Lymphatic system

The lymphatic system is an extensive drainage network that helps keep bodily fluid levels in
balance and defends the body against infections. It is made up of a complex network of lymphoid
organs, lymph nodes, lymph ducts, lymph tissues, lymph capillaries and a network of lymphatic
vessels that carry lymph and other substances throughout the body.

The spleen, which is located in the upper left part of the abdomen under the ribcage, works as
part of the lymphatic system to protect the body, clearing worn out red blood cells and other
foreign bodies from the bloodstream to help fight off infection

FUNCTIONS

1. Fluid balance. The lymphatic vessels transport back to the blood fluids that have escaped
from the blood vascular system. The remaining fluid enters the lymphatic capillaries, where the
fluid is called lymph.

2. Fat absorption. The lymphatic system absorbs fats and other substances from the digestive
tract. Lacteals are special lymphatic vessels located in the lining of the small intestine. Fats enter
the lacteals and pass through the lymphatic vessels to the venous circulation.

3. House of the body’s defenses. The lymphoid tissues and organs house phagocytic cells
and lymphocytes, which play essential roles in body defense and resistance to disease.

Anatomy of the Lymphatic System

two semi-independent parts:
(1) a meandering network of lymphatic vessels and
(2) various lymphoid tissues and organs scattered throughout the body.

Lymphatic Vessels
- form an elaborate drainage system that picks up excess tissue fluid, now called lymph

• Lymphatics. The lymphatic vessels, also called lymphatics, form a one-way system,
and lymph flows only toward the heart.
• Lymph capillaries. The microscopic, blind-ended lymph capillaries weave between
the tissue cells and blood capillaries in the loose connective tissues of the body and
absorb the leaked fluid.
• Minivalves. The edges of the endothelial cells forming their walls loosely overlap one
another, forming flaplike mini-valves that act as one-way swinging doors
• Lymphatic collecting vessels. Lymph is transported from the lymph capillaries
through successively larger lymphatic vessels referred to as lymphatic collecting
vessels, until it is finally returned to the venous system through one of the two large
 ducts in the thoracic region.
• Right lymphatic duct. The right lymphatic duct drains the lymph from the right arm
and the right side of the head and thorax.
• Thoracic duct. The large thoracic duct receives lymph from the rest of the body; both
ducts empty the lymph into the subclavian vein on their own side of the body.

Lymph Nodes
- help protect the body by removing foreign material such as bacteria and tumor cells from the
lymphatic stream and by producing lymphocytes that function in the immune response

Macrophages
- engulf and destroy bacteria, viruses, and other foreign substances in the lymph before it is
returned to the blood.
Lymphocytes.
- lymphocytes (a type of white blood cell) respond to foreign substances in the lymphatic
stream.
Size and shape.
- most are kidney-shaped, less than 1 inch (approximately 2.5 cm) long, and “buried” in the
connective tissue that surrounds them.
Trabeculae
- Each node is surrounded by a fibrous capsule from which strands called trabeculae extend
inward to divide the node into a number of compartments.
Cortex
- The outer part of the node, the cortex, contains collections of lymphocytes called follicles,
many of which have dark-staining centers called germinal centers.
Plasma cells
- These centers enlarge when specific lymphocytes (the B cells) are generating daughter cells
called plasma cells, which release antibodies.
T cells
- circulate continuously between the blood, lymph nodes and lymphatic stream, performing
their surveillance role.
Medulla
- Phagocytic macrophages are located in the central medulla of the lymph node.
Afferent lymphatic vessels
- Lymph enters the convex side of a lymph node through the afferent lymphatic vessels.
Efferent lymphatic vessels
- It then flows through a number of sinuses that cut through the lymph node and finally exits
from the node at its indented region, the hilum, via the efferent lymphatic vessels.

Other Lymphoid Organs

Lymph nodes are just one of the many types of lymphoid organs in the body. Others are the
spleen, thymus gland, tonsils, and Peyer’s patches of the intestine, as well as bits of lymphoid
tissue scattered in the epithelial and connective tissues.

Spleen
The spleen is a soft, blood-rich organ that filters blood.
Location. The spleen is located on the left side of the abdominal cavity, just beneath the
diaphragm, and curls around the anterior aspect of the stomach.
Function. Instead of filtering lymph, the spleen filters and cleanses the blood of bacteria, viruses,
and other debris; it provides a site for lymphocyte proliferation and immune surveillance, but its
most important function is to destroy worn-out red blood cells and return some of their
breakdown products to the liver.
Fetal spleen. In the fetus, the spleen is an important hematopoietic (blood cell-forming) site, but
as a rule only lymphocytes are produced by the adult spleen.

Thymus Gland

The thymus gland functions at peak levels only during youth.

• Location. The thymus gland is a lymphoid mass found low in the throat overlying the
heart.
• Functions. The thymus gland produces thymosin and others that function in the
programming of certain lymphocytes so they can carry out their protective roles in the
body.

Tonsils
The tonsils are small masses of lymphoid tissue that ring the pharynx (the throat), where they are
found in the mucosa.
• Function. Their job is to trap and remove any bacteria or other foreign pathogens
entering the throat.
• Tonsilitis. They carry out this function so efficiently that sometimes they become
congested with bacteria and become red, swollen, and sore, a condition called
tonsilitis.

Peyer’s Patches
Peyer’s patches resemble the look of the tonsils.

• Location. Peyer’s patches are found in the wall of the small intestine.
• Function. The macrophages of Peyer’s patches are in an ideal position to capture and
destroy bacteria (always present in tremendous numbers in the intestine), thereby
preventing them from penetrating the intestinal wall.
• Mucosa-associated lymphatic tissue. Peyer’s patches and the tonsils are part of the
collection of small lymphoid tissues referred to as mucosa-associated lymphatic tissue
(MALT); MALT acts as a sentinel to protect the upper respiratory and digestive tracts
from the never-ending attacks of foreign matter entering those cavities.

Physiology of the Lymphatic System

Every second of the day, an army of hostile bacteria, viruses, and fungi swarms on our skin and
invades our inner passageways- yet we stay amazingly healthy most of the time, thanks to our
body defense, the lymphatic system.

Body Defenses
The body’s defenders against these tiny but mighty enemies are two systems, simply called the
innate and the adaptive defense systems; together, they make up the immune system.

Innate Defense System

The innate defense system, also called the non-specific defense system, responds immediately to
protect the body from all foreign substances, whatever they are.
• Definition. The term innate or nonspecific body defense refers to the mechanical barriers
that cover body surfaces and to the cells and chemicals that act on the initial
battlefronts to protect the body from invading pathogens.

Surface Membrane Barriers

The body’s first line of defense against the invasion of disease-causing microorganisms is the
skin and mucous membranes.
• Skin. As long as the skin is unbroken, its keratinized epidermis is a strong physical
barrier to most microorganisms that swarm on the skin.
• Mucous membranes. Intact mucous membranes provide similar mechanical barriers
within the body; recall that mucous membranes line all body cavities open to the
exterior: the digestive, respiratory, urinary, and reproductive tracts.
• Protective secretions. Besides serving as physical barriers, these membranes produce a
variety of protective secretion: (1) the acidic pH of skin secretions (pH of 3-5)
inhibits bacterial growth, and sebum contains chemicals that are toxic to bacteria;
vaginal secretions of adult females are also very acidic; (2) the stomach mucosa
secretes hydrochloric acid and protein-digesting enzymes, both kill pathogens; (3)
Saliva and lacrimal fluid contain lysozyme, an enzyme that destroys bacteria; and (4)
sticky mucus traps many microorganisms that enter digestive and respiratory
passageways.
• Structural modifications. Mucus-coated hairs inside the nasal cavity trap inhaled
particles, and the respiratory tract mucosa is ciliated; the cilia sweep dust- and bacteria
laden mucus superiorly toward the mouth, preventing it from entering the lungs.
• Damage. Although surface barriers are quite effective, they are broken from time to
time by small nicks and cuts resulting, for example from brushing the teeth or shaving,
so microorganisms invade deeper tissues, and then the internal innate mechanisms
come into play.

Internal Defenses: Cells and Chemicals

For its second line of defense, the body uses an enormous number of cells and chemicals to
protect itself

• Phagocytes. Pathogens that make it through the mechanical barriers are confronted by
phagocytes, such as a macrophage or neutrophil, engulfs a foreign particle much the way an
amoeba ingests a food particle; flowing cytoplasmic extensions bind to the particle and then pull
it inside, enclosing it in a vacuole; the vacuole is then fused with the enzymatic contents of a
lysosome, and its contents are broken down, or digested.
•Natural killer cells. Natural killer cells, which “police” the body in blood and lymph, are a
unique group of lymphocytes that can lyse and kill cancer cells and virus-infected body cells well
before the adaptive arm of the immune system is enlisted to fight; they act spontaneously against
any such target by recognizing certain sugars on the “intruder’s” surface as well as their lack of
certain “self” cell surface molecules; they attack the target cell’s membrane and release a lytic
chemical called perforins.

•Inflammatory response. The inflammatory response is a nonspecific response that is triggered

whenever body tissues are injured; the four most common indicators of an acute inflammation are
redness, heat, swelling, and pain.

•Antimicrobial proteins. A variety of antimicrobial proteins enhances the innate defenses: (1)
Complement is a group of plasma proteins that lyses microorganisms, enhances phagocytosis by
opsonization, and intensifies inflammatory response; (2) Interferons are proteins released by
virus-infected cells that protect uninfected tissue cells from viral takeover and mobilize immune
system; (3) Urine has a normally acidic pH that inhibits bacterial growth, and cleanses the lower
urinary tract as it flushes from the body.

• Fever. Fever, or abnormally high body temperature, is a systemic response to invading

microorganisms; normally the body’s “thermostat” is set at approximately 37 degrees Celsius, but
it can be reset upward in response to pyrogens, chemicals secreted by white blood cells and
macrophages exposed to foreign cells or substances in the body.

The Inflammatory Process

The inflammatory sequence of events are described below.
[1]• Chemical alarm. When cells are injured, they release inflammatory chemicals,
including histamine and kinins.
[2]• Body’s reaction. The release of histamine, kinins, and other chemicals cause blood
vessels in the involved area to dilate and capillaries to become leaky, activate pain
receptors, and attract phagocytes and white blood cells to the area (chemotaxis).
[3]• Redness and heat. Dilatation of the blood vessels increases the blood flow to the area,
accounting for the redness and heat observed.
[4]• Edema and pain. Increased permeability of the capillaries allows plasma to leak from
the blood into the tissue spaces, causing local edema (swelling) that also activates pain
receptors in the area.
[5]• Limitation of joint movement. If the swollen, painful area is a joint, its function may
be impaired temporarily, which forces the injured part to rest, which aids healing.

Adaptive Body Defenses

Sometimes referred to as the body’s third line of defense, the specific defense system is a
functional system that recognizes foreign molecules (antigens) and acts to inactivate or destroy
them.
• Important aspects. There are three important aspects of the adaptive defense: (1) It is
antigen-specific, it recognizes and acts against particular pathogens or foreign
substances; (2) It is systemic, immunity is not restricted to the initial infection site;
(3)It has “memory”, it recognizes and mounts even stronger attacks on previously
 encountered pathogens.
• Classifications. Humoral immunity, also called antibody-mediated immunity, is
provided by antibodies present in the body’s “humors”, or fluids. while cellular
immunity or cell-mediated immunity involves lymphocytes that defend the body, as
the protective factor is living cells.

Antigens

An antigen (Ag) is any substance capable of mobilizing our immune system and provoking an
immune response.
• Foreign intruders. An almost limitless variety of substances can act as antigens,
including virtually all foreign proteins, nucleic acids, many large carbohydrates, and
some lipids; proteins are the strongest antigens.

• Self-antigens. Our own cells are richly studded with a variety of protein molecules or
self-antigens; although these self-antigens do not trigger an immune response in us,
they are strongly antigenic to other people.

• Hapten. As a rule, small molecules are not antigenic, but when they link up with our
own proteins, the immune system may recognize the combination as foreign and
mount an attack that is harmful rather than protective; in such cases, the troublesome
small molecule is called a hapten or incomplete antigen.

Cells of the Adaptive Defense System: An Overview

The crucial cells of the adaptive system are lymphocytes and

macrophages. Lymphocytes

Lymphocytes exist in two major “flavors”: the B lymphocytes, or B cells, and the T lymphocytes,
or T cells.

•B lymphocytes. The B lymphocytes, or B cells, produce antibodies and oversee humoral

immunity.
• T lymphocytes. The T lymphocytes, or T cells, are non-antibody-producing
lymphocytes that constitute the cell-mediated arm of the adaptive defense system.
• Origin. Like all blood cells, lymphocytes originate from hemocytoblasts in red bone
marrow.
• Immunocompetent. Whether a given lymphocyte matures into a B cell or T cell
depends on where in the body it becomes immunocompetent, that is, capable of
responding to a specific antigen by binding to it.
• Maturation of T cells. T cells arise from lymphocytes that migrate to the thymus, where
they undergo a maturation process of 2 to 3 days, directed by thymic hormones; only
those maturing T cells with the sharpest ability to identify foreign antigens survive.
• Self-tolerance. Lymphocytes capable of binding strongly with self-antigens (and of
acting against body cells) are vigorously weeded out and destroyed; thus, the
development of self-tolerance for the body’s own cells is an essential part of a
lymphocyte’s “education”.
 • Maturation of B cell. B cells develop immunocompetence in bone marrow, but less is
known about the factors that regulate B cell maturation.
• Migration. After they become immunocompetent, both T cells and B cells migrate to
the lymph nodes and spleen (and loose connective tissues), where their encounters
with antigens will occur.
• Full maturation. Then, when the lymphocytes bind with recognized antigens, they
complete their differentiation into fully mature T cells and B cells.

Macrophages
Macrophages, which also become largely distributed throughout the lymphoid organs and
connective tissues, arise from monocytes, formed in the bone marrow.
• Major role. A major role of macrophages in the innate defense system is to engulf
foreign particles and rid them from the area; they also present fragments of those
antigens, like signal flags, on their own surfaces, where they can be recognized by
immunocompetent T cells.
• Cytokines. Macrophages also secrete cytokines proteins that are important in the
immune response.
• Killer macrophages. Activated T cells, in turn, release chemicals that causes
macrophages to become insatiable phagocytes, or killer macrophages.
• Location. Macrophages tend to remain fixed in the lymphoid organs, but lymphocytes,
especially T cells circulate continuously through the body.

Humoral (Antibody Mediated) Immune Response

An immunocompetent but as yet immature B lymphocyte is stimulated to complete its
development, when antigens bind to its surface receptors.
• Clonal selection. An immunocompetent but as yet immature B lymphocyte is
stimulated to complete its development (into a fully mature B cell) when antigens bind
to its surface receptors; this binding event sensitizes, or activates, the lymphocyte to
“switch on”, and undergo clonal selection.
• Primary humoral response. The resulting family of identical cells descended from
the same ancestor cell is called a clone, and clone formation is the primary humoral
response to that antigen.
• Plasma cells. Most of the B cell clone members, or descendants, become plasma cells.
• Antibody production. After an initial lag period, these antibody-producing
“factories” swing into action, producing the same highly specific antibodies at an
unbelievable rate of about 2000 antibody molecules per second.
• Life span. This flurry of activity lasts only 4 to 5 days, then the plasma cells begin to
die; antibody levels in the blood during this primary response peak about 10 days after
the response begins and then slowly decline.
• Memory cells. B cell clone members that do not become plasma cells become long
lived memory cells capable of responding to the same antigen at later meetings with it;
memory cells are responsible for the immunological memory, and these later immune
responses called secondary humoral responses, are produced much faster, are more
prolonged, and are more effective than the events of the primary response because all
the preparations for this attack have already been made.
Active and Passive Humoral Immunity

There are two kinds of humoral immunity: active and passive humoral immunity.

• Active immunity. When your B cells encounter antigen and produce antibodies
against them, you are exhibiting active immunity; active immunity is (1) naturally
acquired during bacterial and viral infections, and (2) artificially acquired when we
receive vaccines.
• Vaccines. We receive two benefits from vaccines: (1) they spare us most of the signs
and symptoms of the disease that would otherwise occur during the primary response
and (2) the weakened antigens are still able to stimulate antibody production and
promote immunological memory.
• Booster shots. So-called booster shots, which may intensify the immune response at
later meetings with the same antigen, are also available.
• Passive immunity. In passive immunity, the antibodies are obtained from the serum of
an immune human or animal donor; as a result, the B cells are not challenged by the
antigen, immunological memory does not occur, and the temporary protection
provided by the “borrowed antibodies” ends when they naturally degrade in the body.
• Natural passive immunity. Passive immunity is conferred naturally on a fetus when
the mother’s antibodies cross the placenta and enter fetal circulation, and after birth
during breastfeeding.
• Artificial passive immunity. Passive immunity is artificially conferred when one
receives immune serum or gamma globulin.
• Monoclonal antibodies. Monoclonal antibodies prepared commercially for use in
research are produced by descendants of a single cell and are pure antibody
preparations that exhibit specificity for one, and only one, antigen.

Antibodies

Antibodies, also referred to as immunoglobulins, or Igs, constitute the gamma globulin part of
blood proteins.
• Antibodies. Antibodies are soluble proteins secreted by activated B cells or by their
plasma-cell offspring in response to an antigen and they are capable of binding
specifically with that antigen.
• Basic antibody structure. Regardless of its class, every antibody has a basic structure
consisting of four amino acid (polypeptide) chains linked together by disulfide (sulfur
to-sulfur) bonds.
• Heavy chains. Two of the four chains are identical and contain approximately 400
amino acids each.
• Light chains. The two other chains, the light chains, are also identical to each other
but are only about half as long as the heavy chains.

• Antibody classes. There are five major immunogloblin classes- IgM, IgA, IgD, IgG, and
IgE.
• IgD. IgD is virtually always attached to B cell and is believed to be the cell surface
receptor of immunocompetent B cell; and it is also important in activation of B cell.
• IgM. IgM is attached to B cell and free in plasma; when it is bound to the B cell
 membrane, it serves as an antigen receptor; first Ig class released to plasma by
plasma cells during primary response; it is also a potent agglutinating agent and
fixes complement.
• IgG. IgG is the most abundant antibody in plasma, representing 75% to 85% of
circulating antibodies; it is the main antibody of both primary and secondary
responses; crosses the placenta and provides passive immunity to fetus; fixes
complement.
• IgA. Some are found in plasma; dimer in secretions such as saliva, tears, intestinal
juice, and milk; it bathes and protects mucosal surfaces from attachment of pathogens.
• IgE. It is secreted by plasma cells in skin, mucosae of gastrointestinal and respiratory
tracts, and tonsils; it binds to mast cells and basophils and triggers release of histamine
and other chemicals that mediate inflammation and certain allergic responses. •
Antibody function. Antibodies inactivate antigens in a number of ways- by
complement fixation, neutralization, agglutination, and precipitation.
• Complement fixation. Complement is the chief antibody ammunition used against
cellular antigens, and it is fixed (activated) during innate defenses; it is also activated
very efficiently when it binds to antibodies attached to cellular targets.
• Neutralization. Neutralization occurs when antibodies bind to specific sites on
bacterial exotoxins (toxic chemicals secreted by bacteria) or on viruses that can cause
cellular injury; in this way they block the harmful effects of the exotoxin or virus.
• Agglutination. When the cross-linking involves cell-bound antigens, the process
causes clumping of the foreign cells, a process called agglutination; this type of
antigen antibody reaction occurs when mismatched blood is transfused and is the basis
of tests used for blood typing.
• Precipitation. When the cross-linking involves soluble antigenic molecules, the
resulting antigen-antibody complexes are so large that they become insoluble and
settle out of solution; this cross-linking reaction is more precisely called precipitation.

Cellular (Cell-Mediated) Immune Response

Like B cells, immunocompetent T cells are activated to form a clone by binding with a
“recognized” antigen; however, T cells are not able to bind with free antigens. \

• Antigen presentation. Apparently, T cell must recognize “nonself”, the antigen

fragment presented by the macrophage, and also “self” by coupling with a specific
glycoprotein on the macrophage’s surface at the same time; antigen binding alone is
not enough to sensitize T cells; they must be “spoon-fed” the antigens by
macrophages, and something like a “double handshake” must occur; this is called
antigen presentation and is essential for activation and clonal selection of the T cells.
• Cytotoxic (killer) T cells. Some T cells are cytotoxic ,or killer, T cells that specialize
in killing virus-infected, cancer, or foreign graft cells; one way a cytotoxic T cell
accomplishes this is by binding tightly to a foreign cell and releasing toxic chemicals
called perforins and granzymes from its granules.
• Helper T cells. Helper T cells are the T cells that act as the “directors” or “managers”
of the immune system; once activated, they circulate through the body, recruiting other
cells to fight the invaders; the helper T cells also release a variety of cytokine
chemicals that act indirectly to rid the body of antigens by (1) stimulating cytotoxic T
cells and B cells to grow and divide; (2) attracting other types of protective white
blood cells, such as neutrophils, into the area; and (3) enhancing the ability of
macrophages to engulf and destroy microorganisms.
 • Regulatory T cells. Another t cell population, the regulatory T cells, formerly called
suppressor T cells, releases chemicals that suppress the activity of both T and B cells;
regulatory T cells are vital for winding down and finally stopping the immune
response after an antigen has been successfully inactivated or destroyed.
• Memory cells. Most of the T cells enlisted to fight in a particular immune response are
dead within a few days; however, a few members of each clone are long-lived memory
cells that remain behind to provide immunological memory for each antigen
encountered and enable the body to respond quickly to subsequent invasions.

Lymphocyte Differentiation and Activation

The process of differentiation and activation of lymphocytes include the following:

• Immunocompetence. Lymphocytes destined to become T cells migrate from bone

marrow to the thymus and develop immunocompetence there; B cells develop
immunocompetence in the bone marrow.
• Activation. After leaving the thymus or bone marrow as naive immunocompetent
cells, lymphocytes “seed” the infected connective tissues, where the antigen challenge
occurs and the lymphocytes become fully activated.
• Circulation. Activated (mature) lymphocytes circulate continuously in the
bloodstream and lymph, and throughout the lymphoid organs of the body.

Allergies and Disorders of the Immune System

The immune system can overreact, causing allergies or autoimmune diseases. Likewise, a
suppressed, absent, or destroyed immune system can also result in disease and death.

Allergies result from immune system hypersensitivity to weak antigens that do not cause an
immune response in most people. Allergens, substances that cause allergies, include dust, molds,
pollen, cat dander, certain foods, and some medicines (such as penicillin). Up to 10% of the US
population suffer from at least one allergy.

After exposure to an allergen, some people make IgE antibodies as well as B and T memory cells.
Subsequent exposure to the same allergen causes a massive secondary immune response that
releases plenty of IgE antibodies. These bind to mast cells found usually in connective tissues
surrounding blood vessels. Mast cells then release histamine, which starts the inflammatory
response. In some individuals the histamine release causes life-threatening anaphylaxis or
anaphylactic shock.

The immune system usually distinguishes "self" from "nonself". The immune system learns the
difference between cells of the body and foreign invaders. Autoimmune diseases result when the
immune system attacks and destroys cells and tissues of the body. Juvenile diabetes, Grave's
disease, Multiple sclerosis, Systemic lupus erythematosus, and Rheumatoid arthritis are some of
the autoimmune diseases.

Myasthenia gravis (MG) is a muscle weakness caused by destruction of muscle-nerve

connections. Multiple sclerosis (MS) is caused by antibodies attacking the myelin of nerve cells.
Systemic lupus erythematosis (SLE) has the person forming a series of antibodies to their own
tissues, such as kidneys (the leading cause of death in SLE patients) and the DNA in their own
cellular nuclei. In systemic lupus erythematosus (SLE), the immune system attacks connective
tissues and major organs of the body. Rheumatoid Arthritis; sufferers have damage to their
joints. Some evidence supports Type I diabetes as an auto immune disease. Juvenile diabetes
results from the destruction of insulin-producing cells in the pancreas.

Immunodeficiency diseases result from the lack or failure of one or more parts of the immune
system. Affected individuals are susceptible to diseases that normally would not bother most
people. Genetic disorders, Hodgkin's disease, cancer chemotherapy, and radiation therapy can
cause immunodeficiency diseases.

Severe Combined Immunodeficiency (SCID) results from a complete absence of the cell
mediated and antibody-mediated immune responses. Affected individuals suffer from a series of
seemingly minor infections and usually die at an early age. A small group suffering from
adenosine deaminase (ADA) deficiency, a type of SCID, are undergoing gene therapy to provide
them with normal copies of the defective gene.

Acquired Immunodeficiency Syndrome (AIDS) is currently receiving the most attention

among the immunodeficiency diseases. AIDS is a collection of disorders resulting from the
destruction of T cells by the Human Immunodeficiency Virus (HIV), a retrovirus. When HIV
replicates in the human T cells, it buds from the T cell plasma membrane encased in a coat
derived from the T cell plasma membrane. HIV selectively infects and kills T4 helper cells. The
viral RNA is converted into DNA by the enzyme reverse transcriptase; this DNA can become
incorporated into a human chromosome for months or years.

When the infected T cell is needed in the immune response, the viral genes are activated and the
virus replicates, killing the infected cell and producing a new round on T4 cell infection.
Gradually the number of T4 cells, the master on switch for the immune system, decline. The
immune response grows less powerful, eventually failing. Premature death results from a series
of rare diseases (such as fungal pneumonia and Kaposi's sarcoma, a rare cancer) that overwhelm
the body and its compromised immune system.
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