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Immune system
Composed of many
interdependent cell types that
collectively protect the body
from bacterial, parasitic, fungal,
or viral infections, and from the
growth of some tumor cells.
Definition of terms:
Immune system
- Group of cells, molecules,
and organs that act
together to defend the body
against foreign invaders
that may cause disease
such as bacterial, viruses of
fungi.
Immunology
- Study of our protection from
foreign macromolecules or
invading microorganism and
our responses to them.
Immunity
- Ability to resist damage
from foreign substances.
Antigen
- Molecules that trigger an
immune response, a protein
that stimulates an immune
reaction, causing the
production of antibodies.
Antibodies
- Proteins that fight
infections, a globulin
produced by B cells as a
defense mechanism against
foreign materials.
Epidemiology
- Study of how disease is
produced, and its
distribution in a given
population.
Pathogens
- Microorganism or
proteinaceous substances
capable of producing
disease.
Virulence
- Ability to cause damage.
Nosocomial infections
- Acquired in health care
setting.
Immune competent
- Client whose immune
system is able to identify
antigens and effectively
destroy or remove them.
Immune compromised
- Whose immune system is
unable to effectively destroy
or remove antigens
Mast cells
- Tissue cells that resemble a
peripheral blood basophil
and that contain granules
with chemical mediators.
Types of T-cells
1. Helper T (CD4 + TH) cells
have central role in immune
response, these activate
macrophage and help form
cytotoxic T-cells.
2. Cytotoxic T (CD8 + CTLs)
destroys target cells on contact
by producing perforin that lysis
an infected cells
3. Delayed hypersensitivity T (TD)
cells: mostly T helper and a few
cytotoxic T cells that are
involved in some allergic
reactions (poison ivy) and
rejection of transplanted tissue
4. Suppressor T (TS) cells inhibit
the production of CTL cells to
shut down immune response
once they are unneeded, least
they cause more damage than
necessary
(N.C regulatory T cells)
Immune response:
- Third line of defense
involves production of
antibodies and generation
of specialized lymphocytes
against specific antigens.
Immune system components
1. Leukocytes
1. Engulf and destroy
pathogens (bacteria)
2. Suppress inflammation
3. Fight parasitic infection
4. Produce antibodies and
provide immunity
A. Granulocytes immediate and provide
immunity
Neutrophils
- Phagocytic response to cell
injury
Eosinophil
- Hypersensitivity reaction
Basophil
- Inflammatory response
B. Agranulocytes fight infection
Monocytes
- Phagocytosis
Lymphocytes
- Production of
immunoglobulin
Lymphocytes
- Lymphocytes mount a dual
defense
2 kinds of (B and T) lymphocytes carry
out the immune responses
1. Humoral immunity
- (Antibody mediated)
involves the production of
antibody by the B cells
which attack Ag
2. Cell mediated immunity
- Is governed by Tlymphocytes. T cells attack
cells infected with
pathogens
3. NK cells
- Neither T/B in killing tumor
Humoral immunity
Apoptosis
Programmed cell death (falling
away)
Human body makes 100 million
lymphocytes everyday. If an
equivalent number doesnt die,
will develop leukemia.
B cells do not encounter
stimulating antigen will selfdestruct and send signals to
phagocytes to dispose of their
remains.
Many virus infected cells will
undergo apoptosis, to prevent
spread of the infection
Immunological memory
Antibody titer
- The amount of antibody in
the serum
Hybridomas
- Cell hybrids made from a
fusion of a tumor cells
(easytogrow) and a B cells
(specific for a single
antigenic determinant)
1L - 2 is a key growth
factor, which activates T
cells to divide
Other cytokines amplify
and regulate immune and
non-specific responses.
Examples includes:
Perforin and lymphotoxin
cell toxins
Gamma interferon
enhanced the killing power
of macrophages
Inflammatory factors
Antibody mediated
response (humoral)
produced by B lymphocytes
Cell-mediated response
produced by T
lymphocytes.
Immune response
Recognition of self and nonself
Antigens
CLASSIFICATIONS
Immediate
- Type I (anaphylactic )
reactions- mediated by
IgE antibody, which
promotes the release of
histamine and other
reactive mediators
- Type II (cytotoxic)
reactions mediated by
IgM and IgG antibodies,
which attach to cells
and cause cell lysis
- Type III (immune
complex) reactions(rheumatoid arthritis)
mediated by antigenantibody complexes
that deposit in the lining
of blood vessels or on
tissue surfaces
Delayed response
- Type IV (delayed
hypersensitivity)
reactions (transplant
rejection) are mediated
by lymphokines
released from sensitized
T lymphocytes
Chemical Mediators of Immediate
Hypersensitivity reactions
Histamine
Leukotrienes- potent
bronchoconstrictor, cause
increased venous
permeability
Prostaglandins- potent
vasodilators and potent
bronchoconstrictors
Cytokines- control and/or
regulate immunologic
functions
Platelet-activating
Factor- causes platelet
aggregation
Pharmacology
Acetaminophen (Tylenol)
reduces fever and pain
- has no anti-inflammatory
effect.
Anti-inflammatory Meds
3 GROUPS
Salicylates
NSAID ex. Diclofenac Na
(Voltaren), Ibuprofen
(Advil), Indomethacin
(Indocin), Ketorolac
Tromethamine (Toradol)
for pain management only,
Naproxen (Naprosyn)
Corticosteroids
Nosocomial infection
Infection acquired in a health care
setting.
Typically manifest after 48 hrs.
UTI most common type
Gerontologic Consideration
Cardiovascular changes
Respiratory system changes
Loss of muscle tone
Gastrointestinal system changes
Skin and subcutaneous changes
Slowed or impaired healing
process.
FACTORS THAT MAY CONTRIBUTE TO
INCREASED RISK FOR INFECTIOUS
DISEASE:
Decreased activity level
Poor nutrition
Chronic disease
Hospitalization
Presence of invasive device
Standard precautions
Blood
All body fluids, secretions,
excretions,
Non-intact skin
Mucous membranes
Essential elements
Use barrier protection
Prevent inadvertent percutaneous
exposure, dispose of needles
Immediate and thorough hand
washing
Pharmacology
check for:
History of hypersensitivity.
Age and childbearing status of the
client.
Renal function
Hepatic function
Site of infection
Classification of antimicrobial
preparations:
Bacteriostatic
Bactericidal
Five Basic Mechanisms of antimicrobial
agents
Impairing cell wall synthesis,
leading to lysis and cell
destruction.
Protein synthesis inhibition,
impairing microbial function
Altering the permeability of the
cell membrane, causing
intracellular contents to leak.
Inhibiting the synthesis of nucleic
acids
Inhibiting other specific
biochemical pathways of the
organism.