Lymphatic and Immune System (Group 4) PDF

THE LYMPHATIC AND IMMUNE SYSTEM BY GROUP Christian Dimayuga Stephanie 4: Jennilyn Jastillana Sheehan Macabinguel Jeaneca Lacy Reyes  Outline 0 Describe the Structure and Function 1 0 Explore Immune Responses 2 0 Identify Lymphatic Disorders 3 0 Exa...

THE LYMPHATIC AND IMMUNE SYSTEM BY GROUP Christian Dimayuga Stephanie 4: Jennilyn Jastillana Sheehan Macabinguel Jeaneca Lacy Reyes  Outline 0 Describe the Structure and Function 1 0 Explore Immune Responses 2 0 Identify Lymphatic Disorders 3 0 Examine the Interconnection 3  What is the lymphatic system? It is made up of vessels, cells, and organs that help manage excess fluids and filter harmful substances from the blood. Its main job is to maintain the body's fluid balance. Working alongside the blood vessels, it collects fluid from tissues and returns it to the bloodstream. What is the immune system? A complex network of cells and organs protects the body by eliminating harmful invaders that can cause sickness or death. It works closely with the lymphatic system, which is essential for its function, so these two systems are typically discussed together.  Functions of the Lymphatic System 1. Fluid Drainage and 2. Interstitial Fluid and 3. Edema Homeostasis Cellular Health Accumulation of fluid Drains excess interstitial Plasma that leaks from in tissues due to fluid, preventing swelling capillaries becomes (edema). Returns fluid lymphatic blockage or interstitial fluid, (lymph) to the injury. bathing cells. bloodstream via vessels, Can cause swelling Facilitates nutrient trunks, and ducts. and serious medical Prevents depletion of blood delivery and waste removal for cellular consequences. volume (approximately 3 liters of plasma leak from homeostasis. capillaries daily).  Functions of the Lymphatic System 4. Immune System 5. Lymphatic and Interaction Immune Lymphatic system helps System Connection monitor tissues for infection or Fluid regulation in the tissue damage. lymphatic system supports Immune cells travel via the immune system. lymphatic vessels and utilize The lymphatic system lymph nodes as staging areas collects fluid and transports for immune responses. immune cells throughout the Lymph nodes become swollen body, linking both systems. during infection due to activated leukocytes. Fluid Recycling in the Body Edema Structure of Lymphatic System Lymphatic Capillaries: These are the smallest vessels in the lymphatic system, which collect interstitial fluid. The fluid is referred to as lymph once inside the capillaries. Lymphatic Vessels: Lymphatic capillaries lead to larger lymphatic vessels that eventually return the lymph to the bloodstream via ducts. Along the way, lymph passes through lymph nodes, commonly found near the groin, armpits, neck, chest, and abdomen. Lymph Nodes: Humans have approximately 500–600 lymph nodes Structure of Lymphatic System Flow of Lymph: Lymph is not actively pumped by the heart. Movement of lymph depends on the contraction of skeletal muscles, body movements, and breathing. Lymphatic vessels have one-way valves to prevent backflow as the lymph moves toward the heart. Lymph eventually empties into the bloodstream through the lymphatic ducts located at the junction of the jugular and subclavian veins in the neck. More to the structure LYMPHATIC CAPILLARIES: These are vessels where interstitial fluid enters the lymphatic system, becoming lymph fluid. Located in almost all tissues of the body, lymphatic capillaries are intertwined with the arterioles and venules of the circulatory system, especially in soft connective tissues. Some parts of the body do not have lymphatic capillaries, these are the central nervous system (CNS), bone marrow, bones, teeth, and the cornea of the eye. More to the structure LYMPHATIC CAPILLARIES: These are only one cell thick, making them similar to blood vessel capillaries but with a distinct structure. Endothelial Cells: These cells overlap slightly, forming a one-way system where fluid can flow in but not out. Pressure Mechanism: When pressure in the interstitial space (tissue) increases, it pushes the cells open, allowing fluid to flow into the capillaries. When pressure builds inside the capillaries, the cells close to prevent fluid from leaking back out. More to the structure LYMPHATIC CAPILLARIES: Special Function in the Small Intestine: Lymphatic capillaries known as lacteals are vital for transporting dietary lipids and lipid-soluble vitamins into the bloodstream. These lipids are too large to pass through blood capillaries but are absorbed by the lacteals. More to the structure LARGER LYMPHATIC VESSELS, TRUNKS, AND DUCTS: Larger Vessels: Lymphatic vessels merge to form larger structures called lymphatic trunks, which eventually drain into larger ducts. Right Lymphatic Duct: ⚬ Drains lymph from the upper right side of the body (right arm, right side of the head, and thorax) into the right More to the structure LARGER LYMPHATIC VESSELS, TRUNKS, AND DUCTS: Thoracic Duct: ⚬ Drains lymph from the rest of the body into the left subclavian vein. ⚬ The thoracic duct begins at a sac-like structure called the cisterna chyli, which receives lymph from the lower limbs, pelvis, and abdomen. Asymmetrical Drainage: ⚬ Lymph drainage in the body is not symmetrical. The right More to the structure LYMPH NODES: Filtration Role: As lymph travels through the vessels, it passes through lymph nodes, which filter out debris and pathogens, acting as the "filters of lymph." More to the structure LYMPH NODES: Bacteria Removal: ⚬ Any bacteria found in the tissues are picked up by lymphatic capillaries and taken to the lymph nodes for destruction. Pathogen Removal: Within the lymph node, certain cells can engulf and destroy pathogens, eliminating them from the body. Other cells in the lymph node may become activated by signals or signs of infection within the lymph, helping to fight off the invaders. More to the structure LYMPH NODES: Structure: Shape and Support: Lymph nodes are round or bean-shaped, surrounded by a capsule of connective tissue. They are divided into compartments by trabeculae, which are extensions of the capsule. Reticular Fibers: A network of reticular fibers provides additional structural support to the lymph node. More to the structure LYMPH NODES: Lymph Flow: Afferent Vessels: Lymph enters the node through afferent lymphatic vessels. Efferent Vessels: Lymph, cells, and any remaining fluid exit the node through efferent lymphatic vessels. Filtration Pathway: Once inside the node, lymph flows through the subcapsular sinus (the filtration zone), where cells engulf More to the structure LYMPH NODES: Lymph Flow: Cortex: Lymph moves into the cortex, which contains rapidly dividing lymphocytes that can replicate in response to pathogens. Medulla: Finally, lymph flows through the medulla, which contains cells specializing in antibody production before leaving through efferent vessels. LYMPHOID NODULES: Structure: Unlike lymph nodes, lymphoid nodules lack a capsule and consist of a dense cluster of lymphocytes found in other tissues. Locations: These nodules are common in the respiratory and digestive tracts, areas frequently exposed to pathogens. TONSILS: Role: Tonsils are specific lymphoid nodules located in the throat, where they help the body develop immunity to oral pathogens. Swelling (Adenoids): Swollen tonsils, also called adenoids, indicate an active immune response. TONSILS: Structure: Tonsils lack a complete capsule and contain tonsillar crypts, deep invaginations that collect food particles, mucus, and microbes. This interaction helps the immune system differentiate between harmful invaders and harmless materials. Children's Immunity: Tonsils play a key role in helping children’s bodies recognize and develop immunity to pathogens, protecting them later in life. MUCOSA-ASSOCIATED BRONCHUS-ASSOCIATED LYMPHOID TISSUE (MALT) LYMPHOID TISSUE Location: MALT is a group of (BALT) lymphoid nodules found in various LOCATION: BALT organs, including the CONSISTS OF LYMPHOID gastrointestinal tract, breast tissue, lungs, and eyes. FOLLICLES LOCATED Role in Immunity: MALT cells ALONG THE WALLS OF sample materials from the organ's THE BRONCHI IN THE lumen, triggering immune LUNGS. responses to potential pathogens FUNCTION: LIKE THE while also helping the body TONSILS, BALT HELPS develop tolerance to harmless substances like food. PROTECT THE BODY FROM INHALED PATHOGENS. Thymus The thymus is found in the space between the sternum and aorta of the heart. The outer region of the organ is known as the cortex and the inner region is the medulla. Thymus is a small gland in the lymphatic system that makes and trains special white blood cells called T-cells. Spleen The spleen is major lymphoid organ. It is found in the posterioral abdominal cavity (Left upper quadrant). The spleen is divided into nodules by strips of connective tissue, and within each nodule is an area reddish in color and one that purplish in color. The red are is referred to as red pulp and consists mostly of red blood cells. The purplish area called white pulp and is filled with leukocytes.  Overview of the Immune Response Three groups of immune defenses: Barriers such as the skin and mucous membranes, which act instantaneously to prevent pathogenic invasion into the body tissues. The rapid "Emergency responders" of the Innate Immune Response. A variety of cells and soluble factors that activate quickly. Adaptive Immune Response invloves many cells types and soluble factors and is notable for its long lasting memory capability.  Overview of the Immune Response White blood cells or Leukocytes. Functionally, white blood cells are divided into three broad classes: Phagocytic cells. Phagocytic cells can ingest phatogens or other cellular debris for destruction. Lymphocytes. These cells are responsible for antibody production, direct cell-mediated killing of virus-infected and tumor cells, and regulation of the immune response. Granular cells. Cells that containing granules, which are packet of noxious materials that can be released in attack against pathogens. Barrier defenses  Lysozyme Lysozyme - an enzyme that destroys bacteria by digesting their cell walls.  Table 1 Barrier Defenses Site Specific Defense Protective Aspect Skin Epidermal surface Keratinized cells, Langerhans cells Skin Sweat glands, sebaceous Low pH, washing action (Sweat/Secretions) glands Specific Defense Oral cavity Salivay glands Lyzozyme Stomach Gastrointestinal tract Low pH Mucosal Surfaces Mucosal epithelium Nonkeratinized epithelial cells Normal flora Prevent pathogens from growing on mucusal (Nonpathogenic Mucosal tissue surfaces Bacteria) Phagocytosis - the destruction of debris or pathogens through engulfment, The phagocyte takes the organism inside itself as a phagosome, which subsequently fuses with a lysosome and its digestive enzymes, effectively killing many pathogens.  Macrophage Macrophage - It’s an irregularly shaped phagoxytic cell that is the most versatile of the phagocytes in the body. Macrophages have long cellular extension that can reach out like arms to grab and pull bacteria or debris toward the cell membrane for engulfment.  Neutrophils Neutrophils- A type of white blood cell found in tremendous numbers in the bloodstream. Neutrophils are both granular cell and phagocytes cells. Neutrophils are attracted to an are of infection via chemotaxis.  Natural killer (NK) Cells Natural Killer (NK) Cells - are type of lymphocyte that have the ability to induce apoptosis in cells infected with intracellular pathogens such as viruses. Recognition of Pathogens The two big functional differences between the innate and adaptive responses can be summarized with the words time and specificity. Recognition of Pathogens Time: Where the innate response can kick in immediately or within hours of infection, the adaptive immune response takes several days to be effective. Recognition of Pathogens Specificity: The adaptive immune response is exquisitely specific in its ability to recognize details of pathogens. The adaptive immune response is specific, not only distinguishing between pathogens like influenza and Ebola, but also recognizing different variants of the same pathogen, such as the alpha and delta variants of SARS-CoV-2. Recognition of Pathogens Pattern Recoginition Receptor (PRR): are membrane-bound receptors that detect features of pathogens or signals from stressed or damaged cells. They are always present on the cell surface and evolved before the adaptive immune response. Soluble Mediators of the Innate Immune Response Chemical signals can prompt cells to change traits, such as receptor expression. These soluble factors are released during both innate and adaptive immune responses. Cytokines and Chemokines *Cytokines are signaling molecules that enable short-distance communication between cells, inducing physiological changes in the receiving cell. Chemokines are similar but attract cells over longer distances (chemotaxis). Interferons, a type of cytokine, are secreted by virus-infected cells to alert nearby cells to produce antiviral proteins, helping them prepare defenses against potential infection. Soluble Mediators of the Innate Immune Response Complement System The complement system consists of proteins present in blood plasma, always ready for activation to combat pathogens. Produced in the liver, these proteins play various roles in both innate and adaptive immune responses. The system operates as a cascade, with each protein activating the next in an irreversible series of reactions. Soluble Mediators of the Innate Immune Response Complement System Key functions include: Opsonization Chemotaxis to attract phagocytic cells to infection sites  Inflammatory Response The hallmark of the innate immune response is inflammation, which everyone has experienced through injuries. It features four characteristics: heat, redness, pain, and swelling. Inflammation can be triggered by pathogens or tissue damage. Its primary goal is to recruit cells to the damaged area for debris clearance and pathogen response, setting the stage for wound repair. The inflammatory response consists of four main parts Tissue Injury: Damaged cells release contents that stimulate mast cells to release inflammatory mediators like histamine, which causes vasodilation and increased blood flow, leading to swelling. Vasodilation: Prostaglandins and histamine increase blood vessel diameter, resulting in increased blood flow, heat, and redness.  The inflammatory response consists of four main parts Increased Vascular Permeability: Cytokines enhance capillary permeability, allowing cells to exit the blood more easily and causing fluid leakage, which results in swelling (edema). Recruitment of Phagocytes: Neutrophils and monocytes are attracted to the injury site. Neutrophils phagocytose pathogens, while monocytes mature into macrophages,  Fever Definition: Fever is an increase of over 1°C (1.8°F) in body temperature, acting as a tool of the innate immune system. Mechanism: Triggered by pyrogens (cytokines) that prompt the hypothalamus to produce prostaglandin E2, raising body temperature through changes  Fever Benefits of Fever: Inhibits replication of bacteria and viruses. Enhances interferon activity and speeds up cytokine production. Reduces iron availability to limit bacterial growth. Can shorten infections when allowed to persist safely.  Fever Pain and Inflammation: Prostaglandins sensitize nociceptors, increasing pain signals and promoting vasodilation and swelling. NSAIDs (e.g., ibuprofen, aspirin) inhibit prostaglandin synthesis to reduce pain, inflammation, and fever.  The Benefits of the Adaptive Immune Response Specificity: Recognizes a wide variety of pathogens. Antigens: Molecules identified as non-self, detected by B and T lymphocytes. - Can provoke responses to harmless substances (e.g., food proteins). Components: Cellular Responses: ⚬ T lymphocytes (T cells) identify and attack infected/abnormal cells. Antibody-Mediated Responses: ⚬ Antibodies bind to specific antigens, neutralizing them and marking for destruction. Together, these components form a robust defense against various Primary Disease and Immunological Memory The immune system’s first exposure to a pathogen triggers a primary response, with many infection symptoms reflecting this immune action. Mucus, coughing, sneezing, vomiting, and diarrhea help expel pathogens, while pain, inflammation, and fever indicate an innate response. Primary disease often results in severe symptoms as the adaptive immune response takes time to activate. Upon re-exposure, a stronger and faster secondary adaptive immune response kicks in, often eliminating the pathogen before it causes noticeable symptoms. This response underlies immunological memory, preventing repeated infections by the same pathogen. Consequently, children tend to experience more frequent infections than adults, who have more developed defenses. Early exposure to pathogens in childhood can provide lasting immunity later in life.  Self Recognition A key feature of the adaptive immune response is its ability to distinguish between self-antigens, which are normally present in the body, and foreign antigens found on potential pathogens. As T and B cells mature, mechanisms help prevent them from recognizing self-antigens, protecting the body from damaging immune responses. However, these mechanisms are not foolproof, and reactive cells against self-antigens can lead to immune responses against the body’s own tissues. When these responses are consistent or severe, they result in autoimmune diseases.  T-Cell Mediated Immune T-cellsResponses have special proteins on their surface called T-cell receptors. These receptors are made out of two protein chains and have a specific site where they can bind to antigens (foreign substance like parts of bacteria or viruses). T Cell Receptors The antigen-binding site is where the T cell connects with the antigen, allowing the T cell to recognize and respond to  Antigen s are usually large and Antigens on pathogens complex, and consist of many individual characteristics. Antigens are substances that provoke an immune response, and they often have specific parts called antigenic determinants (epitopes) that are recognized by immune cells. T cells - locks Antigens - keys  Antigen Processing and In this process, TPresentation cells won’t be able to recognize free- floating or cell-bound cells, instead the antigen- presenting cells(APCs) will help recognize antigens when it is displayed on the surface. When a pathogen invades, pieces of antigen are broken down and presented on the surface of other cells using molecules called MHC (Major Histocompatibility Complex). Two types of MHC Class I: Found MHC: MHC Class II: Found on specialized on almost all body immune cells (like macrophages cells. These present and dendritic cells) and present antigens from inside antigens from outside the cell, like the cell. bacteria. Antigen Presentation by Cells containing MHC Class II Protein  T-Cell Development and Differentiation The genome encodes the antigen receptors on T cells, enabling the recognition of a wide variety of antigens, though self-reactive lymphocytes are rarely produced due to T cell tolerance. T cells are initially produced in the bone marrow but complete their maturation in the thymus, where they undergo a selection process to remove any T cells that might attack the body’s own antigens. T cells that pass this selection process become self-tolerant and immunocompetent, meaning they can safely recognize and respond to foreign antigens without targeting body’s own cells.  Mechanisms of T Cell-Mediated Immune Activation of T Cells Responses occurs when they recognize foreign antigens presented alongside an MHC (Major Histocompatibility Complex) molecule, this recognition creates many new identical T cell clones in no time. Clonal expansion makes the immune response strong enough to control a pathogen. Clonal selection binds the antigens that are specifically only for its own receptor. Activated T cells has a “hard wired” receptor into its DNA, therefore all of its offspring will have the same DNA and T cell receptors.  ANTIBODY STRUCTURE Antibodies, also known as immunoglobulins (Ig), are large Y-shaped glycoproteins produced by B-cells. ; the base of the Y is known as the Fc region. The Fc region of the antibody is formed by the two heavy chains coming together. two identical heavy chains and two identical light chains.  Five Classes of Antibodies and Their Function IgG is a major antibody involved in the late primary responses, which are the initial immune reactions to a pathogen, and the main antibody of secondary responses, which are the subsequent, stronger immune reactions, in the blood -it is a monomeric antibody  Five Classes of Antibodies and Their Function IgD is mostly found expressed on B cell plasma membranes, but is secreted in very small amounts into the bloodstream  Five Classes of Antibodies and Their Function IgE is usually associated with allergies and anaphylaxis. -it is present in the lowest concentration in the blood but is found in much higher concentrations in interstitial fluid.  Five Classes of Antibodies and Their Function IgA is a structure consisting of two antibodies joined at their Fc regions.  Five Classes of Antibodies and Their Function IgM is describes as a pentamer which is composed of five monomers. It is usually the first antibody made during a primary response.  Active Immunity vs Passive Immunity Active immunity is the resistance to pathogens acquired during an adaptive immune response within an individual. This can happen through natural infection or vaccination.  Active Immunity vs Passive Immunity There are 2 types of active immunity: Natural acquired active immunity- This occurs when a person is infected with a pathogen and their immune system responds by producing antibodies. (e.g; chickenpox) Artificial acquired active immunity- This is achieved through vaccinations, where a killed or weakened form of the pathogen is introduced into the  Active Immunity vs Passive Immunity Passive Immunity arises from the transfer of antibodies to an individual without requiring them to mount their own active immune response.  Active Immunity vs Passive Immunity There are 2 types of passive immunity: Naturally acquired passive immunity Artificially acquired passive immunity  Responses to Different Pathogens The human immune system is a highly sophisticated network designed to protect the body from a wide array of pathogens, including viruses, bacteria, fungi, and multicellular parasites.  Responses to Different Pathogens Viruses: are intracellular pathogens. They are unable to replicate themselves. The adaptive response involves cytotoxic T cell activation to eliminate infected host cells and B cell production of neutralizing antibodies.  Responses to Different Pathogens Bacterial and fungal: both have unique molecules on their cell walls that can trigger immune responses. Both are typically extracellular pathogens, though some small bacterial species can live inside  Responses to Different Pathogens Multicellular Parasites: come in all shapes and sizes. Some, such as malarial parasites, can be intracellular, but most are multicellular extracellular  LYMPHADENOPATHY & LYMPHADENITIS Lymphadenopathy is the swelling of lymph nodes, caused by inflammation, infection, or cancer. When due to an infection or inflammatory disorder, it's called lymphadenitis. For example, strep throat can swell neck lymph nodes, while breast cancer can enlarge nodes in the armpits.  LYMPHADENOPATHY & LYMPHADENITIS Symptoms Swollen, tender lymph nodes Redness or warmth in the area Fever, fatigue, or signs of infection Treatment Antibiotics for infections Anti-inflammatory meds for pain and swelling Warm compresses for relief Cancer treatment if caused by cancer Duration Typically lasts a few days to weeks with treatment, but may persist longer in chronic conditions.  LYMPHANGIOMA A lymphangioma is an uncommon noncancerous fluid-filled bump under the skin (cyst) caused by overgrown lymph vessels. Lymph vessels (or channels) are responsible for moving lymphatic fluid and white blood cells through your tissues and bloodstream.  LYMPHANGIOMA Symptoms Cystic hygroma (cystic lymphangioma): A red to blue swollen, fluid-filled mass often found on the neck, groin or armpit. Cavernous lymphangioma: A red to blue swollen, rubbery mass often found on the tongue but can form anywhere on the body. Lymphangioma circumscriptum: A small group of clear to pink to red to brown or black pimple-sized, fluid-filled blisters found on the mouth, shoulders, neck, arms and legs. Treatment Complete surgical excision  TONSILLITIS Tonsillitis is the inflammation of the tonsils, typically caused by viral or bacterial infections. Treatment Viral Tonsillitis: Symptomatic relief with pain relievers, warm liquids, and rest. Bacterial Tonsillitis: Antibiotics are prescribed, along with symptom management. Chronic Tonsillitis: Tonsillectomy may be recommended. Home Remedies: Gargling salt water or using throat lozenges can help.  TONSILLITIS Symptoms Sore Throat: Painful swallowing. Difficulty Swallowing: Swollen tonsils hinder eating/drinking. Swollen Lymph Nodes: Tender neck nodes. Fever: Body's response to infection. Red and Swollen Tonsils: May have white/yellow pus. Bad Breath: Foul odor from infection. Coughing: Due to mucus. Children may show irritability and have trouble eating or sleeping. Seek medical attention for severe or persistent symptoms.  CASTLEMAN DISEASE Castleman Disease (CD) is a rare disorder involving an overgrowth of cells in the body’s lymph nodes. There are two main types: unicentric Castleman disease (UCD) and multicentric Castleman disease (MCD), each with different clinical manifestations.  CASTLEMAN DISEASE Unicentric Castleman Disease (UCD): Affects a single lymph node. Symptoms: Often asymptomatic, but may cause localized pain or swelling. Treatment: Surgical removal of the affected lymph node. Multicentric Castleman Disease (MCD): Affects multiple lymph nodes and organs. Symptoms: Fever, night sweats, weight loss, enlarged spleen/liver. Treatment: Immune therapy, antivirals, corticosteroids, sometimes chemotherapy. General: CD involves abnormal growth of lymph nodes, can resemble lymphoma but is not cancerous. MCD can lead to serious complications like organ failure if untreated.  LYMPHATIC SYSTEM CANCERS Lymphatic system cancers primarily refer to lymphomas, which are cancers that begin in the lymphatic system when lymphocytes (white blood cells) multiply uncontrolled a crucial part of the immune system. two main types: Hodgkin lymphoma and non-Hodgkin lymphoma  LYMPHATIC SYSTEM CANCERS Symptoms Treatment Swollen Lymph Chemotherapy Nodes Radiation Therapy Fever Immunotherapy Night Sweats Targeted Therapy Weight Loss Stem Cell Fatigue Transplantation Itching Durati on treatment might last several months with continuous follow-up care afterward Thank you!  Reference s https://www.mayoclinic.org/diseases-conditions/edema/symptoms-causes/syc- 20366493 https://teachmeanatomy.info/the-basics/ultrastructure/lymphatic-system/ https://www.researchgate.net/figure/Diagrammatic-illustration-of-the-lymphatic- drainage-of-the-whole-human-body-The-right_fig3_354519870 https://my.clevelandclinic.org/health/body/23131-lymph-nodes https://www.buzzrx.com/blog/diseases-of-the-lymphatic-system https://www.google.com/search?client=ms-android-oppo-terr1- rso2&sca_esv=247a3cc0ba513c42&sxsrf=ADLYWIKIUclrgU1WTe1qSKPMh4r21Bluhg:1728510797467&q=lysozyme+enzy me&uds=ADvngMjcH0KdF7qGWtwTBrP0nt7dAAh-P1KL938xtHbIzGFid3RSaXXUHPoK5V9LtMjYTS- RjD2qbAhlUKdVLqrYD5FcxqzfigaFpzePs1IOwgzSR5A8-SiXR0iiXX2NJ2qId6hacUvU&udm=2&sa=X&ved=2ahUKEwjL- MrApIKJAxXIm68BHbLcKCcQxKsJegQIDhAB&ictx=0&biw=360&bih=674&dpr=2#vhid=xV0OJk9HfAP5PM&vssid=mosaic https://bioxcell.com/educational-articles/antibody-structure/? fbclid=IwZXh0bgNhZW0CMTEAAR35RYxeU6WwtFHJSVkaJXQQxiSxSopdlAwaqvArdw5kqWsNqvZEkBxbfl4_aem_hXQn4VW- oxLeXf7HY4eKrw https://ph.pinterest.com/pin/732538695652577053/ https://www.nhs.uk/conditions/tonsillitis/ https://gacetamedica.com/investigacion/celulas-nk-la-nueva-generacion-de-car-t/