1.
Introduction to Immunity
Definition:
Immunity is the body’s ability to resist infection and protect
against disease by recognizing and responding to foreign
substances (antigens).
Importance:
o Protects from infectious agents (bacteria, virus, fungi,
parasites).
o Helps in recognizing self vs. non-self.
o Plays a role in allergy, autoimmunity, transplantation, and
vaccination.
2. Types of Immunity
A. Innate Immunity (Natural / Non-specific)
Definition: Present at birth, first line of defense, non-specific.
Components:
o Physical barriers → skin, mucous membrane.
o Physiological barriers → temperature, pH, gastric acid.
o Cellular barriers → macrophages, neutrophils, NK cells.
o Humoral barriers → complement system, lysozymes,
interferons.
Example: Acid in stomach killing microbes.
B. Acquired Immunity (Adaptive / Specific)
Definition: Immunity that develops after exposure to antigen;
highly specific and has memory.
Types:
o Active Immunity:
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Produced by body’s own immune system after
infection or vaccination.
Example: Immunity after measles infection or after
measles vaccine.
Long-lasting (months to years).
o Passive Immunity:
Transfer of ready-made antibodies.
Example: Maternal antibodies through placenta/breast
milk, injection of anti-rabies serum.
Immediate but short-lived (weeks to months).
3. Classification of Immunity (with examples)
Natural Active → Infection (chickenpox).
Natural Passive → Placental transfer of IgG to fetus.
Artificial Active → Vaccination (BCG, DPT).
Artificial Passive → Immunoglobulin injection (Anti-tetanus
serum).
4. Antigen and Antibody
A. Antigen
Definition: Any substance (protein, polysaccharide, toxin, etc.)
that stimulates an immune response.
Classification of Antigen
1. Based on ability to induce antibody formation:
o Complete antigen → induces antibody production (proteins,
polysaccharides).
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o Incomplete antigen (Hapten) → alone cannot induce
antibodies, requires carrier protein.
2. Based on sources:
o Exogenous antigens (microbes, toxins).
o Endogenous antigens (virus-infected cells).
o Autoantigens (self-antigens in autoimmune disease).
3. Based on immunogenicity:
o Strong immunogens (proteins).
o Weak immunogens (lipids, nucleic acids).
Properties of Antigen
Foreignness (non-self).
High molecular weight.
Chemical complexity.
Degradability (should be processed and presented).
B. Antibody (Immunoglobulin)
Definition: Glycoproteins produced by plasma cells in response to
antigen.
Basic Structure:
o Y-shaped molecule.
o 2 heavy chains + 2 light chains.
o Fab region → antigen-binding site (variable).
o Fc region → constant region (activates complement, binds
to cells).
5. Classification of Immunoglobulins – Structure & Function
1. IgG
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o Most abundant (75%).
o Crosses placenta → provides passive immunity to fetus.
o Role in opsonization, complement activation.
2. IgA
o Found in secretions (saliva, tears, breast milk).
o Provides mucosal immunity.
3. IgM
o First antibody produced during infection.
o Large pentamer structure.
o Excellent in complement activation.
4. IgE
o Involved in allergy and hypersensitivity.
o Protects against parasitic infections.
5. IgD
o Found on B-cell surface.
o Functions as receptor for antigen recognition.
6. Antigen-Antibody Reactions
Introduction
Antigen combines specifically with antibody → leads to visible or
measurable reaction.
General Features
Highly specific.
Do not alter antigen or antibody.
Reactions can be detected visually or by lab tests.
Types of Serological Reactions (with mechanism)
1. Precipitation → Soluble antigen + antibody → visible precipitate.
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o Example: VDRL test for syphilis.
2. Agglutination → Particulate antigen + antibody → clumping.
o Example: Widal test for typhoid.
3. Complement Fixation Test (CFT) → Antigen-antibody reaction
activates complement → detected by lysis.
4. Neutralization → Antibody neutralizes toxins/viruses.
5. ELISA (Enzyme Linked Immunosorbent Assay) → Antigen-
antibody reaction detected by enzyme color change.
o Example: HIV test.
6. Immunofluorescence → Antibody labeled with fluorescent dye
binds to antigen.
7. Western Blot → Detects specific proteins/antibodies (HIV
confirmation).
7. Hypersensitivity
Introduction
Exaggerated or inappropriate immune response causing tissue
damage.
Classification (Gell & Coombs)
1. Type I – Immediate (Anaphylactic)
o Mediated by IgE.
o Examples: Asthma, hay fever, anaphylaxis.
2. Type II – Cytotoxic
o IgG or IgM mediated.
o Example: Hemolytic anemia, transfusion reaction.
3. Type III – Immune Complex
o Antigen-antibody complexes deposit in tissues.
o Example: Serum sickness, SLE.
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4. Type IV – Delayed (Cell-mediated)
o T-cell mediated.
o Example: Tuberculin test, contact dermatitis.
Diagnostic Hypersensitivity Skin Tests
Immediate type: Skin prick test (allergies).
Delayed type: Mantoux test for tuberculosis.
8. Immunoprophylaxis and Vaccines
Introduction
Immunoprophylaxis: Prevention of disease by inducing immunity
artificially.
A. Active Immunization
Stimulation of immune system by vaccines.
Long-lasting protection.
Examples: BCG, DPT, Hepatitis B vaccine.
B. Passive Immunization
Administration of pre-formed antibodies (immunoglobulins,
antisera).
Provides immediate protection but short duration.
Example: Anti-rabies serum, anti-tetanus immunoglobulin.
C. Immunization Administration at Different Levels
National level: Universal Immunization Programme (UIP).
Community level: Primary Health Centers (PHC), Sub-centers.
Hospital level: Immunization clinics.
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9. Cold Chain System
System of storing and transporting vaccines in a potent condition
from manufacturer → user.
Equipment:
o Ice-lined refrigerator (ILR).
o Deep freezers.
o Cold boxes, vaccine carriers, ice packs.
Temperature maintenance: +2°C to +8°C.
Purpose: Maintains vaccine potency till administration.
10. National Immunization Schedule (India – 2025, under UIP)
At Birth
BCG → for TB.
OPV-0 → Oral polio vaccine (zero dose).
Hepatitis B-0.
6 Weeks
OPV-1
Pentavalent-1 (DPT + Hep B + Hib).
Rotavirus-1.
IPV-1 (Inactivated polio vaccine).
PCV-1 (Pneumococcal).
10 Weeks
OPV-2
Pentavalent-2
Rotavirus-2
7
14 Weeks
OPV-3
Pentavalent-3
Rotavirus-3
IPV-2
PCV-2
9–12 Months
Measles-Rubella (MR-1).
JE-1 (Japanese Encephalitis, in endemic areas).
PCV booster.
16–24 Months
DPT booster-1.
OPV booster.
MR-2.
JE-2 (in endemic areas).
5–6 Years
DPT booster-2.
10 and 16 Years
Tdap / TT.
