医学免疫学是一门独立的学科，是研究免疫系统的组织结构和功能的科学。它从不同的角度和水平来揭示免疫系统识别并消除抗原性异物的应答过程和规律，并应用这些规律来阐明免疫相关疾病发生发展的机制，达到防治相关疾病的目的。医学免疫学进展迅速，知识量大，本教材基于*基本的理论和知识，介绍了抗原、免疫器官和免疫细胞、免疫分子（抗体、补体、细胞因子、黏附分子和 MHC等）、免疫应答、免疫预防、免疫治疗、免疫诊断、免疫耐受、免疫相关疾病以及感染免疫等。　　本教材适用于医学专业外国留学生的医学免疫学英文教学和本科双语教学。

正版原版，原汁原味，留学生与双语教学用。 

序言 Immunology is the study focusing on the organizational structures and functions ofimmune system. It demonstrates remarkable features of high-speed development andintersections with multiple disciplines, and gradually formed frontier branches such asmodern cellular immunology and immunogenetics. Meanwhile, immunology is an advanceddiscipline which is closely related to clinical applications. Therefore, immunology plays a keyrole in medical science, and thus become an important compulsory course for the students ofmedicine or biology.The contents of this textbook covers the knowledge from the basis of immunology toclinical applications, including overview of immunology, the antigens, components inimmune system (immune organs, immune cells, immune molecules, etc.) and immuneresponses. It also involves the applications of immunology (immunological techniques,immunoprophylaxis and immunotherapy, etc.), immune-related diseases and immunity ininfectious diseases. This edition of Medical Immunology is intended as a comprehensive,concise and valuable textbook for the foreign medical students studying in China andalso suitable for 5-year program Chinese medical students to learn the basic knowledge ofimmunology and to build up solid foundations for subsequent clinical courses of study andfuture academic studies.This textbook was edited and adapted on the basis of Textbook of Immunology [Sunil KumarMohanty, et al. Jaypee Brothers Medical Publishers (P) Ltd.(2nd edition, 2014)]. Sixteenprofessors from different universities who have been experienced in teaching immunologyfor foreign medical students joined the team for the work of this textbook. They also addedaccurate and up-to-date knowledge into each chapter according to the development ofimmunology, e.g., Chapter 16 is a completely new part in which the author explained themechanisms of immunity in viral, bacterial, fungal and parasitic infections, considering theactual health conditions in some countries where the foreign medical students come from.There might be some mistakes or omissions in this textbook since immunology is developingrapidly, we sincerely hope the readers give valuable opinions and comments through email sothat we can make corrections in the next edition.YAO ZhiDepartment of ImmunologyTianjin Medical UniversityTianjin 300070, P.R.Chinayaozhi@tmu.edu.cnJanuary 11, 2017

姚智教授现任天津医科大学基础医学院免疫学系主任、天津医科大学病原生物与免疫学学科学术带头人、天津医科大学党委书记等职务。任第十七届世界支原体联盟常务理事，中华微生物学及免疫学会主任委员，中国免疫学会理事，中国医药生物技术协会临床应用委员会常务理事，中国细胞生物学与分子生物学学会临床分会常务理事，中华医学会天津分会检验学会主任委员等学术职务。任中国检验医学杂志英文版主编，中国免疫学杂志编委，中国肿瘤临床（英文版）编委，中草药编委等植物。曾获天津市教书育人十大标兵、天津市卫生系统科技先进个人；他领导的课题组获天津市卫生系统科技先进集体、天津市十五立功先进集体；天津市五一立功先进集体，他本人荣获天津市八五九五十五立功奖章、天津市劳动模范、天津市科技明星、天津市第四届青年科技奖；为国务院特殊津贴专家；天津市131工程人才培养第一层次人选；卫生部有突出贡献中青年专家；天津市授衔专家；2006年入选新世纪百千万人才工程*人选。

Chapter 1 Introduction......................................... 1

A BRIEF OVERVIEW OF IMMUNOLOGY................. 1

HIST ORY OF IMMUNOLOGY................................... 10

STUDY QUESTIONS.................................................... 13

Suggested readingS .......................................... 13

Chapter 2 Antigen.................................................... 14

DEFINITION................................................................. 14

Epitopes...................................................................... 14

Classification of Antigens BASED ON

IMMUNE RESPONSE............................................. 15

DETERMINANTS OF IMMUNOGENICITY............ 15

ANTIGEN RECEPTORS.............................................. 16

ANTIGENIC SPECIFICITY......................................... 17

STUDY QUESTIONS ................................................... 18

Suggested readingS........................................... 18

Chapter 3 Antigen Recognition Molecules

....................................................................... 19

ANTIBODIESIMMUNOGLOBULINS................... 20

Major Histocompatibility Complex ......... 25

STUDY QUESTIONS.................................................... 28

Suggested ReadingS........................................... 28

Chapter 4 The Complement System............ 29

Complement Activation................................. 29

Regulation of the Complement

System ................................................................. 31

Biological Consequences of

Complement Activation.............................. 32

Defects in the Complement System........... 34

STUDY QUESTIONS ................................................... 34

Suggested readingS........................................... 35

Chapter 5 Organs and Tissues of the

Immune System................................. 36

LYMPHOID ORGANS................................................. 36

Contents

STUDY QUESTIONS.................................................... 39

Suggested ReadingS........................................... 39

Chapter 6 Immune Cells...................................... 41

Lymphocytes........................................................... 41

Phagocytic Cells................................................. 47

Dendritic Cells .................................................... 48

STUDY QUESTIONS.................................................... 48

Suggested ReadingS........................................... 48

Chapter 7 Immune Response............................ 49

AN TIGEN PROCESSING AND

PRESENTATION................................................... 49

AC TIVATION OF HELPER T LYMPHOCYTES.......... 51

HU MORAL IMMUNE RESPONSE

(HUMORAL IMMUNITY).................................... 55

PRIMARY AND SECONDARY RESPONSE ........... 58

FA CTORS INFLUENCING ANTIBODY

PRODUCTION........................................................ 59

CE LL-MEDIATED IMMUNE RESPONSE

(CELL-MEDIATED IMMUNITY).......................... 60

CYTOKINES.................................................................. 64

THEORIES OF IMMUNE RESPONSE....................... 71

STUDY QUESTIONS.................................................... 73

SUGGESTED READINGS........................................... 75

Chapter 8 Immunological Tolerance........... 76

CE NTRAL T CELL TOLERANCE TO SELFANTIGENS...............................................................

76

PE RIPHERAL T CELL TOLERANCE TO SELFANTIGENS...............................................................

77

B C ELL TOLERANCE TO SELF-ANTIGENS........... 78

AR TIFICIALLY INDUCED TOLERANCE IN

VIVO......................................................................... 79

STUDY QUESTIONS.................................................... 80

SUGGESTED READINGS........................................... 80

Contents

目 录

XIV 医学免疫学Meeddiiccaall IImmuunnoollooggyy

Chapter 9 Hypersensitivity................................ 81

DEFINITION................................................................. 81

GELL AND COOMBS CLASSIFICATION................ 81

IMMEDIATE TYPE I HYPERSENSITIVITY.............. 81

TY PEⅡ HYPERSENSITIVITY REACTION

(ANTIBODY-DEPENDENT CYTOTOXICITY)........ 89

TY PEⅢ HYPERSENSITIVITY REACTION

(IMMUNE COMPLEX-MEDIATED).................... 93

TY PE Ⅳ CELL-MEDIATED (DELAYED)

HYPERSENSITIVITY.............................................. 96

STUDY QUESTIONS.................................................. 101

SUGGESTED READINGS......................................... 101

Chapter 10 Autoimmunity................................ 102

PR OBABLE MECHANISMS OF

AUTOIMMUNITY................................................ 102

AUTOIMMUNE DISEASES...................................... 107

STUDY QUESTIONS.................................................. 109

Suggested readings......................................... 110

Chapter 11 Immunodeficiency Disorders...... 111

PRIMARY IMMUNoDeFICIENCIES...................... 111

SE CONDARY (ACQUIRED) IMMUNodEFICIENCIES

.................................................................................. 117

STUDY QUESTIONS.................................................. 125

SUGGESTED READINGs......................................... 125

Chapter 12 Tumor Immunology......................... 126

CANCER: ORIGIN..................................................... 126

TUMOR ANTIGENS.................................................. 129

Cancer Immunotherapy................................ 134

STUDY QUESTIONS.................................................. 136

SUGGESTED READINGs......................................... 137

Chapter 13 Transplantation Immunology...... 138

Graft Rejection................................................... 138

FACTORS FAVORINGALLOGRAFT SURVIVAL...... 140

Mechanism Involved in Graft Rejection

................................................................................ 142

Tempo of Rejection............................................ 145

STUDY QUESTIONS.................................................. 147

SUGGESTED READINGS......................................... 147

Chapter 14 Immunological Techniques.......... 149

ST AGES OF ANTIGEN-ANTIBODY

INTERACTIONS.................................................... 149

ME ASUREMENT OF ANTIGEN AND ANTIBODY

................................................................................ 149

PrecipitationReactions................................. 149

Agglutination Reaction............................. 154

MO NOCLONAL ANTIBODIES AND

HYBRIDOMA TECHNIQUE............................. 167

STUDY QUESTIONS.................................................. 170

SUGGESTED READINGs......................................... 171

Chapter 15 Immunoprophylaxis &

Immunotherapy............................... 172

IMMUNOPROPHYLAXIS........................................ 172

IMMUNOTHERAPY.................................................. 179

STUDY QUESTIONS.................................................. 183

SUGGESTED READINGs......................................... 183

Chapter 16 Immunity in Viral, Bacterial,

Fungal, and Parasitic

Infections............................................. 184

IMMU NITY IN VIRALINFECTIONS...................... 184

IMMU NITY IN BACTERIAL INFECTIONS........... 188

IMMU NITY IN FUNGAL INFECTIONS................ 197

IMMU NITY IN PARASITIC INFECTIONS............ 198

STUDY QUESTIONS.................................................. 204

SUGGESTED READINGs......................................... 204