Lymphatic & Immune system

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13.1 The Lymphatic System

Lymphatic System Functions The lymphatic system has three main functions: 1. Lymphatic vessels return excess tissue fluid to the bloodstream 2. lacteals receive and transport lipoproteins 3. lymphatic organs work with the immune system to combat disease The walls of lymphatic capillaries consist mostly of simple squamous (scaled) epithelium

Lymphatic Vessels Small, lymphatic capillaries join to form lymphatic vessels The lymphatic vessels collect fat molecules at intestinal villi and excess tissue fluid at blood carry lymph to the veins The fluid inside lymphatic vessels is called lymph Lymphatic Ducts Lymphatic vessels merge before entering one of two ducts 1. Thoracic duct: collects and returns lymph from below thorax, and from left arm, left side of head and neck and leads to left subclavian vein 2. Right lymphatic duct: collects and returns lymph from right arm, right side of head and neck and returns to subclavian vein Q: Which one is bigger and why? The thoracic duct (left lymphatic duct) is larger; it returns lymph collected from the body below the thorax, the left arm, left side of the head and neck into the left subclavian vein. The right lymphatic duct only returns lymph from the right arm and right side of the head

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and neck into right subclavian vein. The thoracic duct is responsible for returning lymph collected from a greater range (mainly the area below the thorax) than the right lymphatic duct.

Lymphatic Vessels (ctd) Lymph vessels are similar in structure to cardiovascular veins: o Have one way valves o Dependent upon muscle contraction Edema is retention of fluids in the tissues (failure of lymphatic system to drain them) Lymphatic Organs Lymphoid organs, which contain large numbers of lymphocytes, are separated into primary (the red bone marrow and the thymus gland) and secondary (lymph nodes and spleen) Lymphocytes, which are produced and mature in the primary lymphatic organs, accumulate in the cortex of these organs Q: What are the two types of lymphocytes again?

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A: B cells and T cells

Red Bone Marrow Red Bone Marrow o Produce stem cells that become blood cells o Only found in certain locations in adults o B lymphocytes mature here

Thymus Gland The thymus gland: o Divided into lobes o Site of T-lymphocyte maturation

Secondary Lymphatic Organs In secondary lymphatic organs, lymphocytes encounter and bind to antigens, after they proliferate and engage foreign material in the body Blood is cleansed of pathogens and their toxins in the larger spleen.

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Lymph Nodes Small ovoid structures found near lymph vessels Clean lymph; made of many nodules Each nodule o Contains a sinus o Macrophages filter lymph in sinuses by engulfing pathogens o T-lymphocytes fight infections and attack cancerous

Questions
Q: What is Metastasis? A: Metastasis is the spread of cancer from the place of origin throughout the body, which is caused by the ability of cancer to migrate and invade tissue. Q: Where is bone marrow found in children? What about in adults? A: Red bone marrow is found in most bones in a child. In adult, it is present in the bones of the skull, the sternum, the ribs, the clavicle, the pelvic bones, and the vertebral column. Q: What occurs at the sinuses of red bone marrow? A: The thin-walled sinuses that are filled with venous blood can be found outside the reticular cells, the stem cells and their progeny. Differentiated blood cells will enter the bloodstream at these sinuses. Q: Where is the thymus gland located? Have a figure that indicates the thymus gland. A: Thymus gland is located in the thoracic cavity between the trachea and the sternum above the heart. Q: Where are T-lymphocytes produced? Where do they mature? A: T-lymphocyte develops in the primary lymphoid organs the bone marrow, and matures in the thymus Q: Which T-lymphocytes leave the Thymus? A: Only 5% of the T-cells which are capable of reacting to foreign molecules or cells leave the thymus. Q: Why is the thymus gland crucial to immunity? A: Thymus gland is crucial to the adapting immune system, since it allows the T cells to mature. Q: Of what is the spleen made and what is the spleens function? What happens if the spleen is damaged/destroyed/removed? A: Red pulp consists of blood vessels and sinuses where macrophages remove old and defective blood cells; lymphocytes cleanse the blood of foreign particles. To conclude, most of the spleen is red pulp that filters the blood. The spleen also has white pulp that is inside the red pulp and Biology 12 Chapter 13 Lymphatic and Immune System Notes Ve 1.50) P a g e 5 | 18

consists of small areas of lymphatic tissue. If the spleen of a person is damaged/burst due to an infection of trauma, the person is often slightly more susceptible to infections and may have to receive antibiotic therapy indefinitely. Q: A sick person comes to visit the doctor. Why might he/she feel the patients neck during an examination? A: This is to check whether or not the lymph nodes are abnormal. Swollen, tender lymph nodes might be evidence that the body is fighting an infection.

13.2 Innate (Nonspecific) and Acquired (Specific) Immunity

Immunity Immunity is the bodys ability to defend against infection and involves o Nonspecific (Innate) or o Specific (Acquired) defenses Non-specific Defenses There are 4 types of non-specific defenses: 1. Barriers to entry 2. Inflammatory reaction 3. Natural killer cells 4. Protective Proteins Barriers to Entry All of the following contribute to keeping pathogens from entering the body o Skin and mucous membranes lining the respiratory, digestive and urinary tract (mechanical barrier against entry) o Oil glands (contains chemicals that awaken or kill bacteria on skin) o Ciliated cells (sweep particles in mucus for expectoration (coughing)) o an acidic stomach (kills or inhibits growth) Beneficial bacteria also prevent pathogens from taking up residence Inflammatory Reaction

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 The inflammatory reaction involves 1) redness, ii) heat, iii) swelling, and iv) pain, which are all due to changes in the capillary, such as dilation and increased permeability. The release of histamine (an inflammatory chemical) and kinins from damaged tissue cells and mast cells causes redness, heat, and swelling The swollen area and kinins stimulate free nerve endings, causing the sensation of pain. Macrophages migrate to the site of injury and can engulf pathogens and also release colony stimulating factors that cause the bone marrow to release more white blood cells (aka stimulate other immune cells) Anti-inflammatory drugs act against the chemical mediators (histamine is a chemical mediator) released by white blood cells. Chemical mediators may cause chronic inflammation. Natural Killer Cells Natural killer (NK) cells kill virus infected cells and tumor cells by cell-to-cell contact o NK cells are granular lymphocytes that look for selfproteins on cells; virus-infected or cancer cells sometimes have altered self-proteins, which NK cells look for and then attack. o NK cells are not specific like some other white blood cells, they have no memory, and their numbers do not increase when exposed to a specific antigen. Complement proteins, a large part of the complement system (often simply called complement) are a number of plasma proteins that assist nonspecific immunity They can o amplify (complement) the inflammatory reaction by attracting phagocytes and promoting phagocytosis o trigger histamine release o bind to pathogens already coated with antibodies to ensure phagocytation by a neutrophil, dendritic cell of macrophage o Some complement proteins join to form pores in the surface of bacteria and cause them to burst

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o Interferon is a protein produced by virusinfected cells that prepares non-infected cells for attack and interferes with viral replication; it is specific to a species Specific Defenses Take effect when non-specific defenses have failed to stop an infection Take 5-7 days to become fully activated, and have lasting effect (able to stop or impede subsequent infections from same pathogen) Antigen An antigen is a foreign substance. The body does not consider its own proteins foreign; therefore the immune system must distinguish self from non-self Lymphocytes have a large number of antigen receptors B- and T- cells Specific defenses require B (B-cells) and T (Tcells) lymphocytes, which are produced in the bone marrow. B cells give rise to antibodies that are shaped as an antigen receptor T-cells T-cells do not produce antibodies; they differentiate into help-T and cytotoxic-T cells Each lymphocyte is specific to only one receptor; our bodies contain lymphophytes that recognize hundreds of thousands (to millions) of different type of pathogens B-Cells and Antibody - Mediated Immunity As B-cells encounter an antigen in a lymph node or spleen, its BCR (B-cell receptor) is activated and the B-cell clonally divides many times. The resulting cells are plasma cells, mature B-cells that can mass-produce antibodies which are specific to the antigen that triggered the BCR Memory B-cells Some members of the clone become memory B cells that remain in the body and produce antibodies if the same antigen enters the body at a later date When infection passes, plasma cells undergo apoptosis (programmed cell death)
After clearing the body of an invading organism, the B-cell retains memory of its target and rests until another infection occurs.

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Structure of an antibody (i.e. IgG) The most common type of antibody, the IgG (immunoglobulin) antibody, is a Y-shaped molecule that has two binding sites for a specific antigen. Each one has a light and heavy chain IgGs (cont'd) Antigen- antibody complexes often mark the antigen for destruction and/or activate complement Some portions of the IgG have fixed amino-acid chains, while others have variable amino-acid chains, which allows them to recognize all sorts of different pathogens Other Types of Antibodies Immunoglobulins (Igs) include a total of five types including IgG. They activate the complement system IgE antibodies are responsible for immediate allergic responses. All differ in structure and function as described in Table 13.1 Table 1302A: Classes of Antibodies Class Presence IgG Main antibody type in circulation IgM IgA IgD IgE Antibody type found in circulation; largest antibody Main antibody type in secretions such as saliva and milk Antibody type found on surface of immature B cells Antibody type found as antigen receptors on eosinophils in blood and on mast cells in tissues Function Binds to pathogens, activates complement, and enhances phagocytosis Activates complement, clumps cells Prevents pathogens from attaching to epithelial cells in digestive and respiratory tract Presence signifies readiness of B cell to respond to antigens Responsible for immediate allergic response and protection against certain parasitic worms

T-cells mature in the thymus. Like B cells, each T-cell bears a specific receptor (TCR) However, for a T-cell to recognize an antigen, the antigen must be presented by an

antigen-presenting cell (APC), such as a dendritic cell or macrophage

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MHC
An APC will travel to the spleen or lymph node and

present a portion of a digested pathogen to a groove in an MHC When a viral or cancer cell antigen is presented, the antigen is first linked to a major histocompatibility complex (MHC) protein. After presentation: MHC 1 -> activates T cells to form cytotoxic T cells MHC 2 -> activates T cells to form helper T cells Human MHC Human MHC proteins are called HLA (Human lymphocyte-associated) antigens. Cytokines are signal chemicals that stimulate various immune cells; many copies of activated T cells are produced Types of T Cells The two main types of T cells are cytotoxic T cells and helper T cells Cytotoxic T-cells kill infected cells that bear a foreign antigen on contact Helper T cells stimulate other immune cells and produce cytokines, which enhance the response of all types of immune cells Some T cells are memory cells that will jump-start an immune reaction upon reinfection. B cells cannot be activated without T cells help.

Questions
Q: From what is pus made, and what does it indicate is happening in the body? A: Pus is a protein-rich liquid, usually yellowish (to green) that is formed at the site of inflammation during infection and is composed of white blood cells, bacteria and cellular debris. Q: What do aspirin, ibuprofen and cortisone all do? A: Aspirin, ibuprofen and cortisone are all anti-inflammatory medications that may be used to minimize the effects of various chemical mediators.
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Q: a) What do helper T cells do? b) What do cytotoxic T cells do? A: a) Helper T cells, once stimulated by antigen-presenting cells (APC), TH cells secrete various cytokines. The cytokines produced by TH cells may help activate cytotoxic T cells, as well as B cells. b) Cytotoxic T cells are also called Killer T-cells. They have storage vacuoles that contain many molecules of perforin and enzymes called granzymes. Activated TC cell binds to a virusinfected or cancer cell that is presenting foreign antigen on its MHC class I molecules, it releases perforin molecules, which form pores in the plasma membrane of the abnormal cell. This allows the granzymes to enter the target cell, which is induced to undergo apoptosis and die. Q: Why are plasma cells larger than B cells? A: Plasma cells are larger than regular B cells because they have extensive rough endoplasmic reticulum for the mass production and secretion of antibodies to a specific antigen. Antibodies are the secreted form of the B-cell receptor of the B cell that was activated. Q: What is the clonal selection theory? A: The clonal selection theory states that an antigen binds to the antigen receptor of only one type of B cell or T cell, and then this B-cell or T-cell divides, forming clones of itself. Q: What is antibody-mediated immunity? A: Defense by B cells is called the antibody-mediated immunity because the various types of activated B cells become plasma cells that produce antibodies. It is also called humoral immunity because these antibodies are present in blood and lymph. Q: What is humor? (Not humour) A: Humor is any fluid normally occurring in the body. Q: What are the characteristics of B cells? Provide antibody-mediated immunity against pathogens Produced and mature in bone marrow Reside in lymph nodes and spleen; circulate in blood and lymph Directly recognize antigen and then undergo clonal selection Clonal expansion produces antibody-secreting plasma cells as well as memory B cells Q: Why is an antigen-antibody like a lock and a key? A: The variable regions of antibodies become hypervarible at their tips and form antigen-binding sites; their shape is specific for a particular antigen. It is the variable and hypervarible regions that allow that antibody to bind to a specific antigen. The antigen combines with the antibody at the antigen-binding site in a lock and key manner. Q: What are the 5 main types of antibodies (or Igs)*? Where are they present? What is each ones function? A: Refer to Page 9 of this note package- Table 1302A: Classes of Antibodies Q: What happens when apoptosis does not occur as it should? What may also happen in the thymus?
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A: When apoptosis does not occur as it should, T-cell cancers (i.e., lymphomas and leukemias) can result. Q: What are perforins and granzymes? A: TC have storage vacuoles that contain many molecules of perforin and enzymes called granzymes. Q: How does AIDS affect the immune system? Where does it reside hide in the body? A: AIDS infects helper T cells and other cells of the immune system, it suppresses many components of acquired immune responses and makes HIV-infected individuals susceptible to opportunistic infections. Infected macrophages and dendritic cells also serve as reservoirs for HIV. Q: What are the characteristics of T cells? Produced in bone marrow, mature in thymus Function in cell-mediated immunity against virus-infected cells and cancer cells Reorganize antigens presented in groove of an MHC molecule Cytotoxic T cells destroy nonself protein-bearing cells Helper T cells secrete cytokines that control the immune response
* The original question asks for the 5 main types of IgG, which does not exist as IgG only has 4 subclasses according to Wi kipedia, and are not included within the Biology 12 curriculum. This should be a typo and antibodiesor Igs (Immunoglobulins) should be in place for IgG

13.3 (Active vs. Passive) / (Induced) Immunity

Active immunity A person naturally develops immunity after infection Vaccines are available to induce long-lived active immunity when a person is well. After exposure to a vaccine - usually an a virulent (non-harmful) disease agent - antibodies are produced Bacteria can be used to mass produce proteins (aka - from pathogens) that can be used as a vaccine With a booster shot or second exposure, the antibody titre (count of antibodies in a fixed volume) rises to a much higher level Active immunity is long-lived because there are memory B cells and memory T cells that will respond to lower doses of antigen in the body Passive Immunity Passive immunity occurs when an individual is given antibodies from an outside source. For example, nursing passes antibodies from mother to child However, passive immunity is short-lived since the antibodies were not produced by the person's own B cells.
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Cytokines and Immunity Cytokines are signalling molecules produced by white blood cells. Both interferon and interleukins are cytokines that are used to improve a person's own T cell performance in fighting against cancer Monoclonal Antibodies All plasma cells derived from a B cell secretes an identical antigen. These are called monoclonal antibodies B lymphocytes can therefore be exposed to a particular antigen and will produce monoclonal antibodies that are quick and certain indicators of various specific conditions Activated B lymphocytes are fused with myeloma cells and these hybridomas produce only one type of antibody. Monoclonal antibodies are most often used in diagnostic procedures such as pregnancy tests but could carry isotopes to destroy cancerous tumors

Questions
Q: What is a "booster" shot? Draw a graph with titer level [antibodies] on y-axis and time on x-axis. Label 1st and 2nd exposure to vaccine. A: A booster shot is the second exposure of a vaccine to a persons body. For graph refer to the diagram at the top of this page. Q: What is a gamma globulin injection, and why is it used? A: Gamma globulin injection is serum that contains antibodies, perhaps taken from individuals who have recovered from the illness. It is used to prevent illness in a patient who has been expectedly expose to disease. Q: Why are cancer cells more susceptible to cytotoxic T cells? How might cytokines help in the fight against cancer? A: Because many cancer cells carry altered proteins on cell surface, they should be attacked and destroyed by cytotoxic T cells. Cytokines could activate the cytotoxic T cells and awaken the immune system, leading to the destruction of the cancer. Q: How are monoclonal antibodies related to pregnancy tests? How does it works? A: A particular hormone is present in the urine of a pregnant women. A monoclonal antibody can be used to detect this hormone; if it is present, the woman is pregnant.

13.4(-13.5*) Adverse Effects (and Disorders) of Immune Responses

Sometimes, the immune system harms the body

*Textbook 12th Edition Only

Develop allergies Incompatible blood Tissue rejection Autoimmune disease

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Allergies Allergic responses occur when the immune system reacts vigorously to substances (allergens) that would not normally harm the body. The response itself can cause some degree of tissue damage. Immediate Allergic Response Immediate allergic responses occur within seconds of contact with an allergen. Hay fever is an example. Anaphylactic shock is a severe reaction that may cause a fatal drop in blood pressure Delayed Allergic Response Delayed allergic responses, such as contact dermatitis, are due to the activity of memory T cells. This skin test for tuberculosis is an example, as is allergy to poison ivy, jewelry, etc. Occurs at site of contact of allergen with skin/part of body.

Blood type and reactions

The membranes of red blood cells may contain type A, AB, B or no antigens (type O) In the plasma there are two possible antibodies: anti-A and anti-B. If the corresponding antigen and antibody are put together, clumping, or agglutination, occurs; in this way the blood type of the individual may be determined. o Antigen-A is an antigen, but not to people with type A blood o Antigen-B is an antigen, but not to people with type b blood. o receiving the wrong blood type is like injecting something someone is allergic to into their blood system.(bad) Rh System The Rh antigen is also a blood type. Rh antigen is important during pregnancy because an Rh-mother may form antibodies to Rh antigen while carrying or at the birth of a child who is Rh+ o These antibodies can cross the placenta to destroy the red blood cells of any subsequent Rh+ child
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A Rho-Gm shot uses anti-Rh antibodies to attack Rh+ cells before they can stimulate the mother to produce her own antibodies

Tissue rejection

Rejection occurs when cytotoxic T cells bring about the destruction of foreign tissue in the body. A close match between donor and recipient can reduce rejection. Immunosuppressive drugs act by inhibiting the response of T cells to cytokines, but can result in kidney damage.

Diseases of the immune system Autoimmune diseases occur when T cells or antibodies mistakenly attack the body's own cells as if they bear foreign antigens Autoimmune diseases include: myasthenia gravis, multiple sclerosis, systemic lupus, rheumatoid arthritis, and heart damage after rheumatic fever Diabetes, AIDS and SCID

It has been suggested that type I diabetes is an autoimmune disease immunodeficiency results when the immune system is unable to protect the body against diseases Examples include AIDS and SCID (Severe combined autoimmune deficiency disorder), a genetic disorder in which the immune system fails to develop.

Questions
Q: How are IgE related to immediate allergic responses? Q: IgE leads to immediate allergic responses, as they are attached to receptors on the plasma membrane of mast cells in the tissues and also to eosinophils and basophils in the blood. When an allergen attached to IgE, these cells release histamine that bring about allergic symptoms. Q: What causes the symptoms for i) Hay fever ii) Asthma A: i) When pollen is an antigen, histamine stimulates the mucous membranes of the nose and eyes, causes runny nose and watery eyes typical of hay fever. ii) In asthma, the airways leading to the lungs constrict, resulting in difficult breathing accompanied by wheezing. When food contains an allergen, nausea, vomiting, and diarrhea often result.
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Q: What is anaphylactic shock? What causes it? What are its characteristic symptoms and what can be done to slow it down? A: Anaphylactic shock is an immediate allergic response that occurs because the allergen has entered the blood steam. It is often caused by bee stings and penicillin shots, and characterized by a sudden and life-threatening drop in blood pressure due to increased permeability of the capillaries caused by histamines. Injecting epinephrine can counteract this reaction until medical help is available. Q: What happens if you give someone with Blood type A an infusion of type B blood? A: Type A blood would have type A antigen, which the person with type B blood would contain anti-B antibodies in their blood to attack. Q: What percent of people are Rh+ and Rh-? A: 85% of people are Rh+, and 15% of people are Rh-. Q: What is xenotransplantation? (it is not growing plants for the aliens) A: Xenotransplantation is the use of animal organs instead of human organs in transplant patients.

The lymphatic system consists of lymphatic vessels and the lymphoid organs. It is closely associated with the cardiovascular system. Lymphatic Vessels Lymphatic vessels form a one-way system that begins with lymphatic capillaries that take up excess tissue fluid. The fluid inside lymphatic vessels is called lymph. Lymphoid Organs The primary lymphoid organs are red bone marrow and the thymus gland. The secondary lymphoid organs are the spleen and lymph nodes. Primary Lymphoid Organs Red bone marrow is the site of stem cells that are ever capable of dividing and producing blood cells. The thymus gland is largest in children and shrinks as we get older. Immature T cells migrate from the bone marrow through the blood stream to the thymus, where they mature. Secondary Lymphoid Organs Lymphocytes migrate to the secondary lymphoid organs. Here they encounter foreign molecules or cells, after which they proliferate and become activated. The spleen filters the blood. Lymph nodes are packed with B and T cells. Immunity is the bodys capability of removing or killing fore ign substances, pathogens, and cancer cells. Mechanisms of innate immunity are fully functional without previous exposure to these substances, while Biology 12 Chapter 13 Lymphatic and Immune System Notes Ve 1.50) P a g e 16 | 18

adaptive immunity is enhanced by exposure to specific antigens. An antigen is any molecule that stimulates an immune response. Innate Immunity The four types of innate immunity include physical and chemical barriers, inflammation, phagocytes and natural killer cells, and protective proteins. Physical and Chemical Barriers Skin and mucous membranes lining the respiratory, digestive, and urinary tracts serve as mechanical barriers to entry of pathogens. The secretions of oil glands in the skin contain chemicals that weaken or kill certain bacteria on the skin. The stomach has an acid pH, which kills many types of bacteria or inhibits their growth. Inflammation An inflamed area has four signs: redness, heat, swelling, and pain. Phagocytes and Natural Killer Cells Neutrophils and macrophages migrate to the area of tissue damage where they engulf pathogens. Natural killer cells kill abnormal cells by cell-to-cell contact. Protective Proteins The complement system is composed of a number of blood plasma proteins that form a membrane attack complex to destroy invading bacteria. Interferons are proteins produced by virus-infected cells as a warning to noninfected cells. Adaptive Immunity In adaptive immunity, the body is able to distinguish self from nonself. Adaptive defenses primarily depend on the action of lymphocytes, which differentiate as either B cells or T cells. B Cells and Antibody-Mediated Immunity When a B cell is activated by binding to a specific antigen, it is activated and makes many copies of itself. Activated B cells become plasma cells that produce antibodies. Structure of an Antibody Antibodies are also called immunoglobulins. They are typically Yshaped molecules with two binding sites for foreign antigens. Types of Antibodies There are five major classes of antibodies: IgG, IgM, IgA, IgD, and IgE. T Cells and Cell-Mediated Immunity T cells can only recognize an antigen when it is displayed to them by an antigen presenting cell in conjunction with an MHC (major histocompatibility complex) protein. There are two major types of T cells: helper T cells and cytotoxic T cells. Helper T cells secrete various cytokines while cytotoxic T cells destroy the target cell.

In active immunity, the individual alone produces an immune response against an antigen; in passive immunity, the individual is given prepared antibodies or cells via an injection. Active Immunity Active immunity usually develops naturally after a person is infected with a pathogen. Immunization involves the use of vaccines to initiate immunity. Passive Immunity Passive immunity occurs when an individual is given prepared antibodies or immune cells to combat a disease. This occurs naturally from mother to fetus. Immune Therapies Cytokines and Immunity Biology 12 Chapter 13 Lymphatic and Immune System Notes Ve 1.50) P a g e 17 | 18

Cytokines are chemical messengers produced by T cells, macrophages, and other cells. They regulate white blood cell formation and/or function. They may be used as immunotherapeutic drugs in the future. Monoclonal Antibodies Monoclonal antibodies can be produced in vitro. Currently these are being used for quick and certain diagnosis of various conditions. These may be used to treat cancer.

Allergies Allergies are hypersensitivities to substances, such as pollen, food, or animal hair that ordinarily would do no harm to the body. An immediate allergic response can occur within seconds of contact with the antigen and may result in anaphylactic shock, a life- threatening problem. A delayed allergic response is initiated by memory T cells. Blood-Type Reactions The ABO blood system is the most important of the blood typing systems. ABO System The presence or absence of type A and type B antigens on red blood cells determine a persons blood type. Transfusion with the wrong type blood can be fatal. Rh System Another important antigen in matching blood types is the Rh factor. A mismatch can be fatal. Tissue Rejection The immune system is responsible for rejection of transplanted tissue. Organ rejection can be controlled by administering immunosuppressive drugs.

When a person has an autoimmune disease, cytotoxic T cells or antibod ies mistakenly attack the bodys own cells. Examples include myasthenia gravis, multiple sclerosis, and systemic lupus erythematosus. In an immune deficiency, the immune system is unable to protect the body against disease. Examples include AIDS and severe combined immunodeficiency disease (SCID).

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