Immunology

Ian Todd, Gavin Spickett, Lucy Fairclough, Gavin P. Spickett

• Publisher: Wiley-Blackwell
• Year: 2016
• Print ISBN: 9781118451649
• eBook ISBN: 9781118451632
• Edition: 7
• Topic: Medicine
• Subtopic: Medical Theory, Practice & Reference

Highly Commended at the British Medical Association Book Awards 2016

Immunology Lecture Notes provides a thorough grounding in basic concepts of immunity. Covering the core components of the immunology curriculum at medical school, it presents a concise overview of the immune system, its interactions with pathogens, the major areas of immunopathology, including immunodeficiency, allergy, autoimmunity, lymphoptopliferative diseases and transplantation, and their therapy.

Immunology Lecture Notes includes:

• Full-colour descriptive illustrations and diagrams throughout, supplemented by new molecular graphics and anatomical scans
• New clinical cases developed as themes throughout the book to illustrate the practical application of immunological principles
• Fully updated self-assessment questions with expanded explanation of answers

With learning objectives and key points guiding you through the vital concepts, Immunology Lecture Notes will help you to address the key disorders of the immune system, and use immunological developments in clinical practice.

Part 1
Immunity and the Immune System

1
The nature of immunity

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Key objectives

This chapter will enable you to:

Outline the general purpose and properties of the immune system

Distinguish the features of innate and adaptive immunity and the components of the immune system involved in each

Give an overview of the processes that generate an immune response appropriate for defence of the body against the pathogen that instigated the response

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Immunology is a relatively new science. It is a branch of biomedical science that covers the study of all aspects of immunity and the immune system in organisms. Immunity is a state of resistance to infection, and the immune system is composed of those constituents of the body (i.e. molecules, cells, tissues and organs) that contribute to generating this resistance. Immunology deals with the physiological functioning of the immune system in states of both health and disease. It incorporates malfunctions of the immune system, as well as the physical, chemical and physiological characteristics of the components of the immune system. These components can be studies individually (in isolation), in terms of their mutual interactions, and within the body as a whole. Its origin is usually attributed to events in the eighteenth century – firstly, to Lady Mary Wortley Montagu, the wife of the British ambassador in Constantinople (now known as Istanbul), who observed the positive effects of variolation on the native population in 1712. Variolation is the deliberate infection with smallpox, where dried smallpox scabs were blown into the nose of an individual who then contracted a mild form of the disease. She introduced it into England with royal patronage following initial experiments on condemned criminals and orphaned children. However, this procedure was not without risk of causing smallpox (variola) itself and the high morbidity and mortality associated with it made others look for less dangerous and more effective ways of controlling the disease.

Subsequently, Edward Jenner, a Gloucestershire family doctor, made the important observation that dairymaids, who frequently contracted cowpox (an infection of the hands acquired during milking), were remarkably resistant to smallpox and did not develop the disfigured pock-marked faces of those who had had smallpox infection.

Edward Jenner had suffered painfully from variolation performed when he was 8 years old. The increasing spread of smallpox throughout the population led him to develop the alternative technique of vaccination. This was first performed in 1796 when he inoculated material obtained from cowpox pustules into the arm of a healthy boy. Jenner was subsequently able to inoculate the boy with smallpox more than 20 times without any untoward effect. This courageous experiment aroused much criticism, but Jenner offered his new preventive treatment to all who sought it and performed many of his vaccinations in a thatched hut – which became known as the Temple of Vaccinia – in the grounds of his house at Berkeley. These are restored and now contain the Jenner Museum and a Conference Centre.¹

Although this vaccination was successful, it took almost two centuries (1796–1980) before the World Health Organization (WHO) was able to announce that smallpox was eradicated in 1980.

Interestingly, Jenner knew nothing of infectious agents that cause disease. Numerous scientific breakthroughs occurred, but it was not until Robert Koch first demonstrated, in 1876, that bacterial infectious agents (pathogens) cause disease. Any organism with the potential to cause disease is called a pathogen. There are five broad categories of pathogens, namely, viruses, bacteria, fungi, other relatively large and eukaryotic organisms (termed parasites) and prions (Table 1.1).

Table 1.1 Examples of types of pathogens and the diseases they cause.

Type of pathogen	Example pathogens	Diseases
Virus	Variola	Smallpox
	Human immunodeficiency virus	Acquired immune deficiency syndrome
Bacteria	Staphylococcus aureus or Streptococcus pneumoniae	Community-acquired pneumonia
Fungi	Candida albicans	Thrush
Parasite	Plasmodium malariae	Malaria
Prion	Creutzfeldt–Jakob disease (CJD) prion	CJD

Recognition and defence components

Before considering the complexity of the immune system as it exists, it is useful to consider some of the general design requirements of an immune system in order for it to protect the host organism. Clearly, the two important biological events are recognition of the target pathogen and effective defence against it. A major consideration is how many recognition specificities are required and how many kinds of defence, that is, methods of pathogen destruction, are necessary.

There exists an enormous variety of infectious pathogens, including many types of bacteria, viruses, fungi, parasites and prions, each with its own mechanisms of transmission, infection and reproduction. This means that no single recognition or defensive strategy is effective against all pathogens and therefor...

Table of contents

• Cover
• Title page
• Table of Contents
• Preface to the seventh edition
• From the preface to the first edition
• Key to symbols used in this edition
• Overview of the immune system
• Part 1: Immunity and the Immune System
• Part 2: Immunopathology
• Part 3: Self-assessment: answers
• Index
• End User License Agreement