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Review Article
T
HE immune system is an organization of cells
and molecules with specialized roles in de- overcome numerous surface barriers, such as enzymes
fending against infection. There are two fun- and mucus, that either are directly antimicrobial or
damentally different types of responses to invading inhibit attachment of the microbe. Because neither
microbes. Innate (natural) responses occur to the same the keratinized surface of skin nor the mucus-lined
extent however many times the infectious agent is body cavities are ideal habitats for most organisms,
encountered, whereas acquired (adaptive) responses microbes must breach the ectoderm. Any organism
improve on repeated exposure to a given infection. that breaks through this first barrier encounters the
The innate responses use phagocytic cells (neutro- two further levels of defense, the innate and acquired
phils, monocytes, and macrophages), cells that release immune responses.
inflammatory mediators (basophils, mast cells, and IMMUNE RECOGNITION
eosinophils), and natural killer cells. The molecular
The body can potentially respond to almost any-
components of innate responses include complement,
thing that can be bound by the receptors of either
acute-phase proteins, and cytokines such as the in-
the innate or the acquired immune system. Molecules
terferons. Acquired responses involve the prolifera-
recognized by receptors on lymphocytes are generi-
tion of antigen-specific B and T cells, which occurs
cally referred to as antigens and can range from small
when the surface receptors of these cells bind to an-
chemical structures to highly complex molecules.
tigen. Specialized cells, called antigen-presenting cells,
Both the T-cell receptor and the antibody that is em-
display the antigen to lymphocytes and collaborate
bedded in the B-cell membrane, the B-cell receptor,
with them in the response to the antigen. B cells se-
have binding sites1,2 that are only 600 to 1700 Å2.
crete immunoglobulins, the antigen-specific antibod-
Therefore, these receptors recognize only a small part
ies responsible for eliminating extracellular microor-
of a complex antigen, referred to as the antigenic
ganisms. T cells help B cells to make antibody and
epitope. For these reasons, complex antigens consist
can also eradicate intracellular pathogens by activat-
of a mosaic of individual epitopes.
ing macrophages and by killing virally infected cells.
Antigens that elicit immune responses are termed
Innate and acquired responses usually work together
immunogens. Not all antigens are naturally immu-
to eliminate pathogens.
nogenic. Small, nonimmunogenic antigens are called
All these cells develop from pluripotent stem cells
haptens and must be coupled to larger immunogenic
in the fetal liver and in bone marrow and then circu-
molecules, termed carriers, to stimulate a response.3
late throughout the extracellular fluid. B cells reach
Large protein antigens usually contain epitopes equiv-
maturity within the bone marrow, but T cells must
alent to carriers and haptens and are therefore inher-
travel to the thymus to complete their development.
ently immunogenic. Carbohydrates, by contrast, must
Adaptive immune responses are generated in the
often be coupled to proteins in order to be immuno-
lymph nodes, spleen, and mucosa-associated lymph-
genic, as is the case for the polysaccharide antigens
used in the Haemophilus influenzae type b vaccine.
Even large protein antigens with adequate numbers
From the Department of Immunology, the Windeyer Institute of Med-
ical Sciences, University College London, London. of carrier epitopes can be made more immunogenic
©2000, Massachusetts Medical Society. by combining them with an adjuvant — a substance
GLOSSARY
Allele: An alternative form of a gene. Graft-versus-host disease: The consequence of an im-
mune reaction of transplanted allogeneic lymphocytes
Allogeneic: Genetically dissimilar individuals of the same (usually contained in a bone marrow graft) against al-
species; usually used in the context of organ or cell loantigens of the recipient (host).
transplantation (i.e., allografts).
Haplotype: Closely linked alleles on a single chromosome
Allotypes: Antigenic determinants that differ among indi- that are usually inherited as a group and determine a
viduals of the same species, such as the epitopes of the particular phenotype.
Rh blood group system or epitopes of the HLA system.
Helper T cell: A T lymphocyte (which usually expresses
Anergy: A potentially reversible form of immunologic tol- CD4) that secretes the various cytokines required for
erance in which lymphocytes become functionally un- the functional activity of other cells in the immune
responsive. system.
Antibody-dependent cellular cytotoxicity (ADCC): The Idiotype: An antigenic determinant within the binding
killing of antibody-coated target cells by Fc receptor– site of an antibody that is recognized by another
bearing leukocytes, including natural killer cells, macro- antibody.
phages, and neutrophils.
Immunologic memory: The ability of the immune system
Apoptosis: A specific form of cell death mediated by en- to recall an encounter with a specific antigen and to
zymatic degradation of DNA and that, in contrast to ne- mount a quantitatively and qualitatively superior sec-
crosis, is not associated with signs of inflammation. ondary immune response on reencountering the anti-
Also called programmed cell death. gen, a process that involves the generation of memory
B1 cells: A minor population of B lymphocytes that secrete T and B cells during the primary immune response.
polyspecific low-affinity IgM antibodies. Most express Intrinsic affinity: The binding strength between a receptor
CD5 on their cell surface and may be self-renewing. (e.g., one Fab arm of an antibody) and a ligand (e.g., an
B2 cells: The chief population of B lymphocytes, B2 cells antigenic epitope).
arise from stem cells in the bone marrow, do not ex- Isotypes: Antigenic determinants of immunoglobulin
press CD5, and secrete highly specific antibody within heavy chains that define classes of immunoglobulins,
the secondary lymphoid tissues. such as IgM and IgE, and subclasses, such as IgG1 and
CD antigen: Cell-surface antigens are classified according IgG2.
to the cluster of differentiation (CD), in which individual Knockout mouse: A mouse in which a particular gene has
molecules are assigned a CD number on the basis of been intentionally deleted through homologous recom-
their reactivity to panels of monoclonal antibodies. bination.
Chemokine: Chemotactic cytokines that regulate the Locus: The site or location of a gene in a chromosome.
transit of leukocytes from blood into tissues. Each type
of leukocyte (e.g., neutrophil, lymphocyte, and eosino- Natural antibody: Antibody that occurs naturally without
phil) bears chemokine receptors that guide it to partic- apparent antigenic stimulation from an infection or im-
ular chemokines in the tissue. munization. Often, these antibodies are polyspecific,
low-affinity IgM antibodies secreted by B1 cells.
Clone: A group of genetically identical cells with a com-
mon ancestor. Natural killer (NK) cell: The cell of the innate response that
recognizes and then kills abnormal cells — for example,
Complementarity-determining region (CDR): The surface infected cells or tumor cells that lack cell-surface major-
of the variable region of an antibody or a T-cell receptor histocompatibility-complex class I molecules.
that binds to antigen. The CDR consists of three subre-
gions: CDR1, CDR2, and CDR3. Also known as the hy- Polymorphism: An allele with a frequency in a population
pervariable region. of at least 1 percent.
Costimulatory molecule: A molecule that provides addi- Tolerance: Specific immunologic unresponsiveness that
tional (“second”) signals for lymphocyte activation be- occurs either centrally, in the primary lymphoid organs
yond those provided through the antigen receptor. (bone marrow and thymus) (central tolerance), or pe-
ripherally, at any other location in the body (peripheral
Cytokines: A large family of low-molecular-weight soluble tolerance), and is induced mainly by clonal deletion (in-
proteins involved in regulating cellular activity, particu- volving apoptosis) or by clonal anergy.
larly (but by no means exclusively) within the immune
system. Transgenic animal: An animal bearing a foreign gene
(termed a transgene), which is usually spliced to a tis-
Cytotoxic T cell: A T lymphocyte (which usually expresses sue-specific or cell-specific promoter. The transgene is
CD8) that kills its target cell on recognizing complexes of inserted into a fertilized egg in vitro, and thus becomes
peptides and major-histocompatibility-complex mole- integrated into the animal’s germ line.
cules on the target-cell membrane.
Type 1 (Th1) helper T cell: A helper T cell that secretes the
Epitope: The structure on the antigen that is recognized cytokines interleukin-2 and interferon-g (but not inter-
by an antigen receptor (antibody or T-cell receptor). leukin-4, 5, or 6), inhibits type 2 helper T cells, and is
Gene library: A collection of cloned genes from which in- chiefly involved in cell-mediated immunity (i.e., the ac-
dividual genes of interest can be selected (for example, tivation of macrophages and cytotoxic T cells).
by antibody screening after the expression of the gene Type 2 (Th2) helper T cell: A helper T cell that secretes the
in bacteria). cytokines interleukin-4, 5, 6, and 10 (but not interleukin-2
Germ line: The genetic material carried by ova and sperm. or interferon-g), inhibits type 1 helper T cells, and is chief-
The germ line contains the genes that parents transmit ly involved in humoral immunity (i.e., the production of
to their offspring. antibody by B cells).
38 · Jul y 6, 2 0 0 0
ADVA NC ES IN IMMUNOLOGY
that nonspecifically enhances antigen-specific immuni- wall mannans, lipopolysaccharides on the surface of
ty.4 Many microorganisms inherently possess adjuvant gram-negative bacteria, and teichoic acids, which are
activity in the form of immunostimulatory molecules present on gram-positive bacteria.9
such as lipopolysaccharide and muramyl dipeptide. Activation causes dendritic cells to up-regulate the
expression of B7 costimulatory molecules (also known
INNATE IMMUNE RESPONSES
as CD80 and CD86) on their surface. Costimulatory
Cellular Components of Innate Responses molecules are molecules that provide the signals nec-
The innate immune system consists of all the im- essary for lymphocyte activation in addition to those
mune defenses that lack immunologic memory. Thus, provided through the antigen receptor. These acti-
a characteristic of innate responses is that they re- vated dendritic cells migrate to the local draining
main unchanged however often the antigen is encoun- lymph node, where they present antigen to T cells.
tered. These types of responses developed earlier in The antigen is processed intracellularly into short pep-
evolution than acquired responses. Nonetheless, de- tides by means of proteolytic cleavage before it is pre-
fects in these evolutionarily primitive innate immune sented by major-histocompatibility-complex (MHC)
mechanisms, such as those that occur in chronic gran- molecules on the surface of dendritic cells.
ulomatous disease (in which there is defective killing There are two classes of MHC molecules, class I and
of phagocytosed microorganisms) can be fatal. (This class II. There are three main types of class I mole-
subject will be discussed in more detail later in the cules, HLA-A, B, and C, and three main kinds of
Advances in Immunology series.) class II molecules, HLA-DP, DQ, and DR. The MHC
Macrophages (derived from blood-borne mono- class II molecules present the peptides to the T-cell
cytes) possess receptors for carbohydrates that are receptor on the surface of helper T cells. Dendritic
not normally exposed on the cells of vertebrates,5 cells are particularly efficient at initiating (priming)
such as mannose, and therefore can discriminate be- immune responses for which immunologic memory
tween “foreign” and “self ” molecules. In addition, has not been established — that is, they activate so-
both macrophages and neutrophils have receptors for called naive T cells (Fig. 1). (This subject will be dis-
antibodies and complement, so that the coating of cussed in more detail later in the series.)
microorganisms with antibodies, complement, or both Unlike macrophages and neutrophils, eosinophils
enhances phagocytosis.6 The engulfed microorgan- are only weakly phagocytic and, on activation, prob-
isms are subjected to a wide range of toxic intracel- ably kill parasites mainly by releasing cationic proteins
lular molecules, including superoxide anion, hydroxyl and reactive oxygen metabolites into the extracellu-
radicals, hypochlorous acid, nitric oxide, antimicro- lar fluid. They also secrete leukotrienes, prostaglan-
bial cationic proteins and peptides, and lysozyme. dins, and various cytokines.11
Phagocytes also remove the body’s own dead or dying Basophils and mast cells have similar functional
cells. Dying cells in necrotic tissue release substances characteristics,12 but there is little evidence that blood
that trigger an inflammatory response, whereas cells basophils develop into tissue mast cells.13 Both types
that are dying as a result of apoptosis (programmed of cells possess high-affinity receptors for IgE (Fc eR)14
cell death resulting in the digestion of DNA by en- and thereby become coated with IgE antibodies.
donucleases) express molecules on their cell surface, These cells are important in atopic allergies such as
such as phosphatidyl serine, that identify them as eczema, hay fever, and asthma, in which allergen bind-
candidates for phagocytosis.7 ing to the IgE cross-links the FceR. This event trig-
A key cellular component of innate immunity — gers the cell to secrete inflammatory mediators such
and one of the most intensely studied components as histamine, prostaglandins, and leukotrienes. (This
during the past decade — is the interdigitating den- subject will be discussed in more detail later in the
dritic cell (Fig. 1).8 Cells of this type, which include series.)
Langerhans’ cells in skin, constantly but quietly en- Natural killer cells destroy infected and malignant
docytose extracellular antigens. However, they become cells.15 They recognize their targets in one of two
activated and behave as antigen-presenting cells when ways. Like many other cells, they possess Fc recep-
pattern-recognition receptors on their surface recog- tors that bind IgG (FcgR). These receptors link nat-
nize distinctive pathogen-associated molecular pat- ural killer cells to IgG-coated target cells, which they
terns on the surface of microorganisms.9 Endogenous kill by a process called antibody-dependent cellular
danger signals,10 such as the release of interferon-a cytotoxicity. The second system of recognition that is
from virally infected cells or an increase in heat-shock characteristic of natural killer cells relies on the killer-
proteins as a result of necrotic cell death, also activate activating receptors and killer-inhibitory receptors of
dendritic cells. Molecules that act as pattern-recog- these cells (Fig. 2). The killer-activating receptors rec-
nition receptors on dendritic cells include the lipo- ognize a number of different molecules present on
polysaccharide receptor, the mannose receptor, and the surface of all nucleated cells, whereas the killer-
members of a family of molecules called toll. Patho- inhibitory receptors recognize MHC class I mole-
gen-associated molecular patterns include yeast-cell- cules, which are also usually present on all nucleated
PAMP Pathogen
Dendritic* Pattern-*
cell recognition* Interdigitating*
receptor dendritic cell*
*
MHC–*
B7 peptide
Endogenous*
T-cell*
activators
receptor
CD28
Lymph node
Activated T cell
cells.16,17 If the killer-activating receptors are engaged, mechanism — for example, after herpesvirus infec-
a “kill” instruction is issued to the natural killer cell, tion — or malignant transformation. Therefore, cells
but this signal is normally overridden by an inhibi- that lack MHC class I surface molecules are in some
tory signal sent by the killer-inhibitory receptor on way abnormal. This lack of MHC class I molecules
recognition of MHC class I molecules (Fig. 2). means that there is no inhibitory signal from the killer-
Although all nucleated cells normally express MHC inhibitory receptor, and the natural killer cell kills
class I molecules on their surface, they can some- the abnormal target cell by inserting the pore-form-
times lose this ability. This loss may occur as a result ing molecule perforin into the membrane of the target
of either microbial interference with the expression cell and then injecting it with cytotoxic granzymes.
40 · Jul y 6, 2 0 0 0
ADVA NCES IN IMMUNOLOGY
Killer-* Killer-*
activating* inhibitory*
receptor receptor
No attack Kill
Ubiquitous*
molecule MHC class I*
molecule
Perforin*
and*
granzymes
Figure 2. A System Used by Natural Killer Cells to Recognize Normal Cells and Cells That Lack Major-Histocompatibility-
Complex Class I Surface Molecules.
Killer-activating receptors recognize a number of molecules present on the surface of normal, nucleated cells, and in
the absence of an inhibitory signal from killer-inhibitory receptors, which recognize major-histocompatibility-complex
(MHC) class I molecules, the receptors issue an order to the natural killer cells to attack and kill the other cell. The cy-
totoxic granules of the natural killer cells, which contain perforin and granzymes, become polarized at the interface with
the target cell and are then released into the cell.
The role of erythrocytes and platelets in immune ments C3a, C4a, and C5a cause the release of in-
responses is sometimes overlooked, but because they flammatory mediators from mast cells. C5a also acts
have complement receptors, they play an important as a powerful neutrophil chemoattractant. The com-
part in the clearance of immune complexes consist- plement components C5b, C6, C7, C8, and C9 form
ing of antigen, antibody, and components of the com- the membrane-attack complex, which perforates cell
plement system. membranes and thereby leads to the death of the tar-
get cell.
Soluble Factors in Innate Defense The molecules collectively referred to as acute-
Innate responses frequently involve complement, phase proteins enhance resistance to infection and
acute-phase proteins, and cytokines. The early events promote the repair of damaged tissue.20 Plasma lev-
of complement activation, which are based on an en- els of these proteins change rapidly in response to
zymatic amplifying cascade comparable to that seen infection, inflammation, and tissue injury. In addition
in blood clotting, can be triggered by one of three to some complement components, the acute-phase
pathways.18 The classic pathway is activated by anti- proteins include C-reactive protein (a useful marker of
gen–antibody complexes, the alternative pathway by inflammation, particularly in diseases such as rheu-
microbial-cell walls, and the lectin pathway by the matoid arthritis), serum amyloid A protein, protein-
interaction of microbial carbohydrates with mannose- ase inhibitors, and coagulation proteins.
binding protein in the plasma.19 Cytokines constitute another group of soluble
Irrespective of the source of activation, the out- mediators. They act as messengers both within the
come is the generation of a number of immunolog- immune system and between the immune system and
ically active substances. For example, a proteolytic- other systems of the body, forming an integrated
cleavage fragment of complement component C3, network that is highly involved in the regulation of
the C3b molecule, becomes deposited on the surface immune responses.21 The presence of a cytokine is
of microorganisms. This event enhances phagocyto- sensed by a cell by means of specific cytokine recep-
sis of the microbe, because phagocytic cells have cell- tors. However, the distinction between cytokines and
surface receptors for C3b. The complement frag- cytokine receptors is sometimes blurred, because there
are soluble forms of cytokine receptors 22 and mem- and in bone marrow is guided by interactions with
brane-anchored forms of some cytokines.23 stromal cells (such as fibroblasts) and by cytokines
In addition to acting as messengers, some cyto- (including stem-cell factor and various colony-stim-
kines have a direct role in defense; for example, the ulating factors).28 The initial stages of lymphocyte de-
interferons that are released by virally infected cells velopment do not require the presence of an antigen,
establish a state of viral resistance in the surrounding but once these cells express a mature antigen recep-
cells. Cytokines and their antagonists are increasing- tor, their survival and further differentiation become
ly being used as therapeutic agents. For example, a antigen-dependent.
combination of interleukin-2 and interferon-a has
The Structure of Antigen-Specific Molecules
proved valuable in the treatment of melanoma.24 In-
fliximab, a chimeric monoclonal antibody against tu- The B-Cell Receptor and Soluble Antibodies
mor necrosis factor a, has had strikingly beneficial Antibodies consist of two identical heavy chains
effects in patients with rheumatoid arthritis.25 and two identical light chains that are held together
by disulfide bonds.29 The N terminal of each chain
The Acute Inflammatory Response
possesses a variable domain that binds antigen through
Infection with a pathogen triggers an acute in- three hypervariable complementarity-determining re-
flammatory response in which cells and molecules of gions (Fig. 4). The C terminal domains of the heavy
the immune system move into the affected site. The and light chains form the constant regions, which
activation of complement generates C3b, which coats define the class and subclass of the antibody and
the surface of the pathogen. The neutrophil chemo- govern whether the light chain is of the k or l type.
attractant and activator C5a is also produced, and The amino acid sequence of the constant region of
together with C3a and C4a triggers the release of the heavy chains specifies five classes of immunoglob-
histamine by degranulating mast cells. This in turn ulins (IgG, IgA, IgM, IgD, and IgE), four subclasses
causes the contraction of smooth muscles and a rap- of IgG, and two subclasses of IgA. These classes and
id increase in local vascular permeability. Substances subclasses have different functions. Each type of an-
released from the pathogen and from damaged tis- tibody can be produced as a circulating molecule or
sues up-regulate the expression of adhesion molecules as a stationary molecule. The latter type has a hydro-
on vascular endothelium, alerting passing cells to phobic transmembrane sequence that anchors the
the presence of infection. The cell-surface molecule molecule in the B-cell membrane, where it functions
L-selectin on neutrophils recognizes carbohydrate as the B-cell receptor.
structures such as sialyl-Lewisx on the vascular adhe- All immunoglobulins are glycoproteins and con-
sion molecules.26 The neutrophil rolling along the tain 3 to 13 percent carbohydrate, depending on the
vessel wall is arrested in its course by these interac- class of the antibody. The carbohydrate is essential
tions. As the neutrophil becomes activated, it rapidly in maintaining the structure of the antibody. The bas-
sheds L-selectin from its surface and replaces it with ic antibody “monomeric unit” (which is biochemi-
other cell-surface adhesion molecules, such as the in- cally a tetramer) is bivalent, with two antigen-bind-
tegrins. These integrins bind the molecule E-selectin, ing arms of identical specificity. Each of these arms
which appears on the blood-vessel wall under the in- can be cleaved proteolytically in the laboratory to
fluence of inflammatory mediators such as bacterial yield individual monovalent antigen-binding frag-
lipopolysaccharide and the cytokines interleukin-1 ments (Fab) (Fig. 4).30 Another part of the immu-
and tumor necrosis factor a. Complement compo- noglobulin molecule, the Fc region, contains most of
nents, prostaglandins, leukotrienes, and other inflam- the constant region of the heavy chains. The secre-
matory mediators all contribute to the recruitment tory IgA at mucosal surfaces is a tetravalent “dimer,”
of inflammatory cells, as does an important group of whereas circulating IgM is a decavalent “pentamer.”
chemoattractant cytokines called chemokines. (This These IgA and IgM polymers are stabilized by a poly-
subject will be discussed in more detail later in the peptide, the J (joining) chain. Secretory IgA also con-
series.) The activated neutrophils pass through the tains a molecule called secretory component, which
vessel walls, moving up the chemotactic gradient to may protect the IgA against proteolytic cleavage with-
accumulate at the site of infection, where they are in the gastrointestinal tract.
well placed to phagocytose any C3b-coated microbes
(Fig. 3). Mutations in the genes for a number of dif- The T-Cell Receptor
ferent adhesion molecules have been described in pa- Unlike antibodies, T-cell receptors are produced
tients with leukocyte-adhesion deficiencies, some of only as transmembrane molecules. They consist of
which are associated with life-threatening infections.27 a/b or g/d heterodimers; each a, b, g, and d chain
contains a variable domain and a constant domain.
ACQUIRED IMMUNE RESPONSES As in the antibody molecule, the variable domains
The development of lymphocytes and the myeloid contain three complementarity-determining regions
lineage from primordial stem cells in the fetal liver (Fig. 4), which in the case of the a/b T-cell receptor
42 · Jul y 6, 2 0 0 0
ADVA NCES IN IMMUNOLOGY
: Rolling
L-selectin Shedding of* Blood-*
L-selectin vessel*
wall
Adhesion Diapedesis
Neutrophil
Integrin
E-selectin
Sialyl-Lewisx
Activating substances*
released by bacteria and* Lipopolysaccharides, *
damaged tissues interleukin-1, and*
tumor necrosis factor a*
*
* C3a C5a,*
chemokines,*
histamine,*
prostaglandins,*
and leukotrienes*
*
Phagocytosis and destruction*
of C3b-coated bacteria
recognize a complex formed by a peptide seated with- recombination processes that cut, splice, and modify
in the groove of an MHC molecule.2,31 Most g/d variable-region genes.33
T cells do not recognize antigen in the form of pep- The genetic components that encode the immu-
tide–MHC complexes, although MHC-like (“non- noglobulins lie on three chromosomes: the IGH clus-
classic MHC”) molecules such as CD1 may present ter (named for the heavy chain and located on chro-
certain antigens (particularly lipids and glycolipids) mosome 14), the IGK cluster (named for the k light
to some g/d T cells. Other g/d T cells do recognize chain and located on chromosome 2), and the IGL
antigen directly, just as antibody molecules do.32 cluster (named for the l light chain and located on
chromosome 22). Within the IGH cluster are four
The Diversity of Antigen Receptors types of gene segments: V (variable), D (diversity),
It has been estimated that lymphocytes are capable J (joining), and C (constant). The IGK and IGL clus-
of producing about 1015 different antibody variable ters lack D segments. All these segments contain mul-
regions (B cells) and a similar number of T-cell–recep- tiple genes; in the IGH cluster, for example, there
tor variable regions. Remarkably, the vast diversity of are about 50 functional V segments.
the immune repertoire originates from fewer than 400 The T-cell receptor genes have a similar organiza-
genes. This extraordinary feat is achieved by unique tion and also contain V, D, J, and C segments. The
44 · Jul y 6, 2 0 0 0
ADVA NCES IN IMMUNOLOGY
TdT
V C
Rearrangement of D and J
DJ
TdT
Rearrangement of V
V D J
tigens bear several different epitopes (Fig. 6), each ondary lymphoid tissues. The changes in amino ac-
with the capacity to bind to a unique clone. ids in the antibody that result from this process fine-
Unlike the genes for T-cell receptors, the genes tune the recognition of antigen by B-cell receptors
encoding B-cell receptors undergo a process of so- and determine the strength of binding (affinity) of
matic hypermutation. This process occurs during the antibody. The stronger the binding to antigen,
B-cell proliferation within the germinal centers of sec- the greater the chance the B cell has of surviving and
46 · Jul y 6, 2 0 0 0
ADVA NCES IN IMMUNOLOGY
generation of the thymus that occurs at puberty, from both the MHC molecule and the antigenic pep-
T cells continue to develop in the thymus through- tide. Thus, the T-cell receptor recognizes an individ-
out life.44 T cells with a/b T-cell receptors initially ual’s own MHC molecules (self ) together with pep-
remain in the thymus, where they are subjected to a tides derived from foreign antigens.
series of selection procedures (Fig. 7).45 Unlike the Since MHC molecules are highly polymorphic,
antibody molecule, which acts as the antigen receptor the desirable immature T cells in each person in an
on B cells and recognizes antigen in its native (nat- outbred population are those that can recognize self
ural) state, the a/b T-cell receptor recognizes short MHC molecules but that are not autoreactive. This
peptides that result from the intracellular processing objective is achieved by thymic education, a process
of protein antigens, which are presented to the T-cell that involves both positive and negative selection.46-49
receptor by MHC molecules on the cell surface. The Cells are positively selected if they express a T-cell
amino acids recognized by the T-cell receptor derive receptor capable of interacting with the MHC com-
Cortex Medulla
MHC CD8 *
T-cell receptor Dendritic cell*
or*
macrophage
T cell MHC
Medulla
plexes on the person’s own epithelial cells in the thy- This explains why the immune system needs only a
mic cortex. Positive selection switches off the signal few kinds of specialized “professional antigen-pre-
for spontaneous apoptosis that is otherwise triggered senting cells” (dendritic cells, B cells, and activated
naturally in developing T cells. More than 95 percent macrophages) to express MHC class II molecules.
of T cells are not selected at this stage and therefore A minority of T cells in the thymus use g and
die in the thymus. In contrast, negative selection in- d chain genes to produce a T-cell receptor. These
volves the induction of apoptosis in any lymphocyte g/d T cells rapidly leave the thymus, and some may
that expresses a T-cell receptor with a high affinity also develop outside the thymus, possibly in the gut.51
for the complex of a self peptide plus a self MHC Thymus-derived g/d T cells migrate to various loca-
molecule on dendritic cells and macrophages in the tions throughout the body, including the epithelium
thymic medulla. (This subject will be discussed in of the gastrointestinal tract, where they are thought
more detail later in the series.) to contribute to mucosal defenses. The range of their
During thymic education, the expression of a large specificities remains to be fully characterized, but they
number of T-cell–surface molecules is switched on include both proteinaceous and nonproteinaceous
and off in a highly regulated manner. Some of these, antigens from mycobacteria and other infectious or-
and many other cell-surface molecules with a role in ganisms. In addition, they have an important immu-
immune responses, were originally characterized on noregulatory role because they influence antibody
the basis of their reactivity to panels of monoclonal production and immunoglobulin class switching by
antibodies. The antibodies produced by various lab- B cells and modify T-cell responses.32 Precisely how
oratories were said to form a cluster when they could they mediate these immunoregulatory functions also
be grouped together because they recognized the remains to be established.
same cell-surface molecule. This led to a nomencla-
ture in which a given molecule was assigned a “clus- Tolerance Mechanisms
ter of differentiation,” or CD, number — for example Negative selection constitutes one form of immu-
CD1, CD2, and CD3. This CD nomenclature has nologic tolerance in that it removes from the im-
become the standard way of referring to these cell- mune system T cells that recognize any of the body’s
surface molecules. own antigens within the thymus. Tolerance of T cells
The CD4 and CD8 molecules are of particular induced in the thymus and of B cells in the bone mar-
note with regard to T-cell development; together with row is called central tolerance,52 but another mech-
the CD3 group of molecules, they form an essential anism to prevent autoimmunity is necessary, because
part of the T-cell–receptor complex. CD4 binds to an most tissue-specific antigens are not present in the
invariant part of the MHC class II molecule, where- thymus or bone marrow or are present in amounts
as CD8 binds to an invariant part of the MHC class too small for the induction of tolerance.
I molecule. CD4 T cells usually act as helper T cells Mechanisms occurring elsewhere in the body, which
and recognize antigens presented by MHC class II are collectively referred to as peripheral tolerance,
molecules, whereas CD8 T cells are usually cytotoxic supplement central tolerance.53 They are thought to
and recognize antigen presented by MHC class I mol- be based largely on incomplete activation signals giv-
ecules. Early in T-cell development in the thymus, en to the lymphocyte when it encounters self anti-
immature T cells express both CD4 and CD8.50 If gen in the periphery, a phenomenon that leads to a
they have an appropriate T-cell receptor, these dou- state of specific unresponsiveness termed anergy (as-
ble-positive immature T cells have the potential to sociated with impaired intracellular signaling) or to
recognize an antigen-derived peptide presented by apoptosis.54 (This subject will be discussed in more
either MHC class I or MHC class II molecules. As detail later in the series.)
T cells mature in the thymus, however, the expres- Many autoreactive B cells undergo clonal deletion
sion of one of these molecules is lost, resulting in or become anergic as they mature within the bone
single-positive CD4 or CD8 T cells that recognize a marrow. Negative selection occurs in the bone mar-
peptide presented only by MHC class II or MHC row if B cells encounter high levels of self antigen,
class I molecules, respectively. either in the soluble phase or as cell-membrane con-
MHC class I molecules are expressed on all nucle- stituents. However, the deletion of self-reactive B cells
ated cells. This allows infected cells to signal their may be more rigorously enforced in the germinal cen-
plight to cytotoxic CD8 T cells and establish intimate ters of secondary lymphoid tissues such as the spleen.55
intercellular contacts by presenting the complex of Because B cells recognize native antigen, there is no
foreign peptide and MHC molecule to the T-cell re- role for MHC molecules in any of these processes.
ceptor of the effector cell. Since MHC class II mol- For self antigens that are present at relatively low lev-
ecules signal CD4 helper T cells to secrete cytokines, els, immunologic tolerance is often maintained only
the effector function of the helper T cell does not within the T-cell population. This is sufficient to main-
always depend on the establishment of intimate con- tain tolerance because it denies the help essential for
tact with the cell that will respond to the cytokine. antibody production by self-reactive B cells.
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ADVA NCES IN IMMUNOLOGY