Psychoimmunology is the relation of immunity with the psychiatric Illness

1. PSYCHOIMMUNOLOGY
Javaid Ahmad Mir
PhD Nursing Scholar

2. IMMUNITY
• Immunis literally means exempt/free from
burden.
• Immunity broadly involves the resistance shown,
and protection offered by the host organism
against the infectious diseases.

3. TYPES OF IMMUNITY
 INNATE IMMUNITY
 ACQUIRED IMMUNITY

4. INNATE IMMUNITY
Innate immunity is non-specific, and represents the
inherent capability of the organism to offer resistance
against diseases. Simply, Innate, or nonspecific,
immunity is the defense system with which one is
born.
Examples of innate immunity include:
• Cough reflex
• Enzymes in tears and skin oils
• Mucus, which traps bacteria and small particles
• Skin
• Stomach acid.

5. FIRST LINE OF DEFENCE
• The skin is the largest organ in the human body,
• constituting about 15% of the adult body weight.
• The skin provides mechanical barrier to prevent the entry of
microorganisms and viruses.
• The acidic (pH 3-5) environment on the skin surface inhibits
the growth of certain microorganisms.
• Further, the sweat contains an enzyme lysozyme that can
destroy bacterial cell wall.

6. SECOND LINE OF DEFENCE
The body tries to kill the pathogens by phagocytosis (involving macrophages
and complement system).
Innate immunity includes the following :
• Phagocytosis of bacteria and other invaders by white blood cells and cells
of the tissue macrophage system.
• Destruction of swallowed organisms by the acid secretions of the stomach
and the digestive enzymes.
• Resistance of the skin to invasion by organisms.
• Presence in the blood of certain chemical compounds that attach to foreign
organisms or toxins and destroy them (Lysozymes, Natural killer
lymphocytes, etc)

8. ACQUIRED IMMUNITY
o Acquired immunity is caused by a special immune system that
forms antibodies and/or activated lymphocytes that attack and
destroy the specific invading organism or toxin.
o For instance, certain toxins such as the paralytic botulinum toxin or
the tetanizing toxin of tetanus can be protected against in doses as
high as 100,000 times the amount that would be lethal without
immunity. This is the reason the treatment process known as
immunization is so important in protecting human-beings against
disease and against toxins.

9. The Immune System Consists Of Several Organs Distributed
Throughout The Body. The Lymphoid Organs Are
Categorized As Primary And Secondary.
ORGANIZATION OF IMMUNE
SYSTEM :

10. PRIMARY LYMPHOID
ORGANS ;
• These organs provide appropriate micro-
environment for the development and maturation of
antigen-sensitive lymphocytes (a type of white
blood cells).
• The thymus (situated above the heart) and bone-
marrow are the central or primary lymphoid
organs.
• T-lymphocyte maturation occurs in the thymus
while
• B-lymphocyte maturation takes place in the bone
marrow.

11. SECONDARY LYMPHOID ORGANS
;
• These are the sites for the initiation of immune
response. e.g. spleen, tonsils, lymph nodes,
appendix, Peyer's patches in the gut.
• Secondary lymphoid organs provide the micro-
environment for interaction between antigens and
mature lymphocytes.

13. CELLS OF THE IMMUNE SYSTEM

14. B-lymphocytes :
• Mature and develop within the bone marrow itself.
• B-cells mature into plasma cells and secrete
antibodies (immunoglobulin).
• B lymphocytes provide the body with humoral
immunity as they circulate in the fluids in search of
specific foreign invaders to destroy.
• The B-cells possess the capability to specifically
recognize each antigen and produce antibodies.

16. T-lymphocytes
• From the bone marrow, one group of lymphocytes
migrates to a gland called the thymus and become T
lymphocytes or T cells.
• T-lymphocytes are responsible for the cell-mediated
immunity.
• The maturation of T-cells occurs in the thymus.

17. The T-cells mature into
several different types :
 Inducer T-cells
 Cytotoxic T-cells (TC)
 Helper T-cells (TH)
 Suppressor T-cells
 Memory cells

19. MAJOR HISTOCOMPATIBILITY
COMPLEX (MHC) :
• The major histocompatibility complex (MHC) represents a special
group of proteins, present on the cell surfaces of T-lymphocytes. MHC
is involved in the recognition of antigens of T-cells. It may be noted
here that the B-cell receptors (antibodies) can recognize antigens on
their own, while T-cells can do so through the mediation of MHC.
• The major histocompatibility complex in humans is referred to as
human leukocyte antigen (HLA).

21. COMPLEMENT SYSTEM
The complement system is composed of about 20 plasma
proteins. The complement system is a part of the
immune system that enhances (complements) the ability
of antibodies and phagocytic cells to clear microbes and
damaged cells from an organism, promotes inflammation,
and attacks the pathogen's plasma membrane.

22. FUNCTIONS:-
Complement triggers the following immune functions:[5]
• Phagocytosis – by opsonizing antigens. C3b has most
important opsonizing activity
• Inflammation – by attracting macrophages and
neutrophils
• Membrane attack – by rupturing cell wall of bacteria

26. THE IMMUNE RESPONSE :
The immune response refers to the series of reactions carried out by the
immune system in the body against the foreign invader. When an infection
takes place or when an antigen enters the body, it is trapped by the
macrophages in lymphoid organs. Cells responsible for nonspecific immune
reactions include neutrophils, monocytes and macrophages. They work to
destroy the invasive organism and initiate and facilitate damaged tissue. If
these cells are not effective in accomplishing a satisfactory healing response,
specific immune mechanisms take over

27. Specific immune mechanisms are divided into
two major types:
 The cellular response and
 The humoral response

28. NORMAL IMMUNE
RESPONSE
When the body is invaded by a specific antigen, the T-cells, and particularly the CD4 T-
lymphocytes (also called helper T-cells), become sensitized to and specific for the foreign
antigen. These antigen-specific CD 4 T-cells divide many times, producing antigen-
specific CD4 T-cells with other functions. One of these, the killer T-cells, destroys viruses
that reproduce inside other cells by puncturing the cell membrane of the host cell and
allowing the contents of the cells, including viruses, to spill out into the bloodstream,
where they can be engulfed by macrophages. Another cell produced through division of the
CD4 T-cells is the suppressor T-cell, which serves to stop the immune response once the
foreign antigen has been destroyed (Scanlon & Sanders, 2011).

29. The humoral response is activated when antigen-specific CD4 T-cells
communicate with the B-cells in the spleen and lymph nodes. The B-cells
in turn produce the antibodies specific to the foreign antigen. Antibodies
attach themselves to foreign antigens so that they are unable to invade
body cells. These invader cells are then destroyed without being able to
multiply.

30. NORMAL IMMUNE RESPONSE

32. IMPLICATIONS OF THE IMMUNE
SYSTEM IN PSYCHIATRIC-ILLNESS
An implication is something that is suggested, or
happens, indirectly

33. In studies of the biological response to stress, it has been
hypothesized that individuals become more susceptible to
physical illness following exposure to a stressful stimulus or
life event. This response is thought to be due to the effect of
increased glucocorticoid release from the adrenal cortex
following stimulation from the hypothalamic-pituitary-
adrenal axis during stressful situations.
The result is a suppression of lymphocyte proliferation
and function.

34. Studies have shown that nerve-endings exist in tissues of the immune
system. The CNS has connections both in bone-marrow and thymus, where
immune system cells are produced, and in the spleen and lymph nodes,
where those cells are stored.

35. • Growth hormone, which may be released in response to
certain stressors, may enhance immune functioning
• Testosterone is thought to inhibit immune functioning
• Increased production of epinephrine and nor-epinephrine
occurs in response to stress and may decrease immunity
• Serotonin has demonstrated both enhancing and
inhibitory effects on immunity.

36. Schizophrenia and the Immune System :
• There is a considerable amount of evidence that schizophrenic patients
have longer healing times after major surgeries.
• A study investigated the levels of plasma interleukin in the blood of
twenty-five control and schizophrenics during all stages of the surgery
process of hemicolectomy and sigmoidectomy. Plasma IL-8 levels were
significantly lower in the schizophrenic patients after surgery.
• Plasma cortisol concentrations were significantly lower during surgery for
the schizophrenic patients as well.
• The conclusion of the study was that schizophrenic patients had a reduced
ability for cytokine to fight inflammations.
• The reason for the findings could be explained by a schizophrenic's
hypothalamus-pituitary-adrenal dysfunction.

37. Kiecolt-Glaser et al., (1984) : A study was
conducted;
Procedure:
This was a natural experiment. The researchers
took blood samples from 75 first year medical
students (49 males and 26 females), all of whom
were volunteers.
Blood samples were taken:
(a) one month before their final examinations
(relatively low stress), and
(b) during the examinations (high stress).
Immune functioning was assessed by
measuring T cell activity in the blood samples.
The students were also given questionnaires to
assess psychological variables such as life events
and loneliness.
AIM: To investigate whether stress of important examinations has an effect on the
functioning of the immune system

38. • Findings: The blood sample taken from the first group
(before the exam) contained more t-cells compared with
blood samples taken during the exams. The volunteers
were also assessed using behavioral measures. On both
occasions they were given questionnaires to assess
psychiatric symptoms, loneliness and life events.
• Kiecolt-Glaser et al found that immune responses were
especially weak in those students who reported feeling
most lonely, as well as those who were experiencing other
stressful life events and psychiatric symptoms such as
depression or anxiety.