LABSCI 200 Midterm Lecture 1

Principles of Immunology:
An Introduction to the Immune System

The Immune System

Functions of the Immune System:

For homeostasis Defense against infectious agents For surveillance

Terminologies
Immunity Antigen (Ag) bodys defense against an antigen substances that cause the body to produce specific Abs

Antibody (Ab) Proteins made in response to an Ag Serology Globulins Study of reactions bet. Abs & Ags Serum proteins Serum fraction containing Ab

Gamma globulin

White Blood Cells

Neutrophils: Basophils: Eosinophils: Monocytes: Lymphocytes: _________________ _________________ _________________ _________________ _________________

Host Defenses

Figure 16.1

Nonspecific Host Defenses

Susceptibility

Lack of resistance to a disease

Resistance
Nonspecific resistance Specific resistance

Ability to ward off disease

Defenses against any pathogen Immunity, resistance to a specific pathogen

FIRST LINE OF DEFENSE

Mechanical Factors
SKIN Epidermis consists of tightly packed cells with

Keratin, a protective protein

MUCOUS MEMBRANES Ciliary escalator Lacrimal apparatus Saliva Urine Vaginal secretions

Chemical Factors

Fungistatic fatty acid in sebum Low pH (3-5) of skin Lysozyme in perspiration, tears, saliva & tissue fluids Low pH (1.2-3.0) of gastric juice Transferrins in blood find iron NO inhibits ATP production

SECOND LINE OF DEFENSE A. PHAGOCYTOSIS

Microbial Evasion of Phagocytosis

Inhibit adherence Kill phagocytes M protein
capsules

Leukocidins

Lyse Membrane phagocytes attack complex Escape phagosome Prevent phagosomelysosome fusion Survive in phagolysosome

B. INFLAMMATION
Functions:
contain & isolate the injury destroy microorganisms/ toxins prepare tissue for healing & repair

Cardinal Signs :
Rubor Tumor Calor Dolor

Functio Laesa.

Chemicals Released by Damaged Cells

Histamine Kinins Prostaglandins Leukotrienes Vasodilation Vasodilation Intensify histamine and kinin effect Increased permeability of blood vessels, phagocytic attachment

C. FEVER

D. The Complement System

Classical Pathway Alternative Pathway

Figure 16.13

Common Pathway

Serum proteins activated in a cascade.

Figure 16.10

Cytokines
Interleukin 1 mediator of leukocytic population IL-1 IL-2 IL-12

Chemokines induce WBC migration

 Interferon from a virus-infested cell -Interferon(Increase activity of macrophages) Tumor Necrosis Factor inflammatory reactions

GM Colony Stimulating Factor stimulate production of WBCs

Specific Host Defenses : The Immune Response

Acquired immunity Developed during an individual's lifetime Involves Ab produced by B cells Involves T cells

Humoral immunity

Cell-mediated immunity

Acquired Immunity
Naturally acquired active immunity Naturally acquired passive immunity

Artificially acquired active immunity

Artificially acquired passive immunity

Antigenic Determinants

Haptens

Figure 17.3

IMMUNOGLOBULINS

IgG

IgE

80% of serum Abs Cross placenta Enhance phagocytosis; neutralize toxins & viruses; protects fetus & newborn

0.002% of serum Abs

On mast cells and basophils, in blood

Allergic rxns; lysis of parasitic worms

IgM
5-10% of serum antibodies 1st Ab produced in response to infection In blood, lymph, on B cells Agglutinates microbes

IgA

IgD

10-15% of serum Abs In secretions Mucosal protection

0.2% of serum Abs

On B cells, initiate immune response

Figure 17.10

HUMORAL IMMUNITY
Involves Ab production Defends primarily against:
Bacteria Bacterial toxins Viruses (in body fluids) Transplanted tissues

B CELLS

Figure 17.8

The Results of Ag-Ab Binding

Figure 17.9

CELL-MEDIATED IMMUNITY
Involves T-cells Most effective against:
Intracellular Bacteria & viruses Fungi Protozoa Helminths

T Cell
CD4, TH
TH1 TH2

CD8, TC
Destroy target cells with perforin

TD
allergies, transplant rejection, and TB skin test

TS
Turn off immune response

Antibody Production

Figure 17.16

Cell-mediated Cytotoxicity

Figure 17.14

DISEASES of the IMMUNE SYSTEM

A. Hypersensitivity Reactions

Response to antigens (allergens) leading to damage Require sensitizing dose(s)

Type I (Anaphylactic) Reactions

Involves IgE
Localized: Hives or asthma Systemic: Shock

Figure 19.1a

Type II (Cytotoxic) Reactions

Involves IgG or IgM and complement

Complement activation causes cell lysis or damage by macrophages

Type III (Immune Complex) Reactions

Figure 19.6

Type IV (Cell-Mediated) Reactions Delayed-type hypersensitivities due to TD cells Cytokines attract macrophages and initiate tissue damage

Figure 19.8

B. AUTOIMMUNE DISEASES

Type I Due to Ags against pathogens Type II Abs react with cell-surface Ags Type III IgM, IgG, complement immune complexes deposit in tissues Type IV Mediated by T cells

C. IMMUNE DEFICIENCIES Congenital:

Selective IgA immunodeficiency Severe combined immunodeficiency

Acquired: Artificial: Immunosuppressive drugs Natural: HIV infections

The Immune System and Cancer

Cancer cells possess tumor-specific antigens TC cells recognize and lyse cancer cells Cancer cells may lack tumor antigens or kill TC cells

IMMUNOTHERAPY
Treatment of cancer using immunologic methods TNFs, IL-2, and interferons may kill cancer cells Vaccines contain tumor-specific antigens
Figure 19.11

Medical Parasitology

deals with human parasites and their medical significance as well as their importance in human communities

HELMINTHS
Eukaryotic Multicellular animals Chemoheterotrophic Kingdom: Animalia Phylum: Nematodes Phylum: Platyhelminthes

GENERAL TYPES OF PARASITES

1. Ectoparasites 2. Endoparasites
TYPES OF HOSTS

1. Intermediate Hosts 2. Definitive Hosts

SOURCES OF INFECTION
1. Contaminated soil & water 2. Contaminated food 3. Consumption of undercooked or raw fish 4. Arthropods 5. Beddings of infected person 6. Infected food handlers

MODES OF TRANSMISSION
1. 2. 3. 4. 5. 6. Fecal-Oral route Skin penetration Bites of arthropods Congenital infection Inhalation of airborne eggs Sexual intercourse

ARTHROPODS
Kingdom: Animalia Phylum: Arthropoda Types of Involvement Cause of disease Intermediate host Definitive host Vector

 Class Insecta (insects) Reduviid bugs Lice Mosquitoes Fleas Flies Class Arachnida (arachnids) Mites Ticks

Class Crustacea (crustaceans) Crabs Crayfish Cyclops

NEMATODES
INTESTINAL NEMATODES

Ascaris lumbricoides Enterobius vermicularis Necator americanus Strongyloides stercoralis Trichuris trichiura

1. Ascaris lumbricoides
COMMON NAME: Large Intestinal Roundworm

INTERMEDIATE HOST: DEFINITIVE HOST:

Human

ACQUIRED BY: Ingestion of Eggs

Observation of eggs in stool INFECTIVE STAGE: Embryonated egg DIAGNOSTIC STAGE: ova
DX:

2. Enterobius vermicularis
COMMON NAME: Pinworm

INTERMEDIATE HOST: DEFINITIVE HOST: Human

ACQUIRED BY:

Ingestion of Eggs

DX: eggs in Scotch Tape Method INFECTIVE STAGE: Embryonated eggs DIAGNOSTIC STAGE: Eggs on perianal folds

3. HOOKWORMS
INTERMEDIATE HOST: DEFINITIVE HOST: Human

ACQUIRED: Skin penetration by larva

DX: eggs in stool specimens INFECTIVE STAGE: Filariform larva DIAGNOSTIC STAGE: Ova

4. Strongyloides stercoralis
COMMON NAME: Threadworm

INTERMEDIATE HOST: DEFINITIVE HOST: Human

ACQUIRED: Skin penetration by larva

DX: eggs/larva in duodenal aspirates or stool INFECTIVE STAGE: Filariform larva DIAGNOSTIC STAGE: Rhabditiform larva

5. Trichuris trichiura
COMMON NAME: Whipworm INTERMEDIATE HOST: DEFINITIVE HOST: Human

ACQUIRED:

Ingestion of eggs

DX: eggs in stool specimens INFECTIVE STAGE: Embryonated egg DIAGNOSTIC STAGE: Eggs

TISSUE NEMATODES 1. Dracunculus medinensis

2. Trichinella spiralis

1. Dracunculus medinensis
CN : Guinea Worm
I.H.: Cyclops (fresh water crustacean)

D. H.: Human
ACQUIRED: Ingestion of infected Cyclops DX: adult worm beneath the skin or emerging from a blister (ankle or foot) I.S.: Larva in fresh water fish

D. S.: Adult worm

2. Trichinella spiralis
IH/DH: Pig, Bear, Walrus,Human
ACQUIRED: Ingestion of meat with larva

DX: Mostly undiagnosed or incidental finding

I.S./ D.S.: Encysted larva in striated muscles

FILARIAL NEMATODES
1. Brugia malayi Wuchereria bancrofti 2. Loa loa 3. Onchocerca volvulus

Brugia malayi Wuchereria bancrofti

I.H.: mosquitoes D.H.: Human ACQUIRED: Injection of larvae by mosquito DX: microfilariae in stained blood smears I.S.: L3 (3rd stage larvae)

D.S.: microfilariae

Loa loa
CN: Eye Worm

I.H.:Chrysops ( Mango Fly).

D.H.: Human ACQUIRED: Injection of larvae by Chrysops Dx: adult worm beneath skin or in the conjunctiva I.S.: L3 (3rd stage larvae) D.S.: microfilariae

Onchocerca volvulus
CN: Blinding Worm

IH: Simulium (Black Fly).

DH: Human ACQUIRED:Injection of larvae by Simulium DIAGNOSED: microfilariae in skin snips I.S.: L3 (3rd stage larvae)

D.S.: microfilariae

CESTODES
INTESTINAL CESTODES

Diphyllobothrium latum Dipylidium caninum Hymenolepis diminuta Hymenolepis nana Taenia saginata Taenia solium

Diphyllobothrium latum
CN: Fish Tapeworm IH: Cyclops (1st IH) Fresh Water Fish (2nd IH) DH: Human ACQUIRED: Ingestion of fresh H2O fish with L2 DX: proglottids or eggs in stool IS: procercoid larva DS: unembryonated eggs

Dipylidium caninum
CN: Dog Tapeworm IH: Flea DH: Dog, Cat, Human ACQUIRED: Ingestion of infected flea DX: proglottids / egg packets in stool I.S.: cysticercoid D.S.: proglottid

Hymenolepis diminuta
CN: Rat Tapeworm IH: Beetle DH: Rat, Mouse, Human ACQUIRED: Ingestion of beetle DX: egg in stool INFECTIVE STAGE: embryonated egg

DS: embryonated egg (absence of proglottid)

Hymenolepis nana
CN: Dwarf Tapeworm IH: DH: Human ACQUIRED: Fecal-Oral route DX: egg or proglottids in stool INFECTIVE STAGE: embryonated egg

DS: embryonated egg (no proglottid)

Taenia saginata
CN IH DH Beef Tapeworm Cow Human ACQUIRED beef

Taenia solium
Pork Tapeworm Pig Human Ingestion of pork

DX

egg / segment in stool

IS DS

-SAMEcysticercosis (MRI, sero) cysticerci ova or proglottids eggs / proglottids -SAME-

TISSUE CESTODE

Echinococcus granulosus
IH: Sheep, Human (dead-end) DH: Dog ACQUIRED: Ingestion of eggs DX: cysts by CT scans, MRI, x-ray, serotests

DS: eggs or proglottids in stool

TREMATODES
1. Adults have oral and ventral suckers. 2. Hermaphroditic. 3. Requires 2 IH in their life cycle. 4. Eggs are operculated. 5. Infective stage is metacercaria (in 2nd IH). 6. 1st IH is always a snail. 7. 2nd IH: fish, crustacean, snail, fresh H2O plants. 8. Grouped together based on their habitat.

INTESTINAL TREMATODE

Fasciolopsis buski
CN: Intestinal Fluke IH: Fresh Water Snails DH: Human, Dog, Pig, Rabbit

ACQUIRED: Ingestion of raw or uncooked plants with metacercariae

DIAGNOSED: eggs in stool specimens

LIVER TREMATODE

Clonorchis sinensis
CN: Chinese or Oriental Liver Fluke IH: Fresh Water Snails (1st) Fresh Water Fish (2nd) DH: Human, Dog, Cat ACQUIRED: Ingestion of fresh water fish DX: eggs in stool

LIVER TREMATODE

Fasciola hepatica
CN: Liver Fluke IH: Fresh Water Snails

DH: Human, Cow, Sheep

ACQUIRED:Ingestion of raw or undercooked aquatic vegetation with metacercariae DIAGNOSED: eggs in stool specimens

Paragonimus westermani
CN: Lung Fluke IH: Fresh Water Snails(1ST) Crabs or Crayfish (2ND) DH: Human, Dog, Cat ACQUIRED: Ingestion of crabs or crayfish DX: eggs in sputum or stool

BLOOD TREMATODES

Schistosoma
CN: Blood Fluke IH: Fresh Water Snails DH: Human

ACQUIRED: Skin penetration by cercariae DX: eggs in urine (S. haematobium) or stool (S. japonicum & S. mansoni)

PROTOZOA
eukaryotic single-celled animal-like mostly free-living soil & water break down & absorb nutrients from host

CLASSIFICATION OF PROTOZOA
Sarcodina (Amoebae) Mastigophora (Flagellates) Ciliata (Ciliates) Sporozoa

SUBPHYLUM

Sarcodina:
Amebiasis; Amebic Dysentery;

Entamoeba histolytica

Extraintestinal amebic abscesses

ACQD: ingestion of cysts

DX: cysts &/ trophozoites in stool

Naegleria fowleri Primary Amebic Meningoencephalitis

ACQD: diving in ponds DX: trophozoites in CSF cysts in tissue

SUBPHYLUM Mastigophora
Giardia lamblia Trichomonas vaginalis Leishmania spp Trypanosoma brucei Trypanosoma cruzi

Giardia lamblia
Giardiasis
ACQD: ingestion of cysts

DX: trophozoites or cysts in stool

Trichomonas vaginalis

Trichomoniasis Vaginitis

ACQD: contact; STD

DX: trophozoites in genital discharges, prostatic secretions

Leishmania
Leishmaniasis
ACQD: bite of sand fly (Phlebotomus) DX: parasite in aspirates or biopsy spxns

Trypanosoma brucie African Trypanosomiasis (African Sleeping Sickness)

ACQD: bite of Tsetse fly DX: trypomastigotes in bld,CSF, LN aspirates

Trypanosoma cruzi
American Trypanosomiasis (Chagas Disease) ACQD: orgs in Reduvid bug feces gets rubbed into bug bite DX: trypomastigotes in spxn

SUBPHYLUM Ciliata

Balantidium coli
Balantidiasis (a dysenteric disease) ACQD: Ingestion of cysts DX: cysts / trophozoites in stool

SUBPHYLUM Sporozoa
Cryptosporidium parvum Plasmodium spp Toxoplasma gondii

Cryptosporidium parvum Cryptosporidiosis (a diarrheal disease)

ACQD: Ingestion of DX: oocysts in feces Toxoplasma gondii

oocysts

Toxoplasmosis
ACQD: Ingestion of oocysts in cat feces / cysts in meat DX: Immunodiagnosis

Plasmodium species Malaria

P. P. P. P. ACQD: falciparum malariae ovale vivax

Injection of sporozoites by female Anopheles mosquito

DX: trophozoites, schizonts,gametocyte in blood spxs