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  • Image not available. Cells of the immune system are derived from the pluripotent stem cell. Hematopoiesis is a closely regulated to assure adequate amounts of each of the different types of blood cells. The development of the different kinds of cells or cell lineages depends on cell-to-cell interactions and hematopoietic growth factors.
  • Image not available. After activation, dendritic cells express higher concentrations of major histocompatibility complex class II molecules, B7-1, B7-2, CD40, ICAM-1, and LFA-3 molecules than other antigen-presenting cells. They also produce more IL-12. These differences may explain why in vitro dendritic cells are the most efficient antigen-presenting cell.
  • Image not available. A T lymphocyte expresses hundreds of T-cell receptors (TCRs). All the TCRs expressed on the surface of an individual T lymphocyte have the same antigen specificity.
  • Image not available. A B lymphocyte can simultaneously express membrane immunoglobulin as IgM (monomeric) or IgD with the same variable region (i.e., antigen-binding site). The B lymphocyte then can secrete different isotypes (e.g., IgM [pentamer], IgA, IgG, IgE) with the same variable region as the membrane immunoglobulin.
  • Image not available. A serum protein electrophoresis determines the total concentration of circulating immunoglobulins (i.e., IgG, IgA, IgM, IgD, and IgE). If one wishes to determine the concentration of the individual isotypes, one needs to order isotype quantification. The vast majority of clinical laboratories quantitate only IgG, IgM, and IgA because they are the most prevalent isotypes in the bloodstream. In patients with allergic disorders, quantification of IgE may be useful. Depending on the clinical laboratory, results may come back in IU/mL, kIU/L, or mg/L for IgE.
  • Image not available. An understanding of the mechanism by which immunomodulators act along with an understanding of the immune system allows a clinician to anticipate potential adverse effects. The benefit of manipulating the immune responses must be balanced with the potential consequences and long-term sequela of such manipulation.

Upon completion of the chapter, the reader will be able to:

  • 1. List the characteristics of the pluripotent stem cell and the cell lineages derived from the pluripotent stem cell.
  • 2. State where the education of B- and T-lymphocytes occurs.
  • 3. List the primary and secondary lymphoid organs and know their function.
  • 4. State the difference between the adaptive and innate arms of the immune system.
  • 5. Define the roles of neutrophils, mast cells, eosinophils, monocytes/macrophages, dendritic cells, and plasma cells in eradicating pathogens.
  • 6. Know three mechanisms by which a phagocyte can recognize a pathogen.
  • 7. List the four main functions of the complement system in the immune response.
  • 8. State the two signals required for activation of B-lymphocytes and T-lymphocytes (CD4+ and CD8+).
  • 9. List the five classes of immunoglobulin and know their characteristics (i.e. ability to activate complement, distribution, etc.)
  • 10. Know two mechanisms by which a natural killer cell recognizes its target.
  • 11. Define the role of CD40 ligand and CD40 in the immune response.
  • 12. Know the cell types that express HLA Class I and II molecules.
  • 13. List three factors to be considered ...

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