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Updated: Mar 23 2022


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  • Types of Immune Responses
    • Types of Immune Responses
      • innate response
        • not specific to a type of immunological challenge
        • represents the immune response which does not have memory
          • e.g., anatomic barriers (skin), inflammation, complement cascade
        • recognizes structures common to multiple microbes
        • found in nearly all forms of life
        • cells include
          • natural killer cells
          • mast cells
          • eosinophils
          • basophils
          • phagocytic cells (macrophages, neutrophils, and dendritic cells)
      • acquired response
        • portion of immune response which has memory
        • occurs in a pathogen and antigen specific mechanism
        • requires antigen processing and presentation
          • performed by antigen presentation cells (APC)
            • B cells and dendritic cells are two examples of APCs
          • the APC breaks down the protein antigen in a multitude of enzymatic reactions and presents key peptide sequences via the major histocompatibility complex (MHC) receptors
          • once presented on the surface of the APC, the T-cell receptor recognizes the MHC/antigen complex prior to T-cell activation
        • cells include
          • CD8+ T lymphocytes
          • T helper cells
          • delta gamma T cells
          • B cells and plasma cells
  • Types of Immunological Reactions
    • Type I: Immediate anaphylactic reaction
      • associated with allergy
      • mediated by IgE antibody activation of mast cells and basophils
    • Type II: Antibody dependent (aka cytotoxic) hypersensitivity
      • mediated by IgG and IgM antibodies
    • Type III: Immune complex (antigen bound to antibody) deposition type of hypersensitivity
      • mediated by IgG and IgM antibodies which when bound to antigen get deposited in various tissues
    • Type IV: Delayed-type or cell-mediated hypersensitivity
      • mediated by T cells, monocytes and macrophages
      • take several days to develop
      • examples include
        • tuberculosis skin test
        • topical antibiotic ointment 
        • the immune response to metallic orthopaedic implants is typically a Type IV (delayed-type hypersensitivity reaction)
  • Immunoglobulins
    • Immunoglobulin types
      • IgG
        • the most abundant immunoglobulin
      • IgM
        • the first class of antibody to appear in our serum after exposure to an antigen
      • IgA
        • the major class of antibody in external secretions (e.g. intestinal mucus, bronchial mucus, saliva, and tears)
      • IgE
        • important in conferring protection against parasites and allergic reactions
  • Immunologic Variations

    • Benign Ethnic Neutropenia
      • Most common neutropenia in the world
      • Approximately 25%-50% of people of African descent and some sub-groups in the Middle East found to have low ANC without increased infection risk
      • ANC < 1.5 x 10(9) cells/L considered "abnormally low" without clear clinical relevance.
        • 4.5% African Americans, 0.79% white Americans, 0.38% Mexican-Americans below this ANC
      • Also more common in males vs females, athlete vs non-athlete, and children under age 5
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