Antibody classes

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Antibody classes

Critical Care - Nursing

Critical Care - Nursing

Shock: Clinical
Burns: Clinical
Asthma: Clinical
Seizures: Clinical
Skin cancer: Clinical
Neck trauma: Clinical
Stroke: Clinical
Pancreatitis: Clinical
Heart failure: Clinical
Hypertension: Clinical
Brain herniation
Concussion and traumatic brain injury
Traumatic brain injury: Pathology review
Traumatic brain injury: Clinical
Intracerebral hemorrhage
Bundle branch block
ECG basics
ECG rate and rhythm
ECG axis
ECG cardiac infarction and ischemia
Wolff-Parkinson-White syndrome
Atrioventricular block
Atrioventricular nodal reentrant tachycardia (AVNRT)
Atrial flutter
Atrial fibrillation
ECG normal sinus rhythm
Ventricular arrhythmias: Pathology review
Supraventricular arrhythmias: Pathology review
Ventricular fibrillation
Myocarditis
Class II antiarrhythmics: Beta blockers
Class IV antiarrhythmics: Calcium channel blockers and others
Tricyclic antidepressants
Dilated cardiomyopathy
Class III antiarrhythmics: Potassium channel blockers
Positive inotropic medications
Class I antiarrhythmics: Sodium channel blockers
Coronary artery disease: Pathology review
Seizures: Pathology review
Endocarditis: Pathology review
Shock: Pathology review
Hypertension: Pathology review
Heart failure: Pathology review
Cardiomyopathies: Pathology review
Cirrhosis: Pathology review
Pancreatitis: Pathology review
Headaches: Pathology review
Ventilation-perfusion ratios and V/Q mismatch
Clinical Skills: Mechanical ventilation - conventional ventilators
Clinical Skills: High-frequency oscillatory ventilation (HFOV)
Respiratory alkalosis
Respiratory acidosis
Acute respiratory distress syndrome: Clinical
Pulmonary embolism
Acute respiratory distress syndrome
Advanced cardiac life support (ACLS): Clinical
Deep vein thrombosis and pulmonary embolism: Pathology review
Obstructive lung diseases: Pathology review
Respiratory distress syndrome: Pathology review
Blood products and transfusion: Clinical
Ventilation
Anatomic and physiologic dead space
B- and T-cell memory
Zones of pulmonary blood flow
Action potentials in pacemaker cells
Reading a chest X-ray
Renal failure: Pathology review
Regulation of renal blood flow
Heart failure
Toxidromes: Clinical
Child abuse: Clinical
Carbon monoxide poisoning: Nursing process (ADPIE)
Chest trauma: Clinical
Angina pectoris
Coronary artery disease: Clinical
Antiplatelet medications
cGMP mediated smooth muscle vasodilators
Sympathomimetics: Direct agonists
Compliance of lungs and chest wall
Combined pressure-volume curves for the lung and chest wall
Stable angina
Ludwig angina
Unstable angina
Normal heart sounds
Abnormal heart sounds
Rheumatic heart disease
Heart blocks: Pathology review
Hypoplastic left heart syndrome
Cardiac conduction system
Acyanotic congenital heart defects: Pathology review
Cyanotic congenital heart defects: Pathology review
Post-COVID syndrome: Heart, lungs and clotting
Myocardial infarction
Congenital heart defects: Clinical
MHC class I and MHC class II molecules
T-cell activation
Type III hypersensitivity
Antiphospholipid syndrome
B-cell activation, differentiation, and contraction
Type IV hypersensitivity
Graft-versus-host disease
Antibody classes
Type II hypersensitivity
Integrase and entry inhibitors
Small bowel ischemia and infarction
ACE inhibitors, ARBs and direct renin inhibitors
Cell-mediated immunity of CD4 cells
Cell-mediated immunity of natural killer and CD8 cells
Anaphylaxis
Shock
Hemophilia
Non-steroidal anti-inflammatory drugs
Transplant rejection
Stroke volume, ejection fraction, and cardiac output
Delirium
Dementia and delirium: Clinical
Amnesia, dissociative disorders and delirium: Pathology review
Substance misuse and addiction: Clinical
Typical antipsychotics
Metabolic and respiratory acidosis: Clinical
Dementia with Lewy bodies
Vascular dementia
Abnormal uterine bleeding: Clinical
Bleeding disorders: Clinical
Headaches: Clinical
Post-traumatic stress disorder
Trauma- and stressor-related disorders: Clinical
Clinical Skills: Pulse oximetry
Clinical Skills: BiPAP and CPAP
Anemia: Clinical
Aortic dissections and aneurysms: Pathology review
Aortic aneurysms and dissections: Clinical
Aortic dissection
Cardiac tamponade
Pericardial disease: Pathology review
Coarctation of the aorta
Hypertension
Pneumothorax
Pneumothorax: Clinical
Pleural effusion, pneumothorax, hemothorax and atelectasis: Pathology review
General anesthetics
Emphysema
Pleural effusion: Clinical
Abdominal trauma: Clinical
Glycolysis
Carbohydrates and sugars
Oxygen-hemoglobin dissociation curve
Cellular structure and function
Fatty acid synthesis
Ketone body metabolism
Metabolic acidosis
Disorders of consciousness: Clinical
Hyperkalemia: Clinical
Acid-base disturbances: Pathology review
Plasma anion gap
Diabetes mellitus
Diabetes mellitus: Clinical
Diabetes mellitus: Pathology review
Electrolyte disturbances: Pathology review
Fatty acid oxidation
Alveolar gas equation
Gas exchange in the lungs, blood and tissues
Cardiac muscle histology
Neuromuscular blockers
Long QT syndrome and Torsade de pointes
Opioid agonists, mixed agonist-antagonists and partial agonists
Anticonvulsants and anxiolytics: Benzodiazepines
Nonbenzodiazepine anticonvulsants
Bipolar and related disorders
Serotonin and norepinephrine reuptake inhibitors
Seizures and epilepsy
Hypertensive emergency
Hypertensive disorders of pregnancy: Clinical
Adrenergic antagonists: Alpha blockers
Adrenergic antagonists: Beta blockers
Cardiac work
Cardiac cycle
Cardiac afterload
Cardiac contractility
ECG cardiac hypertrophy and enlargement
Cardiac conduction velocity
Imaging features of COVID-19 (LifeBridge Health)
Altering cardiac and vascular function curves
Action potentials in myocytes
Resting membrane potential
Valvular heart disease: Clinical
Anatomy of the heart
Valvular heart disease: Pathology review
Premature ventricular contraction
Brugada syndrome
Premature atrial contraction
Sleep apnea
Cardiomyopathies: Clinical
Metabolic and respiratory alkalosis: Clinical
Neonatal respiratory distress syndrome
Bronchodilators: Leukotriene antagonists and methylxanthines
Hypokalemia
Hyperkalemia
Newborn management: Clinical
Carbonic anhydrase inhibitors
Regulation of pulmonary blood flow
Baroreceptors
Cranial nerves
Renin-angiotensin-aldosterone system
Anticonvulsants and anxiolytics: Barbiturates
Chronic bronchitis
Bronchiectasis
Brown-Sequard Syndrome
Bacterial epiglottitis
Ectopic pregnancy
Complications during pregnancy: Pathology review
Miscarriage
B-cell development
Placental abruption
Abnormal labor: Clinical
Ischemia
Ascending and descending spinal tracts
Spinal cord disorders: Pathology review
Pyramidal and extrapyramidal tracts
Acute kidney injury: Clinical
Free radicals and cellular injury
DNA damage and repair
Metabolic alkalosis
The role of the kidney in acid-base balance
Psychomotor stimulants
Carbon dioxide transport in blood
Acid-base map and compensatory mechanisms
Pulmonary shunts
Cardiovascular system anatomy and physiology
Pulmonary edema
Sleep disorders: Clinical

Transcript

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The immune response is highly specific for each invader, and that’s because the cells of the adaptive immune response have unique receptors that are able to differentiate friendly bacteria from potentially deadly pathogens from their unique parts - called antigens.

The key cells of the adaptive immune response are the lymphocytes - the B and T cells.

B cells develop in the bone marrow where they undergo a process called VDJ rearrangement to generate a massively diverse set of B cell receptors.

The B cell receptor is essentially an antibody except that has a transmembrane part that goes through the membrane attaching the receptor to the surface of the B cell.

The B cell receptor, has two heavy chains and two light chains, and the region or fragment of the B cell receptor that binds the antigen is called the fragment-antigen binding or Fab region.

The Fab region is where the ends of the heavy and light chains meet, and there are two Fab fragments on each B cell receptor.

The remainder of the heavy chain makes up the constant region or constant fragment region, also called Fc.

The two heavy chains are linked to one another by disulfide bonds and each heavy chain is also linked to a light chain by a disulfide bond.

Each B cell receptor, has two identical heavy and light chains, resulting in two identical antigen binding sites.

As the B cell develops into a plasma cell, the B cell receptor gets secreted as an antibody with the exact same antigen specificity.

However, the heavy chain actually changes as the B cell develops.

There are 5 major types of heavy chains which encode the isotypes or classes of immunoglobulins: IgM, IgD, IgG, IgA, and IgE.

These five are encoded by heavy chain genes which are referred to by the greek letters mu, delta, gamma, alpha, and epsilon.

Each of these immunoglobulins has a different function, shape, and consequently valence.

The valence of an antibody is the amount antigen binding or Fab fragments it has.

Immunoglobulin M, or IgM, is the first antibody response made in all immune responses.

It makes up approximately 4% of the immunoglobulin found in the serum.

This is because it serves as the the B cell receptor, and like a transformer, it has two completely different conformations.

When it’s serving as the B cell receptor it’s a monomer, and it has a valence of 2 meaning that it has two Fab regions.

When IgM is secreted from a plasma cell it joins up with four other identical IgM antibodies, making a total of 5 antibodies that form a pentamer that’s held together by a J or joining chain.

The J chain is a 15 kDa polypeptide chain that promotes the polymerization of the pentamer by covalently linking to the cysteines of the tails of the Fc regions of the IgM molecule.

Because it’s a pentamer, secreted IgM has a valence of 10.

IgM is the first type of antibody produced in a primary immune response, meaning the first time you see a pathogen.

Unlike all of the other antibodies, IgM can be made without T cell help, which also means that IgM doesn’t rely on a peptide antigen, and can even work against carbohydrates and lipids antigens.

Finally, IgM is the most effective antibody at activating the complement pathway which is particularly helpful in fighting bacterial infections.

IgG is the most abundant immunoglobulin, making up 75% of the immunoglobulin found in serum!

The IgG molecule is a monomer made up of two gamma heavy chains and two light chains, so its valence is 2.

There are four subclasses of IgG molecules - IgG1, IgG2, IgG3, and IgG4 - and they have slight differences in their constant regions but all still make IgG molecules.

The most important role of IgG is to serve as an opsonin, and in general opsonins are terrific because they help phagocytes get a firm grip on bacteria.

Normally, bacteria have an antiphagocytic capsule which makes them slippery and hard to grab.

Opsonization is the process by which pathogens are coated with molecules so that they can be more easily picked up and eaten by phagocytes.

Imagine trying to pick up a slippery meatball with your fingers versus stabbing it with a fork and then just having to pick up the fork. Opsonization also makes it easier to eat meatballs faster too.

In this case, IgG is serving as that fork, and the phagocyte has a receptor for IgG, knows as Fc gamma receptor, which allows it to bind to - or hold the fork.

IgG is also great at activating the classical complement pathway, which helps destroy extracellular pathogens like bacteria.

For intracellular pathogens, like viruses, IgG works with natural killer cells to perform antibody dependent cell mediated cytotoxicity, or ADCC.

Key Takeaways

Antibodies, also known as immunoglobulins (Ig), are a type of protein produced by plasma cells as part of the adaptive immune response to foreign substances, such as a virus or bacteria. There are five main classes of antibodies, which are IgA, IgD, IgE, IgG, and IgM, with each class having a different role in fighting the infection.

Sources

  1. "Basic immunology: Functions and Disorders of the Immune System. ISBN 978-0443105197 " Elsevier (2023)