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The diverse responses of T cells are collectively called cell-mediated immune reactions. This is to distinguish them from antibody responses, which, of course, also depend on cells (B cells). Like antibody responses, T cell responses are exquisitely antigen-specific, and they are at least as important as antibodies in defending vertebrates against infection. Indeed, most adaptive immune responses, including antibody responses, require helper T cells for their initiation. Most importantly, unlike B cells, T cells can help eliminate pathogens that reside inside host cells. Much of the rest of this chapter is concerned with how T cells accomplish this feat.

T cell responses differ from B cell responses in at least two crucial ways. First, T cells are activated by foreign antigen to proliferate and differentiate into effector cells only when the antigen is displayed on the surface of antigen-presenting cells in peripheral lymphoid organs. The T cells respond in this manner because the form of antigen they recognize is different from that recognized by B cells. Whereas B cells recognize intact antigen, T cells recognize fragments of protein antigens that have been partly degraded inside the antigen-presenting cell. The peptide fragments are then carried to the surface of the presenting cell on special molecules called MHC proteins, which present the fragments to T cells. The second difference is that, once activated, effector T cells act only at short range, either within a secondary lymphoid organ or after they have migrated into a site of infection. They interact directly with another cell in the body, which they either kill or signal in some way (we shall refer to such cells as target cells). Activated B cells, by contrast, secrete antibodies that can act far away.

There are two main classes of T cells—cytotoxic T cells and helper T cells. Effector cytotoxic T cells directly kill cells that are infected with a virus or some other intracellular pathogen. Effector helper T cells, by contrast, help stimulate the responses of other cells—mainly macrophages, B cells, and cytotoxic T cells.

In this section, we describe these two classes of T cells and their respective functions. We discuss how they recognize foreign antigens on the surface of antigen-presenting cells and target cells and consider the crucial part played by MHC proteins in the recognition process. Finally, we describe how T cells are selected during their development in the thymus to ensure that only cells with potentially useful receptors survive and mature. We begin by considering the nature of the cell-surface receptors that T cells use to recognize antigen.