Dr.

Bangar Raju

Immunity = Immunis (Latin) = Free from burden

Defn: State of resistance exhibited by the host to
toxic molecules, microorganisms and foreign
cells
This resistance plays a major role in warding
off infectious diseases
Carried out by the process of recognition and
disposal of non-self or foreign material that
enters the body
Susceptibility- lack of resistance



Immunity


Innate/natural Adaptive/Acquired
immunity immunity
(Non specific) (Specific)




INNATE IMMUNITY
Resistance which individual possesses by birth
by virtue of his genetic or constitutional make
up

All normal healthy individuals are borne with
innate defence mechanisms

It comprises of non specific general
mechanisms acting as barriers against
frequently encountered pathogens

TYPES OF INNATE IMMUNITY
4Species Immunity: Resistance shown by all
members of a particular species
4Racial Immunity: Different races within one species
exhibiting differences in resistance to infections
4Individual Immunity: Resistance to infection varies
with different individuals of same race and species

FACTORS INFLUENZING INNATE
IMMUNITY
Age
Hormones
Nutrition

MECHANISMS OF INNATE IMMUNITY

3 types of general mechanisms
Anatomical factors
+ Mechanical factors
+ Chemical factors
+ Biological factors
Cellular factors
Humoral factors
ANATOMICAL FACTORS
The epithelial surfaces form a physical barrier
that is very impermeable to most infectious
agents
SKIN

+ Intact ,unbroken skin- mechanical covering
+ Multilayered structure
+ Keratinized cells- hardened , protective barrier
+ Desquamation
+ Sebaceous glands- sebum fatty acids acid
pH
+ Sweat glands sweat high salt
concentration-lethal to many bacteria.

NOSE, NASOPHARYNX AND RESPIRATORY
TRACT
+ Mucus secretions- traps the organisms
+ Hair like cilia- propels out the microbes
+ Cough reflex-drives out the particles







+ Alveolar macrophages- phagocytose the
organisms reaching the alveoli.



EYES
Eye lids, eye lashes- mechanical
protection
Conjunctiva- coated with mucus
Tear glands secrete tears flushing
action
Tears- lysozyme- bactericidal
It lyses the cell wall of bacteria


Both tears and sweat are salty, but they
render a different result. Tears will get you
sympathy; sweat will get you change.
Jesse Jackson

BUT I SAY THAT BOTH WILL MAKE
YOU IMMUNE!!

EAR
=Auditory canal lined with ciliated epithelium
=Ceruminous glands secrete cerumin/wax
=Traps microorganisms- moves out away from middle
ear due to beating action of cilia
=Eardrum- mechanical barrier

DIGESTIVE TRACT:
-Lined with mucus memb. coated with mucus
-Oral cavity- saliva- mild bactericidal action
-Stomach- Gastric acid- Hcl- lethal to microbes
-Gall bladder- Bile Salts- inhibits bacteria
-Colon- diverse normal flora- produce substances called
bacteriocins
-Inhibit growth of potential pathogens
-Colonization resistance



URINARY TRACT
+Flushing action of urine
+Sphincter muscle mechanical barrier
+Urine- Acid pH - 4.5-5.0

REPRODUCTIVE SYSTEM:
w Male :semen- antibacterial substances
w Female : vagina lined with mucus membranes
Acidic pH due to fermenting action of
lactobacillus


Downloaded from: StudentConsult (on 15 July 2008 10:01 AM)
2005 Elsevier
CELLULAR FACTORS

The cells
Phagocytosis and intracellular killing
Inflammation


CELL FUNCTIONS
NEUTROPHIL

Phagocytosis and intracellular killing
Inflammation and tissue damage
MACROPHAGE
Phagocytosis and intracellular killing
Extracellular killing of infected or altered self targets
Tissue repair
Antigen presentation for specific immune response
NK AND LAK
CELLS

Killing of virus-infected and altered self targets,
tumor cells
EOSINOPHIL
Killing of certain parasites
NEUTROPHILS
MACROPHAGE & NEUTROPHILS
ALVEOLAR MACROPHAGE
Downloaded from: StudentConsult (on 16 July 2008 11:07 AM)
2005 Elsevier
EOSINOPHIL


Attachment
Pseudopod extension
Phagosome formation
Granule fusion
Phagolysosome formation
Downloaded from: StudentConsult (on 15 July 2008 10:09 AM)
2005 Elsevier
INTRACELLULAR KILLING PATHWAYS
BY PHAGOCYTES
Intracellular Killing
Oxygen Dependent
(Respiratory burst)
Oxygen Independent
lysozyme
Cathepsin
lactoferrin

Hypochlorus acid
Singlet oxygen
Superoxide anion
Hydrogen peroxide

INFLAMMATION
+Generalized response following any type
cell injury- trauma, chemical agents,
physical agents, invasion by microbes
+Occurs as a result of
Release of various mediators
Increased blood flow
Aggregation of micro & macrophages by
chemotactic mechanisms

FUNCTIONS:
1.Destroy and /or remove injurious agent
2. Limits spread of injurious agent
3. Repair or replace injured tissues
CLINICAL FEATURES


HUMORAL BARRIERS
Non specific antibacterial substances in
blood and tissue
Includes
Complement system
Interferons
Acute phase proteins
Defensins



COMPLEMENT SYSTEM

+A system of series of serum proteins involved
in immunity
+When activated, these proteins react in a
specific series of overlapping reactions
(complement cascade)
Results in lysis of cell membrane
phagocytosis
Inflammation


Downloaded from: StudentConsult (on 15 July 2008 10:09 AM)
2005 Elsevier



INTERFERONS
+Group of soluble proteins in plasma
+Antiviral
+Types- interferon, interferon, interferon
+Produced by WBCs, fibroblasts, T-lymphocytes
+Produced only after viral penetration
+Viral specific- acts against viruses only
+Non specific in action- effective against wide
variety of viruses
+Aspirin inhibits interferon production Ryes
syndrome

Downloaded from: StudentConsult (on 15 July 2008 10:09 AM)
2005 Elsevier

DEFENSINS
Important component of innate immunity
Highly positively charged (cationic) peptides
Create pores in bacterial membrane thereby
killing them
Located primarily in GIT and lower respiratory
tract
Types: alpha and beta defensins
Alpha defensins: GIT
Beta defensins: Lower resp tract


ACUTE PHASE PROTEINS
+Normal serum proteins- synthesized in liver
+Levels increase markedly in inflammation,
infection, trauma
+Helps in innate immunity
Common examples
C- reactive protein
Alpha-1 antitrypsin
Haptoglobin
Ceruloplasmin

FEVER


=Protective defense mechanism of the body
=Increase in body temperature
inhibits growth of most viruses & some bacteria
increase metabolic reactions in host cells
^ses blood circulation and flushing of tissues that help
to eliminate toxin thro urine & sweat
Stimulates the prodn of interferons- recovery from viral
infections
=Controlled by hypothalamus
=Activated by pyrogens - released by microbes, injured
host cells


ACQUIRED IMMUNITY
The resistance acquired by an individual during his life
AQUIRED IMMUNITY


Active passive

Active immunity
Resistance induced in an individual after effective
contact with antigen
Active participation of ones immune system in the
production of antibody & cell mediated immunity
Develops slowly over a period of days and weeks
Persists for a long time, usually for years

ACTIVE IMMUNITY

Natural Active Artificial active

wThrough clinical or Thro vaccination
subclinical infections
w
wEg:-persons recovering
from small pox infection

VACCINATION
The vaccines are preparations of live attenuated or killed
microorganisms, or their antigens, or active materials
derived from them

VACCINES
INACTIVATED ( KILLED) VACCINES:
wInactivated/ killed organisms
wKilled by formalin, phenol, alcohol etc
wEg: Bacterial- TAB vaccine for typhoid fever
Viral- Salk vaccine for poliomyelitis

LIVE ATTENUATED VACCINES:
wLive attenuated organisms
wAttenuation done by ageing of culture, drying,
passage thro animals of different species etc
wEg: Bacterial- BCG, Anthrax, plague, brucella
vaccines
Viral- MMR, Polio (sabin), Smallpox


TOXOIDS
=Inactivated bacterial exotoxins
=Retain immunogenicity, but loose toxigenicity
eg: tetanus toxoid, diphtheria toxoid

ANTIGENIC PREPARATIONS
=extracted from organism, genetically
engineered
=Eg: Capsular Ag of Strep. pneumoniae,
Genetically engineered protein-
Hepatitis B


PASSIVE IMMUNITY
=Resistance that is induced in the recipient by
transfer of preformed (readymade) antibodies
against infective agent or toxin in another host
=No active role for immune system
=Immediate effect
=Protection short lasting only for days or weeks

Passive immunity

NATURAL ARTIFICIAL







Placental
transfer of IgG
(from mother to
fetus)
Readymade
Antibodies or
immunoglobulins
Colostral
transfer of IgA(
from mother to
infant)
Immune cells

ARTIFICIAL PASSIVE IMMUNITY
w Useful where instant immunity is required
when faced with the threat of a serious infection
wAgents used:
Hyper immune sera of animal or human origin
wEg:- Diphtheria, tetanus, gas gangrene, rabies
Convalescent sera
Pooled human gamma
globulins



Vaccination as such will be dealt in detail in
another class!!!!
Non specific immunity
(INNATE IMMUNITY)

=Response is antigen
independent

= Immediate maximal
response


=No immunological
memory

Specific immunity
(AQUIRED IMMUNITY)

=Response is antigen
dependant

=A lag time between
exposure and
maximum response

=Immunological memory
present

Immunity
Natural/Innate Acquired
Mechanical factors
Cellular factors
Humoral factors

Active Passive
Natural Artificial Natural Artificial
Clinical or Vaccination Mother to Readymade
Subclinical inf fetus Abs


REFERENCES
Warren Levinsons review of medical
microbiology and immunology- 9nth edition
Javetzs medical microbiology- 24
th
edition
Cedric Mims Medical microbiology- 4
th
edition