The Fight against Immune Deficiency Disorders (IDD)

Setting the perspective 3 billion people worldwide are suffering from malnutrition and immune deficiencies - Global Alliance For Improved Nutrition (GAIN) 15 million people in Southern Africa are affected by malnutrition and poverty 26 million people in the SADC region are infected with HIV and AIDS “ The progress of opportunistic diseases can be significantly retarded with appropriate nutrition and immune enhancing nutrients ” World Health Organisation (WHO)

3 billion people worldwide are suffering from malnutrition

and immune deficiencies - Global Alliance For Improved

Nutrition (GAIN)

15 million people in Southern Africa are affected by

malnutrition and poverty

26 million people in the SADC region are infected with HIV

and AIDS

What is Immunity and The Immune System

What is Immunity? Active natural (contact with infection): develops slowly, is long term, and antigen specific. Active artificial (immunization): develops slowly, lasts for several years, and is specific to the antigen for which the immunization was given. Passive natural (trans-placental = mother to child): develops immediately, is temporary, and affects all antigens to which the mother has immunity. Passive artificial (injection of gamma globulin): develops immediately, is temporary, and affects all antigens to which the donor has immunity. Immunity can be either natural or artificial , innate or acquired=adaptive , and either active or passive:

Active natural (contact with infection): develops slowly, is long term, and antigen specific.

Active artificial (immunization): develops slowly, lasts for several years, and is specific to the antigen for which the immunization was given.

Passive natural (trans-placental = mother to child): develops immediately, is temporary, and affects all antigens to which the mother has immunity.

Passive artificial (injection of gamma globulin): develops immediately, is temporary, and affects all antigens to which the donor has immunity.

Immune System - organs primary organs : bone marrow (in the hollow center of bones) and the thymus gland (located behind the breastbone above the heart), and secondary organs at or near possible portals of entry for pathogens: adenoids, tonsils, spleen (located at the upper left of the abdomen), lymph nodes (along the lymphatic vessels with concentrations in the neck, armpits, abdomen, and groin), Peyer's patches (within the intestines), and the appendix.

primary organs : bone marrow (in the hollow center of bones) and the thymus gland (located behind the breastbone above the heart), and

secondary organs at or near possible portals of entry for pathogens: adenoids, tonsils, spleen (located at the upper left of the abdomen), lymph nodes (along the lymphatic vessels with concentrations in the neck, armpits, abdomen, and groin), Peyer's patches (within the intestines), and the appendix.

Immune system / organ functioning

Major cells and proteins of the Immune system The immune system isn't located in just one part of the body . The thymus, liver, bone marrow, tonsils, lymph nodes, spleen, and blood all have a role in the immune response. These organs help make, store and transport the cells and proteins that fight foreign invaders. The major cells and proteins of the immune system are: B-cells (also called B-lymphocytes) T-cells (also called T-lymphocytes) Phagocytes — "Eater Cells" Complement —Special Proteins

The immune system isn't located in just one part of the body . The thymus, liver, bone marrow, tonsils, lymph nodes, spleen, and blood all have a role in the immune response. These organs help make, store and transport the cells and proteins that fight foreign invaders.

The major cells and proteins of the immune system are:

B-cells (also called B-lymphocytes)

T-cells (also called T-lymphocytes)

Phagocytes — "Eater Cells"

Complement —Special Proteins

T lymphocytes – the cell T lymphocytes become CD4+ or helper T cells, or they can become CD8+ cells, which in turn can become killer T cells, also called cytotoxic T cells. Immune system process

T lymphocytes become CD4+ or helper T cells, or they can become CD8+ cells, which in turn can become killer T cells, also called cytotoxic T cells.

Immune system process

T lymphocytes – the cell activated Activation of helper T cells Activation of cytotoxic T cells

Activation of

helper T cells

B lymphocytes – the cell Activation of B cells to make antibody B cells become plasma cells, which produce antibodies when a foreign antigen triggers the immune response

Activation of B cells

to make antibody

Integrated working of the Immune system

What is Immunodeficiency disorder?

Immunodeficiency Disorders A primary immune deficiency occurs when the abnormalities of the immune system develop from an inborn defect in the cells. Affected cells include T-cells , B-cells , phagocytic cells or the complement system . There is overwhelming evidence that the majority of secondary immune deficiency disorders have as part of their cause some type of external environmental infection. This can be viral, bacterial, fungal, protozoa and various other types of parasites.

A primary immune deficiency occurs when the abnormalities of the immune system develop from an inborn defect in the cells. Affected cells include T-cells , B-cells , phagocytic cells or the complement system .

Primary Immunodeficiency disorders The most primary immune deficiencies are inherited diseases. Examples are: a include X-linked agammaglobulinemia (XLA), severe combined immunodeficiency (SCID), and variable immunodeficiency (CVID), etc. The causes of the defects are unknown and genetic factors cannot be ruled out

The most primary immune deficiencies are inherited diseases. Examples are:

a include X-linked agammaglobulinemia (XLA),

severe combined immunodeficiency (SCID), and

variable immunodeficiency (CVID), etc.

Secondary Immunodeficiency disorders Alternative examples of secondary immune deficiencies are: Flu Tuberculosis (TB) Pneumonia AIDS (HIV) Bird Flu (virus H5N1) Congo Fever (Ebola Virus ) Secondary immune deficiencies occur when damage is caused by environmental factors. Such as: Radiation Chemotherapy Burns and furthermore infections contribute to the many causes of secondary immune deficiencies.

Alternative examples of secondary immune deficiencies are:

Flu Tuberculosis (TB)

Pneumonia AIDS (HIV)

Bird Flu (virus H5N1) Congo Fever (Ebola Virus )

Immunodeficiency disorders A Summary

IMMUNODEFICIENCY AND MALNUTRITION Malnutrition with immunodeficiency and infection is the World’s leading cause of infant and child deaths Ref: The Merck Manual 16 th Edition Pg. 317

Malnutrition with immunodeficiency and infection is the World’s leading cause of infant and child deaths

Ref: The Merck Manual 16 th Edition Pg. 317

MARASMUS OR KWASHIOKOR Malnutrition is caused due to a deficiency of all nutrient’s ( MARASMUS ) or primarily of protein deficiency ( KWASHIOKOR ), usually with superimposed vitamin and mineral deficiencies. e.g. ( vitamin A , Iron , Zinc ) When malnutrition is severe enough to reduce your weight to < 80% of the expected mean, impairment of the immune function is noted. Ref: Merck Manual Pg 317

Malnutrition is caused due to a deficiency of all nutrient’s ( MARASMUS ) or primarily of protein deficiency ( KWASHIOKOR ), usually with superimposed vitamin and mineral deficiencies. e.g. ( vitamin A , Iron , Zinc )

When malnutrition is severe enough to reduce your weight to < 80% of the expected mean, impairment of the immune function is noted.

Ref: Merck Manual Pg 317

IMMUNE IMPAIRMENT The degree of immune impairment depends on the degree and duration of malnutrition, and on underlying illness e.g. Infection and other nutritional deficiencies With nutritional rehabilitation , the immunologic defect reverses rapidly Ref: Merck Manual Pg 318

The degree of immune impairment depends on the degree and duration of malnutrition, and on underlying illness e.g. Infection and other nutritional deficiencies

With nutritional rehabilitation , the immunologic defect reverses rapidly

Ref: Merck Manual Pg 318

Nutritional Supplementation An organism as complex as the human body is an ordered aggregation of cells . Each cell obtains the nutrients essential for its well-being from the circulating extra cellular interstitial fluid in which it is bathed Sound nutrition depends on a proper dietary regimen, or food intake. This must include the six major components of the diet namely: Carbohydrates Proteins Fats Vitamins Minerals Water Reference : Biochemistry . A case – orientated Approach pg. 1&2

An organism as complex as the human body is an ordered aggregation of cells . Each cell obtains the nutrients essential for its well-being from the circulating extra cellular interstitial fluid in which it is bathed

Sound nutrition depends on a proper dietary regimen, or food intake. This must include the six major components of the diet namely:

HOMEOSTASIS The internal cellular composition must be kept constant within narrow limits , otherwise the human dies The maintenance of this stable internal environment is termed Homeostasis It can thus clearly be seen that in order for the human body to be in Homeostasis it needs a fully balanced diet consisting of all six the principal food components Reference: Biochemistry A Case – orientated approach pg. 3

The internal cellular composition must be kept constant within narrow limits , otherwise the human dies

The maintenance of this stable internal environment is termed Homeostasis

It can thus clearly be seen that in order for the human body to be in Homeostasis it needs a fully balanced diet consisting of all six the principal food components

Reference: Biochemistry A Case – orientated approach pg. 3

IMMUNE NETWORKS The immune system consists of individual components and it operates as a whole, not one of the components operates autonomously. In any given immune response, the components function in concert, tandem or are in conflict Ref: The Merck Manual 16 th Editiopg.288

The immune system consists of individual components and it operates as a whole, not one of the components operates autonomously.

In any given immune response, the components function in concert, tandem or are in conflict

Ref: The Merck Manual 16 th Editiopg.288

CONCLUSION With reference to the above it is clear that that the Immune System is complex One or two supplements is NOT enough to boost the whole immune system One needs to supplement the whole diet to enhance the body to maintain and obtain Homeostasis

With reference to the above it is clear that that the Immune System is complex

One or two supplements is NOT enough to boost the whole immune system

One needs to supplement the whole diet to enhance the body to maintain and obtain Homeostasis

HOMEOSTASIS AND THE IMMUNE SYSTEM Simplistically we can say that Homeostasis = Immune system = CD4 = Correct diet A body in homeostasis produces 1-2 billion CD4 cells in 24 hours

Simplistically we can say that Homeostasis = Immune system = CD4 = Correct diet

A body in homeostasis produces 1-2 billion CD4 cells in 24 hours

HIV VIRUS HIV can produce up to 10 Billion viruses in 24 hours An important cause for a CD4 decline over time is failure of the body to regenerate enough CD4 cells (2 billion against 10 billion HIV) resulting in an impaired immune system If the body is fed correctly it can produce more CD4 cells, thus enhancing its immune system and fight HIV over a longer period of time

HIV can produce up to 10 Billion viruses in 24 hours

An important cause for a CD4 decline over time is failure of the body to regenerate enough CD4 cells (2 billion against 10 billion HIV) resulting in an impaired immune system

If the body is fed correctly it can produce more CD4 cells, thus enhancing its immune system and fight HIV over a longer period of time

A generalized graph of the relationship between HIV copies (viral load) and CD4 counts over the average course of untreated HIV infection; any particular individual's disease course may vary considerably. ---- CD4+ T cell count (cells per µL) ----- HIV RNA copies per mL of plasma Wikipedia ® Encyclopedia .