The Anatomy of the Immune System
The organs of the immune system are stationed throughout the body. They are
generally referred to as lymphoid organs because they are concerned with the
growth, development, and deployment of lymphocytes, the white cells that are the
key operatives of the immune system. Lymphoid organs include the bone marrow and
the thymus, as well as lymph nodes, spleen, tonsils and adenoids, the appendix,
and clumps of lymphoid tissue in the small intestine known as Peyer's patches.
The blood and lymphatic vessels that carry lymphocytes to and from the other
structures can also be considered lymphoid organs.
Cells destined to become immune cells, like all other blood cells, are produced
in the bone marrow, the soft tissue in the hollow shafts of long bones. The
descendants of some so-called stem cells become lymphocytes, while others
develop into a second major group of immune cells typified by the large,
cell-and particle-devouring white cells known as phagocytes.
The two major classes of lymphocytes are B cells and T cells. B cells complete
their maturation in the bone marrow. T cells, on the other hand, migrate to the
thymus, a multilobed organ that lies high behind the breastbone. There they
multiply and mature into cells capable of producing immune response-that is,
they become immunocompetent. In a process referred to as T cell "education," T
cells in the thymus learn to distinguish self cells from nonself cells; T cells
that would react against self antigens are eliminated.

Upon exiting the bone marrow and thymus, some lymphocytes congregate in immune
organs or lymph nodes. Others-both B and T cells-travel widely and continuously
throughout the body. They use the blood circulation as well as a bodywide
network of lymphatic vessels similar to blood vessels.
Laced along the lymphatic routes-with clusters in the neck, armpits, abdomen,
and groin-are small, bean-shaped lymph nodes. Each lymph node contains
specialized compartments that house platoons of B lymphocytes, T lymphocytes,
and other cells capable of enmeshing antigen and presenting it to T cells. Thus,
the lymph node brings together the several components needed to spark an immune
response.
The spleen, too, provides a meeting ground for immune defenses. A fist-sized
organ at the upper left of the abdomen, the spleen contains two main types of
tissue: the red pulp that disposes of worn-out blood cells and the white pulp
that contains lymphoid tissue. Like the lymph nodes, the spleen's lymphoid
tissue is subdivided into compartments that specialize in different kinds of
immune cells. Microorganisms carried by the blood into the red pulp become
trapped by the immune cells known as macrophages. (Although people can live
without a spleen, persons whose spleens have been damaged by trauma or by
disease such as sickle cell anemia, are highly susceptible to infection;
surgical removal of the spleen is especially dangerous for young children and
the immunosuppressed.)
Non encapsulated clusters of lymphoid tissue are found in many parts of the body.
They are common around the mucous membranes lining the respiratory and digestive
tracts-areas that serve as gateways to the body. They include the tonsils and
adenoids, the appendix, and Peyer's patches.
The lymphatic vessels carry lymph, a clear fluid that bathes the body's tissues.
Lymph, along with the many cells and particles it carries-notably lymphocytes,
macrophages, and foreign antigens, drains out of tissues and seeps across the
thin walls of tiny lymphatic vessels. The vessels transport the mix to lymph
nodes, where antigens can be filtered out and presented to immune cells.
Additional lymphocytes reach the lymph nodes (and other immune tissues) through
the bloodstream. Each node is supplied by an artery and a vein; lymphocytes
enter the node by traversing the walls of the very small specialized veins.

All lymphocytes exit lymph nodes in lymph via outgoing lymphatic vessels. Much
as small creeks and streams empty into larger rivers, the lymphatics feed into
larger and larger channels. At the base of the neck, large lymphatic vessels
merge into the thoracic duct, which empties its contents into the bloodstream.
Once in the bloodstream, the lymphocytes and other assorted immune cells are
transported to tissues throughout the body. They patrol everywhere for foreign
antigens, then gradually drift back into the lymphatic vessels, to begin the
cycle all over again.
The immune system stockpiles a tremendous arsenal of cells. Some staff the
general defenses, while others are trained on highly specific targets. To work
effectively, however, most immune cells require the active cooperation of their
fellows. Sometimes they communicate through direct physical contact, sometimes
by releasing versatile chemical messengers.
In order to have room for enough cells to match millions of possible foreign
invaders, the immune system stores just a few of each specificity. When an
antigen appears, those few specifically matched cells are stimulated to multiply
into a full-scale army. Later, to prevent this army from overexpanding wildly,
like a cancer, powerful suppressor mechanisms come into play.


Lymphocytes are small white blood cells that bear the major responsibility for
carrying out the activities of the immune system; they number about one
trillion. The two major classes of lymphocytes are: B cells, which grow to
maturity independent of the thymus, and T cells, which are processed in the
thymus. Both B cells and T cells recognize specific antigen targets.
B cells work chiefly by secreting soluble substances called antibodies into the
body's fluids, or humors. (This is known as humoral immunity.) Antibodies
typically interact with circulating antigens such as bacteria and toxic
molecules, but are unable to penetrate living cells. T cells, in contrast,
interact directly with their targets, attacking body cells that have been
commandeered by viruses or warped malignancy. (This is cellular immunity.)
Although small lymphocytes look identical, even under the microscope, they can
be told apart by means of distinctive molecules they carry on their cell
surface. Not only do such markers distinguish between B cells and T cells, they
distinguish among various subsets of cells that behave differently. Every mature
T cell, for instance, carries a marker known as T3 (or CD3); in addition, most
helper T cells carry a T4 (CD4) marker, a molecule that recognizes class II MHC
antigens. A molecule known as T8 (CD8), which recognizes class I MHC antigens,
is found on many suppressor/cytotoxic T cells. In addition, different T cells
have different kinds of antigen receptors-either alpha/beta or gamma/delta.
Mounting a Response
Infections remain the most common cause of human disease. Produced by
bacteria, viruses, parasites and fungi, infections may range from relatively
mild respiratory illnesses such as the common cold, to debilitating conditions
like chronic hepatitis, to life-threatening diseases such as AIDS and
meningitis.

To fend off the threatening horde, the body as devised astonishingly intricate
defenses. Microbes attempting to enter the body must first find a chink in the
body's external protection. The skin and the mucous membranes that line the
body's portals not only pose a physical barrier, they are also rich in scavenger
cells and IgA antibodies.
Next, invaders must elude a series of nonspecific defenses-those cells and
substances equipped to tackle infectious agents without regard for their
antigenic peculiarities. Many potential infections are cut short when microbes
are intercepted by patrolling scavenger cells or disabled by complement or other
enzymes or chemicals. Virus-infected cells, for instance, secrete interferon, a
chemical that rouses natural killer cells.
Disorders of the Immune System
Allergies
The most common types of allergic reactions-hay fever, some kinds of asthma,
and hives-are produced when the immune system response to a false alarm. In a
susceptible person, a normally harmless substance-grass pollen or house dust,
for example-is perceived as a threat and is attacked.
Such allergic reactions are related to the antibody known as immunoglobulin E.
Like other antibodies, each IgE antibody is specific; one reacts against oak
pollen, another against ragweed. The role of IgE in the natural order is not
known, although some scientists suspect that it developed as a defense against
infection by parasitic worms.
The first time an allergy-prone person is exposed to an allergen, he or she
makes large amounts of the corresponding IgE antibody. These IgE molecules
attach to the surfaces of mast cells (in tissue) or basophils (in the
circulation). Mast cells are plentiful in the lungs, skin, tongue, and linings
of the nose and intestinal tract.
When an IgE antibody siting on a mast cell or basophil encounters its specific
allergen, the IgE antibody signals the mast cell or basophil to release the
powerful chemicals stored within its granules. These chemicals include
histamine, heparin, and substances that activate blood platelets and attract
secondary cells such as eosinophils and neutrophils. The activated mast cell or
basophil also synthesizes new mediators, including prostaglandins and
leukotrienes, on the spot.
It is such chemical mediators that cause the symptoms of allergy, including
wheezing, sneezing, runny eyes and itching. They can also produce anaphylactic
shock, a life-threatening allergic reaction characterized by swelling of body
tissues, including the throat, and a sudden fall in blood pressure.
Cancers
Cells of the immune system, like those of other body systems, can proliferate uncontrollably; the result is cancer. Leukemias are caused by the proliferation of white blood cells, or leukocytes. The uncontrolled growth of antibody-producing (plasma) cells can lead to multiple myeloma. Cancers of the lymphoid organs, known as lymphomas, include Hodgkin's disease. These disorders can be treated-some of them very successfully-by drugs and/or irradiation.