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PowerPoint® Lecture Slides prepared by Janice Meeking, Mount Royal College CHAPTER 21 The Immune System: Innate and Adaptive:Body Defenses: Part A Copyright © 2010 Pearson Education, Inc. Immunity: Two Intrinsic Defense Systems • Innate (nonspecific) system responds quickly and consists of: • First line of defense – skin and mucosae prevent entry of microorganisms • Second line of defense – antimicrobial proteins, phagocytes, and other cells • Inhibit spread of invaders throughout the body • Inflammation is its most important mechanism • Adaptive (specific) defense system • Third line of defense – mounts attack against particular foreign substances • Takes longer to react than the innate system • Works in conjunction with the innate system Copyright © 2010 Pearson Education, Inc. Types of Nonspecific Defenses • Physical/surface barriers • Internal Defenses: Cells and Chemicals • Phagocytes • Netural killer cells • Inflammation • Antimicrobial proteins • Interferons • Complement system • fever Copyright © 2010 Pearson Education, Inc. Surface Barriers • Skin, mucous membranes, and their secretions make up the first line of defense • Keratin in the skin: • Presents a physical barrier to most microorganisms • Is resistant to weak acids and bases, bacterial enzymes, and toxins Copyright © 2010 Pearson Education, Inc. Epithelial Barriers • Epithelial membranes produce protective chemicals that destroy microorganisms • Skin acidity (pH of 3 to 5) inhibits bacterial growth • Sebum contains chemicals toxic to bacteria • Stomach mucosae secrete concentrated HCl and proteindigesting enzymes • Saliva and lacrimal fluid contain lysozyme • Mucus traps microorganisms that enter the digestive and respiratory systems • Mucus-coated hairs in the nose trap inhaled particles • Mucosa of the upper respiratory tract is ciliated • Cilia sweep dust- and bacteria trapped by mucus away from lower respiratory passages Copyright © 2010 Pearson Education, Inc. Internal Defenses: Cells and Chemicals • The body uses nonspecific cellular and chemical devices to protect itself • Phagocytes and natural killer (NK) cells • Antimicrobial proteins in blood and tissue fluid • Inflammatory response enlists macrophages, mast cells, WBCs, and chemicals Copyright © 2010 Pearson Education, Inc. Phagocytes • Macrophages are the main phagocytic cells • Two general types: • Macrophages – most derived from monocytes • Fixed (ex. Kupffer cells in liver) • Free/mobile - wander throughout a region in search of cellular debris • Microphages eosinophils Copyright © 2010 Pearson Education, Inc. – circulating neutrophils and Figure 21.2a Phagocytes • Neutrophils become phagocytic when encountering infectious material • Eosinophils are weakly phagocytic against parasitic worms • Mast cells bind and ingest a wide range of bacteria • Mast cells are found in the connective tissue and are similar to basophiles • Originate in the bone marrow • contain special cytoplasmic granules which store mediators of inflammation Copyright © 2010 Pearson Education, Inc. Natural killer (NK) cells • Are a small, distinct group of large granular lymphocytes • React nonspecifically and eliminate cancerous and virus-infected cells • Kill their target cells by releasing perforins and other cytolytic chemicals • Secrete potent chemicals that enhance the inflammatory response • NK cells • Recognize cell surface markers on foreign/abnormal cells • Recognize variety of antigens (less selective) • Immediate response when contact abnormal cells • Destroy cells with foreign antigens Copyright © 2010 Pearson Education, Inc. How Natural Killer Cells Kill Cellular Targets Figure 22.11 Copyright © 2010 Pearson Education, Inc. Inflammation: Tissue Response to Injury • The inflammatory response is triggered whenever body tissues are injured • Prevents the spread of damaging agents to nearby tissues • Disposes of cell debris and pathogens • Initiate repair processes • The four signs of acute inflammation are • Swelling • Redness • Heat • Pain Copyright © 2010 Pearson Education, Inc. Inflammation Response • Begins with chemical “alarm” • a flood of inflammatory chemicals released into the extracellular fluid • Macrophages and epithelial cells of boundary tissues have Toll-like receptors (TLRs) • TLRs recognize specific classes of infecting microbes • Activated TLRs trigger the release of cytokines that promote inflammation and attract WBC Copyright © 2010 Pearson Education, Inc. Inflammatory Response • Some of the inflammatory mediators • Histamine – amino acid derivative produced by basophiles and must cell- promote vasodilation • Kinins – plasma proteins that are activated by tissue injury and promote vasodilation • prostaglandins (PGs) – promote neutrophil diapedesis • Leukotrienes – stimulate vasodilation and netrophil cemotaxis • Complement – set of proteins that promote phgocytosis, activates cells of the immune system • Colony-Stimulating Factors – hormones that promote WBC count • Cells that are involved • WBC, helper T cells, platelets, endothelial cells Copyright © 2010 Pearson Education, Inc. Vasodilation and Increased Vascular Permeability • The most immediate requirement is to bring WBC to the injury site! • Vasodilation – causes hyperemia (increased blood flow) (Which sign of inflammation?) • Increase permeability of blood walls (cells separate slightly) – causes edema (leakage of exudate) (Which sign of inflammation?) • Exudate—fluid containing proteins, clotting factors, and antibodies • Exudate moves into tissue spaces causing local edema (swelling), which contributes to the sensation of pain Copyright © 2010 Pearson Education, Inc. Vasodilation and Increased Vascular Permeability • The surge of protein-rich fluids into tissue spaces (edema): • Helps dilute harmful substances • Brings in large quantities of oxygen and nutrients needed for repair • Allows entry of clotting proteins, which prevents the spread of bacteria Copyright © 2010 Pearson Education, Inc. Inflammatory Response: Phagocytic Mobilization • Four main phases: • Leukocytosis – neutrophils are released from the bone marrow in response to leukocytosis-inducing factors released by injured cells • Margination – neutrophils cling to the walls of capillaries in the injured area • Endothelial cells in the injury site produce cell-adhesion molecules that make the surface “sticky” to help in this process • Diapedesis – neutrophils squeeze through capillary walls and begin phagocytosis • Chemotaxis – inflammatory chemicals attract neutrophils to the injury site Copyright © 2010 Pearson Education, Inc. Antimicrobial Proteins • Enhance the innate defenses by: • Attacking microorganisms directly • Interfering with microorganisms’ ability to reproduce • The most important antimicrobial proteins are: • Interferon • Complement proteins Copyright © 2010 Pearson Education, Inc. Interferons • Interferons (INF) provide rapid response. • Produced by a variety of body cells • Lymphocytes produce gamma (), or immune, interferon • Most other WBCs produce alpha () interferon • Fibroblasts produce beta () interferon • INF alpha and beta are the most potent against viruses Copyright © 2010 Pearson Education, Inc. Interferon (IFN) • when a host cell is invaded by a virus it activates the genes that synthesize IFN • Interferon molecules leave the infected cell and enter neighboring cells • Interferon stimulates the neighboring cells to activate genes for PKR (an antiviral protein) • PKR nonspecifically blocks viral reproduction in the neighboring cell • Interferons also activate macrophages and mobilize NKs • Interferon can not save the infected cell but can prevent the virus from infecting other cells Copyright © 2010 Pearson Education, Inc. Complement – “complete the action of antibody” • 30 or so proteins synthesized mainly by the liver • circulate in the blood in an inactive form and activate in the presence of pathogen • Proteins include C1 through C9, factors B, D, and P, and regulatory proteins Copyright © 2010 Pearson Education, Inc. Complement system functions • Destruction of target cells membrane (MAC) • Stimulation of inflammation – C3a stimulates mast cells and basophils to secrete histamine • Attraction of phagocytes • Enhancement of phagocytosis – • Phagocytes membrane carry receptors that can bind to the complex of the complement proteins and antibodies. • The binding results in much more efficient phagocytosis. • The antibodies in such a complex are called opsonins and the effect is called opsonization (enhanced attachment ) Copyright © 2010 Pearson Education, Inc. Complement Pathways • Complement can be activated by two pathways: • The classical pathway is activated by the binding of antibody molecules to a foreign particle. This pathway is antibody-dependent. • The alternative pathway it is activated by invading microorganisms and does not require antibody. This pathway is antibody-independent. Copyright © 2010 Pearson Education, Inc. Complement Pathways • Each pathway involves a cascade in which complement proteins are activated in a sequence where each step catalyzes the next • Both pathways converge on C3, which cleaves into C3a and C3b • C3b initiates formation of a membrane attack complex (MAC) • MAC causes cell lysis Copyright © 2010 Pearson Education, Inc. Complement Pathways Copyright © 2010 Pearson Education, Inc. Figure 21.6 Fever • Abnormally high body temperature in response to invading microorganisms • Maintenance of a body temperature above 37.2oC (99oF) • The body’s thermostat is reset upwards in response to pyrogens, chemicals secreted by leukocytes and macrophages exposed to bacteria and other foreign substances • High fevers are dangerous because they can denature enzymes • Moderate fever can be beneficial: • Promotes INF activity • May inhibit some viruses and bacteria reproduction • Increase body metabolism so enzymatic reactions occur faster and so is tissue repair Copyright © 2010 Pearson Education, Inc. Properties of specific immunity • Specificity – activated by and responds to a specific antigen • Versatility – is ready to confront any antigen at any time • Memory – “remembers” any antigen it has encountered • Tolerance – responds to foreign substances but ignores normal tissues Copyright © 2010 Pearson Education, Inc. Complete Antigens • Substances that can mobilize the immune system and provoke an immune response • mostly large, complex molecules not normally found in the body (nonself) • Important properties of antigene: • Immunogenicity – ability to stimulate proliferation of specific lymphocytes and antibody production • Reactivity – ability to react with products of activated lymphocytes and the antibodies released in response to them • Complete antigens include foreign protein, nucleic acid, some lipids, and large polysaccharides Copyright © 2010 Pearson Education, Inc. Haptens (Incomplete Antigens) • Small molecules, such as peptides, nucleotides, and many hormones, that are not immunogenic but are reactive when attached to protein carriers • If they link up with the body’s proteins, the adaptive immune system may recognize them as foreign and mount a harmful attack (allergy) • Haptens are found in poison ivy, dander, some detergents, and cosmetics Copyright © 2010 Pearson Education, Inc. Antigenic Determinants Only certain parts of an entire antigen are immunogenic Copyright © 2010 Pearson Education, Inc. Figure 21.7 Cells of the Adaptive Immune System • Two types of lymphocytes • B lymphocytes – oversee humoral immunity • T lymphocytes – non-antibody-producing cells that constitute the cell-mediated arm of immunity • Antigen-presenting cells (APCs): • Do not respond to specific antigens Copyright © 2010 Pearson Education, Inc. Lymphocytes • Immature lymphocytes released from bone marrow are identical • During their development the lymphocyte: • Must become able to recognize its one specific antigen – become immunocompetent • Must be relatively unresponsive to self so it will not attack the body’s own cells – self tolerance • Location of becoming immunocompetent is the key for a lymphocyte to become B cell or a T cell • B cells mature in the bone marrow • T cells mature in the thymus Copyright © 2010 Pearson Education, Inc. Immunocompetent B or T cells • It is genes, not antigens, that determine which foreign substances our immune system will recognize and resist • Become immunocompetent before they encounter antigens they may later attack • Immunocompetence - displaying a unique type of receptor that responds to a specific antigen • Each cell develops numerous plasma membrane proteins that serve as antigen receptors and become immunocompetent. Copyright © 2010 Pearson Education, Inc. Immunocompetent B or T cells • An immunocompetent cell divides rapidly to form a clone of cells with identical receptors. All clones yet to encounter an antigen are called the virgin/naive lymphocyte pool. • Are exported to secondary lymphoid tissue where encounters with antigens occur • Mature into fully functional antigen-activated cells upon binding with their recognized antigen • Clonal selection of B or T cells occurs when antigens bind to their receptors, causing them to proliferate. Copyright © 2010 Pearson Education, Inc. T Cells • T cells mature in the thymus under negative and positive selection pressures • Positive selection • Selects T cells capable of binding to self-MHC proteins (MHC restriction) • Negative selection • Prompts apoptosis of T cells that bind to selfantigens displayed by self-MHC • Ensures self-tolerance Copyright © 2010 Pearson Education, Inc. B Cells • B cells mature in red bone marrow • Self-reactive B cells • Are eliminated by apoptosis (clonal deletion) or • Undergo receptor editing – rearrangement of their receptors • Are inactivated (anergy) if they escape from the bone marrow Copyright © 2010 Pearson Education, Inc. Antigen-Presenting Cells (APCs) • Major rolls in immunity are: • To engulf foreign particles • To present fragments of antigens on their own surfaces, to be recognized by T cells • Major APCs are • Dendritic cells (DCs), • Dendritic cells (DC) are bone marrow-derived cells that are specialized to take up, process and present antigen • Dendritic cells are present in small quantities in tissues that are in contact with the external environment, mainly the skin (where they are often called Langerhans cells) and the inner lining of the nose, lungs, stomach and the intestines. • Macrophages that are found all over the body • Activated B cells Copyright © 2010 Pearson Education, Inc. Importance of Cellular and humoral Responses • Importance of Humoral Response (Soluble antibodies) • The simplest ammunition of the immune response • Interact in extracellular environments such as body secretions, tissue fluid, blood, and lymph • Importance of Cellular Response (T-cells) • T cells recognize and respond only to processed fragments of antigen displayed on the surface of body cells • T cells are best suited for cell-to-cell interactions, and target: • Cells infected with viruses, bacteria, or intracellular parasites • Abnormal or cancerous cells • Cells of infused or transplanted foreign tissue Copyright © 2010 Pearson Education, Inc. Humoral Immunity Response Copyright © 2010 Pearson Education, Inc. Humoral Immunity Response • Antigen challenge – first encounter between an antigen and a naive immunocompetent cell • Takes place usually in the spleen or lymph node • If the lymphocyte is a B cell: • The challenging antigen provokes a humoral immune response • Antibodies are produced against the challenger • Clonal Selection - A naive, immunocompetent B cell is activated when antigens bind to its surface receptors Copyright © 2010 Pearson Education, Inc. Fate of the Clones • Most clone cells become antibody-secreting plasma cells • Plasma cells secrete specific antibody at the rate of 2000 molecules per second • Secreted antibodies: • Bind to free antigens • Mark the antigens for destruction by specific or nonspecific mechanisms • Clones that do not become plasma cells become memory cells that can mount an immediate response to subsequent exposures of the same antigen Copyright © 2010 Pearson Education, Inc. Antibodies • Also called immunoglobulins • Plasma cells make over a billion types of antibodies • makes the gamma globulin portion of blood proteins • Are soluble proteins secreted by activated B cells and plasma cells in response to an antigen • Are capable of binding specifically with that antigen • There are five classes of antibodies: IgD, IgM, IgG, IgA, and IgE • Antibodies themselves do not destroy antigen; they inactivate and tag it for destruction Copyright © 2010 Pearson Education, Inc. Basic Antibody Structure • Consists of four polypeptide chains linked together with disulfide bonds • Two identical heavy (H) chains and two identical light (L) chains • The four chains bound together form an antibody monomer • Each chain has a variable (V) region at one end and a constant (C) region at the other • Variable regions of the heavy and light chains combine to form the antigen-binding site • Constant region Determine the class of the antibody (one of the 5 groups) Copyright © 2010 Pearson Education, Inc. Basic Antibody Structure Copyright © 2010 Pearson Education, Inc. Figure 21.14 Classes of Antibodies • IgD – monomer attached to the surface of B cells, important in B cell activation • IgM – pentamer released by plasma cells during the primary immune response • IgG – monomer that is the most abundant and diverse antibody in primary and secondary response; crosses the placenta and confers passive immunity • IgA – dimer that helps prevent attachment of pathogens to epithelial cell surfaces • IgE – monomer that binds to mast cells and basophils, causing histamine release when activated Copyright © 2010 Pearson Education, Inc. Antibodies functions Copyright © 2010 Pearson Education, Inc. http://www.as.wvu.edu/~rbrundage/chapter12b/sld012.htm Neutralization – by binding to specific sites on the antigen, the antibody prevents its binding to cells Copyright © 2010 Pearson Education, Inc. Actions of antibodies – agglutination and precipitation • Ab molecules have at least 2 binding sites • Ag have many antigenic determinant sites • When Ag are far apart Ab will bind with 2 binding sites to the same antigen • If Ag are close, Ab can bind to antigenic determinant sites of different Ag. • As a consequence, the Ab “tie” Ag molecules together. Such a complex is called immune complex • When the complexes are too big to be soluble they “sink” in a process called precipitation • When the target Ag are on the surface of the cell or virus the formation of the large complex is called agglutination (example: clumping of RBCs in incompatible blood transfusion) Copyright © 2010 Pearson Education, Inc. http://www.as.wvu.edu/~rbrundage/chapter12b/sld012.htm Copyright © 2010 Pearson Education, Inc. Complement Fixation and Activation • Complement fixation: • Main mechanism used against cellular antigens • Antibodies bound to cells change shape and expose complement binding sites • This triggers complement fixation and cell lysis • Complement activation: • Enhances the inflammatory response • Uses a positive feedback cycle to promote phagocytosis • Enlists more and more defensive elements Copyright © 2010 Pearson Education, Inc. http://www.as.wvu.edu/~rbrundage/chapter12b/sld012.htm Activation of complement (nonspecific reaction) – when antibody bind to antigen, the Ab shape changes and that allows the binding of the complement proteins (which pathway?) Copyright © 2010 Pearson Education, Inc. The prevention of bacterial and viral adhesion • Covered by Ab, pathogens have reduced ability to attach to body surfaces and penetrate. Fig. 1: Bacterial Adherence Via Pili Fig. 1A: Blocking Bacterial Adherence with Antibody Molecules http://www.cat.cc.md.us/courses/bio141/lecguide/unit3/humoral/abydefense/opsonization/opsonization.html Copyright © 2010 Pearson Education, Inc. http://www.as.wvu.edu/~rbrundage/chapter12b/sld012.htm Phagocytes membrane carry receptors that can bind to the complex of the complement proteins and antibodies. The binding results in much more efficient phagocytosis. The antibodies in such a complex are called opsonins and the effect is called opsonization (enhanced attachment ) Copyright © 2010 Pearson Education, Inc. Other actions of antibodies • Attraction of phagocytes – the antigen-antibody complex attracts phgocytes that destroy pathogens • Antibodies may promote inflammation through the stimulation of basophils and mast cells Copyright © 2010 Pearson Education, Inc. Immunological Memory • Primary response – the initial response to an antigen • Cellular differentiation and proliferation, which occurs on the first exposure to a specific antigen • Lag period: 3 to 6 days after antigen challenge • Peak levels of plasma antibody are achieved in 10 days • Antibody levels then decline • If the antigen is not present anymore, the antibody production decrease. This reduction happens because: • Plasma cells have short life span (few days) • Suppressor T cells suppress plasma cells production • IgM molecules are the first to appear during primary response. IgM provide the immediate defense. This defense is limited because no memory cells are being produced • IgG – rise slow. Memory cells are formed Copyright © 2010 Pearson Education, Inc. Secondary antibody response • Secondary immune response – re-exposure to the same antigen • Sensitized memory cells respond within hours • Antibody levels peak in 2 to 3 days at much higher levels than in the primary response • Antibodies bind with greater affinity, and their levels in the blood can remain high for weeks to months • Memory B cells can leave for 20 years or longer • When a second exposure to antigen occur, memory B cells differentiate into plasma cells • This response is immediate because memory B cells are activated by relatively low levels of antigen • The antibody titer rises rapidly and to higher levels than during primary response Copyright © 2010 Pearson Education, Inc. The Primary and Secondary Immune Responses Figure 22.22 Copyright © 2010 Pearson Education, Inc. Cellular response Copyright © 2010 Pearson Education, Inc. Antigen Recognition and MHC Restriction • Immunocompetent T cells are activated when the V regions of their surface receptors bind to a recognized antigen • T cells must recognize: • Nonself (the antigen) • Self (a MHC protein of a body cell) Copyright © 2010 Pearson Education, Inc. Self-Antigens: MHC Proteins • Major histocompatibility complex - MHC proteins, mark a cell as self • The two classes of MHC proteins are: • Class I MHC proteins – found on virtually all body cells • Class II MHC proteins – found on certain cells in the immune response • Each MHC molecule has a deep groove that displays a peptide, which is a normal cellular product of protein recycling • In infected cells, MHC proteins bind to fragments of foreign antigens, which play a crucial role in mobilizing the immune system Copyright © 2010 Pearson Education, Inc. MHC classes – class I • Class I – found on all nucleated cells (“hey, I’m an abnormal cell – please kill me”) • “Sign” infected, sick or abnormal cells that need to be destroyed by the T-cells • When type I are forming they “pick up” peptides from the cytoplasm and carry them to the cell surface • If the peptides are normal (healthy cell) the T-cells will ignore them • If the cytoplasm contain abnormal peptides or viral proteins, T-cells will be activated. This activation will lead to the cell destruction Copyright © 2010 Pearson Education, Inc. MHC classes – class I Copyright © 2010 Pearson Education, Inc. MHC classes – class II • Class II MHC proteins are found only on mature B cells, some T cells, and antigen-presenting cells (“Hey, this antigen is dangerous – get rid of it”) • Class II are found on cells that the body does not need to destroy – it is only a mean to present non-self material • Phagocytes cells engulf and break down pathogens • A phagosome containing pathogens (with exogenous antigens) merges with a lysosome • This antigen processing creates fragments that are bound to type II MHC and inserted into the cell membrane Copyright © 2010 Pearson Education, Inc. MHC classes – class II Copyright © 2010 Pearson Education, Inc. Cell-Mediated Immune Response • Two major populations of T cells mediate cellular immunity: • CD4 cells (T4 cells) are primarily helper T cells (TH) • CD8 cells (T8 cells) are cytotoxic T cells (TC) that destroy cells with foreign antigens • MHC restriction – TH and TC bind to different classes of MHC proteins • TH / CD4 cells bind to antigen linked to class II MHC proteins • TC / CD8 cells are activated by antigen fragments presented by class I MHC proteins Copyright © 2010 Pearson Education, Inc. Copyright © 2010 Pearson Education, Inc. Specific T-cells roles: Helper T Cells (TH) • Regulatory cells that play a central role in the immune response • Once primed by APC presentation of antigen, they: • Chemically or directly stimulate proliferation of other T cells • Stimulate B cells that have already become bound to antigen • Without TH, there is no immune response • TH cells interact directly with B cells that have antigen fragments on their surfaces bound to MHC II receptors • TH cells stimulate B cells to divide more rapidly and begin antibody formation • Most antigens require TH co-stimulation to activate B cells • Cytokines released by TH amplify nonspecific defenses Copyright © 2010 Pearson Education, Inc. Specific T-cells roles: Cytotoxic T Cell (Tc) • TC cells, or killer T cells, are the only T cells that can directly attack and kill other cells • They circulate throughout the body in search of body cells that display the antigen to which they have been sensitized • Their targets include: • Virus-infected cells • Cells with intracellular bacteria or parasites • Cancer cells • Foreign cells from blood transfusions or transplants Copyright © 2010 Pearson Education, Inc. Mechanisms of Tc Action • Bind to the target cell and release perforin into its membrane • In the presence of Ca2+ perforin causes cell lysis by creating transmembrane pores • Secreting lymphotoxin, which fragments the target cell’s DNA • Secreting gamma interferon, phagocytosis by macrophages Copyright © 2010 Pearson Education, Inc. which stimulates Antigen Recognition and the Activation of Cytotoxic T Cells Figure 22.17 Copyright © 2010 Pearson Education, Inc. Other T Cells • Suppressor T cells (TS) – regulatory cells that release cytokines, which suppress the activity of both T cells and B cells Copyright © 2010 Pearson Education, Inc. T Cell Activation • APCs migrate to lymph nodes and other lymphoid tissues to present their antigens to T cells • T cell activation is a two-step process • Antigen binding • Co-stimulation • It means that the T cell has to “check twice” to make sure that it is APC presenting foreign antigen • The co-stimulation helps to ensure that the immune system does not attack self • Co-stimulation will trigger clonal selection Copyright © 2010 Pearson Education, Inc. T Cell Activation: Co-Stimulation • Without co-stimulation, anergy occurs • T cells • Become tolerant to that antigen • Are unable to divide • Do not secrete cytokines • T cells that are activated • Enlarge, proliferate, and form clones • Differentiate and perform functions according to their T cell class Copyright © 2010 Pearson Education, Inc. T Cell Activation • Primary T cell response peaks within a week after signal exposure • T cells then undergo apoptosis between days 7 and 30 • Effector activity decreases as the amount of antigen declines • The disposal of activated effector cells is a protective mechanism for the body • activated T-cell can be dangerous because they produce cytokins that can promote unnecessary inflammation. • Memory T cells remain and mediate secondary responses to the same antigen Copyright © 2010 Pearson Education, Inc. A Summary of the Pathways of T Cell Activation Figure 22.19 Copyright © 2010 Pearson Education, Inc.