Immunology4physicians


Your hub for learning in Clinical Immunobiology!

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Video lecture series

Primer of Clinical Immunobiology

MCQs in Clinical Immunobiology

Revision and Learning Exercises

Primer of Clinical Immunobiology

About 'The Primer'

This is a book about immunology written by a doctor, for doctors. It provides the essential elements of the workings of the immune system that doctors need, particularly those with an interest in internal medicine.

A firm grasp of the immune system is important for all physicians, not only to understand the pathogenesis of many conditions, or to recognise and diagnose common immune conditions, but also to understand new therapeutics like monoclonals, checkpoint inhibitors, cytokine or Jak inhibitors etc., all of which are becoming increasingly used in clinical practice. This book will help the reader get on top of all this information and prepare them for imminent advances in this field.

The Primer not only teaches the fundamental biology of the immune system, but the relevance of each immunological concept for clinical medicine. This is what is meant by 'Clinical Immunobiology'.

The book does not get bogged down with the minutiae of immunology, but rather concentrates on the fundamentals of Immunobiology as they apply to human disease, the essentials that will be relevant to patients seen every day in practice.

The concepts are presented in an easy-going readable style, illustrated by over 350 bespoke graphics. Each chapter builds on the previous one, and when enough of the basic concepts have been explained, the importance of the immunobiology is illustrated by the exposition of specific medical disorders in detail, including clinical presentation, diagnosis and management, particularly concentrating on immunodeficiency disorders as well as allergic disease.

To read this book, it certainly helps to have a medical background, but even if you are a science undergraduate with one eye on medicine or medical research, there is enough basic biology presented to give a solid grounding in immunobiology as well as sparking your interest in the application of the science of immunology! But if your interest is in internal medicine and you need to get on top of the basic immunological concepts required to learn and practise medicine, this book is for you!

This eBook is for:

  • Doctors training in internal medicine (such as Basic Physician Trainees)
  • Established physicians wanting to update their knowledge in Immunology
  • Paediatric trainees: many aspects of the course are very relevant for paediatric training, and there is a dedicated lecture on Paediatric Immunodeficiency
  • Anyone with a medical background where an understanding of immunology might help with their chosen career path
  • Medical students who are interested in Immunology 

How do I get it?

The eBook of the Primer of Clinical Immunobiology is available NOW on Apple Books and Kindle:






Primer Cover

Lecture Series in Clinical Immunobiology

This is the lecture series based on the Primer of Clinical Immunobiology. Each chapter has a matching lecture, so read along, listen along, or both! Whatever suits your style of learning!

Course Includes

  • A preliminary 'Introduction to the Immune system'
  • A series of ~26 lectures, ~30-40 minutes each
  • Three revision MCQs after each lecture to consolidate learning
  • Multiple graphics accompanying the lecture materials to reinforce critical immunological concepts

Access to the Lectures

  • All lectures are accessed by Video-on-demand. You can start the lecture series anytime on a rental basis via Vimeo and you will have 30-days to complete it.

MCQs in Clinical Immunobiology

You've done the course, you've read the book, now it's time to test what you have learnt!

Drawing on material from the Primer and the Video lectures, these lectures and companion eBook tests your knowledge with 50 Multiple Choice Questons. First do the quiz (by video on Vimeo, or in the eBook) and then go through the worked answers. Each question contains cross-references to the Primer to direct your revision, and of course is replete with all the usual graphics.

How do I get it?

MCQs in Clinical Immunobiology eBook is available NOW either as a video series (of two) and/or an eBook:







Primer Cover

Patreon Revision and Learning Exercises

Immunology4physicians on Patreon is all about consolidation of learning in 'Clinical Immunobiology', reinforcing knowledge of basic immunobiology with an emphasis on how it helps an understanding of disorders across the spectrum of specialist internal medicine, particularly clinical immunology. Here you will find short lectures, MCQs, revision exercises and various snippets to help reinforce your knowledge of Immunology. It draws heavily on material from the Primer and Video lecture.

How to join

The site is free to join, and let's you access a few learning activities to give you an idea. To unlock access to the entire site of over 100 learning activities costs $AUD11/month.

Follow this link to join up:




All profits are donated to the World Wildlife Fund!

Primer Cover

Video-on-demand

Vimeo lecture series in Clinical Immunobiology: $AUD 285 ($US 185)

(Access to Revision and learning activities on Patreon: $AUD11 ($US8 per month))

Primer of Clinical Immunobiology

Apple Books: AUD $69.99 | Kindle: AUD $79.99

Course Content (Primer and Video course)

Topics Covered  

Innate Immunity and Complement

Lectures 1-6

Antibodies and B Cells

Lectures 7-11

T Cells

Lectures 14-19, 20

Allergic Disease

Lecture 19-21

HLA

Lecture 13, 23

Autoimmunity

Lecture 24
Course Content

Lecture / Chapter Details

The course is designed to cover a wide scope of basic and applied immunology. Here's what we'll be covering!

Lecture 0

Introduction to Immunology

Basic Science

  • Commensals vs pathogens, innate vs specific immunity, anatomical and chemical barriers.
  • Immune cells: macrophages, neutrophils, eosinophils, mast cells & basophils, innate lymphoid cells (ILCs), dendritic cells.
  • Innate immunity: pattern recognition receptors (PRRs) and pathogen-associated molecular patterns (PAMPs). Complement. Inflammation & vasoactive mediators, cytokines, chemokines.
  • Adaptive immunity: clonal selection (Burnet), Generation of diversity, signals for lymphocyte activation, B cells, antigen binding by antibody. T cells. immunological memory Lymphoid tissues: thymus, lymphatics, lymph nodes, spleen, mucosa-associated lymphoid tissue (MALT).
  • Effector mechanisms in immune responses: cytotoxicity, type1, type 2, type 3 immunity. Role of MHC molecules. Cytotoxic T lymphocytes (CTL), T-helper (Th) cells), B-cell activation & plasma cells.
David Fulcher profile picture

Prof David A. Fulcher

MBBS, PhD, FRACP, FRCPA

Lecture 1

Innate Receptors

Basic Science

  • Innate immunity principles: physical / epithelial barriers, molecules recognised by innate immune system, pathogen associated molecular patterns (PAMPs), damage-associated molecular patterns (DAMPs), pattern recognition receptors (PRRs), Antimicrobial Peptides (AMPs).
  • Toll-like receptors.
  • C-type Lectins.
  • NOD-like receptors & Inflammasomes.

Clinical Applications

  • Gram negative septic shock.
  • Gout.
  • Autoinflammatory diseases.
  • Familial Mediterranean Fever.
  • Autoinflammatory disease and NLRP3.
  • NOD2 and Crohn's disease.
David Fulcher profile picture

Prof David A. Fulcher

MBBS, PhD, FRACP, FRCPA

Lecture 2

Complement

Basic Science

  • Complement functions, principles, nomenclature. Alternate, classical pathway & lectin pathways. Membrane attack complex, complement receptors, anaphylatoxins
  • Mannose-binding lectin, ficolins.
  • Complement control proteins, self-non-self discrimination.
David Fulcher profile picture

Prof David A. Fulcher

MBBS, PhD, FRACP, FRCPA

Lecture 3

Complement Disorders

Clinical Applications

  • Hereditary angioedema.
  • Complement deficiency syndromes.
  • Complement assays.
  • Paroxysmal Nocturnal Hemoglobinuria (PNH).
  • Atypical HUS.
  • Complement and therapy: eculizumab, pegcetacoplan, avacopan.
David Fulcher profile picture

Prof David A. Fulcher

MBBS, PhD, FRACP, FRCPA

Lecture 4

Innate Cytokines

Basic Science

  • Acute phase response, TNF, IL-1, IL-6.
  • RNA & DNA sensors.
  • Interferons-type I, Innate & Adaptive Interaction.

Clinical Applications

  • Therapeutic inhibitors of IL-1, IL-6, TNF.
  • Type I interferonopathies.
  • STING-associated vasculopathy.
  • IFN type I and SARS-CoV-2.
David Fulcher profile picture

Prof David A. Fulcher

MBBS, PhD, FRACP, FRCPA

Lecture 5

Innate Cells

Basic Science

  • Phagocytes: monocytes, macrophages, neutrophils.
  • Neutrophil Extracellular Traps (NETs).
  • Eosinophils.
  • Dendritic cells: classical (cDCs) vs plasmacytoid dendritic cells (pDCs).
  • Innate-lymphoid cells (ILCs), NK cells.
  • Antibody-dependent cellular cytotoxicity (ADCC).

Clinical Applications

  • Assessment of Neutrophils.
  • Chronic granulomatous disease.
  • Furunculosis.
  • DC-based vaccines.
  • ILC2 and atopic disease, anti-TSLP.
David Fulcher profile picture

Prof David A. Fulcher

MBBS, PhD, FRACP, FRCPA

Lecture 6

Cell movement

Basic Science

  • Chemokines, adhesion cascade.

Clinical Applications

  • Chemokines and disease: HIV entry.
  • Leukocyte Adhesion Deficiency.
  • Integrin blockers in IBD, MS.
David Fulcher profile picture

Prof David A. Fulcher

MBBS, PhD, FRACP, FRCPA

Lecture 7

Immunoglobulins

Basic Science

  • Antibody basic structure, immunoglobulin regions, isotypes/classes/subclasses: IgG, IgM, IgA, IgD, IgE.
  • Immunoglobulin superfamily.
  • Ig response to pathogen.
  • Antibody function including opsonisation, ADCC, Fc Receptors.
David Fulcher profile picture

Prof David A. Fulcher

MBBS, PhD, FRACP, FRCPA

Lecture 8

Immunoglobulin Disorders

Clinical Applications

  • IgG4 Related Disease.
  • Serum sickness.
  • Cryoglobulinaemia.
David Fulcher profile picture

Prof David A. Fulcher

MBBS, PhD, FRACP, FRCPA

Lecture 9

Immunoglobulins and Therapeutics

Basic Science

  • Polyclonal vs monoclonal Abs (mAbs), CD nomenclature.
  • Therapeutic antibodies (“biologics”), mAb modifications & nomenclature.

Clinical Applications

  • Monoclonal antibodies and therapeutics.
  • Anti-IgE (omalizumab).
  • Intravenous Immunoglobulin.
David Fulcher profile picture

Prof David A. Fulcher

MBBS, PhD, FRACP, FRCPA

Lecture 10

Antibody Deficiency

Clinical Applications

  • General principles of Immunodeficiency.
  • Manifestations of Primary Antibody Deficiency.
  • Common Variable Immunodeficiency (CVID).
  • Secondary Ab deficiency.
  • IgA deficiency.
  • IgG subclass deficiency.
  • Specific Antibody Deficiency (SAD, SpAD, FAD).
David Fulcher profile picture

Prof David A. Fulcher

MBBS, PhD, FRACP, FRCPA

Lecture 11

How B Cells are Made

Basic Science

  • B cell overview.
  • Clonal selection (Burnet).
  • Generation of Diversity (VDJ rearrangement), immunoglobulin genes.
  • B-cell development (pre-Ag).
  • B-cell tolerance. Transitional B cells & BAFF.

Clinical Applications

  • VDJ rearrangement and diagnosis of lymphoma.
  • Agammaglobulinaemia with absent B cells, e.g. X-linked agammaglobulinaemia (XLA).
  • Btk inhibitors.
  • BAFF inhibitors.
David Fulcher profile picture

Prof David A. Fulcher

MBBS, PhD, FRACP, FRCPA

Lecture 12

How B Cells are Activated

Basic Science

  • B-cell differentiation after Ag, isotype switching, affinity maturation/somatic hypermutation in germinal centres.
  • 1˚ vs 2˚ humoral responses.
  • Plasma cells, memory B cells.
  • T-dependent versus T-independent Ags.
  • B cell surface antigens.

Clinical Applications

  • Hyper IgM syndrome.
  • Rituximab (anti-CD20).
David Fulcher profile picture

Prof David A. Fulcher

MBBS, PhD, FRACP, FRCPA

Lecture 13

Human Leukocyte Antigens (HLA) and Antigen presentation

Basic Science

  • MHC (Major Histocompatibility Complex)/HLA structure (class I vs II), variation, function.
  • Ag processing pathways (class I vs II), cross-presentation.
David Fulcher profile picture

Prof David A. Fulcher

MBBS, PhD, FRACP, FRCPA

Lecture 14

How T Cells are Made

Basic Science

  • Introduction to T-cells.
  • T-cell receptor, CD3 signalling chains, TCR:MHC interaction.
  • CD4 vs CD8 T cells.
  • T-cell development in the thymus.
  • TCR gene rearrangement.
  • T-cell selection.
  • Thymic expression of peripheral antigens (AIRE).
  • CD4-8 selection.
David Fulcher profile picture

Prof David A. Fulcher

MBBS, PhD, FRACP, FRCPA

Lecture 15

How T Cells are Activated

Basic Science

  • T-cell recirculation.
  • T-cell activation & co-stimulation, including CTLA4.
  • Super-antigens, IL-2.
  • Memory T cells.

Clinical Applications

  • Manipulating the co-stimulatory pathway: blockers: CTLA4-Ig (Abatacept).
  • Checkpoint inhibitors: anti-CTLA4, anti-PD-1/PD-L1, and immune-related adverse events.
  • Autoimmune lymphoproliferative syndrome (ALPS).
David Fulcher profile picture

Prof David A. Fulcher

MBBS, PhD, FRACP, FRCPA

Lecture 16

T cells Immunodeficiency

Basic Science

  • T-cell Receptor Excision Circles (TRECs)

Clinical Applications

  • Laboratory assessment of T-cells and interpretation.
  • SCID.
  • Combined Immunodeficiency (CID)
  • Idiopathic CD4 lymphopenia (ICL)
David Fulcher profile picture

Prof David A. Fulcher

MBBS, PhD, FRACP, FRCPA

Lecture 17

T Cell Tolerance

Basic Science

  • T-cell tolerance: central vs peripheral, inhibitory molecules. clonal ignorance, Fas.
  • Treg cells.

Clinical Applications

  • CTLA4 deficiency.
  • IPEX (foxp3 deficiency).
  • tTreg therapeutics.
David Fulcher profile picture

Prof David A. Fulcher

MBBS, PhD, FRACP, FRCPA

Lecture 18

T helper cells subsets

Basic Science

  • Effector T cell subsets: Th1/Th2/Th17 cells, follicular helper T cells (Tfh).

Clinical Applications

  • Mendelian Susceptibility to Mycobacterial Disease (Th1 deficiency).
  • Role of Th17 cells in psoriasis.
  • Chronic Mucocutaneous Candidiasis (CMC)(Th17 deficiency).
  • IL-17 blockers.
David Fulcher profile picture

Prof David A. Fulcher

MBBS, PhD, FRACP, FRCPA

Lecture 19

Pathophysiology of Allergy

Basic Science

  • Allergic (Th2) pathophysiology, Th2 cytokines & receptors.
  • Mast cells, basophils, ILC2
  • Early vs late-phase allergic response, chronic allergic inflammation.
  • Mechanisms of Desensitisation.

Clinical Applications

  • Interpreting IgE levels.
  • Th2 pathway blockers.
David Fulcher profile picture

Prof David A. Fulcher

MBBS, PhD, FRACP, FRCPA

Lecture 20

Atopic Allergic disease

Clinical Applications

  • Allergic rhinitis.
  • Food allergy.
  • Anaphylaxis.
Ming-Wei Lin profile picture

A/Prof Ming-Wei Lin

MBBS, FRACP, FRCPA

Lecture 21

Non-atopic Allergic disease

Clinical Applications

  • Insect sting allergy.
  • Mastocytosis.
  • Antibiotics (penicillin, cephalosporins, sulphonamides), anaesthetic agents, radiocontrast media, ACE inhibitors, aspirin and NSAIDs.
  • Principles of drug “desensitisation”.
  • Stevens Johnson Syndrome (SJS)/Toxic Epidermal Necrolysis (TEN).
  • Chronic Idiopathic Urticaria (CIU).
Ming-Wei Lin profile picture

A/Prof Ming-Wei Lin

MBBS, FRACP, FRCPA

Lecture 22

More T cells and T-cell therapeutics

Basic Science

  • Cytotoxic T cells, innate-like T cells.
  • T cell surface molecules.

    • Clinical Applications

    • CAR T cells & therapy.
    • Bispecific antibodies.
    • Jak inhibitors.
    David Fulcher profile picture

    Prof David A. Fulcher

    MBBS, PhD, FRACP, FRCPA

    Lecture 23

    HLA in Practice

    Basic Science

    • MHC restriction.
    • Genomic structure of HLA, inheritance of HLA alleles.
    • HLA nomenclature.
    • Non-classical HLA molecules.

    Clinical Applications

    • HLA and Autoimmune susceptibility
    • HLA & Disease: coeliac disease, drug hypersensitivity (abacavir, carbamazepine, allopurinol), transfusion.
    David Fulcher profile picture

    Prof David A. Fulcher

    MBBS, PhD, FRACP, FRCPA

    Lecture 24

    Autoimmunity

    Basic Science

    • Immune tolerance mechanisms
    • Pathogenic mechanisms in autoimmunity: antibody-mediated (pathogenic vs marker Abs), immune complexes, T-cells.
    • Mechanisms of tolerance failure: influence of sex, genes & environment (especially infection), bystander activation, molecular mimicry.

    Clinical Applications

    • Risk genes in autoimmune disease.
    • Pathogenesis of narcolepsy, coeliac disease, lupus.
    David Fulcher profile picture

    Prof David A. Fulcher

    MBBS, PhD, FRACP, FRCPA

    Lecture 25

    Immunology in a Page

    Basic Science

    • One page revision summary of the entirety of the immune system!
    David Fulcher profile picture

    Prof David A. Fulcher

    MBBS, PhD, FRACP, FRCPA

    Course Content

    Example Graphics

    Slides are packed with detailed illustrations to reinforce critical immunological concepts

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    Speaker Profiles

    About Prof David Fulcher 

    David Fulcher profile picture

    Prof David A. Fulcher

    MBBS, PhD, FRACP, FRCPA

    Hon Prof Fulcher's medical degree was from the University of Sydney in 1984, and after the obligatory Resident Medical Officer years, he specialised in Clinical Immunology and Immunopathology under the auspices of the Royal Australasian Colleges of Physicians / Pathologists (RACP, RCPA). He then proceeded to doctorate studies in B-cell tolerance, at what was to become the Centenary Institute, Sydney (PhD, 1996).
    Then he joined the public hospital system as a Clinical Immunologist/Immunopathologist for 20 (long!) years before moving to private practice! Currently he works as Immunopathologist at 4Cyte Pathology. Dr Fulcher has been teaching Immunology his entire professional career!
    Prof Fulcher has held every major Australian teaching position in Immunology and Immunopathology, including Co-ordinator of Advanced Training in Immunology, Chair of the Joint Specialist Advisory Committee in Immunology (RACP), and Chief Examiner in Immunopathology (RCPA). He was also Director of Physician Training and then Network Director of Physician Training at a major public hospital in Sydney. Currently, he holds an honorary Professorship in Immunology at Australian National University, which followed on from his work there (from 2016) in rejuvenating the ‘Advanced and Applied Immunology’ course which he convened for five years. At ANU he was also responsible for the teaching outreach arm of the ‘Centre for Personalised Immunology’ and supervised the Flow Cytometry data as a Chief Investigator in the Centre for Research Excellence NHMRC grant.
    In 2006 he started the 'immunology4bpts' course, an intensive weekend of lectures designed to cover the essentials of Immunobiology and Clinical Immunology for doctors specialising in internal medicine (BPT means Basic Physician Trainee, which in Australia is a doctor preparing for their written examination in internal medicine). That endeavour went from strength to strength, and lead to the writing of 'The Primer of Clinical Immunobiology', and subsequently 'MCQs in Clinical Immunobiology', to serve as a revision of the essentials in that book.

    Hon. Prof. David A. Fulcher. MBBS (Hons II), PhD, FRACP, FRCPA. Hon. Prof., The Australian National University; Immunopathologist, 4Cyte Pathology, Sydney, Australia.

    What Others Say

    Hear From Past Attendees

    Very good introduction to immunology for those of us who have very little knowledge of it. Takes you right the way through the basics to the clinical applications.

    Anonymous Post-Attendance Feedback Form

    This course is simply excellent. Most of the concepts were new to me, but they were presented in a way that was so easy to digest. I also found the course very enjoyable! I would 100% recommend this course.

    Anonymous Post-Attendance Feedback Form

    I thought the lectures were fantastic - really great breakdown of the important components of basic immunology, that we're really nicely intertwined with clinical immunology. I definitely feel more confident with my immunology knowledge than prior to sitting the course.

    Anonymous Post-Attendance Feedback Form

    This is an absolutely brilliant 2-day course on Immunology. So thorough, so much detail, and so well explained from the foundations upwards. I really enjoyed the reflection time and MCQs at the end of each section, giving us the chance to assess what we have learnt and how we can apply our understanding. The exam-style MCQs are perfect for this. The visual aids, schematics, graphs and diagrams are awesome. I also like the addition of videos to explain the biology in a slightly different way. Finally, Dr Fulcher's passion for the subject is palpable and infectious.

    Anonymous Post-Attendance Feedback Form

    I felt like I was learning rather than simply being fed a list of facts.

    Anonymous Post-Attendance Feedback Form

    Excellent thorough summary of a lot of key immunology concepts. Really enjoyed the online lecture format - very well done.

    Anonymous Post-Attendance Feedback Form