Immune Response & Inflammation Lecture Notes PDF

Objectives 1. Brief PowerPoint review of: Chapter 7 – Stress Management Chapter 12 - Inflammation Chapter 14 – Normal Immune Response, Type I IgE-Mediated Reactions, Allergic Disorders Chapter 33 – Hematological Assessment Chapter 34 – Hematological Problems 2. In-class applicat...

Objectives 1. Brief PowerPoint review of: Chapter 7 – Stress Management Chapter 12 - Inflammation Chapter 14 – Normal Immune Response, Type I IgE-Mediated Reactions, Allergic Disorders Chapter 33 – Hematological Assessment Chapter 34 – Hematological Problems 2. In-class application activities 3. Group nutrition presentation - Anemia Immune Responses & Inflammation Michelle Husbands, DNP, FNP-BC Antigens Foreign substance that evokes an immune response. All cells have surface antigens unique self enables the body to recognize itself non-responsive to self  Types of Immunity Innate Acquired present at birth Active – (Long-lived) Passive – (Short-lived) 1st line defense not antigen specific invasion of a foreign Receives antibodies to responds immediately antigen an antigen (i.e., (natural WBC response) Makes antibodies (i.e., immunoglobulins from primarily neutrophils & disease, immunization) mother to fetus, injection monocytes reinvasion – more rapid of serum antibodies) response No retention of memory cells memory cells Hematopoiesis Lymphoid Organs Central: Thymus gland – T cells Bone marrow – B cells Peripheral: Lymph nodes Tonsils Spleen Gut Genital Bronchial Skin  Inflammatory & Immune Response  B-Lymphocytes  matures in bone marrow  differentiates into plasma cells  produces antibodies (immunoglobulins)  last to arrive at site of injury  T-Lymphocytes  migrate & matures in Thymus  responsible for immunity to viruses, tumor cells, and fungi  Antibody Immunity  B-lymphocytes – 1st exposure Immunoglobins or antibodies (IgG, IgA, IgM, IgD, IgE) produced in response to antigen  2nd Exposure to an antigen  Memory B-lymphocytes recognize antigen = more rapid production of antibodies  Cell-Mediated Immunity  T-lymphocytes differentiate into  T cytotoxic cells (CD8)  T helper cells (CD4)  CD8 – attacks & destroys antigen by releasing cytolytic substance; remains as memory T cells  CD4 – regulates cell-mediated immunity, antibody response, cytokines, NK cells, T Dendritic cells  Cytokines  Cell messengers  Instructs cells to alter their proliferation, differentiation, secretion or cellular activity  Types Interleukins, Interferons, Tumor Necrosis Factor (TNF), Colony-stimulating factors, Erythropoietin  https://youtu.be/lXfEK8G8CUI?t=1  Autoimmune Diseases Body’s inability to recognize self  Cause is unknown  Loss of self-tolerance for the body’s own DNA antigens.  Examples: Table 14.14 (p.228)  Altered Immune Response Reaction Type I: Type II: Cytotoxic Type III: Immune- Type IV: IGE-mediated Complex Delayed Hypersensivity Onset Immediate Minutes to hours Hours to days Several days Mediator Histamine IgG & IgM Monocytes T cytotoxic cells Leukotrienes antibody-antigen Macrophages Cytokines Mast cells binding Neutrophils Prostaglandins Example Asthma Transfusions RA Contact AR ITP SLE dermatitis Hives Graves disease  Stress on the Immune Response: Involved Systems: CNS – hypothalamus SNS & CRH ACTH Endocrine – adrenal medulla (epi/norepinephrine) Immune: - acute/chronic stress immunosuppression - decrease # of NK cells - decrease lymphocytes proliferation - alteration production of cytokines - decrease phagocytosis of neutrophils/monocytes.  Allergic Disorders Assessment – H & P (Table 14.10)  personal & FHx of allergies  social/environmental factors Diagnostic studies  skin testing (scratch/prick; intradermal, patch) Treatment  Anaphylaxis – ABCs (Table 14.11) – EMERGENT  Seasonal/chronic – recognition & control  Medications  Immunotherapy Inflammatory & Immune Response (Fig. 12.1, p. 180): Vascular Response – Facilitating fluid movement from capillaries into tissue spaces, vasodilation Cellular Response (WBCs with Differential)  Neutrophils – 1st responders (6 to 12 hours), phagocytize bacteria, foreign material + damaged cells + dead neutrophils = pus accumulation  Monocytes (macrophages) – phagocytize bacteria & presents antigen to T or B lymphocytes; triggers a cell-mediated immune response  Inflammation (cont.)  Lymphocytes – differentiates into B & T cells, responsible for long-term immunity  Eosinophils – associated with allergic response & atopic disorders  Basophils – Release histamine for inflammatory response  Chemical mediators  Prostaglandins & leukotrienes  Complements  Clinical Manifestations  Fever (antipyretics, hydration)  Inflammation (anti-inflammatory, vitamins, RICE)  Erythema  ↑ WBC count  Green/ yellow colored sputum  Purulent (pus) exudate  Odor  Urine – cloudy, discolored CBC - Shifts Left Shift Right Shift (Bacterial) (Viral) ↑ WBC ↓ WBC (or normal) ↑ Neutrophils ↓ Neutrophils Bands ↑ Lymphocytes https://youtu.be/CMwcoaZNauQ?t=3