O Seu Incrível Sistema Imune

O Seu Incrvel
Sistema Imune
Como Ele Protege
Seu Corpo

O Seu Incrvel
Sistema Imune
Como Ele Protege
Seu Corpo

Compllado pela Socledade !aponesa de lmunologla (!Sl)
lllusLrado por 1omoko lshlkawa

Ld|tores: Soc|edade Iaponesa de Imuno|og|a e, (em ordem a|fabnca)

Plroshl kawamoLo CenLro de esqulsa para Alergla e lmunologla, 8lkLn
Sachlko Mlyake lnsuLuLo naclonal de neuroclncla, CenLro naclonal de neurologla e slqulaLrla
Masayukl Mlyasaka s-Craduao da laculdade de Medlclna, unlversldade de Csaka
1oshlakl ChLekl lnsuLuLo de esqulsa Medlca, unlversldade Medlca e CdonLolglca, 1qulo
norlko Sorlmachl lnsuLuLo de esqulsa, CenLro Medlco lnLernaclonal do !apo
?ousuke 1akahama lnsuLuLo para esqulsa sobre o Cenoma, unlversldade de 1okushlma
Shlnsuke 1akl s-Craduao da laculdade de Medlclna, unlversldade de Shlnshu

1raduz|do por: An[all aLel (lngls)
!oo aulo Maruns do Carmo (nlP-nlAlu/llCC8uZ) e Crlsuana lerraz Colmbra
(lngls para orLugus)
Colaboradores: Angela Saue nlshlkaku (unllLS) e Anderson de S nunes (uS)
8evlsor: Luls Craa (lnsuLuLo de Medlclna Molecular, unlversldade de Llsboa, orLugal)

1raduo auLorlzada da edlo em llngua !aponesa,

1lLulo do Lrabalho: kA8AuA WC MAMC8u MLnLkl nC luSPlCl
nome do proprleLrlo: ?CuCSPA Co., LLd.
ueLenLor dos dlrelLos auLorals: Socledade !aponesa de lmunologla (!Sl - 1he !apanese SocleLy for lmmunology)
llusLradora: 1omoko lshlkawa
Lncadernado por: 1akashl Cno
?aruyary ?a Ponpo

1odos os dlrelLos reservados (lnclulndo aqueles de Lraduo para
ouLras llnguas). nenhuma parLe desLe llvro pode ser reproduzlda em
qualquer forma - lmpresso, mlcrolme ou qualsquer ouLros melos
- nem Lransmludos ou Lraduzldos em uma llnguagem aruclal sem a
permlsso escrlLa da LllS ou da Socledade !aponesa de lmunologla.
nomes reglsLrados, marcas comerclas, eLc., usados nesLe llvro,
mesmo quando no especlcamenLe marcados como, no so
conslderados desproLegldos legalmenLe.

verso em lngls (Amazlng lmmune SysLem") lmpressa na
8epubllca lederal da Alemanha, em papel sem cldo

1|pograha 1ypoueslgn Pecker CmbP, Lelmen
Impresso e Lncadernao SLrauss CmbP, Mrlenbach
lS8n: 978-3-00-028073-3
LsLe llvro fol produzldo culdadosamenLe. LnLreLanLo, edlLores, auLores
e grca no garanLem que a lnformao conuda aqul esLe[a llvre de
erros. Aconselha-se que os lelLores manLenham consclncla de que as
declaraes, dados, llusLraes e deLalhes de procedlmenLos ou ouLros
lLens possam lnadverudamenLe esLar lmpreclsos.

8|b||oteca do Congresso, Carto N.:
ap||ca-se aos Dados de Cat|ogo em ub||cao da 8|b||oteca 8r|tn|ca
uma cha caLalogrca para esLe llvro enconLra-se dlsponlvel na
8lblloLeca 8rlLnlca (verso Amazlng lmmune SysLem").

Informao b|b||ogrhca pub||cada pe|a D|e Deutsche
Nanona|b|b||othek (8|b||oteca Nac|ona| A|em)
ule ueuLsche nauonalblblloLhek llsLa esLa publlcao na ueuLsche
nauonalblbllograe (8lbllograa naclonal Alem), dados blbllogrcos
deLalhados esLo dlsponlvels na lnLerneL em hup:]]dnb.d-nb.de.

2012 Luropean lederauon of lmmunologlcal Socleues (LllS)
refc|o

LsLe llvro fol elaborado para a[ud-lo a enLender melhor como o slsLema lmune
funclona. lol compllado pela Socledade !aponesa de lmunologla, um grupo que
pesqulsa a lmunldade.
C slsLema lmune, ou o modo como o corpo se proLege conLra germes
como bacLerlas, e lncrlvelmenLe organlzado. CuanLo mals voc ca sabendo
sobre ele, mals voc compreende o quo esse slsLema e verdadelramenLe
fasclnanLe. Lle e felLo de uma enorme quanudade de moleculas e celulas que
Lrabalham [unLas em coordenao lnuma para proLeger nossos organlsmos de
lnvasores esLranhos. Alnda asslm, e exaLamenLe esLa complexldade que faz
algumas pessoas pensarem que o slsLema lmune deve ser dlncll demals para ser
enLendldo. Lsperamos que ao ler esLe llvro, voc comece a pensar, Ah, enLo e
lsLo que e o slsLema lmune?" ou LnLo, e asslm que ele funclona!" e lsso far
voc querer aprender mals sobre o assunLo.
1omoko lshlkawa generosamenLe llusLrou o llvro. C llvro lnLelro fol crlado
aLraves da dedlcao e enLuslasmo do ur ?ousuke 1akahama, colaborando com
membros do ComlL de romoo da Lducao e o ComlL de negclos ubllcos
da Socledade !aponesa de lmunologla. Seus esforos foram edlLados com grande
culdado por Shlnobu ?amashlLa, do deparLamenLo de edlo da ?odosha. Meus
agradeclmenLos a Lodos eles.
llnalmenLe, peo que se voc enconLrar parLes do llvro que se[am dlncels
de enLender, por favor avlse-nos. ns gosLarlamos de uullzar seus comenLrlos
para Lornar esLe llvro alnda melhor. L, anal de conLas, um llvro que fol crlado
para Lodos vocs, por lsso esLou ansloso para ouvlr o que vocs pensam.

Abrll de 2008, Socledade !aponesa de lmunologla
Masayukl Mlyasaka

refc|o para a 1raduco em Ing|s
C Seu Incr|ve| S|stema Imune:
Como L|e rotege o Seu Corpo

1odo dla, o slsLema lmune esL ocupado proLegendo-o de mllhares de germes
ao seu redor que podem faz-lo car doenLe. Seu slsLema lmune faz esLe
Lrabalho Lo eclenLemenLe que voc nem percebe que ele esL Lrabalhando.
As vaclnas auvam seu slsLema lmune, capaclLando-o para defender o organlsmo
conLra germes que alnda esLo para serem enconLrados. normalmenLe, as
vaclnas no causam mals lncmodo do que uma rplda plcada no seu brao ou
coxa, facllmenLe esqueclvel, mas o salvam de car serlamenLe doenLe ou
morrer daquela doena.
ALualmenLe, mulLas pessoas sofrem de alerglas como a asma ou doenas
auLolmunes como a arLrlLe reumaLlde. Claro que aqueles de vocs que sofrem
desses padeclmenLos [ esLo cauLelosos, Lendo sofrldo de resposLas do slsLema
lmune excesslvamenLe agresslvas. LnLreLanLo, no se esqueam de que essas
quelxas so resulLado de uma resposLa lmune mal dlrlglda, mas que, quando
esL Ludo bem, na realldade ela prevlne que voc cala como presa de Lodos os
agenLes lnfecclosos ao seu redor. uma olhada no que pode aconLecer se o
slsLema lmune falhar val a[ud-lo a reconhecer a lmporLncla da resposLa para o
seu bem esLar. Se voc crescer sem um slsLema lmune funclonanLe, voc no s
Ler falLa de qualsquer melos de proLeg-lo dos germes que causam doena,
como Lambem seu corpo no ser capaz de deLecL-los ou ellmln-los, bem
como qualsquer de suas celulas que se comporLem de manelra errada. Se no
forem ellmlnadas, Lals celulas podem evenLualmenLe se desenvolver em um
cncer.
Cs clenusLas acredlLam que um melhor enLendlmenLo de como o
slsLema lmune opera nos capaclLar para desenvolver novas vaclnas. MulLos
esLo Lrabalhando a procura de uma vaclna conLra doenas lnfecclosas como a
AluS, que ameaa mllhes de pessoas, a malorla nos palses em
desenvolvlmenLo. Alem dlsso, ouLros esLo LenLando enLender o que aconLece
de errado com a resposLa lmune no caso de vrlas doenas auLolmunes e
alerglas, e Lambem por que o slsLema lmune as vezes falha em combaLer o
cncer. Com esLe enLendlmenLo, os clenusLas esperam um dla desenvolver
vaclnas efeuvas conLra doenas auLolmunes, doenas alerglcas e cncer, e mals
efeuvas conLra doenas lnfecclosas.
LsLe llvro, orlglnalmenLe lnuLulado karada wo Mamoru Menekl no
lushlgl", fol concebldo e crlado por pesqulsadores [aponeses que Lrabalham na
rea de lmunologla. lol publlcado pela Socledade !aponesa de lmunologla como
parLe dos seus esforos de dlvulgao para o uay of lmmunology 2008" (ula da
lmunologla), com o ob[euvo de Lornar a lmunologla acesslvel ao publlco.
8econhecendo uma boa ldela e um bom llvro, pesqulsadores que
Lrabalham com lmunologla na Luropa pensaram que Lal publlcao serla
Lambem de lnLeresse para os Luropeus. orLanLo, Lraduzlmos o llvro para o
lngls para aumenLar a consclncla da lmporLncla da lmunologla para a saude
e o bem esLar aqul. A lederao Luropela das Socledades de lmunologla (LllS),
a organlzao que reune Lodos os lmunologlsLas Luropeus, forneceu apolo
nancelro para a Lraduo, lmpresso e verso eleLrnlca desLe llvro. An[all
aLel generosamenLe Lraduzlu o llvro para o lngls e a[udou na sua edlo.
Apolo edlLorlal adlclonal fol fornecldo por Mary Loulse Crossman. Meus
agradeclmenLos vo para ambas por sua dedlcao e Lrabalho rduo em nos
a[udar a reallzar esLe pro[eLo. na presenLe edlo, vrlos Lermos e expresses
[aponeses foram slmpllcados para o beneclo de um alcano mals amplo de
lelLores.
Lu espero slnceramenLe que voc ache esLe llvro lnLeressanLe e que o
a[ude a enLender melhor o seu slsLema lmune. LsLou ansloso pra ouvlr como
vocs gosLaram - ou no - do llvro. Suas sugesLes so vallosas porque o llvro
fol crlado aclma de Ludo, pra vocs.
Cue venham Lradues em ouLras llnguas!

!unho de 2009! #$%&'()* +(,(%)-&* &. /00$*&1&234)1 5&43(-(6
57(.)* 8! #! 9)$.0)**
Foreword . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Part I All about Immunity
1 The Basics of the Immune System
What does the immune system do? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Ever wondered why you dont get the same disease twice? . . . . . . . . . . . . 12
Where in your body is the immune system? . . . . . . . . . . . . . . . . . . . . . . . . 14
The many cells of the immune system . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Three ways of destroying a pathogen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
2 How the Immune System Works
How the immune system distinguishes among pathogens . . . . . . . . . . . . 20
How the immune system can recognise different germs . . . . . . . . . . . . . . 24
How the immune system remembers pathogens its met before . . . . . . . 26
3 Where the Cells of the Immune System are Made and
Where They Work
Where are immune cells made? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Where do immune cells work and how do they get there? . . . . . . . . . . . . . 30
How immune cells find their way around . . . . . . . . . . . . . . . . . . . . . . . . . . 32
How immune cells help each other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
How the immune system regulates itself . . . . . . . . . . . . . . . . . . . . . . . . . . 36
Why the immune system doesnt attack the body or food . . . . . . . . . . . . . 38
Contents
00I_008q.qxd 0I.0I.?009 II.49 Uhr Seite I
Contedo
Foreword . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Part I All about Immunity
1 The Basics of the Immune System
What does the immune system do? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Ever wondered why you dont get the same disease twice? . . . . . . . . . . . . 12
Where in your body is the immune system? . . . . . . . . . . . . . . . . . . . . . . . . 14
The many cells of the immune system . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Three ways of destroying a pathogen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
2 How the Immune System Works
How the immune system distinguishes among pathogens . . . . . . . . . . . . 20
How the immune system can recognise different germs . . . . . . . . . . . . . . 24
How the immune system remembers pathogens its met before . . . . . . . 26
3 Where the Cells of the Immune System are Made and
Where They Work
Where are immune cells made? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Where do immune cells work and how do they get there? . . . . . . . . . . . . . 30
How immune cells find their way around . . . . . . . . . . . . . . . . . . . . . . . . . . 32
How immune cells help each other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
How the immune system regulates itself . . . . . . . . . . . . . . . . . . . . . . . . . . 36
Why the immune system doesnt attack the body or food . . . . . . . . . . . . . 38
Contents
00I_008q.qxd 0I.0I.?009 II.49 Uhr Seite I
refclo . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

arte I 1udo sobre a Imun|dade

1 C 8s|co do S|stema Imune
- C que o slsLema lmune faz?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
- Sempre se pergunLou por que no pega a mesma doena duas vezes? . . . . . . . . . . 12
- Cnde ca o slsLema lmune no seu corpo? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
- As mulLas celulas do slsLema lmune . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
- 1rs manelras de desLrulr paLgenos . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

2 Como o S|stema Imune 1raba|ha
- Como o slsLema lmune dlsungue enLre paLgenos . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
- Como o slsLema lmune pode reconhecer germes dlferenLes. . . . . . . . . . . . . . . . . . . . 24
- Como os slsLema lmune se lembra de paLgenos que [ enconLrou anLes . . . . . . . . . 26

3 Cnde as C|u|as do S|stema Imune So Ie|tas e Cnde L|as 1raba|ham
- Cnde as celulas lmunes so felLas? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
- Cnde as celulas lmunes Lrabalham e como elas chegam l? . . . . . . . . . . . . . . . . . . . . .30
- Como as celulas lmunes enconLram seu camlnho . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
- Como as celulas lmunes se a[udam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
- Como o slsLema lmune se regula . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
- or que o slsLema lmune no aLaca o corpo ou o allmenLo . . . . . . . . . . . . . . . . . . . . . 38
arte II 1udo sobre as Doenas

1 Combatendo Doenas Infecc|osas
- 1udo sobre paLgenos . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
- Cue upos de doenas lnfecclosas exlsLem? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
- C que e a AluS? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
- voc pode evlLar pegar a grlpe avlrla? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
- C quanLo as vaclnas podem fazer? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30

2 Doenas Auto|munes
- C que e uma doena auLolmune? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
- Cue upos de doenas auLolmunes exlsLem? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
- ArLrlLe reumaLlde e seu LraLamenLo . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36

3 A|erg|as 1ambm So keaes Imunes
- C que e uma alergla? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
- ALe esLes lLens podem causar alergla . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60
- Como a asma se desenvolve . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62
- voc consegue curar a febre do feno? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64

4 A Imuno|og|a ode Ser Usada ara Curar o Cncer?
- C que e o cncer? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66
- Como o slsLema lmune Lrabalha conLra o cncer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68
- 1raLando cncer com lmunoLerapla . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70

s-fclo . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72

1udo sobre a Imuno|og|a
arte I
C 8s|co do S|stema Imune
C ue o S|stema Imune Iaz?
Sabe o que e o slsLema lmune?
Sabe onde pode enconLr-lo no
corpo? L sabe o que ele faz?
10
Well lets see. Roughly one in every hundred thou-
sand babies is born without any immunity whatso-
ever. This condition is known by the rather long and
difficult term of Severe Combined Immunodeficien-
cy or SCID. Babies born with this condition dont
have any of the protection that healthy babies do
against pathogens.
By pathogens we mean germs like the bacteria,
viruses and fungi that can make you sick. This is
why babies who have SCID end up getting very sick
from infectious diseases.
Do you know what the immune sys-
tem is? Do you know where you can find
it in the body? And do you know what it
does?
When you are feeling
well, you dont give much thought
to your immune system or what it does.
But what do you think would happen to you if you
didnt have one?
1.
What does the immune system do?
The Basics of the Immune System
100,000
Severe Combined
Immunodeficiency
009_09q.qxd 0I.0I.?009 II.SS Uhr Seite I0
100.000
Imunodehc|nc|a
Comb|nada Grave
Cuando voc esL se senundo bem, voc no d
mulLa aLeno ao seu slsLema lmune ou ao que ele
faz. Mas o que voc acha que aconLecerla se voc
no uvesse um?

8em, ve[amos. CrosselramenLe, um em cada
100.000 (cem mll) bebs nasce sem qualquer
lmunldade. LsLa condlo e conheclda pelo longo e
dlncll Lermo lmunodeclncla Comblnada Crave ou
S C l u ( d o l n g l s , S e v e r e C o m b l n e d
lmmunodeclency). 8ebs que nascem com esLa
condlo no Lem qualquer proLeo que bebs
saudvels Lm conLra paLgenos.
or paLgenos queremos dlzer germes como
bacLerlas, vlrus e fungos que fazem voc car
doenLe. L por lsso que bebs que Lem SClu acabam
cando mulLo doenLes de doenas lnfecclosas.
10
against pathogens.
does?
didnt have one?
1.
100,000
Severe Combined
Immunodeficiency
10
against pathogens.
does?
didnt have one?
1.
100,000
Severe Combined
Immunodeficiency
11
Youve no doubt heard about a disease called AIDS.
AIDS causes the body to lose its immunity and leaves
it unable to protect itself from all sorts of germs.
AIDS does this by knocking out the immune sys-
tems ability to function.
By now you probably realise that if you were born with-
out any immunity whatsoever or if your immune system
stopped functioning, youd be at the mercy of germs that
your body could normally protect you from. So you see, it
might feel like your immune system doesnt do very
much, but, in fact, it is there protecting your body night
and day.
There are all sorts of
germs floating about in
the air.
009_09q.qxd 0I.0I.?009 II.SS Uhr Seite II
Sem duvlda voc [ ouvlu sobre a doena
chamada AluS. Lla faz com que o corpo perca
sua lmunldade, delxando-o lncapaz de se
proLeger de Loda varledade de mlcrblos.
A AluS faz lsso ellmlnando a capacldade do
slsLema lmune de funclonar.
P vrlos upos de mlcrblos
uLuando no ar.
Agora voc provavelmenLe percebe que se
nasceu sem lmunldade ou se o seu slsLema lmune
parou de funclonar, voc esLarla a merc dos
mlcrblos conLra os quals seu corpo normalmenLe
poderla proLeg-lo. LnLo voc lmaglna que Lalvez
seu slsLema lmune no faz mulLo, mas, de faLo, ele
esL al proLegendo o seu corpo nolLe e dla.
A|guma vez [ se perguntou porque no pega
a mesma doena duas vezes?
1enho cerLeza de que voc [ ouvlu dlzerem
algo como: 8em, [ uve caxumba uma vez,
por lsso eu devo esLar bem, ou Lu [ uve
grlpe esLe ano, por lsso no vou Ler de novo.
C que as pessoas querem dlzer e que quando
se dlz que um paLgeno em parucular o faz
senur doenLe uma vez e voc se recupera,
enLo no car doenLe do mesmo paLgeno
novamenLe.
LsLa habllldade e ouLra lmporLanLe funo
do seu slsLema lmune.
Lle se lembra de Lodos os paLgenos
que [ o lnfecLaram de forma que se
voc os pegasse de novo, no carla
doenLe.
|nfeco
Cuando mlcrblos enLram no seu corpo, voc Lem o que chamamos
de lnfeco. ComumenLe, quando se pega uma lnfeco, voc Lem
febre, Losse e/ou um mal esLar no esLmago (dlarrela). orem, se voc
descansar um pouco, na malorla dos casos, voc deve car bem de
novo.
voc deve agradecer ao slsLema lmune por esLa recuperao. Mas
lsso no e Ludo o que ele faz por voc.
Memr|a
Imuno|g|ca
LspeclallsLas chamam essa habllldade de memr|a
|muno|g|ca. Lmbora o proLe[a de car doenLe de
novo com o mesmo upo de paLgeno, ela no a[uda
se voc se lnfecLar com um paLgeno dlferenLe. Lm
cada nova lnfeco, o slsLema lmune Lem que
comear a memorlzar do zero o paLgeno que a
causou.
A cada dla, cada um de ns cruza com mllhares de
germes. no momenLo em que nos Lornamos
adulLos, nosso slsLema lmune [ Ler udo a chance
de memorlzar um numero lncrlvel deles. As vaclnas
que voc recebeu quando crlana se somam ao
numero de germes que seu organlsmo e capaz de
reconhecer.
Llas conLm paLgenos que foram enfraquecldos em laboraLrlo para que possam
consLrulr a lmunldade a eles sem que voc Lenha que car doenLe.
A palavra vaclna vem do laum para vaca ou :)44). Mas o que as
vaclnas Lem a ver com as vacas? voc pergunLa. 8em, Ldward
!enner descobrlu a vaclnao quando ele demonsLrou que ao
ln[eLar pessoas com vlrus da vacclnla, uma forma branda de varlola
que lnfecLava somenLe o gado, ele as proLegla conLra a forma faLal
da doena chamada varlola.
13
The word vaccine comes from the Latin for cow or Vacca. But
what have vaccines to do with cows, you ask? Well, Edward Jen-
ner discovered vaccination when he showed that injecting
people with the cowpox virus would protect them from a dead-
ly disease called smallpox.
Experts call this ability immunological memory.
Although immunological memory protects you
from getting sick with the same type of pathogen
again, it cant help if you are infected by a new
pathogen. With each new infection, the immune sys-
tem has to start from scratch to memorise the
pathogen that caused it.
Every day each one of us comes across thousands
of germs. By the time we become adults, our im-
mune system has had the chance to memorise an
amazing number of them. The vaccinations that you
get as a child add to the number of germs that your
body can recognise. They contain pathogens that
have been weakened so that you can build immuni-
ty to them without having to get sick.
Immunological
Memory
009_09q.qxd 0I.0I.?009 II.SS Uhr Seite I
Cnde hca o s|stema |mune no corpo?
nossos corpos so felLos de unldades exLremamenLe pequenas chamadas
celulas, cada qual Lo pequena que no pode ser vlsLa a olho nu. Ao longo do
corpo, h uma lncrlvel varledade de celulas, cada upo execuLando sua funo
separadamenLe. C slsLema lmune Lambem e felLo de celulas especlallzadas. LsLas
celulas so chamadas de celulas lmunes ou celulas do slsLema lmune.
nosso sangue e vermelho porque conLem uma grande quanudade
de celulas vermelhas chamadas erlLrclLos ou hemclas. LnLreLanLo,
ele Lambem conLm celulas brancas ou leucclLos. L so esLas
celulas brancas que funclonam como parLe do slsLema lmune.
Como o sangue clrcula aLraves do nosso corpo lnLelro, os leucclLos esLo
presenLes em Lodo lugar Lambem. LnLo, para responder a pergunLa, voc
pode enconLrar o slsLema lmune em qualquer e Lodo lugar no seu corpo.
orem, h lugares no corpo em que os leucclLos esLo parucularmenLe
concenLrados. LsLes lugares so os llnfonodos (Lambem conhecldos como
ndulos ou gngllos llnfucos) e o bao, e so lmporLanLes porque e neles que
o slsLema lmune lana uma resposLa quando voc Lem uma lnfeco.
ConLaremos mals sobre o bao e os llnfonodos depols.
14
Where in the body is the immune system?
Our bodies are made up of extremely small units called cells, each so small that
it cant be seen with the naked eye. Throughout the body there are an amazing
variety of cells, each kind performing its own separate function. The immune sys-
tem too is made up of specialised cells. These cells are called immune cells.
Our blood is red because it contains a great many red blood cells
called erythrocytes (eri-throw-sites). However, it also contains white
blood cells or leukocytes (loo-co-sites). And it is these white blood
cells that work as part of the immune system.
Because blood
circulates throughout
our entire body, white blood cells are
present everywhere too. So, to answer the question, you can find the
immune system anywhere and everywhere in your body. However,
there are places in the body where white blood cells are particularly
concentrated. These places are the lymph nodes and the spleen, and
they are important because they are the sites from which the immune
system launches when you have an infection. We will tell you more
about what the spleen and the lymph nodes do later.
Cl!
bao
C|u|a branca
ou |eucc|to =
c|u|a |mune
Cps
15
We said white blood cells can be found any-
where in the body and this includes those parts
of it that come in contact with the outside world
through food or air that is, the mouth, nose,
lungs and the gut. Many white blood cells are
also found in the skin, where they can destroy
any germs that enter the body right on the spot.
White blood cell =
immune cell
Hi!
gulp
spleen
009_09q.qxd 0I.0I.?009 II.S Uhr Seite IS
Cl!
bao
ulssemos que os leucclLos podem ser
enconLrados em qualquer lugar do corpo, o que
lnclul as parLes que enLram em conLaLo com o
mundo exLerno aLraves da comlda ou do ar - ou
se[a, a boca, o narlz, os pulmes e os lnLesunos.
MulLos leucclLos so enconLrados na pele, onde
podem desLrulr qualsquer mlcrblos que enLram
no organlsmo, [ no local em que eles enLram.
LnLo vamos agora dar uma olhada nas dlferenLes celulas que compem o slsLema lmune
(lembrem-se que esLas so os leucclLos, as celulas brancas).
neuLrlo
Se voc se machucar e sua pele se romper, germes
podem enLrar no seu corpo aLraves do corLe.
Cuando lsLo aconLece, neuLrlos, um grupo de
leucclLos que esLo presenLes no sangue, mlgram
para o local e desLrem os germes.
macrfago
CuLro upo de leucclLo e
o macrfago, que desLrl
paLgenos dlreLamenLe ao
com-los". voc enconLra
macrfagos nos pulmes,
ngado, pele e lnLesunos.
Cs leucclLos so Lo
pequenos que e necessrlo um
mlcroscplo para v-los.
As mu|tas c|u|as do s|stema |mune
16
The many cells of the immune system
So now lets look at some of the different cells that make up the immune system (remember these are
white blood cells).
If you get hurt and your skin breaks open, germs
can get into your body through the cut. When this
happens, neutrophils, a group of white blood cells
that are always present in the blood, migrate to the
site to destroy the germs.
Another type of white blood
cell is the macrophage, which
destroys pathogens directly by
eating them. Youll find macro-
phages in the lungs, liver, skin
and gut.
neutrophil
macrophage
Immune cells are so small
you need a microscope to see
them.
009_09q.qxd 0I.0I.?009 II.S Uhr Seite I
LlnfclLos so ouLro upo de leucclLos, e eles so os menores membros
da famllla. Llas podem medlr menos do que um cenLeslmo de um
mlllmeLro ou 10 mlcra. Se voc os observasse em um mlcroscplo, eles
Lodos parecerlam lguals. Mas se voc lnvesugar um pouco mals, voc
descobrlrla que h dlferenLes upos, cada qual com sua prprla funo
especlallzada.
um upo de llnfclLo que voc enconLrarla e o llnfclLo 8 ou
celula 8. Celulas 8 produzem armas especlals chamadas
anncorpos, que grudam em um paLgeno e a[udam o slsLema
lmune a desLrul-lo. CuLros llnfclLos so conhecldos como
llnfclLos 1 helper" ou Auxlllares e os llnfclLos 1 klller" ou
exLermlnadores. Cs llnfclLos 1 exLermlnadores, como o
prprlo nome sugere, so os maLadores de aluguel"
da famllla de celulas brancas do sangue.
Llas ellmlnam qualsquer celulas que esLe[am
lnfecLadas por um vlrus.
um upo mals lmporLanLe de leucclLo e a celula dendrluca. Lla
recebe esLe nome por causa de Lodos os braos que ela Lem, que se
espalham para o lado exLerno como se fossem os ramos de uma
rvore (dendron e a palavra grega para rvore). Cuando os
germes enLram no organlsmo, so as uCs que auxlllam as celulas 1
helper a enLender que upo de paLgeno ele e, e qual a
melhor manelra de desLrul-lo.
ALe agora, aprendemos que dlferenLes upos de leucclLos
concenLram-se em dlferenLes reas do organlsmo (bao e
llnfonodos). L Lambem sabemos que eles Lm papels dlsunLos,
mas Lodos Lrabalham [unLos para proLeger o organlsmo.
Lm humanos, o 8 das celulas 8 vem de bone
marrow" (em lngls), ou medula ssea, onde esLas celulas
so produzldas. 1ambem vem de bursa de labrlclus, onde
as celulas do sangue so produzldas nos pssaros. C 1 em
celulas 1 vem de umo, o rgo onde esLas celulas se
desenvolvem.
llnfclLo 8
llnfclLo 1 klller"
llnfclLo 1 helper"
Celula dendrluca
17
One more important type of white blood cell is the den-
dritic cell. This cell gets its name from all the arms it has
that reach out of it like the branches of a tree (Dendron is
Greek for tree). When germs enter the body, it is the den-
dritic cells that help helper T cells understand what kind of
pathogen it is, and how best to destroy it.
So far we have learnt that different types white blood cells are
concentrated in different areas of the body (spleen and lymph
nodes). And we also know that while they have distinct roles, they all
work together to protect the body.
One type of lymphocyte youd discover is the B lympho-
cyte or B cell. B cells produce special weapons called anti-
bodies which stick to a pathogen and help the immune sys-
tem to destroy it. Other lymphocytes are known as
helper T cells and killer T cells. Helper T cells help B
cells to produce antibodies and also boost the abili-
ty of macrophages to attack pathogens. Killer T
cells, as their name suggests, are hit men of the
white blood cell family. They bump off any cells
that have been infected by a virus.
Lymphocytes are another type of white blood cell, and they are the smallest
members of the family. They can measure less than a 100
th
of a millimetre or 10
microns. If you were to look at them under a microscope, they would all look the
same. But if you were to investigate a little further, youd find that there are dif-
ferent types, each with its own specialised function.
In humans, the B in B cell stands for bone marrow,
where the cells are produced. It also stands for the
bursa of Fabricius, where the cells are made in birds.
The T in T cells stands for thymus, the organ where
these cells develop.
B cell
helper T cell
dendritic cell
killer T cell
009_09q.qxd 0I.0I.?009 II.S Uhr Seite II
1rs mane|ras de destru|r um patgeno
Agora vamos aprender um pouco mals sobre como os leucclLos llvram o
organlsmo de paLgenos
Lngo||ndo-os |nte|ros.
neuLrlos e macrfagos
engol em paLgenos, em
parucular bacLerlas, lnLelros.
L l e s L a m b e m m a L a m
b a c L e r l a s f a g o c l L a d a s
(engolldas) quebrando-as em
pedaclnhos.
Destru|ndo c|u|as
|nfectadas
Celulas que foram lnfecLadas por
um vlrus so um perlgo para o
organlsmo e devem ser removldas
rapldamenLe. L aqul que as celulas
1 klller enLram em ao. Llas
pram o vlrus que esLo se
repllcando rapldamenLe denLro
das celulas e lmpedem que eles se
espalhem enconLrando celulas
lnfecLadas e maLando-as.
bacLerla
neuLrlo
macrfago
nossa!
val fundo!
LlnfclLo 1 klller"
maLa
vlrus
Celula lnfecLada
por vlrus
morre
1chau-Lchau
18
Three ways of destroying a pathogen
Now lets find out a little more about how white blood cells rid the body of pathogens.
Swallowing them whole
Neutrophils and macrophages
swallow pathogens, in particular bac-
teria, whole. They also kill the bacteria
they swallowed by breaking them
down into pieces.
1
Killing infected cells
Cells that have been infected by
a virus are a danger to the body
and have to be removed quickly.
This is where killer T cells come
into play. Killer T cells stop virus
that is rapidly multiplying in the
cells from spreading by finding
the infected cells and killing them.
2
bacterium
neutrophil
macrophage
killer T cell
Bye-bye
kills
Wow!
Go for it!
virus
virus-infected cell
dies
009_09q.qxd 0I.0I.?009 II.S Uhr Seite I8
18
down into pieces.
1
2
bacterium
neutrophil
macrophage
killer T cell
Bye-bye
kills
Wow!
Go for it!
virus
virus-infected cell
dies
18
down into pieces.
1
2
bacterium
neutrophil
macrophage
killer T cell
Bye-bye
kills
Wow!
Go for it!
virus
virus-infected cell
dies
LlnfclLo 8
bacLerla
1oxlnas
bacLerlanas
19
Antibody smothering
Once inside the body, bacteria not only multiply, but also
produce chemicals that are harmful to the body called bacte-
rial toxins. To stop bacterial toxins from being able to func-
tion, B cells smother them with weapons called antibodies.
Antibodies can also attach themselves to viruses to prevent
them from penetrating cells. And viruses that cant enter
cells, cant multiply.
Antibodies have another important job. They attach them-
selves to bacteria to flag them as a meal for macrophages. We
know that macrophages swallow bacteria anyway, but they
can do this job much better when the bacteria are covered in
antibodies. Antibodies travel around the whole body via the
blood. That means that whatever part of the body is infected,
antibodies can move to it quickly to confront the pathogen.
3
B cell
antibody
macrophage
Hey, how about
this?
bacterium
Ow
B cell
bacterial
toxins
virus with antibody
attached to it
bacterium with
antibodies
stuck to it
Al...
macrfago
uma vez denLro do corpo, as bacLerlas no s se
mulupllcam, como Lambem produzem subsLnclas
qulmlcas pre[udlclals chamadas tox|nas bacter|anas.
ara lmpedlr que esLas Loxlnas funclonem, os llnfclLos
8 as neuLrallzam com armas chamadas anucorpos. LsLas
moleculas Lambem podem aderlr aos vlrus para
prevenlr que eles peneLrem nas celulas. L os vlrus que
no enLram nas celulas no podem se mulupllcar.
Cs anucorpos Lm ouLro papel lmporLanLe. Lles
aderem a superncle de bacLerlas para marc-las como
uma refelo para macrfagos. Sabemos que
macrfagos englobam as bacLerlas de qualquer modo,
mas eles podem reallzar esLe Lrabalho bem melhor
quando as bacLerlas so coberLas de anucorpos. Cs
anucorpos vla[am ao redor do organlsmo pelo sangue.
lsLo slgnlca que qualquer que se[a a parLe do
organlsmo lnfecLada, os anucorpos podem se mover
rapldamenLe para l para confronLar o paLgeno.
Ll, e lsLo aqul?
19
Antibody smothering
3
B cell
antibody
macrophage
Hey, how about
this?
bacterium
Ow
B cell
bacterial
toxins
virus with antibody
attached to it
bacterium with
antibodies
stuck to it
vlrus com
anucorpo aderldo
anucorpo
llnfclLo 8
8acLerla com
anucorpos
grudados
llnfclLo 8
bacLerla
Loxlnas
bacLerlanas
Neutra||zao por anncorpos
19
Antibody smothering
3
B cell
antibody
macrophage
Hey, how about
this?
bacterium
Ow
B cell
bacterial
toxins
virus with antibody
attached to it
bacterium with
antibodies
stuck to it
Como o s|stema |mune func|ona
Como o s|stema |mune d|snnge entre d|ferentes patgenos
C slsLema lmune pode ldenucar qual paLgeno lnfecLou o
corpo e declde qual a melhor manelra de lldar com ele.
AnLerlormenLe, aprendemos que por causa da memrla
lmunolglca, quem [ Leve caxumba uma vez, no ca
doenLe dlsso ouLra vez. Mas lsso no o/a lmpedlrla de pegar
ouLra doena, como sarampo, por exemplo. As celulas do
slsLema lmune sabem a dlferena enLre os vlrus da caxumba
e do sarampo porque elas as memorlzam como 2 colsas
compleLamenLe dlferenLes.
A capacldade do slsLema lmune de fazer lsLo e conheclda
pelo bem dlncll Lermo especlcldade anugnlca.
LnLo, como e exaLamenLe que o slsLema lmune dlscrlmlna os paLgenos?
C papel de dlsungulr enLre dlferenLes paLgenos
perLence aos llnfclLos. 1anLo os 8 quanLo os 1
possuem ferramenLas especlals que cobrem a
superncle lnLelra da celula para separar paLgenos.
LsLas ferramenLas so chamadas receptores de
anngenos e se parecem com mlnusculos basLes
com pequenos buracos em suas exLremldades.
Alguns dos buracos so formados para encalxar
exaLamenLe os vlrus do sarampo, enquanLo ouLros
so formados para se comblnar com os vlrus da
caxumba ou algum ouLro paLgeno somenLe. C
slsLema lmune saber se um deLermlnado paLgeno
[ enLrou no organlsmo anLes, e ser capaz de
ldenuc-lo, com base em quals de suas celulas
possuem recepLores de angenos que comblnam.
aberLura
recepLor de
angeno
llnfclLo 8
20
The immune system can identify what pathogen has infected your
body and decide on the best means to deal with it. Earlier, we learned
that because of immune memory, people whod had mumps once
couldnt get sick with it again. But this would not stop them from get-
ting sick from something else, like measles. The cells of the immune
system can tell the difference between mumps virus and measles
virus because the cells memorise them as two entirely different
things.
The immune systems ability to do this is known by the rather diffi-
cult term of antigen specificity.
The job of distinguishing among different
pathogens belongs to the lymphocytes. Both T
and B cells have special tools for telling
pathogens apart that cover the entire surface of
the cell. These tools are called antigen receptors
and they look like tiny rods with small holes at the
end.
Some of the holes are shaped to fit the measles
virus exactly, while others are shaped to match
the mumps virus or some other pathogen only.
The immune system will know if a pathogen has
entered the body before, and be able to identify
it, based on whether any of its cells possess anti-
gen receptors that match.
So how exactly does the immune system tell pathogens apart?
2
.
How the Immune System Works
How the immune system distinguishes among pathogens
B cell
antigen
receptor
opening
009_09q.qxd 0I.0I.?009 II.S Uhr Seite ?0
20
things.
end.
2
.
B cell
antigen
receptor
opening
20
things.
end.
2
.
B cell
antigen
receptor
opening
paLgeno
8ecepLor de Angeno
erfelLo!
no
comblna
lorma
errada
Com-
blna!
L esLe aqul?
Cue comblnao perfelLa!
cllck
1anLo os llnfclLos 8 quanLo os 1 possuem
recepLores que reconhecem dlferenLes
paLgenos, mas as suas formas e funes so
um pouqulnho dlferenLes. Cs recepLores de
angenos da celula 8 Lm o formaLo da leLra
? e possuem um buraco na exLremldade de
cada brao.
! os recepLores de celulas 1 assemelham-se a basLes e Lm
somenLe um buraco na exLremldade.
ulssemos anLerlormenLe que os llnfclLos 8 se llvram de
paLgenos produzlndo anucorpos que os neuLrallzam.
na realldade, esLes anucorpos parecem exaLamenLe como
recepLores de angeno que foram corLados de uma celula
em sua base. L eles Lm exaLamenLe as mesmas aberLuras
que os recepLores de llnfclLos 8. Cuando alguem conLral
caxumba, somenLe as celulas 8 que Lm recepLores de
angeno para o vlrus da caxumba produzlro anucorpos,
porque somenLe esLes anucorpos podem aderlr a esses
vlrus. no farla senudo se os llnfclLos 8 produzlssem
anucorpos que pudessem aderlr a, dlgamos, vlrus do
sarampo nesLe caso. LnLo voc percebe
que desLe modo o slsLema lmune e
basLanLe lnLellgenLe.
22
Both T cells and B cells have antigen receptors
that recognise different pathogens, but their
shapes and functions are a little different. B cell
antigen receptors looks like the letter Y and have
a hole at the end of each arm.
Earlier we told you that B cells get rid of pathogens by pro-
ducing antibodies that smother them.
Actually, these antibodies look exactly like antigen receptors
that have been cut off a cell at the base of the stem. And they
have exactly the same shaped openings as B cell receptors.
When you catch mumps, only B cells that have antigen re-
ceptors for the mumps virus will produce antibod-
ies, as only these antibodies can attach to the
virus. It wouldnt make any sense for B cells to pro-
duce antibodies that could attach to, say, the
measles virus in this case. So you see, in this way
the immune system is very clever.
T cells receptors, however, look like rods and have just one hole
at the end.
B cell
009_09q.qxd 0I.0I.?009 II.S Uhr Seite ??
pedaos do paLgeno para exlblo em plaLaformas que cobrem a superncle
das uCs. ApresenLados desLa manelra, os pedaos de paLgenos aLuam como
slnals para os llnfclLos 1 dlzendo, Ll, ve[am! esLamos lnfecLadas
com (67( germe."
ulferenLe dos anucorpos, os recepLores de angenos de llnfclLos 1 no
conseguem aderlr aos paLgenos sem a[uda.
Aqul, as uCs, que [ menclonamos, Lm um papel lmporLanLe. As uCs ellmlnam
paLgenos do organlsmo, e o fazem por 2 camlnhos. Llas engolem paLgenos
dlreLamenLe ou engolem celulas que foram lnfecLadas por paLgenos. 1endo
udo esLe banqueLe com paLgenos, as uCs empurram culdadosamenLe pra fora
LsLe aLo de slnallzar qual germe causou
uma lnfeco e conhecldo como apresentao
de anngenos.
L como pedaos de cada vlrus, como
os da caxumba e do sarampo, so
dlferenLes em formaLo, um llnfclLo 1
consegue dlzer exaLamenLe
qual vlrus lnfecLou o corpo.
uma vez que as uCs
apresenLaram um
angeno, os llnfclLos 1
conseguem ldenuc-lo e segulr
adlanLe com o seu Lrabalho.
llnfclLo 1 helper"
A plaLaforma descrlLa aqul e chamada de Complexo rlnclpal de PlsLocompaubllldade, ou MPC (do
lngls, Ma[or PlsLocompaublllLy Complex). LsLe nome vem da deLermlnao de quo bem um Lecldo ou
rgo LransplanLado e acelLo pelo organlsmo. 8367& e a palavra launa para Lecldo e compavel slgnlca
capaz de se comblnar. um melhor enLendlmenLo de como o MPC funclona e vlLal para o progresso com
a medlclna dos LransplanLes ou LraLamenLo com celulas Lronco para doenas degenerauvas.
celula dendrluca
Llas alerLam ouLras celulas
do slsLema lmune dlzendo
com qual paLgeno elas Lm que
lldar. C slsLema lmune pode agora
comear a aLacar os germes que esLo vlvendo
e se mulupllcando denLro das celulas do organlsmo.
23
Unlike antibodies, T cell antigen receptors cant attach themselves to pathogens without
help.
Here, the dendritic cells that we told you about earlier play an important role. Dendritic
cells clear the body of pathogens, and they do this in two ways. They swallow pathogens di-
rectly or they swallow cells that have been infected by them. Having feasted on them
in this way, dendritic cells carefully push out pieces of the pathogen for display on
platforms that cover the surface of the dendritic cell. Presented in this way,
the pieces of pathogen act as signs for T cells saying, Hey, look! Weve
been infected with this germ.
This act of signalling what germ caused an infec-
tion is known as antigen presentation.
And because pieces of each virus, like
those for the mumps and measles,
are different in shape, a T cell
can tell exactly which virus has
infected the body.
Once dendritic cells have
presented an antigen, T cells
can identify it and go ahead
and do their work.
They alert the other cells of
the immune system telling
them what pathogen they have
to deal with. The immune system
can now begin to attack germs that are living
and multiplying inside the bodys cells.
The platform described here is called the Major Histocompatibility Complex, or MHC. It got its name
because it determines how well a tissue or organ transplant is accepted by the body. Histo is the
Latin word for tissue and compatible means to match. Improving our understanding of how the MHC
works is vital to making progress with transplant medicine or stem cell treatments for degenerative
diseases.
dendritic cell
helper T cell
009_09q.qxd 0I.0I.?009 II.S Uhr Seite ?
Como o s|stema |mune pode
reconhecer d|ferentes germes
lellzmenLe, ele Lem. Se voc fosse pesqulsar quanLos recepLores
de angenos ns humanos Lemos, voc enconLrarla que h mals de
10 8lLPLS de dlferenLes upos. Cu se[a, 10.000.000.000. Com LanLos
dlferenLes recepLores, deLermlna-se que, pra cada paLgeno, ha[a um llnfclLo
especlco no organlsmo que possa reconhecer qualquer paLgeno que enLre nele. L
com Lodos esLes llnfclLos Lrabalhando [unLos, o slsLema lmune pode proLeger o
organlsmo de uma enorme varledade de paLgenos.
24
How the immune system can
recognise different germs
Weve learned that each lymphocyte has only one type of antigen receptor.
So when you catch the mumps, only lymphocytes with antigen receptors for
the mumps virus will detect it. Cells that detect other pathogens will ignore
it. But all around us are millions upon millions of different germs. Clearly
then, the body needs to have an enormous number of different lymphocytes
to protect it.
Luckily, it does. If you were to look up how many antigen receptors humans have, you would
find that there are over 10 BILLION different kinds! That is 10,000,000,000. With so many dif-
ferent receptors, there is bound to be one lymphocyte in the body that can recognise whatever
pathogen enters it. And with all of these lymphocytes working together, the immune system can
protect the body from a huge variety of pathogens.
Our parents pass between 30,000 and 40,000
genes on to us, and all of these genes together are
known as our genome. Within our genome there are
genes for making the different parts of our body like
muscles, skin, bones and organs. They are also
genes for making antigen receptors.
So how does your body make so many different
kinds of antigen receptors?
dad mum
Genes
me
Your genome is
all over your
body.
Aprendemos que cada llnfclLo Lem somenLe um upo de recepLor de
angeno. LnLo, quando se pega caxumba, somenLe os llnfclLos com
recepLores de angeno para vlrus da caxumba deLecL-lo-o. Celulas que
deLecLam ouLros paLgenos lro lgnor-lo. Mas ao nosso redor, h
mllhes e mllhes de dlferenLes germes. ClaramenLe enLo, o corpo
necesslLa Ler um numero enorme de llnfclLos dlferenLes para proLeg-lo.
LnLo como e que o seu organlsmo faz
LanLos dlferenLes upos de recepLores de
angenos?
nossos pals nos passam enLre 30.000 e
40.000 genes, e Lodos esLes genes [unLos so
conhecldos como nosso genoma. uenLro de
nosso genoma, h genes para fazer dlferenLes
parLes de nosso organlsmo, como musculos,
pele, ossos e rgos. P Lambem genes para
fazer recepLores de angenos.
24
How the immune system can
recognise different germs
Weve learned that each lymphocyte has only one type of antigen receptor.
So when you catch the mumps, only lymphocytes with antigen receptors for
the mumps virus will detect it. Cells that detect other pathogens will ignore
it. But all around us are millions upon millions of different germs. Clearly
then, the body needs to have an enormous number of different lymphocytes
to protect it.
Luckily, it does. If you were to look up how many antigen receptors humans have, you would
find that there are over 10 BILLION different kinds! That is 10,000,000,000. With so many dif-
ferent receptors, there is bound to be one lymphocyte in the body that can recognise whatever
pathogen enters it. And with all of these lymphocytes working together, the immune system can
protect the body from a huge variety of pathogens.
Our parents pass between 30,000 and 40,000
genes on to us, and all of these genes together are
known as our genome. Within our genome there are
genes for making the different parts of our body like
muscles, skin, bones and organs. They are also
genes for making antigen receptors.
So how does your body make so many different
kinds of antigen receptors?
dad mum
Genes
me
Your genome is
all over your
body.
pal me
eu
Seu genoma
esL dlsLrlbuldo
pelo seu corpo
lnLelro
normalmenLe, dlzemos que um gene faz uma parLe do corpo, mas no e esLe o
caso com os recepLores de angenos. Cs genes que os fazem esLo separados
em segmenLos como os pedaos de um quebra-cabeas. L e somenLe denLro dos
llnfclLos que esLes pedaos de genes podem se comblnar em dlferenLes
manelras para produzlr qualsquer numeros de con[unLos para recepLores de
angenos.
uas cenLenas de peas de quebra-cabeas
dlsponlvels, um llnfclLo seleclona 2 ou 3 para se
comblnar. um llnfclLo pode [unLar esLas peas de
dlferenLes modos, e como h uma Lendncla de
algumas peas no se encalxarem, um numero
exLraordlnrlo de dlferenLes recepLores de
angenos pode ser produzldo.
25
Usually we say that one gene makes one part of the body, but this is not the case with antigen
receptors. The genes that make them up are all separated into segments like the pieces of a
puzzle. And its only inside lymphocytes that these pieces of genes can be combined in differ-
ent ways to produce any number of blueprints for antigen receptors.
From the hundreds of puzzle pieces available, a lym-
phocyte selects two or three to combine. A lymphocyte
can put these pieces together in many different ways,
and because there tends to be inaccuracies when the
pieces are linked, an extraordinary number of different
antigen receptors can be produced.
pu
zz
le
009_09q.qxd 0I.0I.?009 II.S Uhr Seite ?S
Como o s|stema |mune se |embra
de patgenos que [ v|u antes?
26
How the immune system remembers
pathogens its met before
The first time a B cell meets a pathogen, it
takes over a week for the cell to produce an-
tibodies against it. During this time the B
cell changes itself into a cell that can pro-
duce vast amounts of antibody. However,
not all B cells become antibody-producing
cells. Some B cells have the job of remem-
bering the new pathogen. These B cells are
known as memory B cells.
When a memory B cell again meets the pathogen that it
has the job of remembering, it sets to work immediately
and produces an enormous amount of antibodies in just
a few days.
But memory cells arent just quicker at making antibod-
ies. They also make better quality antibodies than B cells
that have encountered a pathogen for the first time. These super-antibodies can
attach themselves to bacterial toxins more firmly, and theyre also better at flagging
bacteria for macrophages to find and eat.
Lymphocytes can remember pathogens
that theyve met before.
1
st
time
2
nd
time
Hello ...
memory B cell
virus
B cell
009_09q.qxd 0I.0I.?009 II.S Uhr Seite ?
Cs llnfclLos podem se lembrar de
paLgenos que eles [ vlram anLes.
A prlmelra vez que um llnfclLo 8
enconLra um paLgeno, leva mals de
uma semana para que as celulas
produzam anucorpos. uuranLe esLe
perlodo, o llnfclLo 8 se Lransforma
em uma celula que pode produzlr
vasLas quanudades de anucorpos.
LnLreLanLo, nem Lodos os llnfclLos 8
se Lornam c|u|as produtoras de
anncorpos. Alguns llnfclLos 8 Lm o
papel de lembrar o novo paLgeno.
LsLes llnfclLos 8 so chamados de
||nfc|tos 8 de memr|a.
Cuando um llnfclLo 8 de memrla enconLra
novamenLe um paLgeno, que era de seu Lrabalho
l embr ar , el e s e pr epar a pr a L r abal har
lmedlaLamenLe e produz uma enorme quanudade
de anucorpos em apenas alguns dlas.
Mas as celulas 8 de memrla no so Lo rpldas apenas em fazer anucorpos. Llas
Lambem fazem anucorpos de melhor qualldade do que llnfclLos 8 que enconLraram
um paLgeno pela prlmelra vez. LsLes super-anucorpos podem aderlr a Loxlnas
bacLerlanas mals rmemenLe, e so melhores Lambem em marcar bacLerlas para que
macrfagos as enconLrem e as comam.
LlnfclLo 8 de memrla
LlnfclLo 8
vlrus
Cl
1 vez
2 vez
uesLa forma, pessoas que se recuperaram de caxumba Lm um grande numero
de llnfclLos 1 e 8 de memrla e que podem reconhecer somenLe aquele vlrus. ue
modo semelhanLe, pessoas que se recuperaram de qualquer ouLra lnfeco Lero
numeros aumenLados de somenLe aqueles llnfclLos 1 e 8 de memrla que
possam ldenucar os paLgenos especlcos envolvldos.
Cs llnfclLos 1 Lambem fazem celulas
de memrla. normalmenLe, os
llnfclLos 1 helper" e klller" apenas
vla[am pelo corpo, paLrulhando-o.
Cuando enconLram um paLgeno, os
llnfclLos 1 cu[os recepLores de
angeno comblnam com um cerLo
angeno dlvldem-se rapldamenLe e
cam pronLos para Lrabalhar. Leva
cerca de uma semana para lsLo Ludo
aconLecer. uuranLe esLe Lempo,
algumas das celulas auxlllares se
Lornam celulas de memrla. L se elas
enconLram o mesmo paLgeno
novamenLe, elas cam prlmadas" pra
lr Lrabalhar lmedlaLamenLe.
superanucorpo
anucorpo normal
Acho que val
levar mals uma
semana...
S mals uns dols
dlas agora...
val em
frenLe!
27
T cells also make memory cells.
Helper T cells and killer T cells nor-
mally just travel around the body pa-
trolling it. When they do come across
a pathogen, the T cells with antigen
receptors that match the antigen be-
gin to divide rapidly and get ready for
work. It takes about a week for all of
this to happen. During that time,
some of the helper T cells change
into memory T cells. And if they meet
the same pathogen again, they are
primed to go to work immediately.
In this way people who have recovered from the mumps have a large number
of memory T and B cells that can recognise just that virus. Similarly, people
whove recovered from any other infection will have large numbers of just those
memory T and B cells that can identify the specific pathogens involved.
I guess itll take
another week ...
Just a couple of
days now.
Thats
quick!
Go for it!
superantibody
normal antibody
009_09q.qxd 0I.0I.?009 II.S Uhr Seite ?I
lsLo e
rpldo!
llnfclLo 1 helper"
Meu...
llnfclLo 1 klller
umo
medula ssea
osso
28
bone
bone marrow
My
ne
helper T cell
killer T cell
thymus
29
All immune cells are white blood cells, and they are
made in the bones. Bones are very hard, but they
have a soft, spongy core called the bone marrow.
Blood cells are made from special cells in the bone
marrow called haematopoietic (he-ma-toe-po-etic)
or blood stem cells. Just one stem cell can make any
number or any type of immune cell.
Like red blood cells and platelets, most immune cells like neu-
trophils, B cells and macrophages are made in the bone marrow.
Only T cells are different. They are made in a special organ near
the heart called the thymus. Blood stem cells that are destined to
be T cells move to this organ to mature.
Newly made immune cells stream out into the body from the
marrow and thymus via blood vessels. The cells then migrate to
the lymph nodes and spleen the sites from which the immune
response is launched to begin their work.
3
.
Where are immune cells made?
Where the Cells of the Immune System are Made
and Where They Work
How did the thymus get its name? Some people think its
because the thymus of a cow, which is sometimes used in
cooking, smells just like the herb thyme.
macrophage
dendritic cell
neutrophil
B cell
29
3
.
and Where They Work
macrophage
dendritic cell
neutrophil
B cell
Cnde as c|u|as do S|stema Imune so
fe|tas e onde e|as traba|ham?
29
3
.
and Where They Work
macrophage
dendritic cell
neutrophil
B cell
29
3
.
and Where They Work
macrophage
dendritic cell
neutrophil
B cell
Cnde so fe|tas as c|u|as |munes?
1odas as celulas lmunes so celulas brancas do
sangue (leucclLos), e elas so felLas nos ossos. Cs
ossos so mulLo duros, mas eles Lem um nucleo
leve, espon[oso chamado de medu|a ssea. As
celulas do sangue so felLas de celulas especlals na
me d u l a s s e a c h a ma d a s d e c | u | a s
hematopo|ncas ou c|u|as tronco. Apenas uma
celula Lronco pode fazer qualquer quanudade ou
upo de celula lmune.
Como as celulas vermelhas do sangue e as
plaqueLas, a malorla das celulas como neuLrlos,
llnfclLos 8 e macrfagos so felLos na medula
ssea. SomenLe os llnfclLos 1 so dlferenLes. Lles
so felLos em um rgo especlal perLo do corao
chamado nmo. As celulas Lronco do sangue que so
desunadas a se Lornar llnfclLos 1 mudam-se para
esLe rgo para se maLurar.
Celulas recem-produzldas correm pelo corpo a parur da
medula e umo por melo dos vasos sangulneos. As celulas
mlgram para os llnfonodos e bao - os lugares a parur dos
quals a resposLa lmune e lnlclada - para comear seu Lrabalho.
ue onde vem o nome do rgo umo? Alguns pensam que e por
causa do umo de vaca, que as vezes e usado na cullnrla, e Lem
exacLamenLe o chelro da erva chamada umo.
llnfclLo 8
macrfago
celula dendrluca
As celulas lmunes produzldas na medula ssea e umo
vla[am pelo corpo lnLelro, paLrulhando-o. uo Lopo de sua
cabea as ponLas de seus dedos dos pes, onde houver
uma lnfeco, as celulas lmunes apressam-se para o local,
derrubam o germe e asslm proLegem o organlsmo.
As celulas lmunes vla[am ao redor
do or ganl s mo us ando v as os
sanglneos e vlas excluslvamenLe
para seu uso, chamados vasos
||nfncos. Como os vasos sanglneos,
os llnfucos espalham-se ao longo de
nosso corpo formando uma rede.
Aqul e l ao longo dos llnfucos h posLos de
parada chamados ||nfonodos. LsLes nodos so
onde as celulas lmunes que vla[am pelos vasos
llnfucos e sangulneos podem se reunlr em
grandes numeros. As celulas lmunes que
vla[am ao redor do sangue reunem-se no
bao, que locallza-se no abdmen.
llnfonodo
vaso
llnfuco
ve[a Lodos esLes
llnfonodos!
llnfonodo
LsLe
e o
bao.
vaso llnfuco
Cnde as c|u|as do S|stema Imune traba|ham
e como e|as chegam at |?
30
Immune cells travel around the body
using blood vessels and routes exclusive-
ly for their use called lymph vessels. Like
blood vessels, lymph vessels spread
throughout our body forming a network.
Here and there along the lymph vessels
are staging posts called lymph nodes. These nodes are
where the immune cells that travel in lymph vessels
and blood vessels can gather in large numbers.
Immune cells that travel around in the blood
gather in the spleen, which is located in the
abdomen.
Where do immune cells work and how do
they get there?
This is
the
spleen.
Look at all
those lymph
nodes!
lymph
node
lymph
vessel
lymph vessel
lymph node
Immune cells made in the bone marrow and thymus travel
around the whole body, patrolling it. From the top of your head
to the tip of your toes, wherever there is an infection, immune
cells rush over to the site, knock out the germ and thus protect
the body.
009_09q.qxd 0I.0I.?009 II.S Uhr Seite 0
Lmbora se[a um evenLo raro, algumas pessoas nascem sem
bao. Cuando elas se lnfecLam pela boca ou narlz, elas
conseguem lanar uma resposLa lmune adequada conLra o
germe. LnLreLanLo, se elas Lm um corLe ou algo parecldo que
as lnfecLem pelo sangue, elas no conseguem lanar uma
resposLa lmune efeuva. Como resulLado, esLas pessoas sofrem
mals de Lals lnfeces.
C bao e os llnfonodos so onde
os leucclLos se enconLram.
AnLerlormenLe no llvro, aprendemos
que cada leucclLo em parucular Lem
uma funo mulLo especlca. Mas como o
corpo Lem uma quanudade enorme de
leucclLos, e eles Lodos Lrocam lnformao e
Lrabalham [unLos lnumamenLe, o slsLema
lmune pode proLeger o corpo dos germes. Cs
llnfonodos e bao fornecem o cenrlo para
os leucclLos se enconLrarem e Lrocarem
lnformao. Lles so Lambem os lugares
onde os anucorpos so produzldos e os
llnfclLos 1 klllers" so auvados.
Cuando voc pegou resfrlado pela uluma vez, a
sua garganLa cou dolorlda e voc senuu
pequenas bolas no pescoo? LsLas
bollnhas so os seus llnfonodos, e
eles cam lnchados porque e
neles que seus leucclLos
luLaram conLra o vlrus
do resfrlado,
perLo do
narlz
e boca, aLraves dos
quals eles enLraram.
Como as c|u|as |munes encontram seu cam|nho
Menclonamos que as celulas lmunes usam os vasos
sanglneos e llnfucos para paLrulhar o corpo. Mas como esLas
celulas conseguem enconLrar seu camlnho para os llnfonodos?
L, quando h lnfeco, como elas conseguem chegar
exaLamenLe aonde os paLgenos lnvadlram o corpo?
As celulas lmunes podem enconLrar
llnfonodos porque os nodos produzem
moleculas que agem como slnals que
dlzem lsLo e um llnfonodo. As celulas
lmunes que paLrulham o corpo, ao
enconLrar esLes slnals, reconhecem onde
esLo e respondem enLrando nos nodos.
Moleculas so grupos de Lomos. So as menores unldades em
que se pode quebrar uma subsLncla e alnda reconhecer de onde
ela vem a parur de suas proprledades nslcas e qulmlcas.
Lomos
mole-
cula
32
How immune cells find their way around
Immune cells can find lymph nodes
because the nodes make molecules
that act as signs that read, this is a
lymph node. Immune cells patrolling
the body come across these signs, recog-
nise where they are and respond by enter-
ing the nodes.
* Molecules are groups of atoms. They are smallest units into
which you can breakdown a substance and still recognise
what it is from its physical and chemical properties.
We mentioned that immune cells use blood and lymph vessels
to patrol the body. But how do these immune cells manage to
find their way to the lymph nodes? And, when there is an infec-
tion, how do they manage to find out exactly where the
pathogens have invaded the body?
atoms
mole-
cule
009_09q.qxd 0I.0I.?009 II.SI Uhr Seite ?
As qulmloclnas so um bem conhecldo grupo de moleculas qulmloaLraLoras.
essoas que no conseguem produzlr qualsquer moleculas de adeso no
conseguem lnlclar uma resposLa lmune adequada porque se Lorna mals dlncll
que seus llnfclLos cheguem aLe os llnfonodos.
llnfonodo
Se[am
bem-vlndos!
molecula de adeso
Culmlo-
aLraLoras
LnLrem!
Ln18AuA
C8 ACul!
uuranLe uma lnfeco, as uCs no dlzem aos llnfclLos 1 apenas qual germe e a
causa da doena. Llas Lambem llberam moleculas slnallzadoras que alerLam as suas
vlzlnhanas para a lnfeco. Cs leucclLos que
passam pelos vasos vlzlnhos respondem a
esLas moleculas mlgrando para o sluo de
lnfeco e lldando com os germes. 1als
moleculas slnallzadoras locallzadas nas
superncles celulares so chamadas
de moleculas de adeso, e elas
mosLram as celulas lmunes que se
aproxlmam, exaLamenLe onde elas
esLo, grudando-se nelas. CuLras
moleculas slnallzadoras, chamadas
qulmloclnas, so llberadas por
celulas e podem vla[ar alguma
dlsLncla para convldar ouLros
leucclLos que eles enconLram
em sua [ornada. L
exaLamenLe como uma lo[a
que LenLa chamar sua aLeno
pondo um slnal grande (moleculas
de adeso) na porLa e enLo Lendo
pessoas (qulmloaLraLoras) na
enLrada para convld-lo
a enLrar.
33
During an infection, dendritic cells, dont just tell T
cells what germ is the cause. They also release sig-
nalling molecules that alert their surroundings to the
infection. Immune cells that pass through blood and
lymph vessels nearby respond to these mole-
cules by migrating to site of infection and deal-
ing with the germs.
Such signalling molecules located on
cell surfaces are called adhesion mole-
cules, and they show immune cells that
approach exactly where they are by
sticking to these cells. Other signalling
molecules, called chemo-attractants,
are discharged by cells and can travel
some distance to invite over immune
cells that they meet on their journey.
Its just like a shop that tries to grab
your attention by putting up a large sign
(adhesion molecules) over the door
and then having people (chemo-attrac-
tants) at the entrance to invite you in.
Chemokines are a well-known group of chemo-attractants.
People who cant produce any adhesion molecules cant launch a
proper immune response because their lymphocytes find it difficult
to get into the lymph nodes.
lymph node
ENTRANCE
THIS WAY IN!!!
Welcome!
Step inside!
Chemo-
attractants
adhesion molecule
009_09q.qxd 0I.0I.?009 II.SI Uhr Seite
Como os |eucc|tos se a[udam
34
How immune cells help each other
However, unlike real letters cy-
tokines dont have to be ad-
dressed to be delivered to the cor-
rect destination. Cytokines have
various different shapes, and
only those immune cells that
have a letterbox that has the cor-
responding shape can receive
them (like a square peg fits only
in a square hole). This letterbox is
called a cytokine receptor and it
differs from an antigen receptor.
In the lymph nodes, and wherever else immune cells
meet, cells use a whole range of molecules to exchange
information.
Molecules commonly used by immune
cells to communicate are called cytokines.
Cytokines allow immune cells to deliver in-
formation to each other although they are
far apart, acting just like a letter.
helper T cell
killer T cell
B cell
009_09q.qxd 0I.0I.?009 II.SI Uhr Seite 4
nos llnfonodos, e onde mals for que os
leucclLos se enconLrem, as celulas usam uma
gama l nLel ra de mol ecul as para Lrocar
lnformao.
Moleculas commumenLe usadas pelas
celulas lmunes para se comunlcar so
chamadas clLoclnas. Llas permlLem que
as celulas lmunes enLreguem lnformao
umas as ouLras embora elas esLe[am
bem longe, aLuando exacLamenLe como
uma carLa.
LnLreLanLo, dlferenLe das
carLas reals, as clLoclnas no
Lem que ser endereadas para
ser dlsLrlbuldas para o desuno
correLo. As clLoclnas Lm
vrlos formaLos dlferenLes, e
somenLe aquel as cel ul as
lmunes que possuem uma
calxa de correlo que Lenha a
forma correspondenLe a da
carLa pode receb-las. LsLa
calxa de correlo e chamada de
receptor de c|toc|nas e dlfere
de um recepLor de angeno.
llnfclLo 1 klller"
llnfclLo 8
llnfclLo 1 helper"
Agora, algumas clLoclnas dlsLrlbuem comandos
como Acordem! ou ulvldam-se! para as celulas.
Alnda asslm, ouLras clLoclnas dlzem as celulas para
reduzlrem a velocldade e descansarem ou se auLo-
desLrulrem. Cuando as celulas lem uma mensagem
que as ordena a comear a Lrabalhar, algumas
respondem comporLando-se furl osamenLe.
uependendo da slLuao, enLreLanLo, ouLras
respondem morrendo no lugar.
usando clLoclnas para envlar mensagens, os
leucclLos so capazes de consLrulr uma sosucada
rede de lnformaes. LxaLamenLe como as pessoas
usam Lelefones celulares e e-mall para se conecLar
com aqueles alem de sua vlzlnhana lmedlaLa, os
leucclLos conunuam a se comunlcar uns com os
ouLros pela rede de clLoclnas, enquanLo paLrulham
Lodo o organlsmo para proLeg-lo.
Cl!
1em
alguem
al?
Slm, eu
o ouo.
Cs pesqulsadores descobrlram upos basLanLe dlferenLes de clLoclnas. um upo, lnLerferon, Lornou-se
bem conhecldo depols que os douLores comearam a us-lo para LraLar cncer e hepauLe C. C lnLerferon
auxllla os leucclLos em nossos corpos a comunlcarem-se uns com os ouLros.
35
Now, some cytokines deliver commands like Wake
up! or Divide! to cells. Yet other cytokines tell cells
to slow down and rest or to self destruct. When cells
read a message that orders them to get to work, some
respond by beavering away furiously. Depending on
the situation, however, others respond by dying on the
spot.
Researchers have discovered quite a few different types of cytokines. One type, interferon, became well
known after doctors started using it to treat cancer and hepatitis C. Interferon helps the immune cells in
our bodies to communicate with one another.
By using cytokines to send messages, immune cells are able to
build a sophisticated information network. Just like people who
use mobile phones and e-mail to connect with those beyond their
immediate surroundings, immune cells continue to communicate
with one another via the cytokine network while they patrol all
around the body to protect it.
I think theyre
getting the
message ...
Network
Hello! Is
anybody
there?
Yes, I
hear you.
009_09q.qxd 0I.0I.?009 II.SI Uhr Seite S
8ede
Acho que esLo
enLendendo a
mensagem
Como o S|stema Imune se auto-
regu|a
36
How the immune system regulates
itself
The attack that immune cells launch to rid the body of pathogens is called an immune re-
sponse.
By now you probably realise that youd be in trouble if your immune system didnt launch
a response when you needed it. However, itd be just as bad if it responded to each and every
little thing. What you need is an immune response that launches when needed, as needed.
The fever you get when you have a cold is caused by the immune response, but think what
would happen to your body if your temperature didnt drop even after the virus had been
fought off.
The immune system has a number of ways to stop an overblown response from launch-
ing. It possesses molecules and cells that have the role of suppressing the immune re-
sponse. One cell that specialises in this task is the regulatory T cell.
regulatory T cell
009_09q.qxd 0I.0I.?009 II.SI Uhr Seite
C aLaque que os leucclLos lanam para llvrar o organlsmo de paLgenos e
chamado de resposta |mune.
or ora, voc [ deve Ler percebldo que esLarla em encrenca se seu slsLema
lmune no lnlclasse uma resposLa quando voc preclsasse. orem, serla Lo rulm
quanLo se ele respondesse a Loda e cada pequena colslnha. C que voc preclsa e
de uma resposLa lmune que se lnlcla ;$)*,& necessrla, (*;$)*7& necessrla. A
febre que voc Lem quando pega um resfrlado e causada pela resposLa lmune,
mas pense no que aconLecerla se a LemperaLura de seu organlsmo no calsse
mesmo aps os vlrus uvessem sldo ellmlnados.
C slsLema lmune Lem vrlos modos de lmpedlr que uma resposLa exagerada se
lnlcle. Lle possul moleculas e celulas com o papel de suprlmlr a resposLa lmune.
uma celula que se especlallza nesLa Larefa e o ||nfc|to 1 regu|ador.
llnfclLo 1 regulador
37
The immune system not only can halt a response already underway, it can also pre-
vent an unnecessary one from launching. Antigen receptors on lymphocytes are ultra-
sensitive and can detect very faint signals. However, when cells receive a weak signal,
they just respond by waiting and standing at the ready. Only when they get a strong
signal caused by an infection, do they kick off into action.
The immune system provides the body with an extremely reliable defence system.
Its manned with specialised cells, equipped with a sophisticated communications sys-
tem and armed with weapons such as antibodies. And now you know that the system
also has a whole host of safety measures that make sure that it doesnt start any need-
less fights, nor harm the body by wielding more force than necessary.
009_09q.qxd 0I.0I.?009 II.SI Uhr Seite I
C slsLema lmune no s pode parar uma resposLa [ em andamenLo,
como Lambem pode prevenlr que uma resposLa desnecessrla se lnlcle.
Cs recepLores de angenos dos llnfclLos so mulLo senslvels e podem
deLecLar slnals bem pequenos. LnLreLanLo, quando as celulas recebem um
slnal fraco, elas apenas respondem esperando e permanecendo de
pronudo. SomenLe quando elas recebem um slnal forLe causado por uma
lnfeco, elas do o ponLape lnlclal e enLram em ao.
C slsLema lmune fornece ao organlsmo um slsLema de defesa
exLremamenLe convel. Lle e equlpado com celulas especlallzadas, um
slsLema de comunlcao sosucado e um arsenal de armas como
anucorpos. L agora voc sabe que esse slsLema Lambem Lem uma gama
de medldas de segurana que garanLem que ele no comece baLalhas
desnecessrlas, nem pre[udlque o corpo, cedendo mals fora do que
necessrlo.
1odo dla, mulLas colsas que no so germes enLram no seu
corpo. uo ponLo de vlsLa do corpo, o allmenLo que voc come ou
os mllhes de mlcrblos que Lm um lar no seu lnLesuno
poderlam ser pensados como lnvasores. Mas o SlsLema lmune
no se lncomoda em lanar um aLaque conLra cada e Loda colsa
que ele enconLra no camlnho.
Lle Lambem no lnlcla um aLaque conLra o organlsmo. C
SlsLema lmune, em vez dlsso, acelLa o corpo - frequenLemenLe
referldo como prprlo - e colsas que so lnumas ao organlsmo
mas no pre[udlclals (exemplo: allmenLo). LsLa habllldade do
slsLema lmune e chamada de auto-to|ernc|a.
or que o S|stema Imune no
ataca o corpo nem os a||mentos
38
Why the immune system doesnt
attack the body or food
Every day a host of things other than germs enter your body. From the
bodys point of view the food that you eat or the millions of microbes
that make a home in your gut could be thought of as invaders. But the
immune system doesnt bother launching an attack against each and
every thing that it comes across.
It doesnt launch an attack against the body, either. The immune sys-
tem instead accepts the body often referred to as self and things that
are close to the body but not harmful
(e.g. food). This ability of the
immune system is called self
tolerance.
It died ...
click
click
EXIT
T cell
thymus
Yeah. I guess
theyre all
waiting to be
tested.
Look at
that
queue!
L, acho
que esLo
Lodos
esperando
para
serem
LesLados. LlnfclLo 1
ve[a
aquela
la!
SAluA
Morreu...
umo
cllck
cllck
39
So, lets find out first why the body doesnt attack itself.
Remember we told you that B cells and T cells have well over
10 billion different antigen receptors? With so many types,
there could just be an antigen receptor that matches one of the
bodys own antigens among them. If a lymphocyte with such
an antigen receptor did enter the blood, the cell would begin to
attack the body and that could spell disaster.
To stop this from happening, lymphocytes are tested to see
if their antigen receptors match the bodys own antigens before
they are released into the blood. For B cells this test takes place
in the bone marrow. For T cells, it takes place in the thymus.
Cells that have dangerous antigen receptors are destroyed on
the spot.
But if some of these dangerous lymphocytes did make it out
of the test sites and into rest of the body, not all would be lost.
Those mechanisms we told you about earlier the ones that
that stop unnecessary immune responses would take care of
these cells.
As for the food you eat and all those beneficial microbes that
live in your stomach and bowel, the immune system has spe-
cial mechanisms that allow it to tolerate them.
Oh,
it died ...
Welcome!
LnLo vamos descobrlr prlmelramenLe porque o
corpo no se aLaca.

Lembra-se que dlssemos que llnfclLos 8 e 1 Lm
bem mals que 10 bllhes de dlferenLes recepLores de
angenos? Com LanLos upos, poderla haver enLre
eles apenas um upo de recepLor que comblnasse
com um dos prprlos angenos do corpo. Se um
llnfclLo com Lal recepLor de angeno enLrasse na
correnLe sanglnea, a celula comearla a aLacar o
corpo e lsso poderla ser um desasLre.

ra lmpedlr que lsso aconLea, os llnfclLos so
LesLados para ver se seus recepLores se comblnam
com os prprlos angenos do corpo anLes que eles
se[am llberados no sangue. ara os llnfclLos 8, lsso
aconLece na medula ssea e para os llnfclLos 1, lsso
aconLece no umo. Celulas com recepLores de
angenos perlgosos so desLruldos nesses locals.

Mas se alguns desLes llnfclLos perlgosos escapam
aos locals de LesLe e enLram no resLo do corpo, nem
Ludo esLarla perdldo. Aqueles mecanlsmos que
menclonamos anLerlormenLe - que pararlam
resposLas lmunes desnecessrlas - Lomarlam conLa
desLas celulas.
8em vlndos!
Ch,
morreu...
CuanLo a comlda e Lodos aqueles mlcrblos
benecos que vlvem no seu esLmago e lnLesuno, o
slsLema lmune possul mecanlsmos especlals que o
permlLe Loler-los.
1udo sobre Doenas
arte II
Combatendo Doenas Infecc|osas
1udo sobre patgenos
42
Infectious diseases are caused by invisible microorganisms that enter the body and multiply
there. The history of immunology, which began in the 18
th
century with Jenners discovery of
vaccines, is also the history of the fight against infectious diseases. Thanks to the worldwide
use of the vaccine Jenner discovered, the disease smallpox has vanished. And thanks to the
many excellent vaccines that have been developed since, we are safe from a large variety of in-
fectious diseases.
The microorganisms that cause infectious diseases are called pathogens or, more common-
ly, germs. Pathogens include bacteria and viruses. Bacteria are single-celled and are a few mi-
crons in size. (1 micron is 1/1000 of a millimetre.)
Smallpox is an infectious disease caused by the smallpox virus. If you catch the disease, you get a fever of
40 degrees and your whole body becomes covered in pustules and blisters. Many people used to die of
this disease, but thanks to Jenners vaccine, not a single person has developed the disease since 1977.
Virus is the Latin word for poison. In ancient Greece, Hippocrates used the word virus to mean a poison
that causes illness.
1.
Fighting Infectious Diseases
All about pathogens
So a virus is
1/1000 of the size
of a bacterium.
Thats
miniscule!
mm
mm
mm
virus
bacterium
cell
040_0I?q.qxd 0I.0I.?009 I?.0? Uhr Seite 4?
42
th
fectious diseases.
1.
All about pathogens
So a virus is
1/1000 of the size
of a bacterium.
Thats
miniscule!
mm
mm
mm
virus
bacterium
cell
As doenas lnfecclosas so causadas por mlcrorganlsmos lnvlslvels que enLram no
corpo e se mulupllcam l. A hlsLrla da lmunolglca, que comeou no seculo vlll
com a descoberLa de !enner das vaclnas, e Lambem a hlsLrla da luLa conLra as
doenas lnfecclosas. Craas ao amplo uso da vaclna que !enner descobrlu, a varlola
desapareceu. L graas as mulLas excelenLes vaclnas que foram desenvolvldas desde
enLo, esLamos proLegldos de uma grande varledade de doenas lnfecclosas.
Cs mlcrorganlsmos que causam doenas lnfecclosas so chamadas de patgenos ou,
mals comumenLe, germes. aLgenos lncluem bacLerlas e vlrus. 8acLerlas so
organlsmos de uma unlca celulas e possuem Lamanho de mlcras. (1 mlcron e 1/1000
de um mlllmeLro).
A varlola e uma doena lnfecclosa causada pelo vlrus da varlola (smallpox). Se voc conLral a doena,
voc Lem uma febre de 40 graus e seu corpo lnLelro ca coberLo de pusLulas e bolhas. MulLas pessoas
morreram desLa doena, mas graas a vaclna de !enner, nlnguem desenvolveu a doena desde 1977.
vlrus e a palavra launa para veneno. na Crecla anuga, PlpcraLes usou a palavra vlrus para descrever
um veneno que causa doena.
42
th
fectious diseases.
1.
All about pathogens
So a virus is
1/1000 of the size
of a bacterium.
Thats
miniscule!
mm
mm
mm
virus
bacterium
cell
lsso e
mlnusculo!
LnLo, um vlrus e
1/1000 do Lamanho
de uma bacLerla
celula bacLerla
bacLerla
LxLerlor do
corpo
Loxlnas
vlrus
lnLerlor do
corpo
mucosa
morLe celular
cncer

Como as bacLerlas que lnvadem seu corpo causam doena?

As bacLerlas produzem Loxlnas que desLroem ou parallsam as celulas. Llas Lambem
Lm Loxlnas lncorporadas as suas paredes celulares que podem causar febre,
dlarrela ou uma queda na presso sangulnea. Asslm como as Loxlnas, as bacLerlas
possuem uma ampla gama de armas que podem lhe causar dano.

Cs vlrus so enLre 100 e 1000 vezes menores que as bacLerlas e podem lnvadlr
uma grande varledade de celulas. uma vez denLro delas, eles comeam a se
mulupllcar rapldamenLe. A lnfeco vlral pode aLrasar o funclonamenLo normal de
uma celula, fazendo com que ela morra, ou pode fazer com que uma celula
mulupllque-se sem conLrole, aLe se Lransformar em uma celula cancerosa. Lm
segulda a lnfeco, alguns upos de vlrus mulupllcam-se lenLamenLe para causar uma
|nfeco pers|stente. CuLros param de se mulupllcar Lodos [unLos e causam o que
se conhece como |nfeco |atente.
43
How do the bacteria that invade your body cause disease?
Bacteria produce toxins that destroy cells or paralyse them. They also have toxins incorporat-
ed into their cell walls that can cause fever, diarrhoea, or a drop in blood pressure. As well as
toxins, bacteria have a whole host of other weapons that can cause you harm.
Viruses are between 100 and 1000 times smaller than bacteria and they can invade a whole
range of cells. Once inside the cell they begin to multiply rapidly. Viral infection can either de-
rail the normal functioning of a cell, causing it to die, or it can make a cell multiply uncontrol-
lably so that it turns into a cancer cell. Following infection, some types of viruses multiply slow-
ly to cause a persistent infection. Yet others stop multiplying all together and cause what is
known as a latent infection.
bacterium
toxins
mucosa
cell death
cancer
virus
Outside the Body
Inside the Body
040_0I?q.qxd 0I.0I.?009 I?.0? Uhr Seite 4
ces
ralva
AssusLador...
raLos
pulgas
praga
ovelha
anLraz
ue npos de doenas ex|stem?
Comlda
conLamlnada
Lm Lodo o mundo, h mulLas doenas que
al nda so dl ncel s de conLrol ar. ue
preocupao parucular so as doenas
zoonncas, causadas por paLgenos que
podem lnfecLar anlmals e humanos, e as
recenLes doenas emergentes, que foram
relaLadas pela prlmelra vez nos anos 1970.

As doenas zoonucas causadas por
bacLerlas lncluem anLraz de caprlnos ou
ovelhas, a praga de pulgas que vlvem nos
raLos, Luberculose do ar ao nosso redor
quando um paclenLe Losse, e salmonela de
comlda conLamlnada. odem lnclulr Lambem
doenas causadas por vlrus, como a grlpe que
e comum no lnverno, ralva que voc conLral
quando e mordldo por um anlmal lnfecLado, e
malrla que voc pega de plcadas de
mosqulLo. CuLras doenas zoonucas so
causadas por paraslLas.

uoenas emergenLes l ncl uem SA8S
(Slndrome 8esplraLrla Aguda Crave, do
lngls Severe AcuLe kesplraLory Syndrome),
que e causada por um novo coronavlrus,
Lbola, que e uma febre hemorrglca que
causa sangramenLo nos lnLesunos e maLa 30 a
90 das pessoas lnfecLadas, AluS que maLa
mals pessoas do que qualquer ouLra doena
lnfecclosa, e grlpe avlrla, que pode se
desenvolver em uma pandemla, ou se[a, uma
doena que alge mulLas pessoas no mundo
Lodo, como a grlpe espanhola.
45
Zoonotic diseases caused by bacteria include
anthrax from goats or sheep, the plague from fleas
that live on rats, tuberculosis from the air around
us when a patient coughs, and salmonella from
contaminated food. They can also include dis-
eases caused by viruses, like influenza which is
common in winter, rabies which you catch if bit-
ten by an infected animal, and malaria which you
can get from mosquito bites. Other zoonotic dis-
eases are caused by parasites.
Emerging diseases include SARS (Severe Acute
Respiratory Syndrome) which is caused by a new
coronavirus, Ebola which is a haemorrhagic (he-
mo-ra-jic) fever that causes your intestines to
bleed and kills 50 to 90% of people who catch it,
AIDS which kills more people than any other in-
fectious disease, and avian influenza, a disease
could develop into a pandemic, that is, a disease
that afflicts many people all over the world like the
Spanish flu.
All over the world, there are many diseases that
are still difficult to control. Of particular concern
are zoonotic diseases that are caused by
pathogens that can infect both animals and hu-
mans and newly emerging diseases, which were
first reported in the 1970s.
malaria
Salmonella
Influenza
mosquito
contaminated
food
Influenza virus
040_0I?q.qxd 0I.0I.?009 I?.0? Uhr Seite 4S
mosqulLo
malrla
Salmonella
lnueza
(Crlpe avlrla) vlrus da
lnueza
C vlrus da lmunodeclncla Pumana (Plv, do lngls, numan
Immunodeclency Vlrus) e um vlrus que lnfecLa llnfclLos 1 auxlllares e as
desLrl. Com menos celulas, seu slsLema lmune ca enfraquecldo e voc pode
car doenLe dos germes que no causarlam doena em pessoas saudvels.

Cuando lsLo aconLece, a pessoa Lem o que se chama AluS (do lngls, Acqulred
ImmuneDeclency Syndrome) ou Slndrome da lmunodeclncla Adqulrlda. Seu
sangue e uldos corporals alnda conL<m o vlrus Plv, e a pessoa pode Lransmlur
para os lhos ao nasclmenLo e passar para ouLros aLraves de relaes sexuals.
C que a AIDS?
46
What is AIDS?
The Human Immunodeficiency Virus (HIV) is a virus that infects helper T cells and
destroys them. With fewer T cells, your immune system is weakened and you can get
sick from germs that would not cause disease in healthy people.
When this happens, the person has what is called AIDS or Acquired Immunodefi-
ciency Syndrome. Her/his blood and bodily fluids will still contain the HIV virus, and
she can pass it to her children at birth or she/he can pass it to others through having
sex.
If you are infected with HIV ...
T cells
llnfclLos 1
Se voc se lnfecLa com o
Plv
A AluS pode ser curada? lnfellzmenLe, no h LraLamenLo alnda que
possa cur-la lnLelramenLe. no momenLo, paclenLes esLo sendo
LraLados com uma comblnao de 3 ou 4 upos de drogas. LsLe
LraLamenLo reduz drasucamenLe a quanudade de vlrus no corpo de
alguem e Lem a[udado a reduzlr slgnlcanLemenLe o numero de
pessoas que morrem. Alnda asslm, pessoas com Plv que vlvem no
mundo em desenvolvlmenLo no podem se dar ao luxo de adqulrlr
esLas drogas.
voc se Lorna lnfecLado
com vrlos upos de paLgenos
ClenusLas acredlLam que o Plv se desenvolveu de um vlrus
da lmunodecncla dos chlmpanzes, que sofreu muLao h
vrlos anos e se Lornou capaz de lnfecLar humanos. or volLa
do nal de 2007, o numero de pessoas lnfecLadas pelo Plv ao
redor do mundo alcanou 30 mllhes. SessenLa por cenLo de
Lodas as pessoas lnfecLadas vlvem na frlca ao sul do Saara.
AluS se desenvolve
47
Scientists believe that HIV developed from a chimpanzee
immunodeficiency virus that mutated several hundred years
ago and became able to infect humans. By the end of 2007, the
number of people infected by HIV around the world had
reached 30 million. Sixty percent of all infected people live in
Sub-Saharan Africa.
Can AIDS be cured? Unfortunately, there is no treatment yet that can cure
the disease entirely. At the moment, people are being treated with a combi-
nation of three or four types of drugs. This treatment drastically reduces the
amount of virus in a persons body, and has helped reduce the number of
people who die from AIDS significantly. But still, people with HIV who live in
the developing world cannot afford these drugs.
You become infected with
all kinds of pathogens.
AIDS develops
HIV virus
cell death
040_0I?q.qxd 0I.0I.?009 I?.0? Uhr Seite 4I
vlrus Plv
morLe celular
Voc consegue ev|tar
uma gr|pe av|r|a?
A grlpe (lnuenza) avlrla e uma doena que lnfecLa aves e e causada
pelo vlrus da grlpe A avlrla. LsLe vlrus unha o hblLo de ser Lransmludo
de ave a ave, mas em 1997 o prlmelro caso fol relaLado em humanos. lol
causado pela cepa P3n1 do vlrus. or volLa de 2007, mals de 300 pessoas
no mundo foram lnfecLadas. L desLes, 2 Leros faleceram. rosslonals de
saude publlca preocupam-se que o vlrus possa em breve muLar
novamenLe e passar de humano para humano. Se lsso aconLecer, o vlrus
poderla causar uma pandemla.
48
Bird flu is dangerous because it kills a large proportion of young,
healthy people who have a properly functioning immune system. We
dont really understand why this happens, but we do know that when a
person catches bird flu, her/his body produces vast amounts of cytokines
and that immune cells go on the rampage.
Avian influenza, or bird flu, is a dis-
ease that infects birds and is caused by the avian influenza A virus. This virus
used to only pass from bird to bird, but in 1997 the first case of a bird-to-hu-
man infection was reported. It was caused by the H5N1 strain of the virus. By
2007 more than 300 people around the world had been infected, and of these
over two-thirds died. People working in public health worry that the virus could
soon mutate again so it can pass from human to human. If this happens, the
virus could cause a pandemic.
Can you avoid catching
bird flu?
Influenza
virus
Oh no!
A grlpe avlrla e perlgosa porque maLa uma grande proporo
de [ovens saudvels que Lm um slsLema lmune funclonando
adequadamenLe. ns no enLendemos porque lsLo aconLece,
mas sabemos que quando alguem recebe a grlpe avlrla
(lnuenza P3n1), seu corpo produz uma vasLa quanudade de
clLoclnas e que os leucclLos enLram em uma LempesLade (de
clLoclnas).
vlrus da
grlpe
avlrla
LnLo, como e que voc pode evlLar conLralr a grlpe avlrla?
no momenLo, os clenusLas acredlLam que o melhor melo de par-la serla
desenvolver uma vaclna. CbvlamenLe, a vaclna no pode conslsur de vlrus
da lnuenza avlrla vlvos exaLamenLe como eles so. LnLo os
pesqulsadores esLo Lrabalhando agora em pro[eLos que usam parLes do
vlrus lnuenza pra fazer uma vaclna. uesLa forma, o seu slsLema lmune
poderla ser apresenLado ao vlrus sem qualquer perlgo de voc car doenLe.
Claro que a vaclna Lerla que Ler sua segurana e eccla LesLadas anLes.
49
So how can you stop yourself from catching bird flu?
At the moment scientists believe that best means to stop bird flu would be to
develop a vaccine. Obviously, the vaccine cannot consist of live avian influenza
virus just as it is. So researchers are now working on projects that use parts of
the flu virus to make a vaccine. This way your immune system could be intro-
duced to the virus without any danger of your getting sick. Of course the vaccine
would have to be tested for safety and efficacy first.
cytokine (letter)
helper T cell
macrophage
B cell
dendritic
cell
celula
dendrluca
llnfclLo 8
llnfclLo 1 helper"
macrfago
clLoclna (carLa)
uanto as vac|nas podem fazer?
50
Most bacteria and viruses that cause infectious
diseases enter through mucosal (mew-co-sal) mem-
branes and then spread throughout the entire body.
The mucosal membrane is a thin layer of cells that
covers the inner surface of all the cavities in the body
that have contact with the outside. It covers the in-
side of the mouth, nostrils, gullet, lungs, stomach,
intestine and anus. If you could stimulate a good,
strong immune response at the mucosal
membrane, you could prevent germs from
even entering the body.
The vaccines we currently use only help
the immune system stage a response
once the pathogen is inside the body, they
cannot prevent pathogens from entering
through the mucosal membrane.
In the first part of this book we heard that vaccines have already
been used successfully to protect us from a great many infectious
diseases. At the moment, the type of vaccine that Jenner developed is still the most
effective way of controlling infectious diseases. But scientists are making progress
in developing new types of vaccines that can prevent or even treat infectious dis-
eases.
How can we make vaccines even more effective?
How much can vaccines do?
mucosal
membrane
040_0I?q.qxd 0I.0I.?009 I?.0? Uhr Seite S0

na prlmelra parLe desLe llvro, aprendemos que as
vaclnas [ vm sendo usadas com sucesso para proLeger-nos
de uma grande varledade de doenas lnfecclosas. no momenLo, o upo de
vaclna que !enner desenvolveu e alnda o melo mals efeuvo de conLrolar essas
doenas. Mas os clenusLas esLo fazendo progresso em desenvolver novos
upos de vaclnas que possam prevenlr ou mesmo LraLar esse upo de doenas.

Como podemos fazer vaclnas alnda mals efeuvas?

A malorla das bacLerlas e vlrus que causam
doenas lnfecclosas enLram por membranas
mucosas e enLo se espalham pelo corpo lnLelro.
A membrana mucosa e uma na camada de
celulas que cobre a superncle lnLerna de Lodas
as cavldades corporals que Lm conLaLo com o
exLerlor. Lla cobre o lnLerlor da boca,
narlnas, garganLa, pulmes, esLmago,
lnLesuno e nus. 5( voc pudesse
esumular uma boa e forLe resposLa
lmune na membrana mucosa, voc
poderla lmpedlr que germes
enLrassem no seu organlsmo.
As vaclnas que usamos
aLualmenLe somenLe a[udam o
slsLema lmune a esLabelecer uma
resposLa desde que o paLgeno
esLe[a denLro do corpo. Llas no
conseguem lmpedlr que
paLgenos enLrem aLraves da
membrana mucosa.
membrana
mucosa
51
What could these new vaccines
look like?
At the moment, researchers are
developing vaccines that you can
eat, drink or inhale. Being vaccinat-
ed in this way is less scary than fac-
ing a needle and it should improve
the mucosal immune response. Re-
sults have been promising. Already
a flu vaccine you can inhale is avail-
able in the US and many mucosal
vaccines are in development.
drink
inhale
eat
virus
vaccine
T cell
B cells
antibody
dendritic
cell
mucosal
cells
040_0I?q.qxd 0I.0I.?009 I?.0? Uhr Seite SI
Como esLas novas vaclnas poderlam se
apresenLar?

no momenLo, os pesqulsadores esLo
desenvolvendo vaclnas que voc pode
comer, beber ou lnalar. Ser vaclnado
desLa forma e menos assusLador do que
encarar uma agulha e deve melhorar a
resposL a l mune de mucosas. Cs
resulLados so promlssores. ! h
uma vaclna para grlpe dlsponlvel
nos LuA e mulLas vaclnas mucosas
esLo em desenvolvlmenLo.
beber
comer
lnalar
vaclna
celulas
mucosas
llnfclLo 1
celula
dendrluca
anucorpo
llnfclLo 8
52
We know now that immune cells are dependable allies, al-
ways at the ready to defend our body from the germs that in-
vade it.
Before the cells get to work they are tested in the bone marrow and
thymus, where they are made. The cells need to distinguish between the
body (self), and potential invaders if they are to be our true friends. An
immune cell that attacks the body is a danger and has to be destroyed.
Sometimes, however, these rogue cells manage to survive.
2
.
Autoimmune Diseases
What is an autoimmune disease?
If rogue cells
survive
Bone Marrow and Thymus Test Sites
Doesnt
fit!
A fit!
Excellent!
Itll menace
the enemy,
but wont
harm us.
Oh no!
We have
to kill it.
lymphocyte
cell from your
own body
cell from your
own body
survives
dies
FAIL
PASS
040_0I?q.qxd 0I.0I.?009 I?.0? Uhr Seite S?
52
vade it.
2
.
Autoimmune Diseases
If rogue cells
survive
Doesnt
fit!
A fit!
Excellent!
Itll menace
the enemy,
but wont
harm us.
Oh no!
We have
to kill it.
lymphocyte
cell from your
own body
cell from your
own body
survives
dies
FAIL
PASS
52
vade it.
2
.
Autoimmune Diseases
If rogue cells
survive
Doesnt
fit!
A fit!
Excellent!
Itll menace
the enemy,
but wont
harm us.
Oh no!
We have
to kill it.
lymphocyte
cell from your
own body
cell from your
own body
survives
dies
FAIL
PASS
52
vade it.
2
.
Autoimmune Diseases
If rogue cells
survive
Doesnt
fit!
A fit!
Excellent!
Itll menace
the enemy,
but wont
harm us.
Oh no!
We have
to kill it.
lymphocyte
cell from your
own body
cell from your
own body
survives
dies
FAIL
PASS
Doenas Auto-|munes

C ue uma doena auto-|mune?
Agora sabemos que os leucclLos so allados convels, sempre de
planLo para defender nosso organlsmo dos germes que o lnvadem.

AnLes que as celulas comecem a Lrabalhar, elas so LesLadas na
medula ssea e umo, onde elas so produzldas. As celulas preclsam
dlsungulr enLre o corpo (prprlo) e lnvasores poLenclals, se eles sero
nossos verdadelros amlgos. um leucclLo que aLaca o corpo e um
perlgo e Lem que ser desLruldo. s vezes, porem, esLas celulas
defelLuosas conseguem sobrevlver.
Loca|s de 1este na Medu|a Cssea e 1|mo
LxcelenLe!
Ameaa o
lnlmlgo, mas
no nos faz
mal.
Lssa no!
1emos que
maL-la!
52
vade it.
2
.
Autoimmune Diseases
If rogue cells
survive
Doesnt
fit!
A fit!
Excellent!
Itll menace
the enemy,
but wont
harm us.
Oh no!
We have
to kill it.
lymphocyte
cell from your
own body
cell from your
own body
survives
dies
FAIL
PASS
celula do seu
prprlo corpo
sobrevlve
morre
celula do seu
prprlo corpo
Lncalxa!
no
encalxa!
ASSA
lALPA
llnfclLo
Se uma celula
d e f e l L u o s a
sobrevlve...
53
All is not lost, however, because of the
self-tolerance mechanisms built into the
immune system that we told you about in
Part I. These safeguards stop immune
cells from attacking the body or things that
are of no harm to us, like food. Normally
these mechanisms also take care of any
escaped rogue cells and keep us safe.
However, if this ability to tolerate self
breaks down, the body ends up under at-
tack as the immune system mistakes the
bodys cells for enemies. This condition is
called autoimmunity or autoimmune dis-
ease. Exactly why this happens is not well
understood.
Oh no!
Look! Theyre
attacking the
bodys own
cells.
040_0I?q.qxd 0I.0I.?009 I?.0? Uhr Seite S
orem, nem Ludo esL perdldo, por
causa dos mecanlsmos de auLo-
Lolerncla produzldos denLro do
slsLema lmune, sobre os quals
falamos na arLe l. LsLas proLees
lmpedem que as celulas lmunes
aLaquem o corpo ou colsas que no
so pre[udlclals para ns, como os
allmenLos. normalmenLe esLes
mecanlsmos Lambem Lomam conLa
de qualsquer celulas defelLuosas
que escaparam e nos manLem
seguros.
LnLreLanLo, se esLa capacldade de Lolerar
o prprlo falha, o corpo acaba sob aLaque,
uma vez que o slsLema lmune Loma as celulas
do prprlo corpo como lnlmlgas, por engano.
LsLa condlo e chamada de auLo-lmunldade ou doena
auto-|mune. no se sabe exaLamenLe porque lsLo aconLece.
Lssa no!
ve[a! LsLo
aLacando as
celulas do
prprlo corpo.
ua|s npos de doenas auto-|munes ex|stem?
54
What kinds of autoimmune disease are there?
There are a great number of autoimmune diseases, and they can oc-
cur in any part of your body. Lets take a look at a few.
Every cell of the body contains a structure called a nucleus in which
all your genes are packed. If you get a disease called Systemic Lupus
Erythematosus (SLE), your immune cells make antibodies that attack
the nucleus and this causes inflammation all over your body. Other
autoimmune diseases attack your joints, like rheumatoid arthritis, or
your brain and spinal cord, like multiple sclerosis.
The symptoms of each autoimmune disease and how it develops
differs from person to person. We do not clearly understand why the
body begins to attack itself.
skin blisters
muscle
liver damage
muscle weakness
pancreas islet
damage
(type I
diabetes)
kidney
failure
blood vessels
skin
joints
muscle damage
eye damage
central nervous sytem
destruction (multiple sclerosis)
joint damage
(rheumatoid arthritis)
blood vessel
destruction
P um grande numero de doenas auLo-lmunes e elas podem
ocorrer em qualquer parLe do corpo. vamos dar uma olhada em
algumas.

Cada celula do organlsmo conLem uma esLruLura chamada
nucleo na qual Lodos os genes esLo empacoLados. Se voc pega
uma doena chamada Lupus LrlLemaLoso SlsLmlco (SLL), suas
celulas lmunes fazem anucorpos que aLacam o nucleo e causam
lnamao por Lodo o seu corpo. CuLras doenas auLo-lmunes
aLacam as aruculaes, como a arLrlLe reumaLlde, ou o
cerebro, como a esclerose mulupla.

Cs slnLomas de doena auLo-lmune e como ela se desenvolve
dlferem de pessoa pra pessoa. no enLendemos claramenLe
porque o corpo comea a se aLacar.
54
What kinds of autoimmune disease are there?
There are a great number of autoimmune diseases, and they can oc-
cur in any part of your body. Lets take a look at a few.
Every cell of the body contains a structure called a nucleus in which
all your genes are packed. If you get a disease called Systemic Lupus
Erythematosus (SLE), your immune cells make antibodies that attack
the nucleus and this causes inflammation all over your body. Other
autoimmune diseases attack your joints, like rheumatoid arthritis, or
your brain and spinal cord, like multiple sclerosis.
The symptoms of each autoimmune disease and how it develops
differs from person to person. We do not clearly understand why the
body begins to attack itself.
skin blisters
muscle
liver damage
muscle weakness
pancreas islet
damage
(type I
diabetes)
kidney
failure
blood vessels
skin
joints
muscle damage
eye damage
central nervous sytem
destruction (multiple sclerosis)
joint damage
(rheumatoid arthritis)
blood vessel
destruction
llnfclLo 1
desLrulo do slsLema nervoso
cenLral (esclerose mulupla)
leso ocular
leso nas aruculaes
(arLrlLe reumaLlde)
desLrulo de
vasos sanglneos
leso muscular
bolhas na pele
fraqueza muscular
leso hepuca
leso nas
llhoLas
pancreucas
(dlabeLe upo l)
aruculaes
leso
renal
Leso
mulupla
de rgos
leso nas
glndulas
hldraLanLes
leso na
urelde
urelde
ngado
corao
pulmes
ve[a algumas
das doenas
exlsLenLes
glndulas
lacrlmals
glndula sallvar
glndula
paruda
55
With that being the case, we
currently treat autoimmune
diseases with drugs that sup-
press the bodys immune sys-
tem entirely while trying to
help the function of joints and
organs that have been weak-
ened by attack.
However, there are people for whom this
treatment doesnt work or for whom the side
effects, like a weakened immune system, in-
crease the risk of infection. Clearly, developing
new treatment methods is important.
le
tear
glands
Moisture-
producing
gland
damage
parotid
gland
salivary
gland
Thyroid
damage
Multiple
organ
damage
Look at all the
diseases there
are ...
thyroid
heart
lungs
liver
kidneys
spleen
040_0I?q.qxd 0I.0I.?009 I?.0? Uhr Seite SS
bao
rlns
ConLudo, h pessoas para as quals esLe
LraLamenLo no funclona ou os efelLos
col aLeral s, como um sl sLema l mune
enfraquecldo, aumenLam o rlsco de lnfeco.
ClaramenLe, Lorna-se lmporLanLe desenvolver
novos meLodos de LraLamenLo.
S e n d o e s L e o c a s o ,
aLualmenLe as doenas auLo-
lmunes so LraLadas com
drogas que suprlmem o
slsLema lmune lnLelramenLe,
enquanLo LenLam a[udar a
funo das aruculaes e
r g o s q u e f o r a m
enfraquecldos pelo aLaque.
slnvla
osso
carulagem
C que
houve?
Artr|te reumat|de e seu
tratamento
ArLrlLe reumaLlde e uma doena auLo-lmune que faz doer as
aruculaes do corpo, e se delxada sem LraLar, acaba as desLrulndo.
Se uma aruculao se Lorna lnfecLada, os leucclLos se acumulam ao
redor dela e produzem uma correnLe de clLoclnas com a ordem Causem
lnamao! A aruculao lnchada, vermelha e palplLanLe que resulLa e
dolorosa, mas e uma resposLa necessrla a lnfeco. Se esLe aLaque, enLreLanLo,
for dlrlgldo conLra a prprla aruculao, as colsas se Lornam serlas.

A slnvla e uma membrana que proLege as aruculaes. Se suas celulas
receberem mensagens de clLoclnas com a ordem de causar lnamao, elas
enLram em ao produzlndo mals cplas. Como as celulas conunuam a se
mulupllcar, a slnvla comea a crescer, e em vez de proLeger uma aruculao,
ela comea a desLrulr o osso e a carulagem, causando dano a aruculao.
56
Rheumatoid arthritis is an autoimmune disease that
makes the joints around the body ache, and if it is left untreat-
ed, it ends up destroying them. If a joint becomes infected, immune
cells collect around it and produce a stream of cytokines with the order Cause in-
flammation! The swollen, red and throbbing joint that results is painful, but it is
the result of a necessary response to an infection. If this attack, however, is di-
rected against the joint itself, things become serious.
The synovium (si-no-vi-um) is a membrane that protects joints. If its cells receive
cytokine messages with the order to cause inflammation, they spin into action
making more copies. As the cells continue to multiply, the synovium begins to
grow, and instead of protecting a joint, it starts to destroy the bone and cartilage,
causing damage to the joint.
Rheumatoid arthritis and
its treatment
synovium
bone
Whats up?
cartilage
040_0I?q.qxd 0I.0I.?009 I?.0? Uhr Seite S
57
Based on their understanding of
how the mechanism behind arthritis
works, scientists have developed a
new treatment, called anti-cytokine
therapy, which stops the cytokines
that cause inflammation from func-
tioning.
In fact anti-cytokine therapy is al-
ready in use and has proved far more
effective than any of the treatment
methods that have been used until
now.
Anti-cytokine
therapy
Works pretty
well, eh?
Cause
inflammation!
There need to be
more of us!
040_0I?q.qxd 0I.0I.?009 I?.0 Uhr Seite SI
Com base no enLendlmenLo de
como funclona o mecanlsmo por
Lrs da arLrl Le, os cl enusLas
d e s e n v o l v e r a m u m n o v o
LraLamenLo, chamado Lerapla anu-
clLoclnas, que faz com que as
clLoclnas que causam lnamao
parem de funclonar.

ue faLo, a Lerapla anu-clLoclnas [
esL em uso e provou ser bem mals
efeuva do que qualsquer dos
meLodos de LraLamenLo que [
foram usados aLe agora.
Causem
lnamao!
reclsa haver
mals de ns!
lunclona
mulLo bem,
no?
1erapla anu-
clLoclnas
58
Things that cause allergies, like pollen, dust mites and
food, are known as allergens. And when your immune cells
launch an attack against things that are not generally harm-
ful, you get an allergy.
Most allergies are caused by a group of immune cells called
mast cells. Mast cells contain lots of chemicals that cause
sneezing and inflammation. People with allergies have an an-
tibody called IgE (I-G-E) stuck to the surface of their mast
cells. When IgE comes across an allergen, the mast cell
thinks that it has come across an enemy and in a flash it
spews out all the chemicals it contains. The inflammation
this action causes makes your skin turn red and itchy.
Other immune cells quickly come onto the scene, and, be-
cause they then fire off weapons normally meant for germs,
your body hurts instead.
This is what you call an allergy.
When spring arrives, do you start sneezing non-stop? And do your
eyes get itchy? When you eat an egg do you break out in hives?
When you go hiking do your hands get itchy as soon as you touch
the grass or trees? For the most part, these reactions are immune re-
sponses and are better known as allergies.
3
.
Allergies are also Immune Reactions
What is an allergy?
Wow! Even
cats can be
allergic
Even
cats are
allergic?
Itchy ...
allergens
mites
Thats
right!
040_0I?q.qxd 0I.0I.?009 I?.0 Uhr Seite S8
As a|erg|as tambm so reaes |munes
58
3
.
What is an allergy?
Wow! Even
cats can be
allergic
Even
cats are
allergic?
Itchy ...
allergens
mites
Thats
right!
58
3
.
What is an allergy?
Wow! Even
cats can be
allergic
Even
cats are
allergic?
Itchy ...
allergens
mites
Thats
right!
C ue uma a|erg|a?
Cue
cocelra!
ALe os
gaLos Lm
alergla?
Cuando chega a prlmavera, voc comea a esplrrar sem parar?
L os seus olhos cam lrrlLados? Cuando voc come ovo, voc
Lem surLos de urucrla?

Cuando voc val escalar, suas mos comeam a coar asslm
que voc Loca a grama ou as rvores? Lm sua malorla, esLas
reaes so resposLas lmunes e so melhor conhecldas como
alerglas.

Colsas que causam alergla, como plen, caros da poelra e
comlda, so conhecldos como alergenos. L quando os seus
leucclLos aLacam conLra colsas que no so geralmenLe
pre[udlclals, voc Lem uma alergla.

A malorla das alerglas so causadas por um grupo de leucclLos
chamados masLclLos. Cs masLclLos conLm mulLas subsLnclas
qulmlcas que causam esplrros e lnamao. essoas com
alerglas possuem um anucorpo chamado lgL grudado na
superncle de seus masLclLos. Cuando o lgL enconLra um
alergeno, o masLclLo pensa que ele enconLrou um lnlmlgo e em
um segundo ele expele Lodas as subsLnclas qulmlcas que ele
conLm. A lnamao que esLa ao causa faz a sua pele coar e
car vermelha.

CuLros leucclLos rapldamenLe enLram em cena, e, como eles
lanam armas normalmenLe dlrlgldas aos germes, seu corpo ca
machucado, em vez dlsso.

L o que chamamos de alergla.
nossa! ALe
mesmo os
gaLos podem
ser alerglcos!
lsso
mesmo!
masLclLo
subsLnclas
qulmlcas
lncrlvel!
masLclLos
plen
lgL
59
pollen
mast cells
Incredible!
chemicals
mast cell
IgE
As pessoas so alerglcas a que upo de colsas ?

A alergla mals comumenLe conheclda e provavelmenLe a febre do feno,
causada por plen de cerLas rvores. CuLras alerglas comuns so o
eczema, que faz sua pele car vermelha e lrrlLadla, asma, que faz voc
Losslr o Lempo Lodo, e alerglas a allmenLos.

As pessoas podem Lambem ser alerglcas a colsas como plo de anlmals,
caros da poelra, plcadas de abelha, ou meLal do qual a [oalherla e felLa.
ALe lenLes de conLaLo ou medlcamenLos como penlclllna podem causar
alergla.
60
What kinds of things are people allergic to?
The most common allergy known is probably hay fever caused by pollen from
certain trees such as birch. Other common allergies are eczema, which makes
your skin red and itchy, asthma, which makes you cough all the time, and food
allergies.
People can also be allergic to things like animal hair, dust mites, bee stings, or
the metal from which jewellery is made. Even contact lenses or medicines like
penicillin can cause an allergy.
pollen
grains
peanuts
eggs
mites
shellfish fish
Even these items
040_0I?q.qxd 0I.0I.?009 I?.0 Uhr Seite 0
At estes |tens
gros
amendolm
ovos
caro
plen
fruLos do mar
pelxe
meLals
abelhas
plo anlmal
penlclllna
lenLes de conLaLo
beLula
podem causar a|erg|as
voc preclsa Ler parucular culdado com colsas como nozes, plcadas de
abelha e penlclllna, pols elas causam uma reao alerglca lnLensa que envolve
o corpo lnLelro. Lssa reao e conheclda como choque analuco. C melhor
melo de se proLeger conLra reaes alerglcas como essa, e evlLar que esses
alergenos enLrem no seu corpo.

Alerglas podem ocorrer asslm que os alergenos enLram no seu corpo
(reaes do upo lmedlaLo) ou algum Lempo depols (reaes do upo Lardlo).

ra cada upo de reao, o leucclLo com o prlnclpal papel na resposLa dlfere,
asslm como o mecanlsmo usado. Aprender mals sobre como esLes
mecanlsmos dlferem e vlLal para desenvolver Leraplas para LraLar as alerglas.
61
You need to be particularly careful about things like nuts, bee stings and peni-
cillin as they can cause an intense allergic reaction involving the whole body. This
reaction is known as anaphylactic shock. The best way to protect yourself against
allergic reactions like this from occurring, is to stop these allergens from enter-
ing your body.
Allergies can occur as soon as allergens enter your body (immediate-type reac-
tions) or slightly later (delayed-type reactions).
For each type of reaction, the immune cell that plays the major role in the re-
sponse differs, as does the mechanism used. Learning more about how these
mechanisms differ is vital in order to develop therapies for treating allergies.
animal hair
metals
bees
birch
contact lenses penicillin
can cause allergies
040_0I?q.qxd 0I.0I.?009 I?.0 Uhr Seite I
Como a asma se
desenvo|ve
vamos dar uma olhada mals prxlma em uma
alergla comum em crlanas - a asma.

A asma Lem mulLas causas, mas a mals
comum e a reao aos caros da poelra.
uuvldamos que voc [ Lenha vlsLo um caro,
mas se voc usasse um mlcroscplo e desse
uma boa olhada no seu colcho ou no carpeLe
de casa blngo! voc enconLrarla mllhares
deles. P alergenos perLo de voc, em Lodos os
lugares.

Agora, se voc uvesse uma reao alerglca
resplrando caros, Ludo esLarla bem asslm que
voc volLasse a resplrar um ar fresco, sem
caros. C que aconLecerla, porem, se voc
conunuasse resplrando em um ar chelo de
caros?

8em, suas vlas aereas permanecerlam
lrrlLadas enquanLo os leucclLos que causaram
a lnamao conunuarlam a permanecer por
mulLo Lempo no local. Com o Lempo, o formaLo
das vlas aereas comearla a mudar e as
passagens aLraves das quals o ar ul se
Lornarlam cada vez mals esLrelLas.

C Lermo Lecnlco para esLa alLerao no
formaLo e remode|amento. uma vez que suas
vlas aereas esLo remodeladas, e mulLo dlncll
volLar a sua forma normal. or essa razo,
LraLamenLo e mulLo compllcado.
Now, if you had an allergic reaction from breathing in
mites, everything would be fine as soon as you got a
breath of mite-free, fresh air. What would happen,
though, if you kept on breathing in air filled with mites?
Well, your airway would remain irritated as the im-
mune cells that caused the inflammation continued to
linger. Over time the shape of the airway would begin
to change and the passages through which air flows
would become narrower and narrower.
The technical term for this change in shape is remod-
elling. Once your airway remodels it is very difficult to
return it to its normal shape. For that reason treatment
is very complicated.
How does asthma
develop
Lets take a closer look at a common allergy among
kids asthma.
Asthma has many causes, but the most common is a
reaction to dust mites. We doubt youve ever seen a
mite, but if you were to use a microscope and take a
good look at your mattress or the carpet at home ... bin-
go! Youd find thousands of them. Thats right. There
are allergens close to you, everywhere.
62
wheeze
cross section
of a bronchus
or an airway
040_0I?q.qxd 0I.0I.?009 I?.0 Uhr Seite ?
ALchlm!
L por lsso que e crluco prevenlr que o
remodelamenLo aconLea. P excelenLes
drogas chamadas esLerldes, para LraLar
alerglas. Se voc e alerglco a caros, seu
medlco pode LraL-lo com esLas drogas. Ao
mesmo Lempo, el e provavel menLe o
aconselharla a se llvrar de qualsquer carpeLes
ou obLer um colcho hlpoalergnlco pra voc
reduzlr sua exposlo aos caros.
Como suas vlas aereas se remodelam
That is why it is critical to prevent re-
modelling from happening. There are ex-
cellent drugs around to treat allergies
called steroids. If you are allergic to dust
mites, your doctor might treat you with
these drugs. At the same time, she/he
would probably advise you to get rid of any
carpets or get a hypoallergenic mattress so
that you reduce your exposure to mites.
63
How your airways remodel
allergen
Wait ...
Gotta get
this stinky
fish-shaped
blanket
clean!
Cat
basket
040_0I?q.qxd 0I.0I.?009 I?.0 Uhr Seite
alergeno
Lspere...
balalo
de gaLo
1enho que
llmpar esLe
fedldo
Lravesselro
em forma
de pelxe!
L poss|ve| se curar
a febre do feno?
no parece mulLo dlverudo, no e mesmo?
CerLamenLe, algo poderla ser felLo sobre as
alerglas causadas por plen?

no mundo da l munol ogl a, mul Los
pesqulsadores esLo ocupados procurando
a[udar pessoas que sofrem da febre do feno.

ALe agora, as drogas usadas para LraLar a
febre do feno Lm focado no allvlo de
slnLomas ao lmpedlr que os masLclLos
llberem subsLnclas qulmlcas. Mas vamos dar
um Lemplnho pra pensar sobre o que lsso
poderla slgnlcar. LnquanLo as esLaes
mudam, o upo de plen no ar Lambem muda.
L geralmenLe quem e alerglco a um upo de
plen se Lorna alerglco a ouLros upos de
plen, com o Lempo. Asslm, LraLando-se
somenLe os slnLomas da febre do feno
slgnlca que voc poderla acabar Lendo que
Lomar remedlos por cerca de meLade do ano.

Algo mals poderla ser felLa em vez dlsso?
na prlmavera, as ores comeam a desabrochar, seus humores comeam
a aparecer, e voc senLe a vonLade de salr de casa e enLrar em conLaLo com
a naLureza. Alnda asslm, a medlda que voc se dlrlge para fora de casa, voc
no consegue parar de esplrrar e seu narlz comea a escorrer sem parar...
celula dendrluca
64
Can you cure hay
fever?
In spring flowers begin to bloom, your spirits begin to
soar, and you feel in the mood to get out and about. And
yet, as soon as you head outdoors, you cant stop sneez-
ing and your nose starts running non-stop...
Not much fun, is it? Surely, something can be
done about allergies caused by pollen?
In the world of immunology, many re-
searchers are busy looking to help people
who suffer from hay fever.
Until now, the drugs used to treat hay
fever have focused on relieving symptoms
by stopping mast cells from releasing chem-
icals. But lets take a moment to think about
what that could mean. As the seasons
change, the type of pollen in the air changes
too. And generally people who are allergic to
one type of pollen become allergic to other
types of pollen over time. So treating just
the symptoms of hay fever would mean that
you could end up having to take medicine
for about half of the year.
Can anything else be done instead?
dendritic cell
B cell
voc aprendeu como as alerglas so de faLo
resposLas lmunes. L voc sabe da prlmelra parLe
do llvro que o slsLema lmune Lem celulas que
agem como lnlbldores, suprlmlndo a escala de
uma resposLa ou Lermlnando-a lnLelramenLe. Lm
vez de apenas LraLar os slnLomas da febre do
f eno, os cl enusL as esper am usar seu
conheclmenLo sobre a capacldade do slsLema
lmune de auLoconLrole para desenvolver novas e
lnLellgenLes vaclnas e drogas que lmpedem o
organlsmo de reaglr a alergenos como plen, em
prlmelro lugar.
65
You have learned how allergies are in fact immune
responses. And you know from the first part of the
book that immune system has cells that act as in-
hibitors by suppressing the scale of a response or by
ending it entirely. Instead of just treating the symp-
toms of hay fever, scientists hope to use their knowl-
edge of the immune systems ability to control itself
to develop clever new vaccines and drugs that stop
the body from reacting to allergens like pollen in the
first place.
helper T cell
vaccine
regulatory T cell
040_0I?q.qxd 0I.0I.?009 I?.0 Uhr Seite S
ode-se usar a Imuno|og|a para curar o cncer?
C que cncer?
normalmenLe, cada celula do corpo se
comunlca com suas vlzlnhas pra decldlr
sobre descansar, mulupllcar, Lrabalhar ou
morrer, e asslm, as celulas formam
coleuvamenLe um Lecldo saudvel.

s vezes, porem, os genes de uma celula
so danlcados e podem no mals ser
capazes de produzlr proLelnas normals.
Como resulLado, a celula no e capaz de se
comunlcar correLamenLe com suas vlzlnhas.
Se as celulas comeam a se mulupllcar,
parLe do Lecldo em que ela esL a crescer
causa o que chamamos de Lumor. nesLe
esLglo o Lumor e benlgno e no causa
nenhum pre[ulzo.
orem, celulas com leso podem se
comporLar mals desconLroladamenLe. LsLas
celulas sem conLrole no somenLe formam
Lumores, como Lambem lnvadem os
Lecldos clrcunvlzlnhos ou usam os uldos
corporals para mlgrar para ouLras parLes do
corpo onde elas se mulupllcam para formar
novos Lumores (meLsLases). LsLes Lumores
so chamados cncer e as celulas que os
crlam so perlgosas porque elas roubam
voc da sua vlda.
Lecldo normal
Lumor benlgno
cncer
66
Normally each cell of the body communicates with its
neighbours about whether to rest, multiply, work, or die,
and in this way the cells collectively form healthy tissue.
Sometimes, however, a cells genes get damaged and it
can no longer make normal proteins. As a result, the cell
isnt able to communicate with its neighbours properly. If
this cell begins to multiply, it causes that part of the tis-
sue where it is to grow into what we call a tumour. At this
stage the tumour is benign, and will do you no harm.
However, damaged cells can behave more
roguishly. These rogue cells not only form tu-
mours where they are, but they also invade sur-
rounding tissues or they use the bodys fluids to
migrate to other parts of the body where they
multiply to form new tumours (metastasis).
These tumours are called cancer, and the cells
that create them are dangerous because they
can rob you of your life.
4
.
Can Immunology be Used to Cure Cancer?
What is cancer?
normal tissue
benign tumour
cancer
040_0I?q.qxd 0I.0I.?009 I?.0 Uhr Seite
67
What kind of cancers
are there?
Our body can be divided into what
is considered the surface and what is
considered the content. Although di-
gestive organs like the stomach and
intestine are inside the body, they are
still considered a surface. Cancers
formed from such surface tissues
are called carcinomas. Other cancers
have different names depending on
where they develop in the body. For
example, cancer of the bones and
muscles is called a sarcoma and can-
cer of the lymphocytes is called a lym-
phoma.
All these cancers invade tissue or
spread through the body in similar
ways but cancers formed from sur-
face tissue (carcinomas) are more
common and they occur more often
in old people.
Cancer can occur in any tissue. The
most common cancer in humans world-
wide is lung cancer, followed by stom-
ach, colon, liver and breast cancer.
People all around the world hope that
researchers will one day be able to de-
velop a cure for cancer.
1. Lung
cancer
2. Stomach
cancer
3. Colon
cancer
5. Pancreatic cancer
4. Liver
cancer
surface
content
040_0I?q.qxd 0I.0I.?009 I?.0 Uhr Seite I
2. Cncer de
esLmago
3. Cncer de
pncreas
3. Cncer de
clon
1. Cncer de
pulmo
4. Cncer de
ngado
Cncer pode ocorrer em qualquer
Lecldo. C cncer mals comum em
humanos no mundo Lodo e o de
pulmo, seguldo pelos de esLmago,
clon, ngado e mama.

essoas no mundo Lodo esperam que
os pesqulsadores se[am um dla capazes
de desenvolver uma cura para o cncer.
nosso corpo pode ser dlvldldo no que
conslderamos a superhc|e e o que e
conslderado o contedo. Lmbora os
rgos dlgesuvos como o esLmago e o
lnLesuno esLe[am denLro do corpo, eles
alnda so conslderados uma superncle.
Cs cnceres formados de Lecldos de Lal
s uper ncl e s o chamados de
carclnomas. CuLros cnceres Lm
dlferenLes nomes dependendo de onde
eles se desenvolvem no organlsmo. or
exemplo, cncer dos ossos e musculos
so chamados sarcoma e cncer de
llnfclLos e chamado llnfoma.

1odos esLes cnceres lnvadem o
Lecldo ou se espalham pelo corpo de
modos semelhanLes mas cnceres
formados a parur de Lecldo de
superncle (carclnomas) so mals
c o m u n s e o c o r r e m m a l s
frequenLemenLe em ldosos.
ue npos de
cncer ex|stem?
superncle
conLeudo
68
How the immune
system works against
cancer
We know that the body uses the immune system to recog-
nise what is foreign to it and expel it. But as we have learnt
here, cancers are a part of the body. So how does the im-
mune system deal with cancer?
If a cancer develops, the immune system can still get rid
of it as long as the cancer remains small. It does this by
means of immunological surveillance.
Lets take a look at how the immune system
works, and learn why it cant guard people
completely from getting ill with the disease.
As we explained a little earlier, cancer
cells are a part of you but they behave dif-
ferently from your other cells. They often
produce damaged proteins or proteins
not produced by other cells.
It is these proteins, often called tu-
mour-associated or cancer antigens, that
the immune system targets.
lymph node
killer T cell
dendritic cell
cancer antigen
cancer cell
Como o s|stema
|mune traba|ha
contra o cncer
Sabemos que o corpo usa o slsLema lmune para
reconhecer o que e esLranho e expuls-lo. Mas como
aprendemos aqul, os cnceres so uma parLe do
corpo. LnLo como o slsLema lmune llda com o cncer?

Se um cncer se desenvolve, o slsLema lmune pode
se llvrar dele enquanLo o cncer permanece pequeno.
Lle faz lsso por melo da v|g||nc|a |muno|g|ca.

vamos dar uma olhada em como o slsLema
Lrabalha, e porque ele no consegue vlglar
as pessoas compleLamenLe de carem
doenLes de cncer.
Como expllcamos anLerlormenLe, as
celulas cancerosas so parLe de voc
mas elas se comporLam de manelra
dlferenLe das suas ouLras celulas. Llas
frequenLemenLe produzem proLelnas
danl cadas ou pr oL el nas no
produzldas pelas ouLras celulas.
So esLas proLelnas, frequenLemenLe
chamadas angenos de cncer ou
assoclados a Lumores, que so alvo do
slsLema lmune.
llnfclLo 1 klller"
celula dendrluca
angeno do cncer
celula cancerosa
llnfonodo
Asslm que o slsLema lmune deLecLa angenos de cncer, suas
celulas lanam um aLaque.

C processo e o mesmo de uma resposLa lmune normal. As celulas
dendrlucas englobam os angenos do cncer e expem lnformao
sobre eles para os llnfclLos 1. LlnfclLos 1 klller" enLo desLrem as
celulas do cncer que os produzem, enquanLo as celulas 1 helper"
lnsLruem celulas 8 produLoras de anucorpos, que Lm como alvo
angenos de cncer, para comear a Lrabalhar. Alem dlsso, ouLro upo
de leucclLo chamado exLermlnador naLural ou nk (naLural klller")
usa o faLo de que as celulas do cncer produzem proLelnas anormals
c omo ma r c a dor e s pa r a
ldenucar esLas celulas e maL-
las.
Asslm, o corpo se llvra
das celulas cancerosas.
LnLo, e
asslm que
ele os
pega!
llnfclLo 1
helper"
llnfclLo 8
celula cancerosa sem
os angenos de cncer
69
There is no guarantee, however, that the body will be able to rid itself
of cancer cells entirely. For example, cancer cells that dont produce anti-
gens or ones that are formed from the cytokine-producing cells that con-
trol the immune system could dodge immunological surveillance and
multiply, finally resulting in your developing cancer.
As soon as the immune system detects cancer antigens, its cells launch an at-
tack.
The process is the same as in a normal immune response. Dendritic cells engulf
the cancer antigens and relay information about them to T cells. Killer T cells then
destroy the cancer cells that make them while helper T cells instruct antibody-pro-
ducing B cells that target cancer antigens to get to work. The antibodies attach to
any cancer cells they encounter, enabling molecules in the blood, called comple-
ment, to take up attack on cancer cells and kill them. Added to this, another type
of immune cell called natural killer or NK cell uses the fact that cancer cells pro-
duce abnormal proteins as a marker to
identify these cells and kill them.
In this way, the body rids itself
of cancer cells.
helper T cell
B cell
antibody
So this is
how it gets
them.
cancer cell without
cancer antigens
no h garanua, enLreLanLo, de que o corpo ser capaz de se
llvrar das celulas cancerosas lnLelramenLe. or exemplo, celulas do
cncer que no produzem angenos ou aqueles que so formados
a parur de celulas produLoras de clLoclnas, que conLrolam o
slsLema lmune, poderlam evlLar a vlgllncla lmunolglca e se
mulupllcar, resulLando nalmenLe no cncer em desenvolvlmenLo.
70
Treating Cancer with
Immunotherapy
Even the cancer cells that manage to avoid
the bodys immunological surveillance and
multiply possess some sort of antigens. Evoking an immune response against
these antigens could provide a means to cure cancer. This is exactly the goal of var-
ious clinical trials that are taking place now.
Cancer Vaccine Therapy
Treatment with a combination of cancer anti-
gens and agents that stimulate the immune sys-
tem holds some promise as vaccines against
cancer.
Dendritic Cell Therapy
This method involves taking dendritic cells
from the body, incorporating antigens into them,
and then reintroducing them to the body to fight
the cancer.
T Cell Therapy
Killer T cells and dendritic cells are removed from the
body and stimulated with cancer antigens. The activat-
ed killer T cells are then returned to the body so that they
can attack the cancer.
cancer antigen
cancer antigen
cancer antigen
adjuvant
(an immunostimulant)
dendritic cell that
has swallowed
cancer antigens
cancer-destroying
killer T cells
Hurrah!
Hurrah!
killer T cell
killer T
cell
040_0I?q.qxd 0I.0I.?009 I?.0 Uhr Seite I0
oelra!
LevanLou
poelra!
Mesmo as celulas que conseguem
evlLar a vlgllncla lmunolglca e se mulupllcar possuem algum upo de
angenos. Lvocar uma resposLa lmune conLra esLes angenos poderla
fornecer um melo de curar o cncer. LsLe e exaLamenLe o ob[euvo de vrlas
Lrlagens cllnlcas que esLo aconLecendo agora.
1ratando cncer
com Imunoterap|a
1erap|a Com Vac|na Contra C Cncer
1erap|a Com C|u|as Dendr|ncas
C LraLamenLo com uma comblnao de
angenos de cncer e agenLes que esumulam o
slsLema lmune fornece alguma esperana como
vaclnas conLra cncer.
1erap|a Com L|nfc|tos 1
angeno do cncer
LsLe meLodo envolve a reurada de celulas
dendrlucas do corpo, a lncorporao de angenos a elas
e a sua relnLroduo ao corpo para combaLer o cncer.
LlnfclLos 1 klller" e celulas dendrlucas so removldas do corpo e
esumuladas com angenos com cncer. Cs llnfclLos 1 klller auvados
so enLo devolvldos ao corpo para que elas possam aLacar o cncer.
angeno do cncer
llnfclLo 1 klller"
desLruldor do cncer
llnfclLo 1
klller"
llnfclLo 1
klller"
celula dendrluca que
engollu angenos de cncer
ad[uvanLe (um
lmunoesumulanLe)
angeno de cncer
cncer prlmrlo
pequenos pedaos de
cncer meLasLuco
lmunoLerapla
remoo
clrurglca
celulas dendrlucas
conLendo angenos
de cncer, eLc.
no recorrenLe
(sem cncer)
A lmunoLerapla sozlnha no e capaz de desLrulr cnceres
grandes. LsLes preclsam ser removldos clrurglcamenLe
prlmelro e enLo a lmunoLerapla pode ser usada para ellmlnar
qualsquer pedaos de cncer meLasLuco que Lenham
permanecldo. usado desLa manelra, o LraLamenLo promeLe
ser um melo efeuvo de prevenlr que ocorram cnceres.
1erap|a Com Anncorpos
anucorpos
conLra
angenos de
cncer
LsLa Lerapla envolve LraLamenLo
c om anuc or pos que L m
angenos de cncer como alvo.
celula
dendrluca
celula cancerosa
llnfclLo 1
klller"
71
Immunotherapy alone is not capable of destroying large cancers.
These cancers need to be removed surgically first and then im-
munotherapy can be used to mop up any small pieces of metastat-
ic cancer that remain. Used in this manner, the treatment promises
to be an effective way of preventing cancers from recurring.
Antibody Therapy
Antibody therapy involves treat-
ment with antibodies that target
cancer antigens.
primary cancer
small pieces of
metastatic
cancer
remove
surgically
dendritic cells
containing cancer
antigens, etc
immunotherapy
no recurrence
(clear of cancer)
Most immunotherapies are still at the experimental stage. Some
types, however, such as antibody therapies for particular types of
cancer, have already been put to practical use.
In the past, nothing could be done for pa-
tients whose cancer had spread around the
body. However, immunotherapy holds the
potential to help.
We believe the future holds a great deal of
promise.
killer T cell
dendritic
cell
cancer cell
antibodies
against cancer
antigens
040_0I?q.qxd 0I.0I.?009 I?.0 Uhr Seite II
A malorla das lmunoLeraplas alnda esL em
esLglo experlmenLal. Alguns upos, enLreLanLo,
como Leraplas com anucorpos para alguns upos
de cncer, [ foram colocadas em uso na pruca.

no passado, nada poderla ser felLo para
paclenLes cu[o cncer se espalhasse pelo corpo.
orem, a lmunoLerapla fornece um poLenclal para
a[ud-los.

AcredlLamos que o fuLuro da lmunoLerapla Lraz
uma grande promessa.
s-fc|o para a Ld|o Iaponesa

LsLe llvro faz parLe das auvldades de exLenso da Socledade !aponesa de
lmunologla. ns o crlamos porque acredlLamos que nossa socledade deve
oferecer a Lodos, de crlanas do Lnslno lundamenLal a adulLos, um llvro que lhes
d acesso fcll ao mundo da lmunologla. Comblnando um conLeudo rlgoroso com
um formaLo abordvel, o ob[elLvo fol dar ao lelLor um gosunho do assunLo na
esperana de que lsso desperLasse seu lnLeresse para explor-lo no fuLuro.
C pro[eLo comeou com a crlao de palnels de exlblo e manuals para o
publlco do evenLo de exLenso, Menekl lushlgl Mlral, organlzado pela Socledade
em 2007. llnallzar Lal llvro e como uma nova [ornada pra ns, mas como agora
ns nos Lornamos uma organlzao sem ns lucrauvos, consLrulr enLendlmenLo e
dlssemlnar lnformao Lm Lomado uma slgnlcncla malor. nesse senudo, a
publlcao desLe llvro poderla ser vlsLa como um LesLe de como organlzaes
como a nossa podem enconLrar papels aproprlados para elas mesmas no mundo
de ho[e. AcredlLamos que, alem dlsso, Lals auvldades de exLenso oferecem aos
pesqulsadores uma boa oporLunldade para re-examlnar seus papels publlcos
Lambem. Se a publlcao desLe llvro Lrouxer algum benenclo para a socledade e
nossos membros e, por exLenso, a[udar a apolar o progresso da lmunologla ou
da Socledade, enLo eu eu carla mulLo fellz.

CosLarla de oferecer meus slnceros agradeclmenLos a Lodos os membros da
Socledade !aponesa de lmunologla, comeando pelo resldenLe, ur Masayukl
Mlyasaka, por sua genul dlreo e apolo desde a orlgem e concepo do pro[eLo.
1ambem, ao ur Plroshl klyono, por seu Lrabalho pesado em fazer esLe pro[eLo
salr do cho. L aos auLores colaboradores desLe llvro, ur Plroshl kawamoLo,
ulreLor do ComlL romoLor de Lducao, e ur 1oshlakl ChLekl, ur norlko
Sorlmachl, ur Shlnsuke 1akl, e ur Sachlko Mlyake, do ComlL de 8elaes
ubllcas, por seus Lrabalhos dedlcados em decldlr sobre o conLeudo, formaLo e
LexLo desLe llvro. Alem dlsso, sou mulLo graLo a Sra Shlnobu ?amashlLa do
deparLamenLo de edlo da ?odosha por sua paclncla em lldar com nossas
negoclaes connuas e a Sra 1omoko lshlkawa, nossa llusLradora, por sua
resposLa graclosa a nossas sollclLaes mulLo deLalhadas.

Aprll 2008 =)')*(6( 5&43(7> .&% /00$*&1&2>
?% @&$6$A( B)A)C)0)
Compllado pela Socledade !aponesa de lmunologla (!Sl)
llusLrada por 1omoko lshlkawa
A Lraduo para o lngls por An[all aLel, para o orLugus por
!oo aulo Maruns do Carmo e a publlcao foram posslvels
graas a lederao Luropela das Socledades de lmunologla - LllS
(Luropean lederauon of lmmunologlcal Socleues).
www.es.org
www.wlley-vch.de
Your Amazing
Immune System
How it Protects
Your Body

ISBN 978-3-00-028073-3
Compiled by the Japanese Society for Immunology (JSI)
Illustrated by Tomoko Ishikawa
The English translation by Anjali Patel and publication
was made possible thanks to the
European Federation of Immunological Societies (EFIS).
Y
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A
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k
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www.wiley-vch.de
www.efis.org
Your Amazing
Immune System
How it Protects
Your Body

ISBN 978-3-00-028073-3
Compiled by the Japanese Society for Immunology (JSI)
Illustrated by Tomoko Ishikawa
The English translation by Anjali Patel and publication
was made possible thanks to the
European Federation of Immunological Societies (EFIS).
Y
o
u
r

A
m
a
z
i
n
g

I
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www.wiley-vch.de
www.efis.org

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