Immunology

complement system

The complement system comprises an assembly of liver-manufactured, soluble and cell-bound proteins that participate in innate and adaptive immunity. Activation of the complement cascade by protease cleavage leads to chemotaxis (C5a), inflammation and increased capillary permeability (C3a, C5a), opsonization (C3b), and cytolysis.

activation : alternative pathway : amplification by C3 : anaphylatoxins C3a, C5a : antigen uptake : C1 : C2 : C3 : C4 : C5 : C6 : C7 : C8 : C9 : C1INH : CD59 : chemotaxis : classical pathway : complement cascade : complement control proteins : convertases C3, C3/C5, C5 : disorders : evolution : Factor B : Factor H : Factor I : ficolins : immunoglobulins and complement activation : inhibitory proteins : lectin pathway : MBL -MAPS : mannose-binding lectin pathway : membrane attack complex : opsonin : pathways : perforin : phagocytosis : pore : proteases : regulation : serine proteases : sialic acid

Sequential activation of the protein components of the complement cascade upon cleavage by a protease, leads to each component's becoming, in its turn, a protease. Three pathways are involved in complement attack upon pathogens:
classical pathway
alternative pathway
mannose-binding lectin pathway (MBL -MAPS)

The classical pathway utilizes C1, which is activated by binding of an antibody to its cognate antigen.

Inactive C1 circulates as a serum molecular complex comprising 6 C1q molecules, 2 C1r molecules, and 2 C1s molecules. Constant regions in some immunoglobulins specifically bind C1q, activating C1r and C1s. The mu chains of IgM and some gamma chains of IgG contain specific binding sites, though IgM is far more effective than IgG.

Activated C1s is a serine protease that cleaves C4 and C2 into small inactive fragments (C4a, C2a) and larger active fragments, C4b and C2b. The active component C4b binds to the sugar moieties of surface glycoproteins and binds noncovalently to C2b, forming another serine protease C4b•C2b, which is called C3 convertase because it cleaves C3, releasing an active C3b opsonin fragment.

Macrophages and neutrophils possess receptors for C3b, so cells coated with C3b are targetted for phagocytosis (opsonization). The small C3a fragment is released into solution where it can bind to basophils and mast cells, triggering histamine release and, as an anaphylatoxin, potentially participating in anaphylaxis.

C3 amplifies the humoral response because of its abundance and its ability to auto-activate (as a C3 convertase). Breakdown of C3b generates an antigen-binding C3d fragment that enhances antigen uptake by dendritic cells and B cells .

Binding of C3b to C5 induces an allosteric change that exposes C3b•C5 to cleavage by C4b•C2b, which is now acting as C3/C5 convertase. The alternative pathway possesses a distinct C5 convertase, so the two pathways converge through C5.

Cleavage of C5 by the C3/C5 convertase releases:
anaphylotoxic C5a, which promotes chemotaxis of neutrophils
C5b, which complexes with one molecule of each of C6, C7, and C8. The resultant C5b•6•7•8 complex assists polymerization of as many as 18 C9 molecules to form a cytolysis-promoting pore (membrane attack complex, tem) through the plasma membrane of the target cell, which then suffers osmosis-induced cytolysis.

Another cytolytic mediator utilized by CTLs and NK cells is perforin, which is a 534 aa glycoprotein with sequence homology to the membrane attack component of complement C9. Like C9, perforin integrates into the target cell membrane, forming polyprotein pores up to 20nm in diameter comprising 12—18 perforin monomers, which breach membrane integrity and permit cytolytic cell death.

The alternative pathway is not activated by antigen-antibody binding, but instead relies upon spontaneous conversion of C3 to C3b, which is rapidly inactivated by its binding to inhibitory proteins and sialic acid on the cell's surface. Because bacteria and other foreign materials lack these inhibitory proteins and sialic acid, the C3b is not inactivated and it forms the C3b•Bb complex with Factor B. The C3b.Bb complex acts as a C3 convertase, forming C3b•Bb•C3b, which acts as a C5 convertase that can ititiate assembly of the membrane attack complex. C3b•Bb, acting as a C3 convertase, provides a positive feedback loop that amplifies production of C3.

The lectin pathway (MBL - MASP) is homologous to the classical pathway, but utilizes opsonin, mannan-binding lectin (MBL, MBP) and ficolins rather than C1q. Binding of mannan-binding lectin to mannose residues on the pathogen surface activates the MBL-associated serine proteases, MASP-1, MASP-2, MASP-3, which cleave C4 into C4b and C2 into C2b. As in the classical pathway, C4b and C2b bind to form the C4b•C2b C3 convertase. Ficolins are homologous to MBL and function through MASPs. Diversified ficolins are of particular importance in invertebrates, which lack the adaptive immune response that evolved some 500 million years ago in jawed vertebrates.

Several complement control proteins regulate activity of the complement system, including:
● C1 inhibitor (C1INH), which eliminates the proteolytic activity of activated C1r and C1s. Following C1 activation by antigen-antibody complexes, C1INH permits only a brief interval during which activated C1 can cleave C4 and C2.
● Factor I, which inactivates C3b
● Factor H, which removes Bb, thus interrupting the C3 convertase feedback loop within the alternative pathway
● CD59, which inhibits C9 polymerization during assembly of the membrane attack complex.

Dysregulation of the complement system manifests variously as immune complex disorders (C2 deficiency), susceptibility to bacterial infections (C3 deficiency), the autoimmune disorder SLE (early component or C2 deficiency), hereditary angioneurotic edema (HANE) (C1INH deficiency).

activation : alternative pathway : amplification by C3 : anaphylotoxins C3a, C5a ф antibodies ф antigen : antigen uptake : C1 : C2 : C3 : C4 : C5 : C6 : C7 : C8 : C9 : C1INH : CD59 : chemotaxis : classical pathway : complement cascade : complement control proteins : convertases C3, C3/C5, C5 : disorders : evolution : Factor B : Factor H : Factor I : ficolins : immunoglobulins and complement activation : inhibitory proteins : lectin pathway : MBL -MAPS : mannose-binding lectin pathway : membrane attack complex : opsonin : pathways : perforin : phagocytosis : pore : proteases : regulation : serine proteases : sialic acid

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cytotoxicity

Cytotoxic agents are toxic to cells:
● Cytotoxic physical agents
___ ● thermal (excessive heat or cold)
___irradiation

● Cytotoxic drugs and chemicals have cytolytic, carcinogenic, mutagenic and/or teratogenic potential. Direct contact may cause tissue irritation, ulceration, and necrosis.
___ ● antineoplastic and immunosuppressive therapeutic agents
___ ● free radicals
___ ● strong acids and alkalis
___ ● secreted digestive enzymes and antimicrobials – lysozyme, phospholipase, defensins
___ ● secreted cytolytic molecules • FasL, granzymes, granulysin, perforin
___phagocytosis-promoting opsoninsC3b of complement cascade, pulmonary surfactants

● Cytotoxic cellular immune responses
_ ● Antibody-dependent cell-mediated cytotoxicity (ADCC) is mediated by antibody-marking
_ ● Complement-dependent cytotoxicity (CDC) is mediated by the complement system (opsonin-induced phagocytosis performed by macrophages and neutrophils, anaphylatoxin induced histamine release by basophils and mast cells).
_ ● Lymphocyte-mediated cytotoxicity ('LMC') requires is independent of antibody-marking and the complement system

__killer cells
___ ● non-specific 'attack' cells – eosinophils (IgE, CD67), macrophages (IgG, CD14), K cells (IgG), LAK cells (IL-2 activated cytolysis cells, lymphokine-activated killer cells), NK cells (CD16, CD56)
___ ● natural killers cells (NK) of innate immune system – have activating receptors and killer inhibitory receptors (KIR) – secrete cytolytic granzymes and perforin ('LMC')
___ ● natural killer T cells (NKT) – have αβ TCR plus some of the cell-surface molecules of NK cells – respond to glycolipid antigens presented by the cell-surface molecule CD1d (ADCC) – secrete IFN-γ (Th1 cytokine) plus IL-4 and IL-13 (Th2 cytokines)
___ ● cytotoxic T cells • (CD8 +) Tc matures into CTL (killer T cells) following activation (ADCC)
___phagocytic cells engulf pathogens, often after pathogen coating by opsonins (CDC)

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inflammatory response

Inflammation is a signal-mediated response to cellular insult by infectious agents, toxins, and physical stresses. While acute inflammation is important to the immune response, chronic inappropriate inflammation can cause tissue destruction (autoimmunity, neurodegenerative, cardiovascular disease).

acute phase : agents : cytokines : events : pro-inflammatory cytokines : sequence : signs/symptoms

Symptoms & Signs: Inflammation is variably accompanied by fever (pyrogenesis), redness (rubor), swelling (turgor), pain (dolor), and tissue/organ dysfunction (functio laesa).

The sequence of inflammatory events is:
● insult by trauma or pathogenacute phase reaction
_ ● platelet adhesion, vasoconstriction of efferent vessels
_cytokine induced afferent vascular dilatation (vasodilation causing increased blood flow (redness, local heat) to infected/damaged area
_ ● activation of complement system, clotting system, fibrinolytic system, and kinin system
__leukocyte adhesion cascade
__ ● endothelial gaps increase vascular permeability and allow extravasation of serum proteins (exudate) and leukocytes (→ neutrophilsmacrophageslymphocytes) with resultant tissue swelling
___phagocytosis of foreign material with pus formation

The inflammatory response is part of the innate immune response, and employs cellular and plasma-derived agents (pathway):
complement system
interferons (IFN)
cytokines, lymphokines, monokines
prostaglandins and leukotrienes – arachidonic acid derivatives
● platelet activating factor (PAF)
● histamine
kinins (bradykininpain)

Pain-evoking mediators include proinflammatory cytokines, chemokines, protons, nerve growth factor, and prostaglandins, which are produced by invading leukocytes or by local cells.

Acute phase proteins fluctuate in response to tissue injury and infections. They are synthesized (by hepatocytes) in response to pro-inflammatory cytokines and include:
C-reactive protein (CRP),
mannose-binding protein,
complement factors,
alpha-1 acid glycoprotein,
alpha 1-antitrypsin,
alpha 1-antichymotrypsin,
alpha 2-macroglobulin,
serum amyloid P component (SAP, amyloid),
haptoglobins (alpha-2-globulins),
ceruloplasmin,
complement components C3, C4 ,
coagulation factors (fibrinogen, prothrombin, factor VIII, von Willebrand factor, plasminogen)● ferritin

Pro-inflammatory cytokines include IL-1, IL-6, IL-8, TNF-α (tumor necrosis factor alpha), and TNF-β (lymphotoxin α, LT).

In response to infection, macrophages secrete IL-1 and TNFs, which are broad-spectrum cytokines that stimulate inflammatory responses of neutrophils, fibroblasts, and endothelial cells. The fibroblasts and endothelial cells respond to IL-1 and TNF by recruiting more immune cells to the site of inflammation.

Pain:
When tissue is destroyed or invaded by leukocytes in inflammation, numerous mediators are delivered by the circulation and/or liberated from resident and immigrated cells at the site. Proalgesic mediators include proinflammatory cytokines, chemokines, protons, nerve growth factor, and prostaglandins, which are produced by invading leukocytes or by resident cells. Less well known is that analgesic mediators, which counteract pain, are also produced in inflamed tissues. These include anti-inflammatory cytokines and opioid peptides. Interactions between leukocyte-derived opioid peptides and opioid receptors can lead to potent, clinically relevant inhibition of pain (analgesia). Opioid receptors are present on peripheral endings of sensory neurons. Opioid peptides are synthesized in circulating leukocytes, which migrate to inflamed tissues directed by chemokines and adhesion molecules. Under stressful conditions or in response to releasing agents (e.g., corticotropin-releasing factor, cytokines, noradrenaline), leukocytes can secrete opioids. They activate peripheral opioid receptors and produce analgesia by inhibiting the excitability of sensory nerves and/or the release of excitatory neuropeptides. This review presents discoveries that led to the concepts of pain generation by mediators secreted from leukocytes and of analgesia by immune-derived opioids.
Leukocytes in the regulation of pain and analgesia. Rittner HL, Machelska H, Stein C. J Leukoc Biol. 2005 Dec;78(6):1215-22. Epub 2005 Oct 4. [Free Full Text Article]

[] inflammatory initiation - skin Џ animation of leukocyte adhesion Џ

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