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The humoral immune response

INTRODUCTION

Preexisting circulating antibodies and the rapidity of the secondary response form the basis of effective immune responses resulting from either natural infection or vaccination. The primary immune response, which is the response in an animal that has never before encountered a given antigen, utilizes preformed antibodies that limit microbial replication at the onset of infection. However, this primary response may be too slow to protect against many pathogens. By comparison, the secondary antibody response, which results from the activation of a memory B cell, is faster and better able to halt the progress of infection. Vaccination is therefore one of the most important contributions of immunology to disease prevention.

An overview of the humoral immune response will be reviewed here. Discussions of immunoglobulin genetics, structure, and function, as well as of B cell development are presented separately. (See "Function and clinical applications of immunoglobulins" and "Immunoglobulin genetics".)

PASSIVE AND ACTIVE HUMORAL IMMUNITY

Passive humoral immunity is the acquisition of preformed antibodies from an external source, such as the administration of intramuscular or intravenous human immunoglobulin (Ig). (See "Medical therapy of immune deficiency".) Passive immunity is also acquired during human gestation by the transplacental transfer of maternal IgG, and postnatally via colostrum and breast milk through transepithelial Ig transport by the neonatal Fc receptor, FcRn [1]. Maternal IgG is gradually lost, with very little remaining after the first year of life.

Before maternal IgG is lost, however, infants develop the ability to respond to most antigenic challenges. The figure shows the pattern of serum IgG levels in the first five years of life (graph 1). IgA and IgM are not transported across the placenta, and the neonate has only small quantities in its circulation. Nevertheless, large amounts of IgA are present in colostrum. This affords local protection in the gut, with only minute quantities reaching the circulation this way. Serum levels of IgA and IgM increase gradually and slowly throughout childhood. Adult levels are reached in adolescence [2].

Active (or adaptive) immunity is the response generated during the encounter of the immune system with antigen. This may occur during the course of a natural infection, or after intentional antigen administration (vaccination).
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