Basic Human NeedsSafety and Protective Environment

Body Defense Mechanisms: Inflammation, Immunity and the Stress

Response

IMMUNITY

• Purpose of inflammation and immunity• Neutralize, eliminate or destroy organisms that invade internal environment

• Healthy self cells are distinguished from non-self cells by immune system cells

SELF AND NON-SELF CELLS

• Body can only defend against an invader if it is able to distinguish between its own cells (self) and those of an invader (non-self)

• Each cell in the body carries on its surface the same distinct marker for selfness

SELF AND NON-SELF CELLS

• Tissue introduced into a person (i.e. transplant) will be recognized as non-self

• Key feature of the immune system is its ability to recognize self against non-self cells (Self-tolerance). If this does not occur can lead to autoimmune disorders where the immune system attacks self cells

HUMAN LEUKOCYTE ANTIGENS

Universal Product Code—proteins found on the surface of all body cells of an individual

Human Leukocyte Antigens (HLAs) are proteins responsible for each individual’s universal product code. Their function is to transport antigens from within the cell to the cell surface

HLAs

• Immune System uses the HLAs to differentiate between self and non-self cells. Any cells displaying that person’s HLA type belongs to that person (and is not an invader)

• HLAs is dependent on which genes are inherited by parents

• Self -Tolerance—Ability to recognize self vs. non-self cells. Necessary to prevent healthy body cells from being destroyed along with invaders

• Antigen (antibody generation) is a specific foreign protein that prompts the generation of antibodies. Antigens specify tissue type of person

FACTORS AFFECTING IMMUNE SYSTEM

FUNCTION

• Nutritional Status• Environmental Conditions• Therapeutic Agents• Presence of Disease• Age• Genetics• Certain viruses

Organization of the Immune System

• Stem Cells• Maturation

• Leukocytes (refer to Ignatavicius Table 19-1, pg. 309)• Actions

• Recognize self vs. non-self• Phagocytic destruction• Production of cytokines• Production of antibodies• Production of cytokines

THE THREE PROCESSES OF HUMAN PROTECTION THROUGH IMMUNITY

• INFLAMMATION

• ANTIBODY- MEDIATED IMMUNITY

• CELL- MEDIATED IMMUNITY

INFLAMMATION

Process by which the body utilizes WBCs and chemicals to provide immediate protection from infection and foreign substances

Nonspecific immune response

Can rid body of harmful organisms

Tissue damage may result from chronic inflammation

INFLAMMATION

WHAT DISEASES ARE ASSOCIATED WITH INFLAMMATION?

WHAT ARE THE SYMPTOMS OF INFLAMMATION?

WHAT CAUSES THE SYMPTOMS OF INFLAMMATION?

WHAT MEDICATIONS ARE USED TO TREAT INFLAMMATION?

TYPES OF CELLS INVOLVED IN INFLAMMATION

• NEUTROPHILS• SEGS, BANDS AND LEFT SHIFT

• MACROPHAGES

• EOSINOPHILS

• BASOPHILS

PROGRESSIOM FROM BAND TO SEG

PHAGOCYTOSIS

• Key process of inflammation

• Cellular process of engulfing solid particles such as bacteria and cell debris and removing them

• Rids the body of debris after tissue injury

• Neutrophils and macrophages

PHAGOCYTOSIS—SEVEN STEPS

• EXPOSURE AND INVASION• ATTRACTION• ADHERENCE• RECOGNITION• CELLULAR INGESTION• PHAGOSOME FORMATION• DEGRADATION

INFLAMMATORY RESPONSE SEQUENCE

• Stage I- Vascular (change in blood vessel)• Phase I rapid blood vessel constriction • Phase II hyperemia, edema

• Stage II- Cellular Exudate increase in circulating neutrophils, formation of pus

• Stage III- Tissue Repair and Replacement

ANTIBODY-MEDIATED IMMUNITY

Antibody—a protein (gammaglobulin) that forms to defend the body from a specific antigen (foreign substance), such as chemical agents, virus particles, and bacterial toxins

All antibodies are gammaglobulins (also called immunoglobulins)Globulin is a protein in a globular shapeGlobular proteins provide immunityResulting term is immumoglobulin

ANTIBODY-MEDIATED IMMUNITY

• Antigen-Antibody Reactions

• Destroy, eliminate, neutralize foreign proteins

• Long lasting immune reaction

• Entire immune system must function adequately for optimal AMI

ANTIBODY-MEDIATED IMMUNITY

CELLS INVOLVED IN AMI B-cells Macrophages T-Lymphocytes

B-CellsStart as stem cells from bone marrowProduce antibodies to specific foreign proteinDevelop in lymphocytic tissueProduce antibodies

ANTIBODY-MEDIATED IMMUNITY

ANTIGEN-ANTIBODY INTERACTIONS

EXPOSUREANTIGEN RECOGNITIONLYMPHOCYTIC SENSITIVATIONANTIBODY PRODUCTION AND RELEASEANTIGEN-ANTIBODY BINDINGANTIBODY BINDING ACTIONSSUSTAINED IMMUNITY: MEMORY

ANTIBODY TYPES

IMMUNOGLOBULINS ARE CLASSIFIED BY SIZE, TIMING, AND ASSOCIATION

IgAIgDIgEIgM

ACQUIRED ANTIBODY MEDIATED IMMUNITY

• Innate-native Immunity

• Adaptive Immunity

• Active Immunity

ACQUIRED ANTIBODY MEDIATED IMMUNITY

• Nature Active Immunity

• Artificial Active Immunity

• Passive Immunity

CELL MEDIATED IMMUNITY

• Provided by mature lymphocyte stem cells• Helps protect the body by differentiating self from

non-self cells. Cells most easily recognized by CMI are cancer cells and those cells inflicted by organisms that live in the host cell

CELL MEDIATED IMMUNITY

• T-lymphocytes (T-cells)

• Helper-Inducer T- Cells

• Suppressor T-cells

• Cytotoxic/Cytolytic T-Cells

• Natural Killer Cells

CYTOKINES

• Small, secreted proteins which regulate immunity, inflammation, and hematopoiesis

• Act by binding to specific membrane receptors, which then signal the cell to alter its behavior, causing a change in function of the target cell.

• Many different types of cells can produce the same cytokine, and a single cytokine may act on a variety of target cells

CYTOKINES

TRANSPLANT REJECTION

• Hyperacute Rejection

• Acute Graft Rejection

• Chronic Rejection

TREATMENT OF TRANSPLANT REJECTION

• Medication

• Maintenance

• Rescue Therapy

Stress & Coping

Scientific Knowledge Base

• Fight or flight response to a stressor• Stimulation of sympathetic nervous system• Medulla Oblongata• Reticular Formation• Pituitary Gland

General Adaptation Syndrome

• Alarm Reaction

• Resistance Stage

• Exhaustion Stage

Response to Stress

• Physiological Responses- LAS, GAS• Local Adaptation Syndrome-1.) Reflex Pain

Response 2.)Inflammatory Response• General Adaptation Response- 1.)Alarm Reaction

(Flight or Fight) 2.) Resistance Stage 3.) Exhaustion Phase

Types of Stress

• Eustress

• Distress

• Post Traumatic Stress Disorder (PSTD)

Understanding Stress Response

• Psychological response- Coping Mechanism, Ego-Defense Mechanism

• Situational Factors• Developmental/Maturational Factors• Intellectual Factors• Emotional, Behavioral Issues• Family Factors• Lifestyle Factors• Sociocultural, Spiritual Factors

Assessing Stress

• Physiological Indicators• Stress Situations• Psychological Indicators• Developmental Indicators• Emotional Behavioral Indicators• Intellectual Indicators• Family Indicators

Implementation• Stress Management• Time Management• Medications• Alternative Therapies• Regular Exercise• Good Nutrition and Diet• Rest• Support Systems• Crisis Intervention

Restorative Care

• Humor• Enhancing Self-esteem • Relaxation Techniques• Spirituality• Stress Management