Immunology Of Cellular Immunity

USMLE Guide: Immunology of Cellular Immunity

Introduction

Cellular immunity is an essential component of the immune system that protects against intracellular pathogens, including viruses, certain bacteria, and parasites. Understanding the immunology of cellular immunity is crucial for medical professionals, particularly for those preparing for the United States Medical Licensing Examination (USMLE). This guide aims to provide a comprehensive overview of the key concepts and mechanisms involved in cellular immunity.

Table of Contents

• 1. Cellular Immune Response
  • 1.1 Antigen Presentation
  • 1.2 Antigen Recognition
  • 1.3 Effector Mechanisms
• 2. Major Players in Cellular Immunity
  • 2.1 T Lymphocytes
  • 2.2 Antigen-Presenting Cells (APCs)
  • 2.3 Cytotoxic T Cells (CTLs)
• 3. Activation and Regulation of Cellular Immunity
  • 3.1 T Cell Activation
  • 3.2 Co-Stimulation
  • 3.3 Regulatory T Cells (Tregs)
• 4. Clinical Applications
  • 4.1 Immunodeficiencies
  • 4.2 Vaccines
  • 4.3 Transplantation

1. Cellular Immune Response

1.1 Antigen Presentation

• Antigen-presenting cells (APCs) capture and process antigens derived from intracellular pathogens.
• APCs present antigens using Major Histocompatibility Complex (MHC) molecules.
• MHC class I molecules present antigens to CD8+ T cells, while MHC class II molecules present antigens to CD4+ T cells.

1.2 Antigen Recognition

• T cell receptors (TCRs) on T lymphocytes recognize the antigen-MHC complex.
• The binding between TCRs and antigen-MHC triggers T cell activation.

1.3 Effector Mechanisms

• Activated T cells differentiate into effector cells, including cytotoxic T cells (CTLs) and helper T cells.
• CTLs kill infected cells through the release of cytotoxic molecules, such as perforin and granzymes.
• Helper T cells secrete cytokines to regulate immune responses and enhance the activity of other immune cells.

2. Major Players in Cellular Immunity

2.1 T Lymphocytes

• T lymphocytes are a subset of white blood cells that play a central role in cellular immunity.
• CD8+ T cells, also known as cytotoxic T cells, directly kill infected cells.
• CD4+ T cells, also known as helper T cells, regulate immune responses and support other immune cells.

2.2 Antigen-Presenting Cells (APCs)

• Antigen-presenting cells capture, process, and present antigens to T lymphocytes.
• Dendritic cells, macrophages, and B lymphocytes are examples of APCs.
• APCs express MHC molecules necessary for antigen presentation.

2.3 Cytotoxic T Cells (CTLs)

• CTLs are CD8+ T cells that recognize and kill infected cells.
• CTLs release cytotoxic molecules that induce apoptosis in infected cells.
• Perforin and granzymes are key cytotoxic molecules released by CTLs.

3. Activation and Regulation of Cellular Immunity

3.1 T Cell Activation

• T cell activation requires binding of TCRs to antigen-MHC complexes on APCs.
• Co-stimulatory signals, such as CD28-B7 interaction, are necessary for full T cell activation.

3.2 Co-Stimulation

• Co-stimulation ensures that T cell activation occurs in the presence of a genuine infection, preventing unnecessary immune responses.

3.3 Regulatory T Cells (Tregs)

• Tregs play a crucial role in maintaining immune homeostasis and preventing excessive immune responses.
• Tregs suppress immune responses by inhibiting other T cells and APCs.

4. Clinical Applications

4.1 Immunodeficiencies

• Understanding cellular immunity is essential in diagnosing and managing immunodeficiency disorders.
• Defects in T lymphocytes, APCs, or cytokines can lead to impaired cellular immunity.

4.2 Vaccines

• Knowledge of cellular immunity helps in the design and development of vaccines.
• Vaccines stimulate cellular immunity by promoting T cell activation and memory cell formation.

4.3 Transplantation

• Cellular immunity plays a critical role in graft rejection after organ transplantation.
• Immunosuppressive drugs are used to inhibit cellular immune responses and prevent graft rejection.

Conclusion

Cellular immunity is a complex and vital aspect of the immune system. Understanding the immunology of cellular immunity is crucial for medical professionals preparing for the US