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<br/>O 1 OVERVIEW OF THE IMMUNE SYSTEM, 1<br/>Introduction, 1<br/>Innate and Acquired Immunity, 2<br/>Innate Immunity, 2<br/>Acquired Immunity, 2<br/>Active, Passive, and Adoptive Immunization, 3<br/>Clonal Selection Theory, 4<br/>Humoral and Cellular Immunity, 6<br/>Cell-Mediated Immunity, 7<br/>Generation of Diversity in the Immune Response, 8<br/>Benefits of Immunology, 8<br/>Damaging Effects of the Immune Response, 9<br/>The Future of Immunology, 9<br/>The Short Course Begins Here, 10<br/>References, 10<br/>O 2 ELEMENTS OF INNATE AND ACQUIRED<br/>IMMUNITY, 11<br/>Introduction, II<br/>Innate Immunity, 11<br/>Physical and Chemical Barriers ofInnate Immunity, 11<br/>Intracellular and Extracellular Killing<br/>of Microorganisms, 12<br/>Cells Involved in the Innate Immune System, 14<br/>Inflammation, 16<br/>Fever, 17<br/>Biologically Active Substances, 18<br/>Receptors Involved in the Innate Immune System, 18<br/>Pattern Recognition Receptors, 18<br/>Acquired Immunity, 19<br/>Cells and Organs Involved in Acquired Immunity, 20<br/>The Lymphatic Organs, 20<br/>Lymphocyte Migration and Recirculation, 23<br/>CONTENTS<br/>Fate of Antigen After Penetration, 24<br/>Frequency ofAntigen-Specific Naive Lymphocytes, 25<br/>Interrelationship Between Innate and Acquired<br/>Immunity, 25<br/>Summaiy, 26<br/>References, 26<br/>Review Questions, 26<br/>Answers to Review Questions, 27<br/>O 3 IMMUNOGENS AND ANTIGENS, 29<br/>Introduction, 29<br/>Requirements for Immunogenicity, 29<br/>Foreignness, 29<br/>High Molecular Weight, 30<br/>Chemical Complexity, 30<br/>Degradability, 30<br/>Haptens, 30<br/>Further Requirements for Immunogenicity, 31<br/>Primary and Secondary Immune Responses, 32<br/>Antigenicity and Antigen-Binding Site, 32<br/>Epitopes Recognized by B and T Cells, 33<br/>Major Classes of Antigens, 34<br/>Binding of Antigen to Antigen-Specific Antibodies<br/>or T Cell Receptors, 35<br/>Cross-Reactivity, 35<br/>Adjuvants, 36<br/>Summary, 37<br/>References, 38<br/>Review Questions, 38<br/>Answers to Review Questions, 39<br/>O 4 ANTIBODY STRUCTURE AND FUNCTION, 41<br/>Introduction, 41<br/>Isolation and Characterization of Immunoglobulins, 42<br/>Structure of Light and Heavy Chains, 42<br/>Immunoglobulin Domains, 44<br/>Immunoglobulin Hinge Region, 45<br/>Immunoglobulin Variable Region, 45<br/>IX<br/>Immunoglobulin Variants, 47<br/>Isotypes, 47<br/>Allotypes, 47<br/>Idiotypes, 47<br/>Structural Features of IgG, 49<br/>Biologic Properties of IgG, 49<br/>Agglutination and Formation of Precipitate, 50<br/>Passage of Ig Through the Placenta and Absorption<br/>in Neonates, 51<br/>Opsonization, 51<br/>Antibody-Dependent, Cell-Mediated Cytotoxicity, 52<br/>Activation of Complement, 52<br/>Neutralization of Toxins, 52<br/>Immobilization of Bacteria, 52<br/>Neutralization of Viruses, 52<br/>Structural Features of IgM, 52<br/>Biologic Properties of IgM, 53<br/>Complement Fixation, 53<br/>First Line of Humoral Defense, 53<br/>Agglutination, 54<br/>Isohemagglutinins, 54<br/>Structural and Biologic Properties of IgA, 54<br/>Biologic Properties of IgA, 54<br/>Role in Mucosal Infections, 54<br/>Bactericidal Activity, 55<br/>Antiviral Activity, 55<br/>Structural and Biologic Properties of IgD, 55<br/>Structural and Biologic Properties of IgE, 55<br/>Importance of IgE in Parasitic Infections<br/>and Hypersensitivity Reactions, 56<br/>Kinetics of Antibody Responses Following<br/>Immunization, 56<br/>Primary Response, 56<br/>Secondary Response, 56<br/>The Immunoglobulin Superfamily, 57<br/>Summary, 58<br/>References, 58<br/>Review Questions, 59<br/>Answers to Review Questions, 60<br/>O 5 ANTIGEN-ANTIBODY INTERACTIONS,<br/>IMMUNE ASSAYS, AND EXPERIMENTAL<br/>SYSTEMS, 61<br/>Introduction, 61<br/>Antigen-Antibody Interactions, 61<br/>Primary Interactions Between Antibody and Antigen, 62<br/>Association Constant, 63<br/>Affinity and Avidity, 63<br/>Secondary Interactions Between Antibody and Antigen, 63<br/>Agglutination Reactions, 63<br/>Precipitation Reactions, 65<br/>Immunoassays, 67<br/>Direct-Binding Immunoassays, 67<br/>Solid-Phase Immunoassays, 68<br/>Immunofluorescence, 70<br/>Direct Immunofluorescence, 70<br/>Indirect Immunofluorescence, 70<br/>Fluorescence-Activated Cell-Sorting Analysis, 70<br/>Immunoabsorption and Immunoadsorption, 71<br/>Cellular Assays, 71<br/>Assays to Assess Lymphocyte Function, 71<br/>B- and T-Cell Proliferation Assays, 72<br/>Assays that Assess Antibody Production by B Cells, 72<br/>Effector Cell Assays for T and NK Cells, 72<br/>Cell Culture, 72<br/>Primary Cell Cultures and Cloned Lymphoid<br/>Cell Lines, 73<br/>B-Cell Hybridomas and Monoclonal Antibodies, 73<br/>T-Cell Hybridomas, 74<br/>Genetically Engineered Molecules and Receptors, 74<br/>Experimental Animal Models, 75<br/>Inbred Strains, 75<br/>Adoptive Transfer, 75<br/>SCID Mice, 75<br/>Thymectomized and Congenically Athymic (Nude)<br/>Mice, 76<br/>Transgenic Mice and Gene Targeting, 76<br/>Transgenic Mice, 76<br/>Knockout Mice, 76<br/>Analysis of Gene Expression: Microarrays, 77<br/>Summary, 78<br/>References, 79<br/>Review Questions, 79<br/>Answers to Review Questions, 80<br/>O 6 THE GENETIC BASIS OF ANTIBODY<br/>STRUCTURE, 81<br/>Introduction, 81<br/>A Brief Review of Nonimmunoglobulin Gene Structure<br/>and Gene Expression, 81<br/>Genetic Events in Synthesis of Ig Chains, 83<br/>Organization and Rearrangement of Light-Chain<br/>Genes, 83<br/>Organization and Rearrangement of Heavy-Chain<br/>Genes, 84<br/>Regulation of Ig Gene Expression, 85<br/>Class or Isotype Switching, 86<br/>Generation of Antibody Diversity, 87<br/>Presence of Multiple V Genes in the Germline, 87<br/>VJ and VDJ Combinatorial Association, 87<br/>CONTENTS<br/>CONTENTS<br/>Random Assortment of H and L Chains, 87<br/>Junctional Diversity, 87<br/>Somatic Hypermutation, 87<br/>Somatic Gene Conversion, 88<br/>Receptor Editing, 88<br/>Role of Activation-Induced Cytidine Deaminase<br/>in Generating Antibody Diversity, 88<br/>Summary, 89<br/>References, 89<br/>Review Questions, 90<br/>Case Study, 91<br/>Answers to Review Questions, 91<br/>Answer to Case Study, 91<br/>O 7 BIOLOGY OF THE BLYMPHOCYTE, 93<br/>Introduction, 93<br/>Development of B Lymphocytes, 93<br/>Overview, 93<br/>Sites of Early B-Cell Differentiation, 94<br/>Early Stages of B-Cell Differentiation: Pro-B<br/>and Pre-B Cells, 94<br/>Immature B Cells, 95<br/>Mature B Cells, 96<br/>B-Lymphocyte Traffic: Anatomical Distribution<br/>of B-Cell Populations, 97<br/>Sites of Antibody Synthesis, 98<br/>Thymus-Dependent Antibody Synthesis in the<br/>Germinal Center, 98<br/>Antibody Synthesis in Mucosal Tissue, 100<br/>Thymus-Independent Antibody Responses at Different<br/>Sites, 101<br/>B-Cell Membrane Proteins, 102<br/>Stage-Specific Markers, 103<br/>Antigen-Binding Molecules: Membrane<br/>Immunoglobulin, 103<br/>Signal Transduction Molecules Associated<br/>with Membrane Immunoglobulin, 103<br/>Molecules Involved in T Cell-B Cell Interactions, 104<br/>Summary, 104<br/>References, 105<br/>Review Questions, 105<br/>Answers to Review Questions, 106<br/>O 8 ROLE OF THE MAJOR HISTOCOMPATIBILITY<br/>COMPLEX IN THE IMMUNE RESPONSE, 107<br/>Introduction, 107<br/>How the MHC Got Its Name, 107<br/>Different MHC Molecules Interact with Different Sets<br/>of T Cells, 108<br/>Variability of MHC Class I and MHC Class II<br/>Molecules, 109<br/>Structure of MHC Class I Molecules, 109<br/>Selectivity of Peptide Binding to MHC Class I<br/>Molecules, 111<br/>CD8 Binding to Invariant Region of MHC Class I<br/>Molecules, 111<br/>Structure of MHC Class II Molecule, 111<br/>Antigen Processing and Presentation: How MHC<br/>Molecules Bind Peptides and Create Ligands that<br/>Interact with T Cells, 111<br/>Exogenous Antigens and Generation of MHC Class<br/>n-Peptide Complexes, 112<br/>Endogenous Antigens: Generation of MHC Class<br/>I-Peptide Complexes, 114<br/>Decreased MHC Class I Expression in Virus-Infected<br/>and Tumor Cells, 115<br/>Cross-Presentation: Exogenous Antigens Presented<br/>in the MHC Class I Pathway, 116<br/>Which Antigens Trigger Which T-Cell<br/>Responses?, 116<br/>Binding of Peptides Derived from Self-Molecules<br/>by MHC Molecules, 116<br/>Inability to Respond to an Antigen, 117<br/>Other Types of Antigen that Activate T-Cell<br/>Responses, 117<br/>Lipids and Glycolipids Presented by CDl to NKT<br/>Cells, 118<br/>Genes of the HLA Region, 118<br/>Polymorphic MHC Class I and II Genes, 118<br/>Nomenclature of Polymorphic MHC Molecules, 118<br/>Regulation of Expression of MHC Genes, 119<br/>Codominant Expression, 119<br/>Coordinate Regulation, 119<br/>Inheritance of MHC Genes, 119<br/>Other Genes Within HLA, 120<br/>MHC in Other Species, 120<br/>Diversity of MHC Molecules: MHC Association<br/>with Resistance and Susceptibility to Disease, 121<br/>Summary, 122<br/>References, 123<br/>Review Questions, 123<br/>Answers to Review Questions, 124<br/>O 9 BIOLOGY OF THE TLYMPHOCYTE, 125<br/>Introduction, 125<br/>The Antigen-Specific T-Cell Receptor, 125<br/>Molecules that Interact with Antigen, 125<br/>T-Cell Receptor Complex, 127<br/>Coreceptor Molecules, 127<br/>Other Important Molecules Expressed on the T-Cell<br/>Surface, 128<br/>XI<br/>Xll<br/>Genes Coding for T-Cell Receptors, 130<br/>Generation of T-Cell Receptor Diversity, 130<br/>T-Cell Differentiation in Thymus, 131<br/>Interactions of Developing T Cells with Nonlymphoid<br/>Cells of Thymus, 131<br/>Early T-Cell Receptor Gene Rearrangements:<br/>Double-Negative Cells and Splitting Off<br/>of yST Cells, 132<br/>Pre-T Cells, 133<br/>Double-Positive Cells, 133<br/>Thymic Selection, 134<br/>Role of AIRE Gene Product in Negative Selection, 134<br/>Single-Positive Cells, 135<br/>Generation of the T-Cell Repertoire, 135<br/>Characteristics of ap T Cells Emerging<br/>from Thymus, 135<br/>Further Differentiation of CD4+ and CDS"^ T Cells<br/>Outside Thymus, 136<br/>Differentiation of Other Sets of Cells in Thymus, 136<br/>Summary, 136<br/>References, 137<br/>Review Questions, 138<br/>Answers to Review Questions, 138<br/>O 10 ACTIVATION AND FUNCTION<br/>OF T AND B CELLS, 141<br/>Introduction, 141<br/>Activation of CD4+ T Cells, 141<br/>Specialized Cells Present Antigen to Naifve CD4''"<br/>T Cells, 141<br/>Paired Interactions at the Surface of APC and CD4+<br/>T Cells, 143<br/>Intracellular Events in CD4+ T-Cell Activation, 144<br/>Clonal Expansion, Differentiation to Effector Cells,<br/>and Migration Out of the Lymph Node, 147<br/>Other Ways to Activate CD4"'" T Cells, 147<br/>Superantigens, 148<br/>Plant Proteins and Antibodies to T-Cell Surface<br/>Molecules, 148<br/>T-Cell Function, 148<br/>Subsets of CD4+ T Cells Defined by Cytokine<br/>Production and Effector Function, 148<br/>CD4+ T Cells, 148<br/>T-Helper-Cell Function: Interaction of CD4"'' T Cells<br/>with B Cells to Synthesize Antibody, 151<br/>Activation and Function of<br/>CDS"^ T Cells, 153<br/>Generation of Effector CD8+ T Cells, 154<br/>CD8'^ T-Cell Killing of Target Cells, 154<br/>MHC Restriction and CDS"^ T Cell Killer<br/>Function, 156<br/>Tentiination of the Response: Induction of Memory<br/>Cells, 156<br/>Function of NKT Cells and T Cells. 157<br/>NKT Cells. 157<br/>yh T Cells, 157<br/>B-Cell Function: Antibody Synthesis in the<br/>Absence of<br/>T-Cell Help, 157<br/>Conjugate Vaccines, 158<br/>Intracellular Pathways in B-Cell Activation, 159<br/>Modulation of BCR Signal, 160<br/>Summary, 161<br/>References, 162<br/>Review Questions, 162<br/>Answers to Review Questions, 163<br/>O 11 CYTOKINES, 165<br/>Introduction, 165<br/>The History of Cytokines, 165<br/>Pleiotropic and Redundant Properties of Cytokines, 166<br/>General Properties of Cytokines, 166<br/>Common Functional Properties, 166<br/>Common Systemic Activities, 167<br/>Common Cell Sources and Cascading Events, 168<br/>Functional Categories of Cytokines, 168<br/>Cytokines that Facilitate Innate Immune<br/>Responses, 168<br/>Cytokines that Regulate Adaptive Immune<br/>Responses, 170<br/>Cytokines that Induce Differentiation of Distinct<br/>T-Cell Lineages, 170<br/>Cytokines that Inhibit Lineage-Specific T-Cell<br/>Differentiation, 171<br/>Cytokines that Promote Inflammatory Responses, 171<br/>, Cytokines that Affect Leukocyte Movement, 172<br/>Cytokines that Stimulate Hematopoiesis, 173<br/>Cytokine Receptors, 174<br/>Cytokine Receptor Families, 174<br/>Common Cytokine Receptor Chains, 175<br/>Cytokine Receptor-Mediated Signal Transduction, 176<br/>Role of Cytokines and Cytokine Receptors in Disease, 176<br/>Toxic-Shock Syndrome, 176<br/>Bacterial Septic Shock, 177<br/>Cancers, 177<br/>Autoimmunity and Other Immune-Based Diseases, 177<br/>Therapeutic Exploitation of Cytokines and Cytokine<br/>Receptors, 178<br/>Cytokine Inhibitors/Antagonists, 178<br/>Reversing Cellular Deficiencies, 179<br/>Treatment of Immunodeficiencies, 179<br/>Treatment of Cancer and Transplant Patients, 179<br/>Treatment of Allergies and Asthma, 180<br/>Summary, 180<br/>CONTEHTS<br/>CONTENTS<br/>References, 181<br/>Review Questions, 181<br/>Answers to Review Questions, 182<br/>O 12 TOLERANCE AND AUTOIMMUNITY, 183<br/>Introduction, 183<br/>Central Tolerance, 184<br/>Anergy, Receptor Editing, Deletion, and Clonal<br/>Ignorance, 184<br/>Peripheral Tolerance, 186<br/>Anergy, 186<br/>Fas-FasL Interactions, 187<br/>Regulatory/Suppressor T Cells, 188<br/>Oral Tolerance, 189<br/>Immune Privilege, 190<br/>Autoimmunity and Disease, 190<br/>Genetic Susceptibility, 190<br/>Environmental Susceptibility, 192<br/>Drug and Hormonal Triggers of Autoimmunity, 193<br/>Autoinmiune Diseases, 193<br/>Autoimmune Diseases in Which Antibodies Play a<br/>Predominant Role in Mediating Organ Damage, 194<br/>Autoimmune Diseases in Which T Cells Play a<br/>Predominant Role in Organ Damage, 198<br/>Therapeutic Strategies, 201<br/>Summary, 201<br/>References, 202<br/>Review Questions, 203<br/>Answers to Review Questions, 204<br/>O 13 COMPLEMENT, 205<br/>Introduction, 205<br/>Overview of Complement Activation, 205<br/>Classical Pathway, 206<br/>Lectin Pathway, 207<br/>Alternative Pathway, 207<br/>Steps Shared by All Pathways: Activation of C3<br/>and C5, 209<br/>Terminal Pathway, 209<br/>Regulation of Complement Activity, 210<br/>Biologic Activities of Complement, 212<br/>Production of Opsonins, 212<br/>Production of Anaphylatoxins, 213<br/>Lysis, 214<br/>Other Important Complement Functions, 214<br/>Complement Deficiencies, 216<br/>Summary, 217<br/>References, 218<br/>Review Questions, 218<br/>Answers to Review Questions, 219<br/>O 14 HYPERSENSITIVITY: TYPE I. 221<br/>Introduction, 221<br/>Coombs-Gell Hypersensitivity Designations, 221<br/>General Characteristics of Allergic Reactions, 222<br/>Sensitization Phase, 222<br/>Activation Phase, 223<br/>Effector Phase, 224<br/>Late-Phase Reaction, 226<br/>Clinical Aspects of Allergic Reactions, 228<br/>Allergic Rhinitis, 228<br/>Food Allergies, 228<br/>Atopic Dermatitis, 229<br/>Asthma, 229<br/>Clinical Tests for Allergies and Clinical Intervention, 229<br/>Detection, 229<br/>Intervention, 229<br/>Protective Role of IgE, 231<br/>Summary, 233<br/>References, 233<br/>Review Questions, 234<br/>Answers to Review Questions, 235<br/>O 15 HYPERSENSITIVITY: TYPES II AND III, 237<br/>Introduction, 237 .<br/>TVpe II Hypersensitivity, 237<br/>Complement-Mediated Reactions, 237<br/>Antibody-Dependent, Cell-Mediated Cytotoxicity, 237<br/>Antibody-Mediated Cellular Dysfunction, 238<br/>Examples of l^pe II Hypersensitivity Reactions, 239<br/>Transfusion Reactions, 239<br/>Drug-Induced Reactions, 239<br/>Rh Incompatibility Reactions, 239<br/>Reactions Involving Cell Membrane Receptors, 240<br/>Reactions Involving Other Cell Membrane<br/>Determinants, 240<br/>Type III Hypersensitivity, 240<br/>Systemic Immune Complex Disease, 241<br/>Localized Immune Complex Disease, 243<br/>Summary, 244<br/>References, 245<br/>Review Questions, 245<br/>Answers to Review Questions, 246<br/>O 16 HYPERSENSITIVITY: TYPE IV, 247<br/>Introduction, 247<br/>General Characteristics and Pathophysiology of DTH, 247<br/>Mechanisms Involved in DTH, 248<br/>Examples of DTH, 249<br/>XIII<br/>XIV<br/>Contact Sensitivity, 249<br/>Granulomatous Hypersensitivity, 250<br/>Tuberculin-Type Hypersensitivity, 251<br/>Allograft Rejection, 252<br/>Additional Examples of DTH, 252<br/>Treatment of DTH, 252<br/>Summary, 252<br/>References, 253<br/>Review Questions, 253<br/>Answers to Review Questions, 254<br/>O 17 IMMUNODEFICIENCY DISORDERS<br/>AND NEOPLASIAS OF THE LYMPHOID SYSTEM, 255<br/>Introduction, 255<br/>Immunodeficiency Syndromes, 256<br/>Primary Immunodeficiency Syndromes, 256<br/>Secondary Immunodeficiency Diseases, 268<br/>Acquired Immunodeficiency Syndrome, 268<br/>Initial Description and Epidemiology, 268<br/>Human Immunodeficiency Virus, 269<br/>Clinical Course, 270<br/>Prevention, Control, Diagnosis, and Therapy of HIV<br/>Infection, 272<br/>Neoplasms of Lymphoid System, 273<br/>B-Cell Neoplasms, 274<br/>T-Cell Neoplasms, 278<br/>Hodgkin Lymphoma, 279<br/>Immunotherapy, 279<br/>Summary, 280<br/>References, 280<br/>Review Questions, 281<br/>Answers to Review Questions, 282<br/>O 18 TRANSPLANTATION, 285<br/>Introduction, 285<br/>Relationship Between Donor and Recipient, 285<br/>Immune Mechanisms Responsible for Allograft<br/>Rejection, 287<br/>Categories of Allograft Rejection, 287<br/>Hyperacute Rejection, 287<br/>Acute Rejection, 287<br/>Chronic Rejection, 288<br/>Role of MHC Molecules in Allograft Rejection, 288<br/>Mechanisms of Alloantigen Recognition<br/>by T Cells, 288<br/>Role of T-Cell Lineages and Cytokines in Allograft<br/>Rejection, 289<br/>Laboratory Tests Used in Tissue Typing, 290<br/>Prolongation of Allograft Survival: Immunosuppresive<br/>Therapy, 291<br/>Anti-Inflammatory Agents, 291<br/>Cytotoxic Drugs, 292<br/>Agents that Interfere with Cytokine Production<br/>and Signaling, 292<br/>Immunosuppressive Antibody Therapy, 293<br/>New Immunosuppressive Strategies and Frontiers, 293<br/>Hematopoietic Stem Cell Transplantation, 293<br/>Graft-Versus-Host Disease, 294<br/>Xenogeneic Transplantation, 295<br/>The Fetus: A Tolerated Allograft, 295<br/>Summary, 295<br/>References, 296<br/>Review Questions, 296<br/>Answers to Review Questions, 297<br/>O 19 TUMOR IMMUNOLOGY, 299<br/>Introduction, 299<br/>Tumor Antigens, 299<br/>Categories of Tumor Antigens, 300<br/>Normal Cellular Gene Products, 300<br/>Mutant Cellular Gene Products, 301<br/>Tumor Antigens Encoded by Oncogenes, 302<br/>Immunologic Factors Influencing the Incidence of<br/>Cancer, 302<br/>Effector Mechanisms in Tumor Immunity, 303<br/>B-Cell Responses to Tumors, 305<br/>Cell-Mediated Responses to Tumor Cells, 305<br/>Cytokines, 306<br/>Limitations of the Effectiveness of Immune Responses<br/>Against Tumors, 307<br/>Immunodiagnosis, 307<br/>Detection of Myeloma Proteins Produced by Plasma<br/>Cell Tumors, 308<br/>Detection of a-Fetoprotein, 308<br/>Carcinoembryonic Antigen, 308<br/>Detection of Prostate-Specific Antigen, 308<br/>Cancer Antigen-125, 308<br/>Radiolabeled Monoclonal Antibody B72.3, 308<br/>Tumor Immunoprophylaxis, 308<br/>Immunotherapy, 309<br/>Summary, 311<br/>References, 311<br/>Review Questions, 312<br/>Answers to Review Questions, 312<br/>O 20<br/>RESISTANCE AND IMMUNIZATION<br/>TO INFECTIOUS DISEASES, 313<br/>Introduction, 313<br/>CONTENTS<br/>CONTENTS<br/>Host Defense Against Various Classes of Microbial<br/>Pathogens, 315<br/>Immunity to Viruses, 315<br/>Immunity to Bacteria, 316<br/>Immunity to Parasites, 317<br/>Immunity to Fungi, 318<br/>Mechanisms by Which Pathogens Evade Immune<br/>Responses, 318<br/>Encapsulated Bacteria, 318<br/>Toxins, 319<br/>Superantigens, 319<br/>Antigenic Variation, 319<br/>Intracellular Survival, 320<br/>Suppression of the Immune System, 320<br/>Extracellular Enzymes, 321<br/>Expression of Antibody-Binding Proteins, 321<br/>Principles of Immunization, 321<br/>Objectives<br/>of Immunization, 321<br/>Active Immunizations, 322<br/>Recommended Immunizations, 322<br/>Use of Vaccines in Selected Populations, 322<br/>Basic Mechanisms of Protection, 324<br/>Significance of Primary and Secondary<br/>Immune Responses, 324<br/>Age and Timing of Immunizations, 324<br/>Vaccine Precautions, 326<br/>Site of Administration of Antigen, 326<br/>Hazards, 326<br/>Recent Approaches to Production of Vaccines, 327<br/>Vaccines Produced by Recombinant DNA, 327<br/>Conjugated Polysaccharides, 327<br/>Synthetic Peptide Vaccines, 327<br/>Anti-Idiotype Vaccines, 327<br/>Virus-Carrier Vaccine, 328<br/>Bacterium-Carrier Vaccine. 328<br/>DNA Vaccines, 328<br/>Toxoids, 328<br/>Passive Immunization, 328<br/>Passive Immunization Through Placental Antibody<br/>Transfer, 329<br/>Passive Immunization via Colostrum, 329<br/>Passive Antibody Therapy and Serum<br/>Therapy, 329<br/>Monoclonal and Polyclonal Antibodies, 330<br/>Preparation and Properties of Human Immune Serum<br/>Globulin, 331<br/>Indications for Use of Immune Globulin, 331<br/>Precautions About Uses of Human Immune Serum<br/>Globulin Therapy, 332<br/>Colony-Stimulating Factors, 332<br/><br/><br/> |
