Immunology and Serology

Francis Ian L. Salaver, RMT BMLS 3C-D-E

INTRODUCTION TO IMMUNOLOGY

IMMUNOLOGY AND THE IMMUNE SYSTEM

* Immunology * Study of the components and function of the immune system * Immune System * Molecules, cells, tissues and organs which provide nonspecific and specific protection against
* Microorganisms * Microbial toxins * Tumor cells

* Crucial to human survival

THE IMMUNE RESPONSE AND IMMUNITY

* Immune response
* Innate/non-specific/natural * Adaptive (specific)
* Primary * Secondary

* Immunity
* State of non-specific and specific protection

* Acquisition of Immunity
* Natural * Artificial

Innate vs. Adaptive Immunity

The immune system

Immune system
Innate (non-specific) immunity
Anatomic barriers (Skin,mucous membranes) Physological barriers (temperature, pH) Phagocytic Barriers (cells that eat invaders) Inflammatory barriers (redness, swelling, heat and pain)

Adaptive (specific) immunity

Antigen specificity Diversity Immunological memory Self/nonself recognition

NATURALLY ACQUIRED IMMUNITY

* Active
* Antigens enter body naturally with response of
* Innate and adaptive immune systems

* Provides long term protection

* Passive
* Antibodies pass from mother to
* Fetus across placenta * Infant in breast milk

* Provides immediate short term protection

ARTIFICIALLY ACQUIRED IMMUNITY

* Active
* Antigens enter body through vaccination with response of
* Innate and adaptive immune systems

* Provides long term protection

* Passive
* Antibodies from immune individuals injected into body
* Referred to as
* Immune serum globulins (ISG) * Immune globulins (IG) * Gamma globulins

* Provides immediate short term protection

PRINCIPAL FUNCTION OF THE IMMUNE SYSTEM

* To protect humans from pathogenic microorganisms * Pathogenic microorganisms (Pathogens) * Microorganisms capable of causing infection and/or disease

ORIGIN OF CELLS OF THE IMMUNE SYSTEM

* Derived from common progenitor cell in bone marrow
* Pluripotent hematopoietic stem cell

* Progenitor Stem Cells

* Erythroid lineage
* Erythrocytes and Megakaryocytes

* Myeloid lineage
* Monocyte/macrophage, dendritic cells, PMNs, mast cells

* Lymphoid lineage
* Small and large lymphocytes

CELLS OF INNATE AND ADAPTIVE IMMUNITY

* Myeloid Lineage
* Neutrophil
* Principal phagocytic cell of innate immunity * Referred to as Polymorphonuclear leukocytes (PMNs)
* Nuclei are multilobed (2 to 5)

* First cell to migrate towards the site of infection * 6-7 hours = PUS

CELLS OF INNATE AND ADAPTIVE IMMUNITY

* Myeloid Lineage
* Eosinophil
* Principal defender against parasites * Bilobed * Acid-loving

Charcot Leyden Crystals

CELLS OF INNATE AND ADAPTIVE IMMUNITY

* Myeloid Lineage
* Basophil
* Bilobed * Alkaline-loving * Mast cells in tissues * Has receptors for Fc portion * Of IgE

Basophils and Mast cells

CELLS OF INNATE AND ADAPTIVE IMMUNITY

* Myeloid lineage
* Monocytes
* Leukocytes with bean shaped or brain-like convoluted nuclei * Circulate in blood with half life of 8 hours * Precursors of tissue macrophages

* Macrophages
* Mononuclear phagocytic cells in tissue * Derive from blood monocytes

CELLS OF INNATE AND ADAPTIVE IMMUNITY

* Myeloid lineage
* Monocytes
* 2nd cell to migrate to site of infection * Has higher phagocytic activity than neutrophils * APC

CELLS OF INNATE AND ADAPTIVE IMMUNITY

* Lymphoid Lineage
* Large lymphocytes (large granular lymphocytes)
* Natural killer (NK) cells (CD16, CD56) * Innate immunity to viruses and other intracellular pathogens * Participate in antibody-dependent cell-mediated cytotoxicity (ADCC)

* Small lymphocytes
* B cells (CD19) * T cells (CD3, CD4 or CD8) * Adaptive immunity

* Lymphocytes refers to small lymphocytes

T cells
* CD8 cytotoxic T cells
* Enter bloodstream and travel to infection site * Kill cells infected with viruses and other intracellular microorganisms

* CD4 TH1 helper T cells

* Enter blood stream and travel to infection site * Help activate macrophages

* CD4 TH2 helper T cells

* Work within secondary lymphoid tissues * Help activate B cells

Stages of lymphocyte activation

Nave lymphocytes
Mature lymphocytes that have not previously encountered antigen; function -- antigen recognition Preferential migration to peripheral lymphoid organs (lymph nodes), the sites where immune responses start

Effector lymphocytes
Activated lymphocytes capable of performing the functions required to eliminate microbes (effector functions) Effector T lymphocytes: cytokine secretion (helper cells), killing of infected cells (CTLs) B lymphocytes: antibody-secreting cells (e.g. plasma cells)

Memory lymphocytes
Long-lived, functionally silent cells; mount rapid responses to antigen challenge (recall, or secondary, responses)

THE CLUSTER OF DIFFERENTIATION (CD)

* A protocol for identification and investigation of cell surface molecules * CD number assigned on basis of 1 cell surface molecule

THE CLUSTER OF DIFFERENTIATION (CD)

* CD markers on leukocytes
Granulocyte Monocyte T lymphocyte T helper lymphocyte T cytotoxic lymphocyte B lymphocyte Natural killer cell CD45+, CD15+ CD45+, CD14+ CD45+, CD3+ CD45+, CD3+, CD4+ CD45+, CD3+, CD8+ CD45+, CD19+ CD45+, CD16+, CD56+, CD3-

COMPLETE BLOOD COUNT WITH DIFFERENTIAL (CBC WITH DIFF)

References Ranges
Erythrocytes (RBC) Thrombocytes (Platelets) Leukocytes (WBC) Neutrophils Band neutrophils Eosinophils Basophils Lymphocytes Monocytes 4.0 to 5.4 150 to 400 4.8 to 10.8 40 to 74 0 to 9 0 to 6 0 to 1 15 to 47 0 to 12 M/uL K/uL K/uL %

LYMPHOCYTES, LYMPHOID TISSUES AND ORGANS

* Lymphocytes originate in bone marrow
* Lymphoid tissues and organs
* Primary
* Development and maturation of lymphocytes * Bone Marrow (B cells) and thymus gland (T cells)

* Secondary
* Mature lymphocytes meet pathogens * Spleen, adenoids, tonsils, appendix, lymph nodes, Peyers patches, mucosa-associated lymphoid tissue (MALT)

THE LYMPHATIC SYSTEM

* Lymph * Fluid and cells in lymphatic vessels
* Lymphatic vessels * Collect and return interstitial fluid to blood * Transport immune cells throughout body * Transport lipid from intestine to blood * Lymph nodes * Kidney shaped organs at intervals along lymphatic vessels * Other secondary lymphatic tissues and organs

LYMPHOCYTES AND THE SPLEEN

* Spleen
* Lymphoid organ in upper left abdomen * Functions
* Remove damaged or old erythrocytes * Activation of lymphocytes from blood borne pathogens

* Architecture of Spleen
* Red pulp
* Erythrocytes removed

* White pulp
* Lymphocytes stimulated

SECONDARY LYMPHOID TISSUES ASSOCIATED WITH MUCOUS MEMBRANES

* Primary portals of entry for pathogens
* Respiratory tract * Gastrointestinal tract

* Secondary lymphoid tissues

* Bronchial-associated lymphoid tissue (BALT) * Gut-associated lymphoid tissues (GALT)
* Tonsils, adenoids, appendix, Peyers patches

* Pathogens are directly transferred across mucosa by M cells