Immunology

Contents
1.defination
2.types of immunity
3.mechanism of immunity
4.measurement of immunity
5.antigens
 Determination of antigenicity
 Biological classes of antigens
6.antibodies-immunoglobin
 Structure
 Immunoglobin classes
 Abnormal iimmunoglobulin specification]
 Immunoglobulin specificities
7.antigens-antibody reactions
 General features
 Measurements of Ag-Ab
 Serological reactions
 Agglutination reactions
 Opsonization
 Immunofluorescene
 Radio immuno assay (RIA)
 Enzyme immuno assay (EIA)
 Immune electron microscopic test
 Immuno electro blot techniques
 Immuno chromatographic tests
8.complement systems
 General properties
 Components
 Complement activation (classical/alternative pathways)
  Regulation of complement activation
 Biological effects of complement &its components
 Quantitave of complement
 Biosynthesis of complement
 Deficiency of complement system
9. Structure and functions of immune system
 Central lymphoid organs
 Peripheral (secondary) lymphoid organs
 Cells of lymph reticular systems
 Major histocompatibility complex
10.Immune response
 Antibody mediated immunity (AMI)
 Cell mediated immunity (CMI)-cytokines
 Immunological tolerance
 Theories of immune response
11.immunodeficiency diseases
 Primary immuno deficiencies
 Disorders of complements
 Disorders of phagocytes
 Secondary immuno deficiency
12.hypersensitivity
 Classification
13.auto immunity
 Mechanism
 Classification of auto immune diseases
 Transitory
 Pathogenesis of autoimmune disease
14.immunology of transplantation and malignancy
 Graft versus –host reaction
 Immunology of malignancy
15.immuno hematology
1.IMMUNITY:
 Definition: the term immunity refers to the resistance exhibited by the host
towards injury caused by microorganisms and their products.
2.TYPES:
a. Innate immunity
i. Non-specific
ii. Specific
b. Acquired immunity
i. Active-natural/artificial
ii. Passive-natural/artificial

a. Innate or native immunity: it is the resistance to infections, which an individual

possesses by virtue of his genetic and constitutional make up.
It may be non-specific, when it indicates a degree of resistance to
infections in general, or specific where resistance to a particular pathogenic and
concerned.
Innate immunity may be considered at the level of species, race or
individual.
Several factors influence the level of innate immunity in an individual.
They are;
 AGE: Two extremities of life carry higher susceptibility to infections diseases
as compared with adults. Some pathogens cross-placental barrier causing
overwhelming infections resulting in fetal death. Ex: rubella, herpes, CMV
and toxoplasma gondi, lead to congenital malformations .old persons are
highly susceptible to infections due to the warning of their immune responses
and other infirmities like enlarged prostate leading to urinary staris.
 HORMONAL INFLUNCE: Endocrines such as diabetes mellitus,
hypothyroidism and adrenal dysfunction are associated with an enhanced
susceptibility to infections
  NUTRITION: the interaction between malnutrition and immunity is complex
but in general, both humoral and cell mediated immune responses are
reduced in malnutrition status.
3.MECHANISM OF IMMUNITY:
i. Innate:
a) Epithelial surfaces: the intact skin and mucous membrane covering the
body protect t considerably against invasion of microorganisms. Healthy
skin pocess bacteria activity to which the presence of high concentration
salt in the drying sweats, the sebaceous secretion and the long chain fatty
acids contribute.
The mouth is constantly bathed in saliva, which has an
inhibitory effect on many microorganisms.

b) Antibacterial substance in blood and tissues:

Ex: complement, bataysis against antherene, lenkins from leukocytes,
plakins from platelets
Lactic acid found in muscles, Lactoperoxidase milk,
speruine in kidneys, interferon produces by cells stimulated by live or dead
viruses.
c) Microbial antagonism: The skin and mucous membrane surfaces have
resident bacterial flora, which prevent colonization by pathogens.
d) Cellular factors in innate immunity: They are:
 Microphages (PMNs)
 Macrophages (Ex: dendritic cells)
 Natural killer cells
e) Inflammation is an important non-specific defense mechanism.
f) Fever: acceration the physiological processes but may in same cases
atually destroy the infecting pathogens. Fever also stimulates the production
of interferon and aids recovery from viral infections.
g) Acute phase proteins (CRP):Infection or injury leads to production of
CRP, which activate the alternate pathway of complement
4.Mechanism of acquired immunity: the resistance that an individual acquires
during life is known as acquired immunity. Acquired immunity of two types;
a). Active immunity: does an individual as a result of an antigenic stimulus
develop the resistance.
This involves the functioning of the host’s immune apparatus
leading to the synthesis of antibodies and the production of immunologically
active cells. Active immunization is more effective and confers better
protection than passive immunization.
b). Passive immuity: The resistance that is transmitted to a recipient in a
“readymade” from is known as passive immunity. Here the recipient’s
immune systems play no active role. There is no antigenic stimulus instead
preformed antibodies are immunization is that it acts immediate and therefore,
can be employed when “instant” immunity is desired.
Active immunity may be natural or artificial. Natural active immunity results
from either clinical or an in apparent infection by a parasite. A person who has
recovered from an attack of measles developed natural active immunity. This
type of immunity is long lasting but the duration varies in different diseases.
Preminution: special type of immunity which lasts only as long as the
originally infection remains active. Once the disease is cured, the patient
become susceptible to the microorganism again Ex; Syphilis
Artificial active immunity: do vaccines induce the resistance. Vaccines are
preparations of live or killed microorganism or their products used for
immunization.
Examples of vaccines are as follows:
1. Bacterial toxins
a) Live (BCG vaccine for TB)
b) Killed (cholera vaccine)
c) Subunit (typhoid vaccine: antigen)
d) Bacterial products (tetanus toxoid)

2.Viral vaccine:
 a) Live (oral polio vaccin-sabin)
b) Killed (inject able polio vaccine-salk)
c) Subunit (HB vaccine)
Live vaccine initiate an infection without causing any injury
or disease.
Killed vaccines are generally less immunogrnic than live
vaccines and protection lasts only for a short period.
Natural passive immunity is the resistance passively transferred from mother
to baby. Predominantly through placenta (IgG) and through colostrums (IgA)
It is only about the age of three months that the infant
acquires a satisfactory level of immunoogical independence.
Artificial passive immunity: is the resistance passively transferred to a
recipient by the administration of antibodies.
Ex: Equine hyper immune sera such as antitetamus serum, human hyper
immune globulin ,(TIG).convalescent sera is that of patients recovering from
infectious disease.
Combined immunization: a combination active and passive method of
immunization is employed.
Adoptive immunity: Special type of immunization in which immunologically
competent lymphocytes are injected.
4.MESUREMENT OF IMMUNITY:
A simple method of testing immunity is to relate its level to
some convenient indicator, such as demonstration of specific antibody.
Antibodies may be demonstrated by a variety of techniques such as
agglutination, precipitation, complement fixation, hem agglutination
inhibition, neutralization and others .Ex: shick test in diphtheria.
ANTIGENS:

An antigen has defined as any substance which, when introduced parent rally
into the body, stimulates the production of an antibody with which it reacts
specifically and in an observable manner.
Complete antigen: Is able to induce antibodies formation and produce a
specific and observable reaction with the antibody produced.

Haptens: Are substances, which are incapable of inducing antibody formation

by them, but can react specifically with antibodies
The smallest unit of antigenic ally is known as the antigenic
determinant or epitope. The epitote is that small area on the antigen , usually
consisting of four or five amino acid or monosaccharide residues , possessing
a specific chemical structure , electric charge and steric (spatial)configuration
capable of sensitizing an immunocyte and of reacting with its complementary
site on the specific antibody or T-cell receptor.

Determinants of antigencity: A number of properties have been identified

which makes substance antigenic.
a) Size: Antigenically is related to molecular size. Very large molecules
such as hemocynanins (6.75 millions), are highly antigenic and
particles with low molecular weight (<5000) are non antigenic or
feebly so.
b) Chemical nature: Most naturally occurring antigens are proteins and
polysaccharides. Lipids and nucleic acids are less antigenic.
c) Susceptibility to tissue enzymes: Only substances, which are
metabolized and are susceptible to the action of tissue enzymes,
behave as antigens.
d) Foreignness: Only antigens which are foreign to the individual (non-
self) induce an immune response.
e) Antigenic specificity: The basis of antigenic specificity is stereo
chemical, was first demonstration by Obermayer and pick and
confirmed by Land Steiner.
f) Species specificity: Tissues of all individuals in a species contain
species specific antigen
 g) Isospecificity:Isoantigens are antigens found in some but not all
members of a species. Ex.: Human erythrocyte antigens based on
which individual can be classified into different blood groups, blood
transfusion, in soimmunisation during pregnancy, disputes paternity
cases and in anthropology.
h) Auto specificity: autology or self-antigens are ordinary non-antigenic
but there are exceptions. Ex: Sequestrated antigens that are not
normally found free in circulation or tissue fluids (such as lens protein
normally confirmed with its capsule)
i) Organ specificity: Some organs such as the brain, kidneys, and lens
protein of different species, share the same antigen.
j) Heterogenic specificity: The same or closely related antigens may
sometimes occur in different biological species, classes and kingdoms.
Ex: Forssman antigen which is a lipid carbohydrate complex widely
distributed in many animals, birds, plants and bacteria.

Biological classes of antigens:

Depending on their ability to induce antibody formation,
antigens are classified as T-cell dependent (TD) and T cell independent. TI
antigens stimulate antibody production by B-lymphocytes directly, without
apparent participation of T-cells. TD antigens require T-cell participation to
generate an immune response (i.e. stimulation of B cells by T cells)

ANTIBODIES AND IMMUNOGLOBULINS:

In 1964 endorsed by WHO, the generic term, “Immunoglobulin” was

internationally accepted for proteins if animal origin endewed with known
antibody activity and for certain other protein related to them by chemical
structure. Immunoglobulin provides a structural and chemical concept, while
the term ‘antibody’ is a biological and functional concept.
ALL THE ANTIBODIES ARE IMMUNOGLOBULINS BUT ALL
IMMUNOGLOBULINS MAY NOT BE ANTIBODY.
Ig constitutes 20-25% of the total serum proteins. Based on physiochemical
and antigenic differences, five classes of Ig have been recognized-IgG, IgA,
IgM, IgD and IgE. (Both Ig and g are accepted abbreviations for
immunoglobulins)

a). Structure: Studies involving the cleavage of the Ig molecule, pioneered by

porter, Edelman, aisoroff and their colleges, have led to a detailed picture of
its structure. Each molecule of Ig is split into one Fc portion (crystallisable),
and two Fab fragments (antigen binding)
Figure: