In my last post I described how the adaptive branch of the
immune system is the real player when it comes to fighting infection. In this
post I hope to give you some idea of just how sophisticated a tactical machine
this system is.
The battle plan
As any good general knows, not all enemies can be fought in
the same way. History is littered with examples of mighty empires who were
stopped in their tracks by relatively small opponents who simply fought in a
way that they were not used to and couldn’t adapt to. The wars that are being
fought inside you right now are no different, and require your battle
strategies to be adaptive if they are to keep you alive.
Pathogens come in all shapes and sizes. They can be viruses that highjack your cells’ own replicating machinery to make more of
themselves; intracellular bacteria that smuggle themselves into your
cells and devour them from the inside; extracellular bacteria that float
around in the blood or other fluids and generally make a nuisance of
themselves; or they can even be multicellular parasites that can be big
enough to see, such as tapeworms or the Plamodia that cause malaria. The fact that they all
have different molecular components is not a problem since, as discussed in my
last post, your B and T cells all have different antigen recognition receptors,
and so you’ve most likely got one somewhere that can recognise whatever’s invading
you. However, deploying those B and T cells in the most effective way possible
is the tough task that awaits your immune system when a pathogen first invades
you. A strategy must be devised and honed to the specific weakness of the enemy
– but how is this achieved?
B cells – the
artillery not the Field Marshall
B cells circulate in the blood and the lymphatic system and so are exposed to all of the potential antigens that lie therein. As
a pathogen floats around the bloodstream it will expose its presence by leaving
behind fragments of itself, these can then be recognised by any B cell that has
a ‘complementary’ BCR at its surface. B
cells can also recognise antigens that are still attached to the pathogen, such
as the coat proteins of viruses or cell wall components of bacteria.
Once a B cell recognises a pathogen, it becomes partially activated. Full
activation of B cells requires T cell help, as we will talk about later, but at
this stage the B cell is taking matters into its own hands and acting
immediately! The action that the B cell takes is to turn its BCR into a weapon.
Since the BCR can recognise the pathogen, it can be very useful in flagging it
up to the rest of the immune system as a foreign and potentially dangerous invader,
however while it's still attached to the B cell it isn’t much use for that. So,
upon activation, the B cell undergoes rearrangement of the genes that encode
the BCR much in the same way that it did when it first developed its own unique
receptor. These rearrangements mean that the BCR is no longer bound to the surface
of the B cell but instead is launched in large numbers into surrounding blood
or lymph with a the same antigen-recognition domain but a new additional
section called the Fc region, which is constant to all secreted BCRs.
This molecule is probably familiar to you as it is now called an antibody and is the laser-guided missile of the immune system!
There are five main types of antibody: A, D, E, G and M.
They each have different roles but generally speaking they work to either
directly interfere with the action of the pathogen (what’s called a
‘neutralising’ antibody) or to flag up the pathogen to other parts of the
immune system. Antibodies are recognised by immune cells via their Fc regions,
which bind to Fc receptors on the surface of cells such as macrophages.
When a macrophage has bound to an antibody, it will engulf it and deliver it to
specific compartments within itself to destroy the antibody and anything that
it is bound to i.e. the pathogen. Neutralising antibodies are also recognised
like this, but have the added advantage of binding to the pathogen in such a
way that means it can no longer be infections – a double victory!
At this point I here you crying “but James, that sounds fantastic,
why would you say B cells are only the artillery?”. Well, that’s a good
question! A problem with this is that B cells can be a little promiscuous in
their targets, and if the reins of decision-making were handed to them then
they might launch an all-out antibody strike against your own body (I guess
they could be very aptly called ‘lose cannons’). This is what happens in some
autoimmune disorders, including rheumatoid arthritis and lupus.
To prevent this, B cells are only able to become partially activated on their
own. What this entails is that they only secrete type M antibodies, which are
very large and so don’t diffuse out of the blood easily, thereby limiting their
impact if they’re autoreactive; and B cells activated without T cell
help do not become ‘clonally expansive’, which is essentially a way of saying
that they don’t divide loads, which fully active B cells do.
T cell decisions –
the real deal
So, while B cells are vital footsoldiers in the fight
against pathogen, they don’t really have much impact in the direction of the
war in general. Instead, it is T cells that decide what is the best way to
fight the invader. They are able to do this because they know more about what
type of pathogen they’re facing than do B cells. This is because the TCRs on T
cells don’t recognise antigen directly as it floats around the body. Instead,
the TCR recognises antigen that has been presented by the MHC system(stands for Major Histocompatibility Complex, but the name’s not important!). MHC
molecules are a bit like the TCR or BCR in that they bind to antigen and sit on
the surface of cells. Unlike the BCR or TCR, however, they do not vary from
cell to cell but do vary from person to person. Every one of us expresses
several hundred different MHC proteins but this is a selection of the several
thousand that exist in the entire human population. Your MHC expression profile will determine
what diseases you are more susceptible to or resistant against, and also what
autoimmune disorders you are more or less predisposed to – diabetes, for
example, has been linked to several variants of the HLA-DQB1 MHC molecule. It is also what is used in paternity
tests, in case you were wondering, and is also very useful for tracking the
movements of early human populations by looking at the MHCs of their ancestors.
MHCs come in two types:
I and II. MHC class I molecules are expressed on all cells in your body with
the exception of red blood cells. Their job is to bind to antigens of pathogens
that have already infected that cell. If a T cell recognises antigen presented
by a type I MHC molecule then the decision is made for it – kill the cell
immediately! Any cell that has been infected must be destroyed as soon as
possible to prevent the pathogen from spreading. The T cells that do this are,
aptly, named ‘killer’ T cells and kill the cells by sending it orders to heroically commit suicide. Most cells will obey orders and duly sacrifice
themselves for the good of the whole, but this is done very much with a gun to
the head as if they do not follow instructions (mainly because the pathogen has
been working to prevent it) then the killer T cell does it for them and
unleashes all manner of cytotoxic (i.e. cell-killing) molecules at it,
thereby killing the cell and whatever is inside.
Type II MHCs are not
expressed on every cell, but instead are only found on ‘antigen-presentingcells’, including macrophages, dendritic cells, and B cells,
whose job it is to scour the body in search of pathogen antigen. When they
locate some, it is loaded onto MHC II molecules and the cell migrates to the
lymph nodes, where T cells are waiting. The T cells that recognise MHC
II-presented antigen are called ‘helper’ T cells and it is these cells
that are the real strategists behind the battle.
Attack – cellular or humoral?
The first rule of war
is ‘know thy enemy’ and that is exactly what helper T cells try to do. When
they recognise antigen via the MHC II pathway, they use a complex combination
of factors, including the type of cell that is presenting, the size of the
antigen, the strength of the interaction between the TCR and the MCH-antigen
complex, and others to chose what is appropriately named their ‘fate’. This
fate will ultimately determine the direction of the war and, ultimately, the
likelihood of victory.
Helper T cell fates
generally are either TH1 or TH2, though there are others.
If a cell decides to become TH1, it immediately starts to divide and
secrete factors that encourage a ‘cellular’ response. A cellular response is
used to target intracellular invaders, such as viruses or intracellular
bacteria, and works by stimulating the activity of killer T cells and macrophages
to start hunting down and destroying infected cells. Since artillery is useless
against a sheltered enemy, the B cells are not deployed - concentrating fire on
the infected cells and not wasting resources on ineffective antibodies ensures
an efficient and effective response to intracellular invaders.
If, however, the enemy
is extracellular, such as with a Staphylococcus or Streptococcus infection, then trying to hunt down infected cells would be a waste of precious
time. Instead, your tactical helper T cells decide that the best plan of attack
is ‘humoral’ – i.e. antibody-based. This is the TH2 response, and
your helper T cells will start secreting B-cell activating factors to get the
antibodies launching. Importantly, however, only those B cells with BCR (and
hence antibody) to the pathogen must be activated in order to avoid
autoimmunity. To ensure this, a B cell cannot be fully activated unless it proves
its loyalty! This is done by the MHC II system, since when the BCR of a B cell
binds to its antigen, both the BCR and the antigen are engulfed by the cell and
degraded. Fragments of the antigen are then loaded onto MHC II molecules and
presented at the surface. If a T cell then recognizes the antigen-MHC complex
through its TCR then it knows the B cell must be capable of attacking foreign
antigen and hence can be activated.
The factors secreted by
the T cell onto the B cell not only activate it but also authorise it to start
producing antibody that is not class M. Typically class G is the most commonly
used, but some infections require a more tailored weapon. Parasitic infection,
for example, can’t really be cleared using antibodies alone because the
invaders are just too damn big! Instead the B cells are instructed to release
their antibodies in the E form, which binds to cells called mast cells.
When the E antibody on the mast cell binds to its antigen, it causes the mast
cell to release huge amounts of powerful chemical signals that cause smooth
muscle contraction, vasodilation and even intestinal tract changes to cause
diarrhoea – since these responses are on a scale that can clear the
parasite. You’re probably very familiar
with this response if you have allergies as this is what’s being misdirected
against non-pathogenic antigens, such as pollen or animal fur.
Victory or defeat
The strategic decisions
made by your immune system really are vital in fighting an effective campaign
against your pathogenic invaders. Once the order has gone out to chose TH1
or TH2 then there is little way back – both fates strongly inhibit
the other and so it really is all your eggs in one basket. You better hope that
the correct decision has been made because if not it could spell disaster. Leprosy is caused by a class of intracellular bacteria called mycobacteria. As such, the best
defence is a TH1 campaign of infected cell destruction. Leprosy patients
who show a strong TH1 response have only a mild form, called tuberculoid leprosy, which is well-contained.
Those patients whose immune strategists have chosen a TH2 route are
not so lucky. Whilst their B cells are firing out round after round of
ineffective antibodies, the mycobacteria are busy consuming and expanding –
leading to a very nasty case of lepromatous leprosy and ultimately the
loss of the war.
The never-ending war
So, assuming the
correct decisions were made, the battle is won, your invaders have been
destroyed and you are clear once again. Despite this, the war is not over – the
exact same pathogens are still out there, waiting to reinfect. Luckily, some of
your activated B and T cells have been singled out for a unique task – memory.
These cells become extremely long-lived and float around in your body
potentially for years, keeping with them the knowledge (in the form of their
specific BCR or TCR) of what has come before and how to fight it if it ever
comes back. Without this you would have to re-arm for every reinfection – a
much slower and less efficient process – but instead these veterans of the
first conflict live on to help you in future if ever required.
Next time
In my next post I will be looking at what happens when the
battle doesn’t go exactly to plan: when the enemy is clever and comes up with
ways to resist or hide from attack; or when your own troops turn on you and
attack your own tissues during autoimmune disease.
The next post in this series can be found here.
The next post in this series can be found here.
I love how you've turned this into a novelistic drama with characters, a game plan, and heroic self-sacrifice. Must admit that the T cells seem a bit bossy and controlling. They might be the real deal, but so far my sympathies are with the B cell footsoldiers running around in the trenches.
ReplyDeleteWell the T cells are also out there doing the fighting. In many ways they're more exposed than the B cells since the B cells float around spitting out antibodies whereas the T cells have to get up close and personal with infected cells!
ReplyDeleteT cells also have other important decisions that I haven't mentioned in this post - they have to decide which antigens should be passed as non-pathogenic, and to keep any self-targetting responses in check. Read my next post to find out more...
Bio-blogging is an irresistible magnet for spammers named 'Flu'..
ReplyDeleteFor anyone reading this in the future, Michelle's comment above made sense before we deleted a spam comment from Flu. I deleted the comment entirely when I realised that even Flu's name was a link to his/her site. I feel kind of proud. Our first spammer.
ReplyDelete........................................................
This post makes me wish the novel discussed here really did exist. Maybe one of us or our readers needs to write it?
There is so much depth to each of the characters and their roles.
So, I was thinking, all these great fantasy stories require an interloper, introduced into the great fantasy realm. This way they can be our eyes and ears. They can ask the questions we want to ask and they look upon the world with the amazement that we would too (in Narnia this is obvious, in the The Lord of the Rings the Hobbits play the role, Harry Potter plays the role himself at the start of his story (by the end of HP such a character isn't necessary as we know the wizardry world well enough by then - there are no muggle readers left)).
I was thinking, that in the allegorical story of the human immune system, this role could be played by some medicine. It would be great. The medicine would arrive, completely oblivious to its role, but possessing of special powers, none of the rest of the kingdom has. slowly it would learn that precisely these powers were somehow necessary to defeat the enemy trying to destroy the kingdom. The medicine wouldn't have much time to realise its power and unleash its hidden potential before the enemy won. Conflict, drama, excitement follows.
The characters would be able to engage in moments of profound reflection... "Why did the medicine arrive, with precisely the right skills, at precisely the right time, to help us defeat our enemies? Who sent it? Where did it come from? Is there more to existence than just the war against the hordes?"
Slowly as the story progresses, the characters would begin to wonder whether they were a part of something bigger than themselves. As would the reader about themselves (Sophie's World, style).
The medicine would have all the classical aspects of a messiah/saviour in one of these stories.
ReplyDeleteThis isn't just going to be a novel, it's going to be an epic franchise. I can't wait until the movie comes out!
I think a vaccine would be a good candidate for our courageous narrator. So many modern vaccines have to manipulate many branches of the immune system, including directing T cell fate - our narrator would have to work with the army he's been sent to warn in order to train the troops up for battle. Also, most vaccines are now done in combination, so there would be a series of characters, each bringing their own unique expertise that would prepare the body for the oncoming war.
ReplyDeleteI don't know whether I ever wrote this down anywhere, but I'm pretty sure I said it to you in person if I didn't. Nevertheless, having the vaccine as the protagonist would add awesome moral dimensions to the story because the vaccine would resemble the enemy. There could be a whole initial rejection, eventual acceptance story relating to the vaccine.
DeleteThe only hope the story's civilisation has is the mysterious outsider who they've shunned for years because of how much he resembled the bad guys.
This story really does write itself.
James, don't feel any pressure or anything, but we're relying on your narrative skills to take this blog into the stratosphere. It's obvious that you're going to be the one attracting all the spammers, perhaps one day even a hacker.
ReplyDelete