Chapter 15 Introduction to the
Immune Response and Inflammation
BODY DEFENSES
I. Barrier Defenses
- Certain anatomical barriers exist to:
 prevent the entry of foreign pathogens
 to serve as important lines of defense in
protecting the body
a. Skin
- First line of defense
- Physical barrier to protect internal tissues and
organs
- Glands secrete chemicals to destroy pathogens
- Top layer of skin falls off daily, making it difficult
for pathogens to colonize skin
- Normal bacterial flora help destroy disease-
causing pathogens
b. Mucous membranes
- Line areas of the body that are exposed to
external influences but do not have the benefit of
skin protection
- Respiratory tract (exposed to air), GI tract
(exposed to anything ingested by mouth), GU
tract (exposed to pathogens from perineal and
rectal area
- Secreted sticky mucus capable of trapping
invaders and inactivating them for destruction and
removal
- Lined with tiny, hair-like processes called cilia that
sweep any captured pathogen
- In GI tract, mucous membrane serves as protective
coating, preventing erosion of GI cells by acidic
environment of the stomach
- Also secreted mucous that serves as lubricant for
movement of food bolus and waste products
- Acts as thick barrier to prevent foreign pathogens
from penetrating GI tract and entering the body
c. Gastric acid
- Acid secreted by stomach in response to stimuli
- Aids digestion, destroys would-be pathogens that
are ingested or swallowed after removal from the
respiratory tract
d. Major histocompatibility complex
- Last barrier of defense
- Ability to distinguish between self-cells and foreign
cells
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- Genetic information code is carried on a
chromosome and is called the major
histocompatibility complex
- MHC contains histocompatibility antigens or
human leukocyte antigens (HLAs)
- The antigens (proteins) are located on cell
membrane and allow body to recognize cells as
being self-cells
- Cells without these proteins are identified as
foreign and are targeted for destruction
II. Cellular Defenses
- Foreign pathogens that manage to get past
barrier defences will encounter human
inflammatory and immune systems, or
mononuclear phagocyte system (MPS)
- Previously called reticuloendothelial system
- Composed primarily of leukocytes, lymphocytes,
lymphoid tissues, and chemical mediators
- Stem cells in bone marrow produce 2 types of
WBC or leukocytes
o Lymphocytes – key components of
immune system; consist of T cells, B cells,
and natural killer cells
o Myelocytes – develop into different cell
types that are important for basic
inflammatory and immune response;
includes neutrophils, basophils,
eonsinophils, and
monocytes/macrophages
a. Neutrophils
- Polymorphonuclear leukocytes
- Capable of moving outside of the blood stresm
(diapedesis) and engulfing and digesting foreign
material (phagocytosis)
- Rapidly produced when body is injured or
invaded by a pathogen, and move to site of injury
to attack foreign substance
- Called phagocytes
- Able to identify non-self cells by use of the MHC
- Can engulf non-self cells or mark them for
destruction by cytotoxic T lymphocytes
b. Basophils
- Myelocytic leukocytes
- Not capable of phagocytosis
- Contains chemical substances or mediators that
are important for initiating and maintaining an
 immune or inflammatory response (histamine,
heparin, etc)
- Mast cells – basophils that are fixed and do not
circulate; found in respiratory tract, GI tract, and
skin; stimulated by local irritation
c. Eosinophils
- Circulating myelocytic leukocytes
- Exact function is not understood
- Often found at site of allergic reaction
- May be responsible for removing proteins and
active components of the immune reaction from
the site of an allergic response
d. Monocytes/Macrophages
- Mononuclear phagocytes
- Mature leukocytes capable of phagocytizing an
antigen
- Help remove foreign material from the body so
the body can heal
- Can also process antigens and present them to
active lymphocytes for destruction
- Can circulate in blood stream or can be fixed in
specific tissue
- Release chemicals necessary to elicit a strong
inflammatory reaction
- Also respond to chemical mediators released by
other cells to increase intensity of a response and
facilitate body’s reaction
e. Lymphoid tissues
- Includes lymph nodes, spleen, thymus gland,
bone marrow, and lymphoid tissue throughout
respiratory and GI tracts
- Bone marrow and thymus gland are important in
creating cellular components of the MPS
- Bone marrow has a role in differentiation of the T
cells and regulating the actions of the immune
system
- Lymph nodes and lymphoid tissue store
concentration populations of neutro-, baso-,
eosinophils, and lymphocytes in areas of the body
that facilitate their surveillance for and destruction
of foreign proteins
III. Inflammatory Response
- Local reaction of the body to invasion or injury
- Cell injury causes the activation of a chemical in
the plasma called factor XII or Hageman factor
- Hageman factor is responsible for activating at
least 3 systems in the body:
o Kinin system
o Clotting cascade – initiates blood clotting
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o Plasminogen system – initiates dissolution
of blood clots
[Last 2 systems are discussed in Part VIII]
a. Kinin system
- Hageman factor activates kallikrein, a substance
found in the local tissues, which causes the
precursor substance kininogen to be converted to
bradykinin and other kinins
- Bradykinin caused local vasodiation
o Brings more blood to the injured area
o Allows WBC to escape into tissues
o Stimulates nerve endings to cause pain,
alerting the body to injury
- Bradykinin also causes release of arachidonic
acid from cell membrane
o Causes release of autacoids
 Acts like local hormones
 Released from cells, cause effect in
immediate area, then broken down
 Includes:
 Prostaglandins – some augment the
inflammatory reaction, some block it
 Leukotrienes – some cause
vasodilation and increased capillary
permeability, some block it
 Thromboxanes – cause local
vasoconstriction and facilitate
platelet aggregation and blood
coagulation
b. Histamine release
- Occurs while Hageman factor-initiated events are
proceeding
- Release is caused by injury to a cell membrane
- Histamine causes vasodilation
o Brings more blood and blood
components to the area
- Also alters capillary permeability
o Neutrophils and blood chemicals leave
bloodstream and enter injured area
- Stimulates pain perception
- Brings neutrophils to the area and engulf and get
rid of the invader or to remove the injured cell
c. Chemotaxis
- Ability to attract neutrophils and to stimulate then
and other macrophages in the area to be very
aggressive
- Property of some leukotrienes activated by
arachidonic acid
- Activation of neutrophils and release of other
chemicals can lead of cell injury and destruction
- When destroyed, the cell releases various
lysosomal enzymes that dissolve or destroy cell
membranes and proteins
 - Lysosomal enzymes are important in biological
recycling and breakdown of one-living tissues
after death
- They can cause local cellular breakdown and
further inflammation
o Develops into cycle leading to cell death
d. Clinical presentation
o Calor / Heat – occurs due to increased
blood flow to area
o Tumor / Swelling – occurs due to fluid
that leaks into the tissues as a result of the
change in capillary permeability
o Rubor / Redness – related again to
increase in blood flow caused by
vasodilation
o Dolor / Pain – comes from activation of
pain fibers by histamine and the kinin
system
- Once neutrophils become active, they release a
chemical that is a natural pyrogen, or fever-
causing substance
- Pyrogen resets neurons in hypothalamus to
maintain higher body temperature to act as
catalyst to many of the body’s chemical reactions,
making inflammatory and immune responses more
effective
- Leukotrienes affect brain to induce slow-wave
sleep, which is an energy conservation measure
for fighting the invader
o Also causes myalgia and arthralgia
(muscle and joint pain)
IV. Immune Response
- Stimulated by more specific invasion
a. T Cells
- Programmed in the thymus gland
- Provides cell-mediated immunity
i. Effector or Cytotoxic T cells
o found throughout the body
o aggressive against self-cells, releasing
cytokines or chemicals that directly
destroy a foreign cell of mark is for
destruction by phagocytes via
inflammatory response
o Has membrane-identifying antigens
different from those established by
person’s MHC
o May be body’s own cells invaded by a
virus
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ii. Helper T cells
o Respond to chemical indicators of
immune activity
o Stimulate other lymphocytes to be more
aggressive and responsive
iii. Suppressor T cells
o Respond to rising levels of chemicals
associated with an immune response to
suppress or sow the reaction
o Balance of helper and suppressor T cells
allow for rapid response to body injury or
invasion
o Allows body to conserve energy and
components
b. B Cells
- Found throughout MPS in groups called clones
- Programmed to identify specific proteins or
antigens
- Changes into a plasma cell when it reacts with a
specific antigen
o Produces antibodies or immunoglobulins
which circulate and react with this
specific antigen when it is encountered
o When antigen and antibody react, they
form antigen-antibody complex which
reveals a new receptor site on the
antibody that activates a series of plasma
proteins in the body called complement
proteins
c. Complement proteins
- React in cascade fashion to form a ring around
the antigen-antibody complex
- Can destroy the antigen by altering membrane,
allowing osmotic inflow of fluid that causes cell to
burst
- Also induces chemotaxis, increasing activity of
phagocytes, and release histamine
d. Antibody formation
- Aka acquired or active immunity
- Lifelong reaction
- Initial formation of antibodies, or primary
response, takes several days
- Activated B cell form memory cells that will
produce antibodies for immediate release in the
future if antigen is encountered
- Antibodies are released in the form of
immunoglobulins
i. IgM – contains antibodies produced at the
first exposure to the antigen
 ii. IgG contains antibodies made by the
memory cells that circulate and enter tissue;
mostly found in serum
iii. IgA – secreted in plasma cells in GI,
respiratory tract, and epithelial cells; react
with specific pathogens encountered in
exposed areas; found in tears, saliva,
sweat, mucus, bile
iv. IgE – present in small amounts, related to
allergic responses and the activation of mast
cells
v. IgD – role is not determined
e. Other mediators
- Interferons
o Chemicals secreted by cells that have
been invaded by viruses and possibly by
other stimuli
o Prevent viral replication and suppress
malignant cell replication and tumor
growth
- Interleukins
o Chemicals secreted by active leukocytes
to influence other leukocytes
 IL-1 – stimulated T and B cells to
initiate immune response
 IL-2 – released from active T cells
to stimulate the production of
more T cells and to increase the
activity of B cells, cytotoxic cells,
and natural killer cells
- Activates cellular immunity or the immune system’s
response is mild or absent
 Autoimmune disease
- Occurs when the body responds to specific self-
antigens to produce antibodies or cell-mediated
immune responses against its own cells
- Speculations:
o A result of response to a cell that was
invaded by a virus, leading to antibody
production to similar cells;
o Production of autoantibodies is a normal
process that goes on all the time, but in a
state of immunosuppression, the
suppressor T cells do not suppress
autoantibody production; or
o There is a genetic predisposition to
develop autoantibodies
 Transplant rejection
- Self-transplantation, or auto transplantation, results
in no immune response
- All other transplants produce an immune reaction
- Matching a donor’s HLA markers as closely as
possible to those of the recipient for
histocompatibility is essential
o The more closely the foreign cells can be
matched, the less aggressive will the
immune reaction be to the donated tissue

V. Interrelationship of the immune and inflammatory

responses
- Work together to protect the body and to
maintain a level of homeostasis within the body
- Helper T cells stimulate the activity of B cells and
effector T cells.
- Suppressor T cells monitor the chemical activity in
the body and act to suppress B-cell and T-cell
activity when the foreign antigen is under control.
- Both B cells and T cells ultimately depend on an
effective inflammatory reaction to achieve the end
goal of destruction of the foreign protein or cell

PATHOPHYSIOLOGY INVOLVING THE IMMUNE SYSTEM

 Neoplasms
- Occur when mutant cells escape the normal
surveillance of the immune system and begin to
grow and multiply

 Viral invasion of cells

- Alters the cell membrane and the antigenic
presentation of the cell (the MCH)

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