protection to the newborn, and FcRn expressed on endothelial
cells and phagocytes plays a special role in protecting
IgG from intracellular catabolism, thereby prolonging
its half-life in the blood (see Chapter 8).
Helper T cells: CD40L, cytokines
CHAPTER 7 Humoral Immune Responses 151
syndrome is caused by mutations in the CD40L gene,
inherit the mutation. In this disease, much of the serum
antibody is IgM, because of defective heavy-chain isotype
switching. Patients with this disease also have defective
cell-mediated immunity against intracellular microbes,
responses by dendritic cells (see Chapter 6).
The molecular mechanism of isotype switching,
called switch recombination, takes the previously
formed VDJ exon encoding the V domain of an Ig µ
heavy chain and moves it adjacent to a downstream
C region (Fig. 7.13). IgM-producing B cells, which have
constant region cluster, which is Cµ. The heavy-chain
mRNA is produced by splicing a VDJ exon to Cµ exons
a light chain to give rise to an IgM antibody. Thus, the
first antibody produced by B cells is IgM. In the intron
5' of each constant region is a guanine-cytosine (GC)-
rich sequence called the switch region. Signals from
CD40 and cytokine receptors stimulate transcription
through one of the constant regions that is downstream
of Cµ. During switch recombination, the switch region
the rearranged VDJ encoding the V region is adjacent to the µ
constant region genes (Cµ). Signals from helper T cells (CD40
ligand and cytokines) may induce recombination of switch (S)
regions such that the rearranged VDJ DNA is moved close to a
C gene downstream of Cµ, which are C? genes in the example
shown. The enzyme activation-induced deaminase (AID), which
is spliced onto the exons of the downstream C gene, producing
a heavy chain with a new constant region and thus a new class
of Ig. Note that although the C region changes, the VDJ region,
and thus the specificity of the antibody, is preserved. (Each C
region gene consists of multiple exons, but only one is shown
Heavy-chain isotype switching is induced by a
combination of CD40L-mediated signals and cytokines. These signals act on antigen-stimulated B cells
and induce switching in some of the progeny of these
cells. In the absence of CD40 or CD40L, B cells secrete
only IgM and fail to switch to other isotypes, indicating
the essential role of this ligand-receptor pair in isotype
switching. A disease called the X-linked hyper-IgM
152 CHAPTER 7 Humoral Immune Responses
enzyme called activation-induced deaminase (AID),
which is induced by CD40 signals, plays a key role in
this process. AID converts cytosines in the transcribed
switch region DNA to uracil (U). The sequential action
of other enzymes results in the removal of the U’s and
the creation of nicks in the DNA. Such a process on both
strands leads to double-stranded DNA breaks. When
double-stranded DNA breaks in two switch regions are
brought together and repaired, the intervening DNA is
removed, and the rearranged VDJ exon that was originally close to Cµ may now be brought immediately
upstream of the constant region of a different isotype
(e.g., IgG, IgA, IgE). The result is that the B cell begins
to produce a new heavy-chain isotype (determined by
the C region of the antibody) with the same specificity
Cytokines produced by follicular helper T cells
determine which heavy-chain isotype is produced
(see Fig. 7.12). The production of opsonizing IgG
antibodies, which bind to phagocyte Fc receptors, is
stimulated by IL-10 and other cytokines in humans
and mainly by IFN-? in mice. In antibody responses,
these cytokines are produced by Tfh cells. The IgG
antibodies that are produced opsonize microbes and
promote their phagocytosis and intracellular killing.
By contrast, switching to the IgE class is stimulated
which are activated by another Th2 cytokine, IL-5.
Predictably, helminths induce strong Th2 and related
Tfh cell responses. Thus, the nature of the helper T
microbe. These are excellent examples of how different components of the immune system are regulated
coordinately and function together in defense against
different types of microbes and how helper T cells
may function as the master controllers of immune
The antibody isotype produced is also influenced by
the site of immune responses. For example, IgA antibody
is the major isotype produced in mucosal lymphoid
IgA are abundant in these tissues. IgA is the principal
antibody isotype that can be actively secreted through
mucosal epithelia (see Chapter 8). B-1 cells also appear
to be important sources of IgA antibody in mucosal tissues, especially against nonprotein antigens.
microbial antigen increases if the infection is persistent
or recurrent. This increase in affinity is caused by point
only in responses to helper T cell–dependent protein
antigens, indicating that helper cells are critical in the
process. These findings raise two intriguing questions:
how are mutations in Ig genes induced in B cells, and
how are the highest affinity (i.e., most useful) B cells
selected to become progressively more numerous?
hypermutation of Ig genes in dividing B cells, followed by the selection of high-affinity B cells by
Fig. 7.14 Affinity maturation in antibody responses. Early
in the immune response, low-affinity antibodies are produced.
During the germinal center reaction, somatic mutation of
immunoglobulin (Ig) V genes and selection of mutated B cells
with high-affinity antigen receptors result in the production of
antibodies with high affinity for antigen.
CHAPTER 7 Humoral Immune Responses 153
numerous point mutations are introduced into the Ig
genes of the rapidly dividing B cells. The enzyme AID,
which is required for isotype switching, also plays a
critical role in somatic mutation. This enzyme, as stated
B cells with highaffinity membrane Ig
Migration into germinal center
154 CHAPTER 7 Humoral Immune Responses
thymidines during DNA replication, creating C-to-T
nucleotides other than the original mutated cytosine.
The frequency of Ig gene mutations is estimated to be
one in 103 base pairs per cell division, which is much
greater than the mutation rate in most other genes. For
this reason, Ig mutation in germinal center B cells is
called somatic hypermutation. This extensive mutation
results in the generation of different B cell clones whose
Ig molecules may bind with widely varying affinities to
the antigen that initiated the response. The next step in
the process is the selection of B cells with the most useful antigen receptors.
Germinal center B cells undergo apoptosis unless
rescued by antigen recognition and T cell help. While
somatic hypermutation of Ig genes is taking place in
germinal centers, the antibody secreted earlier during
zone of the germinal center and express receptors for
FDCs or free in the germinal center. These B cells can
internalize the antigen, process it, and present peptides
to germinal center Tfh cells, which then provide critical
survival signals. High-affinity B cells more effectively
the antigen, akin to a process of Darwinian survival of
the amount of antibody produced increases. As a result,
the amount of antigen available in the germinal center
decreases. The B cells that are selected to survive must
Generation of Plasma Cells and
Activated B cells in germinal centers may differentiate
plasmablasts. From the blood, they tend to migrate to
the bone marrow or mucosal tissues, where they may
survive for years as plasma cells and continue to produce
A fraction of the activated B cells, which often are the
progeny of isotype-switched high-affinity B cells, do not
differentiate into active antibody secretors but instead
become memory cells. Memory B cells do not secrete
antibodies, but they circulate in the blood and reside
in mucosal and other tissues. They survive for months
or years in the absence of additional antigen exposure,
undergo slow cycling, and are ready to respond rapidly
if the antigen is reintroduced. Therefore, memory from
a T-dependent antibody response can last for a lifetime.
and especially the role of T cell help in this reaction, are
Polysaccharides, lipids, and other nonprotein antigens
elicit antibody responses without the participation of
antibody responses to proteins (Fig. 7.16; see also Fig.
7.2). Extensive cross-linking of BCRs by multivalent
antigens may activate the B cells strongly enough to
stimulate their proliferation and differentiation without
absence of T cell help (see Fig. 7.5).
CHAPTER 7 Humoral Immune Responses 155
After B lymphocytes differentiate into antibody-secreting
cells and memory cells, a fraction of these cells survive
B cells contributes to the physiologic decline of the
humoral immune response. B cells also use a special
mechanism for shutting off antibody production. As
IgG antibody is produced and circulates throughout the
body, the antibody binds to antigen that is still available
in the blood and tissues, forming immune complexes. B
cells specific for the antigen may bind the antigen part of
the immune complex by their Ig receptors. At the same
time, the Fc tail of the attached IgG antibody may be
recognized by a special type of Fc receptor expressed on
B cells (as well as on many myeloid cells) called Fc?RIIB
(Fig. 7.17). This Fc receptor delivers inhibitory signals
that shut off antigen receptor–induced signals, thereby
terminating B cell responses. This process, in which
antibody bound to antigen inhibits further antibody
Fig. 7.16 Features of Antibody responses to T-dependent and T-independent antigens. T-dependent
the absence of T cell help in T-independent responses. Ig, Immunoglobulin.
156 CHAPTER 7 Humoral Immune Responses
production, is called antibody feedback. It serves to
terminate humoral immune responses once sufficient
responses against self antigens, and polymorphisms in
the gene encoding this receptor are associated with the
autoimmune disease systemic lupus erythematosus (see
• Humoral immunity is mediated by antibodies that
bind to extracellular microbes and their toxins,
which are neutralized or targeted for destruction by
phagocytes and the complement system.
• Humoral immune responses to nonprotein antigens
The binding of multivalent antigen cross-links B cell
CHAPTER 7 Humoral Immune Responses 157
antigen receptors of specific B cells, and biochemical
signals are delivered to the inside of the B cells by
Ig-associated signaling proteins. These signals induce
B cell clonal expansion and IgM secretion.
• Humoral immune responses to a protein antigen,
with activated helper T cells that express CD40L and
secrete cytokines. The B cells internalize and process
that antigen and present class II MHC–displayed
peptides to activated helper T cells specific for the
displayed peptide-MHC complex. These helper T
cells contribute to early B cell activation at extrafollicular sites.
• The early T-dependent humoral response occurs in
• Activated B cells induce the further activation of T
cells and their differentiation into Tfh cells. The B
cells, together with the Tfh cells, migrate into follicles
• The full T-dependent humoral response develops
in germinal centers and leads to extensive isotype
switching and affinity maturation; generation of
long-lived plasma cells that secrete antibodies for
many years; and development of long-lived memory
B cells, which rapidly respond to reencounter with
antigen by proliferation and secretion of high-affinity
specificity, of the antibodies produced in response
helper T cells. Different cytokines induce switching
to different antibody isotypes, enabling the immune
system to respond in the most effective way to different types of microbes.
prolonged or repeated exposure to the antigens. The
process is initiated by signals from Tfh cells, resulting
somatic mutation. The antigen may be displayed by
FDCs in the germinal centers. B cells that recognize
the antigen with high affinity are selected to survive,
giving rise to affinity maturation of the antibody
induce antibody responses without T cell help. Most
T-independent antigens contain multiple identical
show less heavy-chain class switching and affinity
maturation than typical for responses to T-dependent
• Secreted antibodies form immune complexes with
residual antigen and shut off B cell activation by
engaging an inhibitory Fc receptor on B cells.
1. What are the signals that induce B cell responses to
protein antigens and polysaccharide antigens?
2. What are the major differences between primary and
secondary antibody responses to a protein antigen?
Where in a lymph node do these interactions mainly
4. What are the signals that induce heavy-chain isotype
5. What is affinity maturation? How is it induced, and
how are high-affinity B cells selected to survive?
6. What are the characteristics of antibody responses to
polysaccharides and lipids? What types of bacteria
stimulate mostly these types of antibody responses?
Answers to and discussion of the Review Questions are
Antibodies prevent infections by blocking microbes
from binding to and entering host cells. Antibodies
also bind to microbial toxins and prevent them from
damaging host cells. In addition, antibodies function
to eliminate microbes, toxins, and infected cells from
the body. Although antibodies are a major mechanism
of adaptive immunity against extracellular microbes,
they cannot reach microbes that live inside cells.
However, humoral immunity is vital even for defense
against microbes that live inside cells, such as viruses,
because antibodies can bind to these microbes before
they enter host cells or during passage from infected to
uninfected cells, thus preventing spread of infection.
Defects in antibody production are associated with
currently in use work by stimulating the production of
This chapter describes how antibodies provide defense
against infections, addressing the following questions:
• What is the role of the complement system in defense
• How do antibodies combat microbes that enter
through the gastrointestinal and respiratory tracts?
• How do antibodies protect the fetus and newborn
antibody molecules that are important for these functions.
these molecules in host defense.
Properties of Antibodies that Determine Effector
Neutralization of Microbes and Microbial Toxins, 161
Opsonization and Phagocytosis, 162
Antibody-Dependent Cellular Cytotoxicity, 164
Immunoglobulin E– and Eosinophil/Mast Cell–
Pathways of Complement Activation, 165
Functions of the Complement System, 168
Regulation of Complement Activation, 170
Functions of Antibodies at Special Anatomic Sites, 171
Evasion of Humoral Immunity by Microbes, 174
CHAPTER 8 Effector Mechanisms of Humoral Immunity 159
Antibodies function in the circulation, in tissues
throughout the body, and in the lumens of mucosal
organs. Antibodies are produced after stimulation of B
tissues) and at tissue sites of inflammation. Many of the
lymphoid organs or inflamed tissues and others migrate
to and reside in the bone marrow. Different plasma cells
synthesize and secrete antibodies of different heavy-chain
isotypes (classes). These secreted antibodies enter the
blood, from where they may reach any peripheral site of
infection, or enter mucosal secretions, where they prevent
infections by microbes that try to enter through epithelia.
Protective antibodies are produced during the
first (primary) response to a microbe and in larger
amounts during subsequent (secondary) responses
(see Fig. 7.3 in Chapter 7). Antibody production begins
within the first week after infection or vaccination.
microbe again tries to infect the host, the continuously
secreted antibodies provide immediate protection. At
the same time, memory cells that had developed during
providing a large burst of antibody for more effective
defense against the infection. A goal of vaccination is
to stimulate the development of long-lived plasma cells
Antibodies use their antigen-binding (Fab) regions
to bind to and block the harmful effects of microbes
and toxins, and they use their Fc regions to activate
diverse effector mechanisms that eliminate these
of antibody molecules was introduced in Chapter 4.
Antibodies block the infectivity of microbes and the
injurious effects of microbial toxins simply by binding
to the microbes and toxins, using only their Fab regions
the heavy-chain constant regions, contain the binding
sites for Fc receptors on phagocytes and for complement
proteins. The binding of antibodies to Fc receptors and
microbial antigen. Therefore, even the Fc-dependent
functions of antibodies require antigen recognition by
the Fab regions. This feature of antibodies ensures that
they activate effector mechanisms only when needed—
that is, when they recognize their target antigens.
Heavy-chain isotype (class) switching and affinity
two changes that occur in the antibodies produced by
antigen-stimulated B lymphocytes, especially during
antibodies with distinct Fc regions, capable of different
the humoral immune system is able to engage diverse
host mechanisms that are optimal for combating those
microbes. Affinity maturation is induced by prolonged
or repeated stimulation with protein antigens, and it
leads to the production of antibodies with higher and
microbes. The progressive increase in antibody affinity
with repeated stimulation of B cells is one of the reasons
for the recommended practice of giving multiple rounds
of immunizations with the same antigen for generating
Switching to the IgG isotype prolongs the duration
that an antibody remains in the blood and therefore
increases the functional activity of the antibody. Most
circulating proteins have half-lives of hours to days
in the blood, but IgG has an unusually long half-life
because of a special mechanism involving a particular Fc
receptor. The neonatal Fc receptor (FcRn) is expressed
in placenta, endothelium, phagocytes, and a few other
the cells. Once bound to the FcRn, the IgG is recycled
back into the circulation or tissue fluids, thus avoiding
160 CHAPTER 8 Effector Mechanisms of Humoral Immunity
Neutralization of microbes and toxins
Opsonization of antigens for phagocytosis by
Activation of the classical pathway of complement
Antibody-dependent cellular cytotoxicity mediated
Neonatal immunity: transfer of maternal antibody
Feedback inhibition of B cell activation
Mucosal immunity: secretion of IgA into lumens of
gastrointestinal and respiratory tracts, neutralization
Activation of the classical pathway of complement
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