Immunology at a Glance Companion website This book has a companion website at: www.ataglanceseries.com/immunology The website includes: • 95 interactive test questions • All figures from the book as PowerPoints for downloading Immunology at a Glance J.H.L. Playfair Emeritus Professor of Immunology University College London Medical School London B.M. Chain Professor of Immunology University College London Medical School London Tenth Edition A John Wiley & Sons, Ltd., Publication This edition first published 2013 © 2013 by John Wiley & Sons, Ltd. Previous editions: 1979, 1982, 1984, 1987, 1992, 1996, 2001, 2005, 2009 Wiley-Blackwell is an imprint of John Wiley & Sons, formed by the merger of Wiley’s global Scientific, Technical and Medical business with Blackwell Publishing. 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Designations used by companies to distinguish their products are often claimed as trademarks. All brand names and product names used in this book are trade names, service marks, trademarks or registered trademarks of their respective owners. The publisher is not associated with any product or vendor mentioned in this book. This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is sold on the understanding that the publisher is not engaged in rendering professional services. If professional advice or other expert assistance is required, the services of a competent professional should be sought. Library of Congress Cataloging-in-Publication Data Playfair, J. H. L. Immunology at a glance / J.H.L. Playfair, B.M. Chain. – 10th ed. p. ; cm. – (At a glance series) Includes bibliographical references and index. ISBN 978-0-470-67303-4 (pbk. : alk. paper) – ISBN 978-1-118-44745-1 (eBook/ePDF) – ISBN 978-1-118-44746-8 (ePub) – ISBN 978-1-118-44747-5 (eMobi) I. Chain, B. M. II. Title. III. Series: At a glance series (Oxford, England) [DNLM: 1. Immune System Phenomena. QW 540] 616.07'9–dc23 2012024675 A catalogue record for this book is available from the British Library. Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books. Cover image: courtesy of Science Photo Library Cover design by Meaden Creative Set in 9/11.5pt Times by Toppan Best-set Premedia Limited, Hong Kong 1 2013 Contents Preface 6 24 The cytokine network 56 Acknowledgements 6 25 Immunity, hormones and the brain 58 Note on the tenth edition 6 Potentially useful immunity How to use this book 7 26 Antimicrobial immunity: a general scheme 60 Further reading 7 27 Immunity to viruses 62 List of abbreviations 8 28 HIV and AIDS 64 Immunity 29 Immunity to bacteria 66 1 The scope of immunology 10 30 Immunity to fungi and ectoparasites 68 2 Innate and adaptive immune mechanisms 12 31 Immunity to protozoa 70 3 Recognition and receptors: the keys to immunity 14 32 Immunity to worms 72 4 Cells involved in immunity: the haemopoietic system 16 Undesirable effects of immunity Innate immunity 33 Immunodeficiency 74 5 Receptors of the innate immune system 18 34 Harmful immunity: a general scheme 76 6 Complement 20 35 Allergy and anaphylaxis 78 7 Acute inflammation 22 36 Immune complexes, complement and disease 80 8 Phagocytic cells and the reticuloendothelial system 24 37 Chronic and cell-mediated inflammation 82 9 Phagocytosis 26 38 Autoimmune disease 84 Adaptive immunity Altered immunity (i) The molecular basis 39 Transplant rejection 86 10 Evolution of recognition molecules: the immunoglobulin 40 Immunosuppression 88 superfamily 28 41 Immunostimulation and vaccination 90 11 The major histocompatibility complex 30 Immunity in health and disease 12 The T-cell receptor 32 42 Cancer immunology 92 13 Antibody diversification and synthesis 34 43 Immunity and clinical medicine 94 14 Antibody structure and function 36 44 Investigating immunity 96 (ii) The cellular basis 45 Immunology in the laboratory 98 15 Lymphocytes 38 46 Out of the past: evolution of immune mechanisms 100 16 Primary lymphoid organs and lymphopoiesis 40 47 Into the future: immunology in the age of genomics 102 17 Secondary lymphoid organs and lymphocyte traffic 42 Self-assessment Self-assessment questions 105 (iii) The adaptive immune response Answers 107 18 Antigen processing and presentation 44 19 The antibody response 46 Appendices 20 Antigen – antibody interaction and immune complexes 48 Appendix I Comparative sizes and molecular weights 109 21 Cell-mediated immune responses 50 Appendix II Landmarks in the history of immunology and some unsolved problems 111 (iv) Regulation Appendix III CD classification 113 22 Tolerance 52 23 Cell communication and cytokines 54 Index 115 Companion website This book has a companion website at: www.ataglanceseries.com/immunology The website includes: • 95 interactive test questions • All figures from the book as PowerPoints for downloading Contents 5 Preface This is not a textbook for immunologists, who already have plenty of aware of having missed both by a comfortable margin. But even in excellent volumes to choose from. Rather, it is aimed at all those on immunology, what is brand new does not always turn out to be right, whose work immunology impinges but who may hitherto have lacked while the idea that any form of presentation, however unorthodox, will the time to keep abreast of a subject that can sometimes seem impos- make simple what other authors have already shown to be complex sibly fast-moving and intricate. can only be, in Dr Johnson’s heartfelt words, ‘the dream of a philoso- Yet everyone with a background in medicine or the biological sci- pher doomed to wake a lexicographer’. Our object has merely been to ences is already familiar with a good deal of the basic knowledge convince workers in neighbouring fields that modern immunology is required to understand immunological processes, often needing no not quite as forbidding as they may have thought. more than a few quick blackboard sketches to see roughly how they It is perhaps the price of specialization that some important aspects work. This is a book of such sketches, which have proved useful over of nature lie between disciplines and are consequently ignored for the years, recollected (and artistically touched up) in tranquillity. many years (transplant rejection is a good example). It follows that The Chinese sage who remarked that one picture was worth a thou- scientists are wise to keep an eye on each others’ areas so that in due sand words was certainly not an immunology teacher, or his estimate course the appropriate new disciplines can emerge – as immunology would not have been so low! In this book the text has been pruned to itself did from the shared interests of bacteriologists, haematologists, the minimum necessary for understanding the figures, omitting almost chemists and the rest. all historical and technical details, which can be found in the larger textbooks listed on the next page. In trying to steer a middle course J.H.L. Playfair between absolute clarity and absolute up to dateness, we are well B.M. Chain Acknowledgements Our largest debt is obviously to the immunologists who made the to Professor H.E.M. Kay, Professor C.A. Mims and Professor L. discoveries this book is based on; if we had credited them all by name Wolpert, all of whom made valuable suggestions. We would like to it would no longer have been a slim volume! In addition we are grate- thank Dr Mohammed Ibrahim (King’s College Hospital), Dr Mahdad ful to our colleagues at UCL for advice and criticism since the first Noursadeghi (UCL) and Dr Liz Lightsone (Imperial College) for help edition, particularly Professor J. Brostoff, Dr A. Cooke, Dr P. Delves, with the new chapters in the ninth edition. Edward Playfair supplied Dr V. Eisen, Professor F.C. Hay, Professor D.R. Katz, Dr T. Lund, a useful undergraduate view of the first edition. Finally, we would like Professor P.M. Lydyard, Dr D. Male, Dr S. Marshall-Clarke, Professor to thank the publishing staff at Wiley-Blackwell for help and encour- N.A. Mitchison and Professor I.M. Roitt. The original draft was shown agement at all stages. Note on the tenth edition Since the last edition in 2009 every chapter has needed some updating, clinical section has been expanded to include a brief survey of methods but the major advances concern the innate immune system, whose in use in the immunology lab. Self-assessment now includes online cells, molecules and receptors continue to attract enormous attention MCQs as well as the essay-type questions at the end of the book. from immunologists. We have added a new chapter on cytokine recep- tors, and completely rewritten the chapter on autoimmunity. Some J.H.L. Playfair chapters have been moved to fit better into the sequence of a typical B.M.