Disease

Types of disease
Diseases can be caused by a range of different factors. Diseases are classified into two main
categories according to their causes non-infectious and infectious.

Non-infectious disease
Non-infectious diseases can be caused by factors including radiation, genetic disorders and poor
nutrition (a bad diet of food). Non-infectious diseases are non-communicable. That is, they
cannot be passed from one person to another. Diabetes is an example of a non-infectious disease.

This Unit does not focus on non-infectious disease.

Infectious disease
Infectious diseases are because they are caused by pathogens. A pathogen is a disease causing
agent. Many pathogens are but it is important to remember that many microorganisms are
beneficial to our health.

Many infectious diseases are spread by poor hygiene. Make sure you cover your mouth
whenever you cough or sneeze, and wash your hands afterwards. (Image by James Gathany)

Most pathogens tend to be host-specific, that is they only infect one type of However, some
pathogens use another organism, called a vector, to transmit them into the host. The vector is
usually a different species to the final host.

Virulence is a measure of the harmfulness of a pathogen in terms of the damage it causes to the
host and how quickly it can spread within the host and between different hosts. Susceptibility is
an indication of easily the host will contract a particular disease.

Symptoms are the observable effects of the pathogen on the host organism. Doctors use
symptoms to help identify what disease a person may have and to help decide what treatment
will be appropriate.
First line of defence
The immune system functions in a number of different ways. Some of these functions are non-
specific, which means that they work against all sorts of different pathogens. Other functions are
highly specific and will target only one pathogen.

Your bodys first line of defence against disease is an example of non-specific immunity. Non-
specific immune responses are innate. This means that these responses have been present since
birth.

Physical and chemical barriers

The first line of defence against disease works by preventing pathogens from entering the body
in the first place. A number of physical and chemical barriers are involved in stopping
pathogens. These barriers are non-specific. They will stop all sorts of different pathogens from
entering the body.

Skin
The skin is the largest organ of your body. It acts as a physical barrier between pathogens and
your internal environment. Pathogens cannot enter the body through the skin unless there are
breaks (cuts or abrasions) in the surface.

The skin also produces a number of chemical barriers in the form of sebum and sweat. Sebum
is a type of oil produced by sebaceous glands. Sweat is produced by sweat glands. Both sebum
and sweat contain substances that helps to kill microorganisms before they enter the body.

Glands in the skin produce oils and sweat. Part of the function of these substances is to kill
pathogens before they enter the body.
Tears, mucus and saliva
in the body are easy entry points for pathogens. As a result, many of these areas are protected by
chemical barriers.

Tears protect your eyes. Tears contain an enzyme called lysozyme that breaks down the cell
wall of many bacteria. Tears also physically wash away pathogens from your eyes as you blink.
Lysozyme enzymes are also found in your saliva and mucus of your nose and throat.

Mucus and the wax in your ears are sticky. Invading pathogens that are not killed by enzymes in
the tears and sweat get trapped in these substances. Pathogens stuck in mucus are prevented from
entering further into the body. Cells the produce mucus line your nose, throat, digestive system
and other passages in your body. Very fine hairs called cilia also line parts of these passages.
Cilia move in wave-like ripples to move the mucus and the pathogens stuck in it away from
susceptible tissues, like your lungs. The mucus is either sneezed or coughed out of the body, or
swallowed.

Acids
Acids are produced by your stomach to aid in the digestion of food. These acids also act as a
chemical barrier by lowering the pH of the internal environment. This low pH will destroy many
pathogens.

The female reproductive tract also produces acids and mucus to prevent the entry of pathogens.

Urine flow
When you urinate, the flow of urine out of your body flushes pathogens out of the urinary tract
and bladder.

Natural flora
Not all bacteria are bad for us. Our natural floral is made up of beneficial bacteria that help
defend us against pathogens as well has helping our digestion.

Bacteria is all around us, all over us and inside us. The beneficial bacteria that grows on and
inside you are called your natural flora. They cover your skin and are found in your mouth,
stomach and intestines. Some types of your natural flora actively compete with pathogenic
microorganisms for space and resources. Other types help you to digest food or produce
vitamins.

Broad spectrum antibiotics cant tell the difference between good bacteria and bad bacteria
and will kill both pathogenic bacteria and some of your natural flora. This explain why you can
sometimes get an upset stomach or a fungal infection when youve been taking antibiotics.
Self and non-self
By Samantha Hopley

The immune system works by being able to tell the difference between the organisms own cells
(self) and pathogens (non-self). Virtually every cell in the body carries distinctive molecules on
their surface that identify the cell as self. These identifying molecules are called major
histocompatibility complex (MHC) proteins or MHC markers.

Like all proteins, MHC markers are controlled by genes in the DNA. In this case, however, a
large number of genes work together to produce the specific molecule, and each gene has a large
number of forms (alleles). This results in a huge number of possible combinations, which is why
it is very unlikely that two different individuals will have the same MHC markers (unless they
are identical twins).

MHC markers produced by the organism are the same on every cell that carries them and
identify the cell as self. MHC markers produced outside the body are called non-self.
Lymphocytes recognise and ignore cells that have the same MHC markers as they do.

Antigens
An antigen is any molecule that is recognised as non-self and triggers an immune response.
MHC markers from a foreign cell will act as an antigen, but so can parts or products of a cell or
pathogen.

The MHC markers on the tissues and cells of another person can also act as antigens during
organ or tissue transplants. The immune system of the detects the differences in the MHC
markers and attacks the tissues as foreign tissue and the transplant is rejected.

Differences between major histocompatibility complex molecules on the surface of cells are used
to distinguish self and non-self cells. Only cells with non-self markers will trigger an immune
response.
Antigen-presenting cells are immune cells that non-self cells or particles and move the antigens
to the surface of their own cells. The antigens bind to the cells MHC markers and are presented
(shown) to other cells of the immune system to help trigger an immune response.

The role of an antigen-presenting cell.

An antigen-presenting cell.

The antigen (red) binds to the MHC marker (yellow) on the outside of the cell, where it can be easily
detected by other cells of the immune system.
Allergens
In some people, an apparently harmless substance such as pollen or cat fur, can trigger an
immune response. In these cases, the antigens are known as allergens, and the response is called
an allergic reaction.

Human immune system

By Samantha Hopley

The lymphatic system

The lymphatic system is a key component of the human immune system. The lymphatic system
is made up of a network of tubes that are similar in structure to blood vessels. However, many
lymph vessels are blind-ended and do not form a connected loop like the

Lymph vessels are found in every part of the body except in the bones and the central nervous
system. Lymph vessels are usually located very close to blood capillaries.
Some of the main components of the lymphatic system. You do not need to learn the names of
specific lymph nodes. (Image by BruceBlaus)

The lymphatic system has many roles in the body, including

returning fluids and proteins that leak out of blood vessels back to the blood vascular
system; and
transporting lymphocytes (a group of white blood cells) around the body and providing a
place for them to mature.

The fluid inside the lymph vessels is called lymph. Lymph contains fats, proteins and a range of
white blood cells including lymphocytes and phagocytes. Unlike blood, lymph is not pumped
around the body by the heart. Instead, the movement of muscles pushes lymph along the lymph
vessels. One-way valves prevent backflow of lymph.
The contraction of muscles pushes lymph through lymph vessels. One-way valves prevent the
lymph from flowing backwards.

Lymph nodes are spread throughout the lymphatic system and store large numbers of white
blood cells. They act as filters for the lymph before it is returned to the blood. Lymph nodes trap
pathogens, cancerous cells and foreign particles to stop them entering the blood and to provide a
location for white blood cells to destroy anything harmful. When a pathogen is detected in the
lymph, nearby lymph nodes swell as white blood cells move to the area and replicate.

Other components of the immune system

Several other components are involved in the immune system.

Lymphocytes are the group of white blood cells found primarily in the lymph and lymph nodes.
They are produced in the bone marrow of the large bones in the body. Some lymphocytes move
to the thymus to mature, while others mature in the lymph nodes. Bone marrow and the thymus
are classified as primary lymphoid organs.

Secondary lymphoid organs include lymph nodes, spleen, tonsils and appendix. Lymphocytes
are activated in these tissues so that they can fight pathogens.
Second line of defence
If pathogens manage to get past the physical and chemical barriers of the body, they will
encounter the second line of defence against disease. The second line of defence is also non-
specific and innate. However, it is a cell-mediated response. That is, the second line of defence
involves cells of the immune system, but the cells do not specifically target particular pathogens.

Cells of the second line of defence

All the cells involved in the immune system are collectively called white blood cells (WBCs).
They are called white blood cells because they dont contain the red coloured protein called
haemoglobin, which red blood cells (RBCs) use to carry oxygen.

WBCs are generally larger than RBCs and contain a nucleus, which mature RBCs do not have.
Some of the key cells involved in the second line of defence are listed in the table below.

Table 10: Some of the main cells and molecules involved in the second line of defence against disease

Cell type Function

Platelet Blood cell fragments

Circulate in the blood
Responsible for blood clotting
Do not interact with pathogens

Mast cell Non-specific

Found in connective tissue rather than in blood or lymph
Produce and release histamine to trigger inflammation
Table 10: Some of the main cells and molecules involved in the second line of defence against disease

Cell type Function

Neutrophil Non-specific
Type of phagocyte
Most common type of leukocyte in the body
Matures in the blood
Primarily attacks bacteria
Release cytokines to attract other leukocytes
Release antimicrobial compounds to destroy membranes of
bacteria and fungi
Fast response

Macrophage Non-specific
Type of phagocyte
Circulate in the blood, but mature at site of infection
Release cytokines to attract other leukocytes
Antigen-presenting cell. Presents the pathogens antigen on its
own surface to help activate other leukocytes

Complement proteins Over 30 types

Circulate in the blood
Are activated by the presence of pathogens
Cause lysis of cellular pathogens

Natural killer (NK) cells Non-specific

Mature in the bone marrow and lymph nodes before entering
the blood stream
Attack virus-infected cells
Fast response
The inflammatory response
You may have noticed that sometimes the skin around a wound become red, hot and swollen.
These are the symptoms of the inflammatory response. Inflammation is triggered by damaged
cells, presence of a pathogen or the release of histamine from specialised white blood cells.

Consider the following scenario:

1. You step on a rusty nail and cut your foot. Bacteria or other pathogens enter the body.
2. release blood-clotting factors and help to close the wound to prevent more pathogens from
entering the body.
3. Damaged cells release which attract to the site of injury. near the injury release histamine.
Histamine causes capillaries to dilate and become leaky the endothelial cells of the capillaries
spread apart to allow WBCs and complement proteins to move out of the blood vessel and into
the infected tissue.
4. Neutrophils are activated and produce compounds that breakdown bacterial and fungal cell
walls. Neutrophils attract macrophages by releasing more cytokines. Complement proteins
break holes in the membranes and walls of the pathogens, causing them to
5. Macrophages are activated and also release cytokines to continue attracting WBCs. Activated
neutrophils and macrophages ingest (or eat) pathogens and foreign particles by a process
called
6. The process continues until all the pathogens have been destroyed and the wound is healed.

The inflammatory response

Immune system chemicals
Complement proteins

There are more than 30 complement proteins present in the blood. They circulate the body in an
inactivated (non-functioning) state but become active in the presence of antigens and other
surface molecules of some bacteria and parasites.

Activated proteins bind to the surface of cellular pathogens and punch holes in their membrane.
The pathogen cells lyse and die as a result. The remaining cell debris promotes inflammation and
attracts phagocytes.

Complement proteins are not very effective against viruses.

Note the spelling:

complement complete set

compliment a nice thing to say

Cytokines

Cytokines are a group of signalling chemicals that trigger a variety of immune system responses.

Causing more WBCs to be produced and mature.

Attracting WBCs to the site of infection.

Interferons are a group of cytokines that are produced by cells that are infected by a virus.
Interferons activate infected cells to break down viral nucleic acids and to prevent translation of
viral nucleic acids. This slows down the spread of the virus. Interferons also attract another type
of WBC, natural killer cells, which attack virus-infected and cancerous cells.

Fever
Another response of the second line of defence is a fever. A fever happens when the body core
temperature is increased above the normal homeostatic set point. The thermoregulatory centres
in the hypothalamus increase the set point (rarely above 41C) in response to the cytokines
released by WBCs.

The increased temperature of the body is linked to higher metabolic rates of the healthy cells,
which may speed up the repair of damaged tissue. Vasodilation and increased blood flow will
also help bring leukocytes to the site of infection.
The enzymes of many pathogens have an optimal temperature of around 37C, normal body
temperature. A core temperature higher than that may start to denature some pathogen enzymes
and help the immune system to destroy them.

Third line of defence: Humoral response

By Samantha Hopley

If the inflammatory response does not completely destroy the invading pathogen, the third line
of defence against disease comes into play. This level of the immune system is called adaptive
immunity. Adaptive immunity has the ability to change (or adapt) its function to respond to new
pathogens.

Adaptive immunity has two key characteristics that distinguish it from the innate immune
responses.

Specificity adaptive immunity has the ability to recognise new antigens and trigger a response
that targets that particular antigen to destroy the pathogen.
Immunological memory the cells involved in adaptive immunity remember the antigens that
they have been in contact with. If the same antigen is detected again, the response is faster and
stronger.

Specific immune responses tend to be slower than innate immune responses, especially when in
first contact with a new pathogen, because they are more complex.

Cells involved in adaptive immunity

The cells involved in the third line of defence are a group of white blood cells called
lymphocytes. Lymphocytes do circulate in the blood but are more commonly found in the
lymph.

Lymphocytes are further categorised into two groups; B lymphocytes and T lymphocytes. Both
B and T lymphocytes are produced in the bone marrow. However, B lymphocytes mature in the
bone marrow and T lymphocytes mature in the thymus.

B = bone marrow

T = thymus

Mature lymphocytes circulate through the blood until they reach secondary lymphoid organs,
such as lymph nodes. The lymphocytes then circulate through the lymphatic system until they
are activated by contact with a specific type of antigen. B and T cells that have not been
activated are called naive cells.

There are two different mechanisms of adaptive immunity. B lymphocytes are associated with
one, while T lymphocytes are associated with the other.

The humoral response

The humoral response involves B lymphocytes.

B lymphocytes and antibodies

B lymphocytes carry antibodies on their surface. Antibodies are also called immunoglobulins
and are molecules. Each antibody is made from four protein chains arranged in the shape of a
Y.

The main section of the antibody is made up the constant regions. This section is the same in
every antibody. The branched ends of the antibody are made up of the variable regions. The
variable regions are the binding sites for antigens. Different antigens will bind to different
variable regions on different antibodies as a result of the complementary 3D shape of both the
antigen and the antibody. Each antibody is able to bind to two antigens, but of the same type.
The Y-shaped structure of an antibody. (Image by Fvasconcellos, via Wikimedia Commons)

The large number of genes and alleles involved in creating the variable region of an antibody
means there that are over 15 million possible combinations. However, each individual B
lymphocyte only carries one type of antibody on its surface.

Antibodies interact with antigens in the following ways:

Neutralisation of toxins antibodies can bind to a toxin molecule, preventing it from

functioning.
Neutralisation of pathogens antibodies bind to antigen on the surface of pathogens,
preventing them from binding to host cells.
Precipitation antibodies bind to soluble antigen molecules, causing them to come out of
solution.
Agglutination antibodies bind to multiple pathogens, clumping them together, preventing
them from moving and making it easier for phagocytes to find them.

Antibody-Antigen complexes (when an antibody binds to a complementary antigen forming an

antibody-antigen complex) also trigger the activation of phagocytes and complement proteins.

Blood antigens

Red blood cells carry a number of antigens on their surface. Blood typing classifies blood
according to the presence or absence of these antigens.

Rhesus factor is one human blood typing system. While this system has many antigens involved,
we focus on the presence of one main antigen, called Rh factor. If a red blood cell has Rh factors,
the blood type is said to be rhesus positive.

If a rhesus negative mother, without the Rh factor, is pregnant with a rhesus positive child, there
is a risk that the mothers immune system may attack the foetus. Red blood cells may pass from
the foetus to the mother via the placenta during development, or during birth.

The mothers immune system identifies the babys Rh antigens as non-self and develops Rh
antibodies. If the mother becomes pregnant with a second rhesus positive baby, her immune
response will be faster and stronger, just like responding to a pathogen. This causes disease in the
baby, which can be fatal.

B lymphocytes in action
Due to the huge number of possible B lymphocytes, not all of them will be triggered by a
pathogen. However, when a pathogen does come in contact with a complementary B
lymphocyte, the cell is activated in a process called clonal selection. The B lymphocyte ingests
the pathogen and presents the antigens on its own MHC markers for other immune cells to
detect.

The activated B lymphocyte then starts to divide rapidly in a process called clonal expansion.
Two different types of cells are formed by the divisions.

Plasma cells

Most of the cloned cells into plasma cells. Plasma cells produce and secrete thousands of free
antibodies (not attached to a cell) per second. The antibodies are identical to those of the original
B lymphocyte.

The antibodies move through the blood and lymph and bind to the antigen. Antibodies can work
individually, in pairs or small groups to bind the pathogen. Most plasma cells live between a few
days and a couple of months.

A plasma cell secretes antibodies to help tag and trap a specific pathogen.

Memory B lymphocytes

The remaining cloned cells differentiate into memory B lymphocytes. Memory B cells carry the
specific antibody on their membrane surface. Again, these antibodies are identical to those of the
original B lymphocyte.

Memory B cells remain in the lymphatic system for years, even for the whole lifetime of the
organism. Their role is to reactive the immune response, by dividing into active plasma cells,
should the same pathogen invade the body again. The response to subsequent exposure to the
same pathogen is typically faster and much stronger than during the first exposure.
Immunity is the ability of an organism to fight a disease. Innate immunity is the non-specific
ability to fight disease that an individual is born with. Adaptive immunity, also called acquired
immunity, is learned and developed through exposure to specific pathogens. Adaptive immunity
can be passive or active.

Passive immunity
Passive immunity occurs when an individual is given antibodies that were produced by another
organism. The ready-made antibodies act in the same way as antibodies that would be produced
by the individuals own body.

Advantage: The immune response is much faster than a natural immune response.

Disadvantage: No memory B or T cells are produced. So, there is no immunological memory to

trigger an immune response if the pathogen is encountered again.

Natural passive immunity

Natural passive immunity occurs

when ready-made antibodies are passed from mother to child. This can happen via the placenta
during pregnancy and via breastmilk after birth. The presence of the maternal antibodies
protects the baby while it is developing its own adaptive immune system.

One health benefit of breastfeeding is that antibodies can be passed from the mother to the child.

Artificial passive immunity

Artificial passive immunity occurs when ready-made antibodies are injected into the individual
in the form of an antiserum. Antiserums are typically used during a highly virulent infection or
for treating toxins like the venom from a snake bite.

An antiserum of anti-Rh antibodies is given to rhesus negative mothers if there is a chance their
unborn child is rhesus positive. The ready-made antibodies destroy any rhesus antigens before
the mothers immune system has time to detect them. The mother does not produce memory B or
T cells and so there is no immune response to the foetus or any later pregnancies.

Active immunity
Active immunity involves the body producing its own antibodies in response to a specific
antigen.

Advantage: Memory B and T cells are produced, so immunity is long lasting.

Disadvantage: The response is slower. It takes time for the pathogen to come in contact with the
complementary T cell receptor and for the helper T cell to start the response cascade.

Natural active immunity

Natural active immunity is the normal humoral and cell-mediated responses to a primary
infection of a pathogen. The immune responses produce memory B and T cells. These memory
cells provide immunological memory and ensure a faster and stronger immune response during a
secondary infection.

Artificial active immunity

Artificial active immunity stimulates B and T lymphocyte responses without a primary
infection. Antigens are typically injected into the individual in the form of a vaccine. Vaccines
can contain either live but weakened (attenuated) pathogens or dead (inactivated) pathogens.
Subunit vaccines only contain part of the pathogen, sometimes just the isolated antigen.

Disadvantages:

Attenuated vaccines can cause a mild form of the disease in Even some healthy people may
experience o=some of the symptoms of the disease because their body is responding to the
vaccine as though it was the real pathogen.
Inactivated and subunit vaccines stimulate a weaker immune response than attenuated
vaccines. This means additional booster doses are required to achieve immunity.

Gaining immunity through the use of a vaccine is called vaccination.

Subunit vaccines often require booster doses to build the required number of antibodies to
achieve immunity.

Table 13: A comparison of passive and active immunity

Passive immunity Active immunity

(antibodies received) (exposed to antigens)

Achieved by passing maternal Achieved through immune
Natural antibodies to child through response to primary infection
placenta and/or breastmilk

Achieved through injection of Achieved through injection of

Artificial ready-made antibodies modified antigens (vaccine)
(antiserum)

Herd immunity

Not everyone can be vaccinated. People with weakened immune systems, such as newborn
babies, the very old or people taking medication to prevent transplant rejection, could react
poorly to a vaccine. And in a small number of cases, even healthy people may not produce
memory cells in response to a vaccine.

However, if enough people in the population have been vaccinated and are immune to a
particular pathogen, the spread of disease can be slowed or even stopped in that population. This
is because there are fewer people who will get sick and who can pass on the disease. The ability
of a population to protect its individuals is called herd immunity.

Click here to learn more about herd immunity.

Summarising immunity
Immune disorders and diseases
By Samantha Hopley

Like all body systems, sometimes things can go wrong in the immune system. There are three
main types of disorders that can occur in the immune system hypersensitivity,
immunodeficiency disorders and autoimmune diseases.

Hypersensitivity of the immune system

hyper = high

sensitivity = ability to detect stimuli (in this case antigens)

Hypersensitivity occurs when the immune system responds to antigens that are not harmful to
the body. In these cases, the response rather than the antigen, can cause disease.

There are four types of hypersensitivity that are classified according to the antigen and specific
responses involved. We will only look at Type I hypersensitivity.

Type I hypersensitivity
Type I hypersensitivity is also known as an allergy. The allergic reactions are in response to
harmless antigens, which are called allergens. Common examples of allergens include pollen,
animal fur, dust, insect bites or stings and foods such as peanuts.

The strength of the allergic reaction can vary between people from very mild hay fever to
anaphylaxis a life-threatening reaction that can cause swelling of the throat and respiratory
passages.

Initial interaction with the allergen causes the production of specific antibodies called
immunoglobulin E (IgE). IgE is produced by plasma cells and circulates in the bloodstream.
The constant region of IgE molecules bind to mast cells, which are common in the lungs, skin,
tongue and linings of the nose and digestive system.

If, when exposed to the same allergen again, the allergen binds to two IgE molecules at the same
time, the mast cell releases histamine and other substances. Histamine triggers the inflammatory
response and other allergic reactions. The response to the allergen is immediate because the
antibodies have already been produced and are already bound to the mast cells.

Antihistamines are medications that reduce allergic reactions by blocking histamine receptors.
The key steps in the process of allergic reactions. What other steps are missing from the
diagram?

Immunodeficiency
immuno = immune system

deficiency = lack of, failing

Immunodeficiency is the opposite to hypersensitivity. It occurs when the immune system does
not respond properly, or at all, to pathogens. There are two main categories of immunodeficiency
disorders primary and secondary.

Primary immunodeficiency disorders are congenital, which means the person is born with the
disorder. Primary immunodeficiency is usually caused by a genetic factor. Genetically inherited
severe combined immunodeficiency disease (SCID) is an example of a primary
immunodeficiency disorder. People suffering from SCID cannot produce functioning B or T
lymphocytes and are highly susceptible to all pathogens.

Secondary immunodeficiency disorders are acquired, or develop during the lifetime of the
person. Secondary immunodeficiency disorders are caused by environmental factors, such as
extreme stress, malnutrition or exposure to a pathogen.

HIV and AIDS an immunodeficiency disorder

Acquired immunodeficiency syndrome (AIDS) is an example of a secondary
immunodeficiency disorder. AIDS is caused by the human immunodeficiency virus (HIV).

HIV is a retrovirus. Retroviruses contain RNA, but are able to force the host cell to convert the
RNA into DNA. The viral DNA is then hidden in the host cells DNA. While the immune
system will fight the initial infection of HIV, some viruses will survive by hiding their DNA in
host cells.

HIV tends to target helper T lymphocytes. When the virus becomes active, the host cell starts to
produce copies of the HIV virus to go infect other cells. The destruction of helper T cells results
in a reduced functioning of both B and T lymphocytes.

The life cycle of the HIV virus. The cycle can pause after the viral DNA has integrated with the
host cells DNA for many years, delaying the development of AIDS.

The loss of functioning B and T lymphocytes impairs the adaptive immune system and results in
AIDS. People with AIDS are more susceptible to other pathogens. These additional infections
are usually the cause of death in AIDS patients.
There is no cure for HIV. However, antiretroviral medications can slow or even prevent the virus
from replicating and prevent AIDS from developing.

Autoimmune diseases
Sometimes the ability of the immune system to recognise self from non-self breaks down. When
this occurs B and T lymphocytes attack and destroy self cells in the same way that they attack
and destroy invading microorganisms. Conditions that develop because of this self-attack are
called autoimmune diseases.

Autoimmune diseases can affect the body general, or attack a specific organ or system. Some
autoimmune diseases and their features are listed in the table below.

Table 14: Some example of autoimmune diseases and their key characteristics

Autoimmune disease Symptoms Main site of action

Graves disease Increased production of thyroid Thyroid gland

hormone

Type 1 diabetes Inability to regulate blood Beta cells in the pancreas are
glucose levels damaged so they no longer
produce insulin

Rheumatoid arthritis Inflammation and damage to Joints, especially in the knees

joints and hands

Multiple sclerosis Myelin sheath around axons of Central nervous system

neurons is degraded, leads to
progressive paralysis

Systemic lupus erythematosus Fever, pain in joints, fatigue damage to heart, lungs, kidneys
and brain

Multiple sclerosis an autoimmune disease

The axons of many in the nervous system are insulated by a fatty substance called myelin. The
myelin sheath helps to protect the axon fibre as well as speeding up nerve impulses and
preventing interference of signals from other neurons.

Specialised cells that grow around the axons produce the myelin. In multiple sclerosis (MS),
plasma cells produce antibodies that break down proteins and lipids that make up the myelin
sheath. While many neurons in the peripheral nervous system are also myelinated, MS typically
only affects neurons in the central nervous system.

axons cannot pass the nerve impulse as quickly as insulated axons and the signals can get mixed
up between different neurons. Eventually the exposed axons become damaged.

MS destroys the myelin of neurons in the central nervous system. Exposed and damaged axons
cannot transmit nerve impulses as quickly or as clearly as myelinated axons.

Symptoms vary between people and can include double vision, numbness, muscle weakness,
difficulty with balance and coordination, memory problems, mood swings and seizures. There is
no cure for MS, but many symptoms can be managed with medication. The progression of the
disease can also be slowed with immunosuppressants to reduce the response of the immune
system.