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Immunology
Anil Dasgupta
1:
Immunology
1.1 HISTORY OF IMMUNOLOGY
1.2 INTRODUCTION TO IMMUNOLOGY
1.3 ANATOMY, PHYSIOLOGY AND PATHOLOGY OF THE IMMUNE SYSTEM
A MAJOR SITE OF IMMUNE REACTIVITY
Yolk Sac and Foetal Liver
Bone Marrow
Thymus
Effect of Neonatal Thymectomy
Effects of Adult Thymectomy
Thymic Hormone
Action of Thymus
Bursa of Fabricius
Effects of Neonatal Bursectomy
Peyer's Patches
Spleen
Lymph Node
Mucous Associated Lymphoid Tissues (MALT)
Cells that Derive from Lympho-myelo-Haemopoietic Stem Cells of the Bone Marrow
THE BASIC UNIT OF LIVING MATTER AND NETWORK INTERACTION
THE IMMUNE RESPONSE TO AN ANTIGEN AND THE GENETICS OF THE IMMUNE SYSTEM
1.4LANDMARKS IN THE HISTORY OF IMMUNOLOGY
FURTHER READING
2:
Immunity
MOLECULAR ELEMENTS OF INNATE IMMUNITY
Interferons
Acute Phase Proteins
Clinical Applications of Acute Phase Proteins
Complement
Clinical Applications of Complement Components
CELLULAR ELEMENTS OF INNATE IMMUNITY
Activation of Cells
Macrophage Activation
Phagocytosis
Nonphagocytic Natural Killer (NK) Cells of Innate Immunity
SUMMARY
Major Histocompatibility Complex
FURTHER READING
MOLECULAR ELEMENTS OF ACQUIRED IMMUNITY
Antigen and Hapten
Antigens of Cellular Origin
Antigenic Determinant also Called Epitope Together with Paratope and Idiotope
CELLULAR ELEMENTS OF ACQUIRED IMMUNITY
LYMPHOCYTES
LYMPHOCYTES ORIGINATE FROM PRECURSORS OF PLEURIPOTENT STEM CELLS AND DEVELOP INTO MATURE CELLS
LYMPHOCYTES ARE OF TWO MAJOR PHENOTYPES: B LYMPHOCYTES AND T LYMPHOCYTES
B Lymphocytes, also Referred to as B Cells, Derived from Bone Marrow
B Cell Subsets
B Cell Differentiation
B Cells Express Surface Immunoglobulin (SIg) Molecule as Antigen Receptor
T Cell Differentiation
T Cells Express Surface Molecules Similar to Ig as Antigen Receptors
B and T Cells Express Membrane Receptors
Membrane Receptors on B and T Cells
Nature of Receptors
B and T Cells Express Cluster of Differentiation (CD) Molecules
B Cell Surface Markers
T Cell Surface Markers
LYMPHOCYTES RECOGNIZE ANTIGEN TO GIVE RISE TO IMMUNE RESPONSE
Immune Response to an Antigen, on Entry, Involves at least Six Steps
Polymeric or Macromolecular Antigens, on Entry into the Body, Undergo Changes and Localize in the Secondary Lymphoid Tissues
LYMPHOCYTES, ON ENCOUNTER, RECOGNIZE MONOMERIC ANTIGENS IN THE PERIPHERAL OR SECONDARY LYMPHOID TISSUES AFTER DISCRIMINATION OF SELF FROM NONSELF TO MOUNT AN IMMUNE RESPONSE
Antigen Encounter to Discriminate Self from Nonself
Antigen Recognition to Initiate Immune Response
Antigen Trigger to Mount an Immune Response
LYMPHOCYTES ON RECOGNITION, MAY UNDERGO ACTIVATION AND CELL-CELL COLLABORATION
B Cell Activation
T Cell Activation
Lymphokine Proteins are T Cell Activation Products
Cytokines
Cell-cell Collaboration in Linked Recognition
Lymphocyte Recognition may also Lead to Memory, Tolerance and Homeostasis
Immunological Memory
Immunological Tolerance
T cell and B cell Unresponsiveness
Mechanism of Tolerance
Immunological Homeostasis
LYMPHOCYTES ON ACTIVATION, SYNTHESIZE ANTIBODY AND LYMPHOKINE PROTEINS, AND THEN RELEASE THEM INTO EXTRACELLULAR FLUID
Antibody Proteins are B cell Activation Products
Protein Synthesis is the Basis for Antibody or Immunoglobulin Synthesis
Protein Synthesis
Monoclonal Immunoglobulins
Polyclonal Immunoglobulins
CHARACTERISTIC FEATURES OF ANTIBODIES OR IMMUNOGLOBULINS
Antibody or Immunoglobulin Structure
Immunoglobulin Variants
Isotypes
Allotypes
Idiotypes
Other Parts of Immunoglobulin
J Chain
Secretory Piece
Role of Antibody
Immunoglobulins or Antibodies in Clinical Practice
Immunoglobulin Gene
Genetic Basis of Antibody Diversity
Antibody Genes to Generate Antigen Binding Specificities
Germ Line versus Somatic Mutation Theories
Genetic Control of Immune Response
Variability in Antibody Response
Immune Response Genes
Primary and Secondary Antibody Responses are the Result of B Cell Activation in Response to Antigen
Antibody and Cell Mediated Immunity are the Result of B and T Cell Activation Respectively
Antibody Mediated Immunity
Cell-mediated Immunity
Cell Types of Lymphoid Series with Cytotoxic, Cytolytic or Killer Activity
B and T Cell Activation Products may Reach Every Corner of the Body through Circulation and be Deployed for Defense of the Host
Clinical Implications of Cell Activation
Clinical Application of Lymphoid Cells
INNATE AND ACQUIRED IMMUNITY ARE SYNERGISTIC
Innate and Adaptive Regulatory T Cells: Cross-talk between NKT, CD4+ CD25+ and Other Types of Regulatory T Cells
SUMMARY
3:
Strategy of the Immune System
4:
Immune Response in Microbial Immunity and Diseases of Immunity
SUMMARY
Man and His Pathogens
Immunity to Viral and Bacterial Infections
Immunity to Fungal and Parasitic Infection
Classification of Immunodeficiency States
Primary Immunodeficiencies
Stem Cell Deficiency
Reticular Dysgenesis
B-cell Deficiency
T-cell Deficiency
Di-George Syndrome
Nezelof's Syndrome
Purine Nucleoside Phosphorylase Deficiency
B and T cell Deficiency
Severe Combined Immunodeficiency Disorders
Myeloid Cell Deficiency
Hereditary Neutropenias
Lazy Leucocytes
Myeloperoxidase Deficiency
Chediak-Higashi Disease
X-linked Recessive Chronic Granulomatous Disease
Complement Deficiency
Secondary Immunodeficiency
Acquired Immunodeficiency Syndrome (AIDS)
Etiological Agents of AIDS
Viral Genome of HIV-1
Immunological Findings in AIDS
Control Measure of AIDS
Nutritional Immunodeficiency Secondary to Malnutrition
Evaluation of Native and Acquired Immune Capabilities of Patient Suspected with Immunodeficiency States
Therapies in Immunodeficiency States
Intravenous Immunoglobulin (IVIG) Preparations
SUMMARY
Man and his immunodeficiency states which make him prone to infections
Primary Immunodeficiencies
Secondary Immunodeficiencies
Recognition/Evaluation of Immunodeficiencies
Therapies in Immunodeficiencies
Classification of Hypersensitivity
Mechanism of Action in Hypersensitivity
Type I Hypersensitivity
Mechanism of Anaphylaxis
Mediators of Anaphylactic Reaction
Histamine
Serotonin
Slow Reacting Substance A
Bradykinin
Prostaglandin
Platelet Aggregating Factor
Eosinophil Chemotactic Factor
Clinical Expression of Anaphylactic Reaction
Anaphylaxis
Local and Systemic Anaphylaxis
Allergy
Atopy
Immunoglobulins Associated with Anaphylaxis
Immunoglobulin G
Immunoglobulin A
Immunoglobulin E
Cells Associated with Anaphylactic Reaction
TH Cells are Required for IgE Production but TS Cells to Control IgE Response
Basophils and Mast Cells have Receptors for IgE
Genetic Control of Allergy
Causes of Allergy
Measurement of Type I Hypersensitivity Reaction
Management of Anaphylaxis
Chemotherapy
Immunotherapy
Type II Hypersensitivity
Mechanism of Cytotoxic Reaction
Isoantigens and Clinical Expression of Isoimmune Reaction
Blood Group Antigens
Leucocyte Antigens
Transfusion Reaction
Erythroblastosis Foetalis
Detection of Rh Antigen
Transplantation Rejection
Auto Antigens and Clinical Expression of Autoimmune Reaction
Red Cell Antigens and Autoimmune Haemolytic Anaemia
Platelet Antigens and Autoimmune Thrombocytopenic Purpura
Drug Associated Autoimmune Reaction
Disease Associated Autoimmune Reaction
Type III Hypersensitivity
Mechanism of Immune Complex Reaction
Formation of Immune Complex
Deposition of Immune Complex
Clinical Expression of Immune Complex Reaction
PROTOTYPE IMMUNE COMPLEX DISEASES
Arthus Reaction
Serum Sickness
Immune Complex Diseases Other than Prototypes
Glomerulonephritis
Rheumatoid Arthritis
Systemic Lupus Erythematosus
Neoplastic Disease
Infectious Diseases
Type IV Hypersensitivity
Mechanisms of Type IV or Delayed Reaction
Molecular Basis of Type IV Reaction
Cellular Basis of Type IV Reaction
Tuberculin Reaction
Type IV Reaction other than Tuberculin Reaction
Contact Sensitivity
Drug Allergy
Jones-Mote-Reaction or Cutaneous Basophil Hypersensitivity
Induction of Type IV Reaction
Clinical Expression of Type IV Reaction
Measurement of Type IV Reaction In Vivo and In Vitro Tests of Type IV Hypersensitivity
Lymphocyte Transformation
Macrophage Migration Inhibition
Aggressor-Target Cell Interaction
Therapy of Type IV Reaction
SUMMARY
Spectrum of Autoimmune Diseases
Overlap of Autoimmune Phenomena
Organ Specific Overlap
Non-organ Specific Overlap
Pathogenesis of Autoimmune Disease
Antibody Associated Autoimmune Disease
Cytotoxic Antibody Mediated Autoimmune Disease
Immune Complex Mediated Auto-Immune Diseases
Stimulatory Antibody or Receptor Mediated Autoimmune Diseases
Mechanism of Receptor Mediated Hypersensitivity
T-cell Associated Autoimmune Disease
Autoimmune Skin Disease
Etiology of Autoimmune Disease
Evasion of Normal Tolerance to Autoantigens
Sequestrated Autoantigens
Modified Autoantigens
Cross-Reacting Antigens
Exposure to Chemical Compounds
Immunoregulatory Bypass
T-cell Bypass
Idiotype Bypass
GENETICS OF AUTOIMMUNE DISEASE
Genetic Predisposition
Association with HLA
Diagnosis of Autoimmune Diseases
Treatment of Autoimmune Diseases
Immune Interventions
Autoimmunity
SUMMARY
Terms Used in Transplantation
Autograft
Syngraft
Allograft
Xenograft
Allograft Rejection
Mode of Expression of Allograft Rejection
Acute Rejection
Hyperacute Rejection
Chronic Rejection
Insidious Rejection
Basis of Allograft Rejection
First Set Rejection
Second Set Rejection
Mechanisms of Allograft Rejection
Cell-mediated Cytotoxic Reaction
Antibody-Mediated Cytotoxic Reaction
Immunological Enhancement in Allograft
Mechanism of Allograft Protection
PROTECTION OF FETUS DURING PREGNANCY IN MATERNAL WOMB
Immunological Relationship between Mother and Fetus
Allograft Rejection
Sequestration
Enhancement
Unresponsiveness
MHC Genes
Transplantation in Clinical Practice
Selection of Site of Tissues
Immunosuppressive Agents for Therapy
Anti-metabolites
Steroids
Anti-lymphocytic Serum
Immunological Tolerance
Conventional Immunological Investigation or Tissue Matching
Leukocyte Agglutination
Microlymphocytotoxicity
Mixed Lymphocyte Culture
DR Typing
DNA-DR typing
Cytotoxic Antibody Testing
Blood Grouping
Genetic Basis of Transplantation
Graft Versus Host Reaction
Bone Marrow Transplantation
SUMMARY
New Antigens on the Surface of Tumour Cells
Tumour Associated Antigens
Tumours may Develop Spontaneously and be Induced Virally and Chemically
Spontaneously Developed
Virally Induced
Chemically Induced
Oncogenes: Journey from Protooncogene to Oncogene and Signal for New Antigen
Virus causes Tumour
Overstimulation of Cells and Expression of Potentially Dangerous Protooncogenes
Immune Response to Tumour Antigens
B-cell Response
T-cell Response
Immunity to Tumours
INNATE AND ACQUIRED IMMUNITY TO TUMOURS
Acquired Immunity
Innate Immunity
Acquired and Innate Immunity can be escaped by the Tumour
Immunodiagnosis of Tumour
Immunotherapy of Tumour
Non-specific Immunotherapy
Specific Immunotherapy
Active Immunization
Passive Immunization
SUMMARY
INFECTIOUS DISEASES
Bacterial Diseases
Streptococcus Associated Diseases
Typhoid and Paratyphoid Fever
Brucellosis
Syphilis
Leprosy
Mycobacterial Infections
Immunological Tests in Mycobacterial Infections
In Vitro Assay
Viral Diseases
Viral Hepatitis
Infectious Mononucleosis
Rubella
Parasitic Diseases
Amoebiasis
Toxoplasmosis
Hydatid Disease
Investigation for Epidemiological Surveillance
Fungal Diseases
NONINFECTIOUS DISEASES
Respiratory Diseases
Gastrointestinal Diseases
Cutaneous Diseases
Cardiovascular Disease
Joint Diseases
Endocrine Diseases
Renal Disease
Multi-System Disease
Multiple Sclerosis (MS)
Malignancies
Immunodeficiencies
5:
Immunological and Molecular Techniques and their Applications
FIRST GENERATION TECHNIQUES
Agglutination
Factors that Influence Agglutination
Application of Agglutination Test
Blood Grouping Antigens are Demonstrable by Agglutination
Complement Fixation
Application of Complement Fixation Test
Neutralization
Application of Neutralization Test
Precipitation
Classical Precipitation Reaction
Qualitative and Quantitative Precipitation
Precipitation Reaction in Solution
Precipitation Reaction in Gel
Immunoelectrophoresis
Variants of Immunoelectrophoresis
Immunofixation
Application of Precipitation Tests
SECOND GENERATION TECHNIQUES
Isotope Techniques
Ammonium Sulphate Precipitation
Anti-Immunoglobulin Co-precipitation
Radioallergosorbent Test
Radioimmunoassay Technique
Radio-Immunoadsorbent Technique
Immunoradiometric Assay
Immunoblotting Assay
Application of Immunoradioisotope Techniques
Non-Isotope Techniques
Immunofluorochrome Technique
Immunoenzymatic Technique
Immunoferritin Antibody Technique
Application of Non-Isotope Techniques
THIRD GENERATION TECHNIQUES
Immunophenotyping for Cell Surface Antigens
Immune Cell Differentiation by Flow Cytometry
Microlymphocytotoxicity for HLA Typing and Restriction Fragment Length Polymorphism (RFLP) for Identity Determination
DNA Hybridization, Polymerase Chain Reaction (PCR) and Nucleotide Sequence
SUMMARY
Genome
Gene can be Cleaved and Isolated
A Bird's Eye View of Gene Cloning
How to Clone Genes
Techniques in Gene Cloning
Byproduct of Gene Cloning or Molecular Technique
DNA TECHNIQUE IN THE DISEASE DIAGNOSIS
Polymerase Chain Reaction
Identity Determination
Restriction Fragment Length Polymorphism (RFLP)
Hybridoma: A Fusion of Two Cells is called Hybridoma and Monoclonal Antibodies in Immunodiagnosis
MONOCLONAL ANTIBODIES
Antibodies Produced by more than One Cell in Response to Conventional Antigens are Polyclonal
Antibodies Produced by a Single Cell (and its progeny) in Response to a Single Epitope are Monoclonal
Single Domain Antibodies (dAbs)
Application of Monoclonal Antibodies
HISTOCOMPATIBILITY TYPING
Histocompatibility Antigens
Tissue Typing
HLA-A and HLA-B Typing
HLA-D and HLA-DR Typing
IgE Mediated Reaction in Association with T-cell in Penicillin Allergy
IgE Mediated Reaction in Association with IgG in Bronchopulmonary Aspergillosis
IgE Mediated Reaction in Allergy
Specific in vivo Tests
P-K Test
Prick Test
Provocation Test
Specific in vitro Tests
Test Based on Histamine Release
Test Based on IgE Binding
Nonspecific Tests
Interpretation of IgE Mediated Skin Test
SERUM PROTEINS IN IMMUNODIAGNOSIS
IMMUNE COMPLEXES
Techniques to Detect Immune Complexes
Tissue Bound Immune Complexes
Circulating Immune Complexes
Antigen Specific Method
Antigen Non-specific Method
Physical Assay
Complement Assay
Antiglobulin Assay
Cellular Assay
Protein Assay
AUTOANTIBODIES
Categories of Autoantibodies
Techniques to Demonstrate Autoantibodies
IMMUNOGLOBULINS
PARAPROTEINS
COMPLEMENT
ACUTE PHASE PROTEINS
BLOOD CELLS IN IMMUNODIAGNOSIS
MYELOID CELLS
PHAGOCYTES
Neutrophil Assay
Monocyte Assay
Interleukin-1 Assay
Immune Adherence
LYMPHOID CELLS
LYMPHOCYTES
Isolation of Lymphocytes
Cell Viability Test
Identification of B-cells
Identification of T-cells
Evaluation of B-cell Function
Evaluation of T-cell Function
Delayed Hypersensitivity Skin Reaction
Lymphoproliferative Response
Mixed Lymphocyte Reaction
Macrophage Migration Inhibition
Cytotoxic Reaction
Interleukin-2 Assay
γ-Interferon Assay
6:
Immunology at a Glance
INNATE AND ACQUIRED IMMUNITY
HISTORY OF IMMUNOLOGY
HISTORY OF IMMUNOGENETICS
RECAPITULATION
Immunity
Lymphocytes
AN AID FOR RECAP
INTRODUCTION TO IMMUNOLOGY AND IMMUNITY
IMMUNITY: INNATE AND ACQUIRED
BASIC IMMUNOLOGY
IMMUNOGENETICS
LYMPHOCYTES
IMMUNE RECOGNITION
APPLIED IMMUNOLOGY
IMMUNE RESPONSE IN MICROBIAL IMMUNITY
IMMUNE RESPONSE IN DISEASES OF IMMUNITY
ATTRIBUTES OF
APPENDIX 1:
Abbreviations for Cells and Molecules of the Immune System
APPENDIX 2:
CD (Cluster of Differentiation) Markers of Haemopoietic Cells
APPENDIX 3:
Cytokines of Immune Reaction
APPENDIX 4:
Chemokines are Chemotactic Cytokines
APPENDIX 5:
HLA (Human Leucocyte Antigen) Specificities
HLA IS SYNONYMOUS WITH MHC
12:
Glossary
INDEX
TOC
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