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醫學免疫學是一門獨立的學科，是研究免疫系統的組織結構和功能的科學。它從不同的角度和水平來揭示免疫系統識別并消除抗原性異物的應答過程和規律，并應用這些規律來闡明免疫相關疾病發生發展的機制，達到防治相關疾病的目的。醫學免疫學進展迅速，知識量大，本教材基于*基本的理論和知識，介紹了抗原、免疫器官和免疫細胞、免疫分子（抗體、補體、細胞因子、黏附分子和 MHC等）、免疫應答、免疫預防、免疫治療、免疫診斷、免疫耐受、免疫相關疾病以及感染免疫等。　　本教材適用于醫學專業外國留學生的醫學免疫學英文教學和本科雙語教學。

正版原版，原汁原味，留學生與雙語教學用。 

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

姚智教授現任天津醫科大學基礎醫學院免疫學系主任、天津醫科大學病原生物與免疫學學科學術帶頭人、天津醫科大學黨委書記等職務。任第十七屆世界支原體聯盟常務理事，中華微生物學及免疫學會主任委員，中國免疫學會理事，中國醫藥生物技術協會臨床應用委員會常務理事，中國細胞生物學與分子生物學學會臨床分會常務理事，中華醫學會天津分會檢驗學會主任委員等學術職務。任中國檢驗醫學雜志英文版主編，中國免疫學雜志編委，中國腫瘤臨床（英文版）編委，中草藥編委等植物。曾獲天津市教書育人十大標兵、天津市衛生系統科技先進個人；他領導的課題組獲天津市衛生系統科技先進集體、天津市十五立功先進集體；天津市五一立功先進集體，他本人榮獲天津市八五九五十五立功獎章、天津市勞動模范、天津市科技明星、天津市第四屆青年科技獎；為國務院特殊津貼專家；天津市131工程人才培養第一層次人選；衛生部有突出貢獻中青年專家；天津市授銜專家；2006年入選新世紀百千萬人才工程*人選。

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

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

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

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

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

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

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

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

Classification of Antigens BASED ON

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

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

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

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

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

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

Chapter 3 Antigen Recognition Molecules

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

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

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

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

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

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

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

Regulation of the Complement

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

Biological Consequences of

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

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

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

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

Chapter 5 Organs and Tissues of the

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

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

Contents

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

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

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

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

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

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

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

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

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

AN TIGEN PROCESSING AND

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

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

HU MORAL IMMUNE RESPONSE

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

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

FA CTORS INFLUENCING ANTIBODY

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

CE LL-MEDIATED IMMUNE RESPONSE

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

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

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

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

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

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

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

76

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

77

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

AR TIFICIALLY INDUCED TOLERANCE IN

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

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

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

Contents

目 錄

XIV 醫學免疫學Meeddiiccaall IImmuunnoollooggyy

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

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

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

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

TY PEⅡ HYPERSENSITIVITY REACTION

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

TY PEⅢ HYPERSENSITIVITY REACTION

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

TY PE Ⅳ CELL-MEDIATED (DELAYED)

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

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

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

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

PR OBABLE MECHANISMS OF

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

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

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

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

Chapter 11 Immunodeficiency Disorders...... 111

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

SE CONDARY (ACQUIRED) IMMUNodEFICIENCIES

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

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

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

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

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

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

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

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

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

Chapter 13 Transplantation Immunology...... 138

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

FACTORS FAVORINGALLOGRAFT SURVIVAL...... 140

Mechanism Involved in Graft Rejection

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

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

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

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

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

ST AGES OF ANTIGEN-ANTIBODY

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

ME ASUREMENT OF ANTIGEN AND ANTIBODY

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

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

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

MO NOCLONAL ANTIBODIES AND

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

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

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

Chapter 15 Immunoprophylaxis &

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

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

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

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

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

Chapter 16 Immunity in Viral, Bacterial,

Fungal, and Parasitic

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

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

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

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

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

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

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