MODULE 12

Module Title: Host Defense Mechanisms

Overview:
This module introduces students to ways in which the body protects itself from pathogens. It
deals with how our bodies fight pathogens in an attempt to prevent the infectious diseases that they
cause. Humans and animals have survived on earth for hundreds of thousands of years because they
have many built-in or naturally occurring mechanisms of defense against pathogens and the infectious
diseases that they cause. The ability of any animal to resist these invaders and recover from disease is
attributable to many complex interacting functions within the body.
The host defense mechanisms consist of three lines of defense. If the pathogen breaks through
the first line of defense, it will encounter the second line of defense which hopefully stop the pathogen.
If the pathogen manages to break through and escape the first two lines of defense, the third line of
defense will attack it. The first two lines of defense are nonspecific; these are ways in which the body
attempts to destroy all types of substances that are foreign to it, including pathogens. The third line of
defense, the immune system, is very specific. In the third line of defense, specific proteins called
antibodies are produced in the body in response to the presence of foreign substances called antigens.
The antibodies that are produced are very specific, in that they usually can only recognize and attach to
antigen that stimulated their production.

Module Objectives:
At the end of the module, the student should be able to:
1. Describe the three lines of defense used by the body to combat pathogen.
2. Differentiate between nonspecific- and specific- host defense mechanisms.
3. Identify ways by which the digestive system is protected from pathogens.
4. Describe how interferons function as host defense mechanisms.
5. Identify cellular and chemical responses to microbial invasion.
6. Describe signs and symptoms associated with inflammation.
7. Discuss the purposes of inflammatory response.
8. Describe the four steps in phagocytosis.
9. Identify ways in which pathogens escape destruction by phagocytes.
10. Differentiate between humoral and cell-mediated immunity.
11. Distinguish between active acquired- and artificial active acquired-immunity.
12. Distinguish between natural passive acquired- and artificial passive acquired-immunity.
13. Identify primary functions of the immune system.
14. Identify and describe the five immunoglobulin classes.
15. Identify four types of hypersensitivity reactions.
16. Describe the steps involved in allergic reactions.

Module Coverage:
A. Nonspecific Host Defense Mechanisms
B. Specific Host Defense Mechanisms

TOPIC A
Topic Title: Nonspecific Host Defense Mechanism
Introduction:
Nonspecific host defense mechanisms are general and serve to protect the body against many
harmful substances. One of the nonspecific host defenses is the innate, or inborn, resistance observed
among some species of animals and some persons who have a natural resistance to certain diseases.
Innate or inherited characteristics make these people and animals more resistant to some diseases than
to others. The exact factors that produce this innate resistance are not well understood but are probably
related to chemical, physiologic and temperature differences between the species as well as the general
state of physical and emotional health of the person and environmental factors that affect certain races,
but not others.
Our bodies are constantly in the process of defending us against microbial invaders. We
encounter pathogens and potential pathogens many times per day, everyday of our lives. Usually our
bodies successfully ward off or destroy the invading microbes. This topic introduces students to
nonspecific host defense mechanisms like mechanical and physical barriers to invasion, chemical factors,
microbial antagonism by our indigenous microflora, fever, the inflammatory response and phagocytic
white blood cells.

Topic Objectives:
At the end of the topic, the student should be able to:
1. Differentiate between nonspecific-and specific host defense mechanisms.
2. Describe the three lines of defense that the body uses to combat pathogens.
3. Identify ways by which the digestive system is protected from pathogens.
4. Describe how interferons function as host defense mechanism.
5. Identify cellular and chemical responses to microbial invasion.
6. Describe the major benefits of complement activation.
7. Identify signs and symptoms associated with inflammation.
8. Discuss the significance of inflammatory response.
9. Describe the steps involved in phagocytosis.
10. Identify ways by which pathogens escape destruction by phagocytosis.

Topic Contents:
 PPP
 Use the internet or print resources to research the benefits of fever in fighting infections and the
detrimental effects high fever or uncontrolled fever can have. Find out at what point physicians
recommend administering fever medicine to a child.
 Think about the steps that individuals can take to help preserve or enhance their own host
defense mechanisms. Indicate how the practice functions to maintain the body’s natural
defenses.
 Use the internet or print resources to research why the stomach is not “digested” by the
digestive enzymes and stomach acid that the stomach uses to protect itself from pathogens.
 Use the interne or print resources to research how smoking affects the body’s natural defenses
against pathogens and why smokers tend to have more respiratory infections.
 Use the internet or print resources to research the practice of testing blood for C-reactive
protein (CRP). What does this protein indicate? How useful is its measurement in predicting the
risk of cardiovascular disease?

Review of Key Points

 Host defense mechanisms are ways in which the body protects itself from pathogens
and infectious diseases.
 Certain human host defense mechanisms are classified as nonspecific, whereas others
are classified as specific. Nonspecific host defense mechanisms serve to protect the
 body from a variety of foreign substances or pathogens. Specific host defense
mechanisms are directed against a particular foreign substance or pathogen that has
entered the body.
 Another way to categorize host defense mechanisms is to divide them into first,
second, and third lines of defense. The first and second lines of defense are
nonspecific, whereas the third line of defense (the immune system) is specific.
 The first line of defense includes innate or inborn resistance; physical barriers such as
intact skin and intact mucous membranes; chemical, physiologic, and temperature
barriers; microbial antagonism by indigenous microflora; and overall nutritional status
and state of health.
 The dryness, acidity, and temperature of the skin inhibit colonization and growth of
pathogens, and perspiration flushes them away.
 Sticky mucous serves as a nonspecific host defense mechanism by trapping pathogens.
It also contains toxic substances, such as lysozyme, lactoferrin, and lactoperoxidase.
 The mucociliary covering on epithelial cells in the respiratory tract move trapped dust
and microbes upward toward the throat, where they are swallowed or expelled.
 Pathogens entering the gastrointestinal (GI) tract are often killed by digestive enzymes
or the acidity or alkalinity of different anatomical regions.
 Peristalsis and urination serve to remove pathogens from the GI tract and urinary tract,
respectively.
 The acidity of vaginal fluid usually inhibits colonization of the vagina by pathogens.
 When indigenous microflora prevent the establishment of arriving pathogens, it is
known as microbial antagonism. Colicin and other bacteriocins are proteins produced
by some bacteria to kill other bacteria.
 A decrease in the number of indigenous microflora at a particular anatomical site can
lead to an overgrowth of pathogens or opportunistic pathogens present at the site; this
is referred to as a superinfection.
 The second line of defense includes nonspecific cellular and chemical responses such
as inflammation, fever, interferon production, activation of the complement system,
iron balance, cellular secretions, activation of blood proteins, chemotaxis,
phagocytosis, neutralization of toxins, and the cleanup and repair of damaged tissues.
 Lactoferrin and transferrin are host molecules that tie up iron, thereby preventing
pathogens access to this essential mineral.
 Substances that stimulate the production of fever are called pyrogens or pyrogenic
substances.
 Fever is a nonspecific host defense mechanism that augments host defenses by
stimulating leukocytes to deploy and destroy invaders, reducing available free plasma
iron, and inducing the production of IL-1, which causes the proliferation, maturation,
and activation of lymphocytes in the immunologic response. Elevated body
temperatures also slow down the rate of growth of certain pathogens and kill especially
fastidious pathogens.
 Interferons are small, antiviral proteins produced by virus-infected cells. They interfere
 with viral multiplication and serve to limit viral infections.
 Interferons are not virus-specific, but they are host-specific.
 The 30 or so proteins of the complement system (collectively referred to as
complement components) interact with each other in a stepwise manner, known as the
complement cascade – a nonspecific host defense mechanism that assists in the
destruction of many different pathogens.
 Complement activation by immune complexes or other mechanisms aids in the
initiation and amplification of inflammation, attraction and activation of leukocytes,
lysis of bacteria and other foreign cells, and enhanced phagocytosis (opsonization).
 Opsonization is a process by which phagocytosis is facilitated by the deposition of
opsonins (e.g., antibodies or certain complement fragments) onto the surface of
particles or cells.
 Cytokines are chemical mediators that are released from many different types of cells
in the human body. They act as chemical messengers, enabling cells to communicate
with each other.
 The three major events in acute inflammation are vasodilation (an increase in the
diameter of capillaries), increased permeability of the capillaries, and escape of
leukocytes from the capillaries.
 Indications of inflammation include redness, heat, edema, and pain. Inflammation is
often accompanied by pus formation, and sometimes there is a loss of function of the
inflamed part of the body.
 The purposes of the inflammatory response are to localize an infection, prevent the
spread of microbial invaders, neutralize toxins, and aid in the repair of damaged tissue.
 Pyogenic means pus-producing; thus, pyogenic microbes are pus-producing microbes.
A purulent (pus-containing) inflammatory exudate is often referred to as pus.
 The primary functions of the lymphatic system include draining and circulating
intercellular fluids from tissues, transporting digested fats from the digestive system to
the blood, removing foreign matter and microbes from the lymph, and producing
antibodies and other factors to aid in the destruction and detoxification of any invading
microbes.
 The two most important groups of phagocytes in the human body - sometimes referred
to as “professional phagocytes” - are macrophages and neutrophils.
 Wandering macrophages leave the bloodstream and migrate to sites of infection and
other areas where they are needed. Fixed macrophages remain within tissues and
oregans.
 Phagocytes rid the body of unwanted or harmful substances, such as dead cells, unused
cellular secretions, dust, debris, and pathogens. After their recruitment to a particular
site by chemotactic substances, they attach to, surround, ingest, and digest the
unwanted or harmful substances.
 The four steps in phagocytosis are chemotaxis, attachment, ingestion, and digestion.
 The directed migration of phagocytes is called chemotaxis. It is caused by chemicals
referred to as chemotactic agents.
 During the ingestion step in phagocytosis, the particle becomes surrounded by a
 membrane. The membrane-bound vesicle is called a phagosome.
 The fusion of a lysosome and a phagosome results in a phagolysosome, within which
the ingested particle is digested.
 Some bacteria and protozoa are able to survive within phagocytes. For example,
Ehrlichia and Anaplasma spp. are intraleukocytic bacteria, able to live and multiply
within leukocytes.
 Leukopenia is a condition in which patients have an abnormally low number of
circulating leukocytes. Neutropenia is a condition in which patients have an
abnormally low number of circulating neutrophils.

TOPIC B
Topic Title: Specific Host Defense Mechanisms
Introduction:
This topic introduces students to the immune system which is the body’s third line of defense
against pathogens. The immune system functions for differentiating between “self” and “non-self” and
destroying that which is “non-self”. It involves very complex interactions among many different types of
cells and cellular secretions. Most immune responses involve the production of antibodies that
recognize, bind to and inactivate or destroy specific pathogens or their toxins. Immune responses
involving the production of antibodies are known as humoral immunity or antibody-mediated immunity.
There are also protective cell-mediated immune responses in which antibodies play only minor roles.
Cell-mediated immune responses involve a variety of cell types like macrophages and various types of
lymphocytes.
The lymphatic system is the site and source of most immune activity. The cells involved in the
immune responses originate in the bone marrow, from which most blood cells develop. Three lines of
lymphocytes - B lymphocytes (or B cells), T lymphocytes (or T calls) and natural killer (NK) cells – are
derived from lymphoid stem cells of bone marrow.
Immunity to an infectious disease maybe innate or acquired. If acquired, the immunity may have
been acquired actively (antibodies were actively produced by the person) or passively (the person
received antibodies that were produced by others). Both active- and passive -acquired immunity may
occur naturally or artificially.

Topic Objectives:
At the end of the topic, the student should be able to:
1. Differentiate between humoral and cell-mediated immunity.
2. Distinguish between active- and passive- acquired immunity.
3. Distinguish between natural- and artificial- active acquired immunity.
4. Distinguish between natural- and artificial- passive acquired immunity.
5. Explain the importance of the immune system.
6. Identify the five types of immunoglobulins.
7. Identify four types of hypersensitivity reactions.
8. Describe the steps involved in allergic reactions.
9. Explain positive response to a tuberculosis skin test.

Topic Contents:
 PPP
 Use the internet or print resources to research the ways in which breastfeeding benefits infants,
especially in the area of immunity. What diseases may be reduced in incidence from
breastfeeding? How long after birth should infants be breastfed?
 Use the internet or print resources to research the progress of HIV infection in an infected
individual. How does HIV affect the TH cell population over time?
 Use the internet or print resources to research how ELISAs (enzyme-linked immunosorbent
assays) work.
 Use the internet or print resources to research how antihistamines work to relieve allergy
symptoms. Why is it older types of histamines can cause drowsiness and why are the newer
drugs better in this regard?

Review of Key Points

 Host defense mechanisms are ways in which the body protects itself from pathogens
and infectious diseases.
 Certain human host defense mechanisms are classified as nonspecific, whereas others
are classified as specific. Nonspecific host defense mechanisms serve to protect the
body from a variety of foreign substances or pathogens. Specific host defense
mechanisms are directed against a particular foreign substance or pathogen that has
entered the body.
 Another way to categorize host defense mechanisms is to divide them into first,
second, and third lines of defense. The first and second lines of defense are
nonspecific, whereas the third line of defense (the immune system) is specific.
 The first line of defense includes innate or inborn resistance; physical barriers such as
intact skin and intact mucous membranes; chemical, physiologic, and temperature
barriers; microbial antagonism by indigenous microflora; and overall nutritional status
and state of health.
 The dryness, acidity, and temperature of the skin inhibit colonization and growth of
pathogens, and perspiration flushes them away.
 Sticky mucous serves as a nonspecific host defense mechanism by trapping pathogens.
It also contains toxic substances, such as lysozyme, lactoferrin, and lactoperoxidase.
 The mucociliary covering on epithelial cells in the respiratory tract move trapped dust
and microbes upward toward the throat, where they are swallowed or expelled.
 Pathogens entering the gastrointestinal (GI) tract are often killed by digestive enzymes
 or the acidity or alkalinity of different anatomical regions.
 Peristalsis and urination serve to remove pathogens from the GI tract and urinary tract,
respectively.
 The acidity of vaginal fluid usually inhibits colonization of the vagina by pathogens.
 When indigenous microflora prevent the establishment of arriving pathogens, it is
known as microbial antagonism. Colicin and other bacteriocins are proteins produced
by some bacteria to kill other bacteria.
 A decrease in the number of indigenous microflora at a particular anatomical site can
lead to an overgrowth of pathogens or opportunistic pathogens present at the site; this
is referred to as a superinfection.
 The second line of defense includes nonspecific cellular and chemical responses such
as inflammation, fever, interferon production, activation of the complement system,
iron balance, cellular secretions, activation of blood proteins, chemotaxis,
phagocytosis, neutralization of toxins, and the cleanup and repair of damaged tissues.
 Lactoferrin and transferrin are host molecules that tie up iron, thereby preventing
pathogens access to this essential mineral.
 Substances that stimulate the production of fever are called pyrogens or pyrogenic
substances.
 Fever is a nonspecific host defense mechanism that augments host defenses by
stimulating leukocytes to deploy and destroy invaders, reducing available free plasma
iron, and inducing the production of IL-1, which causes the proliferation, maturation,
and activation of lymphocytes in the immunologic response. Elevated body
temperatures also slow down the rate of growth of certain pathogens and kill especially
fastidious pathogens.
 Interferons are small, antiviral proteins produced by virus-infected cells. They interfere
with viral multiplication and serve to limit viral infections.
 Interferons are not virus-specific, but they are host-specific.
 The 30 or so proteins of the complement system (collectively referred to as
complement components) interact with each other in a stepwise manner, known as the
complement cascade – a nonspecific host defense mechanism that assists in the
destruction of many different pathogens.
 Complement activation by immune complexes or other mechanisms aids in the
initiation and amplification of inflammation, attraction and activation of leukocytes,
lysis of bacteria and other foreign cells, and enhanced phagocytosis (opsonization).
 Opsonization is a process by which phagocytosis is facilitated by the deposition of
opsonins (e.g., antibodies or certain complement fragments) onto the surface of
particles or cells.
 Cytokines are chemical mediators that are released from many different types of cells
in the human body. They act as chemical messengers, enabling cells to communicate
with each other.
 The three major events in acute inflammation are vasodilation (an increase in the
diameter of capillaries), increased permeability of the capillaries, and escape of
 leukocytes from the capillaries.
 Indications of inflammation include redness, heat, edema, and pain. Inflammation is
often accompanied by pus formation, and sometimes there is a loss of function of the
inflamed part of the body.
 The purposes of the inflammatory response are to localize an infection, prevent the
spread of microbial invaders, neutralize toxins, and aid in the repair of damaged tissue.
 Pyogenic means pus-producing; thus, pyogenic microbes are pus-producing microbes.
A purulent (pus-containing) inflammatory exudate is often referred to as pus.
 The primary functions of the lymphatic system include draining and circulating
intercellular fluids from tissues, transporting digested fats from the digestive system to
the blood, removing foreign matter and microbes from the lymph, and producing
antibodies and other factors to aid in the destruction and detoxification of any invading
microbes.
 The two most important groups of phagocytes in the human body - sometimes referred
to as “professional phagocytes” - are macrophages and neutrophils.
 Wandering macrophages leave the bloodstream and migrate to sites of infection and
other areas where they are needed. Fixed macrophages remain within tissues and
oregans.
 Phagocytes rid the body of unwanted or harmful substances, such as dead cells, unused
cellular secretions, dust, debris, and pathogens. After their recruitment to a particular
site by chemotactic substances, they attach to, surround, ingest, and digest the
unwanted or harmful substances.
 The four steps in phagocytosis are chemotaxis, attachment, ingestion, and digestion.
 The directed migration of phagocytes is called chemotaxis. It is caused by chemicals
referred to as chemotactic agents.
 During the ingestion step in phagocytosis, the particle becomes surrounded by a
membrane. The membrane-bound vesicle is called a phagosome.
 The fusion of a lysosome and a phagosome results in a phagolysosome, within which
the ingested particle is digested.
 Some bacteria and protozoa are able to survive within phagocytes. For example,
Ehrlichia and Anaplasma spp. are intraleukocytic bacteria, able to live and multiply
within leukocytes.
 Leukopenia is a condition in which patients have an abnormally low number of
circulating leukocytes. Neutropenia is a condition in which patients have an
abnormally low number of circulating neutrophils.

Learning Activities
Matching Question
_____ 1. These are chemical mediators that enable cells A. bacteriocins
to communicate with each other. B. chemotactic agents
_____ 2. When attached to the surface of particles or cells, C. complement
 ____________ can facilitate phagocytosis. fragments
_____ 3. Proteins produced by one bacterial species that kill other D. cytokines
bacterial species are known as __________. E. interferons
_____ 4. These are small, antiviral proteins that are produced by
virus-infected cells.
_____ 5. These attract leukocytes to sites where they are needed.
_____ 6. A ______________ is membrane -bound vesicle containing A. chemotaxis
only an ingested object. B. opsonization
_____ 7. The directed migration of leukocytes is known as _______. C. phagolysosome
_____ 8. A ___________ is a membrane -bound vesicle containing D. phagosome
an ingested object and digestive enzymes. E. vasodilation
_____ 9. It is an increase in the diameter of blood cells.
_____ 10. It is a process by which phagocytosis is facilitated by the
deposition of antibodies or complement fragments onto the
surface of particles or cells.

True/False Questions:
_____ 1. Lactoferrin and transferrin are proteins that bind iron, and therefore deprive pathogens of this
essential nutrient.
_____ 2. Pyrogenic substances cause the production of pus.
_____ 3. Interferons are virus-specific but are not species-specific.
_____ 4. Complement is the name of a single plasma protein that “complements” the actions of the
immune system.
_____ 5. Eosinophils are much better phagocytes than neutrophils.
_____ 6. Phagocytes can only ingest objects that they are able to attach to.
_____ 7. The terms “leukemia” and “leukopenia” both refer to an abnormally low number of circulating
leukocytes.
_____ 8. Ehrlichia spp. are intraleukocytic pathogens.
_____ 9. Chemokines are chemotactic agents that are produced by various cells of the human body.
_____ 10. Perspiring, swallowing and urinating are all considered to be part of the first line of defense.

Answers:
Matching Questions True/False Questions
1. D 1. True
2. C 2. False (pyrogenic substances cause the production of fever; pyogenic
3. A substances cause the production of pus)
4. E 3. False (the reverse is true)
5. B 4. False (complement is not a single plasma protein; the term refers to a
6. D group of approximately 30 different proteins found in the blood)
7. A 5. False (the reverse is true)
8. C 6. True
9. E 7. False (leukemia is a type of cancer, in which there is a high number of
10 B abnormal leukocytes in the blood; leukopenia refers to an
Abnormally low number of circulating leukocytes)
8. True
9. True
10. True
Learning Activities:
Matching Questions:
_____ 1. The immunity that fetus acquires in utero, as a A. artificial active acquired
result of receiving protective antibodies from immunity
mother’s blood is called _____________. B. artificial active acquired
_____ 2. The immunity that someone acquires as a result of immunity
an infection is called _________. C. natural active acquired
_____ 3. The immunity that someone acquires after receiving immunity
a shot of gamma globulin is called ___________. D. natural passive acquired
_____ 4. The immunity that someone acquires as a result of immunity
receiving a vaccine is called ___________.
_____ 5. The immunity that an infant acquires as a result of
breast-feeding is called ___________.
_____ 6. These are also known as immunogens. A. antibodies
_____ 7. Molecules referred to as antigenic determinants are B. antigens
also known as _____________. C. epitopes
_____ 8. They belong to a class of proteins called immunoglobulins. D. haptens
_____ 9. Small molecules called _____________ are antigenic only E. immune complexes
when they are coupled with large carrier molecules such
as proteins.
_____ 10. They initiate type 111 hypersensitivity reactions.

True/False Questions:
_____ 1. Technically speaking, all antibodies are immunoglobulins, but not all immunoglobulins are
antibodies.
_____ 2. IgG is the largest of the five classes of immunoglobulins.
_____ 3. The primary function of NK and K cells is to kill foreign cells, virus-infected cells and tumor cells.
_____ 4. Common allergic reactions, such as those experienced in hat fever, are also known as
anaphylactic reactions.
_____ 5. IgM antibodies and basophils play major roles in anaphylactic reactions.
_____ 6. The penicillin molecule is an example of a hapten.
_____ 7. Autoimmune diseases are always the result of type 11 hypersensitivity reactions.
_____ 8. With respect to a particular pathogen, detection of antibodies in a patient’s blood provides
better proof of current infection than does detection of antigen.
_____ 9. If a person’s immune system is not functioning properly, that person is said to be
immunocompetent.
_____ 10. An IgM molecule can bind to ten antigenic determinants, but they would all have to be the
antigenic determinant that stimulated the production of IgM molecule

Answers:
Matching Questions True /False Questions
1. D 1. True
2. C 2. False (IgM is the largest of the five classes of immunoglobulins)
3. B 3. True
4. A 4. True
5. D 5. False (IgE antibodies and basophils play major roles in anaphylactic
6. B reactions)
7. C 6. True
8. A 7. False (autoimmune diseases may be the result of type 11, type 111 or
9. D type 1V hypersensitivity reactions)
10. E 8. False (the reverse is true)
9. False (if a person’s immune system is not functioning properly, the
person is said to be immunosuppressed, immune depressed or
immunocompromised)

Reference:
Engelkirk, P. G. and G. R. W. Burton. 2011. Burton’s Microbiology for the Health Sciences. Lippincott
Williams & Wilkins. Baltimore, MD, 398 pp.