1. Immune system J. Ochotná

2. The main functions of the immune system Immune system belongs to the basic homeostatic mechanisms Defense - identification and protection against pathogenic microorganisms and their toxins Autotolerance – recognition of own tissues and keeping tolerance to them Immune surveillance - identifying and removing the old, damaged and otherwise changed cells

3. Antigen (immunogen) * substance that the immune system recognizes and responds to it * usually proteins or polysaccharides (lipids and nucleic acids only in the combination with proteins or polysaccharides) * Molecules <5 kDa can´t trigger an immune response, the optimal size of the antigen molecules to initiate immune response is about 40 kDa * autoantigen - antigen derived from his own body * exoantigen - alien substance from the external environment allergen - exoantigen that in susceptible individuals may cause pathological (allergic) immune response

4. Haptens * small molecules, that are able to induce specific immune response only after the establishment to the macromolecular carrier (separate haptens are not immunogenic) * typically drugs (eg penicillin antibiotics, hydralazin)

5. Interaction antigen – antibody Binding site of antibody (paratop) form non-covalent complexes with the corresponding part on antigen molecule (epitope) * participation: the hydrogen bonds, electrostatic and hydrophobic interactions, van der Waals forces * antigen-antibody complex is reversible Interaction antigen – antibody * Binding site of antibody (paratop) form non-covalent complexes with the corresponding part on antigen molecule (epitope) * participation: the hydrogen bonds, electrostatic and hydrophobic interactions, van der Waals forces * antigen-antibody complex is reversible

6. Types of antigens according to antigen presentation 1) thymus dependent antigens more frequently, mostly protein Ag * for specific humoral immune response to antigen is necessary to cooperate with T H lymphocytes (or response isn´t enough effective) * assistance implemented in the form of cytokines produced by T H lymphocytes Types of antigens according to antigen presentation 1) thymus dependent antigens * more frequently, mostly protein Ag * for specific humoral immune response to antigen is necessary to cooperate with T H lymphocytes (or response isn´t enough effective) * assistance implemented in the form of cytokines produced by T H lymphocytes

7. Types of antigens according to antigen presentation 2) thymus independent antigens in a small number of antigens can be induced antibodies production directly without the participation of T lymphocytes * this are mainly a bacterial polysaccharides, lipopolysaccharides and polymer forms of proteins (e.g. Haemophilus, Str.pneumoniae) Types of antigens according to antigen presentation 2) thymus independent antigens * in a small number of antigens can be induced antibodies production directly without the participation of T lymphocytes * this are mainly a bacterial polysaccharides, lipopolysaccharides and polymer forms of proteins (e.g. Haemophilus, Str.pneumoniae)

8. Superantigens stimulate lymphocytesa polyclonaly and massively * massive activation of T lymphocytes can cause shock * e.g. bacterial toxins (Staph.aureus, Str.pyogenes, Pseud.aeruginosa) Superantigens * stimulate lymphocytesa polyclonaly and massively * massive activation of T lymphocytes can cause shock * e.g. bacterial toxins (Staph.aureus, Str.pyogenes, Pseud.aeruginosa)

9. Sequestered antigens autoantigens that are normally hidden from the immune system and therefore unknow (e.g. the lens of the eye, testes,brain) * if they are "uncovered" by demage, can induce the immune response (one of the theories of autoimmune processes) Sequestered antigens * autoantigens that are normally hidden from the immune system and therefore unknow (e.g. the lens of the eye, testes,brain) * if they are "uncovered" by demage, can induce the immune response (one of the theories of autoimmune processes)

10. Components of the immune system

11. Components of the immune system * Lymphoid tissues and organs * Cells of the immune system * Molecules of the immune system

12. Lymphoid tissues and organs * are linked with the other organs and tissues by network of lymphatic and blood vessels Primary lymphoid tissues and organs * bone marrow, thymus * place of maturation and differentiation of immunocompetent cells * immature lymphocytes acquire here their antigenic specificity

13. Secondary lymphoid tissues and organs * meeting place of immunocompetent cells with Ag spleen - in contrast to the lymph nodes filter the blood and captures presented antigens lymph nodes and their organized clusters (tonsils, appendix, Peyer patches in the intestine) - filter lymph and capture present antigens MALT (mucous associated lymphoid tissue) - diffuse lymphatic tissue, the main role is capture of antigens that penetrate through the mucous membrane

16. Cells of the immune system * development of red and white blood cells begin at yolk sack, then haematopoiesis travels to fetal liver and spleen (3 to 7 month gestation), the main hematopoietic function has bone marrow * all blood cells arise from a pluripotent stem cell (CD 34) * stem cells self-renew and maintain throughout life * haematopoiesis is regulated by cytokines that are secreted by bone marrow stromal cells, activated T H cells and macrophages

18. Immune mechanisms

19. Nonspecific immune mechanisms * non-adaptive, innate * evolutionarily older * no immunological memory * in the presence of pathogens react quickly, in minutes (based on molecules and cells which are in the body prepared in advance) * component cellular - phagocytes (some are APC), NK cells humoral - complement, interferons, lectins and other serum proteins

20. Specific immune mechanisms * adaptive, antigen-specific * evolutionarily younger * have immunological memory * development of a full-specific immune response takes several days even weeks * component cellular - T lymphocytes (TCR) humoral - antibodies

21. Phagocytosis

22. Phagocytosis = ability to absorb particles from the surroundings Professional phagocytes * cells, which provide defenses by mechanism of phagocytosis * neutrophilic and eosinophilic granulocytes, monocytes and macrophages granulocytes - defense against extracellular pathogens - able to perform effector functions immediately - neutrophils don´t express MHCgpII (not APC) macrophages - removal of own apoptotic cells, defense against certain intracellular parasites - fully functional after activation by cytokines (IFN , TNF)

23. The intersection of phagocytes in damaged and infected tissues 7% of peripheral neutrophils and phagocytes 93% neutrophils and phagocytes in the bone marrow * this ratio changes due to inflammatory cytokines and bacterial products * in place of damage are captured phagocytes to endothelium (due to inflammatory cytokine expression of adhesion molecules is higher) * the first is interactions slows the movement of neutrophils - called roling,

25. * then there is a stronger link between endothelial cells and leukocytes and subsequent penetration between endothelial cells to the tissue - diapedesis, extravasation * phagocytes are directed to the site of inflammation by chemokines (IL-8, MIP-1  and , MCP-1, RANTES, C3a, C5a, bacterial products...), for which phagocytes have receptors

26. Receptors on phagocytes PAMPs- "pathogen associated molecular patterns„ - structures that are located on the surface of microorganisms, but not on their own intact cells * mannose receptor * galactose receptor * CD14 (binds bacterial LPS) * receptors of TLR group (binds bacterial lipoproteins, lipopolysaccharides, bacterial DNA) * scavenger receptors (bind phospholipids on the surface of apoptotic cells) Receptors on phagocytes PAMPs - "pathogen associated molecular patterns„ - structures that are located on the surface of microorganisms, but not on their own intact cells * mannose receptor * galactose receptor * CD14 (binds bacterial LPS) * receptors of TLR group (binds bacterial lipoproteins, lipopolysaccharides, bacterial DNA) * scavenger receptors (bind phospholipids on the surface of apoptotic cells)

27. - process, which increases the efficiency of foreign particles phagocytosis - the establishment of opsonins (IgG, IgA, C3b, MBL, fibronectin, fibrinogen, CRP, SAP) on the surface of foreign particles * Fc receptors on phagocytes (recognize antibodies linked to surface of micro-organism) * complement receptors (for binding C3b) Opsonization - process, which increases the efficiency of foreign particles phagocytosis - the establishment of opsonins (IgG, IgA, C3b, MBL, fibronectin, fibrinogen, CRP, SAP) on the surface of foreign particles * Fc receptors on phagocytes (recognize antibodies linked to surface of micro-organism) * complement receptors (for binding C3b)

29. Liquidation of absorbed organism fusion of fagosome with lysosomes activation of membrane NADPH oxidaseafter activation of Fc receptors and complement receptors, which leads to respiratory (oxidative) flash, when arise reactive oxygen intermediates (superoxid radical O 2 -, singlet oxygen, hydrogen peroxide, hydroxyl radical), which damage the structure of biopolymers, enzymes and DNA of microorganisms; enzyme myeloperoxidase catalyses the reaction of H 2 O 2 with Cl - to form chlornan anions (ClO-) production of nitric oxide (NO)macrophages produce NO after activation with cytokines (IFN , TNF) that are produced by T H 1 lymphocytes, NO liquidate intracellular parasites of macrophages Liquidation of absorbed organism * fusion of fagosome with lysosomes lysosomes contains - bactericidal substances (defensins) - hydrolytic enzymes (cathepsin, lysozyme) - liquid with a pH of 4-5 * activation of membrane NADPH oxidase after activation of Fc receptors and complement receptors, which leads to respiratory (oxidative) flash, when arise reactive oxygen intermediates (superoxid radical O 2 -, singlet oxygen, hydrogen peroxide, hydroxyl radical), which damage the structure of biopolymers, enzymes and DNA of microorganisms; enzyme myeloperoxidase catalyses the reaction of H 2 O 2 with Cl - to form chlornan anions (ClO-) * production of nitric oxide (NO) -macrophages produce NO after activation with cytokines (IFN , TNF) that are produced by T H 1 lymphocytes, NO liquidate intracellular parasites of macrophages

30. Secretory products of phagocytes * IL-1, 6, TNF (systemic response to inflammation) * IL-8 (chemokine) * IL-3, GM-CSF (control haematopoiesis) * TGF , TGF  (helping healing of tissues) * metabolic products of arachidonic acid (prostaglandins, prostacyclin, leukotrienes and thromboxanes

31. Complement

32. Complement * system of about 30 serum and membrane proteins (humoral component of nonspecific immunity) * complement components in serum are present in inactive form * complement activation has cascade character * complement proteins are synthesized in the liver, less by tissue macrophages and fibroblasts * the main complement components: C1-C9 (C3 is the central component) * other complement components: factor B, factor D, factor P * regulatory proteins: C1 - inhibitor, factor I, factor H, DAF, MCP, CR1, CD59 (protektin) inactivator of anafylatoxin

33. Function of complement * Opsonization (C3b) * Chemotaxis (C3a, C5a) * Osmotic lysis (MAC C5b-C9) * Anafylatoxins (C3a, C4a, C5a)

34. Complement activation * Alternative pathway * Clasial pathway * Lektin pathway

36. An alternative pathway * C3 component of complement rarely spontaneously breaks into C3b and C3a * C3b can covalently bind on the surface of microorganism * to bound C3b join a factor B, which is cleaved by factor D to Ba and Bb, resulting complex C3bBb is stabilized by factor P and functions as an alternative C3 convertase * C3 convertase cleaves C3 to C3a (chemotactic for phagocytes) and C3b, which binds to the surface of the microorganism (opsonization), or gives rise to other C3 convertases * from some C3 convertases form C3bBbC3b that act as an alternative C5 convertase, which cleaves C5 to C5a (chemotaxis) and C5b (starts terminal lytic phase)

37. Classical pathway * Can be initiated by antibodies (IgG, not by IgG4; IgM) or so-called pentraxins (CRP, SAP - acute phase proteins) * after binding of antibodies to the bacteria surface, there is a change in its conformation and C1 protein can bind * C1 have to bind to the 2 molecules of antibodies, change their conformation and get proteolytic activity - will cleave proteins C4 and C2 * fragments C4b and C2a bind to the surface of organism and create the classic C3 convertase (C4bC2a), which cleaves C3 to C3a and C3b * then creates a classic C5 convertase (C4bC2aC3b) that cleaves C5 to C5a and C5b

38. Lektin pathway * is initiated by serum mannose binding lectin (MBL) * MBL binds to carbohydrate structures on the surface of some microbes, after the bindins starts cleave C4 and C2 * this way is similar to the classical way

39. Terminal (lytic) phase of the complement cascade C5b fragments creates a complex with C6, C7 and C8, the complex dive into the lipid membrane of the cell and attached to it into a circle 13-18 molecules of C9, thus create in the membrane pores and cell can lysis (G-bacteria, protozoans, some viruses). Most microorganisms is to this lytic effect of complement resistant (protection by cell wall).

41. Regulation of complement and protection of own cells Activation of complement cascade is controlled by the plasma and membrane inhibitors. * C1 inhibitor * DAF (decay-accelerating protein)-degradation of C3 convertase * factor I, MCP (membrane cofactor protein), CR1, factor H – C3b cleavage * CD 59 (protectin) - prevents the polymerization of C9 * inactivator of anafylatoxin - inactivates anafylatoxins (C3a, C4a, C5a)

42. Complement receptors * Bind fragments of complement components CR1 - on various cells - removing of immunecomplexes CR2 - on B lymphocytes and FDC - activation of B cells CR3, CR4 - on phagocytes - participation in opsonization, adhesion

43. NK cells Interferons

44. NK cells Part of antigen non-specific mechanisms (innate)  Part of antigen non-specific mechanisms (innate)  They do not have antigen-specific receptors  Recognize cells that have abnormally low MHCgpI expression (some tumor and virus infected cells)  They are able to kill quickly - without prior stimulation, proliferation and differentiation  Activators of NK cells - IFN , IFN 

45.  Activating receptors - Some surface lectins, Fc receptor CD16 ADCC (antibody-dependent cellular cytotoxicity) NK cells recognize cell opsonized IgG antibody through the Fc receptor CD16, this leads to the activation of cytotoxic mechanisms (NK degranulation)  Inhibitory receptors - Signals provided through these receptors inhibit the cytotoxic mechanisms (recognize MHC gpI)  Imunoglobulin family - KIR (killer inhibitor receptors) inhibitor receptors)  C-type lektin family - eg CD94/NKG2 NK cells receptors

46. NK cell cytotoxic mechanisms  The resulting reaction of NK cell after meeting with another cell depends on which signal prevail, whether activating or inhibitory signals  Cytotoxic granules contain perforin and granzyme (perforin creates pores in the cytoplasmic membrane of target cells, in some cases may cause osmotic lysis of the target cell, formed pores in the cell receiving granzymes, that cause the target cell to die by apoptosis.  Fas ligand (FasL) - which binds to the apoptotic receptor Fas (CD95) presented on the surface of many different cells  TNF 

49. Interferons  Belongs to the humoral component of non-specific mechanisms  IFN  - produced by virus infected lymphocytes, monocytes and macrophages  IFN  - produced by virus-infected fibroblasts and epithelial cells  IFN  and IFN  - bind to receptors on the surface of infected and healthy cells and induce in them an antiviral state (synthesis of enzymes that block viral replication in the cell)  IFN  - produced by T H 1 cells, has regulatory function, activates macrophages and stimulates the expression of MHCgp

50. Basophils and mast cells and their importance in immune responses

51. Mast cells  Mucosal mast cells - in the mucous membranes of respiratory and gastrointestinal tract, participate in parasitosis and allergy  Connective tissue mast cells - the connective tissue, in parasitosis and allergy are not participating

52. Mast cell functions  Defense against parasitic infections  In pathological circumstances, responsible for the early type of hypersensitivity (immunopathological reaction typeI)  Apply during inflammation, in angiogenesis, in tissue remodeling  Regulation of immune response

53. Mast cell activation  Mast cells can be stimulated to degranulate:  cross-linking of IgE Fc receptors  anafylatoxins (C3a, C4a, C5a)  by direct injury (opioids, alcohols, and certain antibiotics)

54. Mast cell activation by cross-linking of IgE Fc receptors  Establishing of multivalent antigen (multicellular parasite) to IgE linked to highaffinnity Fc receptor for IgE (Fc  RI)  Aggregation of several molecules Fc  RI  Initiate mast cell degranulation (cytoplasmic granules mergers with the surface membrane and release their contents)  Activation of arachidonic acid metabolism (leukotriene C4, prostaglandin D2)  Start of production of cytokines (TNF, TGF , IL-4, 5,6...)

55. Activation schema of mast cell

56. Secretory products of mast cells  Cytoplasmatic granules: hydrolytic enzymes, proteoglycans (heparin, chondroitin sulphate), biogenic amines (histamine, serotonin) Histamine causes vasodilation, increased vascular permeability, erythema, edema, itching, contraction of bronchial smooth muscle, increases intestinal peristalsis, increased mucus secretion of mucosal glands in the respiratory tract and GIT (helps eliminate the parasite)  Arachidonic acid metabolites (leukotriene C4, prostaglandin D2)  Cytokines (TNF, TGF , IL-4, 5,6...)

57. The role of mast cells in development of allergy

58. Basophils  Differentiate from myeloid precursor  They are considered to be the circulating form of mast  Receptor equipment, containing granules, the mechanisms of stimulation and functions are very similar to mast cells  They are responsible for the emergence of anaphylactic shock