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NEWS & UPDATES
(Gartner BRS 2018 Histology Lymphoid & Le FA 2021 Immunology Principles) V2 PDF
(Moi Pathology, Vaccines & Pharmacology) V1 PDF
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PRINCIPLES
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CELLS & MOLECULES . ANERGY & TOLERANCE
PATHOLOGY>
. HYPERSENSITIVITY .
DEFICIENCY . AUTOIMMUNE


PHARMACOLOGY
LABORATORY

MAPS

CONTENTS
(Playfair Glance 2012) V1 PDF
(Doan LIR 2013) V1
PDF

GENERALITIES
(Moi Phenomenology & Overview) V1 PDF
(Moi Pathology) V1 PDF


PRINCIPLES

(Gartner BRS 2018 Histology Lymphoid & Le FA 2021 Immunology Principles) V2 PDF

CONCEPTS OF IMMUNITY


INNATE ADAPTIVE
COMPONENTS
Neutrophils, macrophages, monocytes,
dendritic cells, natural killer (NK) cells
(lymphoid origin),
complement,
physical epithelial barriers,
secreted enzymes
T cells, B cells,
circulating antibodies
MECHANISM
Germline encoded
Variation through V(D)J recombination during lymphocyte development
RESPONSE
TO PATHOGENS

Nonspecific
Occurs rapidly (minutes to hours)
No memory response
Highly specific, refined over time
Develops over long periods; memory response is
faster and more robust
SECRETED PROTEINS
Lysozyme, complement, C-reactive protein
(CRP), defensins, cytokines
Immunoglobulins, cytokines
KEY FEATURES IN
PATHOGEN RECOGNITION

Toll-like receptors (TLRs): pattern recognition
receptors that recognize pathogen-associated
molecular patterns (PAMPs) and lead to
activation of NF-κB
Examples of PAMPs: LPS
(gram ⊝ bacteria), flagellin (bacteria), nucleic
acids (viruses)
Memory cells: activated B and T cells; subsequent
exposure to a previously encountered antigen >
stronger, quicker immune response


PASSIVE ACTIVE
MEANS OF
ACQUISITION

Receiving preformed antibodies
Exposure to exogenous antigens
ONSET
Rapid
Slow
DURATION
Short span of antibodies (half-life = 3 weeks)
Long-lasting protection (memory)
EXAMPLES
IgA in breast milk, maternal IgG crossing
placenta, antitoxin, humanized monoclonal
antibody
Natural infection, vaccines, toxoid
NOTES
After exposure to tetanus toxin, HBV, varicella,
rabies virus, botulinum toxin, or diphtheria
toxin, unvaccinated patients are given
preformed antibodies (passive)—“to Heal very
rapidly before dying”
Combined passive and active immunizations
can be given for hepatitis B or rabies exposure

INNATE
Non Speficic
Pattern Recognition by Cells
Toll-like Receptors
Cytosolic Receptors
Inflammasomes

Surface barriers
Cell Components : Leukocytes (Myeloid)
Mast Cells
Phagocytes
- Macrophages < Monocytes
- Neutrophils (Granulocyte)
- Dendritic Cells
Basophils & Eosinophils
(Granulocytes)
Innate lymphoid cells ILC (Lymphoid)
- NK
Gamma delta T cells
Inflammation
Complement system


ADAPTIVE (Jawed vertebrates) Memory
Pathogen & Antigen Specific
Recognition of Antigen
Components : Antigens, Lymphocytes B & T
Antigen presentation to T
Cell mediated
Killer T cells
Helper T cells
Gamma delta T cells

Humoral
Antibodies
Polyclonal B cell response

PASSIVE
Naturally acquired
Artificially acquired
Passive transfer of cell-mediated immunity


Immune privilege

ANATOMY - LYMPHOID STRUCTURES
Diffuse Lymphocytes
-> Follicle
-> Patch
-> Organ


PRIMARY ORGANS
Bone Marrow
Thymus
Thymoma

SECONDARY ORGANS
Allow immune cells to interact with antigen

Spleen
Periarteriolar lymphatic sheath
Follicle
Marginal zone

Lymph Nodes
Follicle
Medulla
Paracortex

Tonsils
MALT
Lymphatic System
Peripheral Lymphoid Tissue
GALT MALT BALT

CNS EQUIVALENT
Glymphatic system


TERTIARY
TLOs

FONCTION OF LYMPHATIC SYSTEM
Removal of interstitial fluid
Absorbs & Transports FAs & Fats as Chyle
Immune Fonction (Adaptive)
Transports WBCs to & from the LNs into the bones
Lymph transports APCs such as DCs, to the LNs


VESSELS

LYMPHATIC DRAINAGE ASSOCIATIONS

PHYSIOLOGICAL REGULATION
Hormones
Vitamin D
Sleep and rest
Nutrition and diet
Repair and regeneration


CELLS & MOLECULES OF THE IMMUNE SYSTEM

INNATE

PHAGOCYTIC CELLS
Neutrophils
Macrophages
Dendritic Cells


ANTIGEN PRESENTING CELLS APCs
Ex
II Ag - T
Dendritic Cells
Macrophages
B cells

NATURAL KILLER CELLS
Virus Tumor

Detect down-regulation of MHC I, Antibody-dependent cellular cytotoxicity (ADCC)
Functions of natural killer cells

COMPLEMENT SYSTEM

ACTIVATION PATHWAYS
Classic pathway
Alternative pathway
Lectin pathway
Proteins
Early Stage
Middle
Late
Inhibitors

FUNCTIONS
Opsonins
Inhibitors

COMPLEMENT DISORDERS
Complement protein deficiencies
Early complement deficiencies (C1–C4)
Terminal complement deficiencies (C5–C9)

Complement regulatory protein deficiencies

C1 esterase inhibitor deficiency
Paroxysmal nocturnal hemoglobinuria


ADAPTIVE
Cell-mediated immunity CMI
Humoral immunity
HI

T CELLS
TH1
TH2
TH17
TC Cytotoxic T cells
Regulatory T cells
IPEX (Immune dysregulation, Polyendocrinopathy, Enteropathy, X-linked) syndrome
Differentiation of T cells
Positive selection
Negative selection
Macrophage- lymphocyte interaction

B CELLS

Major functions of B and T cells

T- and B-cell activation

ANTIBODIES - IMMUNE RESPONSES
Opsonization
Neutralization
Complement activation
ADCC

Antibody structure and function

ANTIBODY DIVERSITY

Somatic recombination of VJ or VDJ genes
Genetic recombination
Random combinations of heavy and light chains
Somatic hypermutation

Immunoglobulin isotypes
IgG
IgA
IgM
IgD
IgE


Antigen type and memory
Thymus-independent antigens
Thymus-dependent antigens


CELL SURFACE RECEPTORS - PROTEINS
T-Cell Receptors
Helper T cells
Cytotoxic T cells
Regulatory T cells
B-Cell Receptors
Major Histocompatibility Complexe I & II MHC encoded by HLA genes. Present antigen fragments to T cells and bind T-cell receptors (TCRs)
HLA subtypes associated with diseases
Clusters of Differentiation
T Cells
B Cells
NK cells
Macrophages
Hematopoietic stem cells

CYTOKINES Acute (IL-1, IL-6, TNF-α), then recruit (IL-8, IL-12)
Interleukins
Interferons
IFN-α and IFN-β
IFN-γ
Tumor Necrosis Factors
SECRETED BY MACROPHAGES
Interleukin-1
Interleukin-6
Tumor necrosis factor-α
Interleukin-8
Interleukin-12
SECRETED BY T CELLS
Interleukin-2
Interleukin-3

FROM TH1 CELLS
Interferon-γ
FROM TH2 CELLS
Interleukin-4
Interleukin-5
Interleukin-10
Interleukin-13


Respiratory burst

IMMUNE SYSTEM INTERACTIONS
T-Cell Activation
Isotype Switching

ANERGY & TOLERANCE
Anergy
State during which a cell cannot become activated by exposure to its antigen.
T and B cells become anergic when exposed to their antigen without costimulatory signal (signal 2)
Another
mechanism of self-tolerance

T CELLS
Clonal Selection
Peripheral Tolerance

Clonal deletion
Anergy
Active suppression
Ignorance
B CELLS
Clonal Deletion
Anergy
Clonal Ignorance


IMMUNIZATIONS & VACCINES
Killed vaccines
Live attenuated vaccines
Toxoid vaccines
Recombinant vaccines
Conjugate vaccines


PATHOLOGY
(Moi Pathology, Vaccines & Pharmacology) V1 PDF

HYPERSENSITIVITY TYPES
(Moi Hypersensitivity) V1 PDF
Four types (ABCD) :
Anaphylactic and Atopic (type I)
AntiBody-mediated (type II)
Immune Complex (type III)
Delayed (cell-mediated, type IV)
Types I, II, and III are all antibody-mediated.

I
: IgE-MEDIATED - Foreign Allergen - "1st and fast" - Skin test for specific Ig
PATHOGENESIS
DISORDERS
Allergic & Atopic disorders
Urticaria or Hives
Allergic Rhinitis & Asthma
Hay fever
Eczema

Anaphylaxis
(eg, bee sting, some food/drug allergies)

II: Ab (M & G) - MEDIATED (CYTOTOXIC) -
"Cy-2-toxic" - Direct & indirect Coombs tests - Foreign & Autoimmune
Occurs when Abs are directed to fixed Ags on cell surfaces
PATHOGENESIS
Circulating Ab binds to an Ag on the pathogen
Complement is activated.
Outcomes include :
Opsonization, followed by phagocytosis
ADCC Antibody-Dependent Cell-mediated Cytotoxicity
Cell death mediated by NK or T cells
Immune response-mediated damage to healthy tissue

DISORDERS
Incompatible blood transfusions - Acute hemolytic transfusion reactions
Erythroblastosis fetalis
Goodpasture syndrome
Autoimmune hemolytic anemia
Bullous pemphigoid
Graves disease
Guillain-Barré syndrome
Idiopathic thrombocytopenic purpura
Myasthenia gravis
Pemphigus vulgaris
Pernicious anemia
Rheumatic fever

III: IMMUNE COMPLEX-MEDIATED - " 3 things in an IC: Ag, Ab & C " - Immunofluorescent staining
- Foreign & Autoimmune
Soluble Ag-Ab complexes form when antigen is abundant
Complex deposition in tissues causes

PATHOGENESIS
DISORDERS
SLE
Serum sickness
Arthus reaction
Polyarteritis nodosa
Poststreptococcal glomerulonephritis

IV: CELL-MEDIATED (DELAYED)
DTH - 4th & last 4 Ts = T lymphocytes, Transplant rejections, TB tests, Touching (contact dermatitis) - Patch test, PPD - Foreign, Autoimmune & GVHD
T cells are primed as effector cells specific to intracellular antigens or aberrant cells (foreign or mutated)
PATHOGENESIS
DISORDERS
Tuberculin skin test PPD
Contact dermatitis (eg, poison ivy, nickel allergy)
Graft-versus-host disease
Multiple sclerosis


UNKNOWN/MULTIPLE TYPES
Foreign & Autoimmune

IMMUNOLOGIC BLOOD TRANSFUSION REACTIONS
Allergic/anaphylactic reaction
Acute hemolytic transfusion reaction
Febrile nonhemolytic transfusion reaction
Transfusion-related acute lung injury
Delayed hemolytic transfusion reaction

DEFICIENCY
(Moi Deficiency) V1 PDF

B-CELL
X-Linked (Bruton) Agammaglobulinemia
Dysgammaglobulinemia (Selective Immunoglobulin IgA Defciency)
Common Variable Immunodefciency

T-CELL DEFCIENCIES  
Thymic Aplasia (DiGeorge Syndrome)
IL-12 Receptor Defciency
Autosomal Dominant Hyper-IgE Syndrome (Job Syndrome)
Chronic Mucocutaneous Candidiasis
Acquired Immunodefciency Syndrome

COMBINED   
Severe Combined Immunodefciency
Wiskott-Aldrich Syndrome
Hyper-IgM Syndrome
Ataxia-Telangiectasia


PHAGOCYTE
Leukocyte Adhesion Defciency
Syndrome (Type 1)
Chronic Granulomatous Disease
Chédiak-Higashi Syndrome

INFECTIONS IN IMMUNODEFICIENCY

AUTOIMMUNE
(Moi Autoimmune) V1 PDF

AUTOANTIBODIES & ASSOCIATIONS

HLA ASSOCIATIONS
HLA Genes
HLA Polymorphism and Disease Risk

GENERAL AUTOIMMUNE
SYSTEMIC AUTOIMMUNE
Scleroderma (Systemic Sclerosis)
OTHER AUTOIMMUNE

AUTOANTIBODY TARGETS AND CLINICAL FEATURES OF AUTOIMMUNE DISEASES
SYSTEMIC AUTOIMMUNE
Systemic lupus erythematosus (SLE)
Antiphospholipid syndrome
CREST syndrome
Mixed connective tissue disease
Sjögren syndrome
Reactive arthritis
Sarcoidosis
VASCULAR
Vasculitis (multiple)
ENDOCRINE
Diabetes mellitus type 1
Graves disease
Hashimoto thyroiditis
GASTROINTESTINAL
Celiac disease (nontropical sprue)
Primary biliary cirrhosis
Primary sclerosing cholangitis
Autoimmune hepatitis
BLOOD
Autoimmune hemolytic anemia
Pernicious anemia
Idiopathic thrombocytopenic purpura
Heparin-induced thrombocytopenia
MUSCULOSKELETAL
Rheumatoid arthritis
SKIN
Pemphigus vulgaris
Pemphigus foliaceus
Epidermolysis bullosa acquisita
Bullous pemphigoid
Dermatitis herpetiformis
NERVOUS
Myasthenia gravis
Lambert-Eaton myasthenic syndrome
Multiple sclerosis
Autoimmune inner ear disease
RENAL
Goodpasture syndrome

TRANSPLANT REJECTION
Hyperacute
Acute
Chronic
Graft-versus-host disease

CLINICAL IMMUNOLOGY

PHARMACOLOGY
(Moi Pharmacology) V1 PDF

MODULATORS
Interleukins  
Cytokines  
Chemokines  
Immunomodulatory imide drugs (IMiDs)
Other

ACTIVATION
Cancer

ENHANCEMENT
Vaccination


VACCINATION
(Moi Vaccines) V1 PDF
Live attenuated vaccine
Killed or inactivated vaccine
Subunit, recombinant, polysaccharide, and conjugate
Toxoid
mRNA


SUPPRESSANTS

IMMUNOSUPPRESSANTS
Cyclosporine
Tacrolimus (FK506)
Sirolimus (Rapamycin)
Basiliximab
Azathioprine
Mycophenolate Mofetil
Glucocorticoids

IMMUNOSUPPRESSION TARGETS

RECOMBINANT CYTOKINES AND CLINICAL USES
Bone marrow stimulation
Erythropoietin
Colony stimulating factors
Thrombopoietin

Immunotherapy
Interleukin-2
Interferons


THERAPEUTIC ANTIBODIES

Autoimmune disease therapy
Adalimumab, infliximab
Eculizumab
Guselkumab
Ixekizumab, secukinumab
Natalizumab
Ustekinumab
Vedolizumab
Other applications

Denosumab
Emicizumab
Omalizumab
Palivizumab


LABORATORY

REFERENCES

AUTHORS

Bie. Immunology Self and Non-self from a Phenomenological Point of View. 2006. [ Bolk's Companions ] [ Info & Download ]
Playfair. Immunology at a Glance. 10e. 2012. Download ] Download ]

Le. First Aid USMLE Step 1. Immunology. 33e. 2023. 30e. 2020.
Le. First Aid Basic Sciences General Principles. Immunology. 3e. 2017.

Abbas. Basic Immunology : Functions and Disorders of the Immune System. 7e. 2023. [ 336 pages ] [ Download 5e 2016 ]
Abbas. Cellular and Molecular Immunology. 10e. 2021. [ 600 pages ] [ Download ]
Sompayrac. How the Immune System Works. 6e. 2019. 4e. 2012. [ 168 pages ] [ Companion ]
Doan. LIR Immunology. 3e. 2021. 2e. 2013. [ 408 pages ] [ Download 2e ]
Wood. Understanding immunology. 3e. 2012.
Roitt. Essential immunology. 13e. 2017. 12e. 2011. [ 576 pages ] [ Download ] [ Roitt.com]
Punt. Kuby Immunology. 8e. 2018. [ 944 pages ] [ Download ]

Burmester. Color Atlas of immunology. 2003.
Murphy. Janeway's Immunobiology. 9e. 2016. [ 924 pages ]
medcravers.com/2019/10/immunology-an-introductory-textbook-by-anil-k-sharma
Actor. Introductory Immunology. 2e. 2019. [ 196 pages ] [ Download ]
en.wikipedia.org/wiki/Outline_of_immunology
archive.org/search.php?query=immunology
bmcimmunol.biomedcentral.com
http://medimaps.co.uk/immunology/

Hawley. BRS Microbiology & Immunology. 6e. 2013. Immunology. [ V1 PDF - PDF - Backup ]
Gartner. BRS Cell Biology & Histology. 7e. 2014. Lymphoid Tissue. [ V1 PDF - PDF - Backup ]
Kierszenbaum. Histology and Cell Biology. Immune - Lymphatic System. [ V1 PDF - Backup ]
Dudek. HY Histology. Thymus. [ V1 PDF - Backup ]
Dudek. HY Histology. Lymph Node. [ V1 PDF - Backup ]
Dudek. HY Histology. Spleen. [ V1 PDF - Backup ]
Baillet. Précis de Physiologie Humaine. 1992. HOMÉOSTASIE IMMUNITAIRE. [ V1 PDF - Backup ]
Gerhard. Biochemical Pathways : An Atlas of Biochemistry and Molecular Biology 2e. Immunology. 2012. [ V1 PDF ]
Schneider. BRS Pathology. 5e. 2013. Immune. [ V1 PDF ]
Kumar. Pathologic Basis of Disease. 9e. 2014. Immune. Summary. [ V2 PDF ]

MORE REFERENCES

DETAILED CONTENTS
MYELOID CELLS
Granulocytes
Monocytes
Macrophages
Dendritic
LYMPHOID CELLS
B
T
ILC
OTHERS
Stromal
Epithelial
Pericytes
M
HEMATOPOIESIS
Lymphopoiesis
Myelopoiesis
ANTIGEN RECEPTORS
B
T
PRRs
Membrane bound
Cytoplasmic
Secreted
COMPLEMENT Rs
Fc Rs
CYTOKINE Rs



NK Rs
OTHERS Rs
ANTIBODIES
A
D
E
G
M

CYTOKINES
Chemokines
Interferons
Interleukins
TNFs
CSFs
MHCs
I
II
COMPLEMENT
PROTEINS
Early Stage
Middle
Late
Inhibitors
ANTIMICROBIAL
PEPTIDES

TF
SIGNALING
PATHWAYS

CAMs
OTHERS
IDIOPATHIC
INFLAMMATION
CANCER TUMOR
AMYLOIDOSIS PREDICTING IMMUNOGENICITY
MUSCULOSKELETAL
CONNECTIVE & VASCULITIS
SKIN
REPRODUCTION


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