphigus vulgaris, Goodpasture syndrome, myasthenia gravis, and Graves disease.
19. Type III hypersensitivity is also called immune-complex-mediated hypersensitivity. In this
one, antibodies bind to antigens, forming complexes. These antigen-antibody complexes
circulate (either throughout the whole body, or within one area of the body), get stuck in vessels,
and stimulate inflammation, the end result being inflammation-mediated tissue damage and
necrotizing vasculitis. Examples of this type of hypersensitivity include: systemic lupus
erythematosus, post-streptococcal glomerulonephritis, polyarteritis nodosa, serum sickness, and
the Arthus reaction.
20. Type IV hypersensitivity is also called T-cell-mediated hypersensitivity. This type of
hypersensitivity has two subtypes. In one subtype, called delayed-type hypersensitivity, helper T
cells secrete cytokines that activate macrophages (which eat the antigen) and induce
inflammation (which damages tissue). A good example of delayed-type hypersensitivity is
poison ivy. The other subtype, called T-cell-mediated cytotoxicity, involves cytotoxic T cells
coming and killing target cells (like the cells of a transplanted organ, or the pancreatic islet cells
in a patient with type I diabetes).Tuberculosis , Montoux test , contact dermatitis are classic
examples.
21. Arise from an inappropriate immune response of the body against substances and tissues
normally present in the body. Failure of immune tolerance is the basis, central or peripheral.
22. The following are some of the more common autoimmune diseases: rheumatoid arthritis:
inflammation of joints and surrounding tissues. Systemic lupus erythematosus: affects skin,
joints, kidneys, brain, and other organs. Hashimoto's disease of thyroid. Pernicious anemia and
psoriasis.

23. The immune system has been divided into a more primitive innate immune system and, in
vertebrates, an acquired or adaptive immune system.
24. The acquired immunity is further divided into humoral (or antibody) and cell-mediated
components.
25. The humoral (antibody) response is defined as the interaction between antibodies and
antigens. Antibodies are specific proteins released from a certain class of immune cells known as
B lymphocytes, while antigens are defined as anything that elicits the generation of antibodies
26. Cell-mediated immunity is an immune response that does not involve antibodies, but rather
involves the activation of phagocytes, antigen-specific cytotoxic T-lymphocytes, and the release
of various cytokines in response to an antigen. And CD4cells or helper T cells provide protection
against different pathogens.

27. Transplant rejection occurs when transplanted tissue is rejected by the recipient's immune
system, which destroys the transplanted tissue. It can be hyperacute, acute and chronic.
28. The major histocompatibility complex (MHC) is a set of cell surface proteins essential for the
acquired immune system to recognize foreign molecules in vertebrates, which in turn determines
histocompatibility. The main function of MHC molecules is to bind to peptide fragments derived
from pathogens and display them on the cell surface for recognition by the appropriate T-cells
29. In humans, the MHC is also called the human leukocyte antigen (HLA).
30. The MHC gene family is divided into three subgroups: class I, class II, and class III. Class I
MHC molecules have 2 subunits so can only be recognized by CD8 co-receptors. Class II MHC
molecules have no 2 subunits so can be recognized by CD4 co-receptors
31. Class III MHC molecules have physiologic roles unlike classes I and II, but are encoded
between them in the short arm of human chromosome 6. Class III molecules include several
secreted proteins with immune functions: components of the complement system (such as C2,
C4, and B factor), cytokines (such as TNF-, LTA, and LTB), and heat shock proteins.
32. Antigen-presenting cells (APCs) are a heterogeneous group of immune cells that mediate the
cellular immune response by processing and presenting antigens for recognition by certain
lymphocytes such as T cells. Classical APCs include dendritic cells, macrophages, Langerhans
cells and B cells.