Description

Book Synopsis
2012 PROSE Award, Clinical Medicine: Honorable Mention

The vast majority of medically important pathogens infect their host across a body surface such as the skin, or across a mucosal tissue such as the respiratory tract or intestines, as these sites are the ones exposed to the external environment. By focusing on immunity at mucosal and body surfaces this book presents a fresh, new approach to the teaching of immunology.

After an introduction to the basic structure of the immune system, the book looks at two important families of signalling molecules: cytokines and chemokines, before covering the workings of the mucosal immune system. It continues by examining immunity against the four major groups of pathogens - viruses, bacteria, fungi and parasites, and concludes by looking at disorders of the immune system, mucosal tumour immunology and the process of vaccination.

  • A fresh, new approach to the subject focusing on mucosal and body surfaces.

  • Trade Review

    “Overall, the book is well written, and the concepts are explained clearly, with well-illustrated, informative figures and diagrams. An 11-page glossary supports that text. Summing Up: Recommended. Upper-division undergraduates and above.” (Choice, 1 August 2012)



    Table of Contents
    Preface, xv

    List of Standard Cells and Symbols, xvii

    1 Basic Concepts in Immunology, 1

    1.1 The immune system, 1

    1.2 Tissues and cells of the immune system, 1

    1.3 Activation, regulation and functions of immune responses, 4

    1.4 Innate versus adaptive immunity, 5

    1.5 Primary and secondary immune responses, 6

    1.6 Immune cell development, 7

    1.7 Mast cells and basophils, 9

    1.8 Eosinophils, 11

    1.9 Neutrophils, 11

    1.10 Monocytes and macrophages, 11

    1.11 Dendritic cells, 12

    1.12 Natural killer cells, 12

    1.13 CD4+ T helper cells, 13

    1.14 CD8+ cytotoxic T cells, 14

    1.15 B cells, 15

    1.16 γδ T cells, 16

    1.17 Natural killer T cells, 16

    1.18 Anatomy of the immune system, 16

    1.19 Lymph nodes, 16

    1.20 Spleen, 19

    1.21 Summary, 19

    2 The Innate Immune System, 20

    2.1 Introduction to the innate immune system, 20

    2.2 Innate immune receptors and cells, 20

    2.3 TLRs and pattern recognition, 22

    2.4 TLR signalling in response to LPS, 23

    2.5 Peptidoglycan and Nods, 24

    2.6 Nod-like receptors recognize PAMPs and DAMPs, 25

    2.7 Damage associated molecular patterns (DAMPs), 26

    2.8 Complement proteins perform several innate immune functions, 27

    2.9 The classical complement pathway, 28

    2.10 The lectin and alternative complement pathways, 29

    2.11 Biological properties of complement cleavage products, 29

    2.12 Opsonization by complement proteins, 30

    2.13 Phagocytosis, 31

    2.14 Fc receptors induce phagocytosis, 32

    2.15 Neutrophil function and the respiratory burst, 32

    2.16 ADCC, 33

    2.17 NK cells recognize missing self, 35

    2.18 Activating adaptive immunity, 36

    2.19 Dendritic cells link innate and adaptive immunity, 38

    2.20 Summary, 40

    3 The Adaptive Immune System, 41

    3.1 Introduction to adaptive immunity, 41

    3.2 T cells and B cells recognize foreign antigens, 41

    3.3 Overview of antibody structure, 42

    3.4 Constant region and antibody isotypes, 45

    3.5 B cell receptor (BCR) diversity, 46

    3.6 Genetic recombination of BCR genes, 46

    3.7 Mechanism of VDJ recombination, 47

    3.8 Introducing junctional diversity, 48

    3.9 Somatic hypermutation and affinity maturation, 49

    3.10 Immunoglobulin class switching, 50

    3.11 Structure of Fc receptors, 51

    3.12 Fc receptor specificity and affinity, 53

    3.13 Cross-linking of antibody is necessary for Fc receptor signalling, 53

    3.14 Fc receptor immune functions, 54

    3.15 T cell receptor diversification, 54

    3.16 T cells undergo positive and negative selection within the thymus, 55

    3.17 Antigen presentation to T cells, 57

    3.18 MHC class II processing pathway, 59

    3.19 MHC class I processing pathway, 59

    3.20 Activation requires co-stimulation, 60

    3.21 Late co-stimulatory signals, 62

    3.22 Activation of B cell responses, 63

    3.23 CD4+ T helper cell differentiation, 63

    3.24 Activation of CTLs, 65

    3.25 Generation of memory T cells, 66

    3.26 Summary, 67

    4 Cytokines, 68

    4.1 Introduction to cytokines, 68

    4.2 Structure of cytokine families, 69

    4.3 IL-1 superfamily, 71

    4.4 IL-6 family, 71

    4.5 IL-10 family, 72

    4.6 Common γ-chain family, 73

    4.7 IL-12 family, 74

    4.8 Interferons, 75

    4.9 TNF ligand superfamily, 75

    4.10 Growth factors, 77

    4.11 Functional classification Th1 versus Th2, 78

    4.12 Th17, immunopathology and regulatory cytokines, 79

    4.13 Cytokine receptor signalling, 79

    4.14 Type I and type II cytokine receptors, 79

    4.15 The JAK/STAT signalling pathway, 80

    4.16 IL-2 signalling through the JAK/STAT pathway, 81

    4.17 The JAK/STAT pathway is also used by IL-6, 83

    4.18 Plasticity in type I cytokine signalling, 83

    4.19 Suppressor of cytokine signalling (SOCS), 83

    4.20 IFN-γ signalling pathway, 84

    4.21 TGF-β and the SMAD signalling pathway, 85

    4.22 Type III cytokine receptors and the TNF receptor family, 86

    4.23 The IKK complex and the activation of NF-κB, 87

    4.24 The IL-1R family of type IV cytokine receptors activate NF-κB, 88

    4.25 Soluble cytokine receptors act as decoy receptors, 90

    4.26 IL-33 and ST2 signal regulation, 91

    4.27 Potential for cytokine therapy, 91

    4.28 Summary, 92

    5 Chemokines, 93

    5.1 Introduction, 93

    5.2 Structure and nomenclature of chemokines, 93

    5.3 Chemokine receptors, 94

    5.4 Expression of chemokines and their receptors, 97

    5.5 Chemokines promote extravasation of leukocytes, 97

    5.6 Chemotaxis, 99

    5.7 Chemokine receptor signalling cascade, 99

    5.8 Tissue specific homing, 100

    5.9 Lymphocyte migration to secondary lymphoid tissues, 101

    5.10 Chemokines involved in lymphoid structure formation, 102

    5.11 Chemokines contribute to homeostasis, 104

    5.12 Chemokine receptors on T cell subsets, 104

    5.13 Redundancy in the chemokine/receptor system, 106

    5.14 Chemokines in disease, 108

    5.15 Chemokines as new anti-inflammatory drugs, 109

    5.16 Summary, 110

    6 Basic Concepts in Mucosal Immunology, 111

    6.1 Introduction, 111

    6.2 What is a mucosal tissue?, 112

    6.3 Immune defence at mucosal tissue is multi-layered, 113

    6.4 Origins of mucosal associated lymphoid tissue, 114

    6.5 Concept of the common mucosal immune system, 115

    6.6 How do T and B lymphocytes migrate into mucosal tissues?, 116

    6.7 Special features of mucosal epithelium, 117

    6.8 Toll-like receptors and NOD proteins in the mucosa, 120

    6.9 Antigen sampling at mucosal surfaces, 121

    6.10 Mucosal dendritic cells, 122

    6.11 Secretory dimeric IgA at mucosal surfaces, 124

    6.12 Regulation of J-chain and secretory component expression, 126

    6.13 How does the sub-mucosa differ from the epithelium?, 126

    6.14 Organized lymphoid tissue of the mucosa, 127

    6.15 Cytokines in the mucosa, 128

    6.16 Pathogens that enter via mucosal sites, 130

    6.17 Immune diseases of mucosal tissues, 130

    6.18 Summary, 132

    7 Immunology of the Gastrointestinal Tract, 133

    7.1 Structure of the gastrointestinal tract, 133

    7.2 Development of the gastrointestinal tract, 133

    7.3 The digestive tract as a mucosal tissue, 135

    7.4 Barrier function, 136

    7.5 Defensins and Trefoil factors, 138

    7.6 Structure of Peyer’s patches, 139

    7.7 Lymphoid follicles and germinal centre formation, 140

    7.8 M cells sample the intestinal lumen, 143

    7.9 Dendritic cells sample the lumen contents, 143

    7.10 Lymphocytes within the epithelium (IELs), 143

    7.11 γδ T cells in the GALT, 146

    7.12 NKT cells, 147

    7.13 T cells in the lamina propria, 148

    7.14 Maintenance of T cell homeostasis, 148

    7.15 Sub-mucosal B cells and mucosal IgA, 149

    7.16 How IgA is produced at intestinal mucosal sites, 150

    7.17 Cytokines in the gut, 151

    7.18 Chemokines and the homing of lymphocytes to GALT, 152

    7.19 Pathogens and immune diseases, 153

    7.20 Summary, 154

    8 Immunology of the Airways, 156

    8.1 The airways as a mucosal tissue, 156

    8.2 Development of the respiratory tract, 156

    8.3 The structure of the respiratory tract, 158

    8.4 Barrier function and the mucociliary elevator, 159

    8.5 Mucins and mucociliary clearance, 160

    8.6 Defensins and antimicrobial peptides, 160

    8.7 Structure of the tonsils and adenoids of the Waldeyer’s Ring, 161

    8.8 Local lymph nodes and immune generation, 163

    8.9 Structure of the NALT, 165

    8.10 Structure of the BALT, 165

    8.11 Cells of the lower respiratory tract, 166

    8.12 Surfactant proteins, 167

    8.13 Immune modulation by airway epithelial cells, 167

    8.14 Innate immune response, 168

    8.15 Dendritic cells are located throughout the respiratory tract, 168

    8.16 Alveolar macrophages maintain homeostasis, 169

    8.17 NK cells in the lung, 171

    8.18 T cells at effector sites in the lung, 171

    8.19 Memory T cell responses within the lung, 172

    8.20 Migration of circulating T cell into the lung tissue, 172

    8.21 IgA production in the respiratory tract, 173

    8.22 Respiratory diseases and pathogens, 174

    8.23 Summary, 176

    9 Immunology of the Urogenital Tract and Conjunctiva, 177

    9.1 The urogenital tract as a MALT, 177

    9.2 Epithelial barrier function, 178

    9.3 Passive immunity, 181

    9.4 Immunoglobulins, 181

    9.5 APCs in genital tract mucosa, 182

    9.6 NK cells and the semi-allogeneic foetus, 183

    9.7 Pre-eclampsia is an immune-mediated disease, 184

    9.8 Maintenance of foetal tolerance, 185

    9.9 T cells and adaptive immunity, 186

    9.10 Sexually transmitted diseases and pelvic inflammatory disease, 187

    9.11 Alloimmunization and autoimmune diseases, 189

    9.12 The foetal and neonatal immune system, 189

    9.13 Immunity in the urinary tract, 190

    9.14 Eye associated lymphoid tissue, 191

    9.15 Conjunctiva associated lymphoid tissue (CALT), 192

    9.16 Immune privilege of the eye, 192

    9.17 Immune privilege and inflammation, 193

    9.18 Conjunctivitis, 194

    9.19 Summary, 195

    10 Immunology of the Skin, 196

    10.1 The skin as an immune tissue, 196

    10.2 Barrier Immune function of the skin, 196

    10.3 Cellular immune system of the skin, 198

    10.4 Keratinocytes can act as immune cells, 199

    10.5 Keratinocytes secrete antimicrobial peptides, 200

    10.6 Langerhan’s cells act as immune sentinels in skin, 202

    10.7 Dermal dendritic cells and cross-presentation of antigen, 203

    10.8 Mast cells and NK cells in the skin, 205

    10.9 Intraepidermal lymphocytes in the skin, 206

    10.10 Lymphocytes in the dermis, 206

    10.11 Skin homing T cells express CLA, 206

    10.12 Chemokines and migration, 207

    10.13 Initiation of an immune response in the skin, 208

    10.14 Cytokines, 211

    10.15 Psoriasis, inflammation and autoreactive T cells, 211

    10.16 Autoimmune-mediated diseases of the skin, 213

    10.17 Systemic diseases that affect the skin, 214

    10.18 Infectious diseases of the skin, 215

    10.19 Summary, 216

    11 Immunity to Viruses, 217

    11.1 Introduction, 217

    11.2 Structure of viruses, 217

    11.3 Classification of viruses, 218

    11.4 Viruses replicate within host cells, 218

    11.5 Infections caused by viruses, 219

    11.6 Certain viruses can infect immune cells, 220

    11.7 Virus infection of epithelial cells, 221

    11.8 IFN-α response, 222

    11.9 NK cell response to viruses, 222

    11.10 Viral evasion of NK cell responses, 223

    11.11 Macrophages contribute to virus elimination, 225

    11.12 TLRs and NLRs recognize virus motifs, 226

    11.13 Activation of the inflammasome by viruses, 226

    11.14 Dendritic cells present virus antigens to CD8+ CTLs, 227

    11.15 T cell responses to viruses, 229

    11.16 Evasion of CTL-mediated immunity by viruses, 229

    11.17 Bystander effects of immune responses to viruses, 231

    11.18 Antibody response to viruses, 232

    11.19 Difference between cytopathic and non-cytopathic viruses, 233

    11.20 Immune evasion by antigenic shift and drift, 235

    11.21 Vaccination and therapies against viral infections, 235

    11.22 Summary, 237

    12 Immunity to Bacteria, 238

    12.1 Introduction to bacterial immunity, 238

    12.2 Classification of bacteria, 238

    12.3 Structure of the bacterial cell, 240

    12.4 Diseases caused by bacteria, 241

    12.5 Mucosal barriers to bacterial infection, 241

    12.6 Anti-microbial molecules, 242

    12.7 Recognition of bacterial PAMPs by Toll-like receptors, 243

    12.8 Complement and bacterial immunity, 244

    12.9 Neutrophils are central to bacterial immune responses, 245

    12.10 Some bacteria are resistant to phagosome mediated killing, 247

    12.11 NK cells and ADCC, 248

    12.12 The role of antibody in bacterial immunity, 249

    12.13 Dendritic cells and immunity to bacteria, 250

    12.14 Autophagy and intracellular bacteria, 251

    12.15 T Cells contribute to protective immunity, 253

    12.16 The DTH response and granuloma in TB, 253

    12.17 Th17 cells in bacterial immunity, 254

    12.18 Treg cells in bacterial infection, 255

    12.19 Unconventional T cells, 256

    12.20 Vaccination against bacterial diseases, 256

    12.21 Summary, 256

    13 Immunity to Fungi, 258

    13.1 Introduction, 258

    13.2 Morphology of fungi, 258

    13.3 Yeasts, 260

    13.4 Moulds, 260

    13.5 Fungal dimorphism, 261

    13.6 Diseases caused by fungi, 262

    13.7 Immune response to fungi, 263

    13.8 Innate immunity, 263

    13.9 Mucosal barriers to fungal infection, 263

    13.10 Anti-fungal molecules, 265

    13.11 Recognition of fungal PAMPs by Toll-like receptors, 266

    13.12 Complement and fungal immunity, 266

    13.13 Dendritic cells link innate and adaptive fungal immunity, 268

    13.14 DCs provide the adaptive immune response with instructive signals, 270

    13.15 Macrophages are important APCs during fungal infection, 270

    13.16 Neutrophils participate in the inflammatory response to fungi, 271

    13.17 NK cells provide inflammatory signals to macrophages, 271

    13.18 Adaptive immunity to fungi, 272

    13.19 The DTH response and granuloma formation inhibit fungal

    dissemination, 272

    13.20 The role of antibody in fungal resistance, 273

    13.21 Vaccination and immunotherapies, 274

    13.22 Fungal immune evasion strategies, 276

    13.23 Immuno-modulatory fungal products, 276

    13.24 Evasion of phagolysosomal killing, 276

    13.25 Modifying the cytokine response, 277

    13.26 Summary, 277

    14 Immunity to Parasites, 278

    14.1 Introduction, 278

    14.2 Protozoa are diverse unicellular eukaryotes, 278

    14.3 Structure of the protozoan cell, 278

    14.4 Life cycle of protozoan parasites, 280

    14.5 The life cycle of Trypanosoma brucei, 281

    14.6 Life cycle of Leishmania species, 281

    14.7 The life cycle of Plasmodium falciparum, 281

    14.8 Helminths are multicellular, macroscopic parasites, 282

    14.9 Structure of the trematode Schistosoma mansoni, 283

    14.10 Life cycle of Schistosoma mansoni, 284

    14.11 Structure of the nematode Ascaris lumbricoides, 285

    14.12 The life cycle of A. lumbricoides, 286

    14.13 Immune responses to parasites, 286

    14.14 Innate immunity to trypanosomes, 287

    14.15 Adaptive immunity to trypanosomes, 287

    14.16 Innate immunity to plasmodium, 288

    14.17 Adaptive immunity to plasmodium, 289

    14.18 Immunity to Leishmania – Th1 versus Th2, 290

    14.19 Immunity to Giardia, 291

    14.20 Immunity to schistosomes, 292

    14.21 Innate immunity to schistosomes, 292

    14.22 Adaptive immunity to schistosomes, 293

    14.23 Granuloma formation in schistosomiasis, 294

    14.24 Immunity to intestinal nematode worms, 294

    14.25 Innate immunity to nematode worms in the gut, 294

    14.26 Adaptive immunity to nematode worms in the gut, 295

    14.27 Immune evasion strategies of parasites, 296

    14.28 Trypanosome variant surface glycoproteins (VSGs), 297

    14.29 Plasmodium life cycle contributes to immune evasion, 298

    14.30 Leishmania evade phagocytic killing, 298

    14.31 Immune evasion strategies of helminths, 298

    14.32 Summary, 300

    15 Disorders of the Immune System, 302

    15.1 Introduction to immune disorders, 302

    15.2 Types of allergy, 302

    15.3 Sensitization and the acute phase response, 304

    15.4 Mast cell degranulation, 305

    15.5 Late phase response, 306

    15.6 Allergic asthma, 307

    15.7 Mast cells and the early phase allergic asthma, 308

    15.8 Epithelial cells can trigger allergic asthma, 308

    15.9 T cells and the late phase of allergic asthma, 310

    15.10 Allergic rhinitis, 310

    15.11 Skin allergy and atopic dermatitis, 311

    15.12 Food allergies, 311

    15.13 T cell subsets in allergy, 312

    15.14 Mechanisms of autoimmune disease, 313

    15.15 Disregulation of tolerance and autoimmunity, 313

    15.16 Inflammatory bowel disease, 316

    15.17 Coeliac disease, 317

    15.18 Systemic lupus erythematosus, 317

    15.19 Other autoimmune diseases, 318

    15.20 Immunodeficiencies, 320

    15.21 Summary, 321

    16 Mucosal Tumour Immunology, 322

    16.1 Introduction, 322

    16.2 Transformation into cancer cells, 322

    16.3 Proto-oncogene activation, 323

    16.4 Mutation in the p53 protein, 324

    16.5 Mutant Ras proteins enhance proliferation, 324

    16.6 Aneuploidy and colorectal cancer, 324

    16.7 Tumourigenesis, 324

    16.8 Angiogenesis, 326

    16.9 Metastasis, 327

    16.10 The immune system and cancer, 327

    16.11 Immune surveillance, 328

    16.12 Immunogenicity of tumour cells, 329

    16.13 Recognition of transformed cells, 330

    16.14 Tumour associated antigens, 331

    16.15 Carcinoembryonic antigen in colorectal cancer, 331

    16.16 Melanoma differentiation antigens, 332

    16.17 Viral tumour associated antigens, 332

    16.18 Effector molecules during tumour immune surveillance, 333

    16.19 Dendritic cells modulate anti-tumour immune responses, 333

    16.20 Tumour reactive T cells are activated in lymph nodes, 335

    16.21 NK cell recognition – missing self, 335

    16.22 NKG2D receptor on NK cells, 335

    16.23 Macrophages and neutrophils phagocytose tumour cells but support tumour growth, 336

    16.24 Immune cells can augment tumour growth, 337

    16.25 Immune evasion strategies, 337

    16.26 Darwinian selection and tumour cell escape, 338

    16.27 Cytokine environment and tumour escape, 339

    16.28 Tumours have disregulated MHC expression and antigen presentation, 339

    16.29 Tumour escape through Fas/FasL, 340

    16.30 Summary, 341

    17 Vaccination, 342

    17.1 Introduction, 342

    17.2 The principles of vaccination, 342

    17.3 Passive immunization, 344

    17.4 Active immunization, 344

    17.5 Processing of the vaccine for immune recognition, 344

    17.6 Adaptive Immune response following vaccination, 347

    17.7 Vaccine adjuvants, 347

    17.8 Alum, 348

    17.9 Freund’s complete adjuvant, 348

    17.10 Mucosal adjuvants and vaccine delivery, 350

    17.11 Prospects in adjuvant design, 350

    17.12 Th1/Th2 polarization and vaccine development, 351

    17.13 Live-attenuated vaccines, 351

    17.14 Inactivated vaccines, 353

    17.15 Polysaccharide vaccines, 354

    17.16 Peptide vaccines, 354

    17.17 DNA vaccination, 355

    17.18 Immuno-stimulatory complexes (ISCOMs), 355

    17.19 Dendritic cell vaccines, 358

    17.20 Mucosal administration of vaccines, 359

    17.21 Nasally administered vaccine against genital infections, 360

    17.22 New strategies for vaccine development, 360

    17.23 Summary, 362

    Glossary of Terms, 363

    Index, 374

Immunology

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      View other formats and editions of Immunology by Andrew E. Williams

      Publisher: John Wiley & Sons Inc
      Publication Date: 25/11/2011
      ISBN13: 9780470090046, 978-0470090046
      ISBN10: 0470090049

      Description

      Book Synopsis
      2012 PROSE Award, Clinical Medicine: Honorable Mention

      The vast majority of medically important pathogens infect their host across a body surface such as the skin, or across a mucosal tissue such as the respiratory tract or intestines, as these sites are the ones exposed to the external environment. By focusing on immunity at mucosal and body surfaces this book presents a fresh, new approach to the teaching of immunology.

      After an introduction to the basic structure of the immune system, the book looks at two important families of signalling molecules: cytokines and chemokines, before covering the workings of the mucosal immune system. It continues by examining immunity against the four major groups of pathogens - viruses, bacteria, fungi and parasites, and concludes by looking at disorders of the immune system, mucosal tumour immunology and the process of vaccination.

      • A fresh, new approach to the subject focusing on mucosal and body surfaces.

      • Trade Review

        “Overall, the book is well written, and the concepts are explained clearly, with well-illustrated, informative figures and diagrams. An 11-page glossary supports that text. Summing Up: Recommended. Upper-division undergraduates and above.” (Choice, 1 August 2012)



        Table of Contents
        Preface, xv

        List of Standard Cells and Symbols, xvii

        1 Basic Concepts in Immunology, 1

        1.1 The immune system, 1

        1.2 Tissues and cells of the immune system, 1

        1.3 Activation, regulation and functions of immune responses, 4

        1.4 Innate versus adaptive immunity, 5

        1.5 Primary and secondary immune responses, 6

        1.6 Immune cell development, 7

        1.7 Mast cells and basophils, 9

        1.8 Eosinophils, 11

        1.9 Neutrophils, 11

        1.10 Monocytes and macrophages, 11

        1.11 Dendritic cells, 12

        1.12 Natural killer cells, 12

        1.13 CD4+ T helper cells, 13

        1.14 CD8+ cytotoxic T cells, 14

        1.15 B cells, 15

        1.16 γδ T cells, 16

        1.17 Natural killer T cells, 16

        1.18 Anatomy of the immune system, 16

        1.19 Lymph nodes, 16

        1.20 Spleen, 19

        1.21 Summary, 19

        2 The Innate Immune System, 20

        2.1 Introduction to the innate immune system, 20

        2.2 Innate immune receptors and cells, 20

        2.3 TLRs and pattern recognition, 22

        2.4 TLR signalling in response to LPS, 23

        2.5 Peptidoglycan and Nods, 24

        2.6 Nod-like receptors recognize PAMPs and DAMPs, 25

        2.7 Damage associated molecular patterns (DAMPs), 26

        2.8 Complement proteins perform several innate immune functions, 27

        2.9 The classical complement pathway, 28

        2.10 The lectin and alternative complement pathways, 29

        2.11 Biological properties of complement cleavage products, 29

        2.12 Opsonization by complement proteins, 30

        2.13 Phagocytosis, 31

        2.14 Fc receptors induce phagocytosis, 32

        2.15 Neutrophil function and the respiratory burst, 32

        2.16 ADCC, 33

        2.17 NK cells recognize missing self, 35

        2.18 Activating adaptive immunity, 36

        2.19 Dendritic cells link innate and adaptive immunity, 38

        2.20 Summary, 40

        3 The Adaptive Immune System, 41

        3.1 Introduction to adaptive immunity, 41

        3.2 T cells and B cells recognize foreign antigens, 41

        3.3 Overview of antibody structure, 42

        3.4 Constant region and antibody isotypes, 45

        3.5 B cell receptor (BCR) diversity, 46

        3.6 Genetic recombination of BCR genes, 46

        3.7 Mechanism of VDJ recombination, 47

        3.8 Introducing junctional diversity, 48

        3.9 Somatic hypermutation and affinity maturation, 49

        3.10 Immunoglobulin class switching, 50

        3.11 Structure of Fc receptors, 51

        3.12 Fc receptor specificity and affinity, 53

        3.13 Cross-linking of antibody is necessary for Fc receptor signalling, 53

        3.14 Fc receptor immune functions, 54

        3.15 T cell receptor diversification, 54

        3.16 T cells undergo positive and negative selection within the thymus, 55

        3.17 Antigen presentation to T cells, 57

        3.18 MHC class II processing pathway, 59

        3.19 MHC class I processing pathway, 59

        3.20 Activation requires co-stimulation, 60

        3.21 Late co-stimulatory signals, 62

        3.22 Activation of B cell responses, 63

        3.23 CD4+ T helper cell differentiation, 63

        3.24 Activation of CTLs, 65

        3.25 Generation of memory T cells, 66

        3.26 Summary, 67

        4 Cytokines, 68

        4.1 Introduction to cytokines, 68

        4.2 Structure of cytokine families, 69

        4.3 IL-1 superfamily, 71

        4.4 IL-6 family, 71

        4.5 IL-10 family, 72

        4.6 Common γ-chain family, 73

        4.7 IL-12 family, 74

        4.8 Interferons, 75

        4.9 TNF ligand superfamily, 75

        4.10 Growth factors, 77

        4.11 Functional classification Th1 versus Th2, 78

        4.12 Th17, immunopathology and regulatory cytokines, 79

        4.13 Cytokine receptor signalling, 79

        4.14 Type I and type II cytokine receptors, 79

        4.15 The JAK/STAT signalling pathway, 80

        4.16 IL-2 signalling through the JAK/STAT pathway, 81

        4.17 The JAK/STAT pathway is also used by IL-6, 83

        4.18 Plasticity in type I cytokine signalling, 83

        4.19 Suppressor of cytokine signalling (SOCS), 83

        4.20 IFN-γ signalling pathway, 84

        4.21 TGF-β and the SMAD signalling pathway, 85

        4.22 Type III cytokine receptors and the TNF receptor family, 86

        4.23 The IKK complex and the activation of NF-κB, 87

        4.24 The IL-1R family of type IV cytokine receptors activate NF-κB, 88

        4.25 Soluble cytokine receptors act as decoy receptors, 90

        4.26 IL-33 and ST2 signal regulation, 91

        4.27 Potential for cytokine therapy, 91

        4.28 Summary, 92

        5 Chemokines, 93

        5.1 Introduction, 93

        5.2 Structure and nomenclature of chemokines, 93

        5.3 Chemokine receptors, 94

        5.4 Expression of chemokines and their receptors, 97

        5.5 Chemokines promote extravasation of leukocytes, 97

        5.6 Chemotaxis, 99

        5.7 Chemokine receptor signalling cascade, 99

        5.8 Tissue specific homing, 100

        5.9 Lymphocyte migration to secondary lymphoid tissues, 101

        5.10 Chemokines involved in lymphoid structure formation, 102

        5.11 Chemokines contribute to homeostasis, 104

        5.12 Chemokine receptors on T cell subsets, 104

        5.13 Redundancy in the chemokine/receptor system, 106

        5.14 Chemokines in disease, 108

        5.15 Chemokines as new anti-inflammatory drugs, 109

        5.16 Summary, 110

        6 Basic Concepts in Mucosal Immunology, 111

        6.1 Introduction, 111

        6.2 What is a mucosal tissue?, 112

        6.3 Immune defence at mucosal tissue is multi-layered, 113

        6.4 Origins of mucosal associated lymphoid tissue, 114

        6.5 Concept of the common mucosal immune system, 115

        6.6 How do T and B lymphocytes migrate into mucosal tissues?, 116

        6.7 Special features of mucosal epithelium, 117

        6.8 Toll-like receptors and NOD proteins in the mucosa, 120

        6.9 Antigen sampling at mucosal surfaces, 121

        6.10 Mucosal dendritic cells, 122

        6.11 Secretory dimeric IgA at mucosal surfaces, 124

        6.12 Regulation of J-chain and secretory component expression, 126

        6.13 How does the sub-mucosa differ from the epithelium?, 126

        6.14 Organized lymphoid tissue of the mucosa, 127

        6.15 Cytokines in the mucosa, 128

        6.16 Pathogens that enter via mucosal sites, 130

        6.17 Immune diseases of mucosal tissues, 130

        6.18 Summary, 132

        7 Immunology of the Gastrointestinal Tract, 133

        7.1 Structure of the gastrointestinal tract, 133

        7.2 Development of the gastrointestinal tract, 133

        7.3 The digestive tract as a mucosal tissue, 135

        7.4 Barrier function, 136

        7.5 Defensins and Trefoil factors, 138

        7.6 Structure of Peyer’s patches, 139

        7.7 Lymphoid follicles and germinal centre formation, 140

        7.8 M cells sample the intestinal lumen, 143

        7.9 Dendritic cells sample the lumen contents, 143

        7.10 Lymphocytes within the epithelium (IELs), 143

        7.11 γδ T cells in the GALT, 146

        7.12 NKT cells, 147

        7.13 T cells in the lamina propria, 148

        7.14 Maintenance of T cell homeostasis, 148

        7.15 Sub-mucosal B cells and mucosal IgA, 149

        7.16 How IgA is produced at intestinal mucosal sites, 150

        7.17 Cytokines in the gut, 151

        7.18 Chemokines and the homing of lymphocytes to GALT, 152

        7.19 Pathogens and immune diseases, 153

        7.20 Summary, 154

        8 Immunology of the Airways, 156

        8.1 The airways as a mucosal tissue, 156

        8.2 Development of the respiratory tract, 156

        8.3 The structure of the respiratory tract, 158

        8.4 Barrier function and the mucociliary elevator, 159

        8.5 Mucins and mucociliary clearance, 160

        8.6 Defensins and antimicrobial peptides, 160

        8.7 Structure of the tonsils and adenoids of the Waldeyer’s Ring, 161

        8.8 Local lymph nodes and immune generation, 163

        8.9 Structure of the NALT, 165

        8.10 Structure of the BALT, 165

        8.11 Cells of the lower respiratory tract, 166

        8.12 Surfactant proteins, 167

        8.13 Immune modulation by airway epithelial cells, 167

        8.14 Innate immune response, 168

        8.15 Dendritic cells are located throughout the respiratory tract, 168

        8.16 Alveolar macrophages maintain homeostasis, 169

        8.17 NK cells in the lung, 171

        8.18 T cells at effector sites in the lung, 171

        8.19 Memory T cell responses within the lung, 172

        8.20 Migration of circulating T cell into the lung tissue, 172

        8.21 IgA production in the respiratory tract, 173

        8.22 Respiratory diseases and pathogens, 174

        8.23 Summary, 176

        9 Immunology of the Urogenital Tract and Conjunctiva, 177

        9.1 The urogenital tract as a MALT, 177

        9.2 Epithelial barrier function, 178

        9.3 Passive immunity, 181

        9.4 Immunoglobulins, 181

        9.5 APCs in genital tract mucosa, 182

        9.6 NK cells and the semi-allogeneic foetus, 183

        9.7 Pre-eclampsia is an immune-mediated disease, 184

        9.8 Maintenance of foetal tolerance, 185

        9.9 T cells and adaptive immunity, 186

        9.10 Sexually transmitted diseases and pelvic inflammatory disease, 187

        9.11 Alloimmunization and autoimmune diseases, 189

        9.12 The foetal and neonatal immune system, 189

        9.13 Immunity in the urinary tract, 190

        9.14 Eye associated lymphoid tissue, 191

        9.15 Conjunctiva associated lymphoid tissue (CALT), 192

        9.16 Immune privilege of the eye, 192

        9.17 Immune privilege and inflammation, 193

        9.18 Conjunctivitis, 194

        9.19 Summary, 195

        10 Immunology of the Skin, 196

        10.1 The skin as an immune tissue, 196

        10.2 Barrier Immune function of the skin, 196

        10.3 Cellular immune system of the skin, 198

        10.4 Keratinocytes can act as immune cells, 199

        10.5 Keratinocytes secrete antimicrobial peptides, 200

        10.6 Langerhan’s cells act as immune sentinels in skin, 202

        10.7 Dermal dendritic cells and cross-presentation of antigen, 203

        10.8 Mast cells and NK cells in the skin, 205

        10.9 Intraepidermal lymphocytes in the skin, 206

        10.10 Lymphocytes in the dermis, 206

        10.11 Skin homing T cells express CLA, 206

        10.12 Chemokines and migration, 207

        10.13 Initiation of an immune response in the skin, 208

        10.14 Cytokines, 211

        10.15 Psoriasis, inflammation and autoreactive T cells, 211

        10.16 Autoimmune-mediated diseases of the skin, 213

        10.17 Systemic diseases that affect the skin, 214

        10.18 Infectious diseases of the skin, 215

        10.19 Summary, 216

        11 Immunity to Viruses, 217

        11.1 Introduction, 217

        11.2 Structure of viruses, 217

        11.3 Classification of viruses, 218

        11.4 Viruses replicate within host cells, 218

        11.5 Infections caused by viruses, 219

        11.6 Certain viruses can infect immune cells, 220

        11.7 Virus infection of epithelial cells, 221

        11.8 IFN-α response, 222

        11.9 NK cell response to viruses, 222

        11.10 Viral evasion of NK cell responses, 223

        11.11 Macrophages contribute to virus elimination, 225

        11.12 TLRs and NLRs recognize virus motifs, 226

        11.13 Activation of the inflammasome by viruses, 226

        11.14 Dendritic cells present virus antigens to CD8+ CTLs, 227

        11.15 T cell responses to viruses, 229

        11.16 Evasion of CTL-mediated immunity by viruses, 229

        11.17 Bystander effects of immune responses to viruses, 231

        11.18 Antibody response to viruses, 232

        11.19 Difference between cytopathic and non-cytopathic viruses, 233

        11.20 Immune evasion by antigenic shift and drift, 235

        11.21 Vaccination and therapies against viral infections, 235

        11.22 Summary, 237

        12 Immunity to Bacteria, 238

        12.1 Introduction to bacterial immunity, 238

        12.2 Classification of bacteria, 238

        12.3 Structure of the bacterial cell, 240

        12.4 Diseases caused by bacteria, 241

        12.5 Mucosal barriers to bacterial infection, 241

        12.6 Anti-microbial molecules, 242

        12.7 Recognition of bacterial PAMPs by Toll-like receptors, 243

        12.8 Complement and bacterial immunity, 244

        12.9 Neutrophils are central to bacterial immune responses, 245

        12.10 Some bacteria are resistant to phagosome mediated killing, 247

        12.11 NK cells and ADCC, 248

        12.12 The role of antibody in bacterial immunity, 249

        12.13 Dendritic cells and immunity to bacteria, 250

        12.14 Autophagy and intracellular bacteria, 251

        12.15 T Cells contribute to protective immunity, 253

        12.16 The DTH response and granuloma in TB, 253

        12.17 Th17 cells in bacterial immunity, 254

        12.18 Treg cells in bacterial infection, 255

        12.19 Unconventional T cells, 256

        12.20 Vaccination against bacterial diseases, 256

        12.21 Summary, 256

        13 Immunity to Fungi, 258

        13.1 Introduction, 258

        13.2 Morphology of fungi, 258

        13.3 Yeasts, 260

        13.4 Moulds, 260

        13.5 Fungal dimorphism, 261

        13.6 Diseases caused by fungi, 262

        13.7 Immune response to fungi, 263

        13.8 Innate immunity, 263

        13.9 Mucosal barriers to fungal infection, 263

        13.10 Anti-fungal molecules, 265

        13.11 Recognition of fungal PAMPs by Toll-like receptors, 266

        13.12 Complement and fungal immunity, 266

        13.13 Dendritic cells link innate and adaptive fungal immunity, 268

        13.14 DCs provide the adaptive immune response with instructive signals, 270

        13.15 Macrophages are important APCs during fungal infection, 270

        13.16 Neutrophils participate in the inflammatory response to fungi, 271

        13.17 NK cells provide inflammatory signals to macrophages, 271

        13.18 Adaptive immunity to fungi, 272

        13.19 The DTH response and granuloma formation inhibit fungal

        dissemination, 272

        13.20 The role of antibody in fungal resistance, 273

        13.21 Vaccination and immunotherapies, 274

        13.22 Fungal immune evasion strategies, 276

        13.23 Immuno-modulatory fungal products, 276

        13.24 Evasion of phagolysosomal killing, 276

        13.25 Modifying the cytokine response, 277

        13.26 Summary, 277

        14 Immunity to Parasites, 278

        14.1 Introduction, 278

        14.2 Protozoa are diverse unicellular eukaryotes, 278

        14.3 Structure of the protozoan cell, 278

        14.4 Life cycle of protozoan parasites, 280

        14.5 The life cycle of Trypanosoma brucei, 281

        14.6 Life cycle of Leishmania species, 281

        14.7 The life cycle of Plasmodium falciparum, 281

        14.8 Helminths are multicellular, macroscopic parasites, 282

        14.9 Structure of the trematode Schistosoma mansoni, 283

        14.10 Life cycle of Schistosoma mansoni, 284

        14.11 Structure of the nematode Ascaris lumbricoides, 285

        14.12 The life cycle of A. lumbricoides, 286

        14.13 Immune responses to parasites, 286

        14.14 Innate immunity to trypanosomes, 287

        14.15 Adaptive immunity to trypanosomes, 287

        14.16 Innate immunity to plasmodium, 288

        14.17 Adaptive immunity to plasmodium, 289

        14.18 Immunity to Leishmania – Th1 versus Th2, 290

        14.19 Immunity to Giardia, 291

        14.20 Immunity to schistosomes, 292

        14.21 Innate immunity to schistosomes, 292

        14.22 Adaptive immunity to schistosomes, 293

        14.23 Granuloma formation in schistosomiasis, 294

        14.24 Immunity to intestinal nematode worms, 294

        14.25 Innate immunity to nematode worms in the gut, 294

        14.26 Adaptive immunity to nematode worms in the gut, 295

        14.27 Immune evasion strategies of parasites, 296

        14.28 Trypanosome variant surface glycoproteins (VSGs), 297

        14.29 Plasmodium life cycle contributes to immune evasion, 298

        14.30 Leishmania evade phagocytic killing, 298

        14.31 Immune evasion strategies of helminths, 298

        14.32 Summary, 300

        15 Disorders of the Immune System, 302

        15.1 Introduction to immune disorders, 302

        15.2 Types of allergy, 302

        15.3 Sensitization and the acute phase response, 304

        15.4 Mast cell degranulation, 305

        15.5 Late phase response, 306

        15.6 Allergic asthma, 307

        15.7 Mast cells and the early phase allergic asthma, 308

        15.8 Epithelial cells can trigger allergic asthma, 308

        15.9 T cells and the late phase of allergic asthma, 310

        15.10 Allergic rhinitis, 310

        15.11 Skin allergy and atopic dermatitis, 311

        15.12 Food allergies, 311

        15.13 T cell subsets in allergy, 312

        15.14 Mechanisms of autoimmune disease, 313

        15.15 Disregulation of tolerance and autoimmunity, 313

        15.16 Inflammatory bowel disease, 316

        15.17 Coeliac disease, 317

        15.18 Systemic lupus erythematosus, 317

        15.19 Other autoimmune diseases, 318

        15.20 Immunodeficiencies, 320

        15.21 Summary, 321

        16 Mucosal Tumour Immunology, 322

        16.1 Introduction, 322

        16.2 Transformation into cancer cells, 322

        16.3 Proto-oncogene activation, 323

        16.4 Mutation in the p53 protein, 324

        16.5 Mutant Ras proteins enhance proliferation, 324

        16.6 Aneuploidy and colorectal cancer, 324

        16.7 Tumourigenesis, 324

        16.8 Angiogenesis, 326

        16.9 Metastasis, 327

        16.10 The immune system and cancer, 327

        16.11 Immune surveillance, 328

        16.12 Immunogenicity of tumour cells, 329

        16.13 Recognition of transformed cells, 330

        16.14 Tumour associated antigens, 331

        16.15 Carcinoembryonic antigen in colorectal cancer, 331

        16.16 Melanoma differentiation antigens, 332

        16.17 Viral tumour associated antigens, 332

        16.18 Effector molecules during tumour immune surveillance, 333

        16.19 Dendritic cells modulate anti-tumour immune responses, 333

        16.20 Tumour reactive T cells are activated in lymph nodes, 335

        16.21 NK cell recognition – missing self, 335

        16.22 NKG2D receptor on NK cells, 335

        16.23 Macrophages and neutrophils phagocytose tumour cells but support tumour growth, 336

        16.24 Immune cells can augment tumour growth, 337

        16.25 Immune evasion strategies, 337

        16.26 Darwinian selection and tumour cell escape, 338

        16.27 Cytokine environment and tumour escape, 339

        16.28 Tumours have disregulated MHC expression and antigen presentation, 339

        16.29 Tumour escape through Fas/FasL, 340

        16.30 Summary, 341

        17 Vaccination, 342

        17.1 Introduction, 342

        17.2 The principles of vaccination, 342

        17.3 Passive immunization, 344

        17.4 Active immunization, 344

        17.5 Processing of the vaccine for immune recognition, 344

        17.6 Adaptive Immune response following vaccination, 347

        17.7 Vaccine adjuvants, 347

        17.8 Alum, 348

        17.9 Freund’s complete adjuvant, 348

        17.10 Mucosal adjuvants and vaccine delivery, 350

        17.11 Prospects in adjuvant design, 350

        17.12 Th1/Th2 polarization and vaccine development, 351

        17.13 Live-attenuated vaccines, 351

        17.14 Inactivated vaccines, 353

        17.15 Polysaccharide vaccines, 354

        17.16 Peptide vaccines, 354

        17.17 DNA vaccination, 355

        17.18 Immuno-stimulatory complexes (ISCOMs), 355

        17.19 Dendritic cell vaccines, 358

        17.20 Mucosal administration of vaccines, 359

        17.21 Nasally administered vaccine against genital infections, 360

        17.22 New strategies for vaccine development, 360

        17.23 Summary, 362

        Glossary of Terms, 363

        Index, 374

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