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Physiology of the Blood III. White Blood Cells and the Immune System 2. Prof. Szabolcs Kéri University of Szeged, Faculty of Medicine, Department of Physiology 2016 Virus infected cell, Tumor cell CD8 T [killer] cell - MHC-I+antigen NK cell CELLULAR IMMUNITY Bacteria CD4 T [helper] – MHC-II+antigen B cell: antibody HUMORAL IMMUNITY Adaptive immunity 1. Antigen presentation in the membrane: MHC (major histocompatibility complex) – a protein joined to the antigen for cell surface display (HLA – human leukocyte antigen) MHC-I - every cell contains in membrane - high degree of variety, individual differences (marker of „my cells”) - part of it: TAP/tapasin antigen processing molecule - cytotoxic T-cells recognize MHC-I (virus infected cell, tumor cell, tissue from another non-compatible individual) MHC- II - only in the membrane of immune cells (antigen presenting cells) - join to antigen-fragments digested in the lysosomes (e.g. bacteria) - helper T-cells recognize MHC-II The role of MHC-I in the recognition of self-cells The „Missing Self” hypothesis Adaptive immunity 2. Helper T-cell (TH) - CD4 membrane marker - its receptor recognizes MHC-II + antigen complex - type 1: facilitation of further phagocytosis - type 2: facilitation of B-cells – specific production of antibodies Cytotoxic T-cell (T-killer, T-effector) - CD8 membrane marker - recognizes MHC-I - virus/tumor cell (apoptosis, perforation of the membrane) - NK-cell: cytotoxic without antigen-specificity (part of innate immunity) CD = Cluster of Differentiation Adaptive immunity 3. Memory cell - CD8/CD4 or B-cell - stores the memory of antigens for years, fast activation and division in the case of new exposition Regulatory T-cell (suppressor T-cell) - immuntolerance: active inhibition of response in the case of the antigens of self-tissue and tolerated (non-harmful) others - central: selection of autoreactive cells in the thymus - peripheral: demarcation (e.g. brain, eye, joints), inhibitory cytokines (TGF), negative co-stimulation (CD molecules) γδ T-cell - receptor consists of γδ subunits instead of the common αβ - intraepithelial lymphocyte in the mucosa - recognizing whole proteins without MHC Interim summary 1. Framework of the specific immune response, cellular immunity • Antigen presenting cells – antigen part with MHCII (e.g., dendritic cell) • T[helper] – activation of other T és B cells • T[killer] – virus and tumor cell (cellular immunity, MHC-I) • MHC-I: discrimination of self and alien cells • Immuntolerance (physical separation, inhibiting receptors and cytokines, suppressor T-cells) Adaptive immunity 4. B-cells - transformed to plasma cells producing antibodies - antigen presentation - B-cell receptor = antibody inserted in the B-cell membrane Antibodies (immunoglobulins, Ig): IgG: most common, binds phagocytes (opsonization), passes placenta IgM: ancient, initial synthesis IgA: in mucosa-secreted fluid IgE: cytophil antibody, binds to basophils and mast cells IgD: B-cell receptor before antigen exposition The structure of the antibody Antigen binding Variable region Complement binding Fc receptor binding part (e.g. macrophages) L – light chain H – heavy chain Humoral (antibody dependent) immunity The special role of the NK-cells: „cellular - humoral hybrid” ADCC – antibody-dependent celullar cytotoxicity Ag – antigen Ab –antibody FcR – Fc-receptor Fas (CD95) – apoptosis inducing „death” receptor-ligand complex Granzyme/Perforin – factors for cytolysis Interim summary 2. Specific immune response: humoral immunity • B cell – transformation to plasma cells, antibody production • Antibody structure and groups: „Y”, Fab, Fc regions, complement binding, light and heavy chain • „MEGAD” • ADCC – role of antibodies in cytotoxicity Mediator substances of the immune response and inflammation 1. CYTOKINES 2. ARACHIDONIC ACID DERIVATES 3. COMPLEMENT 4. Acute phase proteins (produced by liver during inflammation and tissue damage) - C-reactive protein, serum amyloid A, procalcitonin – opsonization, precipitation, immune cell activation 5. Kinin-kallikrein system (bradykinin) (blood pressure, blood coagulation, pain, local inflammation) INFLAMMATION: „Rubor, tumor cum calore et dolore et functio laesa” (Red, swollen, warm, pain, impaired function) Matter (pus, purulent): leukocytes + tissue debris Cytokines 1. - Communication and functioning of leukocytes: division, differentiation, chemotaxis, antibody production, cytotoxicity - System-level effects: fever, increased metabolism, nervous system, cytokine-storm ↔ chronic inflammation, autoimmunity 1. INTERLEUKINS (IL) 2. INTERFERONS (INF) (antiviral, treatment of tumors & autoimmune diseases) 3. TUMOR NECROSIS FACTOR (TNF) 4. TRANSFORMING GROWTH FACTOR (TGF) (tumors, tissue regeneration) 5. COLONY-STIMULATING FACTORS (CSF) (bone marrow, cell division) 6. ADIPOKINES (produced by visceral fat!) Cytokines 2. 1. Macrophages „first signal”: IL-1, IL-6, TNFα 2. Cellular immunity: INFγ, TGFβ 3. Antibody production: IL-4, -10, -13 (IL-14 inhibits) 4. Chemotaxis: IL-8 5. TH-stimulation: IL-2 6. Granulocyte-activation: IL-5 (eosinophil), IL-3 (mast cell) Arachidonic acid derivates ARACHIDONIC ACID: long-chain unsaturated fatty acid of the plasma membrane mobilized by phospholipase A2 Cyclooxygenase (COX)-pathway: - prostaglandins (PGD2, -E2, -F2) - prostacyclin (from PGI2) - thromboxane (TXA2) Lipoxygenase-pathway: - leukotrienes (LTC4, -D4, -E4, -F4) Endogenous cannabinoids (e.g. anandamide [arachidonoylethanolamine] as an immune system modulator) NSAID (non-steroid antiinflammatory drugs): aspirin - COX1: prostaglandins protecting the mucosa of the stomach - COX2: inflammatory derivates - Selective COX2-inhibition (e.g. Vioxx) – thrombosis: connection between blood coagulation and inflammation - Paracetamol (acetaminophen), a painkiller and anti-fever drug, may enhances anandamide level The complement system A proteolytic cascade in the plasma, produced by the liver in precursor forms Activation: Classic: antibodies Alternative: antigens (Toll-like CRP = C-reactive protein receptors) lectins (=specific sugar binding proteins attaching to membranes) Function: - Cytolysis (membrane pore – C5-9) - Chemotaxis (C5a fragment) - Opsonization (C3b, C4b) - Changing the molecular structure of viruses MAC = membrane attack complex Interim summary 3. Substances regulating the immune system • Cytokines: IL, TNF, INF • Arachidonic acid: prostaglandins and leukotrienes (inflammatory reaction, NSAID) • Acute phase proteins: liver’s reaction to inflammation and tissue damage • Complement system: chemotaxis, opsonization, cytolysis – reaction dependent and independent of antibodies