As introduced in Chapter 1, most microbial invaders can be detected and destroyed within minutes or hours by the body’s defense mechanisms of innate immunity, which do not rely on expansion of antigen-specific lymphocytes. The innate immune system uses a limited number of secreted proteins and cell-associated receptors to detect infection and to distinguish between pathogens and host tissues. These are called innate receptors because they are inborn; they are encoded by genes directly inherited from an individual’s parents, and do not need to be generated by the gene rearrangements used to assemble antigen receptors of lymphocytes described in Section 1-11. The importance of innate immunity is illustrated by several immunodeficiencies that result when it is impaired, discussed in Chapter 13, which increase susceptibility to infection even in the presence of an intact adaptive immune system.
As we saw in Fig. 1.5, an infection starts when a pathogen breaches one of the host’s anatomic barriers. Some innate immune mechanisms start acting immediately (Fig. 2.1). These immediate defenses include several classes of preformed soluble molecules that are present in extracellular fluid, blood, and epithelial secretions and that can either kill the pathogen or weaken its effect. Antimicrobial enzymes such as lysozyme begin to digest bacterial cell walls; antimicrobial peptides such as the defensins lyse bacterial cell membranes directly; and a system of plasma proteins known as the complement system targets pathogens both for lysis and for phagocytosis by cells of the innate immune system such as macrophages. If these fail, innate immune cells become activated by pattern recognition receptors (PRRs) that detect molecules called pathogen-associated molecular patterns (PAMPs) (see Section 1-5) that are typical of microbes. The activated innate cells can engage various effector mechanisms to eliminate the infection. By themselves, neither the soluble nor the cellular components of innate immunity generate long-term protective immunological memory. Only if an infectious organism breaches these first two lines of defense will mechanisms be engaged to induce an adaptive immune response—the third phase of the response to a pathogen. This leads to the expansion of antigen-specific lymphocytes that target the pathogen specifically and to the formation of memory cells that provide long-lasting specific immunity.
Fig. 2.1 The response to an initial infection occurs in three phases. These are the innate phase, the early induced innate response, and the adaptive immune response. The first two phases rely on the recognition of pathogens by germline-encoded receptors of the innate immune system, whereas adaptive immunity uses variable antigen-specific receptors that are produced as a result of gene segment rearrangements. Adaptive immunity occurs late, because the rare B cells and T cells specific for the invading pathogen must first undergo clonal expansion before they differentiate into effector cells that migrate to the site of infection and clear the infection. The effector mechanisms that remove the infectious agent are similar or identical in each phase.
Anatomic barriers and initial chemical defenses.
The complement system and innate immunity.
Clonal expansion and differentiation to effector cells Removal of infectious agent Recognition by naive B and T cells Adaptive immune response (late: >96 hours) Transport of antigen to lymphoid organs Recognition of PAMPs. Activation of effector cells and infammation Removal of infectious agent Early induced innate response (early: 4–96 hours) Recruitment of effector cells FAIL Recognition by preformed nonspecifc and broadly specifc effectors Removal of infectious agent Infection FAIL Containment by an anatomic barrier Prevention of infection Pathogen FAIL