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USMLE/1
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Introduction
1. Anatomy
2. Microbiology
3. Physiology
4. Pathology
5. Pharmacology
6. Immunology
6.1 T and B lymphocytes
6.2 Immunoglobulins
6.3 T cell activation
6.4 Pathways of antigen processing
6.5 Hypersensitivity
6.6 Innate immunity
6.7 Immunodeficiency disorders
6.8 Complement deficiencies
6.9 Transplant rejections
6.10 Blood transfusion reactions
6.11 Additional information
7. Biochemistry
8. Cell and molecular biology
9. Biostatistics and epidemiology
10. Genetics
11. Behavioral science
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6.4 Pathways of antigen processing
Achievable USMLE/1
6. Immunology

Pathways of antigen processing

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Pathways of antigen processing: To initiate an immune response, antigenic peptides are presented by MHC I and MHC II to CD8 and CD4 T cells, respectively. The endogenous (intracellular) pathway processes peptides for MHC I, while the exogenous (extracellular) pathway processes peptides for MHC II.

i) Endogenous pathway: Viral or self-derived proteins are degraded by proteasomes in the cytosol or nucleus. The resulting peptides are translocated into the endoplasmic reticulum (ER) by TAP. Tapasin, a component of the peptide-loading complex, interacts with TAP. Erp57 and calreticulin are other components of this peptide-loading complex.

This complex helps MHC I fold correctly and associate with beta 2 microglobulin. Once the peptide is in the ER, it’s loaded onto MHC I. The MHC-peptide complex is then transported through the Golgi apparatus to the cell surface. Peptides that fail to associate with MHC I are degraded in the cytosol.

Antigen processing pathways
Antigen processing pathways

ii) Exogenous pathway: This pathway is used by antigen-presenting cells and presents peptides derived from the degradation of endocytosed particles. These particles undergo lysis in endosomes by acid-dependent proteases. The resulting peptides are loaded onto MHC II and presented to T cells.

MHC II is composed of alpha and beta chains and an invariant chain. These are synthesized in the ER and transported through the Golgi into a compartment called MIIC (MHC class II compartment). The acidic pH in MIIC activates proteases such as cathepsins, which digest the invariant chain and leave a remnant called CLIP. CLIP occupies the peptide-binding groove and is later exchanged so that the peptide processed by the exogenous pathway can be loaded onto MHC II. HLA DM and HLA DO molecules assist in loading.

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