Immunology : A Short Course

by Benjamini, Eli

• ISBN13: 9780471348900
• ISBN10: 0471348902
• Edition: 4th
• Format: Paperback
• Copyright: 2000-02-01
• Publisher: WILEY JOHN & SONS INC

Summary

"Immunology: A Short Course undertakes to cover all the important areas of contemporary immunological knowledge and simultaneously to provide a historical view of the discoveries that have built the groundwork of modern immunological thought. . . . Immunology: A Short Course performs this function admirably, taking advantage of the authors' breadth of knowledge and a contemporary molecular and cellular view of immunology. . . . Immunology: A Short Course complements the broad coverage of immunology as a biological discipline with a full set of clear and attractive illustrations of cellular and molecular details of the immune system. [. . Immunology: A Short Course] offers a valuable balance between classic and contemporary, academic and clinical, and will serve many students, and their teachers well." -David H. Margulies, M.D., Ph.D. The Fourth Edition of Immunology: A Short Course,completely updated on a chapter-by-chapter basis,contains extensive revisions to reflect the many recent advances in our understanding of immunology. This text contains a thorough introduction to immunology and concludes each chapter with review questions. Among the numerous additional features are clinical case scenarios and new, full-color illustrations that have been specially designed for this edition. Within this edition, particular emphasis is placed on T-and B-cell responses to antigen, antigen processing and presentation, vaccination technology, immunotherapy, and mechanisms responsible for immune disorders. Immunology: A Short Course, Fourth Edition proves itself to be an invaluable tool by offering the most coherent presentation of topics available. Included in this fully revised new edition: * Two new chapters on cytokines and immune responses to infection * Updated case scenarios and review questions * Accompanying Web site with downloadable illustrations and up-to-date CD and cytokine tables * Full-color interior with all new figures Immunology: A Short Course, Fourth Edition is the clear choice when searching for a concise and accessible book in modern immunology.

Author Biography

Eli Benjamini is a professor emeritus of immunology in the Department of Medical Microbiology and Immunology at the School of Medicine of the University of California at Davis. Dr. Benjamini has taught immunology to undergraduate, graduate, and medical students, as well as having served for 10 years as Chairman of the Graduate Program of Immunology on the Davis campus--a program which he was instrumental in forming. His research interests include the immunobiology of protein antigens, mechanisms of immune regulation, and principles of synthetic vaccine. Richard Coico is a professor and chairman of the Department of Microbiology and Immunology at the City University of New York Medical School (http://med.cuny.edu). For the past six years, he has directed the Microbiology and Immunology course taught to medical students, and also participates in the teaching of immunology to graduate students and physician assistant students at CUNY. He is a member of the Education Committee of the Association of Medical School Microbiology and Immunology Chairs (AMSMIC) and currently serves as program chair of a biannual meeting sponsored by AMSMIC entitled, Educational Strategies Workshop for Microbiology and Immunology. His research interests include studies of the regulation of antibody responses and germinal center formation, mechanisms of T cell-mediated B cell activation, and the physiologic role of IgD in the immune system. Geoffrey Sunshine is a staff scientist at the Health Effects Institute in Cambridge, Massachusetts where he reviews research on the biological effects of air pollutants. He is also a lecturer in the Department of Pathology at Tufts University School of Medicine. For several years, he has directed a course in immunology for graduate dental students at Tufts University Dental School, and previously directed a course for veterinary students at Tufts University Veterinary School. He was also a member of the Sackler School of Graduate Biomedical Sciences at Tufts University, doing research in antigen presentation and teaching immunology to medical, graduate, and undergraduate students.

Table of Contents

Preface and Acknowledgments	xxi
Preface and Acknowledgments to the Third Edition	xxiii
Preface to the Second Edition	xxv
Preface to the First Edition	xxvii
Acknowledgments to the First and Second Editions	xxix
Introduction and Overview	1	(16)
Introduction	1	(1)
Overview	2	(15)
Innate and Acquired Immunity	2	(1)
Active, Passive, and Adoptive Immunization	3	(1)
Characteristics of the Immune Response	4	(1)
Cells Involved in the Acquired Immune Response	4	(1)
Clonal Selection Theory	5	(2)
Humoral and Cellular Immunity	7	(4)
Generation of Diversity in the Immune Response	11	(1)
Benefits of Immunology	11	(1)
Damaging Effects of the Immune Response	12	(1)
Regulation of the Immune Response	13	(1)
The Future of Immunology	13	(4)
Elements of Innate and Acquired Immunity	17	(24)
Introduction	17	(1)
Innate (Nonspecific) Immunity	17	(9)
Physiologic and Chemical Barriers (Skin and Mucous Membranes)	18	(1)
Cellular Defenses	18	(1)
Phagocytosis and Extracellular Killing	18	(6)
Inflammation	24	(2)
Fever	26	(1)
Biologically Active Substances	26	(1)
Acquired Immunity	26	(1)
Cells Involved in the Immune Response	27	(6)
Lymphatic Organs	27	(6)
Lymphocyte Recirculation	33	(1)
The Fate of Antigen After Penetration	34	(2)
Interrelationship Between Innate and Acquired Immunity	36	(1)
Summary	36	(1)
References	37	(1)
Review Questions	37	(1)
Answers to Review Questions	38	(3)
Immunogens and Antigens	41	(16)
Introduction	41	(1)
Requirements for Immunogenicity	42	(4)
Foreignness	42	(1)
High Molecular Weight	42	(1)
Chemical Complexity	42	(1)
Degradability	43	(1)
Haptens	43	(2)
Further Requirements for Immunogenicity	45	(1)
Primary and Secondary Responses	46	(1)
Antigenicity and Antigen-Binding Site	46	(1)
Epitopes Recognized by B Cells and T Cells	47	(2)
Major Classes of Antigens	49	(2)
Binding of Antigen with Antigen-Specific Antibodies or T Cells	51	(1)
Cross-Reactivity	51	(1)
Immunologic Adjuvants	52	(1)
Summary	53	(1)
References	54	(1)
Review Questions	54	(1)
Answers to Review Questions	55	(2)
Antibody Structure and Function	57	(30)
Introduction	57	(1)
Isolation and Characterization	58	(1)
Structure of Light and Heavy Chains	59	(3)
Domains	62	(1)
Hinge Region	63	(1)
Variable Region	63	(2)
Immunoglobulin Variants	65	(4)
Isotypes of Immunoglobulins	65	(1)
Allotypes	66	(1)
Idiotypes	66	(3)
Structural Features of IgG	69	(1)
Biologic Properties of IgG	69	(5)
Agglutination and Formation of Precipitate	71	(1)
Passage Through the Placenta and Absorption in Neonates	72	(1)
Opsonization	72	(1)
Antibody-Dependent, Cell-Mediated Cytotoxicity	72	(1)
Activation of Complement	73	(1)
Neutralization of Toxin	73	(1)
Immobilization of Bacteria	73	(1)
Neutralization of Viruses	74	(1)
Structural Features of IgM	74	(1)
Biological Properties of IgM	74	(2)
Agglutination	75	(1)
Isohemagglutinins	75	(1)
Activation of Complement	76	(1)
Structural and Biologic Properties of IgA	76	(2)
Role in Mucosal Infections	77	(1)
Bactericidal Activity	78	(1)
Antiviral Activity	78	(1)
Structural and Biologic Properties of IgD	78	(1)
Structural and Biologic Properties of IgE	79	(1)
Importance of IgE in Parasitic Infections and Hypersensitivity Reactions	79	(1)
Kinetics of the Antibody Response Following Immunization	79	(2)
Primary Response	79	(1)
Secondary Response	80	(1)
The Immunoglobulin Superfamily	81	(1)
Summary	82	(1)
References	83	(1)
Review Questions	84	(1)
Answers to Review Questions	85	(2)
Antigen--Antibody Interactions, Immune Assays, and Experimental Systems	87	(30)
Introduction	87	(2)
Primary Interactions Between Antibody and Antigen	89	(2)
Association Constant	90	(1)
Affinity and Avidity	91	(1)
Secondary Interactions Between Antibody and Antigen	91	(7)
Agglutination Reactions	91	(3)
Precipitation Reaction	94	(4)
Immunoassays	98	(4)
Direct Binding Immunoassays	98	(3)
Solid-Phase Immunoassays	101	(1)
Immunofluorescence	102	(1)
Direct Immunofluorescence	102	(1)
Indirect Immunofluorescence	103	(1)
Fluorescence-Activated Cell-Sorting Analysis	103	(1)
Immunoabsorption and Immunoadsorption	104	(1)
Assays to Assess Lymphocyte Function	105	(1)
B-Cell and T-Cell Proliferation Assays	105	(1)
Antibody Production by B Cells	106	(1)
Effector Cell Assays for T Cells and NK Cells	106	(1)
Cell Culture Systems	106	(1)
Primary Cell Cultures and Cloned Lymphoid Cell Lines	106	(1)
Monoclonal and Genetically Engineered Antibodies	107	(1)
Monoclonal Antibodies	107	(1)
T-Cell Hybridomas	108	(1)
Genetically Engineered Molecules and Receptors	108	(2)
Experimental Animal Models	110	(1)
Inbred Strains	110	(1)
Adoptive Transfer	110	(1)
SCID Mice	111	(1)
Thymectomized and Congenically Athymic (Nude) Mice	111	(1)
Transgenic Mice and Gene Targeting	111	(2)
Transgenic Mice	111	(1)
Knockout Mice	112	(1)
Summary	113	(1)
References	114	(1)
Review Questions	114	(2)
Answers to Review Questions	116	(1)
The Genetic Basis of Antibody Structure	117	(18)
Introduction	117	(1)
A Brief Review of Nonimmunoglobulin Gene Structure and Gene Expression	118	(2)
Genetic Events in the Synthesis of Immunoglobulin Chains	120	(5)
Organization and Rearrangement of Light-Chain Genes	120	(2)
Organization and Rearrangement of Heavy-Chain Genes	122	(2)
Regulation of Immunoglobulin Gene Expression	124	(1)
Class or Isotype Switching	125	(1)
Generation of Antibody Diversity	126	(3)
Presence of Multiple V Genes in the Germ Line	126	(1)
VJ and VDJ Combinatorial Association	126	(1)
Random Assortment of H and L Chains	127	(1)
Junctional and Insertional Diversity	127	(1)
Somatic Hypermutation	127	(1)
Somatic Gene Conversion	128	(1)
Receptor Editing	129	(1)
Summary	129	(1)
References	130	(1)
Review Questions	130	(2)
Case Study	132	(1)
Answers to Review Questions	132	(1)
Answer to Case Study	133	(2)
Biology of the B Lymphocyte	135	(12)
Introduction	135	(1)
Sites of Early B-Cell Differentiation	135	(1)
Ontogeny of the B Lymphocyte	136	(5)
Early Phases of B-Cell Differentiation: Pro-B and Pre-B Cells	136	(2)
Immature B Cells	138	(1)
Mature B Cells	139	(1)
Anatomical Distribution of B-Cell Populations	140	(1)
B-1 or CD5+ B Cells	140	(1)
B-Cell Membrane Proteins	141	(2)
Antigen-Binding Molecules: Membrane Immunoglobulin	141	(1)
Signal Transduction Molecules Associated with Membrane Immunoglobulin	142	(1)
Molecules Involved in Antigen Presentation	142	(1)
Fc Receptor, CD32	143	(1)
CD21	143	(1)
Summary	143	(1)
References	144	(1)
Review Questions	145	(1)
Answers to Review Questions	146	(1)
The Role of the Major Histocompatibility Complex in the Immune Response	147	(22)
Introduction	147	(1)
Variability of MHC Genes and Products	148	(3)
Genetic Polymorphism	150	(1)
Pattern of Expression	150	(1)
Codominant Expression	151	(1)
Structure of MHC Molecules	151	(3)
Structure of MHC Class I Molecules	151	(2)
Structure of MHC Class II Molecules	153	(1)
Function of MHC Molecules	154	(8)
Antigen Processing and Presentation	156	(5)
MHC Molecules Bind Peptides Derived from Self-Molecules	161	(1)
Inability to Respond to an Antigen	161	(1)
One Antigen can Trigger MHC Class I- or Class II-Restricted Responses	161	(1)
Diversity of MHC Molecules: MHC Association with Resistance and Susceptibility to Disease	162	(2)
Other Genes Within the MHC Region	164	(1)
Summary	165	(1)
References	166	(1)
Review Questions	166	(1)
Answers to Review Questions	167	(2)
Biology of the T Lymphocyte	169	(18)
Introduction	169	(1)
Nature of the Antigen-Specific T-Cell Receptor	169	(3)
Molecules That Interact with Antigen	169	(1)
The T-Cell Receptor Complex	170	(1)
CD4 and CD8	171	(1)
Interaction of the TCR with MHC Molecules	172	(1)
γδ T Cells	173	(1)
Genes Coding for T-Cell Receptors	174	(1)
Generation of T-Cell Receptor Diversity	174	(1)
T-Cell Differentiation in the Thymus	175	(2)
Introduction	175	(1)
Thymocytes Interact with Thymic Nonlymphoid Cells	175	(2)
T-Cell Receptor Gene Rearrangement	177	(1)
Thymic Selection	178	(2)
Lymphocyte Trafficking to Tissues	180	(1)
Specialized Cells Present Antigen to T Cells	181	(1)
Summary	182	(1)
References	183	(1)
Review Questions	183	(1)
Answers to Review Questions	184	(3)
Activation and Function of T and B Cells	187	(24)
Introduction	187	(1)
Activation of CD4+ T Cells	187	(5)
Paired Interactions Between the APC and the CD4+ T Cell	188	(2)
Intracellular Events in CD4+ T-cell Activation	190	(2)
Functions of Costimulatory Pairs	192	(1)
Subsets of CD4+ Cells Defined by Cytokine Production	192	(3)
CD4+ T Memory Cells	195	(1)
Function of CD8+ T Cells	195	(1)
Killing of Target Cells by Cytotoxic T Cells	196	(2)
T-Cell Recognition of Lipids	198	(2)
Other Ways to Activate Unprimed T Cells	200	(1)
Superantigens	200	(1)
Plant Proteins and Antibodies to T-Cell Surface Molecules	200	(1)
B-Cell Activation and Function	201	(3)
T-B Cooperation	201	(2)
The Carrier Effect	203	(1)
T-Independent Responses	204	(2)
B-Cell Activation in the Absence of T-Cell Help	204	(1)
Intracellular Pathways in B-Cell Activation	205	(1)
Summary	206	(1)
References	207	(1)
Review Questions	207	(2)
Case Study	209	(1)
Answers to Review Questions	209	(1)
Answer to Case Study	209	(2)
Control Mechanisms in the Immune Response	211	(18)
Introduction	211	(1)
Tolerance	211	(4)
Induction of Tolerance in Immature T and B Lymphocytes	212	(2)
Regulation of Cell Death in Immature and Mature Lymphocytes	214	(1)
Induction of Tolerance in Mature T and B Lymphocytes	215	(2)
Fas--FasL Interactions	215	(1)
Mechanisms That Inhibit T- and B-Cell Activation	216	(1)
Other Potential Mechanisms of Regulating the Function of Lymphocytes	217	(1)
Active Suppression via T Cells	217	(1)
Idiotype Network	218	(1)
Regulation of the Response in the Individual	218	(5)
Age	218	(1)
Neurologic and Endocrine Factors	219	(1)
Expression of MHC Molecules	219	(1)
Effects of Cytokines	220	(1)
Effects of Antigen	221	(2)
Immunologically Privileged Sites	223	(2)
Immunosuppression by Drugs or Radiation	224	(1)
Summary	225	(1)
References	226	(1)
Review Questions	226	(1)
Answers to Review Questions	227	(2)
Cytokines	229	(24)
Introduction	229	(1)
The History of Cytokines	229	(2)
General Properties of Cytokines	231	(2)
Functional Categories of Cytokines	233	(7)
Cytokines That Regulate Specific Immune Responses	233	(2)
Cytokines Produced by TH1 and TH2 Cells	235	(1)
Cytokines That Facilitate Innate Immune Responses and Activate Inflammatory Responses	236	(2)
Chemokines: Cytokines That Affect Leukocyte Movement	238	(1)
Cytokines That Stimulate Hematopoiesis	238	(2)
Cytokine Receptors	240	(3)
Cytokine Receptor-Mediated Signal Transduction	243	(1)
Role of Cytokines and Cytokine Receptors in Disease	243	(2)
Toxic Shock Syndrome	244	(1)
Bacterial Septic Shock	244	(1)
Cancers	245	(1)
Autoimmunity	245	(1)
Cytokine Antagonists and Inhibitors	245	(1)
Therapeutic Uses of Cytokines and Cytokine Receptors	246	(1)
Reversing Cellular Deficiences	246	(1)
Treatment of Immunodeficiences	246	(1)
Treatment of Cancer	246	(1)
Treatment of Chronic Inflammatory Diseases	247	(1)
Treatment of Transplant Patients	247	(1)
Treatment of Allergies	247	(1)
Summary	247	(2)
References	249	(1)
Review Questions	249	(2)
Case Study	251	(1)
Answers to Review Questions	251	(1)
Answer to Case Study	251	(2)
Complement	253	(26)
Introduction	253	(1)
Historical Background	253	(1)
The Activation Pathways and Their Proteins	254	(15)
The Classical Pathway	256	(1)
The Lectin Pathway	257	(2)
The Alternative Pathway	259	(5)
The Terminal Pathway	264	(3)
Complement Control Proteins	267	(1)
Other Complement Receptors	268	(1)
Biological Activities of Complement	269	(4)
Complement and Disease	273	(1)
Summary	274	(1)
References	275	(1)
Review Questions	276	(1)
Answers to Review Questions	277	(2)
Hypersensitivity Reactions: Antibody-Mediated (Type I) Reactions	279	(22)
Introduction	279	(1)
Historical Background	280	(1)
General Characteristics of Type I Hypersensitivity	280	(1)
Sensitization Phase	281	(2)
IgE Antibody Production is T Cell-Dependent	281	(2)
Activation Phase	283	(2)
Effector Phase	285	(6)
Preformed Mediators	286	(1)
Newly Synthesized Mediators	287	(1)
Late-Phase Reaction	288	(3)
Clinical Aspects of Type I Hypersensitivity	291	(4)
Allergic Rhinitis	291	(1)
Food Allergies	291	(1)
Atopic Dermatitis	291	(1)
Asthma	291	(1)
Detection	292	(1)
Intervention	293	(2)
The Protective Role of IgE	295	(1)
Summary	296	(1)
References	296	(1)
Review Questions	297	(2)
Case Study	299	(1)
Answers to Review Questions	299	(1)
Answer to Case Study	300	(1)
Hypersensitivity Reactions: Antibody-Mediated (Type II) Cytotoxic Reactions and Immune Complex (Type III) Reactions	301	(16)
Introduction	301	(1)
Type II Cytotoxic Reactions	301	(4)
Introduction	301	(2)
Transfusion Reactions	303	(1)
Rh Incompatibility Reaction	304	(1)
Autoimmune Reactions	304	(1)
Drug-Induced Reactions	305	(1)
Type III Immune Complex Reactions	305	(6)
Introduction	305	(1)
Systemic Immune Complex Disease	306	(1)
Localized Immune Complex Disease	307	(1)
Infection-Associated Immune Complex Disease	307	(3)
Occupational Diseases (Hypersensitivity Pneumonitis)	310	(1)
Summary	311	(1)
References	311	(1)
Review Questions	312	(1)
Case Study	313	(1)
Answers to Review Questions	314	(1)
Answer to Case Study	315	(2)
Hypersensitivity Reactions: T-Cell-Mediated, Type IV---Delayed-Type Hypersensitivity	317	(12)
Introduction	317	(1)
General Characteristics	318	(6)
Gross Appearance and Histology of the Reaction	318	(1)
Mechanism of DTH	318	(2)
Consequences of DTH	320	(2)
Variants of DTH	322	(2)
Treatment of Cell-Mediated Immunity	324	(1)
Summary	325	(1)
References	325	(1)
Review Questions	326	(1)
Case Study	327	(1)
Answers to Review Questions	327	(1)
Answer to Case Study	328	(1)
Autoimmunity	329	(18)
Introduction	329	(1)
Autoimmunity and Disease	329	(1)
Criteria for Autoimmune Disease	330	(1)
Direct Proof	330	(1)
Indirect Evidence	330	(1)
Circumstantial Evidence	331	(1)
Etiology of Autoimmune Disease	331	(4)
Genetic Factors in Autoimmune Disease	331	(1)
Environmental Factors	332	(3)
Examples of Autoimmune Disease	335	(7)
Antibody-Mediated Autoimmune Disease	335	(2)
Immune Complex-Mediated Autoimmune Disease	337	(2)
T-Cell-Mediated Autoimmune Diseases	339	(3)
Autoimmune Diseases Arising From Deficiency in Components of Complement	342	(1)
Summary	342	(1)
References	343	(1)
Review Questions	343	(2)
Case Study	345	(1)
Answers to Review Questions	345	(1)
Answer to Case Study	346	(1)
Immunodeficiency and Other Disorders of the Immune System	347	(32)
Introduction	347	(1)
Immune Deficiency Syndromes	347	(14)
Primary Immunodeficiency Syndromes	348	(13)
Secondary Immunodeficiency Syndromes	361	(1)
Acquired Immunodeficiency Syndrome (AIDS)	361	(7)
Initial Description and Epidemiology	361	(1)
Human Immunodeficiency Virus	362	(2)
Clinical Course	364	(3)
Prevention, Control, and Therapy of HIV Infection	367	(1)
Neoplasms of the Immune System	368	(6)
B-Cell Neoplasms	370	(2)
T-Cell Neoplasms	372	(1)
Hodgkin's Disease	373	(1)
Summary	374	(1)
References	374	(1)
Review Questions	375	(1)
Case Study	376	(1)
Answers to Review Questions	377	(1)
Answer to Case Study	378	(1)
Transplantation Immunology	379	(22)
Introduction	379	(1)
Relationship Between Donor and Recipient	379	(2)
The Role of the Immune Response in Allograft Rejection	381	(1)
Clinical Characteristics of Allograft Rejection	382	(1)
Hyperacute Rejection	382	(1)
Acute Rejection	382	(1)
Chronic Rejection	383	(1)
Histocompatibility Antigens	383	(3)
MHC Class I and Class II Molecules as Targets in Allograft Rejection	384	(1)
Xenogeneic Transplanation	385	(1)
Tests for Histocompatibility Antigens	386	(2)
Serologic Detection of Transplantation Antigens	386	(1)
Genotyping of Transplantation Epitopes	387	(1)
Detection of Transplantation Antigens by Mixed Leukocyte Reaction	387	(1)
Prolongation of Allograft Survival	388	(4)
Antiinflammatory Agents	389	(1)
Cytotoxic Drugs	390	(1)
Cyclosporine, FK-506 (Tacrolimus), and Rapamycin (Sirolimus)	390	(1)
Antibody Therapy and Blocking of Costimulatory Molecules	391	(1)
Bone Marrow Transplantation	392	(1)
Graft-Versus-Host Reactions	393	(1)
Fetal-Maternal Relationship	393	(1)
Heart Transplantation: A Personal Story	394	(1)
Summary	395	(1)
References	395	(1)
Review Questions	396	(2)
Case Study	398	(1)
Answers to Review Questions	398	(1)
Answer to Case Study	399	(2)
Tumor Immunology	401	(20)
Introduction	401	(1)
Tumor Antigens	401	(2)
Categories of Tumor Antigens	403	(7)
Normal Cellular Gene Products	403	(1)
Mutant Cellular Gene Products	404	(1)
Tumor Antigens Encoded by Viral Genes	404	(1)
Immunologic Factors Influencing the Incidence of Cancer	405	(1)
Effector Mechanisms in Tumor Immunity	405	(1)
B-Cell Responses	406	(1)
Cell-Mediated Responses	407	(3)
Cytokines	410	(1)
Limitations of the Effectiveness of the Immune Response Against Tumors	410	(2)
Immunodiagnosis	412	(1)
Detection Of Myeloma Proteins Produced By Plasma Cell Tumors	412	(1)
Detection of α-Fetoprotein	412	(1)
Carcinoembryonic Antigen	412	(1)
Detection of Prostate-Specific Antigen	413	(1)
Tumor Immunoprophylaxis	413	(1)
Immunotherapy	413	(3)
Summary	416	(1)
References	416	(1)
Review Questions	417	(1)
Case Study	418	(1)
Answers to Review Questions	418	(1)
Answer to Case Study	419	(2)
Resistance and Immunization to Infectious Diseases	421	(34)
Introduction	421	(1)
Innate and Adaptive Immune Defenses	422	(1)
Host Defense Against the Various Classes of Microbial Pathogens	423	(4)
Immunity to Viruses	423	(2)
Immunity to Bacteria	425	(1)
Immunity to Parasites	426	(1)
Immunity to Fungi	427	(1)
Mechanisms by Which Pathogens Evade the Immune Response	427	(4)
Encapsulated Bacteria	428	(1)
Toxins	428	(1)
Antigenic Variation	429	(1)
Intracellular Survival	430	(1)
Suppression of the Immune System	430	(1)
Extracellular Enzymes	431	(1)
Expression of Antibody Binding Properties	431	(1)
Principles of Immunization	431	(1)
Objectives of Immunization	431	(1)
Historical Aspects of Immunization	432	(1)
Active Immunizations	433	(2)
Recommended Immunizations	433	(1)
Use of Vaccines in Selective Populations	434	(1)
Basic Mechanisms of Protection	435	(4)
Anatomic Location of Host Immune Response	435	(1)
Significance of the Primary and Secondary Responses	436	(1)
Protective Effect of the Immune Response	437	(1)
Age and Timing of Immunizations	437	(2)
Use of Mixed, Multiple Antigens	439	(1)
Precautions	439	(2)
Site of Administration of Antigen	439	(1)
Hazards	440	(1)
Recent Approaches to Production of Vaccines	441	(3)
Vaccines Produced by Recombinant DNA	441	(1)
Conjugated Polysaccharides	441	(1)
Synthetic Peptide Vaccines	442	(1)
Blocking of Specific Receptors	442	(1)
Anti-Idiotype Vaccines	442	(1)
Virus-Carrier Vaccine	443	(1)
Bacterium-Carrier Vaccine	443	(1)
DNA Vaccines	443	(1)
Toxoids	444	(1)
Passive Immunization	444	(5)
Passive Immunization Through Placental Antibody Transfer	444	(1)
Passive Immunization via Colostrum	444	(1)
Passive Antibody Therapy and Serum Therapy	445	(2)
Monoclonal and Polyclonal Preparations	447	(1)
Preparation and Properties of Human Immune Serum Globulin	447	(1)
Indications for the Use of Immune Globulin	448	(1)
Precautions on the Use of Immune Therapy	449	(1)
Immunotherapy	449	(2)
Antibody Therapies	450	(1)
Colony Stimulating Factors	450	(1)
Summary	451	(1)
References	451	(1)
Review Questions	452	(1)
Answers to Review Questions	453	(2)
Glossary	455	(22)
Appendix Partial List of CD Antigens	477	(4)
Index	481