Epithelial Barriers
Physical,
mechanical, and biochemical barriers against microbial invasion are found in
all common portals of entry into the body, including the skin and respiratory,
gastrointestinal, and urogenital tracts. The intact skin is by far the most
formidable physical barrier available to infection because of its design. It is
comprised of closely packed cells that are organized in multiple layers that
are continuously shed. In addition, a protective layer of protein, known as
keratin, covers the skin. The skin has simple chemicals that create a
nonspecific, salty, acidic environment and antibacterial proteins, such as the enzyme
lysozyme, that inhibit the colonization of microorganisms and aid in their
destruction. The complexity of the skin becomes evident in cases of contact
dermatitis where increased susceptibility to cutaneous infection occurs as the
result of abnormalities of the innate immune response including defects in the
epithelial layer itself and defects in both signaling and or expression of
innate responses.
Sheets of
tightly packed epithelial cells line and protect the gastrointestinal,
respiratory, and urogenital tracts and physically prevent microorganisms from
entering the body. These cells destroy the invading organisms by secreting anti-microbial
enzymes, proteins, and peptides. Specialized cells in these linings, such as
the goblet cells in the gastrointestinal tract, secrete a viscous material
comprised of high molecular weight glycoproteins known as mucins, which when
hydrated form mucus. The mucins bind to pathogens, thereby trapping them
and washing away potential invaders. In the lower respiratory tract, hairlike,
mobile structures called cilia protrude through the epithelial cells and
move microbes trapped in the mucus up the tracheobronchial tree and toward the
throat. The physiologic responses of coughing and sneezing further aid in their
removal from the body.
Microorganisms
that are trapped by mucus are then subjected to various chemical defenses
present throughout the body. Lysozyme is a hydrolytic enzyme found in tears, saliva, and human
milk, which is capable of cleaving the walls
of bacterial cells by hydrolyzing the 1,4 beta-linkages between residues in
peptidoglycan. The complement system is found in the blood and is essential for
the activity of antibodies. It is comprised of 20 different proteins, many of
which act as precursors of enzymes. An antigen–antibody complex initiates this
system. Activation of the complement system increases bacteria aggregation,
which renders them more susceptible to phagocytosis through activation of mast
cells and basophils and through the direct release of lytic complexes that
rupture cell membranes of invading organisms (Fig. 13.1). In addition, recent
research has shown that complement plays a key role in bridging the
innate–adaptive immune responses through the release of C3 and C5 from DCs. In
the stomach and intestines, death of microbes results from the action of
digestive enzymes, acidic conditions, and secretions of defensins, small
cationic peptides that kill within minutes both gram-positive and gram-negative
microorganisms by disrupting the microbial membrane.
When
pathogens overcome the epithelial defenses, the innate immune response is
initiated by the body’s leukocytes by the recognition of common surface
receptors present on the invading
microorganisms.