Basic Human Needs Safety 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 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

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

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 shape Globular proteins provide immunity Resulting 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-Cells Start as stem cells from bone marrow Produce antibodies to specific foreign protein Develop in lymphocytic tissue Produce antibodies

ANTIBODY-MEDIATED IMMUNITY

ANTIGEN-ANTIBODY INTERACTIONS EXPOSURE ANTIGEN RECOGNITION LYMPHOCYTIC SENSITIVATION ANTIBODY PRODUCTION AND RELEASE ANTIGEN-ANTIBODY BINDING ANTIBODY BINDING ACTIONS SUSTAINED IMMUNITY: MEMORY

ANTIBODY TYPES IMMUNOGLOBULINS ARE CLASSIFIED BY SIZE, TIMING, AND ASSOCIATION IgA IgD IgE IgM

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