1. T cells develop from progenitor cells in the thymus and bone marrow through a process involving commitment to the T cell lineage, proliferation, rearrangement of T cell receptor genes, selection processes, and differentiation into mature subsets.
2. Key stages of T cell maturation include double negative, double positive, and single positive stages, driven by signals from the pre-T cell receptor and selection in the thymus.
3. T cell receptor diversity is generated through rearrangement of variable, diversity, and joining gene segments and addition of nucleotides at junctions.
T cells are one of the important white blood cells of the immune system and play a central role in the adaptive immune response and are distinguished from other lymphocytes by the presence of a T-cell receptor (TCR) on their cell surface.
B cells, also known as B lymphocytes, are a type of white blood cell of the lymphocyte subtype. They function in the humoral immunity component of the adaptive immune system.. B cells produce antibody molecules.
In mammals, B cells mature in the bone marrow, which is at the core of most bones. In birds, B cells mature in the bursa of Fabricus.
B cells present antigens (they are also classified as professional antigen-presenting cells (APCs)) and secrete cytokines.
T cells are one of the important white blood cells of the immune system and play a central role in the adaptive immune response and are distinguished from other lymphocytes by the presence of a T-cell receptor (TCR) on their cell surface.
B cells, also known as B lymphocytes, are a type of white blood cell of the lymphocyte subtype. They function in the humoral immunity component of the adaptive immune system.. B cells produce antibody molecules.
In mammals, B cells mature in the bone marrow, which is at the core of most bones. In birds, B cells mature in the bursa of Fabricus.
B cells present antigens (they are also classified as professional antigen-presenting cells (APCs)) and secrete cytokines.
B cell Activation by T Independent & T Dependent Antigens-Dr C R MeeraMeera C R
During humoral immune response, Ab production is brought about by B lymphocytes. Based on the ability to induce Ab formation, antigens can be classified into T independent and T dependent antigens. Some antigens can directly induce the B cells to produce the Abs and are called T Independent Ans. However, some Ans require the help of T lymohocytes for the production of Abs from B cells. These Ans are called T Dependent Ans.
Slideshow is from the University of Michigan Medical
School's M1 Immunology sequence
View additional course materials on Open.Michigan:
openmi.ch/med-M1Immunology
B cell Activation by T Independent & T Dependent Antigens-Dr C R MeeraMeera C R
During humoral immune response, Ab production is brought about by B lymphocytes. Based on the ability to induce Ab formation, antigens can be classified into T independent and T dependent antigens. Some antigens can directly induce the B cells to produce the Abs and are called T Independent Ans. However, some Ans require the help of T lymohocytes for the production of Abs from B cells. These Ans are called T Dependent Ans.
Slideshow is from the University of Michigan Medical
School's M1 Immunology sequence
View additional course materials on Open.Michigan:
openmi.ch/med-M1Immunology
The immune system is a complex network of organs, cells and proteins that defends the body against infection, whilst protecting the body’s own cells.
The immune system keeps a record of every germ (microbe) it has ever defeated so it can recognise and destroy the microbe quickly if it enters the body again.
Abnormalities of the immune system can lead to allergic diseases, immunodeficiencies and autoimmune disorders.
On this page
Immune system
The immune system and microbial infection
Parts of the immune system
The body's other defences against microbes
Fever is an immune system response
Common disorders of the immune system
Immunisation
Where to get help
Immune system
The immune system is made up of a complex network of organs, cells and proteins that fight infection (microbes).
The immune system and microbial infection
The immune system keeps a record of every microbe it has ever defeated, in types of white blood cells (B-lymphocytes and T-lymphocytes) known as memory cells. This means it can recognise and destroy the microbe quickly if it enters the body again, before it can multiply and make you feel sick.
Some infections, like the flu and the common cold, have to be fought many times because so many different viruses or strains of the same type of virus can cause these illnesses. Catching a cold or flu from one virus does not give you immunity against the others.wThe immune system is a complex network of organs, cells and proteins that defends the body against infection, whilst protecting the body’s own cells.
The immune system keeps a record of every germ (microbe) it has ever defeated so it can recognise and destroy the microbe quickly if it enters the body again.
Abnormalities of the immune system can lead to allergic diseases, immunodeficiencies and autoimmune disorders.
On this page
Immune system
The immune system and microbial infection
Parts of the immune system
The body's other defences against microbes
Fever is an immune system response
Common disorders of the immune system
Immunisation
Where to get help
Immune system
The immune system is made up of a complex network of organs, cells and proteins that fight infection (microbes).
The immune system and microbial infection
The immune system keeps a record of every microbe it has ever defeated, in types of white blood cells (B-lymphocytes and T-lymphocytes) known as memory cells. This means it can recognise and destroy the microbe quickly if it enters the body again, before it can multiply and make you feel sick.
Some infections, like the flu and the common cold, have to be fought many times because so many different viruses or strains of the same type of virus can cause these illnesses. Catching a cold or flu from one virus does not give you immunity against the others.The immune system is a complex network of organs, cells and proteins that defends the body against infection, whilst protecting the body’s own cells.
The immune system keeps a record of every germ (microbe) it has
This presentation describes the stages of normal development of B and T cells in human. Various cytokines important for these development and different antigen markers expressed in different stages of development are also described. Mechanisms of antibody diversity and mechanisms to prevent autoimmunity are also explained.
Generation of Antibody Diversity- Quick revision from Kuby through presentationSharmistaChaitali
Immunology, Kuby's fifth edition notes for strong background in the topic, General introduction, Types of Antibody and Structure, Experiments, Mechanisms
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TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
1. Biology of T lymphocyte
Tharida Khongcharoensombat, MD
Division of Pediatric Allergy and Immunology
Department of Pediatrics, Faculty of Medicine
King Chulalongkorn Memorial Hospital
22 April 2022
2. Outline
• T cell maturation
• Progenitor commitment
• Thymic migration
• Progenitor proliferation
• TCR recombination
• Selection and differentiation
• T cell activation and function
• T cells activation
• Effector function
3. Lymphocyte development
• The process by which lymphocyte progenitors in the thymus and bone marrow differentiate into
mature lymphocytes that populate peripheral lymphoid tissues
• Occur in the generative lymphoid organs (BM, thymus).
• Commitment of progenitor cells to the B lymphoid or T lymphoid lineage.
• Proliferation of progenitors at specific early stages of development
• Rearrangement of antigen receptor genes
• Selection events
• Preserve cells that have produced functional antigen receptor proteins
• Eliminate potentially dangerous cells that strongly recognize self antigens.
• Differentiation of B and T cells into functionally and phenotypically distinct subpopulations.
• B cells develop into follicular, marginal zone, and B-1 cells
• T cells develop into CD4 + and CD8 + αβ T lymphocytes, natural killer T (NKT) cells, MAIT cells,
and γδ T cells. Abbas AK. et al. Cellular and Molecular immunology 9th edition
4. Abbas AK. et al. Cellular and Molecular immunology 9th edition
5. Role of the Thymus in T Cell Maturation
• Site of maturation
• GA 7-8 weeks
• While in the cortex, thymocytes first
express γδ and αβ TCRs
• Double positive in cortex
• Single positive in medulla
The thymic environment provides stimuli that are required for the proliferation and maturation of thymocytes.
Abbas AK. et al. Cellular and Molecular immunology 9th edition
6. • Naive T cell migration out of the blood through the HEVs into the lymph node parenchyma
involves the adhesion molecules L-selectin and LFA-1 and the chemokine receptor CCR7.
• Mechanism of egress of lymphocytes from lymphoid organs.
• Gradient of sphingosine-1 phosphate in the blood stream
Abbas AK. et al. Cellular and Molecular immunology 9th edition
7. 1. Commitment to the B and T Cell Lineages
• Commitment to different lineages is driven by
• Cell surface receptors
• Transcription factors
T cell
• Notch-1 and GATA-3 transcription
• Pre-TCR
• RAG1, RAG2
B cell
• EBF, E2A, and Pax-5
• Pre-BCR, BCR
• RAG1, RAG2
Abbas AK. et al. Cellular and Molecular immunology 9th edition
8. 2. Proliferation of Progenitors
• Proliferate first in response to cytokines and later in response to
signals generated by a preantigen receptor that select cells that have
successfully rearranged the first set of antigen receptor genes.
• Proliferation ensures that a large enough pool of progenitor cells will be
generated to eventually produce a highly diverse repertoire of mature,
antigen-specific lymphocytes.
• IL-7
• Required for proliferation of T cell progenitors (not B cell)
• Produced by stromal cells in the bone marrow and by cortical thymic
epithelium cells
Abbas AK. et al. Cellular and Molecular immunology 9th edition
9. IL-7: T cell development
IL-15: NK cell development
Abbas AK. et al. Cellular and Molecular immunology 9th edition
10. 3. Rearrangement of antigen receptor gene
• This process is responsible for the generation of a diverse adaptive
immune repertoire.
• Small number of genes can give rise to a vast number of distinct Ig and
TCR molecules, each capable of binding to a different antigen
• Antigen independent
• Antigen receptor genes are randomly recombined and nucleotide
sequence variations are introduced at one of the joints, resulting in the
production of a large number of variable region-encoding exons.
Abbas AK. et al. Cellular and Molecular immunology 9th edition
11. Organization of T Cell Receptor Gene Loci
• In the TCR β and δ proteins, the V domain is encoded by the V,
D, and J gene segments, and in the TCR α and γ proteins, the
V domain is encoded by the V and J gene segments.
3. Rearrangement of antigen receptor gene
Abbas AK. et al. Cellular and Molecular immunology 9th edition
12. TCR diversity are generated by
the recombination of different gene
segment.
• Variable (V)
• Diversity (D)
• Joining (J)
3. Rearrangement of antigen receptor gene
The actual number of antigen receptors on B or T cells expressed in each individual
at any one point in time is probably on the order of only 10 7 or 10 8
Abbas AK. et al. Cellular and Molecular immunology 9th edition
13. V(D)J recombination
• Tremendous diversity of antigen receptors
• Each cell and its clonal progeny produce a distinct antigen receptor
3. Rearrangement of antigen receptor gene
Abbas AK. et al. Cellular and Molecular immunology 9th edition
14. Recognition Signals that drive V(D)J recombination
• Recombination signal sequences (RSS)
12/23 rule
Recombination occurs between two segments only if
• One of the segments is flanked by a 12-nucleotide spacer
• The other is flanked by a 23-nucleotide spacer
Occur 50% in Ig κ locus
Abbas AK. et al. Cellular and Molecular immunology 9th edition
3. Rearrangement of antigen receptor gene
15. Mechanism of V(D)J Recombination is mediated by the coordinated
activities of several enzymes.
1. Synapsis
• Two coding segments and their adjacent RSSs are brought together
2. Cleavage
• V(D)J recombinase (RAG1, RAG2 )
• RAG1/RAG2 complex is required for V(D)J recombination, but
only RAG1 possesses catalytic activity.
• Creates double-stranded breaks at RSS-coding sequence
junctions, forming a covalent hairpin
• Hold the hairpin ends and the blunt ends together
RAG genes are expressed only in developing B and T cells
RAG1 or RAG2 mutations are a cause of SCID (T-B-NK+)
Abbas AK. et al. Cellular and Molecular immunology 9th edition
3. Rearrangement of antigen receptor gene
16. 3. Hairpin opening and end processing
• Artemis; an endonuclease
• Opens up the hairpins at the coding ends
• In the absence of Artemis, hairpins cannot
be opened and mature T and B cells
cannot be generated
• Terminal deoxynucleotidyl transferase (TdT)
• Adds nucleotides to broken DNA ends
Mutations in ARTEMIS are a rare cause of SCID. (T-B-NK+)
Abbas AK. et al. Cellular and Molecular immunology 9th edition
3. Rearrangement of antigen receptor gene
17. 4. Joining
• Nonhomologous end joining
• KU70 and KU80 are DNA end-binding proteins
that bind to the breaks and recruit the catalytic
subunit of DNA-dependent protein kinase
(DNA-PK), a DNA repair enzyme
• DNA ligase IV, XRCC4: ligation
Mutations in affecting DNA-PK result in a failure to
produce mature B and T lymphocytes, causing SCID (T-B-NK+)
Abbas AK. et al. Cellular and Molecular immunology 9th edition
3. Rearrangement of antigen receptor gene
18. Generation of Diversity TCR
• Combinatorial diversity
• Recombination of V(D)J
• Junctional diversity
• The largest contribution to the
diversity of antigen receptors
• Addition or removal of
nucleotides at the junctions of
the V-D, D-J or V-J segments
• Pairing of β (VDJ), α (VJ) chains
Abbas AK. et al. Cellular and Molecular immunology 9th edition
3. Rearrangement of antigen receptor gene
19. Junctional diversity
• P nucleotides
• N nucleotides: randomly
add up to 20 non-template
encoded nucleotides
TdT
Nucleotides may be added to or removed from the coding ends
to generate new sequences that are not present in the germline.
Abbas AK. et al. Cellular and Molecular immunology 9th edition
20. 4. Maturation
Stage of T cell maturation
1. Double-negative (DN) thymocytes
• The majority (>90%) of the DN thymocytes:
αβ T cell
• Pre-TCR
2. Double-Positive Thymocytes
• Thymocytes that fail to rearrangement of the
TCR α chain gene will die by apoptosis.
• The expression of RAG genes and further
TCR gene recombination cease after this
stage of maturation.
3. Single positive T cells
Abbas AK. et al. Cellular and Molecular immunology 9th edition
21. Abbas AK. et al. Cellular and Molecular immunology 9th edition
22. Stage of T cell maturation: Pre-TCR
• Productively rearranged the TCR β chain gene
• Proliferation of Pre-T cells
• Stimulation of alpha chain recombination
• Drive the transition from the double-negative to the
double-positive stage of thymocyte development
4. Maturation
Lack of any component of the pre-TCR complex or associated
signaling molecules (i.e., the TCR β chain, pre-Tα, CD3, ζ, or LCK)
• Results in a block in the maturation of T cells at the double-negative stage
• CD3ε mutations in humans result in SCID. (T-B+NK+)
Abbas AK. et al. Cellular and Molecular immunology 9th edition
23. 4. Maturation
Stage of T cell maturation
1. Double-negative (DN) thymocytes
• The majority (>90%) of the DN
thymocytes: αβ T cell
• Pre-TCR
2. Double-Positive Thymocytes
• Thymocytes that fail to rearrangement of
the TCR α chain gene will die by
apoptosis.
• The expression of RAG genes and
further TCR gene recombination cease
after this stage of maturation.
3. Single positive T cells
Abbas AK. et al. Cellular and Molecular immunology 9th edition
24. 4. Maturation
Stage of T cell maturation
1. Double-negative (DN) thymocytes
• The majority (>90%) of the DN
thymocytes: αβ T cell
• Pre-TCR
2. Double-Positive Thymocytes
• Thymocytes that fail to rearrangement of
the TCR α chain gene will die by
apoptosis.
• The expression of RAG genes and
further TCR gene recombination cease
after this stage of maturation.
3. Single positive T cells
Abbas AK. et al. Cellular and Molecular immunology 9th edition
25. 5. Selection process
Checkpoints - developing cells are tested and continue to mature
1. Successful production of one of the polypeptide chain
• Expression of the pre-antigen receptor; Pre-TCRs in T cells
2. Assembly of a complete receptor
• Requires the second chain and thus assembly of a complete receptor
• At this immature stage, cells that express useful antigen receptors
may be preserved
• Potentially harmful cells that strongly recognize self structures may
be eliminated or induced to alter their antigen receptors
Abbas AK. et al. Cellular and Molecular immunology 9th edition
26. Rearrangement of
TCR β chain
Rearrangement
of TCR α chain
Abbas AK. et al. Cellular and Molecular immunology 9th edition
The presence of multiple checkpoints ensures that
only cells with useful receptors complete their maturation.
27. 5. Selection process
Positive selection
• TCRs bind with low avidity (i.e., weakly) to self peptide–self MHC
complexes are stimulated to survive and to differentiate either into CD4 + T
cells or CD8 + T cells
• MHC Restriction: Class I MHC - CD8, Class II MHC – CD4
• Do not recognize self MHC molecules are permitted to die by a default
pathway of apoptosis -> called death by neglect
• Mature T cells whose precursors were positively selected by self MHC
molecules in the thymus are able to recognize foreign peptide antigens
displayed by the same self MHC molecules on antigen-presenting cells in
peripheral tissues
Abbas AK. et al. Cellular and Molecular immunology 9th edition
28. Negative selection
• Eliminates or alters developing
lymphocytes whose antigen receptors bind
strongly to self antigens
• T cell - clonal deletion
• B cell - receptor edition - clonal deletion
• Maintaining tolerance to many self antigens
-> central tolerance
5. Selection process
TCR signaling may induce
expression of a
pro-apoptotic protein
“BIM”
Abbas AK. et al. Cellular and Molecular immunology 9th edition
Weak – positive selection
Strong – negative selection
Intermediate – Treg
29. • AIRE (autoimmune regulator) that induces low-level
expression of many self antigens that are normally expressed
only in specific peripheral organs (tissue-restricted antigens).
• Their AIRE-dependent expression in the thymus makes these
tissue-specific antigens available for presentation to immature T
cells, facilitating the deletion (negative selection) of these cells
5. Selection process
A mutation in the gene that encodes AIRE results in
an autoimmune polyendocrine syndrome (APS)/APECED
Abbas AK. et al. Cellular and Molecular immunology 9th edition
30.
31. Abbas AK. et al. Cellular and Molecular immunology 9th edition
32. 6. Differentiation
• Mature single-positive thymocytes
leave the thymus to populate
peripheral lymphoid tissues.
T cells develop into
• CD4 + and CD8 + αβ T lymphocytes
• γδ T cells
• Natural killer T (NKT) cells
• MAIT cells
Abbas AK. et al. Cellular and Molecular immunology 9th edition
33. • Less than 5% of all T cells express this form of TCR
• 10% of human intestinal intraepithelial T cells
• Diversity is limited
• Only a few of the available V, D, and J segments are used in mature γδ T cells
• Little or no junctional diversity
• Do not recognize MHC-associated peptide antigens and are not MHC restricted
• Recognize
• Small phosphorylated molecules, alkyl amines, or lipids that are commonly found in
mycobacteria and other microbes and that may be presented by nonclassical class I
MHC–like molecules.
• Protein or nonprotein antigens that do not require processing or any particular type of
APCs for their presentation
6. Differentiation: γδ T Lymphocytes
Abbas AK. et al. Cellular and Molecular immunology 9th edition
34. Function
• Serve as an early defense against a
limited number of commonly
encountered microbes at epithelial
barriers.
• Before the recruitment and activation
of antigen-specific αβ T cells
• IL-17
6. Differentiation: γδ T Lymphocytes
γδ Tcells have several innate cell-like features
In psoriasis, γδ T cells
: earliest IL-17–producing cells in lesions
Bonneville M, et al. Nature Reviews Immunology 2010;10(7):467–78.
35. • Expresses markers such as CD56 that are found on NK cells
• Limited diversity: invariant NKT cells (iNKT cells)
• All NKT cell TCRs recognize lipids that are bound to class I MHC–like
molecules called CD1 molecules
• Function
• IL-4, IFN-γ
• Produce antibodies against lipid antigens
• Mediate innate and adaptive immune responses
• Protect from autoimmunity, tumor, infection (Listeria, Toxoplasma,
Mycoplasma, Salmonella, Plasmodium)
6. Differentiation: NKT cell
Abbas AK. et al. Cellular and Molecular immunology 9th edition
36. • IFNγ promotes DC activation and
maturation
• Augmentation of CD4+and CD8+T
cell responses.
• Help in B cell activation through
CD40–CD40L interactions, improves
antibody titers and B cell memory
responses.
• Production of IL-2 induces regulatory
T cell proliferation
Figure 2. iNKT regulation of NK, T cell, and B cell activation.
Juno JA, et al. PLOS Pathogens 2012;8(8):e1002838.
37. • Most MAIT cells are CD8+ and can be activated either by
• MR1-restricted presentation of microbial riboflavin derivatives
• Directly by cytokines, including IL-12 and IL-18
• The effector functions of MAIT cells
• IFN-γ and TNF
• Cytotoxicity against infected cells: Granzyme, perforin
• MAIT cells are found in the blood, the gastrointestinal tract, and the liver
• 50% of all T cells in the human liver
• Gut barrier function
6. Differentiation:
Mucosa-Associated Invariant T (MAIT) Cells
Abbas AK. et al. Cellular and Molecular immunology 9th edition
38. TCR-dependent activation
• IL-17A (RORγt)
TCR-Independent activation
• IFN-γ (PLZF)
Hinks TSC, et al. Front Immunol. 2020 May 27;11:1014.
40. Outline
• T cell maturation
• Progenitor commitment
• Thymic migration
• Progenitor proliferation
• TCR recombination
• Selection and differentiation
• T cell activation and function
• T cells activation
• Effector function
41. Antigen processing and presentation pathways
Abbas AK. et al. Cellular and Molecular immunology 9th edition
Exogenous
(Endocytic, MHCII) pathway
Endogenous
(Cytosolic, MHC I) pathway
42. Class I MHC pathway
• Microbial protein
• Proteasome
• TAP - Tapasin
• ERAP
• Peptide-Class I MHC-CD8+ T cell
Peptides preferentially bind Class I MHC
• Newly synthesized class I MHC are
attached to the luminal aspect of the
TAP molecules
• Class II MHC in ER are blocked by
invariant chain
Abbas AK. et al. Cellular and Molecular immunology 9th edition
43. Class II MHC pathway
Abbas AK. et al. Cellular and Molecular immunology 9th edition
44. T cell activation
• Occurs mainly in peripheral lymphoid organs
• IL-2
• Effector T cells: remain in Lymphoid organ or migrate to sites of infection
Abbas AK. et al. Cellular and Molecular immunology 9th edition
Sequence event in T cell response
45. Signal for T lymphocyte activation
First signal: Peptide-MHC-TCR
• Class I MHC on surface of
nucleated cells - CD8+ T cell – TCR
• Class II MHC on APC (B cells,
macrophages, DCs) and epithelial
cell in thymus - CD4+T cell - TCR
T cell activation
Recognition of Antigen
Abbas AK. et al. Cellular and Molecular immunology 9th edition
46. • TCR - MHC-peptide ligands
• Clustering of coreceptors
(CD4, CD8)
• Phosphorylation of ITAM tyrosine
residues in CD3 and ζ proteins
• CD4 and CD8 are T cell
coreceptors
• Bind to nonpolymorphic regions
of MHC molecules
• Facilitate signaling by the TCR
complex during T cell activation
T cell activation
Costimulation
Inhibition
Adhesion
Abbas AK. et al. Cellular and Molecular immunology 9th edition
47. Abbas AK. et al. Cellular and Molecular immunology 9th edition
48. Mutation in CD3 complex T-B+NK+ SCID
Tangye SG, et al. J Clin Immunol. 2020 Jan;40(1):24-64.
49. Activation of Tyrosine Kinases and a Lipid Kinase During T Cell Activation
• Within seconds of TCR ligation, Lck phosphorylates the ITAMs of the CD3 and
ζ chains
T cell activation
1. TCR-MHC complex
2. Phosphorylation of ITAM
Abbas AK. et al. Cellular and Molecular immunology 9th edition
50. 3.
4.
Early tyrosine phosphorylation
events in T cell activation.
Abbas AK. et al. Cellular and Molecular immunology 9th edition
Tyrosine kinase
Src: Lyn, Fyn, Lck
Syk: ZAP-70, Syk
Tec: Tec, Btk, Itk
51. Tangye SG, et al. J Clin Immunol. 2020 Jan;40(1):24-64.
ZAP-70 deficiency Combine immunodeficiency
,generally less profound than SCID
52. • PLCγ1 (which is phosphorylated by ZAP-70 and Itk) are activated.
• Active PLCγ1 hydrolyzes membrane PIP2 to generate IP3, DAG
• IP3: stimulates an increase in cytosolic calcium
• DAG: activates the enzyme PKC
Abbas AK. et al. Cellular and Molecular immunology 9th edition
53. • IP3 causes depletion of endoplasmic reticulum calcium, which is sensed by STIM1
• STIM1 activated CRAC channel Influx of extracellular calcium
• Cytosolic free calcium act as a signaling molecule
• Calcium – calmodulin complexes activate several enzymes including calcineurin,
important transcription factor activation
Abbas AK. et al. Cellular and Molecular immunology 9th edition
58. Signal for T lymphocyte activation
Second signal: Co-stimulation
Co-stimulator: activation / Inhibition
• CD28 - B7-1 (CD80) and B7-2 (CD86)
• CD28 expressed on more than
• 90% of CD4 + T cells
• 50% of CD8 + T cells
T cell activation
Abbas AK. et al. Cellular and Molecular immunology 9th edition
59. • In the absence of costimulation
• T cells fail to respond or enter a state
of prolonged unresponsiveness
• Microbe products (TLR), IFN-γ
• Enhance expression of costimulators
• APC -> activated naïve T cell
• Activated CD4+ T cells -> enhance
the expression of B7 costimulators
(pathway dependent on CD40)
• Mature dendritic cells are the most
potent stimulators of naive T cells.
Resting – few or no costimulators
Activated APC express
costimulators
Abbas AK. et al. Cellular and Molecular immunology 9th edition
60. CD28 signals + antigen recognition promote the survival,
proliferation and differentiation of the antigen-specific T cells
Abbas AK. et al. Cellular and Molecular immunology 9th edition
61. Other costimulators
• ICOS (inducible costimulator, CD278)
• ICOS-L (CD275)
• Expressed on dendritic cells, B cells
• Function
• T cell–dependent antibody responses
• Development and activation of T
follicular helper cells - essential for the
formation of germinal centers
• Generation of high-affinity B cells
Abbas AK. et al. Cellular and Molecular immunology 9th edition
62. Tangye SG, et al. J Clin Immunol. 2020 Jan;40(1):24-64.
Mutations in ICOS Combined immunodeficiency disease
(generally less profound than SCID)
63. Coinhibitors
• Expressed following T cell activation and
function to limit immune responses.
• CTLA-4: competitive inhibitor of CD28 by
binding more strongly to B7 molecules
• PD-1: delivers inhibitory signals that block
signaling by the antigen receptor and by CD28
Abbas AK. et al. Cellular and Molecular immunology 9th edition
64. Abbas AK. et al. Cellular and Molecular immunology 9th edition
Defective function of Tregs Autoimmunity
65. Clinical implication of CTLA-4
• CTLA-4 has a higher affinity for B7 than
does CD28.
• CTLA-4-Ig approved therapy for
• Rheumatoid arthritis
• Transplant rejection
• Immunotherapy of tumors
• Mechanism
• Reducing inhibition
• Enhancing T cell activation
• Enabling the cancer-bearing individual
to mount more effective antitumor
immune responses
Abbas AK. et al. Cellular and Molecular immunology 9th edition
66. Role of CD40 in T cell activation
• CD40L: activated T cell, CD40: B cell, macrophages, DCs
• CD40L-CD40 interaction:
• T cell licensing
• Germinal center reaction
• Induced B cell express enzyme AID
Abbas AK. et al. Cellular and Molecular immunology 9th edition
67. CD40L deficiency
• Lack of signaling between activated T cells and B cells
• Failure of B cells to upregulate CD80 and CD86
• Failure of B cell to become IgD-CD27+ memory B cell
• Fail isotype switching, produce only IgM
• Failure of monocyte to production of proinflammatory and anti-
infectious cytokines
Tangye SG, et al. J Clin Immunol. 2020 Jan;40(1):24-64.
68. CD40L deficiency
• Flow cytometry
• Normal number B cell, Normal or low number T cell
• Low memory B cell (CD27), Low memory T cell
• Low Treg >> underlie autoimmune manifestation
• Defective Th1 response
• Low IFN-g production, failure of APC to synthesize cytokine ; esp IL-12 -> defective
cellular immune response, increase OI infection
• T cell function : normal
• Immunoglobulin level
• IgM : normally or elevated (especially during infectious episode) (some : low IgM)
• Markedly low IgG, A
• IgM isotypes (natural isohemagglutinin, antipolysaccharide, anti non-typable H
influenza antibodies): produced normally BUT Absent IgG
69. Functional response of T cell activation
• Changes in the expression of various surface molecule
• IL-2 Secretion and IL-2 Receptor Expression
• Clonal expansion of T cell
• Differentiation of CD4+ T cell to Th1, Th2, Th17
• Differentiation of CD8+ T cell to CTL
• Differentiation memory T cell
70. • CD69: decreased S1PR1 activated T cell retained in lymphoid organ
• IL-2Rα: IL2
• CD40L: help activated APCs
• CTLA-4: Inhibit T cell activation
Abbas AK. et al. Cellular and Molecular immunology 9th edition
71. Functional response of T cell activation
• Changes in the expression of various surface molecule
• IL-2 Secretion and IL-2 Receptor Expression
• Clonal expansion of T cell
• Differentiation of CD4+ T cell to Th1, Th2, Th17
• Differentiation of CD8+ T cell to CTL
• Differentiation memory T cell
72. Regulation of IL-2 expression
• IL-2 is a growth, survival, and differentiation factor for T lymphocytes
• The high-affinity IL-2 receptor (IL-2R) is transiently expressed on activation of naive and
effector T cells; regulatory T cells always express this receptor.
Abbas AK. et al. Cellular and Molecular immunology 9th edition
73. Biologic function of IL-2
• IL-2 stimulates
• Survival
• Proliferation
• Differentiation of
antigen-activated T
cells.
• IL-2
• Required for the
survival and
function of
regulatory T cells
Abbas AK. et al. Cellular and Molecular immunology 9th edition
74. Functional response of T cell activation
• Changes in the expression of various surface molecule
• IL-2 Secretion and IL-2 Receptor Expression
• Clonal expansion of T cell
• Differentiation of CD4+ T cell to Th1, Th2, Th17
• Differentiation of CD8+ T cell to CTL
• Differentiation memory T cell
75. Clonal expansion of T cell
• Signal from
• Antigen receptor
• Costimulators
• Autocrine growth factor: IL2
• To generate a large number of
antigen-specific clones to eliminate
specific antigen from a small pool
of antigen-specific naïve T cells
Abbas AK. et al. Cellular and Molecular immunology 9th edition
76. Functional response of T cell activation
• Changes in the expression of various surface molecule
• IL-2 Secretion and IL-2 Receptor Expression
• Clonal expansion of T cell
• Differentiation of CD4+ T cell to Th1, Th2, Th17
• Differentiation of CD8+ T cell to CTL
• Differentiation memory T cell
77. Differentiation of CD4+ T cell to Th1, Th2, Th17
Subsets of CD4 + Effector T Cells
Abbas AK. et al. Cellular and Molecular immunology 9th edition
CXCR3, CCR5
CCR3, CCR4, CCR8
CCR6 – CCL20
78. • Cytokines drive development of CD4+ T cell subsets
• Stimuli other than cytokines influence the pattern of helper T
cell differentiation
• Affinity of the T cell receptor (TCR) for antigen
• Amount of antigen
• Nature of the APC
• Host genetic
General features of T cell subset differentiation
Abbas AK. et al. Cellular and Molecular immunology 9th edition
79. Development of Th1 cells
• Driven cytokines
• IL-12, IL-18, IFN-γ
• Transcription factors
• T-BET, STAT1, and STAT4 IFN-γ
• TH1 developed
• Secrete IFN-γ
• Inhibit differentiation of Th2 and
Th17
Abbas AK. et al. Cellular and Molecular immunology 9th edition
80. IFN-γ Function
• Activate macrophages to increase phagocytosis and
killing of microbes in phagolysosomes
• Promotes the differentiation of CD4+ T cells to the Th1
subset.
• Stimulates expression MHC molecules and B7
costimulators on APCs
• Produce cytokines that amplify the host response.
• TNF
• IL-1
• IL-12
• Th1-mediated pathology
• Delayed-type hypersensitivity
• Granulomatous inflammation
Abbas AK. et al. Cellular and Molecular immunology 9th edition
81. • Th1 cells activate macrophages
through contact-mediated signals
delivered by CD40L-CD40
interactions and by IFN-γ
• Classically activated macrophages
also called M1 macrophage.
• CD40 activate NF-kB, AP-1
Th1-Mediated classical
macrophage activation and
killing of phagocytosed microbes
Abbas AK. et al. Cellular and Molecular immunology 9th edition
82. Mendelian Susceptibility to Mycobacterial Disease
Bhattad SJc. Mendelian Susceptibility to Mycobacterial Disease: A Clinical and Laboratory Approach. 2019;1:4.
83. • Driven cytokines
• IL-4 (others: IL-25, IL-33, TSLP by damaged
epithelial, ILC2)
• Transcription factors
• STAT6, GATA3
• TH2 developed
• Secrete IL-4, IL-5, IL-13
• Inhibit differentiation of Th1 and Th17
Development of Th2 cells
Abbas AK. et al. Cellular and Molecular immunology 9th edition
84. • IL-4 (IL-13)
• IgE
• Mucosal barrier
• M2 macrophage
• IL-5: Eosinophil
Effector function of
Th2 cells
Abbas AK. et al. Cellular and Molecular immunology 9th edition
85. M2 Macrophage
• Terminate inflammation
• Promote tissue repair
and fibrosis
• Scar formation (platelet-
derived GF, IL-13, TGF-
B, FGF)
Classical and alternative
macrophage activation
Abbas AK. et al. Cellular and Molecular immunology 9th edition
86. • Driven cytokines
• IL-6, IL-1, IL-23, TGF-β
• Transcription factors
• RORγt and STAT3
• TH17 developed
• Secrete IL-17, IL-22
• IL-21: amplifies the reaction
• TGF-β suppress differentiation of Th1 and Th2
Development of Th17 cells
IL-21
Abbas AK. et al. Cellular and Molecular immunology 9th edition
87. IL-17
• Recruitment of Neutrophil (monocyte)
• IL-8, TNF
• G-CSF >> enhance neutrophil
generation
• Increase production of antimicrobial
peptides (defensins)
IL-22
• Maintain epithelial integrity: repair, AMP
Effector function of
Th17 cells
Abbas AK. et al. Cellular and Molecular immunology 9th edition
88. Roles of Th17 Cells in Host Defense
Tangye SG, et al. J Clin Immunol. 2020 Jan;40(1):24-64.
89. Differentiation of CD8+ T cell to CTL
3 transcription
factors for CTL
differentiation are
• T-BET
• Eomesodermin
• BLIMP-1
Cytokines
• IL-2, IL-12, IL-15
Abbas AK. et al. Cellular and Molecular immunology 9th edition
90. Killing mechanism
• Release of perforin/granzymes >>
target cell apoptosis
• Fas-FasL mediated killing
Target cells
• Virus-infected cells, cancer cells
• Phagocytes with intracellular
microbes
Effector function of CTL
Abbas AK. et al. Cellular and Molecular immunology 9th edition
91. Granule-dependent mechanism of killing
(Perforin- granzyme)
• Perforin/granzymes
• Lethal hit to the
target cell
• Death occurs during
the following 2-6 hr
Abbas AK. et al. Cellular and Molecular immunology 9th edition
92. • FasL is expressed on activated CTLs
• Fas on the surface of target cells
• Then induces apoptosis
Granule-independent mechanism of killing
(FAS/FAS-L)
Abbas AK. et al. Cellular and Molecular immunology 9th edition
93. • The effector response start but is
shut down ≠ Tolerance
• Persistent or chronic antigen
exposure
• The response of CD8 + T cells
is suppressed by the
expression and engagement
of PD-1 (programmed cell
death protein-1) and other
inhibitory receptors.
T cell exhausted
Abbas AK. et al. Cellular and Molecular immunology 9th edition
94. Differentiation memory T cell
Properties of memory T cells
• Increase level of anti-apoptotic
proteins: BCL-2, BCL-X
• Response more rapidly
• Greater number
• Migrate to peripheral tissue
• Self-renew
• Exist without need of antigens but
need cytokines
• IL-7: maintenance of CD4+,
CD8+ T cells, early lymphocyte
development, survival of naïve T
cell
• IL-15: survival of memory CD8+ T
cell
Abbas AK. et al. Cellular and Molecular immunology 9th edition
95. Change in proportions of naive and memory T cells with age
Abbas AK. et al. Cellular and Molecular immunology 9th edition