Inflammatory and Immunologic Functions Immune Overview IMMUNITY- Refers to the bodys specific protective response to an invading foreign

n agent or organism IMMUNOPATHOLOGY- Refers to the study of diseases resulting from dysfunctions with in the immune system. Anatomy and Physiology of the Immune System Cells of the Immune System- Cells destined to become immune cells, like all blood cells, arise in the bone marrow from so-called stem cells. T-Cells T helper -A pertinent coordinator of immune regulation. To augment or potentiate immune responses by activating other WBC. Cytotoxic T cell (Natural Killer Cells ) Effector cells that directly kill certain tumors such as melanomas, lymphomas and viral-infected cells, most notably herpes and cytomegalovirus-infected cells. Suppressor T cell Directly killing certain tumor cells, viral-infected cells and sometimes parasites. also important in down-regulation of immune responses. B Cells Production of _________in response to foreign proteins of bacteria, viruses, and tumor cells. Granulocytes composed of __________________________________based on their staining characteristics with certain dyes. Important in the removal of bacteria and parasites from the body. Macrophages regulation of immune responses. Scavengers - pick up and ingest foreign materials and present these antigens to other cells Initiation of an immune response Phagocytes and Granulocytes Monocytes (2-6%) circulate in the blood Macrophages found in body tissues Scavengers Secrete a wide variety of powerful chemicals Activates T cells. Neutrophils (40-75%) Circulate in blood but move into tissues PRN Contain granules filled with potent chemicals Destroys microbes + key role in acute inflammatory reactions. Eosinophils(2-5%) _______________________________________________________________ Decrease granulocyte migration Basophils(0.2-0.5%) inflammatory mediator release Mast cells granule-containing cells in tissue.

IMMUNOGLOBULIN(ANTIBODY) Immunoglobulin G / IgG (75%) Found in serum and tissue (instertitial fluid) _____________________________________________ Activates complement system Crosses the placenta Immunoglobulin A / IgA (15%) Appears in the body fluid e.g. saliva, sweat,pulmo, gastro, repro Prevents absorption of antigen from food ____________________________________ Immunoglobulin M / IgM (10%) Appears in the intravascular serum _______________________________________ Activates the compliment system Immunoglobulin D / IgD (0.2%) Appears in small amount serum Influences B lymphocyte to differentiate Immunoglobulin E / IgE (.004%) Appears in serum Takes part in allergic and hypersensitivity reaction Parasitic infection T Cells T cells attacks and destroys diseased cells they recognize as foreign. T lymphocytes are responsible for ___________________________________. T cells also orchestrate, regulate and coordinate the overall immune response. T cells depend on unique cell surface molecules called the Major Histocompatibility Complex (MHC) to help them recognize antigen fragments Immature T cells (termed T Stem cells) Migrate to the _____________ in the neck, where they mature and differentiate into various types of mature T cells. Killer T cell Helper T cell Suppressor T cell Memory T cell Produce substances called _________________ Interleukins which further stimulate the immune response. T Cells Types Cytotoxic or killer T cells (CD8+) - do their work by releasing ____________, which cause cell _________ Helper T cells (CD4+) - ______________________, secrete chemicals called lymphokines that stimulate cytotoxic T cells and B cells to grow and divide, attract neutrophils, and enhance the ability of macrophages to engulf and destroy microbes Suppressor T cells

 a component of the immune system that suppress immune responses of other cells. These cells are involved in ______________________ after they have successfully tackled invading organisms and also in keeping in check immune responses that may potentially attack one's own tissues ("autoimmunity"). ____________________- programmed to recognize and respond to a pathogen once it has invaded and been repelled. REVIEW ON CELL DEVELOPMENT OF THE IMMUNE SYSTEM Lymphatic System The lymphatic system is a complex network of lymphoid organs, lymph nodes, lymph ducts, lymphatic tissues, lymph capillaries and lymph vessels. They produce and transport lymph fluid from tissues to the circulatory system. The lymphatic system is a major component of the immune system. Functions: To collect and return interstitial fluid, including plasma protein to the blood, and thus help maintain fluid balance. To defend the body against disease by producing lymphocytes To absorb lipids from the intestine and transport them to the blood. Lymphoid Organs IMMUNE FUNCTION: DEFENSES AND RESPONSES Immune Function Two general types of immunity 1. Natural (innate) immunity nonspecific immunity present at birth 2. Acquired (adaptive) immunity developed after birth Natural (innate) Immunity Provides a nonspecific response to any foreign invader Include physical and chemical barriers, the action of WBCs, and inflammatory response. PHYSICAL AND CHEMICAL BARRIERS Physical surface barriers include intact skin and mucous membranes o _________________________________________ Cilia of the respiratory tract along with coughing and sneezing o ________________________________________________ Chemical barriers, such as acidic gastric secretion, mucus, enzymes in tears and saliva, and substances in sebaceous and sweat secretion o _______________________________________ Interferon vactiricidal protein naturally produced by the body. WHITE BLOOD CELLS ACTION Protect the body from invasion by bacteria and other entities

 Granular leukocytes fight invasion by releasing cell mediators such as histamine, bradykinin and prostaglandins, and engulfing the foreign bodies or toxins. Neutrophils are the first to arrive at the site where inflammation occurs. Monocytes are the second to arrive and continue phagocytic activities for long period as macrophages. The primary function of lymphocyte is to produce substances that aid in attacking foreign materials. T lymphocytes kills foreign cell directly or releases a variety of lymphokines. Lymphokines are substances that enhances the activity of phagocytic cells. T lymphocytes are responsible for delayed allergic reaction, rejection of foreign tissue, and destruction of tumor cells. T lymphocyte is responsible for cellular immunity B lymphocyte will differentiate into plasma cells. Plasma cells, in turn, produce immunoglobulin(Ig) Antibodies are protein molecules that destroy foreign materials . A process called humoral immunity Eusinophils and basophils function in hypersensitivity reactions. Eusinophils function is to neutralize histamine Eusonophils are important in the phagocytosis of parasites. INFLAMMATORY RESPONSE A defensive reaction intended to neutralize, control or eliminate the offending agent and prepare the site for repair. Function of inflammatory response:

CARDINAL SIGNS OF INFLAMMATION 1. Redness(__________) 2. Heat(_______) 3. Swelling(________)- results when vascular permeability increases, and plasma leaked into the inflamed tissues. 4. Pain(_______)- results when the pressure of fluids or swelling on nerve endings, and to the irritation of the nerve endings in chemical mediators released at the site. Bradykinin is one chemical mediators suspected to cause pain. 5. Loss of function(__________)- related to pain and swelling. Redness and heat results when vasodilatation occurs after transient vasoconstriction that follows injury INFLAMMATORY RESPONSE 1. Vascular response transient vasoconstriction followed by vasodilatation, causing influx of blood to the inflamed area. This fluid pushed into the surrounding sites of injury would consequently become inflammatory exudates which has the following functions as: - _______________________________________ - __________________________________________ - ___________________________________________ 2. Cellular response as follows: a. _______________ also known as pavementing occurs when leucocytes stick to the walls of the blood vessels.

b. ______________ occurs when leukocytes multiply and travel to the areas of injury c. _____________ is the directional orientation of leucocytes d. _______________ process where bacteria are engulfed or ingested. 3. Chemical response includes the release of the following chemicals. a. __________ initiates vascular response by increasing vascular dilation and permeability b. __________ increases vascular permeability c. __________ also increases vascular permeability. 4. Fibrin-Barrier Response fibrin forms wall on the inflamed area to prevent invasion of irritants to other tissues. This phenomenon is also known as a Wall-Off. TYPES OF INFLAMMATION: Acute Inflammation Characterized by the the local vascular and exudative changes and usually lasts ________________. Chronic Inflammation Develops if the injurious agent persists and the acute response is perpetuated. Causes of Acute Inflammation Microbial infections Hypersensitivity reactions Physical agents Irritant and corrosive chemicals Tissue necrosis Plasma Factors Complement system cascade system of enzymatic proteins activated during inflammatory response Circulating Plasma proteins made in the liver Activated when Antigen-antibody connects Alters the cell membranes permitting fluid to enter the cell an d leading to cell lysis and death It coats microbes with molecules that make them more susceptible to engulfment by phagocytes They also encourage polys to adhere to the walls of capillaries (margination) from which they can squeeze through in a matter of minutes to arrive at a damaged area Emigration by squeezing of the wandering macrophages through the capillary walls to the tissue Extravasation also know as ____________ Once phagocytes do their job, they die and their "corpses," pockets of damaged tissue, and fluid form pus. Coagulation system responsible for the conversion of soluble fibrinogen into fibrin activate the coagulation, kinin and fibrinolytic systems Kinin system (stimulates pain receptors) activated by coagulation factor Bradykinin is also a chemical mediator of pain Fibrinolytic system Plasmin is responsible for the Iysis of fibrin into fibrin degradation products Acquired (adaptive) Immunity ______________________________________________ Usually develops as a result of prior exposure to an antigen through immunization(vaccination) or by contracting a disease

Types of Acquired Immunity 1. ACTIVE ACQUIRED IMMUNITY a. b. c. d. Active acquired immunity could either be: * Natural having contact with antigen naturally such as getting sick or frequent exposure to smaller doses of microorganisms like: chickenpox, measles, mumps * Artificial ________________________________________________. 2. PASSIVE ACQUIRED IMMUNITY: a. b. c. d. Passive acquired immunity could either be: * Natural acquired naturally during breast- feeding like from colostrum * Artificial having preformed antibodies such as antitoxins, antiserum and gammaglobulin, ex. Immune serum globulin Response to Invasion Phagocytic Humoral Cellular Stages of Immune Response Recognition Proliferation Response Effector Phagocytic Immune Response Involves the WBCs (granulocytes & macrophage) which have the ability to ingest foreign particles Phagocytes also remove the bodys own dying or dead cells. __________________________ is the bodys way of destroying unwanted cells such as cancer cells or cells that die a natural death. Humoral Immune Response _____________________________________________________________________ _______________________. Begin with the B lymphocytes transforming into plasma cells that manufactured antibodies Antibodies are transported in the blood stream and attempt to disable the invaders. Role of Antibodies Defend against foreign invaders in several ways. _____________ bind or clumping together of antigen and antibody that helps clear the body of the invading organism by facilitating phagocytosis. ________________ coating sticky substances that facilitates phagocytosis.

Cellular Immune Response

_________________________________________________________________. The part of the invading or attacking organism that is responsible for stimulating antibody production is called ____________. Once antibody is produced it is released into the blood stream and carried to the attacking organism.

Stages of Immune Response

I.

Recognition Stage Immune system recognition of antigen as foreign, or nonself is the initiating event in an immune response. _____________________________________________________________________ ________. When foreign material enters the body, a circulating lymphocytes comes into physical contact with the surface of these material and picks up an imprint of its structure. Presentation to the macrophages Proliferation Stage PROLIFIRATION STAGE The circulating lymphocytes containing the antigenic message returns to the nearest lymph nodes. Once in the node, the sensitized lymphocytes stimulate some of the dormant T & B lymphocyte to enlarge, divide and proliferate. T lymphocyte differentiate into cytotoxic (killer) T cells. B lymphocyte produce and release antibodies Response Stage The cytotoxic T cell and the B Cell perform cellular and humoral function respectively. Effector Stage Antigens are destroyed or neutralized through the action of antibodies, complement, macrophages and cytotoxic T Cells.

II.

III.

IV.

Assessment History Age Life style Nutrition Recent exposure to pathogen Drug intake immunization History of immune disorder

Physical Assessment Respiratory Changes in respiratory rate Cough (dry or productive) Abnormal lung sounds Rhinitis Hyperventilation Bronchospasm Cardiovascular Hypotension Tachycardia Dysrhytmia Vasculitis Anemia Genitourinary Frequency and burning on urination __________ Discharge Gastrointestinal ________________ _________ Vomiting Diarrhea Skin

Rashes Lesion Dermatitis Hematoma or purpura Edema or urticaria Inflammation Discharge

Neurosensory Cognitive dysfunction Hearing loss Visual design Headaches and migraine Ataxia Tetany

DIAGNOSTIC EVALUATION INTRADERMAL TEST (______________) (_____) given ___________ in the forearm, with _______________ significant reaction is positive(+), reading done in ______________, if positive result, it does not mean that active disease is present, but indicates exposure to Tuberculosis. __________________________________ highly sensitive and specific assy method used to determine antibody concentrations or to determine the concentration of any substance against which specific antibody can be produced. ELISA(________________________________________) ______________________________________. It does not establish diagnosis of AIDS, rather it indicates that the person has been exposed to or infected with HIV called SEROPOSITIVE.

WESTERN BLOT ASSAY ______________________________________________________.

BONE MARROW BIOPSY assess the quantity and quality of each type of cell produced within the marrow. Used to document infection or tumor within the marrow.

CAUSES OF DISORDER OF THE IMMUNE SYSTEM: Excesses or defiencies of immunocompetent cells. Alterations in the function of immune cells Immune attack on self-(antigen) Inappropriate or exaggerated responses to specific antigens CATEGORIES OF IMMUNE SYSTEM DISORDERS Immune defeciency Primary defeciency results from improper development of immune cells or tissue, usually with genetic basis. Secondary deficiency results from some interference with an already developed immune system ________________ immunoglobulins are overly produced _____________ normal protective immune response turns against or attack the body, leading to tissue damage ________________ body produces inappropriate or exaggerated responses to specific antigens