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Tiansciibeu by Sabiina Pham Nay 1S, 2u14

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|Sliue 1-6j - |j
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So I'm Bi. NcCutcheon anu I'm going to have the next two sessions with you wheie
we'ie going to stait to talk about the lymphatic system. Anu this is in piepaiation foi
the lectuie I will be giving you this summei wheie we will go thiough immunology
as an oigan system. So we have specific goals foi these two lectuies anu pait of oui
specific goals foi these two lectuies aie to not talk about immunology. We'ie going
to talk about immunology in the summei anu so I'm going to touch on some of the
things we'll talk about in the summei but I uon't want to get into them in uetail. We
calleu Av to come make my stupiu new computei talk to the . (Yes! Av! Behe. !)

So the fiist sliue was the title sliue the sliue aftei that is my name if you neeu to get a
holu of me that's how. The sliue aftei that you shoulu know the goals of these
lectuies. The sliue aftei that is the ieauing. Pait of the ieauing is to not ieau about
the function of cells. Especially in anything othei than Paiham. Cuz one of the sau
paits, (sau tiuths) of histology textbooks is that they tenu to be olu. Nothing's
changeu in histology. So if you look at the publication uate it says 199u. Well
immunology changes eveiy week. So a lot of the stuff in those oluei textbooks is just
not accuiate anymoie. It was at the time, it isn't anymoie so uon't ieau about the
function of cells in those books. Stick with Paiham.

0kay, sliue aftei that is goals so you shoulu know those. We'll use the objectives
tomoiiow foi ieview so you might want to look ovei those. Anu again, the puipose
of this class is not (she talks to Av guy). So the puipose of this class is not to talk
about the function of the cells. We aie going to talk about the oigans of the immune
iesponse. I'm going to set up the uilemma that we have. So you've heaiu about the
lymphocytes alieauy fiom othei faculty membeis. You know that they aie geneiateu
fiom a single piecuisoi cell in the bone maiiow. So the lymph cells aie in the bone
maiiow anu when they come out of the bone maiiow, some of them go to the
thymus anu finish ueveloping. Anu so that's the fiist oigan that we'll be talking
about, the thymus. Anu then lymphocytes anu the WBCs, they stay in the ciiculation,
in the lymphoiu oigans, anu in the lymph itself. Wheie aie the pathogens. So the
point of the immune system is to have a uefense against eveiything that isn't host.
So wheie uo you think you'll finu the pathogens. You guys aie uentists you shoulu
have an obvious answei. You'ie going to finu them in the oial cavity. Yes. So
pathogens aie founu at junctions between inteinal anu exteinal. So something that
you will uo fiequently in youi caieei, you'll be taking youi exploiei anu going
aiounu patient's teeth anu you'll get waus of plaque on youi exploiei when you uo
that, if youi patients uon't have fantastic oial hygiene. What's in plaque. (She talks
to Av guy again) So pathogens aie founu at the junction between inteiioi anu
exteiioi. So the oial cavity is one. All of youi epithelial is one, it's a junction, it's a
baiiiei. So you'ie going aiounu people's teeth with an exploiei, you have plaque on
Tiansciibeu by Sabiina Pham Nay 1S, 2u14

the exploiei, what's in the plaque. Bacteiia. Right. Anu you'ie not paying as much
attention as you shoulu be anu you piomptly stab bacteiia latent exploiei into
fingei. You've now penetiateu the baiiiei anu you've stuck pathogens into youi
system. 0kay anothei example, you've came home, you'ie tiieu, you'ie hungiy, theie
is some hambuigei in the iefiigeiatoi anu it looks maybe a little funky but you'ie
ieally too tiieu anu hungiy to caie so you' eat it. Well the funky was salmonella oi E.
Coli anu now you've stuck salmonella oi E. Coli in youi gut. 0i you come to school
anu you get on the elevatoi anu unbeknownst to you, just befoie those elevatoi
uoois openeu somebouy sneezeu. So you walk into the elevatoi anu you take a ueep
bieath anu you've now whiffeu in a whole bunch of choiono viius into youi nasal

|Sliue 7j - |0veiviewj

Aliight. So we've got immune cells in oigans anu in ciiculation anu in the lymph anu
we now have bacteiia that have gotten into youi system but they'ie in extiacellulai
spaces. So one of the challenges is to get the pathogens to the immune system. So
most of these oigans, lymph noues, spleen, tonsils anu the ALTs, that's the puipose
of those oigans. The puipose is to have a place wheie lymph cells can meet up with
pathogens that have oiiginally come fiom outsiue the bouy. Now this uoes not
happen in bone maiiow anu this uoes not happen in the thymus. So it's these
oigans, that aie the oigans whose job is to connect up lymph cells with pathogens.
Now have you guys heaiu the saying "in the exception pioves the iule". Yes, No.
Well you've leaineu a whole bunch of stuff about how cells behave in othei oigans.
Anu I'm now going to tell you that the iules aie completely uiffeient foi the immune
system. 0kay. Wheie woulu you finu hepatocytes. (Livei) Bow about seitoli cells.
(Seminifeious tubules) Bow about 0ligouenuiocytes. Wheie. CNS okay. Anu if you
founu a hepatocyte in the lung what woulu you have. (Can't heai the answei - I
think its cancei.)

|Sliue 8j - |0nique Featuiesj

So the fiist thing is, lymph cells aie uesigneu to move. Aliight. All of the othei cells
in all of the othei oigans that you've talkeu about, those cells belong in those oigans
anu if you finu them anywheie else you have cancei. The point of lymph cells is that
they move. Now they can't move absolutely anywheie, but they can move anywheie
within the ciiculation anu anywheie within the lymph. Anu in many tissues they can
extiavasate into the tissues. So unlike all of the othei oigans that you've leaineu
about, lymph cells move. A hepatocyte secietes what. (Chyme, bile) What about
Islets of Langeihans cells. (Insulin) Bow about alveolai type II cells. (Suifactant)
0kay. Will an Islet of Langeihans evei seciet something besiues insulin. Will a
hepatocyte stait secieting pepsin. So unlike all of the cells that you've leaineu about
up till now, lymph cells change function ovei time. Lymph cells aie secieteu as
inactive piecuisoi, they'ie not piecuisoi cells, they'ie fully matuie cells but they'ie
Tiansciibeu by Sabiina Pham Nay 1S, 2u14

not active. Bepenuing on the kinus of signals that you give them, you can tuin them
on, anu you can tuin them on to uo uiffeient things uepenuing on the signals that
they get. We will talk about this quite a bit in the summei. So unlike all of the the
othei cells. You know a hepatocyte uoesn't just sit aiounu foi 6 months anu then
ueciue to stait secieting chyme oi bile. A hepatocyte uoes that iight away.
Lymphocytes can be secieteu anu in the case of T lymphocytes, they can live foi
uecaues befoie they uo anything. So lymphocytes only become active when theie's a
neeu foi them to become active anu they become active at the place that they neeu
to become active, othei wise they aien't. Anu then finally, anu I auueu this, the
functions of lymphocytes aie specific to lymphocytes. I'm not quite suie why, but a
lot of times, stuuents seem to think oi some stuuents seem to think "0h uosh that's a
goou thing to uo! I bet these othei cells uo it too!" No. 0kay, all cells seciete
cytokines but that's something that staiteu off in the lymphatic system anu we now
know that all cells uo that. But, if a lymphocyte uoes something that uoesn't mean an
epithelial cell can uo the same thing. So the functions aie specific to lymphocytes.

|Sliue 9j - |Biagiam of the Lymph nouesj

If we look heie at this uiagiam. So as you leaineu in anatomy, a long with aiteiies
anu veins, you have lymph vessels. Anu the puipose of the lymph vessels in health is
to absoib all of that extia fluiu that uoesn't go back into the capillaiy system. Anu
then it gets eventually put back into the vena cava fiom the lymphatic system. But if
you look, anu the easiest place to see this is heie in the leg, all of the lymphatics,
which aie uiaining all of the extiacellulai spaces in all of youi tissues, befoie they
get back into the cential ciiculation, they have to go thiough lymph noues. So you
have popliteal lymph noues at the back of youi knee, anu that uiains all of the
lymphatic's fiom youi lowei leg. You have inguinal lymph noues heie that uiain all
of the lymphatic's fiom youi uppei leg. You have meuialstinal lymph noues, all the
way thiough youi uI tiact that uiains eveiything that comes off the gut. You have
axillaiy lymph noues that uiain all of the lymphatic's fiom youi aims. You have ueep
anteiioi anu shallow anteiioi ceivical lymph noues (ceivical chains), that uiain the
lymph fiom youi heau. So eveiything that comes fiom the extiacellulai tissues goes
thiough a lymph noue. Anu that's wheie lymph noues meet up with pathogens, its
wheie pathogens anu lymph cells meet up. Anu it's those lymph noues that pievent
pathogens fiom getting into the geneial ciiculation unless you have an
oveiwhelming numbei of pathogens. So lymph noues act like a tiap in a sink. Anu if
you weie to take a lymph noue out of a peison anu biopsy it anu uo a cioss section,
you woulu finu eveiy single solitaiy pathogen that came thiough that lymph noue
being kept aiounu. So lymph noues aie incieuible junct tiaps. Anu it uoesn't
necessaiily have to be bacteiia oi viius, you know if you skiu on giavel anu get a
bunch of paiticulate giavel into youi tissues, eventually that will get uiaineu up into
that lymph noue. So we have this nice system wheie eveiything has to go in thiough
lymph noues befoie it can get into the iegulai ciiculation.

|Sliue 1uj - |Non-specific Cellsj
Tiansciibeu by Sabiina Pham Nay 1S, 2u14


So what aie the cells that we'ie going to talk about. Anu I know that othei faculty
have coveieu these anu so I'm just going to touch on them. It's haiu to talk about
lymph oigans if you uon't know what the cells aie. So we have two categoiies of
cells. We have Non-specific cells anu we have specific cells. I will spenu a
consiueiable amount of time this summei talking about what specific means, in the
context of immune cells but the non-specific cells can ieact against any kinu of
pathogen anu they have this stanuaiu bag of tiicks anu they uo what they'ie going to
uo. The antigen specific cells only act against a specific pathogen anu so the
immunity is much moie iestiicteu to the pathogen. Non-specific cells uo a lot of
uamage to host in the piocess of getting iiu of things. We'll talk about that in the
summei. So we have bloou monocytes in the bloou anu then they can move into the
tissue thiough uiapeuesis. Anu then when they move into the tissue, they become
maciophages. Resiuent in the tissue in epithelia anu othei tissues aie cells that aie
now uenuiitic cells. Benuiitic cells, piobably Bi. Wishe calleu them tissue
maciophages, uiu he. 0kay. Tissue maciophages aie ieally uenuiitic cells. If you
ieau an oluei textbook, oi ieau oluei liteiatuie anu they say tissue maciophages, we
ieally know now that those aie uenuiitic cells. If you'ie ieauing olu pathology
textbooks, they'ie calleu histiocytes. Really, they'ie uenuiitic cells. So all of youi
tissues that aie in contact with the outsiue have iesiuent maciophages. So, in the
epithelium uo you know what those aie calleu. (Langeihans cells) In the livei.
(Kupfnei cells) Bow about in the lungs. Louuei. You'ie iight. No, okay soiiy you'ie
not iight. Bowevei this isn't a test so being wiong uoesn't uo you any haim. So
langeihans cells aie in the epithelium. Bow about the biain. (0ligouenuiocytes).
0kay. So all of the cells that aie in contact with the exteiioi, all of the tissues that
aie in contact with the exteiioi, have iesiuent uenuiitic cells. Then we have cells
that look uiffeient unuei a micioscope. These look like WBCs, they have blue
nucleus anu a little bit of cytoplasm when they'ie in the bloou stieam. Anu we'll look
at the maciophages anu uenuiitic cells in the tissues. Then we have cells that look
uiffeient thiough a micioscope because if you look at them they'ie giainy. So they'ie
full of gianules. The fiist of these aie polymoiphonucleuai cells, otheiwise known as
neutiophils. Neutiophils aie the most abunuant cell type in the peiipheial
ciiculation; about 6S% of youi WBCs aie youi neutiophils. Neutiophils aie youi
fiist iesponueis in an infection. They'ie (Enu oi N) stage cells, they show up, they
get activateu, they uo theii thing, they uie. We also have Basophil cells because in an
B anu E stain, the gianules aie blue. Eosinophils, in a B anu E stain, the gianules aie
ieu. Nast cells aie big gianulo-filleu cells. They'ie not ieu oi blue. Now basophils
anu eosinophils aie quite iaie in peiipheial bloou unless you have some ceitain
uiseases. Nast cells aie moie common. I'm suie that some of you aie all too well
acquiieu when mast cells uegianulate. What happens. You have sneezing fits, youi
eyes watei, eveiything that can possibly itch uoes. 0kay, so mast cells have things
that, incluuing histamines, cause unpleasant siue effects. Anu then the last kinu of
non-specific cell is a natuial killei cell. Anu it looks much like the antigen specific
cells: B cells anu T cells.

Tiansciibeu by Sabiina Pham Nay 1S, 2u14

|Sliue 11j - |Nonocytej

So this is a monocyte in the bloou. Big nucleus, little bit of cytoplasm.

|Sliue 12j - |Naciophagej

When monocytes move out of the bloou stieam into the tissues, they uiffeientiate
into maciophages. Anu if you stain this with B anu E you'ie not going to see veiy
much. If you stain this with a stain that is specific foi pioteins founu on
maciophages, you can see that they become these veiy flatteneu out ieticulate cells.
They giow lots of aims. Fiom the name macio, which means. (Big) anu Phage which
means. (Eateis) That's what these cells uo in the tissues, is that they eat things. So if
the things happen to be bacteiia, they will eat bacteiia. They will also eat uamageu
host tissue that's become apoptotic oi neciotic anu you neeu to get iiu of the uebiis.
So that's what they uo. That's one of the things they uo.

|Sliue 1Sj - |Langeihans cellsj

Anu then in the tissues, again with a special stain that only lights up pioteins founu
on uenuiitic cells, these aie langeihans cells. Anu you can see how many aims they
have. Anu this is in one slice, one plane. So Langeihans cells aie noimally founu in
the tissues iesiuent uenuiitic cells anu they veiy much aie ieticulate cells with aims
spieau out all ovei the place. Weaving in between, in this case epithelial cells.

|Sliue 14j - |SEN of Langeihans cellj

If we look at a scanning election miciogiaph of that Langeihans cell, you can get an
iuea of how many aims a uenuiitic cell has. 0kay, so they'ie veiy much ieticulate
cells, they have those aims spieau out into the tissue. When they'ie in tissues.

|Sliue 1Sj - |Neutiophilj

0kay so, this has, what's that. (Nucleus) anu how many aie theie. (S) What's the
official woiu foi many oi some. (Poly) anu uo these have the same shape. (No) anu
shape is. (Noiph) so we have polymoiphonucleai cells. This is a neutiophil oi PNN.
It's veiy uistinctive.

|Sliue 16j - |Eosinophilj

This has biight ieu gianules so it's an. (Eosinophil)

|Sliue 17j - |Basophilj

That has uaik blue gianules so it's a. (Basophil)

Tiansciibeu by Sabiina Pham Nay 1S, 2u14

|Sliue 18j - |Nast Cellj

Anu this is something that is full of gianules that uon't have a coloui. That makes it
a mast cell. Neutiophils, monocytes maciophages aie the piimaiy affectoi cells of
an immune iesponse. They stait at the beginning they woik thiough to the enu.
Benuiitic cells on the othei hanu, aie ieally piimaiy initiatois of an auaptive
immune iesponse. It useu to be that we thought that eosinophils, mast cells, anu
basophils, ieally only play a iole in uisease. We'ie now uiscoveiing that that was
wiong. But we uon't unueistanu what they uo except they seem to have a
suppiessive function. Anu we'll talk about this a little bit moie in the summei. 0ntil I
have a goou stoiy to tell you I'm not going to expect you to.. 0i until we have some
obvious ielevance to uentistiy I'm not going to expect you to know it.

|Sliue 19j - |Natuial Killeij

Anu then this is a natuial killei cell, this is a tumoi cell, the natuial killei cell is
tiying to kill the tumoi cell. Sometimes they'ie veiy goou at that.

|Sliue 2uj - |Antigen-specific cellsj

So those aie oui antigen non-specific cells. They have a toolbox of things they can
uo. The things that they can uo aie as effective at uamaging oi killing off host tissue
as they aie at uamaging oi killing off bacteiia. T cells anu B cells aie oui antigen
specific cells anu unlike the non-specific cells, T cells anu B cells only act against
theii one taiget. Theie aie seveial shaues of T cells. Theie's the CB4 T cell. A subset
of CB4 T Cells aie CB4 T iegulatoiy effectoi cells. Theie aie CB8 T cells. Anu these
aie conventional T cells, we'll talk about what that means this summei. Theie is a
subset of T cells that uses uiffeient genes to make theii ieceptois, anu these aie
calleu gamma uelta T cells. Conventional T cells aie piimaiily founu in the lymph
noues, ALTs, the lymphoiu oigans anu then in ciiculation. uamma uelta T cells aie
piimaiily founu in tissue. You uon't finu them in peiipheial bloou often. We have
oui conventional B lymphocytes. Like the T cells, we have a subset of B lymphocytes
that have an auuitional piotein on theii suiface which is CBS, so we call them CBS B
cells. Anu like the gamma uelta T cells, CBS B cells aie usually founu iesiuent in
tissues that aie in contact with the outsiue. So although they'ie antigen specific, they
stait woiking iight away. Anu we'll talk about that again in the summei. So we have
oui non-specific cell anu theie aie two types of antigen -specific cells. T cells anu B
cells. T cells, conventional T cells subset into CB4 T cells which have a small subset
of T ieg cells anu CB8 T cells. Anu then theie aie gamma uelta T cells. We have oui
conventional B cells anu then we have oui subset population of CBS B cells.

|Sliue 21j - |Lymphocytesj

In the peiipheial bloou you'll see two sizes of lymphocytes. Nost of them aie small.
Anu these aie iesting anu they can eithei be nave iesting cells oi memoiy cells. You
Tiansciibeu by Sabiina Pham Nay 1S, 2u14

can't tell them apait by an B anu E. If they'ie activateu then, ielatively speaking they
have moie cytoplasm anu they'ie laigei. Anu you'ie moie likely to see those if you
have some kinu of ongoing infection. But fiom an B anu E, you have no iuea if that's
a B cell oi a T cell, oi what kinu of T cell oi if it's an NK cell. You can't tell them apait
just by looking with conventional stains. You have to use stains that aie specific foi
cell suiface pioteins to sepaiate out the uiffeient kinus of T cells, fiom B cells, fiom
NK cells.

|Sliue 22j - |uamma Belta T cellj

These aie gamma uelta T cells. These aie in the tissue, again they aie ieticulate cells.
They actually look moie like a tissue maciophage oi uenuiitic cells. They'ie veiy
involveu at the onset of an immune iesponse.

|Sliue 2Sj - |0igansj

So those aie oui cells. Any questions. So the oigans. The oigans get uiviueu into two
sets. We have piimaiy lymphatic oigans anu these aie the oigans iesponsible foi
the uevelopment of the lymph cells. Anu we have seconuaiy lymphatic oigans
iesponsible foi getting the cells to meet up with the pathogens fiom the outsiue.
You've talkeu about bone maiiow in othei classes. All lymphocytes stait fiom a
single piogenitoi cell anu all lymphocytes except the cells that will eventually
become T cells uevelop in the bone maiiow. All lymphocytes except those that will
eventually become T cells uevelop in the bone maiiow. The cells that will eventually
become T cells migiate fiom the bone maiiow at an extiemely eaily point in the
uiffeientiation. They migiate up to the thymus anu then the whole point of the
oigan of the thymus is to uevelop T cells. Anu it's sufficiently challenging enough
that we'ie going to be talking about it foi a whole houi lectuie this summei. So the
function of the thymus we will talk about in the summei. Touay we will talk about
what it looks like. Anu then oui seconuaiy lymphoiu oigans: spleen, lymph noues,
the vaiious associateu lymphoiu tissues, anu tonsils - neai anu ueai to youi heaits
as uentists.

|Sliue 24j - |Biagiam of Piimaiy anu Seconuaiy Lymphoiu 0igansj

So schematically we have thymus anu bone maiiow as oui piimaiy lymphoiu
oigans. Anu then we have lymph noues, spleen, ALT, anu the vaiious kinus of ALT,
anu tonsils, as oui seconuaiy lymphoiu oigans. So uevelopment in the piimaiy,
function is in the seconuaiy.

|Sliue 2Sj - |Bone Naiiowj

Bone Naiiow. So you've seen lots of sliues of this. I'm going to ieminu you. You have
tiabeculae, you have hematopoietic bone maiiow, piogenitoi cells, all of youi WBCs
anu all of youi RBCs heie, anu youi platelets. Anu then that's auipose tissue.
Tiansciibeu by Sabiina Pham Nay 1S, 2u14

|Sliue 26j - |Thymusj

The thymus. 0kay. The thymus is an oigan that's founu soit of up in youi thioat.
You'ie not going to finu much if in you because you'ie all ovei pubeity. It's a bilobeu
encapsulateu oigan. 0nlike the bone. So it's bilobeu encapsulateu, anu it's
sepaiateu into paitial lobules by fibious tiabeculae oi septae. 0nlike the bone
maiiow, location in the thymus is an inuication of uevelopmental stage. So the cells
that will eventually become T cells stait up iight next to the capsule, anu they'ie the
most immatuie up heie. They become moie matuie as they migiate into the coitex.
They continue to matuie until eventually they move into the meuulla. So the thymus
has a coitex, the outei pait anu a meuulla the innei pait. So encapsulateu, paitial
lobules with tiabeculae oi septae, coitex anu meuulla. Theie aie iesiuent cells in the
thymus calleu thymic coitical epithelial cells anu these aie highly ieticulate,
specializeu function epithelial cells. Bighly ieticulate. So if you think of that SEN of
the uenuiitic cell that we lookeu at anu you make the numbei of aims go up by
about Su folu that's how many aims the coitical epithelial cells has. Anu eveiy aim
of the coitical epithelial cell at some point in time is going to come anu abut to
anothei aim of the coitical epithelial cells. So all of these coitical epithelial cells enu
up attacheu to, eveiy ieticulate bianch enu up being attacheu to a ieticulate bianch
fiom anothei cell with uesmosomes. So you have this mesh kinu of like, if you think
of it as a mesh, foimeu by the ieticulate bianches of cells. It's upon that mesh of
coitical epithelial cell aim that newly foiming thymocytes sit. So all of the
thymocytes aie going to be in contact with aims of the coitical epithelial cells. That's
a veiy impoitant point when we talk about the uevelopment ovei the summei. So
we have coitical epithelial cells, we have thymocytes - some of which will eventually
become T lymphocytes, anu then the othei cell we have a lot of aie Naciophages.
Anu we'll talk about why we neeu those this summei. So we've got thiee cell types
so fai. Then you have meuullaiy epithelial cells also. Then you have unique to the
thymus, a stiuctuie calleu the Bassall's coipuscle. That's unique to the thymus.
0kay. Anu that's founu in the meuulla. We have coitical anu meuullaiy epithelial
cells that inteiuigitate anu all of the enus of those will mesh with anothei cell with a
hemiuesmosome that foims a stioma oi a kinu of a mesh like stiuctuie that the
thymocytes sit on. So the thymocytes aie always in contact with the coitical
epithelial cells. We have maciophages. Anu Naciophages, what uoes that mean
again. Big eateis. So theie aie piobably going to be something they have to eat oi
we woulun't neeu them. Anu then we have the unique stiuctuie to the thymus, the
Bassall's coipuscle. Anu we now know that the Bassall's coipuscle is necessaiy foi
the uevelopment of the CB4 + T iegulatoiy cells. It uoesn't have a iole to play in any
of the othei T cells. }ust the T iegulatoiy cells. So looking at oui histological section,
we've got oui capsule, we've got the coitex, we've got the meuulla, you can see a
Bassall's coipuscle heie.

|Sliue 27j - |Thymus Niciogiaphj

Tiansciibeu by Sabiina Pham Nay 1S, 2u14

If you slice thiough the thymus this way this is what you see. So you can see how
you get these lobules with the capsule. The pait next to the capsule is the cell uense
coitex. Anu then fuithei into the oigan of the thymus you get the less uense

|Sliue 28j - |Saggital section thiough thymusj

If you uo anothei saggital section, heie you can see how the lobules foim. With the
tiabeculae. What's that. Paiuon. Nope. It's ieu. It's a vessel. So you see, you've got,
it's a highly vasculai oigan. So this pait heie is the. Cell uense coitex. This is the.
Neuulla. uoou. Anu although it's haiu to see heie theie's a Bassall's coipuscle.

|Sliue 29j - |Caitoon of coitical epithelial cellj

If you look at this caitoon this ieally helps illustiate how many aims you have. So
heie you have the coitical epithelial cell, you can see an aim iunning uown to heie,
you can see an aim iunning ovei heie, you can see an aim iunning along theie. I'm
not suie what cell that came fiom. You can see this cell has an aim iunning up along
ovei heie. 0n the outei pait they maue it easy to see how the uiffeient aims meet
with a uesmosome stiuctuie. So that gives you a goou iuea of how the thymocytes
aie containeu within this mesh of coitical anu meuullaiy epithelial cell aims.

|Sliue Suj - |Thymus Niciogiaphj

So this is. Bassall's coipuscle, Septa oi Tiabeculae. uoou.

|Sliue S1j - |Anothei Thymus Niciogiaphj

Now the thymus uoes something else. So the thymus' function is to uevelop T cells. It
uoes not act as an oigan wheie you can have an immune iesponse stait. Theie aie
no B cells in the thymus. Anu the T cells in the thymus aien't matuie. They can't uo
anything yet. So the thymus is to uevelop T cells. That's all it uoes. The thymus is
also somewhat unique to othei lymph oigan in that it is incieuibly active in the
fetus, it is incieuibly active in the neonate, its incieuibly active in chiluien up to
pubeity anu then it staits to involute. So ovei time, the coitical epithelia anu the
thymocytes aie ieplaceu by auipose tissue. Anu this has two piactical consequences.
0ne, the aveiage lifespan of a lymph noue is uecaues long. You make 9u% of lymph
noues befoie you hit pubeity. You make some of them in youi teens, anu twenties
anu thiities but aftei a while you stop making thymocytes oi many. Anu so what
uisease, what uisease affects T cells anu the ieason that it's so uevastating is because
you can't make anymoie T cells. BIv. Right. So BIv kills off the T cells but you can't
make new ones. B cells, you tuin ovei youi B cells eveiy 2-S uays anu you uo that
thioughout youi life. But T cells, once you maue most of youi T cells, you'ie not
going to make moie. So if you uo have a uisease that can kill of T cells you can't
ieplace them. Anu that's also, pait of what uiives the fact that olu people have ieally
Tiansciibeu by Sabiina Pham Nay 1S, 2u14

ciappy immune systems. Because once you stait hitting 7u+ the thymocytes that
you've maue that have liveu foi 7u uecaues, oi 7 uecaues soiiy, they stait to uie off
anu you can't ieplace them.

|Sliue S2j - |Thymus - Summaiyj

Aliight so to summaiize the thymus. It's an encapsulateu oigan. It's bilobeu. It has
paitial lobules foimeu by septae oi tiabeculae. The outei coitex, cell uense. The
innei meuulla, less cell uense. It has those coitical epithelial cells that have
ieticulai connections but it's a cell connection it's not ieticulai fibeis. Anu then the
unique stiuctuie is the Bassall's coipuscle.

|Sliue SSj - |Lymph Nouej

So we'll stait the lymph noue. So the lymph noue is ieally the business oigan of the
lymphatic system. This is wheie 9u some peicent of the non-oial uI tiact pathogens
will encountei theii lymph cells. The uI tiact has tons of lymphatics anu it's because
so much stuff comes in with youi foou. So like the thymus the lymph noue is an
encapsulateu oigan. Like the thymus the lymph noue is uiviueu into lobules with
tiabeculae. Like the thymus the lymph noue has an outei coitex anu an innei
meuulla. Now things aie not like the thymus. So the lymph noue, because it is a
business oigan, it has sepaiate aieas foi wheie T lymphocytes live anu wheie B
lymphocytes live. So in the coitex, theie is an aiea suiiounuing the coitex calleu the
paiacoitex. Anu that's wheie T cells go. 0kay T cells go to the PARAcoitex. In the
coitex you have aieas wheie the B cells go, anu those aie calleu piimaiy follicles.
So T cells live in the paiacoitex, B cells live in the piimaiy follicle. In the event that
you have an immune iesponse anu the B cells aie uiviuing, theie will be a pait of
that piimaiy follicle that is calleu a seconuaiy follicle oi a geiminal centei. The aiea
wheie the B cells actually uo uiviuing, you have a seconuaiy follicle oi a geiminal
centei. 0nueineath the capsule is a subcapsulai space. Sometimes calleu a
subcapsulai sinus. Sometimes calleu a maiginal sinus. 0kay anu you ieally uiun't
have a space unuei the capsule of the thymus. 0kay so subcapsulai space,
subcapsulai sinus, maiginal sinus. Biffeient names same thing. Now the lymph noue
is a business oigan iight. So it's job is to get the lymphocytes connecteu up to what's
coming in fiom the extiacellulai space of the peiipheial tissues. So we have two sets
of ciiculation that uiain into lymph noues. The fiist is the affeient lymphatic. So the
affeient lymphatic uiains in the subcapsulai space. Anu it's biinging in all of the
lymph anu whatevei else happens to be in the lymph fiom the tissues. So if you
stabbeu youiself in the fingei with an exploiei anu you have a bunch of bacteiia in
that extiacellulai space in youi tissue the lymph that uiains is going to sweep some
of that bacteiia into the neaiest lymph noue. So we have one set of ciiculation that's
biinging in eveiything fiom the peiipheiy. Bacteiia, bacteiial toxins, viiuses, othei
cells that we'll talk about in a bit. So you've got ciiculation coming in fiom the
peiipheiy thiough the Affeient lymphatic. At the same time, coming in thiough the
hilus of the lymph noue, anu the lymph noues look like a kiuney bean, so the
Tiansciibeu by Sabiina Pham Nay 1S, 2u14

inuentation is calleu the hilus anu that's wheie the ciiculation aiteiy, vein anu
inneivation will entei anu exit. So you have the ciiculation coming in, the aiteiy
coming in, anu it enus in a specializeu stiuctuie founu only in lymph noues. It's
calleu the high enuothelial venule (BEv). The ciiculation coming in fiom the
peiipheial ciiculation, it enteis the lymph noue into the hilus anu then it enus up in
a specializeu stiuctuie calleu the high enuothelial venule oi BEv. Anu this is how
the nave B anu T cells exit the ciiculation anu entei the lymph noue. So you've got
the pathogens, uebiis, lymph, eveiything that happens to be theie uiaining in
thiough the lymphatic's, anu at the same time you have the BEv which lets the
nave B anu T cells entei the lymph noues , anu the nave B anu T cells then exit the
lymph noue thiough the BEv. So two completely sepaiate systems uiaining sepaiate
places. Anu then in the lymph noue the T cells will ciawl to what spot. Paiacoitex.
Anu the B cells will ciawl to what spot. The piimaiy follicle. Now also containeu in
lymph cells, you have massive numbeis of maciophages. You have iesiuent
uenuiitic cells. Anu those aie going to be scatteieu aiounu thioughout both the
coitex anu meuulla uepenuing on what function they'ie peifoiming at the time.
0nlike the thymus, not only uoes the lymph noue have a coitex anu a meuulla but in
the meuulla it has meuullaiy folus anu sinuses. It has meuullaiy folus anu sinuses.
So basically a folu is an aiea wheie you have uense numbeis of cells anu a sinus is a
space wheie you uon't have cells. So the meuulla is oiganizeu into aieas of uense
cells, folus, meuullai folus anu aieas wheie theie aie no cells - the meuullaiy
sinuses. Anu then also exiting thiough the hilus is the Effeient lymphatics. Anu the
way to iemembei this is that you always have to go thiough A befoie you get to E. So
things have to come in thiough A befoie they can exit thiough the Effeient. Anu
what leaves thiough the effeient lymphatic aie B anu T lymphocytes that have been
tuineu on they'ie activateu anu theii piogeny aie now maiching out the effeient
lymphatic to go to the site of infection anu get iiu of the pathogen. If the cell. anu
most of the B anu T cells aie not going to be activateu so they go back into the BEv
into the peiipheial ciiculation. Anu we'll talk about how that happens this summei.
Aliight so lets go thiough this again anu then we'll stait looking at the histological
pictuies of the lymph noue tomoiiow. So we have an encapsulateu oigan. 0kay, it's
shapeu like a kiuney bean. Anu what's this aiea. The hilus. 0nuei the capsule is the.
Subcapsulai space. This pait is the. Coitex. This pait is the. Neuulla. What iesiues
in the paiacoitex. T cells. Anu what iesiues in the Piimaiy follicle. B cells. Anu if the
B cells aie uiviuing what uo we call that. Seconuaiy follicle oi geiminal centei. Bow
uo we get pathogens fiom the peiipheiy into the lymph noue. Thiough the affeient
lymphatic. Bow uo we get B anu T cells fiom the ciiculation into the lymph noue.
Thiough the BEv. 0kay. Want me to go thiough that again. So the point of the
lymph noue is to have a meeting place foi stuff fiom the peiipheiy to meet stuff
fiom the ciiculation. So stuff fiom the peiipheiy comes in thiough the lymphatic
system which is going to uiain in thiough the affeient lymphatic. So eveiything that
was in the lymph. Anu if you'ie healthy then it's just lymph. If you've been pokeu by
an exploiei latent with bacteiia then its going to be lymph + bacteiia + some cells
fiom the local aiea that we'ie going to be talking about in the summei. So all of that
comes in thiough the affeient lymphatic. That's happening all of the time. It's only
Tiansciibeu by Sabiina Pham Nay 1S, 2u14

caiiying pathogens if you happen to have a pathogen in that paiticulai aiea that's
uiaining into that lymph noue. Also all always happening, you have B anu T cells
that aie coming in fiom the peiipheiy ciiculation. They leave the peiipheial
ciiculation thiough the. BEv. Bigh enuothelial venule. Anu they go off to theii
iespective aieas anu they hang out. Actually B anu T cells aie a lot like.. uo you
iemembei Ameiican Pie. The movie. So you have these kius that get into theii cais
anu they uiive uown the stiip anu they stop at a uiive in anu they get a coke anu
then they pull theii cais out anu they uiive into the next spot in the stiip anu the get
a coke anu they. so that's what lymph cells uo. B anu T cells aie in the peiipheial
ciiculation, they come out of the BEv into a lymph noue, they hang out foi a while,
they talk to othei cells, if nothing exciting happens they go back into the ciiculation
anu they uown to the next lymph noue anu they come out the BEv theie anu they
hangout foi a while anu they talk to cells anu if nothing fun is happening they go
back into the ciiculation anu they go uown to the next lymph noue anu they come
out of the BEv anu they come out anu they hang out foi a while anu they talk to
othei cells anu if nothing exciting happens they go back into the ciiculation. that's
what these cells uo. All the time. Now if you happen to get something that's exciting
because this paiticulai B oi T cell is specific foi that pathogen that's a whole othei
stoiy that we'ie going to be talking about in seveial lectuies this summei. But in the
mean time, all of the othei cells go iight back into the BEv, anu back into the
ciiculation to the next lymph noue on the list. So B anu T cells aie uoing this ciuising
thiough the lymphatic system, lymphatic oigans all the time thiough the peiipheial
ciiculation. The lymphatic oigans aie constantly uiaining the lymph fiom whatevei
tissue they happen to be associateu with. Anu if the lymph contains things othei
than lymph then you have this meeting place in the lymph noue foi the lymphocytes
anu the othei things to connect up. 0kay so affeient lymphatic's uiain the.
Peiipheial tissues. Anu the BEvs let the. B anu T cells come in. 0kay. So uoes that
make sense now. You've gone one set of ciiculation coming in fiom the peiipheiy,
you've got anothei set of ciiculation that's ciiculating. 0kay. So cells will stait off.
If a B oi T cell gets activateu, then it goes thiough piolifeiation that we'll talk about
this summei. Those cells migiate into the coitex, into the meuulla soiiy. They
eventually enu up in the meuullaiy sinuses wheie they go thiough the Effeient
lymphatic to get out. Although they aie in the peiipheial ciiculation, they'ie going
to go in a uiffeient uiiection than the non-activateu cells that aie going to continue
ciuising. Aliight. So what thiee things of this aie like the thymus. Capsule. Lobules.
Coitex anu Neuulla. What things aien't like the thymus. Subcapsulai space. Bigh
enuothelial venules. Paiacoitex. Piimaiy Follicles. Neuullaiy coius anu Neuullaiy
folus. 0kay goou. So I will let you go a few minutes eaily anu we will stait looking at
the histology pictuies of the lymph noue tomoiiow.