FUNCTION OF THE LYMPHATIC SYSTEM 👉 Think of the lymphatic system as the body’s drainage

🧪 What is inside
system.

One of the basic tenets of life is that many

organisms consume or use other organisms
in order to survive.
lymph?
Some microorganisms use humans as a Lymph contains:
source of vitamins and environment as
where they can reproduce and survive. This 1️⃣ From the blood (plasma):
can result in damage to the body and can
●​ Ions (like sodium, potassium)​
cause disease or even death.
●​ Nutrients​

Any substance or microorganism that ●​ Gases​

causes disease or damage to the tissues of ●​ Some proteins​
the body is considered a pathogen.

Lymphatic systems and others such as 2️⃣ From body cells:

WBC and phagocytes, continually provide ●​ Hormones​

protection against pathogens.
●​ Enzymes​

The lymphatic system functions are: ​ ●​ Waste products​

1. Fluid Balance “Lymph = Leftover fluid”

💧 Lymph & Fluid Balance (Easy Version)

So basically, lymph = extra tissue fluid + substances from blood +
waste from cells

🔄 What happens to body fluid every 2. Lipid Absorption

“Both start with L → Lacteals = Lipid

day?
absorption”
●​ 30 liters of fluid leave the blood capillaries and
enter the interstitial spaces (spaces between
cells).​
When you eat fatty foods, your digestive
system breaks the fats (lipids) down in the
●​ Only 27 liters go back into the blood.​ small intestine. But fats are different from
other nutrients like glucose or amino acids.
👉 That leaves 3 liters extra outside the blood vessels. Instead of going directly into the blood
capillaries, most lipids enter special
⚠ What if the 3 liters stay there? lymphatic vessels called lacteals, which are
found inside the tiny finger-like projections
If that extra 3 L stays in the tissues:
(villi) of the small intestine.
●​ It would cause edema (swelling)​
Lacteals absorb these lipids and transport
●​ Swelling can damage tissues​ them through the lymphatic system instead
of the blood at first. As the fats move
●​ If severe, it can lead to serious problems or
through the lymphatic vessels, the lymph
even death​
becomes milky white because of the high fat

🫀 So what saves us? content. This fat-rich lymph is called chyle.

Eventually, the lymph (carrying the fats)

The lymphatic system.
empties into the venous circulation,
●​ The extra 3 liters enter the lymphatic capillaries​ meaning the fats finally enter the
bloodstream and can be delivered to the
●​ Once inside, the fluid is called lymph​
rest of the body for energy storage or use.
●​ The lymph travels through lymphatic vessels​

●​ Eventually, it returns back to the blood​

3. Defense spaces into lymphatic capillaries to
become lymph.
The lymphatic system helps protect the
body from harmful pathogens, which include The lymphatic capillaries are tiny,
microorganisms and other foreign closed-ended vessels consisting of simple
substances. Lymph nodes filter pathogens squamous epithelium.
from lymph, while the spleen filters
pathogens from the blood. In addition, The lymphatic capillaries are more
special immune cells called lymphocytes permeable than blood capillaries because
(and other cells) can destroy these they lack a basement membrane, and
invaders. Because the lymphatic system is fluid moves easily into them.
directly involved in fighting infections and
filtering blood and lymph, many infectious Overlapping squamous cells of the
diseases cause symptoms that affect this lymphatic capillary walls act as valves that
system, such as swollen lymph nodes or prevent the backflow of fluid.
enlarged spleen.
Lymphatic capillaries are present in most of
1️⃣ Key Terms our body, except CNS, Bone Marrow, and
●​ Pathogens → harmful microorganisms tissues without blood vessels such as
or foreign substances​ epidermis and cartilage.

●​ Lymph nodes → filter lymph​ The lymphatic capillaries connect and

●​ Spleen → filters blood​ form larger lymphatic vessels, which look
similar to small veins. These vessels often
●​ Lymphocytes → immune cells that have a beaded appearance because they
destroy pathogens​ contain one-way valves, just like the valves
in veins. These valves make sure lymph
2️⃣ Easy Memory Trick flows in only one direction. When a
lymphatic vessel is squeezed or
“Nodes, Spleen, Lymphocytes = Body’s compressed—by surrounding muscles or
Defense Team”
body movements—the valves prevent
●​ Nodes → check lymph​ lymph from flowing backward, so the fluid is
pushed forward through the vessels
●​ Spleen → check blood​ toward larger lymphatic ducts and
●​ Lymphocytes → attack invaders eventually back into the bloodstream.

ANATOMY OF THE LYMPHATIC SYSTEM 📌 Exam Tips to Remember

1️⃣ Key Points
Lymphatic Capillaries and Vessels
●​ Lymphatic vessels = larger channels
formed by capillaries​
The lymphatic system includes lymph,
lymphocytes, lymphatic vessels, lymph ●​ Valves = prevent backward flow​
nodes, tonsils, spleen and thymus.
●​ Beaded appearance = due to valves​

●​ Circulatory system = does not ●​ Compression = helps move lymph forward​

circulate fluid to and from tissues.
●​ Lymphatic system = carries fluid in
2️⃣ Easy Memory Trick
one direction, from tissues to the
circulatory system. From blood “Squeeze & Flow”
capillaries to the tissue spaces.
●​ Muscles squeeze → valves open →
Most of the fluid returns to the blood, but lymph moves forward → no
some of the fluid moves from the tissue backward flow​

●​
3️⃣ Common Exam Question Style ​
Tonsils
●​ “How does lymph move through ​ There are 3 groups of tonsils: ​
lymphatic vessels?”​ 1. Palatine tonsils
Answer:​
2. Pharyngeal tonsils
1.​ One-way valves prevent backflow​ 3. Lingual tonsils

2.​ Compression (muscle movement) Palatine (Palate) Tonsils - located on each

pushes lymph forward​ side of the posterior opening of the oral
cavity; these are the ones usually referred
to as “the tonsils.”
Three factors cause compression of the
lymphatic vessels:
Pharyngeal tonsils - located near the
1.​ Contraction surrounding skeletal internal opening of the nasal cavity.
muscle during activity If enlarged = Adenoid or Adenoids
2.​ Periodic contraction of smooth *An enlarged pharyngeal tonsil can interfere
muscle in the lymphatic vessel wall with normal breathing*
3.​ Pressure changes in the thorax
during breathing.
Lingual tonsils - posterior surface of the
The lymphatic vessels converge and tongue.
eventually empty in the blood at two
locations in the body. The tonsils form a ring of lymphatic tissue
around the openings of the nasal and oral
Lymphatic vessels from the right upper limb
cavities into the pharynx. They help protect
and the right half of the head, neck, and
chest form the right lymphatic duct, which against pathogens entering the body. The
empties into the right sub-clavian vein. palatine and pharyngeal tonsils can become
Lymphatic vessels from the rest of the body chronically infected and may need removal,
enter the thoracic duct, which empties into while the lingual tonsil is less often infected
the left subclavian vein. but harder to remove. In adults, tonsils
usually shrink and may eventually
LYMPHATIC ORGANS
disappear.
Tonsils, Lymph Nodes, Spleen and Thymus.

Lymphatic tissue, which consists of many

lymphocytes and other cells, such as
macrophages, is found within lymphatic
organs. The lymphocytes originate from red
bone marrow and are carried by the blood.

These lymphocytes divide and increase in

number when the body is exposed to
pathogens. The increased number of
lymphocytes is part of the immune response
that causes the destruction of pathogens.

Lymphatic tissue contains fine reticular

fibers that form a network holding
lymphocytes and other cells in place. As T&A Procedure
lymph or blood passes through lymphatic ●​ Tonsillectomy = removal of palatine
organs, this network traps microorganisms tonsils
and other particles.​ ●​ Adenoidectomy = removal of
​ adenoid
​
Lymph Nodes Spleen

Rounded structures, varied size (small seed Roughly the size of a clenched fist, and
to shelled almond). It is distributed along located in the left-superior corner of the
different lymphatic vessels and most lymph abdominal cavity.
passes through lymph nodes before
entering the blood. ​ Parts of Spleen ​
A. Capsule - dense connective tissue and a
Three (3) superficial aggregations of lymph small amount of smooth muscle.
nodes on each side of the body: ​ B. Trabeculae - from capsule and divided
​ the spleen into compartments.
1. Inguinal nodes in the groin
2. Axillary nodes in the axilla (armpit) Two specialized types of lymphatic tissue:
3. Cervical nodes in the neck C. White pulp - surrounding the arteries
within the spleen
Parts of the Lymph Node D. Red pulp - associated with veins. It
A. Capsule - surrounds each lymph node consists of a fibrous network (supporting
B. Trabeculae - extensions of the capsule, it framework), filled with macrophages (cells
subdivides a lymph node into compartments that engulf and destroy pathogens and old
containing lymphatic tissue and lymphatic cells) and red blood cells, and enlarged
sinuses capillaries that connect to the veins.
C. Lymphatic tissue - It consists of
lymphocytes and other cells that can form The spleen filters blood, not lymph. Its cells
dense aggregations (clusters) of tissue detect and respond to foreign substances
called lymphatic nodules. and destroy old red blood cells. White pulp
D. Lymphatic Sinuses - spaces between contains lymphocytes that can be activated
lymphatic tissue that contains macrophages like in lymph nodes. Blood passes through
on a network of fibers. red pulp, where macrophages remove
E. Germinal Centers - containing dividing foreign substances and worn-out red blood
lymphocytes cells.

Lymph enters the lymph node through The spleen also acts as a blood reservoir,
afferent vessels, passes through the storing a small amount of blood. In
lymphatic tissue and sinuses, and exits emergencies like severe bleeding, smooth
through efferent vessels. muscles in the spleen contract, releasing
blood into circulation.
As lymph passes through the lymph nodes,
two main functions occur. First, pathogens A ruptured spleen can cause severe
activate lymphocytes, causing them to bleeding, shock and death
divide and form germinal centers. These Cracks are repaired by:
new lymphocytes enter the blood and help sutures, and blood clotting
in the adaptive immune response. Second,
macrophages in the lymph nodes remove Splenectomy - removal of spleen, if any
pathogens from the lymph. technique does not stop the bleeding. Other
lymphatic organs and liver can compensate
Cancer cells from a tumor can spread to for the loss of spleen.
other parts of the body through the
lymphatic system. This process is called
metastasis.
Thymus mature to become T-cells. Then, they
circulate and populate other lymphatic
Bilobed gland roughly triangular in shape. It tissue.
is located in the superior mediastinum,
mediastinum, the partition dividing the B cells and T cells are responsible for much
thoracic cavity into left and right parts. of immunity.

Parts of Thymus IMMUNITY

A.​ Capsule - thin connective tissue that
surround thymus Immunity is the body’s ability to resist
B.​ Trabeculae - from the capsule divide damage from pathogens, toxins, and
each lobe into lobules. internal threats like cancer cells.
C.​ Lobules contains
●​ Cortex - many lymphocytes ●​ Innate immunity (nonspecific
that’s why it’s dark resistance) responds the same way
●​ Medulla - light-staining, to pathogens every time.​
central portion of the lobules
and very few lymphocytes ●​ Adaptive immunity (specific
immunity) improves its response
The thymus is where T cells mature. Many each time it encounters the same
T cells are produced, but most die; the pathogen.
surviving ones can respond to foreign
Adaptive immunity has specificity and
substances. Mature T cells move to the
memory, unlike innate immunity.
medulla, enter the blood, and travel to other
lymphatic tissues to fight pathogens. T cell ●​ Specificity: can recognize and
production declines with age as the thymus target a particular substance (e.g.,
becomes less active. specific bacteria).​

●​ Memory: “remembers” previous

encounters, so future responses are
faster, stronger, and longer-lasting.

Innate immunity is a general, first-line

defense. On the other hand Adaptive
immunity has both.

In innate immunity, the response is the

same every time because there is no
OVERVIEW OF THE LYMPHATIC SYSTEM specificity or memory. For example, bacteria
are phagocytized at the same speed on
Lymphatic capillaries and vessels remove each exposure.
fluid from tissues and absorb lipids from the
small intestine. Lymph nodes filter lymph, In adaptive immunity, the second
and the spleen filters blood. exposure triggers a faster and stronger
response due to memory. After the first
Two (2) types of lymphocytes: ​ exposure, it may take days to fight off
A. B cells ​ bacteria, causing symptoms. After the
B. T cells second exposure, bacteria are destroyed
quickly, often before symptoms appear,
B cells originate and mature in red bone making the person immune.
marrow.

Pre-T cells are produced in red bone

marrow, and migrate to thymus, where they
INNATE IMMUNITY White blood cells are produced in red bone
marrow and lymphatic tissue and released
It is accomplished by physical barriers, into the blood.
chemical mediators, white blood cells and
the inflammatory response. Chemicals released from pathogens or
damaged tissues attract the white blood
Physical Barriers - prevent pathogens and cells, and they leave the blood and enter
chemical from entering the body ​ affected tissues. Important chemicals known
1. The skin and mucous membranes form to attract white blood cells include
barriers that prevent their entry complement, leukotrienes, kinins (kı̄ ′ninz),
2. Tears, saliva, and urine wash these and histamine.
substances from body surfaces.
Chemotaxis - movement of wbc from tissue
Pathogens cannot cause a disease if they toward these chemicals.
cannot get into the body.
Phagocytic Cells - the ingestion and
Chemical Mediators - some chemicals on destruction of particles by cells called
the surface of cells destroy pathogens or phagocytes.
prevent their entry into the cells. ​ Most important phagocytes are
neutrophils and macrophages, although
For example, lysozyme in tears and saliva other wbc have limited phagocytic ability.
kills certain bacteria, and mucus on the
mucous membranes prevents the entry of Neutrophils - small, first-cells to enter
some pathogens. infected tissues from the blood in large
numbers. They release chemical signals
that increase the inflammatory response by
Chemical Mediators recruiting and activating other immune cells.
●​ Molecules that help innate immunity.​
Neutrophils often die after phagocytizing a
●​ Surface chemicals: destroy pathogens or block entry
single microorganism.
(e.g., lysozyme in tears/saliva, mucus on membranes).​

●​ Inflammation mediators: histamine, complement, Pus is an accumulation of fluid, dead

prostaglandins, leukotrienes → cause vasodilation,
increase vascular permeability, stimulate phagocytosis.​ neutrophils, and other cells at a site of
●​ Interferons: protect cells against viral infections.​ infection.

Macrophages
Complement

●​ 20 proteins in plasma, normally inactive.​ ●​ Origin: Monocytes leave blood, enter tissues, and
​ enlarge ~5×.​

●​ Activated by foreign substances or antibodies.​ ●​ Together with monocytes, they form the
mononuclear phagocytic system (single
●​ Activation triggers a cascade, leading to:​ nucleus, phagocytic).​
○​ Inflammation​
●​ Special names:​
○​ Phagocytosis​
○​ Dust cells – lungs​
○​ Direct lysis of bacterial cells​
○​ Kupffer cells – liver​

Interferons ○​ Microglia – CNS​

●​ Function:​
●​ Proteins produced by virus-infected cells.​

●​ They protect neighboring cells (not the infected one) by

○​ Ingest larger amounts/items than
triggering antiviral proteins that stop viral replication.​ neutrophils​

●​ Also activate immune cells like macrophages and ○​ Arrive after neutrophils in infections​
natural killer cells.
○​ Perform most late-stage phagocytosis
(cleaning up dead cells and debris)​
White Blood Cells - cells derived from them
are the most important cellular components
of immunity.
Macrophages are present not only during cells, in general, rather than specific tumor
infections but also in normal, uninfected cells or cells infected by a specific virus.
tissues. They act as early defenders by
phagocytizing pathogens before the For this reason, and because NK cells do
microorganisms can replicate or cause not exhibit a memory response, they are
damage. These cells are strategically classified as part of innate immunity. NK
located at potential entry points of cells use a variety of methods to kill their
pathogens, such as beneath the skin and target cells, including releasing them that
mucous membranes, and around blood and damage cell membranes and cause the
lymphatic vessels. In addition, macrophages cells to lyse (break down/rupture).
protect lymph within lymph nodes and filter
blood in the spleen and liver, helping Inflammatory Response
prevent the spread of infection throughout It involves many chemicals and cells.
the body.
THIS IS A DIAGRAM SHOWING HOW
Cells of Inflammation INFLAMMATORY RESPONSE TO A
BACTERIA
Basophils, which are derived from red
bone marrow, are motile white blood cells Bacteria enter the tissue, causing damage
that can leave the blood and enter infected that stimulates the release or activation of
tissues. chemical mediators, such as histamine,
prostaglandins, leukotrienes, complement,
Mast cells, which are also derived from red and kinins.
bone marrow, are nonmotile cells in
connective tissue, especially near These chemicals produce several effects:
capillaries. 1. Vasodilation increases blood flow and
​ Like macrophages, mast cells are brings phagocytes and other white blood
located at points where pathogens may cells to the area
enter the body, such as the skin, lungs, 2. Phagocytes leave the blood and enter the
gastrointestinal tract, and urogenital tract. tissue
3. Increased vascular permeability allows
Basophils and mast cells can be activated fibrinogen and complement to enter the
through innate immunity (e.g., by tissue from the blood.
complement) or through adaptive immunity ​ Fibrinogen is converted to fibrin,
which isolates the infection by walling off the
When activated, they release chemicals, infected area.
such as histamine and leukotrienes, that ​ Complement further enhances the
produce an inflammatory response or inflammatory response and attracts
activate other mechanisms, such as smooth additional phagocytes. This process of
muscle contraction in the lungs. releasing chemical mediators and attracting
phagocytes and other white blood cells
Eosinophils also participate in continues until the bacteria are destroyed.
inflammation associated with allergies and Phagocytes remove microorganisms and
asthma. dead tissue, and the damaged tissues are
repaired.
Inflammation is beneficial in the fight against ​
pathogens, but too much inflammation can Inflammation can be local or systemic.
be harmful, destroying healthy tissues Local inflammation is an inflammatory
as well as the microorganisms. response confined to a specific area of the
body. Symptoms of local inflammation
Natural Killer Cells - It is produced by include redness, heat, and swelling due to
lymphocytes and accounts for 15% of increased blood flow and increased
lymphocytes. NK cells recognize classes of vascular permeability, as well as pain
cells, such as tumor cells or virus-infected caused by swelling and by chemical
mediators acting on pain receptors. The
tissue destruction, swelling, and pain lead to
loss of function.

Systemic inflammation is an inflammatory

response that is generally distributed
throughout the body. In addition to the local
symptoms at the sites of inflammation, three
additional features can be present.

●​ Red bone marrow produces and

releases large numbers of
neutrophils, which enhance
phagocytosis during infection.​

●​ Pyrogens (fever-producing
chemicals) released by
microorganisms, neutrophils, and
other cells act on the hypothalamus
(the brain’s temperature-regulating
center). This increases heat
production and conservation,
causing fever, which promotes
immune activities such as
phagocytosis and inhibits the growth
of some microorganisms.​

●​ In severe systemic inflammation,

vascular permeability can increase
excessively, allowing large amounts
of fluid to move from the blood into
the tissues. The resulting decrease
in blood volume may lead to shock
and even death.

Interferons are produced for: ​

- viral infections and cancers
- treat hepatitis C, a viral disorder that can
cause cirrhosis and cancer of the liver
- treat genital warts caused by herpes virus
- treat Kaposi sarcoma

ADAPTIVE IMMUNITY
- specificity and memory
- Again, specificity is the ability to recognize
a particular substance, and memory is the
ability to respond with increasing
effectiveness to successive exposure to the
antigen.
Antigen ​
Helper T cells → control and regulate both systems​
Anti (body) + Gen (producing)
It can be divided into foreign antigens and
self-antigens. ORIGIN AND DEVELOPMENT OF
LYMPHOCYTES
Foreign antigens are introduced from
outside the body. Microorganisms, such as Stem cells in red bone marrow are capable
bacteria and viruses, and chemicals of giving rise to all the blood cells. Some
released by microorganisms are examples stem cells give rise to pre-T cells, which
of foreign antigens. Pollen, animal hairs, migrate through the blood to the thymus,
foods, and drugs can cause an allergic where they divide and are processed into T
reaction because they are foreign antigens cells.
that produce an overreaction of the immune
system. Other stem cells produce pre-B cells, which
​ Transplanted tissues and organs are processed in the red bone marrow into
contain foreign antigens, and the response B cells.
to these antigens can cause rejection of the
transplant. Origin:​

Self-antigens are molecules the body ●​ B cells are produced and released by
produces to stimulate an immune system red bone marrow.​
response. It can be beneficial.
​ For example, the recognition of ●​ T cells are produced and released by
the thymus.​
tumor antigens can result in destruction of
the tumor. But the response to self-antigens
can also be harmful. Circulation:​
​ Autoimmune disease results when
self-antigens stimulate unwanted ●​ Both B and T cells travel through the
destruction of normal tissue. An example is blood to lymphatic tissues.​
rheumatoid arthritis, which destroys the
tissue within joints. ●​ They can live from a few months to
many years and continuously circulate
between blood and lymphatic tissues.​
Adaptive immunity; ​
Antibody-mediated immunity and
cell-mediated immunity. Proportion:​

Antibody-mediated immunity involves a ●​ Normally, there are about 5 T cells for

group of lymphocytes called B cells and every 1 B cell in the blood.​
proteins called antibodies, which are found
in the plasma. Response to antigens:​
​ Antibodies are produced by plasma
cells, which are derived from the B cells.
●​ When exposed to an antigen, B cells
B cells → make antibodies → antibody-mediated immunity
and T cells divide and produce new
cells that participate in destroying the
antigen.
Cell-mediated immunity involves T cells,
particularly cytotoxic T cells that directly
destroy infected or abnormal cells, while —-------------
helper T cells regulate and coordinate both 🧠 Understanding Clonal Selection and Self-Tolerance
antibody-mediated and cell-mediated 1.​ Clones of lymphocytes​
immune responses.
○​ During embryonic development,
Cytotoxic T cells → kill infected cells directly → small groups of identical B cells
cell-mediated immunity or T cells form.​
 ○​ Each group, called a clone, adaptive immune response to be effective,
comes from one unique B or T
two events must occur:
cell.​
(1) antigen recognition by lymphocytes and
○​ Each clone is specialized: it can (2) proliferation of the lymphocytes
respond to only one specific recognizing the antigen.
antigen.​
Antigen recognition
2.​ Huge variety of clones​
​ Lymphocytes have proteins, called
○​ Because there are so many antigen receptors, on their surfaces. The
clones, the immune system can antigen receptors on B cells are called
recognize and respond to almost
B-cell receptors, and those on T cells are
any antigen you encounter,
including bacteria, viruses, and
called T-cell receptors. Each receptor binds
other foreign substances.​ with only a specific antigen.

3.​ Self-antigens and tolerance​ Each clone of lymphocytes has identical

antigen receptors; when a matching antigen
○​ Some antigens come from your
own body cells (called binds to these receptors, the lymphocytes
self-antigens).​ are activated, initiating the adaptive immune
response.​

🧠 How B and T Cells Recognize

○​ If clones reacted to self-antigens,
​
they could attack your own body,
causing autoimmune problems.​
Antigens
○​ To prevent this, clones that target
self-antigens are usually 1.​ Processing of antigens:​
eliminated or suppressed.​
○​ B cells and T cells usually
4.​ Timing of this process​
recognize antigens only after
○​ Most of this elimination happens they are broken down into
before birth (prenatal smaller fragments.​
development).​
2.​ Role of antigen-presenting cells
○​ It continues after birth and (APCs):​
throughout your life to keep your
immune system safe and ○​ Cells like macrophages act as
accurate.​
antigen-presenting cells.​

○​ They engulf antigens by

phagocytosis and break them
📌 Simple analogy for memory: down into smaller pieces
(antigen fragments).​
●​ Clones = specialized soldiers​
3.​ Presentation to lymphocytes:​
●​ Each soldier = trained for one target only​
○​ The antigen fragments are
●​ Self-targeting soldiers = removed during bound to major
training​ histocompatibility complex
(MHC) molecules.​
●​ Large army = can fight almost any
invader safely​
○​ These MHC-antigen complexes
are transported to the surface
ACTIVATION AND MULTIPLICATION OF of the macrophage.​
LYMPHOCYTES
○​ The processed antigens are
then shown to B cells and T
The specialized B-cell or T-cell clones can cells, which can recognize them
respond to antigens and produce an and initiate an adaptive immune
adaptive immune response. For the response.
🧠 Major Histocompatibility Complex
(MHC) Molecules
🧠 Other Surface Molecules on
Lymphocytes
1.​ What they are:​ 1.​ Purpose:​

○​ MHC molecules are glycoproteins

○​ Lymphocytes have surface
on cell membranes with binding
sites for antigens.​ molecules besides MHC that
help them bind to other cells
○​ Different MHC molecules have and stimulate an immune
specific binding sites, meaning response.​
each binds only certain antigens.​
2.​ Helper T cells (CD4):​
2.​ Difference from antigen receptors:​
○​ They have a glycoprotein called
○​ MHC molecules are not the same
CD4.​
as the antigen receptors on B or T
cells.​
○​ CD4 helps helper T cells
○​ Both interact with antigens, but connect to macrophages by
MHC molecules are found on binding to MHC class II
many types of cells, while antigen molecules.​
receptors are on lymphocytes.​
○​ Clinical note: The HIV virus
3.​ Classes of MHC molecules:​
binds to CD4, which is why it
mainly infects helper T cells.​
○​ MHC Class I: found on most
nucleated cells.​
3.​ Cytotoxic T cells (CD8):​
○​ MHC Class II: found on
antigen-presenting cells, B ○​ They have a glycoprotein called
lymphocytes, and other defense CD8.​
cells.​
○​ CD8 helps cytotoxic T cells
4.​ Function:​
connect to cells displaying
MHC class I molecules,
○​ MHC molecules act like “serving
trays” that display processed allowing them to destroy
antigens on the cell surface.​ infected or abnormal cells.​

○​ The MHC-antigen complex can

then bind to antigen receptors on Lymphocyte Proliferation

🧠 Helper T Cell Activation and Clonal

B or T cells, stimulating an immune
response.​

Expansion
○​ Example: Helper T cells are
activated when they recognize an
1.​ Initial state:​
antigen presented with an MHC
class II molecule.​ ○​ Before exposure to an antigen, the
number of helper T cells specific
to that antigen is very small, too
The MHC molecule/antigen combination is few to mount an effective immune
usually only the first signal necessary to response.​

produce a response from a B cell or T cell.

2.​ Activation:​

In many cases, costimulation by a second ○​ When a macrophage presents the

signal is also required. Costimulation can be processed antigen to a helper T
achieved by cytokines, which are proteins or cell, the cell becomes activated.​
peptides secreted by one cell as a regulator
○​ The helper T cell produces
of neighboring cells. For example, interleukin-2 (IL-2) and IL-2
interleukin-1 is a cytokine released by receptors.​
macrophages that can stimulate helper T
cells.
 3.​ Clonal expansion:​ ○​ They have a glycoprotein
called CD8.​
○​ IL-2 binds to its receptors,
stimulating the helper T cell to
divide.​ ○​ CD8 helps cytotoxic T cells
connect to cells displaying
○​ The “daughter” helper T cells can MHC class I molecules,
again encounter the antigen
allowing them to destroy
presented by macrophages,
triggering further division.​ infected or abnormal cells.​

○​ This process greatly increases the

number of helper T cells ready to
respond.​

It is important for the number of helper T

cells to increased because helper T cells
are necessary for the activation of most B
cells or T cells.

For example, B cells have receptors that

can recognize antigens. Most B cells,
however, do not respond to antigens without
stimulation from helper T cells. Without
functional helper T cells, the immune
response of B cells would not be effective to
prevent disease.

🧠 Other Surface Molecules on

Lymphocytes

1.​ Purpose:​

○​ Lymphocytes have surface

molecules besides MHC
that help them bind to other
cells and stimulate an
immune response.​

2.​ Helper T cells (CD4):​

○​ They have a glycoprotein

called CD4.​

○​ CD4 helps helper T cells

connect to macrophages
by binding to MHC class II
molecules.​
Antibody-Mediated Immunity
○​ Clinical note: The HIV virus
binds to CD4, which is why it
mainly infects helper T cells.​ Exposure of the body to an antigen can lead
to the activation of B cells and the
3.​ Cytotoxic T cells (CD8):​ production of antibodies. The antibodies
bind to the antigens, which can be
destroyed through several different 1.​ IgG​
mechanisms.
2.​ IgM​
Because antibodies are in body fluids,
3.​ IgA​
antibody-mediated immunity is effective
against extracellular antigens, such as
4.​ IgE​
bacteria, viruses (when they are outside
cells), and toxins. It is also involved in 5.​ IgD​
allergic reactions.

STRUCTURE OF ANTIGENS 🧠 Cytokines and Immune

Modulation
Antibodies are proteins produced in
response to an antigen. They are Y-shaped ●​ Suppressing cytokines:​
molecules consisting of four polypeptide
chains: ○​ Reducing cytokine (tell
two identical heavy chains and immune cells to grow, divide,
two identical light chains or activate) production or
activity can suppress the
The end of each “arm” of the antibody is the immune system.​
variable region, the part of the antibody that
combines with the antigen. ○​ Example: Cyclosporine, a
drug used to prevent organ
The variable region of a particular antibody transplant rejection,
can join only with a particular antigen; this is inhibits interleukin-2 (IL-2)
similar to the lock-and-key model of production.​
enzymes
●​ Stimulating cytokines:​
The rest of the antibody is the constant
region, and it has several functions. For ○​ Genetically engineered
example, the constant region can activate cytokines can boost the
complement, or it can attach the antibody to immune system.​
cells, such as macrophages, basophils, and
mast cells. ○​ Example: Administering

🧠 Antibodies in Plasma IL-2 can enhance T cell

activity and promote the
destruction of cancer cells.
●​ Plasma proteins: Most plasma proteins
are divided into albumin and globulins
(alpha, beta, gamma).​

●​ Antibodies:​

1.​ Found mostly in the gamma

globulin portion of plasma →
sometimes called gamma
globulins.​

2.​ Also called immunoglobulins

(Ig) because they are globulin
proteins involved in
immunity.​

●​ Classes of antibodies: There are five

main types:​
 swelling and mucus
EFFECTS OF ANTIBODIES production in the respiratory
tract.​
Antibodies can affect antigens either directly
or indirectly. 4.​ Phagocytosis:​

Direct effects occur when a single antibody ○​ Macrophages can attach to

binds to an antigen and inactivates the the constant region and
antigen, or when many antigens are bound phagocytize both the
together and are inactivated by many antigen and antibody,
antibodies. helping clear the pathogen.​

Most of the effectiveness of antibodies

results from indirect effects

🧠 Role of the Constant Region of

Antibodies

1.​ Activation of other mechani[Link]

○​ After an antibody’s variable

region binds an antigen,
the constant region can
trigger additional immune
responses.​

2.​ Complement activation:​

○​ The constant region can

activate complement,
which:​

■​ Stimulates
inflammation​

■​ Attracts white blood

cells through
chemotaxis​
ANTIBODY PRODUCTION
■​ Lyses bacteria​

3.​ Inflammatory response via mast 🧠 Primary Immune Response

cells and basophils:​
1.​ Definition:​
○​ Antigen-antibody binding can
stimulate mast cells and ○​ The primary response
basophils to release occurs after the first
inflammatory chemicals, exposure to a specific
e.g., histamine.​ antigen.​

○​ Example: In hay fever, 2.​ B cell activation:​

inhaled pollen antigens
trigger this response, causing
 ○​ The antigen binds to the B a few days.​
cell receptor, and the B cell
is activated by a helper T ○​ Stronger response: more
cell.​ plasma cells and
antibodies are produced.​
○​ The B cell divides into:​
4.​ Outcome:​
■​ Plasma cells →
produce antibodies​ ○​ The antigen is destroyed
quickly, usually before
■​ Memory B cells → symptoms appear, resulting
remain in the body for in immunity.​
faster future
responses​
The secondary response also includes the
3.​ Timing:​ formation of new memory cells, which
provide protection against additional
○​ It usually takes 3–14 days to exposures to a specific antigen.
produce enough antibodies
to fight the antigen Memory cells are the basis of adaptive
effectively.​ immunity. After destruction of the antigen,
plasma cells die, the antibodies they
○​ During this time, disease released are degraded, and antibody levels
symptoms may appear decline to the point where they can no
because the antigen can longer provide adequate protection.
cause tissue damage before
However, memory cells persist for many
enough antibodies are made.
years—for life, in some cases. If memory

🧠 Secondary (Memory) Immune cell production is not stimulated, or if the

memory cells produced are short-lived, it is
Response possible to have repeated infections of the
same disease. For example, the same cold
1.​ Definition:​ virus can cause the common cold more than
once in the same person.
○​ The secondary response
occurs when the immune
system encounters an
antigen it has already seen.​

2.​ Memory B cells:​

○​ Memory B cells formed

during the primary response
quickly divide into plasma
cells upon re-exposure.​

○​ Plasma cells rapidly

produce antibodies.​

3.​ Advantages over primary

response:​

○​ Faster response: antibodies

are produced within hours to
🧠 Monoclonal Antibodies deliver drugs to cancer cells.​

●​ Definition:​ ○​ Hundreds of mAbs are

currently in clinical trials for
○​ Monoclonal antibodies new treatments.​
(mAbs) are pure antibody
preparations that bind to
only one specific antigen.​ CELL-MEDIATED IMMUNITY

●​ Production:​ Cell-mediated immunity is a function of

cytotoxic T cells and is most effective
○​ An antigen is injected into a against microorganisms that live inside body
laboratory animal to cells. Viruses and some bacteria are
activate a B-cell clone.​ examples of intracellular microorganisms.
Cell-mediated immunity is also involved with
○​ The activated B cells are some allergic reactions, the control of
removed and fused with tumors, and graft rejection.
tumor cells.​

○​ The resulting hybrid cells:​ 🧠 Cell-Mediated Immunity and

Viral Infections
■​ Produce only one
specific antibody ●​ Purpose:​
(from the single B-cell
clone)​ ○​ Cell-mediated immunity is
crucial for fighting viral
■​ Divide rapidly infections.​
(thanks to the tumor
cell)​ ●​ How viruses behave:​

○​ This creates many cells ○​ Viruses infect host cells and

producing the same use the cells to make more
antibody.​ viruses, which are then
released to infect other cells.​
●​ Uses:​
○​ Inside the cell, viruses are
○​ Diagnosis: pregnancy tests, protected from antibodies,
detecting gonorrhea, syphilis, because antibodies cannot
hepatitis, rabies, cancer​ cross the cell membrane.​

○​ Treatment: over 20 mAbs ●​ Role of T cells:​

are used clinically to treat
diseases, including some ○​ Cytotoxic T cells detect and
cancers​ destroy virus-infected
cells, stopping the virus from
○​ Specificity & speed: mAbs spreading.​
bind only to the target
antigen, making tests and ○​ Helper T cells coordinate
treatments precise​ the response by activating
cytotoxic T cells and other
●​ Clinical significance:​ immune components.​

○​ Initially called “magic

bullets” for their potential to
In cell-mediated immunity, viral proteins long-term immunity,
from infected cells are processed and similar to memory B
presented on MHC class I molecules, cells
allowing cytotoxic T cells to detect and
destroy the infected cells.

Cytotoxic T cells can distinguish between

virally infected cells and noninfected cells
because the T-cell receptor can bind to the
MHC class I/viral antigen complex, which is
not present on uninfected cells.

🧠 Activation of Cytotoxic T Cells

in Cell-Mediated Immunity

1.​ Antigen recognition:​

🧠 Main Effects of Cytotoxic T
○​ T-cell receptors on cytotoxic Cells
T cells bind to the MHC
class I/antigen complex on 1.​ Cytokine release:​
an infected cell.​
○​ Cytotoxic T cells release
○​ This binding activates the cytokines that:​
cytotoxic T cell.​
■​ Activate other
2.​ Costimulation:​ immune cells, like
macrophages​
○​ CD8 molecules on the
cytotoxic T cell provide ■​ Promote
additional costimulation.​ phagocytosis and
inflammation​
○​ Helper T cells release
cytokines like interleukin-2 ■​ Stimulate more
(IL-2), which further cytotoxic T cells,
stimulate activation and boosting the
division of cytotoxic T cells.​ cell-mediated
response​
○​ More helper T cells →
stronger stimulation of 2.​ Direct killing of target cells:​
cytotoxic T cells.​
○​ Cytotoxic T cells bind to
3.​ Clonal expansion:​ antigens on the surfaces of:​

○​ Activated cytotoxic T cells ■​ Virally infected cells

divide to produce:​ (viral antigens)​

■​ Additional cytotoxic ■​ Tumor cells (tumor

T cells → carry out antigens)​
the immune attack​
■​ Transplanted
■​ Memory T cells → tissues (foreign
provide secondary antigens)​
responses and
 ○​ They then lyse (destroy) ○​ Cytotoxic T cells bind to the
these cells, eliminating the antigen on the target cell
threat and cause it to lyse (burst).​

○​ Target cells can include

virus-infected cells, tumor
cells, or transplanted
foreign cells.​

4️⃣ Memory T Cells

●​ Memory T cells do not attack

1️⃣ Activation of Cytotoxic T Cells immediately, but they enable a
faster and stronger response if the
●​ A T cell recognizes an antigen same antigen is encountered again
presented on the surface of a (secondary response).
target cell (like a virus-infected cell)
via MHC class I molecules.​ Sjogren Syndrome a systemic,
autoimmune inflammatory disorder affecting
●​ This recognition activates the T cell glands and mucous membranes. Innate,
to start the immune response.​ antibody-mediated, and cell-mediated
immunity work together against antigens.
In autoimmune disorders, self-antigens
trigger immune attacks on healthy tissues,
such as in Sjogren syndrome, which
2️⃣ Clonal Expansion causes dry mouth and dry eyes due to
damaged salivary and lacrimal glands. ​
●​ The activated T cell divides into two ​ 9/10 cases are women.
main types:​
ACQUIRED IMMUNITY
1.​ Cytotoxic T cells – directly
attack infected or abnormal There are four ways to acquire adaptive
cells​ immunity: ​
1. Active natural
2.​ Memory T cells – remain in 2. Active artificial
the body for faster response 3. Passive natural
if the antigen appears again​ 4. Passive artificial

Active immunity results when an individual

is exposed to an antigen (either naturally or
artificially) and the response of the
3️⃣ Actions of Cytotoxic T Cells individual’s own immune system is the
cause of the immunity.
●​ Release cytokines:​
Passive immunity occurs when another
○​ These cytokines stimulate person or an animal develops immunity and
other immune cells, the immunity is transferred to a nonimmune
promote inflammation, and individual.
activate more T cells.​

●​ Kill target cells on contact:​

1. Active Immunity – your own immune Achieving passive artificial immunity begins
system makes the antibodies. with vaccinating an animal, such as a horse.
After the animal’s immune system responds
●​ Natural active immunity: You catch to the antigen, antibodies are removed from
chickenpox (varicella), your immune the animal and injected into the human
system fights it off, and now you are requiring immunity.
immune if exposed again.​
Antibodies that provide passive artificial
●​ Artificial active immunity: You get immunity are referred to by the general term
a vaccine, like the MMR (measles, antiserum because the antibodies are
mumps, rubella) vaccine. Your body found in serum, which is plasma minus the
produces antibodies, so you are clotting factors. Antisera are available
protected in the future. against microorganisms that cause disease,
such as rabies, hepatitis, and measles;
This process is called vaccination, and the bacterial toxins, such as those that cause
introduced antigen is a vaccine. A vaccine is tetanus, diphtheria, and botulism; and
usually administered by injection. Examples venoms from poisonous snakes and
of vaccinations are the DTP injection spiders.
against diphtheria, tetanus, and pertussis
(whooping cough) and the MMR injection
against mumps, measles, and rubella
(German measles).

The antigen has been changed so that it will

stimulate an immune response but will not
cause the disease symptoms. Because
active artificial immunity produces
OVERVIEW OF IMMUNE INTERACTIONS
long-lasting immunity without disease
symptoms, it is the preferred method of
acquiring adaptive immunity.
The Immune System: One System,
2. Passive Immunity – antibodies are given Many Interactions
to you; your body doesn’t make them.
●​ Innate immunity: Your body’s first line of
defense—fast, general, non-specific. Examples:
●​ Natural passive immunity: A baby inflammation, phagocytosis by macrophages.​
gets antibodies from the mother
through breast milk or across the ●​ Adaptive (acquired) immunity: Specific
recognition and memory of antigens. Includes:​
placenta. Since, the mother has
been exposed to multiple antigens, ○​ Antibody-mediated (humoral)
immunity: B cells produce antibodies.​
either natural or artificial, which
protects her and the developing ○​ Cell-mediated immunity: T cells
fetus against disease. destroy infected or abnormal cells.​

Some of the antibodies (IgG) can cross the Key point: These categories are just ways to study it—in
placenta and enter the fetal blood. reality, the immune system works as a single integrated
network.
If the mother breastfeeds her baby,
●​ Example of interaction:​
antibodies (IgA) in the mother’s milk may
also provide some protection for the baby. ○​ You get infected with a virus → your
adaptive immune system recognizes the
virus → antibodies are produced →
●​ Artificial passive immunity: innate mechanisms like phagocytosis
Someone is injected with antivenom and inflammation help destroy the virus.​
after a snake bite or with antibodies
against hepatitis B if exposed. So adaptive immunity doesn’t act alone—it uses innate
immunity to fully eliminate the threat.
IMMUNOTHERAPY ○​ Vaccination: Prevents
infectious diseases by
stimulating adaptive
Benefits of Understanding the immunity.​
Immune System
○​ Monoclonal antibodies:
1.​ Understanding disease causes Can target specific tumor cell
and progression – knowing how antigens to:​
the immune system works helps
explain why diseases happen and ■​ Deliver radioactive
how they develop.​ isotopes, drugs,
toxins, enzymes, or
2.​ Development of treatments – cytokines​
allows creation of ways to prevent,
stop, or reverse diseases, ■​ Directly kill tumor
including immunotherapy.​ cells or activate
immune responses.​

Immunotherapy Approaches
Challenges & Examples
1.​ Boosting the Immune System​
●​ Problem: Tumor-specific antigens
○​ Goal: Enhance immune are rare → most tumor antigens are
activity to fight diseases like also on normal cells.​
cancer.​
●​ Still useful if damage to normal cells
○​ Methods: Administer is minimal.​
cytokines or other agents →
increase inflammation → ●​ Promising therapies:​
activate immune cells →
destroy tumor cells.​ ○​ B-cell lymphomas:
Monoclonal antibodies +
2.​ Suppressing the Immune System​ radioactive iodine (131I) →
tumor regression with few
○​ Goal: Prevent the immune side effects.​
system from attacking the
body (autoimmune ○​ Breast cancer: Herceptin
diseases).​ binds to overexpressed
growth factor receptors →
○​ Example: Multiple sclerosis slows tumor growth.​
– immune system attacks
myelin.​

■​ Treatment: Interferon
Key Idea: Immunotherapy can either
beta → blocks MHC
strengthen, suppress, or specifically
molecules →
direct the immune system depending on
prevents self-antigens
the disease.
from being targeted.​

3.​ Specific Immune Targeting​

EFFECTS OF AGING ON THE 3. Cell-Mediated Immunity
LYMPHATIC SYSTEM AND IMMUNITY
●​ Decreased ability to fight
intracellular pathogens (e.g.,
Aging and the Immune System viruses).​

1. Thymus and T Cells ●​ Elderly are more susceptible to flu

→ yearly vaccination
●​ With age, the thymus shrinks and recommended.​
is replaced by fat.​
●​ Some latent pathogens can
○​ By age 40: much of the reactivate:​
thymus is adipose tissue.​
○​ Example: Varicella-zoster
○​ By age 60: thymus is very virus → causes shingles in
small, hard to detect.​ older adults.​

●​ T cell numbers remain stable, but:​

○​ T cells are less functional.​

4. Autoimmunity and Cancer
○​ Helper T cells proliferate
●​ Autoimmune diseases: No big
less in response to
increase in new cases in the
antigens.​
elderly, but chronic inflammation
over life can cause cumulative
●​ Result: weaker stimulation of B
tissue damage.​
cells and cytotoxic T cells, so
both antibody-mediated and
●​ Cancer: More common due to:​
cell-mediated immunity decline.​
○​ Repeated exposure to
carcinogens over life​

2. Antibody Responses ○​ Decreased immune

surveillance​
●​ Both primary and secondary
antibody responses are reduced
with age:​

○​ More antigen is needed to Key Takeaways:

trigger a response.​
●​ Aging → weaker immune function
(both humoral and cell-mediated).​
○​ Response is slower.​
●​ Older adults → more infections,
○​ Less antibody is produced.​
slower recovery, reactivation of
latent viruses, higher cancer risk.​
○​ Fewer memory cells form.​

●​ Effect: less resistance to

infections, slower development of
immunity.​