The Immune System: Basis of so much Health and Disease: 9. Control of Inflammation and Immunity Crispian Scully Eleni A Georgakopoulou Yazan Hassona Dental Update 2024 45:1, 707-709.
The immune system is the body's primary defence mechanism against infections, and disturbances in the system can cause disease if the system fails in defence functions (in immunocompromised people), or if the activity is detrimental to the host (as in auto-immune and auto-inflammatory states). A healthy immune system is also essential to normal health of dental and oral tissues. This series presents the basics for the understanding of the immune system, this article covering control of immunity and inflammation.
Clinical Relevance: Modern dental clinicians need a basic understanding of the immune system as it underlies health and disease.
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The cardinal features of inflammation are:
Mediators of inflammation are shown in Tables 1 and 2 and involve the following:
Key:
mild mediator;
moderate mediator;
important mediator.
Antigen recognition can be influenced by:
T-cell activation is influenced by cytokines:
APCs produce CCL4 (chemokine [C-C motif ] ligand 4), a chemokine which attracts regulatory T cells (Tregs) to the area:
Cytokine release becomes suppressed; for example, IL-1β and TNF-alpha fall under the control of the AUF1 (AU-rich element RNA-binding protein gene) also known as heterogeneous nuclear ribonucleoprotein D (HNRNPD).
Immunoglobulins can influence the immune response positively in several ways, as anti-idiotypes or through immune complex formation or negatively by reducing antigenic challenge or by feedback inhibition of B-cells.
Genetic factors which influence the immune system include both MHC-linked and non-MHC-linked genes.
Tolerance mechanisms are needed because the immune system randomly generates a vast diversity of antigen-specific receptors and some of these will be self-reactive. Self-reactive T-cells share the following features:
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