Activation of dendritic cells,
Macrophages, dendritic cells: inhibition of
cytokine and chemokine production,
reduced expression of costimulators and
Liver: synthesis of acute-phase proteins
B cells: proliferation of antibody-producing
Leukocytes: increased integrin affinity,
All cells: antiviral state, increased class I
major histocompatibility complex (MHC)
NK cells and T cells: IFN-? synthesis
T cells: differentiation of Th17,
Natural killer (NK) cells and T cells: IFN-?
production,increased cytotoxic activity
Stimulation of some antibody responses
Endothelial cells: activation (inflammation,
Liver: synthesis of acute-phase proteins
Muscle, fat: catabolism (cachexia)
Endothelial cells: activation (inflammation,
Liver: synthesis of acute-phase proteins
• Intracellular bacteria, which can survive inside
phagocytes, are eliminated by phagocytes that are
activated by Toll-like receptors and other innate sensors as well as by cytokines.
• Protection against viruses is provided by type I interferons and natural killer cells.
to sites of infection and tissue damage (Fig. 2.16). The
process of inflammation consists of recruitment of cells
and leakage of plasma proteins through blood vessels
prostaglandins, and other mediators by mast cells and
macrophages causes an increase in local blood flow and
these potentially harmful substances. We next describe
the cellular events in a typical inflammatory response.
Fig. 2.16 Acute inflammatory response. Cytokines and other mediators are produced by macrophages,
expression of endothelial adhesion molecules and chemokines that promote the movement of leukocytes
Recruitment of Phagocytes to Sites of Infection and
Neutrophils and monocytes migrate to extravascular
to chemoattractants produced by tissue cells reacting
to infection or injury. Leukocyte migration from the
endothelial cells are followed by firm adhesion and then
transmigration through the endothelium (Fig. 2.17).
If an infectious microbe breaches an epithelium and
enters the subepithelial tissue, resident dendritic cells,
macrophages, and other cells recognize the microbe
near the site of infection and initiate the sequence of
events in leukocyte migration into tissues.
• Rolling of leukocytes. In response to TNF and IL-1,
term selectin refers to the carbohydrate-binding,
or lectin, property of these molecules.) Circulating
neutrophils and monocytes express surface carbohydrates that bind specifically to the selectins. The
neutrophils become tethered to the endothelium,
flowing blood disrupts this binding, the bonds
reform downstream, and this repetitive process
results in the rolling of the leukocytes along the
• Firm adhesion. Leukocytes express another set of
adhesion molecules that are called integrins because
they integrate extrinsic signals into cytoskeletal
alterations. Leukocyte integrins, such as LFA-1 and
which bind to proteoglycans on the luminal surface
of endothelial cells and are thus displayed at a high
concentration to the leukocytes that are rolling on
the endothelium. These immobilized chemokines
bind to chemokine receptors on the leukocytes and
Concurrently, TNF and IL-1 act on the endothelium to stimulate expression of ligands for integrins,
including ICAM-1 and VCAM-1. The firm binding
leukocytes is reorganized, and the cells spread out on
• Leukocyte migration. Leukocytes adherent to the
endothelium crawl to and then through the junctions between endothelial cells, exiting the blood
vessels. Within the tissue, leukocytes migrate along
extracellular matrix fibers, directed by concentration
gradients of chemoattractants, including chemokines, bacterial formyl peptides, and complement
fragments C5a and C3a. The concentrations of these
chemoattractants are highest where the microbes are
The sequence of selectin-mediated rolling, integrin-mediated firm adhesion, and chemokine-mediated
motility leads to the migration of blood leukocytes to an
extravascular site of infection within minutes after the
infection. (As discussed in Chapters 5 and 6, the same
sequence of events is responsible for the migration of
defective leukocyte recruitment to sites of infection and
increased susceptibility to infections. These disorders
are called leukocyte adhesion deficiencies (LADs).
The phagocytes work together with plasma proteins
infections, blood leukocytes other than neutrophils and
macrophages, such as eosinophils, may be recruited to sites
of infection and provide defense against the pathogens.
Phagocytosis and Destruction of Microbes
Neutrophils and macrophages ingest (phagocytose) microbes and destroy the ingested microbes in
microbe. The principal phagocytic receptors are some
complement. Microbes opsonized with antibodies and
cell is followed by extension of the phagocyte plasma
membrane around the particle. The membrane then
The phagosomes fuse with lysosomes to form phagolysosomes.
At the same time that the microbe is being bound by
the phagocyte’s receptors and ingested, the phagocyte
These free radicals are called reactive oxygen species
proteases, break down microbial proteins. All these
microbicidal substances are produced mainly within
lysosomes and phagolysosomes, where they act on the
ingested microbes but do not damage the phagocytes.
In addition to intracellular killing, neutrophils use
additional mechanisms to destroy microbes. They can
inflammatory mediators, neutrophils die, and during
this process they extrude their nuclear contents to form
networks of chromatin called neutrophil extracellular
traps (NETs), which contain antimicrobial substances
that are normally sequestered in neutrophil granules.
Inherited deficiency of the phagocyte oxidase enzyme
is the cause of an immunodeficiency disorder called
chronic granulomatous disease (CGD). In CGD,
neutrophils are unable to eradicate intracellular microbes,
and the host tries to contain the infection by calling in
more macrophages, resulting in collections of activated
macrophages around the microbes called granulomas.
In addition to eliminating pathogenic microbes and
damaged cells, cells of the immune system initiate the
process of tissue repair. Macrophages, especially of the
alternatively activated type, produce growth factors that
stimulate the proliferation of residual tissue cells and
fibroblasts, resulting in regeneration of the tissue and
scarring of what cannot be replaced. Other immune cells,
such as helper T cells and ILCs, may serve similar roles.
Defense against viruses is a special type of host response
Type I interferons inhibit viral replication and
forms of IFN-a and one of IFN-ß, are secreted by many
cell types infected by viruses. A major source of these
I IFNs in response to recognition of viral nucleic acids
by TLRs and other pattern recognition receptors. When
type I IFNs secreted from dendritic cells or other infected
cells bind to the type I IFN receptor on the infected or
genomes (Fig. 2.19). This action is the basis for the use
of IFN-a to treat some forms of chronic viral hepatitis.
Virus-infected cells may be destroyed by NK cells, as
described earlier. Type I IFNs enhance the ability of NK
cells to kill infected cells. Recognition of viral DNA by
proteolytically destroyed (see Fig. 2.6). In addition,
part of the innate response to viral infections includes
increased apoptosis of infected cells, which also helps to
eliminate the reservoir of infection.
Regulation of Innate Immune Responses
Innate immune responses are regulated by a variety of mechanisms that are designed to prevent
Fig. 2.18 Phagocytosis and intracellular killing of microbes.
Macrophages and neutrophils express many surface receptors
that may bind microbes for subsequent phagocytosis; select
examples of such receptors are shown. Microbes are ingested
into phagosomes, which fuse with lysosomes, and the
microbes are killed by enzymes and several toxic substances
produced in the phagolysosomes. The same substances may
be released from the phagocytes and may kill extracellular
microbes (not shown). iNOS, Inducible nitric oxide synthase;
NO, nitric oxide; ROS, reactive oxygen species.
including interleukin-10 (IL-10), which inhibits
the microbicidal and proinflammatory functions of
macrophages (classical pathway of macrophage activation), and IL-1 receptor antagonist, which blocks
the actions of IL-1. There are also many feedback
mechanisms in which signals that induce proinflammatory cytokine production also induce expression
of inhibitors of cytokine signaling. For example, TLR
the responses of cells to various cytokines, including
IFNs. Intracellular regulators of inflammasome activation were mentioned earlier.
Microbial Evasion of Innate Immunity
Listeria monocytogenes produces a protein that
enables it to escape from phagocytic vesicles and
enter the cytoplasm of infected cells, where it is no
longer susceptible to ROS or NO (which are produced mainly in phagolysosomes). The cell walls
of mycobacteria contain a lipid that inhibits fusion
of phagosomes containing ingested bacteria with
lysosomes. Other microbes have cell walls that are
resistant to the actions of complement proteins. As
discussed in Chapters 6 and 8, these mechanisms also
enable microbes to resist the effector mechanisms of
cell-mediated and humoral immunity, the two arms
So far we have focused on how the innate immune
system recognizes microbes and combats infections.
We mentioned at the beginning of this chapter that, in
addition to its roles in host defense, the innate immune
innate immune responses stimulate adaptive immune
Innate immune responses generate molecules
that provide signals, in addition to antigens, that
are required to activate naive T and B lymphocytes.
In Chapter 1, we introduced the concept that full
cells and virus-infected cells in response to intracellular TLR
and activate signaling pathways that induce expression of
enzymes that interfere with viral replication at different steps,
including inhibition of viral protein translation, increasing viral
RNA degradation, and inhibition of viral gene expression and
virion assembly. Type I IFNs also increase the infected cell’s
susceptibility to CTL-mediated killing (not shown).
activation of antigen-specific lymphocytes requires
two signals. Antigen may be referred to as signal 1,
and innate immune responses to microbes and to host
cells damaged by microbes may provide signal 2 (Fig.
2.21). The stimuli that warn the adaptive immune
system that it needs to respond have also been called
danger signals. This requirement for microbe-dependent second signals ensures that lymphocytes
respond to infectious agents and not to harmless,
noninfectious substances. In experimental situations or for vaccination, adaptive immune responses
may be induced by antigens without microbes. In all
such instances, the antigens need to be administered
with substances called adjuvants that elicit the same
innate immune reactions as microbes do. In fact,
many potent adjuvants are the products of microbes.
In infected tissues, microbes (or IFN-? produced by
NK cells in response to microbes) stimulate dendritic
cells and macrophages to produce two types of second
activation of the lymphocytes, and substances produced during
innate immune responses to microbes (or components of
microbes) provide signal 2. In this illustration, the lymphocytes
could be T cells or B cells. By convention, the major second
second signals for T and B lymphocytes is described further in
activation (alternative pathway)
Sialic acid expression inhibits
M protein blocks C3 binding to
Pseudomonas Synthesis of modified LPS
Mechanism of immune evasion Organism (example) Mechanism
Fig. 2.20 Evasion of innate immunity by microbes. Selected examples of the mechanisms by which
microbes may evade or resist innate immunity. LPS, Lipopolysaccharide.
cells and macrophages secrete cytokines such as IL-12,
IL-1, and IL-6, which stimulate the differentiation of
naive T cells into effector cells of cell-mediated adaptive immunity.
Blood-borne microbes activate the complement
system by the alternative pathway. One of the proteins
produced during complement activation by proteolysis
of C3b, called C3d, becomes covalently attached to the
microbe. At the same time that B lymphocytes recognize
microbial antigens by their antigen receptors, the B cells
recognize the C3d bound to the microbe by a receptor
for C3d. The combination of antigen recognition and
These examples illustrate an important feature of
second signals: these signals not only stimulate adaptive
that is, costimulators and cytokines—that stimulate T
cell responses. By contrast, blood-borne microbes need
to be combated by antibodies, which are produced by
B lymphocytes during humoral immune responses.
Blood-borne microbes activate the plasma complement
system, which in turn stimulates B cell activation and
antibody production. Thus, different types of microbes
induce innate immune responses that stimulate the
types of adaptive immunity that are best able to combat
different infectious pathogens.
• The innate immune system uses germline-encoded
• Toll-like receptors (TLRs), expressed on plasma
membranes and endosomal membranes of many
cell types, are a major class of innate immune system
receptors that recognize different microbial products,
NOD-like receptor (NLR) family recognize microbial cell wall lipoproteins, while other NLRs respond
to products of damaged cells and cytosolic changes
active form the proinflammatory cytokine interleukin-1 (IL-1).
• The principal components of innate immunity are:
epithelial barrier cells in skin, gastrointestinal tract,
and respiratory tract; phagocytes; dendritic cells;
mast cells; natural killer cells; cytokines; and plasma
proteins, including the proteins of the complement
• Epithelia provide physical barriers against microbes;
produce antimicrobial peptides, including defensins
and cathelicidins; and contain lymphocytes that may
• The principal phagocytes—neutrophils and monocytes/macrophages—are blood cells that are recruited
to sites of infection, where they are activated by
engagement of different receptors. Some activated
macrophages destroy microbes and dead cells, and
other macrophages limit inflammation and initiate
• Innate lymphoid cells (ILCs) secrete various cytokines that induce inflammation. Natural killer
(NK) cells kill host cells infected by intracellular
microbes and produce the cytokine interferon-?,
which activates macrophages to kill phagocytosed
• The complement system is a family of proteins that
are activated on encounter with some microbes (in
innate immunity) and by antibodies (in the humoral
arm of adaptive immunity). Complement proteins
coat (opsonize) microbes for phagocytosis, stimulate
inflammation, and lyse microbes.
• Cytokines of innate immunity function to stimulate
inflammation (TNF, IL-1, IL-6, chemokines), activate NK cells (IL-12), activate macrophages (IFN-?),
and prevent viral infections (type I IFNs).
• In inflammation, phagocytes are recruited from the
circulation to sites of infection and tissue damage.
The cells bind to endothelial adhesion molecules
that are induced by the cytokines TNF and IL-1 and
migrate in response to soluble chemoattractants,
including chemokines, complement fragments, and
bacterial peptides. The leukocytes are activated, and
they ingest and destroy microbes and damaged cells.
• Antiviral defense is mediated by type I interferons,
which inhibit viral replication, and by NK cells,
• In addition to providing early defense against infections, innate immune responses provide signals
that work together with antigens to activate B and
T lymphocytes. The requirement for these second
signals ensures that adaptive immunity is elicited by
microbes (the most potent inducers of innate immune
reactions) and not by nonmicrobial substances.
1. How does the specificity of innate immunity differ
from that of adaptive immunity?
receptors for these substances?
3. What is the inflammasome, and how is it stimulated?
4. What are the mechanisms by which the epithelium of
the skin prevents the entry of microbes?
5. How do phagocytes ingest and kill microbes?
physiologic significance of this recognition?
7. What are the roles of the cytokines TNF, IL-12, and
type I interferons in defense against infections?
8. How do innate immune responses enhance adaptive
Answers to and discussion of the Review Questions are
B and T lymphocytes differ in the types of antigens they
recognize. The antigen receptors of B lymphocytes—
namely, membrane-bound antibodies—can recognize
a variety of macromolecules (proteins, polysaccharides,
lipids, nucleic acids), in soluble form or cell surface–
associated form, as well as small chemicals. Therefore,
B cell–mediated humoral immune responses may be
generated against many types of microbial cell wall and
(MHC) molecules. Because the association of antigenic
peptides and MHC molecules occurs inside cells, T cell–
mediated immune responses may be generated only
against protein antigens that are either produced in or
taken up by host cells. This chapter focuses on the nature
of the antigens that are recognized by lymphocytes.
Chapter 4 describes the receptors used by lymphocytes
The induction of immune responses by antigens is a
Antigens Recognized by T Lymphocytes, 52
Capture of Protein Antigens by Antigen-Presenting
Structure and Function of Major Histocompatibility
Structure of MHC Molecules, 58
Properties of MHC Genes and Proteins, 59
Inheritance Patterns and Nomenclature of HLA
Peptide Binding to MHC Molecules, 61
Processing and Presentation of Protein Antigens, 63
Processing of Cytosolic Antigens for Display by
Proteolysis of Cytosolic Proteins, 64
Binding of Peptides to Class I MHC Molecules, 65
Transport of Peptide-MHC Complexes to the Cell
Processing of Internalized Antigens for Display by
Internalization and Proteolysis of Antigens, 66
Binding of Peptides to Class II MHC Molecules, 67
Transport of Peptide-MHC Complexes to the Cell
Cross-Presentation of Internalized Antigens to
Physiologic Significance of MHC-Associated Antigen Presentation, 69
Functions of Antigen-Presenting Cells in Addition to
Antigen Recognition by B Cells and Other Lymphocytes, 71
52 CHAPTER 3 Antigen Capture and Presentation to Lymphocytes
are specific for any one antigen, as few as 1 in 105 or
106 circulating lymphocytes, and this small fraction of
the body’s lymphocytes needs to locate and react rapidly
to defend against different types of microbes. In fact,
the immune system has to react in different ways even
to the same microbe at different stages of the microbe’s
life cycle. For example, defense against a microbe (e.g.,
a virus) that has entered the bloodstream depends on
of potent antibodies requires the activation of CD4+
helper T cells. After it has infected host cells, however,
the microbe is safe from antibodies, which cannot enter
cells and eliminate the reservoir of infection. Thus, we
are faced with two important questions:
• How do the rare naive lymphocytes specific for any
• How do different types of T cells recognize microbes
in different cellular compartments? Specifically,
whereas CTLs kill infected cells that harbor microbial
antigens in the cytosol and nucleus outside vesicular
compartments. As we shall see in this chapter, MHC
molecules play a central role in this segregation of
antigen recognition by T cells.
The answer to both questions is that the immune system
has developed a highly specialized system for capturing and
genetic locus whose principal protein products function
as the peptide display molecules of the immune system.
CD4+ and CD8+ T cells can see peptides only when these
peptides are displayed by that individual’s MHC molecules.
This property of T cells is called MHC restriction. The
that peptide (Fig. 3.1). Each TCR, and hence each clone of
CD4+ or CD8+ T cells, recognizes one peptide displayed
by one of the many MHC molecules in every individual.
The properties of MHC molecules and the significance of
MHC restriction are described later in this chapter. How
we generate T cells that recognize peptides presented only
by self MHC molecules is described in Chapter 4. Also,
some small populations of T cells recognize lipid and other
nonpeptide antigens either presented by nonpolymorphic
class I MHC–like molecules or without a requirement for a
specialized antigen display system.
antigen-presenting cells (APCs). Naive T lymphocytes
must see protein antigens presented by dendritic cells
to initiate clonal expansion and differentiation of the
T cells into effector and memory cells. Differentiated
effector T cells again need to see antigens, which may
be presented by various kinds of APCs besides dendritic
cells, to activate the effector functions of the T cells in
both humoral and cell-mediated immune responses. We
first describe how APCs capture and present antigens to
trigger immune responses and then examine the role of
MHC molecules in antigen presentation to T cells.
Fig. 3.1 Model showing how a T cell receptor recognizes
expressed on antigen-presenting cells and function to display
peptides derived from protein antigens. Peptides bind to the
MHC molecules by anchor residues, which attach the peptides
to pockets in the MHC molecules. The antigen receptor of
CHAPTER 3 Antigen Capture and Presentation to Lymphocytes 53
CAPTURE OF PROTEIN ANTIGENS BY
Protein antigens of microbes that enter the body
are captured mainly by dendritic cells and concentrated in the peripheral (secondary) lymphoid
organs, where immune responses are initiated
(Fig. 3.2). Microbes usually enter the body through
the skin (by contact), the gastrointestinal tract (by
ingestion), the respiratory tract (by inhalation), and
the genitourinary tract (by sexual contact). Some
microbes may enter the bloodstream. Microbial antigens can also be produced in any infected tissue.
Because of the vast surface area of the epithelial barriers
and the large volume of blood, connective tissues, and
all these sites searching for foreign invaders; instead,
antigens are taken to the lymphoid organs through
which lymphocytes recirculate.
Dendritic cellassociated antigen
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