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Textbook of Immunology Textbook of Immunology Second Edition Sunil Kumar Mohanty MD Professor and Head Department of Microbiology Kalinga Institute of Medical Sciences Bhubaneswar, Odisha, India K Sai Leela MD Professor Department of Microbiology Kamineni Institute of Medical Sciences Narketpally, Nalgonda, Andhra Pradesh, India Foreword KC Nathsarma ® Jaypee Brothers Medical Publishers (P) Ltd New Delhi • London • Philadelphia • Panama ® Jaypee Brothers Medical Publishers (P) Ltd Headquarters Jaypee Brothers Medical Publishers (P) Ltd 4838/24, Ansari Road, Daryaganj New Delhi-110 002, India Phone: +91-11-43574357 Fax: +91-11-43574314 Email: [email protected] Overseas Offices J.P. Medical Ltd Jaypee-Highlights Medical Publishers Inc 83 Victoria Street, London City of Knowledge, Bld. 237, Clayton SW1H 0HW (UK) Panama City, Panama Phone: +44-2031708910 Phone: + 507-301-0496 Fax: +02-03-0086180 Fax: + 507-301-0499 Email: [email protected] Email: [email protected] Jaypee Medical Inc Jaypee Brothers Medical Publishers (P) Ltd The Bourse 17/1-B Babar Road, Block-B, Shaymali 111 South Independence Mall East Mohammadpur, Dhaka-1207 Suite 835, Philadelphia, PA 19106, USA Bangladesh Phone: + 267-519-9789 Mobile: +08801912003485 Email: [email protected] Email: [email protected] Jaypee Brothers Medical Publishers (P) Ltd Shorakhute, Kathmandu Nepal Phone: +00977-9841528578 Email: [email protected] Website: www.jaypeebrothers.com Website: www.jaypeedigital.com © 2014, Jaypee Brothers Medical Publishers All rights reserved. No part of this book may be reproduced in any form or by any means without the prior permis- sion of the publisher. Inquiries for bulk sales may be solicited at: [email protected] This book has been published in good faith that the contents provided by the authors contained herein are original and is intended for educational purposes only. While every effort is made to ensure a accuracy of information, the publisher and the authors specifically disclaim any damage, liability or loss incurred, directly or indirectly, from the use or application of any of the contents of this work. If not specifically stated, all figures and tables are courtesy of the authors. Where appropriate, the readers should consult with a specialist or contact the manufacturer of the drug or device. Textbook of Immunology First Edition: 2007 Second Edition: 2014 ISBN 978-93-5090-474-9 Printed at Dedicated to The loving memory of my colleague Late Dr Subrat Mishra whose inspiration and encouragement prompted me to write a book on immunology —Sunil Kumar Mohanty The teachers and the taught —K Sai Leela Foreword It is my immense pleasure to write the foreword to the Textbook of Immunology authored by Dr Sunil Kumar Mohanty and Dr K Sai Leela. The immunology as a subject has grown immensely in the last 50 years. The amount of detail knowledge that has been accumulated has already reached paroxysmal proportion. If there has been a remarkable progress, then it is in the domain vaccinology, which led to the control of a number of infectious diseases. But, there remains a crying need for vaccine against others. It is hoped that the immunologists of today, using the tools of molecular and cellular biology, genomics, and proteonomics will make inroads in preventing these diseases. Presently, the immunodiagnostic measures are of great utility in diagnosis and monitoring the treatment of various diseases. The Textbook of Immunology serves a great purpose not only in understanding the fundamentals of immunology but also to delve into the depth to explore the fascinating aspects of the immune system, that will make them doctors, researchers and teachers. Very few books are complete in all aspects. The authors have made every effort to present the text in a lucid and readable style with illustrative graphics and colored diagrams without sacrificing the important details. I congratulate the authors for the compendium, which is bound to be of great interest and utility for students, researchers, teachers and doctors of medical and other allied sciences. KC Nathsarma md (New Zealand) Ex-Professor and Head Department of Microbiology MKCG Medical College Cuttack, Odisha, India Preface to the Second Edition The goals for the second edition of Textbook of Immunology have remained the same as those of the first edition published in 2007 to provide a brief, accurate and updated presentation of those aspects of immunology that are of particular significance in the fields of clinical infections, diagnostic immunology, vaccinology, transplantation immunology and in other allied fields of biological sciences. In the last few years, we have received certain comments from our readers, expressing satisfaction on some parameters and also pointing out certain inadequacies. We acknowledge their inputs with humility and utmost respect and have acted on the shortcomings meticulously in the second edition of Textbook of Immunology. Initially, the book was designed, mainly, for the use of undergraduate students. Therefore, we stressed more on basics than going deeply into the intricacy. In honoring the recommendation of a number of learned teachers, in the fields of immunology, we have not only included certain topics such as HIV infection (AIDS), immunology of fungal infections, etc. but also updated the knowledge on various subjects such as antigen receptors, cytokines, their receptors and future prospects, ‘B’ cell and ‘T’ cell repertoires, autoimmune disease, etc. Almost in every chapter, there has been addition, deletion and correction of inadvertent errors without compromising the lucidity, clarity and consistency. We have also included some more figures and tables wherever required. Perfection is too vast for comprehension. But striving for perfection is the triumph of human intelligence. We have worked hard to minimize the shortcomings. However, we fervently desire to get the regular inputs from our readers to smoothen the angularities. We have consulted friends, especially, Dr SS Mishra, Professor of Pharmacology; Dr Shruti Mohanty, Professor of Biochemistry, and colleagues with relevant expertise to advise us and to those we owe our sincere gratitude. We hope that the second (revised) edition of Textbook of Immunology will invite today’s students not only to acquire familiarity but also to delve into the depth to explore the fascinating aspects of the immune system, that will make them doctors, researchers and teachers. Sunil Kumar Mohanty K Sai Leela