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Introduction to the Immune System Nomenclature, General Properties, and Components

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Introduction to the Immune System Nomenclature, General Properties, and Components 1 Introduction to the Immune System Nomenclature, General Properties, and Components CHAPTER OUTLINE Innate and Adaptive Immunity, 3 Antigen-Presenting Cells, 14 Types of Adaptive Immunity, 4 Tissues of the Immune System, 15 Properties of Adaptive Immune Responses, 6 Peripheral (Secondary) Lymphoid Organs and Specificity and Diversity, 6 Tissues, 15 Memory, 7 Lymphocyte Recirculation and Migration into Other Features of Adaptive Immunity, 8 Tissues, 20 Cells of the Adaptive Immune System, 9 Summary, 21 Lymphocytes, 9 The term “immunity” in a biologic context has his- a more inclusive definition of the immune response is a torically referred to resistance to pathogens; however, reaction to microbes, as well as to other molecules that reactions to some noninfectious substances including are recognized as foreign, regardless of the physiologic or harmless environmental molecules, tumors, and even pathologic consequence of such a reaction. Immunology is unaltered host components are also considered forms of the study of immune responses in this broader sense and of immunity (allergy, tumor immunity, and autoimmunity, the cellular and molecular events that occur after an organ- respectively). The collection of cells, tissues, and mole- ism encounters microbes and other foreign molecules. cules that mediate these reactions is called the immune The importance of the immune system for health system, and the coordinated response of these cells and is dramatically illustrated by the frequent observation molecules to pathogens and other substances comprises that individuals with defective immune responses are an immune response. susceptible to serious, often life-threatening infections. The most important physiologic function of the Conversely, stimulating immune responses against immune system is to prevent or eradicate infections microbes through vaccination is the most effective (Fig. 1.1), and this is the principal context in which immune method for protecting individuals against infections; responses are discussed throughout this book. In addition, this approach has led to the worldwide eradication of it prevents the growth of some tumors, and some cancers smallpox, the only disease that has been eliminated can be treated by stimulating immune responses against from civilization by human intervention (Fig. 1.2). The tumor cells. The immune system also plays a major role in appearance of acquired immunodeficiency syndrome the repair of damaged tissues. Because the immune system (AIDS) in the 1980s tragically emphasized the impor- can respond to microbial and nonmicrobial substances tance of the immune system for defending individuals and also can cause disease under some circumstances, against infection. 1 2 CHAPTER 1 Introduction to the Immune System Role of the immune system Implications Defense against infections Deficient immunity results in increased susceptibility to infections; exemplified by AIDS Vaccination boosts immune defenses and protects against infections Defense against tumors Potential for immunotherapy of cancer Control of tissue Repair of damaged tissues regeneration and scarring The immune system can Immune responses are the cause injure cells and induce of allergic, autoimmune, and other pathologic inflammation inflammatory diseases The immune system Immune responses are barriers to recognizes and responds transplantation and gene therapy to tissue grafts and newly introduced proteins Fig. 1.1 Importance of the immune system in health and disease. This table summarizes some of the phys- iologic functions of the immune system and its role in disease. AIDS, Acquired immunodeficiency syndrome. In contrast to these beneficial roles, abnormal immune • How are the cells and tissues of the immune system responses cause many inflammatory diseases with seri- organized to find and respond to microbes in ways ous morbidity and mortality. The immune response is that lead to their elimination? the major barrier to the success of organ transplantation, The basic principles introduced here set the stage for which is often used to treat organ failure. The products more detailed discussions of immune responses in later of immune cells can also be of great practical use. For chapters. A Glossary of the important terms used in this example, antibodies, which are proteins made by certain book is provided near the end of the book. cells of the immune system, are used in clinical labora- tory testing and in research as highly specific reagents INNATE AND ADAPTIVE IMMUNITY for detecting a wide variety of molecules in the circu- lation and in cells and tissues. Antibodies designed to Host defenses are grouped under innate immunity, block or eliminate potentially harmful molecules and which provides immediate protection against micro- cells are used widely for the treatment of immunologic bial invasion, and adaptive immunity, which develops diseases, cancers, and other types of disorders. For all more slowly and provides more specialized defense these reasons, the field of immunology has captured the against infections (Fig. 1.3). Innate immunity, also attention of clinicians, scientists, and the lay public. called natural immunity or native immunity, is always This chapter introduces the nomenclature of immu- present in healthy individuals (hence the term innate), nology, important general properties of all immune prepared to block the entry of microbes and to rapidly responses, and the cells and tissues that are the principal eliminate microbes that do succeed in entering host tis- components of the immune system. In particular, the sues. Adaptive immunity, also called specific immunity following questions are addressed: or acquired immunity, requires proliferation and differ- • What types of immune responses protect individuals entiation of lymphocytes in response to microbes before from infections? it can provide effective defense (i.e., it adapts to the pres- • What are the important characteristics of immunity, ence of microbial invaders). Innate immunity is phylo- and what mechanisms are responsible for these char- genetically older, and the more specialized and powerful acteristics? adaptive immune response evolved later. CHAPTER 1 Introduction to the Immune System 3 Disease Maximum number Number of of cases (year) cases in 2014 Diptheria 206,939 (1921) 0 Measles 894,134 (1941) 72 Mumps 152,209 (1968) 40 Pertussis 265,269 (1934) 311 Polio 21,269 (1952) 0 (paralytic) Rubella 57,686 (1969) 0 Tetanus 1,560 (1923) 0 Hemophilus ~20,000 (1984) 134 influenzae type B infection Hepatitis B 26,611 (1985) 58 Fig. 1.2 Effectiveness of vaccination for some common infectious diseases in the United States. Many infectious diseases for which effective vaccines have been developed have been virtually eradicated in the United States and other developed countries. (Modified from Orenstein WA, Hinman AR, Bart KJ, Hadler SC. Immunization. In: Mandell GL, Bennett JE, Dolin R, editors: Principles and practices of infectious diseases, 4th ed. New York: Churchill Livingstone, 1995; and MMWR 66, No. 1, 2017.) In innate immunity, the first line of defense is pro- recognize a much wider variety of molecules produced vided by epithelial barriers of the skin and mucosal by microbes, as well as noninfectious molecules. Any tissues and by cells and natural antibiotics present in molecule that is specifically recognized by lymphocytes epithelia, all of which function to block the entry of or antibodies is called an antigen. Adaptive immune microbes. If microbes do breach epithelia and enter the responses often use the cells and molecules of the innate tissues or circulation, several other components of the immune system to eliminate microbes. For example, innate immune system defend against them, includ- antibodies (a component of adaptive immunity) bind to ing phagocytes and innate lymphoid cells, and several microbes, and these coated microbes avidly bind to and plasma proteins, such as the complement system. In activate phagocytes (a component of innate immunity), addition to providing early defense against infections, which ingest and destroy the microbes. Examples of the innate immune responses are required to initiate adap- cooperation between innate and adaptive immunity are tive immune responses against the infectious agents. discussed in later chapters. The components and mechanisms of innate immunity By convention, the term immune response generally are discussed in detail in Chapter 2. refers to adaptive immunity, and that is the focus of The adaptive immune system consists of lympho- most of this chapter. cytes with highly diverse and variable receptors for The cells of the immune system are located in dif- foreign substances, and the products of these cells, ferent tissues and serve different roles in host defense. such as antibodies. Adaptive immune responses are Most of these cells are derived from bone marrow pre- essential for defense against infectious microbes that are cursors that circulate in the blood and are called leuko- pathogenic for humans (i.e., capable of causing disease) cytes (white blood cells). Others are present in tissues at and may have evolved to resist innate immunity. The cells all times. Some of these cells function mainly in innate and molecules of innate immunity recognize structures immunity, others in adaptive immunity, and some func- shared by classes of microbes, whereas the lymphocytes tion in both types of responses. These cells are grouped of adaptive immunity express receptors that specifically into two
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