Immunology: A Short Course

Citation

Coico, R. (2021). Immunology: A Short Course (8th ed.). Wiley-Blackwell.

Chapter Summary

The eighth edition runs to about 430 pages in twenty chapters. It is followed by a glossary, an appendix listing CD antigens and an index. The first chapter states the plan of the book. Chapters on the cells, molecules and methods of the immune response come first, then chapters on how responses are generated and regulated, then the diseases in which the immune system is deficient, misdirected or turned against the self, and finally transplantation, tumours and infection.

Chapter 1: Overview of the Immune System

The opening chapter compares the immune system to an orchestra that must stay in tune and introduces the main ideas of the book. These are innate and adaptive immunity, haematopoiesis, clonal selection, active, passive and adoptive immunisation, humoral and cellular immunity, and the generation of diversity. It also discusses both the benefits and the damaging effects of immune responses. A closing section, "The Short Course Begins Here", sets out the order of the chapters that follow.

Chapters 2–4: Cells and Tissues of the Immune System; Cells of the Innate Immunity; Complement

These chapters lay the cellular foundation: the lymphatic system and the main haematopoietic cells, lymphocyte migration and recirculation, and the fate of antigen after it enters the body. Chapter 3 covers physical and chemical barriers, the cells of innate immunity, pattern recognition and inflammation. Chapter 4 explains complement activation, its regulation and biological activities, and complement deficiencies.

Chapters 5–6: Immunogens and Antigens; Antibody Structure, Function, and Interactions with Antigen

Chapter 5 asks what makes a substance immunogenic. It covers epitopes recognised by B and T cells, primary and secondary responses, cross-reactivity and adjuvants. Chapter 6 describes the structure of immunoglobulins: light and heavy chains, domains, the hinge and the variable region. It treats each class (IgG, IgM, IgA, IgD and IgE) separately and covers the kinetics of the antibody response and antigen–antibody interactions.

Chapters 7–8: Organization and Expression of Lymphocyte Antigen Receptor Genes; The Major Histocompatibility Complex and Antigen Presentation

Chapter 7 begins with a brief review of gene structure and expression. It then explains how B-cell and T-cell receptor genes are assembled, how class switching occurs and how antibody and T-cell receptor diversity is generated, including the role of activation-induced cytidine deaminase. Chapter 8 explains the MHC: how it got its name, the structure and variability of class I and class II molecules, antigen processing and presentation, the HLA genes, and the association of MHC diversity with resistance and susceptibility to disease.

Chapters 9–11: B-Cell Development and Activation; T-Cell Development and Activation; Cytokines

Chapter 9 follows B cells from development and negative selection to activation. Chapter 10 does the same for T cells: thymic differentiation, the two-signal model of activation, dendritic cells as the key antigen-presenting cells for naïve T cells, CD4+ and CD8+ functions, memory T cells and other subsets. Chapter 11 covers the history and general properties of cytokines, their functional categories and receptors, signal transduction, their role in disease and their therapeutic use.

Chapter 12: Tolerance and Autoimmunity

Central and peripheral tolerance, oral tolerance and immune privilege lead into the distinction between autoimmunity and autoimmune disease, and then a survey of autoimmune diseases.

Chapters 13–15: Hypersensitivity: Type I; Hypersensitivity: Types II and III; Hypersensitivity: Type IV

Three chapters follow the classical classification of hypersensitivity. Type I allergic reactions are described through their sensitisation, activation and effector phases, with clinical tests, interventions and the protective role of IgE. Types II and III are taken together. Type IV (delayed-type hypersensitivity) is treated through its pathophysiology, examples and treatment.

Chapters 16–19: Immunodeficiency Disorders and Neoplasias of the Lymphoid System; Transplantation; Tumor Immunology; Resistance and Immunization to Infectious Diseases

Chapter 16 covers immunodeficiency syndromes, acquired immunodeficiency syndrome (AIDS) and neoplasms of the lymphoid system. Chapter 17 explains allograft rejection, tissue typing, immunosuppressive therapy, haematopoietic stem cell transplantation, graft-versus-host disease, xenotransplantation and the fetus as a tolerated allograft. Chapter 18 deals with tumour antigens, tumour immunity, tumour immunosuppression and immunotherapy. Chapter 19 covers host defence against the main classes of pathogen, immune evasion, the principles of active and passive immunisation, vaccine precautions and recent approaches to vaccine production.

Chapter 20: Experimental Systems and Methods

The last chapter, new to this edition according to the publisher, gathers the laboratory techniques of the field. These are immunoassays, immunofluorescence, flow cytometry, cellular assays, cell culture, inbred and transgenic animal models and the analysis of gene expression.

Key Concepts

Chapters 1–4: Overview, cells and innate immunity

• Innate and adaptive immunity: rapid, pattern-based defences, followed by slower, antigen-specific responses with memory.
• Clonal selection: antigen selects lymphocytes that already carry matching receptors, and those lymphocytes then expand.
• Pattern recognition: innate receptors that detect molecular features shared by many microbes.
• Complement: a cascade of plasma proteins that marks, lyses and inflames.

Chapters 5–8: Antigens, antibodies, receptor genes and the MHC

• Epitope: the part of an antigen recognised by an antibody or a T-cell receptor.
• Immunoglobulin classes: IgG, IgM, IgA, IgD and IgE, which have different structures and functions.
• Gene rearrangement and class switching: the DNA events that create receptor diversity and change antibody class.
• MHC restriction and antigen presentation: T cells recognise peptides only when bound to MHC class I or class II molecules.

Chapters 9–12: Lymphocyte activation, cytokines and tolerance

• Two-signal activation: naïve T cells need antigen recognition plus co-stimulation, delivered chiefly by dendritic cells.
• Cytokines: soluble mediators that regulate immune responses and haematopoiesis.
• Central and peripheral tolerance: removal or control of self-reactive lymphocytes in primary organs and in the tissues.

Chapters 13–20: Immune disorders, clinical immunology and methods

• Hypersensitivity types I–IV: four mechanisms by which immune responses cause tissue damage.
• Immunodeficiency: inherited or acquired failure of immune components, including AIDS.
• Allograft rejection: immune attack on transplanted tissue, driven by MHC differences.
• Immunisation: active and passive protection against infectious disease.
• Flow cytometry and immunoassays: core laboratory methods for measuring cells and antibodies.

Critical Analysis

Strengths

• A deliberately limited scope. Chapter 1 says the book keeps to the fundamental elements and basic concepts needed for an integrated, if not extensive, understanding of the immune response. It points readers to reviews and websites for detail. Students get a scaffold rather than an encyclopaedia.
• Broad clinical coverage for its length. Seven of the twenty chapters deal with immune-mediated disease, transplantation, tumours and infection. They include three separate chapters on the types of hypersensitivity and a long chapter on immunodeficiency and lymphoid neoplasia. The publisher describes clinical coverage as expanded in this edition.
• Explicit genetics and methods. Separate chapters on antigen-receptor genes and on experimental systems and methods are new to the eighth edition, according to the publisher. The chapter on receptor genes opens with a review of gene structure and expression, so students with little molecular biology are not left behind.
• Support material. The publisher lists a companion website with multiple-choice questions, flashcards, downloadable figures and sample cases. A separate companion book, Clinical Cases in Immunology, can be used alongside the text. The appendix list of CD antigens and the glossary make the book usable as a quick reference.

Limitations

• Cytokines come late. The chapter on cytokines (Chapter 11) follows the B-cell and T-cell chapters, although helper T-cell function and lymphocyte activation depend on cytokine signals. Readers may need to look ahead to Chapter 11 while working through Chapters 9–10.
• A short course, not a full account. Twenty chapters in about 430 pages means that many topics get only a section; Chapter 12, for example, surveys tolerance, autoimmunity and the autoimmune diseases together. The author's own advice is to turn to reviews and other books for detail.
• Edition date. The eighth edition appeared in early 2021. Chapter 1 mentions the novel coronavirus and the COVID-19 pandemic only as an example of future vaccine needs, so later immunological findings from the pandemic and recent therapies are outside its scope.

Where It Fits in the Course

Of the immunology books on this list, Coico sits between the short general introduction and the full textbooks. Paul Klenerman's The Immune System: A Very Short Introduction can be read first, in a few evenings, to learn the logic of innate and adaptive immunity and memory before tackling Coico's detail. Peter Parham's The Immune System is a similarly concise textbook focused on the human immune system in health and disease. The two can serve as alternatives, and students may prefer whichever explanations suit them.

Kuby Immunology presents the field through classic and current experiments, with data-based problems. It suits students who want to understand how immunological knowledge was obtained, and it is the natural step up after Coico. Janeway's Immunobiology is a more detailed account aimed at advanced undergraduates and graduate or medical students. Paul's Fundamental Immunology is a multi-author reference work for research-level questions, consulted chapter by chapter rather than read through.

How to Use This Book

The book is written for life and health science students, including dental and nursing students who need a short course text, and for scientists and clinicians refreshing their knowledge. Introductory biology is needed. Some cell biology and biochemistry help with Chapters 6–10.

• Core: Chapters 1–10 build the basic model of the immune response and should be read in order. Read the opening sections of Chapter 11 alongside Chapter 10.
• Regulation and disease: Chapters 11–15 are essential for anyone heading towards medicine or pharmacology. Chapters 16–19 can be chosen according to interest or course syllabus.
• Methods: Chapter 20 can be read early by students starting laboratory work, or used later as a reference when papers mention flow cytometry, immunoassays or knockout mice.
• Practice: use the companion website's multiple-choice questions and flashcards after each chapter, and the glossary and CD-antigen appendix while reading. For case-based learning, the separate Clinical Cases in Immunology volume pairs with the text.