The Elements of Immunology This page is intentionally left Blank The Elements of Immunology FAHIM HALIM KHAN A L I G A R H M U S L I M U N I V E R S I T Y Delhi • Chennai • Chandigarh Upper Saddle River, NJ • Boston • London Sydney • Singapore • Hong Kong • Toronto • Tokyo Th e publishers are grateful to the organizations and individuals who have allowed the use of their copyrighted material. Each source is acknowledged in the appropriate place in the text. While every eff ort has been made to trace the owners, the publishers apologize for any inadvertent errors or omissions and would welcome corrections to be incorporated into the next edition or reprint of the book. About the Cover Phagocytosis of Foreign Debris by Monocyte White Blood Cell. Blood monocyte and phagocytosis of foreign debris on a blood ImThem Elemuennts ooflogy vessel. Monocytes are derived from bone marrow monoblasts and Fahim Halim Khan promonocytes. Th ey are delivered to the blood and can enter the tissues to develop into macrophages. Magnifi cation of 1,400. Cover courtesy of Visuals Unlimited/Corbis. Library of Congress Cataloging-in-Publication Data Khan, Fahim Halim. Th e elements of immunology/Fahim Halim Khan. p. cm. Includes bibliographical references and index. ISBN 978-8131711583 (pbk.) 1. Immunology—Textbooks. I. Title. QR181.K43 2009 616.07'9—dc22 2008050350 Copyright © 2009 Dorling Kindersley (India) Pvt. Ltd. Licensees of Pearson Education in South Asia Th is book is sold subject to the condition that it shall not, by way of trade or otherwise, be lent, resold, hired out, or otherwise circulated without the publisher’s prior written consent in any form of binding or cover other than that in which it is published and without a similar condition including this condition being imposed on the subsequent purchaser and without limiting the rights under copyright reserved above, no part of this publication may be reproduced, stored in or introduced into a retrieval system, or transmitted in any form or by any means (electronic, mechanical, photocopying, recording or otherwise), without the prior written permission of both the copyright owner and the above- mentioned publisher of this book. ISBN 978-81-317-1158-3 Head Offi ce: 482 FIE, Patparganj, Delhi 110 092, India Registered Offi ce: 14 Local Shopping Centre, Panchsheel Park, New Delhi 110 017, India Layout designed by Satwinder Singh Channey Illustrations by Tarak Sharma Typeset in 10/12 Minion by Televijay Technologies (P) Ltd Printed in India at Chennai Micro Print Pearson Education Inc., Upper Saddle River, NJ Pearson Education Ltd., London Pearson Education Australia Pty, Limited, Sydney Pearson Education Singapore, Pte. Ltd Pearson Education North Asia Ltd, Hong Kong Pearson Education Canada, Ltd., Toronto Pearson Educacion de Mexico, S.A. de C.V. Pearson Education-Japan, Tokyo Pearson Education Malaysia, Pte. Ltd. Dedicated to my mother This Page is intentionally left Blank BRIEF CONTENTS Preface xxix 1 An Introduction to the Immune System 2 2 Cells and Organs of the Immune System 24 3 Antigens 58 4 Antibodies 70 5 Generation of Antibody Diversity 92 6 Major Histocompatibility Complex 118 7 T-cell Receptors 136 8 T-cell Development and Activation 160 9 B-cell Development and Activation 184 10 The Complement System 208 11 Antigen Presentation and Processing 228 12 Cell-mediated Immunity 246 13 Hypersensitivity 266 14 Cell Migration and Infl ammatory Response 294 15 Immune Response to Infectious Agents 314 16 Vaccines 342 17 Transplantation Immunology 360 18 Cancer and the Immune System 380 19 Primary and Secondary Immunodefi ciencies 404 20 Autoimmunity and Autoimmune Diseases 428 Glossary 449 Index 461 This page is intentionally left Blank CONTENTS PREFACE xxix 1 An Introduction to the Immune System 2 1.1 INTRODUCTION 3 1.2 THE COMPONENTS OF IMMUNITY 4 1.2.1 INNATE IMMUNITY 4 Mechanical Barriers 4 Chemical Barriers 5 Phagocytosis 6 Fever 7 Infl ammation 7 Acute-phase Proteins 9 1.2.2 ADAPTIVE IMMUNITY 10 1.2.3 CELLS OF THE IMMUNE SYSTEM 10 B Lymphocytes 11 T Lymphocytes 11 Antigen-presenting Cells 12 Natural Killer Cells 12 Eosinophils 12 Basophils and Mast Cells 13 Mononuclear Phagocytes 13 Neutrophils 13 1.2.4 ANTIGENS AND ANTIGEN RECOGNITION 13 1.2.5 MHC AND ANTIGEN PRESENTATION 13 Processing of Endogenous Antigens 14 Processing of Exogenous Antigens 14 1.3 TYPES OF IMMUNE RESPONSE 15 1.3.1 ANTIBODY-MEDIATED IMMUNITY 16 1.3.2 CELL-MEDIATED IMMUNITY 17 1.4 ACTIVATION OF THE IMMUNE RESPONSE 17 1.4.1 HUMORAL RESPONSE 17 1.4.2 SELECTIVE ACTIVATION OF B CELLS AND GENERATION OF HUMORAL RESPONSE 18 1.4.3 CELL-MEDIATED RESPONSE 18 1.5 IMMUNE DISORDERS 19 1.5.1 AUTOIMMUNITY 19 1.5.2 IMMUNODEFICIENCY 20 1.5.3 HYPERSENSITIVITY 20 1.6 EVOLUTION OF IMMUNITY 20