Fig. 3.34 The acute-phase response produces molecules that bind pathogens but not host cells. Acute-phase proteins are produced by liver cells in response to cytokines released by macrophages in the presence of bacteria (top panel). They include serum amyloid protein (SAP) (in mice but not humans), C-reactive protein (CRP), fibrinogen, and mannose-binding lectin (MBL). CRP binds phosphocholine on certain bacterial and fungal surfaces but does not recognize it in the form in which it is found in host cell membranes (middle panel). SAP and CRP are homologous in structure; both are pentraxins, forming five-membered discs, as shown for SAP (lower panel). SAP both acts as an opsonin in its own right and activates the classical complement pathway by binding C1q to augment opsonization. MBL is a member of the collectin family, which also includes the pulmonary surfactant proteins SP-A and SP-D. Like CRP, MBL can act as an opsonin in its own right, as can SP-A and SP-D. Model structure courtesy of J. Emsley.
pneumocytes, and are important in promoting the phagocytosis of opportunistic respiratory pathogens such as Pneumocystis jirovecii (formerly known as
P. carinii), one of the main causes of pneumonia in patients with AIDS.
Thus, within a day or two, the acute-phase response provides the host with several proteins with the functional properties of antibodies but able to bind a broad range of pathogens. However, unlike antibodies, which we describe in Chapters 4 and 10, acute-phase proteins have no structural diversity and are made in response to any stimulus that triggers the release of TNF-α, IL-1, and IL-6. Therefore, unlike antibodies, their synthesis is not specifically induced and targeted.
A final, distant effect of the cytokines produced by macrophages is to induce leukocytosis, an increase in the numbers of circulating neutrophils. The neutrophils come from two sources: the bone marrow, from which mature leukocytes are released in increased numbers; and sites in blood vessels, where they are attached loosely to endothelial cells. Thus the effects of these cytokines contribute to the control of infection while the adaptive immune response is being developed. As shown in Fig. 3.33, TNF-α also has a role in stimulating the migration of dendritic cells from their sites in peripheral tissues to the lymph nodes and in their maturation into nonphagocytic but highly co-stimulatory antigen-presenting cells.
3-22 Interferons induced by viral infection make several contributions to host defense.
Viral infection induces the production of interferons, originally named because of their ability to interfere with viral replication in previously uninfected tissue culture cells. Interferons have a similar role in vivo, blocking the spread of viruses to uninfected cells. There are numerous genes encoding antiviral, or type I, interferons. Best understood are the IFN-α family of 12 closely related human genes and IFN-β, the product of a single gene; less well studied are IFN-κ, IFN-ε, and IFN-ω. IFN-γ is the sole type II interferon.
Type III interferons are a newly classified IFN family composed of the products of three IFN-λ genes, also known as IL-28A, IL-28B, and IL-29, which bind a heterodimeric IFN-λ receptor composed of a unique IL-28Rα subunit and the β subunit of the IL-10 receptor. While receptors for type I interferons and IFN-γ are widespread in their tissue distribution, type III receptors are more restricted, not expressed by fibroblasts or epithelial cells, but expressed on epithelial cells.