Page 148 - First Aid for the USMLE Step 1 2020, Thirtieth edition [MedicalBooksVN.com]_Neat
P. 148

104         SECTIon II    Immunology  ` Immunology—Immune reSponSeS                                                                                             Immunology  ` Immunology—Immune reSponSeS





                `  Immunology—Immune reSponSeS

               Antibody structure    Fab (containing the variable/hypervariable regions) consisting of light (L) and heavy (H) chains
               and function            recognizes antigens. Fc region of IgM and IgG fixes complement. Heavy chain contributes to Fc
                                       and Fab regions. Light chain contributes only to Fab region.

                                                                               Fab:
                                                                                   ƒ Fragment, antigen binding
                    Antigen-                                                       ƒ Determines idiotype: unique antigen-binding
                    binding site                          Epitope                 pocket; only 1 antigenic specificity expressed
                                V H  Fab region  Heavy chain  D
                                                     J H                          per B cell
                             V L                                               Fc (5 C’s):
                                    C H 1  Hinge  C H 1  J L
                                  C L               C L  Light chain               ƒ Constant
                         Hypervariable
                         regions
                                      SS   SS    SS                                ƒ Carboxy terminal
                                           SS
                    C = Constant                                                   ƒ Complement binding
                    V = Variable                    Complement                     ƒ Carbohydrate side chains
                    L  = Light          C H 2  C H 2  binding                      ƒ Confers (determines) isotype (IgM, IgD, etc)
                    H = Heavy
                    SS = Disulfide bond  Fc region   Macrophage                 Generation of antibody diversity (antigen
                                                    binding                     independent)
                                        C H 3  C H 3
                                                                                 1.  Random recombination of VJ (light-chain)
                                                                                   or V(D)J (heavy-chain) genes
                                                                                 2.  Random addition of nucleotides to
                     Neutralization       Opsonization         Complement          DNA during recombination by terminal
                                                                activation
                                                                                   deoxynucleotidyl transferase (TdT)
                                                           Membrane              3.  Random combination of heavy chains with
                                                           attack complex
                                                           (MAC)                   light chains
                                                                               Generation of antibody specificity (antigen
                                                                                dependent)
                                                                                 4.  Somatic hypermutation and affinity
                                                                                   maturation (variable region)
                                                                                 5.  Isotype switching (constant region)
                                                                 C3b


                    Antibody prevents    Antibody promotes    Antibody activates
                    bacterial adherence    phagocytosis     complement, enhancing
                                                             opsonization and lysis




































          FAS1_2019_02-Immunology.indd   104                                                                            11/7/19   3:24 PM
   143   144   145   146   147   148   149   150   151   152   153