Burton's Microbiology

for the Health Sciences

Chapter 16.
Specific Host Defense Mechanisms:
An Introduction to Immunology

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

Introduction

• Immunology is the scientific study of the immune system

and immune responses.
• The primary functions of the immune system are to:
– Differentiate between “self’ and “non-self”
– Destroy that which is “non-self”
• Cells involved in immune responses originate in bone
marrow; 3 lines of lymphocytes are derived from
lymphoid stem cells of bone marrow: B lymphocytes (or
B cells), T lymphocytes (or T cells) and natural killer cells
(NK cells)
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Introduction, cont.

• There are 2 categories of T cells:

– Helper T cells and Cytotoxic T cells
• There are 2 major arms of the immune system:
– Humoral immunity; where special glycoproteins
called antibodies are produced by B cells to destroy
specific microbes
– Cell-mediated immunity; involves a variety of cell
types, with antibodies only playing a minor role, if
any

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

The Two Major Arms of the Immune System

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

Immunity
• Acquired immunity = immunity that results from the
active production or receipt of antibodies during one’s
lifetime
• Active acquired immunity:
• Antibodies are produced within the person
• Usually provides long lasting protection
• Passive acquired immunity:
• Antibodies are received that were produced by
another person or persons or by an animal
• Usually provides only temporary protection

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

Active Acquired Immunity
• Two types of active acquired immunity:
1. Natural active acquired immunity – occurs naturally
2. Artificial active acquired immunity – artificially
induced; results when a person receives a vaccine.
§ A vaccine is defined as material that can artificially
induce immunity to an infectious disease, usually
following injection or ingestion of the vaccine.
– Most vaccines are made from living or dead
pathogens or the toxins that they produce.

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

 How Vaccines Work
• Vaccines stimulate the recipient’s immune system to produce protective
antibodies (i.e., antibodies that will protect the person from disease).
• Types of available vaccines:

1. Attenuated vaccines-the process of weakening (live) pathogens; should not

be given to immunosuppressed people because it can cause disease Ex. chicken pox,
measles, mumps, TB, cholera

2. Inactivated vaccines-made from pathogens that have been killed by heat

or chemicals; made easily but less effective than live vaccines since antigen on dead
cells are less effective and shorter period of immunity Ex. Hepatitis A, rabies

3. Subunit vaccines/acellular- uses antigenic portions of a pathogen; Ex.

Hepatitis B, anthrax, whooping cough

4. Conjugate vaccines – conjugating bacterial capsular antigens to molecules

that stimulate the immune system to produce antibodies Ex. meningitis

5. Toxoid vaccines- an exotoxin that has been inactivated by heat or

chemicals; injected safely to stimulate the production of antibodies Ex. Tetanus,
botulism, diptheria Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Passive Acquired Immunity
• A person receives antibodies rather than producing them
• Antibodies produced in one person are transferred to
another person to protect the latter from infection –
provides temporary protection.
• Two types:
– Natural passive acquired immunity
• Small antibodies, IgG, present in mother’s blood
cross the placenta to reach the fetus; mother’s
milk (colostrum)
– Artificial passive acquired immunity
• Antibodies from an immune person are transferred
to a susceptible person; example: hepatitis B
immune globulin
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Major cell types that participate in immune response:

• T lymphocytes (T cells)
3 types of T cells:
1. helper T cells – TH and CD4 cells; secretions of cytokines
2. cytotoxic T cells – destroy virally infected host cells, foreign cells
and tumor cells
3. regulatory T cells – serve as a brake on the immune response to
infection; prevents auto immune disease
• B lymphocytes (B cells)
• NK cells (natural killer cells) – a category of lymphocytes
• Macrophages and dendritic cells – same function with
macrophages; named for their long, thin cytoplasmic
projections called dendrites

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

Humoral Immunity

• Antigens
– Foreign organic substances that are large enough to
stimulate the production of antibodies
– Substances capable of stimulating antibodies are said
to be antigenic
– A bacterial cell has many molecules (antigenic
determinants) on its surface that are capable of
stimulating the production of antibodies

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

Humoral Immunity, cont.
• Antibodies
– Proteins produced by
lymphocytes in response
to the presence of an
antigen
– Are in a class of proteins
called immunoglobulins
– globular glycoproteins
in the blood that
participate in immune
reactions

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

Humoral Immunity, cont.
• Antibodies, cont.
– The amount and type of antibodies produced by a
given antigenic stimulation depend on the nature of
the antigen, the site of antigenic stimulus, the
amount of antigen, and the number of times the
person is exposed to the antigen.
– The majority of antigens are referred to as T-
dependent antigens because T cells are required in
their processing; the processing of T-independent
antigens requires only B cells.

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

Processing of T-
Independent Antigens-
requires only the B cells for
processing; composed of large
polymeric molecules
(polysaccharides);found in the
cell walls of gram-negative
bacteria

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Humoral Immunity, cont.

• Antibodies, cont.
– The processing of either T-dependent or T-
independent antigens results in B cells developing
into plasma cells, which are capable of secreting
antibodies.
– The initial immune response to an antigen is called
the primary response; it takes 10-14 days for
antibodies to be produced.
– The increased production of antibodies following the
second exposure to a particular antigen is called the
secondary response.
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Humoral Immunity, cont.

• Where Do Immune Responses Occur?

– Immune responses to antigens in the blood are
usually initiated in the spleen; responses to microbes
and other antigens in tissues are generated in lymph
nodes located near the infected area.
• Antibody Structure and Function
– Antibodies are a class of glycoprotein called
immunoglobulins; 5 types = IgA, IgD, IgE, IgG, IgM.
– All antibodies are immunoglobulins, but not all
immunoglobulins are antibodies!
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Basic Structure of a
Monomeric Immunoglobulin Molecule

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

Monoclonal Antibodies

• Long-lived, antibody-producing cells called hybridomas

are produced by combining a single plasma cell and a
rapidly dividing tumor cell.
• Hybridomas are capable of producing large amounts of
specific antibodies called monoclonal antibodies.
• Monoclonal antibodies are used in immunodiagnostic
procedures (i.e., immunologic procedures used in
laboratories to diagnose diseases).
• Monoclonal antibodies are being evaluated for possible
use in fighting diseases, killing tumor cells, boosting the
immune system, and preventing organ rejection.
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Antigen-Antibody Complexes

• When an antibody combines with an antigen an antigen-

antibody complex (or immune complex) is formed.
• Antigen-antibody complexes are capable of activating the
complement cascade; results in some of the following
effects:
– Activation of leukocytes
– Lysis of bacterial cells
– Increased phagocytosis as a result of opsonization

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

Cell-Mediated Immunity

• Antibodies are unable to enter cells.

• Cell-mediated immunity (CMI)
– A complex system of interactions among many types
of cells and cellular secretions (cytokines)
– An arm of the immune system capable of controlling
chronic infections by intracellular pathogens (e.g.,
certain bacteria, protozoa, fungi, and viruses)
– Examples of cells that participate in CMI:
macrophages, TH cells, TC cells, NK cells, and
granulocytes
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Cell-Mediated Immunity, cont.

• NK (Natural Killer) Cells

– NK cells are in a subpopulation of lymphocytes called
large granular lymphocytes.
– They resemble lymphocytes, but lack typical T or B
cell surface markers.
– Do not proliferate in response to antigen and appear
not to be involved in antigen-specific recognition.
– NK cells kill target cells, including foreign cells, host
cells infected with viruses or bacteria, and tumor
cells.
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Hypersensitivity and Hypersensitivity
Reactions
• Hypersensitivity refers to an overly sensitive immune
system.
• Different types of hypersensitivity reactions:
– Immediate-type: occurs from within a few minutes to
24 hours after contact with a particular antigen; 3
types: type I, II and III hypersensitivity reactions
– Delayed-type: usually takes more than 24 hours to
manifest themselves
• Also known as Type IV hypersensitivity reactions.

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

Type I Hypersensitivity Reactions

• Type I hypersensitivity reactions are also known as

anaphylactic reactions; they include:
– classic allergic responses such as hay fever
symptoms, asthma, hives, and gastrointestinal
symptoms that result from food allergies

– allergic responses to insect stings and drugs

– anaphylactic shock

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

Type I Hypersensitivity Reactions, cont.

• The Allergic Response

– Type I immediate hypersensitivity is probably the
most common type of hypersensitivity.
– People prone to allergies (atopic persons) produce
IgE antibodies when exposed to allergens (antigens
that cause allergic reactions).
– The allergic reaction results from the presence of IgE
antibodies bound to basophils in the blood or to mast
cells in connective tissues – IgE antibodies that were
produced in response to the person’s first exposure
to the allergen.
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Factors in the Development of
Type I Hypersensitivity

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

Events That Occur in
Type I Hypersensitivity Reactions

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

Transmission
electron micrograph
showing
degranulation of a
rat mast cell

Transmission
electron
micrograph
showing
phagocytosis of
rat mast cell
granules by a rat
eosinophil
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Type I Hypersensitivity Reactions, cont.

• Type I hypersensitivity reactions may be localized or

systemic.
– Localized reactions involve mast cell degranulation;
they result in allergic reactions, such as hay fever
symptoms, asthma, and food allergies; immediate
type hypersensitivity reactions
– Systemic reactions involve basophil degranulation;
they occur throughout the body, can lead to
anaphylactic shock, and can be life-threatening.

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

Type I Hypersensitivity Reactions, cont.
• Systemic Anaphylaxis
– Results from the release of chemical mediators from
basophils in the bloodstream
– Occurs throughout the body – much more serious
than localized anaphylaxis
– Common allergens involved are drugs or insect
venom
• Latex Allergy
– Latex can trigger any of 3 types of reactions: irritant
contact dermatitis, allergic contact dermatitis, and
immediate type hypersensitivity

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

Type I Hypersensitivity Reactions, cont.
• Allergy Skin Testing and Allergy Shots
– Anaphylactic reactions can be prevented by avoiding
known allergens, which is often difficult to do.
– Skin tests (scratch tests) are used to identify
offending allergens in patients.
• A positive test is indicated if cutaneous
anaphylaxis occurs at the site of the scratch.
– Immunotherapy (i.e., allergy shots - IM doses of the
allergen) may be used to treat the patient.
– IgG blocking antibodies are produced in response to
allergy shots.
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Type II Hypersensitivity Reactions

• Type II hypersensitivity reactions are cytotoxic

reactions, meaning that body cells are destroyed during
these reactions.
• Sequence of events in a Type II hypersensitivity
reaction:
1. A particular drug binds to the surface of a cell.
2. Anti-drug antibodies then bind to the drug.
3. Complement activation on the cell surface is
initiated.
4. The complement cascade leads to lysis of the cell.
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Type III Hypersensitivity Reactions

• Type III hypersensitivity reactions are immune complex

reactions – such as those that occur in serum sickness
and certain autoimmune diseases (e.g., systemic lupus
erythematosus and rheumatoid arthritis).
• Involve IgG or IgM antiboides, complement and
neutrophils
• Some complications of untreated or inadequately treated
strep throat and other Streptococcus pyogenes infections
are the result of type III hypersensitivity reactions (e.g.,
rheumatic fever and glomerulonephritis).

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

Type IV Hypersensitivity Reactions
• Type IV hypersensitivity reactions are delayed-type
hypersensitivity (DTH) or cell-mediated immune
reactions, and are part of cell-mediated immunity.
– Reactions are usually observed 24-48 hours or longer
after exposure or contact
• DTH is the prime mode of defense against intracellular
bacteria and fungi.
• DTH involves a variety of cell types, including
macrophages, cytotoxic T cells, and NK cells - antibodies
do not play a major role.
• A classic example of DTH is a positive TB skin test.
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Autoimmune Diseases
• Autoimmune diseases result when a person’s immune
system no longer recognizes certain body tissues as
“self” and attempts to destroy those tissues as if they
were “non-self” or foreign.
• May occur with certain tissues that are not exposed to
the immune system during fetal development and, thus,
are not recognized as “self.”
• There are more than 80 recognized autoimmune
diseases.
• Can be classified as organ-specific or non-organ-specific.
• Examples: Hashimoto’s thyroiditis (autoimmune disease affecting
thyroid gland, Graves disease (overproduction of thyroid hormones)

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

 b cells
Lung
Brain

Thyroid

Scleroderma

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

Immunosuppression
• Persons whose immune systems are not functioning
properly are said to be immunosuppressed.
• Acquired immunodeficiencies may be caused by drugs
(e.g., cancer therapeutic agents), irradiation, or certain
infectious diseases (e.g., HIV infection).
• Inherited immunodeficiency diseases can be the result of
deficiencies in antibody production, complement activity,
phagocytic function, or NK cell function; examples –
DiGeorge syndrome and Wiskott-Aldrich syndrome.
• People born lacking the ability to produce antibodies
(i.e., gamma globulins) have agammaglobulinemia;
persons not producing a sufficient amount of antibodies
are said to have hypogammaglobulinemia.
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Immunodiagnostic Procedures
• Immunodiagnostic procedures (IDPs) help diagnose
infectious diseases by detecting either antigens or
antibodies in clinical specimens; test results are usually
available on the same day!
• 3 possible reasons for the presence of antibodies to a
particular pathogen: present infection, past infection,
vaccination.
• A variety of different laboratory tests have been designed
to observe the presence of an antibody-antigen reaction.
– Examples of these tests include agglutination,
precipitin tests, immunofluorescence, and enzyme-
linked immunosorbent assays (ELISAs).
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Immunodiagnostic Procedures, cont.
• Skin Testing
– Performed in vivo
– Antigens are injected within or beneath the skin
– Example: the tuberculosis skin test
• Procedures Used in the Diagnosis of Immunodeficiency
Disorders
– For assessment of patient’s immune status and
evaluation of immunodeficiency disorders
– Include B-cell deficiency states, cell-mediated
immunodeficiencies, complement deficiencies, etc.

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins