The specialized immune mechanisms that function to eradicate intracellular microbes constitute cell mediated immunity.

The effector phase of cell mediated immunity is carried out by t lumphocytes, and antibodies play no role in eradicating infections by microbes that are living inside host cells. The phases of cell mediated immunity consist of the activation of nave T cells to proliferate and to differentiate into effector cells and the elimination of cell associated microbes by the actions of theses effector t cells. In chapter 3 we described the function of major histocompatibilty complex molecules in displaying the antigens of intra cellular microbes for recognition by t lumphocytes, and in chapster 5 we discussed the way in which nave t cells recognize these antigens in lymphoid organs and develop into effector cells. In this chapter, we will address the following questions: 1. How do effetor T lymphocytes locate intracellular microbes at any site in the body? 2. How do effector T cells eradicate infections by these microbes?

Types of cell mediated immunity There are two types of cell mediated immune reactions designed to eliminate different types of intracellular microbes : CD4 helper T cells activate phagocytes to destroy microbes residing in the vesicles of these phagocytes, and CD8 cytotoxic T lymphocytes kill any cell containing microbes or microbial proteins in the cytoplasm, thereby eliminating the reservoir of infection. This separation of the effector functions of t lumphocytes is not absolute. Some CD4 t cells are capable of killing infected macrophages, and cd8 t cells activate macrophages to eliminate phagocytosed microbes. Nevertheless, phagocyte activation, which is the principal function of cd4 t cell in cell mediated immunity, and cd8 t cell mediated killing of infected cell are fundamentally different immune reactions and are described separately. Microbial infections may occure anywhere in the body, and some infectious pathogens are able to infect and live within host cells. Pathogenic microbes that infect and survive inside host cells include 1. Many bacteria and some protozoa that are ingested by phagocytes byt resist the killing mechanisms of these phagocytes and live in vesicles or cytoplasm, and 2 viruses that infect phagocytic and nonphagocytic cells and live and replicate in the cytoplasm of these cell. Effector t cells whose function is to eradicate these microbes are generated from nave t cells that were stimulated by microbial antigens in lymph nodes and spleen. The differentiated effector T cells then migrate to the site iof infection. Phagocytes at these sites that have ingested the microbes into intracellular vesicles diplay peptide fragments of microbial proteins attached to class II MHC molecules for recognition by CD4 effector T cells. Peptide antigens derived from microbes living in the cytoplasm of infected cells are displayed by class I MHC molecules for recognition by CD8 effector T cells. Antigens recognition by the effector t cells

then activates them to perform their task of eliminating the infectious pathogens. Thus, in cell mediated immunity, t cells recognize protein antigens at two stage: nave t cells recognize antigens in lymphoid tissues and respond by proliferating and differentiating into effector cells, and effector t cells recognize the same antigens anywhere in the body and respond by eliminating these microbes. In the remainder of this chapter, we will describe first how differentiated effector t cells locate microbes in tissues and then how cd4 and cd8 t cells eliminate these microbes.