Chapter 19

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Chapter 19
2013-01-19 16:51:23

Inflammation and the Immune Response
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  1. Leukocytosis
    • Inflammation of infections
    • Pregnancy
    • Meds (glucose steroids)
    • High WBC 
    • Smoking 
    • Stress/Anxiety/Rage
    • Surgery 
    • Exercise 
  2. Immunocompetent 
    • maximum protection against infection
    • reduced by disease, injuries and medical therapies 
  3. self-tolerance
    recognizing self versus non-self, to prevent healthy body cells from being destroyed along with the invaders
  4. human leukocyte antigens (HLAs)
    • found on the surface of all body cells of that person and serve as a "universal product code" or a "cellular fingerprint" for that person
    • on the surface of most body cells
    • determines tissue type of a person
  5. antigens
    • proteins capable of stimulating an immune response
    • key for recognition
  6. stem cells
    • immature undifferentiated cells
    • bone marrow
    • the cell is not yet committed to maturing into a specific blood cell type 
  7. pluripotent
    each cell has more than one potential outcome
  8. neutrophil
    • -makes up 55-70% of WBC
    • -also called granulocytes 
    • -growth requires 12-14 days 
    • -lifespan 12-18 hours
  9. macrophage
    • can have many phagocytic events
    • -monocytes move from blood to body tissues where they mature into macrophages
    • -come from the stem cell
  10. monocyte
    • destruction of bacteria and cellular debris; matures into macrophage
    • -stem cell
  11. eosinophil
    • 1-2% of WBC
    • contains vasoactive chemicals
    • -limits inflammatory reaction
    • -against infections of parasitic larvae 
    • -increased during an allergic response
  12. basophil
    • causes signs of inflammation 
    • -1% of WBC
    • -releases chemicals through blood vessels
  13. b-lymphocyte (b-cells)
    • becomes sensitized to foreign cells and proteins
    • most direct role in AMI
    • start as stem cells
    • migrate into secondary lymphoid tissues, maturation is completed here
  14. plasma cell
    secretes immunoglobulins in response to the presence of a specific antigen
  15. memory cell
    remains sensitized to a specific antigen and can secrete increased amounts of immunoglobulins specific to the antigen on re-exposure
  16. helper/inducer t-cell
    • enhances immune activity through secretion of various factors, cytokines, and lymphokines
    • -recognizes self versus non-self cells 
    • -increase bone marrow production of stem cells and speed up their maturation 
  17. cytotoxic/cytolytic t-cell 
    selectively attacks and destroys non-self cells, including virally infected cells, grafts and transplant organs 
  18. natural killer cell
    non selectively attacks non-self cells, especially body cells that have undergone mutation and become malignant; also attacks  grafts and transplanted organs
  19. natural immunity
    immediate protection against the effects of tissue injury and invading foreign proteins
  20. innate immunity
    skin, mucosa, antimicrobial chemicals on the skin, complement, and natural killer cells
  21. inflammation
    • nonspecific body defense to invasion or injury
    • symptoms depend on: intensity, severity, duration of exposure to initiating event
  22. infection
    • loss of function
    • pain
    • swelling
    • process in response to tissue injury, as well as to invasion by organisms
  23. left shift
    • bands are usually only 10-12%
    • -more circulating bands than mature neutrophils
    • -indicates the patient's bone marrow cannot produce mature neutrophils to fight infection into the blood
  24. neutrophil function
    • provides protection after invadors (bacteria)
    • -higher the numbers, the greater the resistance to infection
  25. macrophage function
    • provides protection
    • -immediate inflammatory responses and stimulates long lasting immune responses
    • -long life spans
    • -traps invading cells
  26. chemicals released during basophil
    • heparin-inhibits blood and protein clotting
    • histamine-constricts small veins, inhibitin blood flow and decreasing venous return
    • kinins-dilate arterioles and increase capillary permeability
  27. phagocytosis
    the engulfing and destruction of invadors
  28. first step of phagocytosis
    • exposure/invasion
    • -triggered by injury or invasion
  29. second step of phagocytosis 
    • attraction
    • -phagocytosis can only occur when the WBC comes into direct contact with the target
  30. third step of phagocytosis
    • adherence
    • -phagocytic cell first binds to the surface
    • -during inflammation, coating the target makes it easier for phagocytic cell to bind to the surface
  31. opsonins
    substances that increase contact of the cell with its target by coating the target cell (antigen or organism)
  32. fourth step of phagocytosis
    • recognition
    • -occurs when the phagocytic cell sticks to the surface of the target cell and "recognizes" it as non-self
  33. fifth step of phagocytosis
    • cellular ingestion
    • -phagocytic destruction occurs inside the cell
    • -phagocytic cell engulfs the target cell to form a vacuole
  34. sixth step of phagocytosis 
    • phagosome formation
    • -occurs when the phagocyte's granules are inside the vacuole
    • -granules break and release enzymes that attack the ingested target
  35. final step of phagocytosis
    • degradation 
    • -the phagocyte ingests the engulfed target
    • -broken into smaller pieces
  36. five cardinal manifestations of inflammation
    • warmth
    • redness
    • swelling
    • pain
    • decreased function
  37. stage one of inflammatory response
    • vascular
    • changes in blood vessels
    • secretes; histamine, serotonin, kinins
    • constrict small veins and dilate the arterioles
    • edema
    • capillary leak
    • subsides within 24-72 hours 
  38. stage two of the inflammatory response
    • cellular exudate
    • pus 
    • necrotic tissue
    • dead WBC
    • fluids that escape from damaged cells
    • neutrophil count can increase up to 5 times within 12 hours after onset
  39. stage three of the inflammatory response
    • tissue repair and replacement
    • begins at the time of injury
    • inducing the remaining healthy cells to divide
    • scar tissue formation
  40. immunity
    • adaptive internal protection that results in long term resistance to the effects of invading microorganisms 
    • not automatic
  41. antibody-mediated immunity (AMI)
    • humoral immunity
    • involves antigen-antibody interactions to neutralize, eliminate, or destroy foreign proteins
  42. plasma cell
    starts immediately to produce antibodies against the sensitizing antigen
  43. agglutination
    • is a clumping action that results from the antibody linking antigens together, forming large and small immune complexes 
    • slows the movement of the antigen in body fluids 
  44. lysis
    is cell membrane destruction, and it occurs now because of antibody binding to membrane-bound antigens of some invaders
  45. humoral immunity 
    circulating antibodies can be transferred from one person to another to provide the receiving person with immediate immunity of short duration 
  46. complement activation and fixation
    are actions triggered by some classes of antibodies that can remove or destroy antigen
  47. antigen-antibody interactions-1
    • exposure or invasion by new antigens
    • -must first enter the person
    • -must occur in large numbers
    • -overwhelms the inflammatory response to get rid of invader
  48. antigen-antibody interactions-2
    • antigen recognition 
    • -started by the macrophages
    • -recognizes the invading antigen as non-self and attaches itself to the antigen
  49. antigen-antibody interactions-3
    • sensitization
    • -bell-cell recognizes the antigen as non-self and is not "sensitized" to this antigen
    • -allows b-cell to respond to any substance that carries the same antigens
  50. antigen-antibody interactions-4
    • antibody production and release
    • -allow the antibodies to search out specific antigens
    • -produced by plasma cells, released into the blood
    • -remains in blood for 3-30 days
  51. antigen-antibody interactions-5
    • antibody-antigen binding
    • -antibodies are Y shaped molecules
    • -each antibody can bind either to two separate antigens or to tow areas of the same antigen 
    • -antibody-antigen binding starts other actions that neutralize, eliminate  or destroy the antigen
  52. antigen-antibody interactions-6
    • antibody-binding actions
    • -actions include:
    • agglutination 
    • lysis
    • complement fixation
    • precipitation
    • inactivation
    • neutralization
  53. precipitation
    antibody molecules bind so much antigen that large antigen-antibody complexes are formed
  54. inactivation (neutralization)
    process of making an antigen harmless without destroying it
  55. antigen-antibody interactions-7
    • sustained immunity (memory)
    • -long lasting immunity to a specific antigen
    • -memory b-cells made during sensitization stage
  56. IgG
    • -responsible for providing long term immunity
    • -involved in cell mediated non-self cell killing action of natural killer cells
    • -composes at least 75% of circulating antibody population
    • -allergic reactions 
  57. IgM
    • -first responders
    • -composes about 10-15% of circulating antibody population
    • -effective i actions of agglutination and precipitation
    • -10 potential binding sites
  58. immunoglobin
    is used for antibodies because they are globular proteins that provide immunity 
  59. gamma globulins
    antibodies are called this because all free antibodies in the plasma separate out in the gamma fraction of plasma proteins during electrophoresis
  60. adaptive immunity
    person's body learns to make as an adaptive response to invasion by organisms
  61. active immunity
    • -you create them
    • -occurs when antigens enter the body and the body responds by making specific antibodies against the antigen 
  62. natural active immunity
    • occurs when an anitgen enters the body without human assistance and the body responds by actively making antibodies against that antigen 
    • (ex: chickenpox virus)
  63. artificial active immunity
    • is the protection developed by vaccination or immunization 
    • -prevent infections or diseases
  64. passive immunity
    • occurs when antibodies against the antigen are in a person's body but were not created there
    • -transferred to the person's body after being made in the body of another person or animal
  65. natural passive immunity
    occurs when antibodies are passed from mother to the fetus via the placenta or through breast milk
  66. artificial passive immunity
    • involves injection the person with antibodies that were produced in another person or animal
    • -prevent diseases or deaths for patients exposed to rabies, tetanus, and poisonous snake bites
  67. suppressor t-cells
    • help prevent hypersensitivity on exposure to non-self cells or proteins
    • -preventing the formation of antibodies directed against normal, healthy self cells 
  68. cytotoxic/cytolytic t-cells 
    • destroy cells that contain a processed antigen's human leukocyte antigens (viruses)
    • -recognize the cell as abnormal and binds to it
  69. Natural killer (NK)
    • "seek and destroy"  missions in the body to eliminate non-self cells
    • -most effective in destroying unhealthy, abnormal cells (cancer)
  70. cytokines
    • small protein hormones produced by the many WBCs
    • -act like "messengers" that tell specific cells how and when to respond
  71. monokines
    cytokines made by macrophages, neutrophils, epsinophils, and monocytes
  72. lymphokines
    cytokines produced by t-cells
  73. cell-mediated immunity (CMI)
    important in preventing the development of cancer and metastasis after exposure to carcinogens