Pharm Week 6: Immunity & Inflammation PDF

Pharm Week 6: Immunity & Inflammation **Immunity** - - - - - - - - - - - - - - - Active Natural immunity - - Active artificial immunity - - - Passive natural - Passive artificial - **Application Concepts** - - - - - **C...

Pharm Week 6: Immunity & Inflammation **Immunity** - - - - - - - - - - - - - - - Active Natural immunity - - Active artificial immunity - - - Passive natural - Passive artificial - **Application Concepts** - - - - - **Cellular Level of Cells of the Innate Immunity** - - - - - - - - - **Immune Response to...** - - - - - - - - - - - - - - - - - - **Strategies of Viruses to Evade the Immune System:** - - - - - - **Responses, Rejections, Reactions, and Diagnostics** Immune Response: - - - - - - - - - - - - Transplant Rejection: - - - - - - - - - - - - - - - - - - - - - - - Hypersensitivity Reactions - - - - - - +-----------------+-----------------+-----------------+-----------------+ | Hypersensitivit | | | | | y | | | | +=================+=================+=================+=================+ | Type 1 - | Type 2 | Type 3 | Type 4 | | allergic | | | | | reactions | | | | +-----------------+-----------------+-----------------+-----------------+ | Initial | Immune response | Are also | Delayed-type | | exposure to the | against the | mediated by | hypersensitivit | | antigen | antigens | circulating | y | | stimulates Th2 | present on the | antigen-antibod | reactions | | cells. | cell surface | y | | | | | complex that | They are | | They release | Antibodies | may be | mediated by | | IL-4 leading | binding to the | deposited in | antigen-specifi | | the B cells to | cell surface, | and damage | c | | switch their | activate the | tissues | activated | | production of | complement | | T-cells | | IgM to IgE | system and | Antigens in | | | antibodies | cause the | type 3 | Antigen enters | | which are | degranulation | relations are | body → | | antigen-specifi | of neutrophils | soluble as | processed by | | c | and destruction | opposed to | antigen-present | | | of the cells | cell-bound | ing | | IgE antibodies | | antigens in | cells | | bind to mast | Such reactions | type 2 | | | cells and | can be targeted | | If the T-helper | | basophils, | at self- or | Examples: | cell has | | sensitizing | non-self | | already been | | them to the | antigens | Glomerulonephri | sensitized to | | antigen | | tis | that particular | | | Example: | | antigen, it | | When the body | | Rheumatoid | will be | | is exposed to | ABO blood group | arthritis | stimulated to | | the allergen | incompatibility | | release | | again, it | leading to | | chemokines to | | cross-links the | **acute | | recruit | | IgE bound to | hemolytic | | macrophages and | | the sensitized | transfusion | | cytokines to | | cells, causing | reactions** is | | activate them. | | degranulation | an example | | | | and release of | | | This causes | | histamine - | | | local tissue | | causing | | | damage | | systemic | | | | | vasodilation, | | | The reaction | | bronchoconstric | | | takes longer | | tion, | | | than all other | | and increased | | | types, around | | permeability of | | | 24-72 hours | | vascular | | | | | endothelium | | | Examples: | | | | | | | The reaction | | | - - - | | can be divided | | | | | into two | | | | | stages: | | | | | | | | | | 1. 2. | | | | | | | | | | Examples: | | | | | | | | | | - - - - | | | | | | | | | +-----------------+-----------------+-----------------+-----------------+ Diagnostics Titer - Indirect Coombs' test - Elisa - - MHC typing - Quantitative Serum Immunoglobulin - - - - - - ANA - - CRP - CD4 and CD8 - - - - - - CBC - 1. a. b. 2. c. d. e. 3. 4. 5. Erythrocyte Sedimentation Rate (ESR) - - - - - - - CHECK YOUR KNOWLEDGE 1. a. Rationale: innate immunity provides immediate, non-specific defense mechanisms against pathogens, but it does not develop memory upon initial exposure. Adaptive immunity, is slower to respond but develops memory, leading to a faster and stronger response upon subsequent encounters with the same pathogen 2. b. 3. c. 4. d. 5. e. 6. f. Rationale: upregulating of major histocompatibility complex (MHC) molecules enhances antigen presentation and facilitates the recognition of infected cells by the immune system, rather than evading immune detection 7. g. 8. h. Rationale: can provide valuable information about the patient\'s immune function. Low levels of immunoglobulins may indicate an underlying immune deficiency, which predisposes the patient to recurrent infections 9. i. 10. j. Rationale: commonly used as the initial screening test for HIV infections. It detects the presence of HIV antibodies in the blood or saliva Inflammation Exudate - - - - - - - - - - Acute inflammation: - - - - - - - - - - - - - - - - -  Chronic inflammation - - - - - - - - Herbs that help inflammation - - - - - - - - - - - - - - Medications - - - - - - - - - - - - - - - - Types of Healing - - - - - - -  Immunity Scar Formation Loss of function - - - - Contractures and obstructions - - Adhesions - Hypertrophic scar tissue - - Ulceration - - Burns - - - - - - - - Rule of nines  Healing of Burns - - - - - - Children and Burns - - - - Autoimmune Disorders - - - - - - - Immunodeficiency - - - - - - - - - - - - +-----------------------------------+-----------------------------------+ | AIDS | Effects | +===================================+===================================+ | Chronic infectious condition | **Typical Effects** | | cause by HIV | | | | - - - - - - - - - | | Targets and destroys helper T | | | lymphocytes, resulting in a | | | compromised immune response and | - - - - | | heightened vulnerability to | | | secondary infections and cancer | - - - | | | | | Progresses through a prolonged | **Secondary Infections** | | latent phase followed by an | | | active infection stage | Common feature of AIDS and | | | represent a primary cause of | | **Etiology** | mortality and are often numerous, | | | extensive and more severe than | | HIV, categorized as type 1 or 2, | usually | | belongs to the retrovirus family | | | and possesses an RNA genome. | Respiratory system: Pneumocystis | | | carinii, now classified as a | | HIV-1 is the predominant cause of | fungus, frequently leads to | | AIDS in the US and Europe | severe pneumonia and is common | | | cause of death | | HIV-2 is primarily found in | | | central Africa and is thought to | Other infections include herpes | | have crossed from chimpanzees to | simplex virus causing lesions, | | humans during hunting and | and Candida fungal infections | | consumption | affecting the mouth and sometimes | | | extending into the esophagus | | HIV primarily targets | | | CD4-positive T-helper | While all cancer types are more | | lymphocytes, gradually | prevalent in AIDS patients, | | diminishing their numbers and | unusual cancers serve as | | function | indicators of AIDS | | | | | HIV attacks macrophages and cells | - - | | in the CNS, establishing | | | reservoirs for sustained | Tuberculosis | | infection within lymphoid tissues | | | early in the infection process | **Women with AIDS** | | | | | **Pathophysiology** | Kaposi sarcoma is less common | | | | | HIV's structure comprises two RNA | Exhibit a high incidence of | | strands within a lipid envelope | severe and drug-resistance | | adorned with glycoprotein spikes | vaginal infections, pelvic | | that facilitate attachment to | inflammatory disease, oral | | human cells | Candida, and herpes infections | | | | | Upon infiltrating host cells, | Sexually transmitted diseases | | viral RNA is converted into viral | tend to be more severe in | | DNA by the reverse transcriptase | infected women, with a higher | | enzyme | risk of cervical cancer | | | | | The hijacked host cell then | In children, 2 positive PCR tests | | produces more virus particles | are required to confirm HIV | | before succumbing to the | infection, and manifestations may | | infection | vary from severe illness and | | | early death to gradual | | **Transmission** | development of symptoms over | | | several years | | Occurs primarily through contact | | | with infected bodily fluids | Infants born with AIDS typically | | (blood, semen and vaginal | exhibit growth failure, | | secretions) | developmental delays, and | | | neurological impairments such as | | **Clinical S&S** | spastic paralysis | | | | | Following exposure, and initial | | | phase by mild, flu-like symptoms | | | may occur, with subsequent | | | periods of asymptomatic latency | | | | | | During latent phase, some | | | individuals may exhibit | | | generalized lymphadenopathy | | | | | | Acute stage - severe | | | complications across various | | | categories | | | | | | - - - - - | | +-----------------------------------+-----------------------------------+ \  Medications - - - - - - - Autoimmune Disease - - 8+Examples: **Systemic disease** - - - - **Organ -specific diseases** +-----------------------------------+-----------------------------------+ | **Blood** | Autoimmune hemolytic anemia | | | | | | Immune thrombocytopenic purpura | +===================================+===================================+ | **CNS** | Multiple Sclerosis | | | | | | Guillain-Barre syndrome | +-----------------------------------+-----------------------------------+ | **Muscle** | \*4ileMyasthenia gravis | +-----------------------------------+-----------------------------------+ | **Heart** | Rheumatic fever | +-----------------------------------+-----------------------------------+ | **Endocrine system** | Addison's disease | | | | | | Thyroiditis | | | | | | Hypothyroidism | | | | | | Type 1 diabetes mellitus | +-----------------------------------+-----------------------------------+ | **Gastrointestinal system** | Pernicious anemia | | | | | | Ulcerative colitis | +-----------------------------------+-----------------------------------+ | **Liver** | Primary biliary cirrhosis | | | | | | Autoimmune hepatitis | +-----------------------------------+-----------------------------------+ | **Eye** | Uveitis | +-----------------------------------+-----------------------------------+ Apheresis - - - Primary and secondary immunodeficiency disorders +-----------------------------------+-----------------------------------+ | Primary | Secondary | +===================================+===================================+ | Fundamental categories of | Typically caused by various | | disorders affecting the immune | factors, including, | | system | medication-induced | | | immunosuppression, malnutrition, | | These encompass deficiencies in | certain diseases like Hodgkin's | | phagocytic function, B cell | lymphoma, viral infections such | | function, T cell function and | as rubella, and exposure to | | combined deficiencies of both B | radiation | | and T cells | | +-----------------------------------+-----------------------------------+ Organ Transplantation - - Tissue Typing - - - Transplant Rejection - - 1. 2. a. b. 3. c. Immunosuppressive therapy - - - - - - - - - - - +-----------------+-----------------+-----------------+-----------------+ | Calcineurin | Sirolimus | Monoclonal | Polyclonal | | inhibitors | | antibodies | antibodies | +=================+=================+=================+=================+ | Prevents | Inhibits T-cell | Plays roles in | Employed for | | cell-mediated | activation and | preventing and | induction | | attacks against | proliferation, | treating acute | therapy or | | transplanted | often used in | rejection | acute rejection | | organs | synergy with | episodes | treatment, | | | calcineurin | | providing | | Typically used | inhibitors and | | significant | | in combination | corticosteroids | | immunosuppressi | | with | at relatively | | on | | corticosteroids | low doses | | immediately | | , | | | post-transplant | | mycophenolate | | | ation | | and sirolimus | | | | | | | | May cause | | Do not | | | allergic | | typically | | | reactions, | | induce bone | | | fever, | | marrow | | | arthralgias and | | suppression or | | | tachycardia | | alter the | | | | | normal | | | Slow | | inflammatory | | | administration | | response | | | and | | | | | premedication | | A/E: | | | can mitigate | | nephrotoxicity | | | these efftcs | +-----------------+-----------------+-----------------+-----------------+ Graft vs host (GVH) - - - - - - - - - - KNOWLEDGE CHECK 1. a. 2. b. 3. c. 4. d. 5. e. 6. f. 7. g. h. 8. i. 9. j. k. 10. l.