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Topic 1 Cellular Abberation
 

Topic 1 Cellular Abberation

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For MMC-CN Students. Lectured by Prof. Julius Floresta.

For MMC-CN Students. Lectured by Prof. Julius Floresta.

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    Topic 1 Cellular Abberation Topic 1 Cellular Abberation Presentation Transcript

    • 1. CELLULAR ABERRATION
    • OVERVIEW Cell appearance (morphology)b. Each normal mature cell type is differentiated, with a distinct and recognizable appearance, size, and shapec. The size of a normal cell nucleus is usually small compared with the size of the rest of the cell, including the cytoplasmd. Normal cells generally have a small N:C ratioe. As cell matures, the nucleus:cytoplasm ratio decrease
    • Anatomy of the Generalized Cell• Cells are not all the same• All cells share general structures• Cells are organized into three main regions • Nucleus • Cytoplasm • Plasma membrane Figure 3.1aCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 3.2
    • The Nucleus• Control center of the cell • Contains genetic material (DNA)• Three regions • Nuclear membrane • Nucleolus • Chromatin Figure 3.1bCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 3.3
    • Nuclear Membrane – double membrane or envelope• Barrier of nucleus• Consists of a double phospholipid membrane• Contain nuclear pores that allow for exchange of material with the rest of the cell – selectively permeableCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 3.4
    • Nucleoli• Nucleus contains one or more nucleoli• Sites of ribosome production • Ribosomes then migrate to the cytoplasm through nuclear poresCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 3.5
    • Chromatin (when not dividing)• Composed of DNA and protein• Scattered throughout the nucleus• Chromatin condenses to form chromosomes when the cell dividesCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 3.6
    • Plasma Membrane• Barrier for cell contents• Double phospholipid layer (fat – water) • Hydrophilic heads • Hydrophobic tails• Other materials in plasma membrane • Protein • Cholesterol • GlycoproteinsCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 3.7a
    • Plasma Membrane Figure 3.2Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 3.7b
    • Plasma Membrane Specializations• Microvilli • Finger-like projections that increase surface area for absorption • Small intestine and nephrons of kidney Figure 3.3Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 3.8a
    • Cytoplasm• Material outside the nucleus and inside the plasma membrane • Cytosol • Fluid that suspends other elements • Organelles • Metabolic machinery of the cell • Inclusions • Non-functioning units – fat, pigments…..Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 3.9
    • Cytoplasmic Organelles Figure 3.4Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 3.10
    • Cytoplasmic Organelles• Ribosomes • Made of protein and RNA • Sites of protein synthesis • Found at two locations • Free in the cytoplasm • Attached to rough endoplasmic reticulumCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 3.11
    • Cytoplasmic Organelles• Endoplasmic reticulum (ER) • Fluid-filled tubules for carrying substances • Two types of ER • Rough Endoplasmic Reticulum • Studded with ribosomes • Site where building materials of cellular membrane are formed • Smooth Endoplasmic Reticulum • Functions in cholesterol synthesis and breakdown, fat metabolism, and detoxification of drugsCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 3.12
    • Cytoplasmic Organelles• Golgi apparatus • Modifies and packages proteinsCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 3.13a
    • Cytoplasmic Organelles Figure 3.5Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 3.13b
    • Cytoplasmic Organelles• Lysosomes • Contain enzymes that digest nonusable materials within the cell• Peroxisomes • Membranous sacs of oxidase enzymes • Detoxify harmful substances • Break down free radicals (highly reactive chemicals) • Replicate by pinching in halfCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 3.14
    • Cytoplasmic Organelles• Mitochondria • “Powerhouses” of the cell • Change shape continuously • Carry out reactions where oxygen is used to break down food • Provides ATP for cellular energyCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 3.15
    • Cytoplasmic Organelles• Cytoskeleton • Network of protein structures that extend throughout the cytoplasm • Provides the cell with an internal frameworkCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 3.16a
    • Cytoplasmic Organelles• Cytoskeleton • Three different types • Microfilaments • Intermediate filaments • Microtubules Figure 3.6Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 3.16b
    • Cytoplasmic Organelles• Centrioles • Rod-shaped bodies made of microtubules • Direct formation of mitotic spindle during cell divisionCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 3.17
    • Cellular Projections• Not found in all cells• Used for movement • Cilia moves materials across the cell surface • Flagellum propels the cellCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 3.18
    • OVERVIEW Epithelial (glandular) tissues: breast (ductal), colon, liver Connective (mesenchymal) tissue – adipose, blood vessel, bone, skeletal and smooth muscle Hematopoietic cells – blood cells
    • Body Tissues• Cells are specialized for particular functions• Tissues • Groups of cells with similar structure and function • Four primary types • Epithelium • Connective tissue • Nervous tissue • MuscleCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 3.41
    • Epithelial Tissues• Found in different areas • Body coverings • Body linings • Glandular tissue• Functions • Protection • Absorption • Filtration • SecretionCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 3.42
    • Epithelium Characteristics• Cells fit closely together• Tissue layer always has one free surface• The lower surface is bound by a basement membrane• Avascular (have no blood supply)• Regenerate easily if well nourishedCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 3.43
    • Classification of Epithelium• Number of cell layers • Simple – one layer • Stratified – more than one layer Figure 3.16aCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 3.44a
    • Classification of Epithelium• Shape of cells • Squamous – flattened • Cuboidal – cube-shaped • Columnar – column-like Figure 3.16bCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 3.44b
    • Simple Epithelium• Simple squamous • Single layer of flat cells • Usually forms membranes • Lines body cavities • Lines lungs and capillaries Figure 3.17aCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 3.45
    • Simple Epithelium• Simple cuboidal • Single layer of cube-like cells • Common in glands and their ducts • Forms walls of kidney tubules • Covers the ovaries Figure 3.17bCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 3.46
    • Simple Epithelium• Simple columnar • Single layer of tall cells • Often includes goblet cells, which produce mucus • Lines digestive tract Figure 3.17cCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 3.47
    • Simple Epithelium• Pseudostratified • Single layer, but some cells are shorter than others • Often looks like a double cell layer • Sometimes ciliated, such as in the respiratory tract • May function in absorption or Figure 3.17d secretionCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 3.48
    • Stratified Epithelium• Stratified squamous • Cells at the free edge are flattened • Found as a protective covering where friction is common • Locations • Skin • Mouth • Esophagus Figure 3.17eCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 3.49
    • Stratified Epithelium• Stratified cuboidal • Two layers of cuboidal cells• Stratified columnar • Surface cells are columnar, cells underneath vary in size and shape• Stratified cuboidal and columnar • Rare in human body • Found mainly in ducts of large glandsCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 3.50
    • Stratified Epithelium• Transitional epithelium • Shape of cells depends upon the amount of stretching • Lines organs of the urinary system Figure 3.17fCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 3.51
    • Glandular Epithelium• Gland – one or more cells that secretes a particular product• Two major gland types • Endocrine gland • Ductless • Secretions are hormones • Exocrine gland • Empty through ducts to the epithelial surface • Include sweat and oil glandsCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 3.52
    • Connective Tissue• Found everywhere in the body• Includes the most abundant and widely distributed tissues• Functions • Binds body tissues together • Supports the body • Provides protectionCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 3.53
    • Connective Tissue Characteristics• Variations in blood supply • Some tissue types are well vascularized • Some have poor blood supply or are avascular• Extracellular matrix • Non-living material that surrounds living cellsCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 3.54
    • Connective Tissue Types• Bone (osseous tissue) • Composed of: • Bone cells in lacunae (cavities) • Hard matrix of calcium salts • Large numbers of collagen fibers • Used to protect and support the body Figure 3.18aCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 3.56
    • Connective Tissue Types• Hyaline cartilage • Most common cartilage • Composed of: • Abundant collagen fibers • Rubbery matrix • Entire fetal skeleton is hyaline cartilage Figure 3.18bCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 3.57
    • Connective Tissue Types• Elastic cartilage • Provides elasticity • Example: supports the external earCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 3.58a
    • Connective Tissue Types• Fibrocartilage • Highly compressible • Example: forms cushion-like discs between vertebrae Figure 3.18cCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 3.58b
    • Connective Tissue Types• Dense connective tissue • Main matrix element is collagen fibers • Cells are fibroblasts • Examples • Tendon – attach muscle to bone • Ligaments – attach bone to bone Figure 3.18dCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 3.59
    • Connective Tissue Types• Areolar connective tissue • Most widely distributed connective tissue • Soft, pliable tissue • Contains all fiber types • Can soak up excess fluid Figure 3.18eCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 3.60
    • Connective Tissue Types• Areolar connective tissue • Most widely distributed connective tissue • Soft, pliable tissue • Contains all fiber types • Can soak up excess fluid Figure 3.18eCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 3.60
    • Connective Tissue Types• Reticular connective tissue • Delicate network of interwoven fibers • Forms stroma (internal supporting network) of lymphoid organs • Lymph nodes • Spleen • Bone marrow Figure 3.18gCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 3.62
    • Connective Tissue Types• Blood • Blood cells surrounded by fluid matrix • Fibers are visible during clotting • Functions as the transport vehicle for materials Figure 3.18hCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 3.63
    • Muscle Tissue• Function is to produce movement• Three types • Skeletal muscle • Cardiac muscle • Smooth muscleCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 3.64
    • Muscle Tissue Types• Skeletal muscle • Can be controlled voluntarily • Cells attach to connective tissue • Cells are striated • Cells have more than one nucleus Figure 3.19bCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 3.65
    • Muscle Tissue Types• Cardiac muscle • Found only in the heart • Function is to pump blood (involuntary) • Cells attached to other cardiac muscle cells at intercalated disks • Cells are striated • One nucleus per cell Figure 3.19cCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 3.66
    • Muscle Tissue Types• Smooth muscle • Involuntary muscle • Surrounds hollow organs • Attached to other smooth muscle cells • No visible striations • One nucleus per cell Figure 3.19aCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 3.67
    • Nervous Tissue• Neurons and nerve support cells• Function is to send impulses to other areas of the body • Irritability • Conductivity Figure 3.20Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 3.68
    • OVERVIEW Normal cell functionsb. Gastric cells – secrete HClc. Nerve cells – generate action potential and conduct impulsesd. Beta cells of the pancrease. Type II pneumocytesf. Immune system
    • OVERVIEW Immunity – the body’s specific protective response to a foreign agent or organism Immune system – part of the body’s defense mechanism against invasion and allows a rapid response to foreign substance Genetic and cellular responses result when the immune system is activated Tolerance – mechanism by which the immune system is programmed to eliminate foreign substances such as microbes, toxins, and cellular mutations but maintains the ability to accept self-antigens
    • OVERVIEW Immunopathology – the study of diseases that result from dysfunctions within the immune system Immune function is affected by a variety of factors3. Central nervous system integrity4. General physical status5. General emotional status6. Stress7. Illness8. Trauma9. Surgery
    • IMMUNE SYSTEM DISORDERS Autoimmunity - is the failure of an organism to recognize its own constituent parts as self, which allows an immune response against its own cells and tissues. Hypersensitivity - refers to excessive, undesirable (damaging, discomfort-producing and sometimes fatal) reactions produced by the normal immune system. Gammopathies - abnormal proliferation of the lymphoid cells producing immunoglobulins. Ex: hodgkins disease Immune deficiencies -  is a state in which the immune systems ability to fight infectious disease is compromised or entirely absent.e. Primaryf. Secondary
    • ANATOMIC AND PHYSIOLOGICOVERVIEW Epitopes – antigenic determinants that are present on foreign materials, initiating a series of action in a host, including the inflammatory response, the lysis of microbial agents, and the disposal of foreign toxins Bone marrow (B lymphocytes originates) Lymphoid tissues – spleen, lymph nodes WBCs, antibodies Types of immunity Natural immunity – or innate immunity is nonspecific and is present at birth (intact skin, phagocytes, compliment system) Acquired or adaptive immunity – specific and develops after birth (humoral & Cellular
    • BASIC CONCEPTSComponents of the Immune System Immune cells Central immune structures: bone marrow and thymus (where immune cells are produced and mature) Peripheral immune structures: lymph nodes, spleen (where the immune cells interact with the antigen)
    • BASIC CONCEPTSComponents of the Immune System Immune cells: T and B lymphocytes (primary cells), macrophages (accessory cells) which aid in processing and presentation of antigens to the lymphocytes Cytokines: molecules that form a communication link between immune cells and other tissues and organs of the body
    • Lymph Nodes Figure 12.3Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide
    • Lymph Node Structure Figure 12.4Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide
    • Other Lymphoid Organs• Several other organs contribute to lymphatic function • Spleen • Thymus • Tonsils • Peyer’s patches Figure 12.5Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 12.9
    • The Spleen• Located on the left side of the abdomen• Filters blood• Destroys worn out blood cells• Forms blood cells in the fetus• Acts as a blood reservoirCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide
    • The Thymus• Located low in the throat, overlying the heart• Functions at peak levels only during childhood• Produces hormones (like thymosin) to program lymphocytesCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide
    • Tonsils• Small masses of lymphoid tissue around the pharynx• Trap and remove bacteria and other foreign materials• Tonsillitis is caused by congestion with bacteriaCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide
    • Peyer’s Patches• Found in the wall of the small intestine• Resemble tonsils in structure• Capture and destroy bacteria in the intestineCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide
    • Mucosa-Associated Lymphatic Tissue (MALT)• Includes: • Peyer’s patches • Tonsils • Other small accumulations of lymphoid tissue• Acts as a guard to protect respiratory and digestive tractsCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide
    • Body Defenses• The body is constantly in contact with bacteria, fungi, and viruses (pathogens)• The body has two defense systems for foreign materials • Nonspecific defense system • Mechanisms protect against a variety of invaders • Responds immediately to protect body from foreign materialsCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide
    • Body Defenses • Specific defense system • Specific defense is required for each type of invader • Also known as the immune systemCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide
    • Nonspecific Body Defenses• Body surface coverings • Intact skin • Mucous membranes• Specialized human cells• Chemicals produced by the bodyCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide
    • Surface Membrane Barriers – First Line of Defense• The skin • Physical barrier to foreign materials • pH of the skin is acidic to inhibit bacterial growth • Sebum is toxic to bacteria • Vaginal secretions are very acidicCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide
    • Surface Membrane Barriers – First Line of Defense• Stomach mucosa • Secretes hydrochloric acid • Has protein-digesting enzymes• Saliva and lacrimal fluid contain lysozyme• Mucus traps microogranisms in digestive and respiratory pathwaysCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide
    • Defensive Cells• Phagocytes (neutrophils and macrophages) • Engulfs foreign material into a vacuole • Enzymes from lysosomes digest the materialCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Figure 12.6b Slide
    • Macrophage attacking e-coli.•
    • Defensive Cells• Natural killer cells • Can lyse and kill cancer cells • Can destroy virus- infected cellsCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Figure 12.6b Slide
    • Inflammatory Response - Second Line of Defense• Triggered when body tissues are injured• Produces four cardinal signs • Redness • Heat • Swelling • Pain• Results in a chain of events leading to protection and healingCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide
    • Functions of the Inflammatory Response• Prevents spread of damaging agents• Disposes of cell debris and pathogens• Sets the stage for repairCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide
    • Steps in the Inflammatory Response Figure 12.7Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide
    • Antimicrobial Chemicals• Complement • A group of at least 20 plasma proteins • Activated when they encounter and attach to cells (complement fixation) Figure 12.8Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide
    • Antimicrobial Chemicals• Complement (continued) • Damage foreign cell surfaces • Will rupture or lyse the foreign cell membrane Figure 12.8Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide
    • Antimicrobial Chemicals• Interferon • Secreted proteins of virus-infected cells • Bind to healthy cell surfaces to inhibit viruses bindingCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide
    • Interferons are a family species-specific proteins synthesized byeukaryotic cells in response to viruses and a variety of natural andsynthetic stimuli. There are several different interferons commonlyused as therapeutics, termed alpha, beta, and gamma. These peptidesare used to treat hairy cell leukemia, AIDS-related Kaposis sarcoma,laryngeal papillomatosis, genital warts, and chronic granulomatousdisease. Side effects include black tarry stools, blood in the urine,confusion, and loss of balance.
    • Fever• Abnormally high body temperature• Hypothalmus heat regulation can be reset by pyrogens (secreted by white blood cells)• High temperatures inhibit the release of iron and zinc from liver and spleen needed by bacteria• Fever also increases the speed of tissue repairCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide
    • Specific Defense: The Immune System – Third Line of Defense• Antigen specific – recognizes and acts against particular foreign substances• Systemic – not restricted to the initial infection site• Has memory – recognizes and mounts a stronger attack on previously encountered pathogensCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide
    • Types of Immunity• Humoral immunity • Antibody-mediated immunity • Cells produce chemicals for defense• Cellular immunity • Cell-mediated immunity • Cells target virus infected cellsCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide
    • Antigens (Nonself)• Any substance capable of exciting the immune system and provoking an immune response• Examples of common antigens • Foreign proteins • Nucleic acids • Large carbohydrates • Some lipids • Pollen grains • MicroorganismsCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide
    • Self-Antigens• Human cells have many surface proteins• Our immune cells do not attack our own proteins• Our cells in another person’s body can trigger an immune response because they are foreign • Restricts donors for transplantsCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide
    • Allergies• Many small molecules (called haptens or incomplete antigens) are not antigenic, but link up with our own proteins• The immune system may recognize and respond to a protein-hapten combination• The immune response is harmful rather than protective because it attacks our own cellsCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide
    • Cells of the Immune System• Lymphocytes • Originate from hemocytoblasts in the red bone marrow • B lymphocytes become immunocompetent in the bone marrow • T lymphocytes become immunocompetent in the thymus• Macrophages • Arise from monocytes • Become widely distributed in lymphoid organsCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide
    • Activation of Lymphocytes Figure 12.9Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide
    • Humoral (Antibody-Mediated) Immune Response• B lymphocytes with specific receptors bind to a specific antigen• The binding event activates the lymphocyte to undergo clonal selection• A large number of clones are produced (primary humoral response)Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide
    • Humoral (Antibody Mediated) Immune Response• Most B cells become plasma cells • Produce antibodies to destroy antigens • Activity lasts for four or five days• Some B cells become long-lived memory cells (secondary humoral response)Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide
    • Humoral Immune Response Figure 12.10Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide
    • Active Immunity• Your B cells encounter antigens and produce antibodies• Active immunity can be naturally or artificially acquired Figure 12.12Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide
    • Passive Immunity• Antibodies are obtained from someone else • Conferred naturally from a mother to her fetus • Conferred artificially from immune serum or gamma globulin• Immunological memory does not occur• Protection provided by “borrowed antibodies”Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide
    • Antibodies (Immunoglobulins) (Igs)• Soluble proteins secreted by B cells (plasma cells)• Carried in blood plasma• Capable of binding specifically to an antigenCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide
    • Antibody Classes• Antibodies of each class have slightly different roles• Five major immunoglobulin classes – (Do Not Need to know!) • IgM – can fix complement • IgA – found mainly in mucus • IgD – important in activation of B cell • IgG – can cross the placental barrier • IgE – involved in allergiesCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide
    • Cellular (Cell-Mediated) Immune Response• Antigens must be presented by macrophages to an immunocompetent T cell (antigen presentation)• T cells must recognize nonself and self (double recognition)• After antigen binding, clones form as with B cells, but different classes of cells are producedCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide
    • Cellular (Cell-Mediated) Immune Response Figure 12.15Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide
    • T Cell Clones• Cytotoxic T cells • Specialize in killing infected cells • Insert a toxic chemical (perforin)• Helper T cells • Recruit other cells to fight the invaders • Interact directly with B cellsCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide
    • T Cell Clones• Suppressor T cells • Release chemicals to suppress the activity of T and B cells • Stop the immune response to prevent uncontrolled activity• A few members of each clone are memory cellsCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide
    • Summary of the Immune Response Figure 12.16Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide
    • Organ Transplants and Rejection• Major types of grafts • Autografts – tissue transplanted from one site to another on the same person • Isografts – tissue grafts from an identical person (identical twin) • Allografts – tissue taken from an unrelated person • Xenografts – tissue taken from a different animal speciesCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide
    • Organ Transplants and Rejection• Autografts and isografts are ideal donors• Xenografts are never successful• Allografts are more successful with a closer tissue matchCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide
    • BASIC CONCEPTSComponents of the Immune System Major Histocompatibility Complex (MHC) – membrane molecules that help the immune system recognise the self from the non-self HLA – (Human Leukocyte Antigens) are human MHC proteins that were first detected on white blood cells; play a role in transplant rejection and are detected in immunologic tests
    • BASIC CONCEPTSMajor Histocompatibility Complex Key recognition molecules which is an essential feature of adaptive or specific immunity Able to discriminate between the body’s own molecules against foreign antigens Coded by closely linked genes in chromosome 6
    • BASIC CONCEPTSMajor Histocompatibility Complex (Two Classes): MHC I - differentiate viral infected and abnormal cells from normal cells MHC II - allow appropriate interactions among immune cells
    • Properties HLA antigens Distribution FunctionsClass I MHC HLA-A, HLA-B, Virtually all Present HLA-C nucleated cells processed (Human antigen to Leucocyte Antigen cytotoxic CD8 T- - helps the immune cells; restrict system distinguish the cytolysis to virus- bodys own proteins from proteins made by infected cells, foreign invaders such tumor cells and as viruses transplanted cells and bacteria. )Class II MHC HLA-DR, HLA-DP, Immune cells, Present HLA-DQ antigen- processed presenting cells, antigenic and macrophages fragments to CD4 T-cells; necessary for effective interaction among immune cells
    • OVERVIEW Normal cells and functionsb. Most normal human cells have 23 pairs of chromosomesc. All normal cells (except the sex cells and the mature red blood cells) have the entire human genome in every celld. Normal cells have about 35,000 genes, and about 50 of these genes are very active during embryonic lifee. Normal cells undergo mitosis either to develop normal tissue during embryonic development, childhood, and adolescence or to replace lost or damaged normal tissue
    • THE CELL CYCLE
    • THE CELL CYCLE The Cell Cycle – consists of 4 phases:2. Gap 1 (G1) – the cell enlarges and synthesizes proteins to prepare for DNA replication3. Synthesis (S) phase – DNA is replicated and the chromosomes in the cell are duplicated4. Gap 2 (G) – the cell prepares itself for mitosis5. Mitosis (M) phase – final step, where the parent cell divides into two exact copies called daughter cells, each having identical genetic material
    • THE CELL CYCLE The cells after the M phase immediately enter the G1 where they begin another cell cycle again Or the cells divert into a resting phase called G0 The cell cycle is controlled by cyclin-dependent kinases Some cyclins cause a “braking” action and prevent the cycle from proceeding Checkpoints in the cell cycle ensure that it proceeds in the correct order
    • THE CELL CYCLE A malfunction of any of these regulators of cell growth and division can result in the rapid proliferation of immature cells In some cases these proliferating immature cells are considered cancerous (malignant) Knowledge of the cell cycle events is used in the development of chemotherapeutic drugs, which are designed to disrupt the cancer cells during different stages of their cell cycle
    • OVERVIEW In embryonic life, there are early development genes called proto-oncogenes, and their activity is not needed after embryonic life Other genes are called tumor suppressor genes, which slow down cell division, repair DNA mistakes, and tell cells when to die (apoptosis, or programmed cell death) Tumor suppressor genes can also reduce expression of proto-oncogenes by negative feedback mechanisms Proto-oncogenes are not abnormal genes, and are part of every human’s normal cellular DNA
    • Normal Cell Reversible (homeostasis) Injury Stress Injurious Mild, stimulus transientAdaptation Cell Injury Inability to adapt Severe, progressive Irreversible Injury Necrosis CELL Apoptosis DEATH
    • OVERVIEW Adaptations are reversible changes in the size, number, phenotype, metabolic activity, or functions of cells in response to changes in their environmentl Hypertrophy – increase in the size of cells, resulting in an increase in the size of the organi Hyperplasia – an increase in the number in an organ or tissue, usually resulting in increased mass of the organ or tissuen Atrophy – reduced size of an organ or tissue resulting from a decrease in cell size and number
    • OVERVIEWa. Metaplasia – reversible change in which one differentiated cell type (epithelial or mesenchymal) is replaced by another cell typeb. Necrosis – cell deathc. Apoptosis – programmed cell deathd. Differentiation - process by which cells or tissues undergo a change toward a more specialized form or function, especially during embryonic developmente. Dysplasiaf. Anaplasia
    • OVERVIEWa. Dysplasia - abnormal development or growth of tissues, organs, or cellsb. Anaplasia - abnormal development or growth of tissues, organs, or cells
    • EPIDEMIOLOGY OF CANCER 2004 – The American Cancer Society estimates that 1,368,030 people will be diagnosed with cancer in the US Cancer continues to be the second leading cause of death in the US 62% of those diagnosed with cancer can expect to be alive in 5 years Incidence and mortality rates for cancer have dropped approximately 1% per year since 1991
    • EPIDEMIOLOGY OF CANCER The American Cancer Society has established the goal of a 25% reduction in the overall age- adjusted cancer incidence rate and a 50% reduction in the overall age-adjusted cancer mortality rate by 2015 Nurses should play a pivotal role in the attainment of these goals through active involvement in cancer prevention and early detection activities Survival rate represents the percentage of persons alive 5 years from now after diagnosis, whether cured, in remission, or with evidence of disease
    • Estimated New Cases Estimated New Deaths Male Female Male FemaleProstate (38%) Breast (32%) Lung and Lung andLung and Lung and bronchus (31%) bronchus (27%)bronchus (13%) bronchus (12%) Prostate (10%) Breast (15%)Colon and rectum Colon and rectum Colon and rectum Colon and rectum(10%) (11%) (10%) (10%)Urinary bladder Uterine corpus Pancreas (5%) Ovary (6%)(7%) (6%) Leukemia (4%) Pancreas (6%)Melanoma of the Non-Hodgkin Esophagus (4%) Leukemia (4%)skin (5%) lymphoma (4%) Liver and Non-HodgkinNon-Hodgkin Melanoma of the intrahepatic bile lymphoma (3%)lymphoma (4%) skin (4%) duct (3%) Uterine corpusKidney and renal Ovary (3%) Non-Hodgkin (3%)pelvis (3%) Thyroid (3%) lymphoma (3%) Multiple myelomaLeukemia (3%) Urinary bladder Kidney and renal (2%)Oral cavity and (2%) pelvis (3%) Brain and otherpharynx (3%) Pancreas (2%) All sites (100%) nervous systemPancreas (2%) All sites (100%) (2%)All sites (100%) All sites (100%)
    • Estimated Incidence (2008) Estimated Deaths (2008) Male Female Male FemaleMelanoma of the Melanoma of the Lung (31%) Brain (2%)skin (5%) skin (4%) Esophagus (4%) Lung (26%)Oropharynx (3%) Thyroid (4%) Liver (4%) Breast (15%)Lung (15%) Lung (14%) Pancreas (6%) Liver (2%)Pancreas (3%) Breast (26%) Kidney (3%) Pancreas (6%)Kidney (4%) Kidney (3%) Colon and rectum Colon and rectumColon and rectum Colon and rectum (8%) (9%)(10%) (10%) Urinary bladder Ovary (6%)Urinary bladder Ovary (3%) (3%) Uterus (3%)(7%) Uterus (6%) Prostate (10%) Leukemia (3%)Prostate (25%) Leukemia (3%) Leukemia (4%) Non-HodgkinLeukemia (3%) Non-Hodgkin Non-Hodgkin Lymphoma (3%)Hon-Hodgkin lymphoma (4%) Lymphoma (3%) All others (25%)lymphoma (5%) All others (23%) All others (24%)All others (20%) Robbins Pathologic Basis of Disease 8th edition
    • EPIDEMIOLOGY OF CANCER Risk factors2. Heredity – 5 to 10% of cancers have a hereditary component3. Age – 76% of cases occur after age 55; hormonal changes, immune system changes4. Gender5. Poverty6. Stress7. Diet8. Occupation9. Infection10. Tobacco use11. Alcohol use12. Recreational drug use13. Obesity – increased risk of hormone-dependent cancers14. Sun exposure
    • EPIDEMIOLOGY OF CANCER Endogenous risk factors:2. Genetic predisposition3. Sex4. Age5. Race6. Family history Exogenous risk factors:8. Alcohol9. Diet10.Exercise11.Occupational exposure12.Cigarette smoking13.Sexual activity
    • EPIDEMIOLOGY OF CANCERRisk Factors and Signs and Symptoms of Common CancersCancer Site Risk Factors Signs and SymptomsBreast Female gender Lump or mass Age >50 years Thickening in breast or Family history axilla Personal history of breast cancer Change in size or contour 2 or more first-degree relatives or texture Known BRCA1 or BRCA2 mutation Skin dimpling or retraction Biopsy history Peau d’orange skin Atypical hyperplasia Nipple discharge, DCIS or LCIS retraction, or scaliness Postmenopausal obesity Erythema Early menarche/late menopause Pain or tenderness Late first pregnancy/nulliparous OCP Radiation to chest wall Alcohol Obesity and high fat diet Hormone replacement therapy
    • EPIDEMIOLOGY OF CANCERRisk Factors and Signs and Symptoms of Common CancersCancer Site Risk Factors Signs and SymptomsProstate Male gender Weak urinary stream and Age >50 years urinary frequency African American ethnicity Difficulty in initiating Family history of first-degree stream or stopping urinary relative (greater if first-degree stream relative diagnosed before age 40) Pain or burning on High-fat diet urinationColorectal Age >60 years Urinary retention Inflammatory bowel conditions Hematuria Sedentary lifestyle Diet high in fat and low in fruits and vegetables Heavy alcohol consumption Family history of colorectal cancer especially if before the age of 40
    • EPIDEMIOLOGY OF CANCERRisk Factors and Signs and Symptoms of Common CancersCancer Site Risk Factors Signs and SymptomsProstate Male gender Weak urinary stream and Age >50 years urinary frequency African American ethnicity Difficulty in initiating Family history of first-degree stream or stopping urinary relative (greater if first-degree stream relative diagnosed before age 40) Pain or burning on High-fat diet urinationColorectal Familial genetic syndromes, e.g., Urinary in bowel habits Change retention familial adenomatous polyposis Hematuria Rectal bleeding (FAP) and hereditary nonpolyposis Abdominal pain colon cancer (HNPCC) Decreased diameter of stools Anemia Rectal pressure or pain Weight loss anorexia
    • EPIDEMIOLOGY OF CANCERRisk Factors and Signs and Symptoms of Common CancersCancer Site Risk Factors Signs and SymptomsLung Cigarette smoking Chronic cough and Occupational exposure to asbestos, wheezing arsenic, chromium, coal products, Persistent respiratory nickel refining, smelter workers, infections ionizing radiation, radon Dull chest pain Hemoptysis Dyspnea Weight loss
    • EPIDEMIOLOGY OF CANCER Carcinogensb. Virusesc. Drugs and hormones – can be either genotoxic or promotionald. Chemical agents – both genotoxic and promotionale. Physical agents – for example radiation
    • Chemical Carcinogens and Relationship to OccupationChemical Agent Action OccupationPolycyclic hydrocarbons Genotoxic Miners, coal/gas(smoke, soot, tobacco, workers, chimnersmoked foods) sweeps, migrant worker, workers in offices whereBenzopyrene Genotoxic smoking is allowed Pesticide manufacturers,Arsenic miningVinyl chloride Promotional Plastic workers ArtistisMethylaminobenzine Genotoxic Fabric workers Rubber and glue workers
    • Chemical Carcinogens and Relationship to OccupationChemical Agent Action OccupationAsbestos Promotional Construction workers, workers in old, run-down buildings with asbestos insulation, insulation makersWood and leather dust Promotional Woodwrokers, carpenters, leatherChemotherapy drugs Genotoxic toolers Drug manufacturers, pharmacists, nurses
    • Occupational CancersAgent Cancer Typical use or occurrenceArsenic and arsenic Lung, skin, Byproduct of metalcompounds hemangiosarcoma smelting; component of alloys, electrical and semiconductor devises, medications and herbicides, fungicides, and animal dipsAsbestos Lung, mesothelioma, Formerly used for many esophagus, stomach, applications because of large intestine fire, heat and friction resistance, still found in existing construction as well as fire-resistant textiles, friction materials (brake linings), underlayment and roofing papers, floor tiles
    • Occupational CancersAgent Cancer Typical use or occurrenceBenzene Leukemia, Hodgkin Principal component of lymphoma light oil, despite known risk, many applications exist in printing and lithography, paint, rubber, dry cleaning, adhesives and coatings, and detergents, formerly widely used as solvent and fumigantBeryllium and beryllium Lung Missile fuel and spacecompounds vehicles, hardener for lightweight metal alloys, particularly in aerospace applications and nuclear reactors
    • Occupational CancersAgent Cancer Typical use or occurrenceChromium compounds Lung Component of metal alloys, paints, pigments, and preservativesNickel compounds Nose, lung Nickel plating, component of ferrous alloys, ceramics, and batteries, by-product of stainless steel arcRadon and its decay Lung welding From decay of mineralsproducts containing uranium, potentially serious hazard in quarries and underground minesVinyl chloride Angiosarcoma Refrigerant, monomer for vinyl polymers, adhesive for plastics, formerly inert aerosol propellant un pressurized containers
    • Occupational CancersAgent Cancer Typical use or occurrenceCadmium and cadmium Prostate Uses include yellowcompounds pigments and phosphors; found in solders; used in batteries and as alloy and in metal platings and coatings
    • EPIDEMIOLOGY OF CANCER HSV types I and IIb. Carcinoma of the lipc. Cervical carcinomad. Kaposi sarcoma Human CMVf. Kaposi sarcomag. Prostate carcinoma
    • EPIDEMIOLOGY OF CANCER EBVa. Burkitt lymphoma HBVa. Primary HCC Papillomavirusf. Malignant melanomag. Cervical, penile, and laryngeal cancers HTLVi. Adult T-cell leukemia and lymphomaj. Kaposi sarcoma
    • EPIDEMIOLOGY OF CANCER Approximately three fourths of all cancers occur in people over the age of 55 Overall cancer incidence in males has stabilized in recent years when compared with that in females Men have a higher lifetime probability of developing and dying of cancer than women, but men have a greater recent decline in death rates Children – overall, cancer is the leading cause of death due to disease in children between 1 and 14 years of age
    • EPIDEMIOLOGY OF CANCERCause of Death by AgeAge (years) Males Females20-39 1. Brain/CNS 1. Breast 2. Leukemia 2. Uterine/cervix 3. Lung 3. Leukemia40-59 1. Lung 1. Breast 2. Colorectal 2. Lung 3. Pancreas 3. Colorectal60-79 1. Lung 1. Lung 2. Colorectal 2. Breast 3. Prostate 3. Colorectal>80 1. Lung 1. Lung 2. Prostate 2. Colorectal 3. Colorectal 3. Breast
    • THE ROLE OF THE NURSE Education Monitoring Documentation Proper referral Being up to date