(MASP1 and MASP2), which also activate C3 cleavage. After C5 is cleaved, all
three pathways follow the same steps [6].
b. Antibody dependent cellular cytotoxicity
In addition to recruiting the complement cascade, the Fc portion of the antibody
also mediates antibody-dependent cellular cytotoxicity (ADCC). As shown in
Figure 3.10, if a virally infected or cancer cell is bound by an antibody, the
NK cells recognize the Fc region of the antibody and this triggers NK cells to
release cytotoxic molecules such as the pore-forming perforin and the apoptosis-
inducing granzyme. The target cell is thus destroyed. It is important to note the
distinction between NK cell-mediated cytotoxicity that was discussed in the
section on innate immunity and what is being discussed here. In the previous
section, NK cells did not rely on specific antibodies for recognizing their targets,
whereas for ADCC, as the name suggests, antibodies are central to the recogni-
tion process.
FIGURE 3.9 Complement cascade. This figure is a schematic representation of the
steps involved in the three pathways that result in activation of the complement pathway.
The classical pathway is activated by the antigen-antibody complex. The binding of
lectins to mannose-rich cell surface molecules triggers the lectin pathway. The alter-
native pathway involves the formation of an activated form of a C3 fragment, by the
sequential action of proteins B, D and properidin. All three pathways converge on the
proteolytic cleavage of C5, which is followed by the formation of the membrane attack
complex.
Introduction to basic immunology
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