Pediatrics in Review
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(Pediatrics in Review. 1997;18:351-356.)
© 1997 American Academy of Pediatrics

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Immune Function

Thomas A. Fleisher, MD*
* Chief, Immunology Service, CP, CC, National Institutes of Health, Bethesda, MD. Dr. Fleisher prepared this manuscript in his private capacity, and no official endorsement or support by the National Institutes of Health is intended or should be inferred.

   Introduction
 
The need to understand basic principles of immune function has become increasingly relevant to pediatricians as the immunopathogenesis of a large variety of human diseases has been elucidated. The central role of the immune system in many diseases coupled with the worldwide pandemic of the human immunodeficiency virus (HIV) infection has moved immunology into the forefront of clinical medicine. The purpose of this review is to develop the basic principles that govern the cellular network of the human immune system as it protects the host against a vast array of foreign pathogens.

These defenses consist first of a phylogenetically more primitive innate system that is provided primarily by phagocytic cells and acts as a first-line defense against many bacterial pathogens. The complement system amplifies the innate immune response by providing critical factors that enhance phagocytosis (opsonins) and attract cells to the site of inflammation (chemoattractants). The more recently acquired defense pathway, the adaptive immune system, involves a highly specific immune response to foreign substances (antigens) that includes lymphocytes. This chain of events is initiated by lymphocyte binding antigen and consists of cell-cell interactions and the release of numerous humoral mediators, including immunoglobulins and potent bioactive hormones called cytokines.

The division of labor within these various arms of the immune system is carried out by specific cell types. The two primary players are neutrophils and macrophages. Neutrophils are mobile phagocytes that migrate to sites of inflammation where they ingest and destroy microorganisms. The macrophage is a fixed tissue cell, found throughout the lymphoid and mucosal tissues, that provides critical phagocytic function for clearing antigenic substances from the circulation. The ingestion of foreign antigens by both cell types is enhanced in the presence of antibody and complement bound to the antigen.

The adaptive immune . . . [Full Text of this Article]




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