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INTRODUCTION TO PHYSIOLOGY COURSE - 1st Year MBChB
Immunity (2 lectures)
LECTURE 1:
List the functions of the immune system
What is the immune system? - body’s defence against foreign material
includes - recognition, removal and destruction of invaders
- ability to remember previous exposures and to mount a stronger second response
- removal of damaged / dead SELF cells (making way for healing and repair)
- recognition of abnormal (SELF) cells in body (cancer prevention)
Abnormal function - autoimmune diseases
immune functioning also involved in
- allergies
- rejection of transplants
- cancer autoimmunity
- AIDS
Define non-specific and specific immunity
Non-specific Immunity:
-refers to general response to damage or invasion
-responds immediately to protect body from foreign substances
-prior exposure to foreign matter not needed
-also known as natural immunity (present from birth)
-the first line of defence is the external body membranes (skin and mucosae)
-the second line of defence includes inflammation, phagocytosis, and mediators
(chemicals) such as complement, interferon and endogenous pyrogen
Specific Immunity:
-involves recognition of cells/matter as non-self
-protects body from infectious micro-organisms, cancer cells and transplanted organs or grafts
-stimulates a strong, specific response directed against a particular foreign organism / molecule
-involves both a chemically/humoral-mediated (antibodies) and cell-mediated response
-allows for adaptation to environment since it has ability to “memorise” the exposure
-often referred to as acquired or adaptive immunity
-specific immunity is the function of the lymphocytes
-lymphocytes are found circulating in the blood but the majority of the lymphocytes are found in
lymph nodes (filters the lymph) as well as specialised lymphoid tissues such as the slpeen
(filters blood), lymphoid tissue of the throat and pharynx (tonsils and adenoids - intercepts
foreign material entering by way of the upper respiratory tract), submucosal areas of the
gastrointestinal tract (Peyer’s Patches - intercepts micro-organisms entering via the gut), and the
bone marrow
-the humoral-mediated specific immunity is the function of B lymphocytes (mature in bone
marrow) whilst the T lymphocytes (which undergo maturation in the thymus) are responsible for
cell-mediated immunity
Describe the surface membrane barriers and their protective functions
-involves skin and mucous membranes of the body and their secretions
-these provide mechanical barriers to most micro-organisms
keratin of skin provides a highly effective acid and enzyme resistant barrier
mucous membranes line all body cavities that open to exterior -
the digestive, respiratory, urinary, and reproductive tracts
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secretions of these physical barriers contain variety of protective chemicals
skin secretions - acidic in nature, inhibits bacterial growth;
- sebum contains chemicals toxic to bacteria
vaginal secretions - also acidic in nature, inhibits bacterial growth
gastric secretions - contain HCl and protein-digesting enzymes which kill bacteria
saliva and tears - contain lysozyme an enzyme that destroys bacteria
respiratory and digestive tracts secrete mucus - sticky in nature, trapping bacteria
structural modifications of the respiratory system which assist to counteract potential invaders
include : mucous-coated hairs in nose and cilia on the cells of the mucosa of the upper
respiratory tract. These trap micro-organisms.
Nonspecific cellular and chemical defences
Body uses a number of nonspecific cellular and chemical means to protect itself. These include :
1. Phagocytosis - destruction of micro-organisms by engulfment
2. Natural killer cells - large granular lymphocytes which are able to kill virus-infected
and cancer cells. They do not depend on specific antigen recognition
3. Inflammation - a process which prevents spread of micro-organisms to other areas;
assists in the healing process and attracts phagocytes into the area
4. Antimicrobial proteins - interferons (released by virus-infected cells to protect
uninfected adjacent cells) and complement ( a group of proteins which
help to kill micro-organisms by inducing cell lysis and enhancing
phagocytosis and inflammation)
5. Fever - a systemic response of the body to invasion of micro-organisms. The high
temperature induced by pyrogens inhibits microbial multiplication and
enhances body repair
Describe the role of phagocytosis as a nonspecific body defence mechanism
Cells involved in phagocytosis are neutrophils and macrophages; neutrophils can usually
phagocytise 5 - 20 bacteria before the neutrophil itself is destroyed; macrophages are
much more powerful phagocytes, being capable of engulfing as many as 100 bacteria;
macrophages can survive much longer than neutrophils
Macrophages derive from circulating monocytes; monocytes are immature cells and are only
activated to act as phagocytes once they enter the tissues
Phagocytes generally circulate in the blood and are attracted to sites of invasion by means of
chemotaxis, by chemicals released as a result of tissue / cellular damage; other events
occurring during phagocyte mobilisation include margination and diapedesis
In some organs, notably liver, lungs and skin there are fixed macrophages ie permanent resident
cells such as the Kupffer cells in the liver; alveolar macrophages in the lungs,
macrophages of lymph nodes, spleen and bone marrow
The combination of monocytes, mobile macrophages, fixed tissue macrophages constitute the
monocyte-macrophage system
Eosinophils the white blood important for the defence against parasites are only weakly
phagocytic
A phagocyte engulfs particles (micro-organisms, cell debris) by enclosing it within a membrane
lined vacuole, known as a phagosome. This is then lysed with a lysosome to form a
phagolysosome. In this way most engulfed micro-organisms are killed. However there
are some pathogens, notably the tuberculosis bacillus that is resistant to lysosomal
enzymes.
Describe the various processes that occur during inflammation
The inflammatory process is triggered whenever body tissues are injured
Injury can occur as a result of 1) physical trauma
2) intense heat (burn)
3) irritating chemicals
4) infection by viruses, fungi and bacteria
There are four cardinal signs. These are redness, heat, swelling and pain
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- redness and heat due to increased blood flow to the area
- swelling (oedema) occurs as a result of increased capillary permeability
- pain results from the swelling compressing adjacent nerve endings
Macrophage and neutrophil responses include: tissue macrophages act as first line of defence;
chemical mediators (eg histamine, complements, prostaglandins) released as a result of tissue injury
attract and cause chemotaxis of neutrophils, and later, monocytes into the area, as well as
mobilisation of stored neutrophils and monocytes into the blood (neutrophilia); leukocytosis is a
characteristic sign of inflammation and occurs after 3-4 days. Pus which may accumulate in a
wound, is a mixture of dead or dying neutrophils, damaged tissue cells, and living/dead pathogens.
Inflammation : 1) prevents spread of damaging agents (fibrinogen clots are formed)
2) removes pathogens and cell debris (chemotaxis, phagocytosis)
3) promotes healing (increased delivery of nutrients and oxygen due to
increased capillary permeability, increased blood flow)
Generally intensity of inflammation proportional to degree of tissue injury
LECTURE 2:
Define antigen and explain its role in the immune system
Antigens “antibody generating molecules” are substances that can provoke a specific immune
response
They are usually large molecules with molecular mass > 8 000 - 10 000 daltons
In general they are large proteins or polysaccharides (complete antigens)
Complete antigens exhibit immunogenicity (ability to stimulate proliferation of lymphocytes and
antibody formation) and reactivity (ability to react with activated lymphocytes and antibodies
formed)
Small molecules when combine with body proteins can stimulate an immune response. These
incomplete antigens or haptens are said to be reactive but not imuunogenic unless attached to
protein carriers
Like enzymes, antigenic molecules have specific sites which are immunogenic (recognised by
activated lymphocytes and antibodies) - known as antigenic determinants or epitopes
An antigen may have many antigenic determinant
The surface of all body cells are covered with a large variety of protein molecules. These self-
antigens are not recognised as foreign to ourselves but are strongly antigenic to other individuals.
Among these cell surface proteins is a specific group of glycoproteins which charaterise the cell as
being a self cell. These are called the MHC (major histocompatibility complex) proteins.
Define humoral immunity
Humoral or B cell immunity is a part of the specific or acquired immune response. It is mediated by
b-lymphocytes and is characterised by the production of antibodies. These circulating gamma
globulin proteins are capable of binding to foreign material.
Define cell-mediated immunity
Cell-mediated or T cell immunity is characterised by the activation of T lymphocytes that are
capable of destroying specific foreign agents as well as virus-infected cells, cancer cells and foreign
graft cells
Compare and contrast active and passive immunity
Specific immunity (ie specific resistance to disease) can be induced either actively (after exposure to
the pathogen) or passively ( by transfer of antibodies).
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Active immunity is acquired following activation of lymphocytes on exposure to specif antigens; this
may be conferred naturally (after contracting the disease eg measles) or artificially (by exposure to a
dead or attenuated pathogen as in the case of measles vaccine)
Passive immunity can also be acquired naturally (transfer of antibodies from mother to foetus via the
placenta, and from mother to child through breast feeding) as well as artificially (infusion of
immune serum to treat snake bites, botulism, rabies and tetanus)
Active immunity is long-lasting as immological memory is stimulated through the activation of
lymphocytes by antigens
Passive immunity is short-lived as no activation of lymphocytes occurs during the process
Define antibodies and describe their functions
Antibodies (also known as immunoglobulins) are the gamma globulin part of the plasma proteins
They are secreted by activated B lymphocytes, also known as plasma cells, in response to exposure
to an antigen
Antibodies are capable of binding specifically with the antigen against which their production was
stimulated
There are five classes of antibodies
The functions of antibodies include:
nuetralisation of antigens,
agglutination (cell clumping),
precipitation (of soluble antigens),
fixation and activation of complement.
All of these processes act to enhance phagocytosis, inflammation and cell lysis. A good
example where the specific immune system enhances the activity of the non-specific
immune system
List the functions of T-lymphocytes
T lymphocytes are responsible for the cell-mediated responses of the specific immune response
There are three major groups of T lymphocytes:
helper T cells
cytotoxic T cells
suppressor T cells
Helper T cells - play a crucial role in specific cell-mediated immunity as evidenced in AIDS
(where they are destroyed)
- stimulate growth and proliferation of cytotoxic T cells
- stimulate growth and proliferation of suppressor T cells
- stimulates proliferation of activated B cells
- activate macrophages
- amplifies nonspecific immune responses
Cytototxic T cells- also known as killer T cells as they are capable of destroying micro-
organisms, virus-infected cells and parasites
- play an important role in destroying cancer cells and foreign transplanted cells
Suppressor T cells - regulation of the Tcell mediated immune response
- capable of suppressing the function of both helper T cells and cytotoxic T
cells
Sources:
1. AC Guyton - Human Physiology and Mechanisms of Disease (5th edition) Chapter 25 pp 261 - 268
2. EN Marieb- Human Anatomy and Physiology (3rd edition) Chapter 22 pp 707 - 731
