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  1. 1. IMMUNITY Dr. Hayat AL AKOUM
  2. 2. 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 bacteria, viruses or fungi.  Immunology: the study of our protection from foreign macromolecules or invading microorganisms and our responses to them.
  3. 3. DEFINITION OF TERMS  Immunity: ability to resist damage from foreign substances.  Antigen: any 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.
  4. 4. DEFINITION OF TERMS Epidemiology: study of how disease is produced, and its distribution in a given population. Pathogens: microorganisms or proteinaceous substances capable of producing disease. Virulence: ability to cause diseases
  5. 5. DEFINITION OF TERMS  Nosocomial infections: acquired in a health care setting  Immunocompetent : client whose immune system is able to identify antigens and effectively destroy or remove them.  Immunocompromised: client whose immune system is unable to effectively destroy or remove antigens  Mast cells: tissue cells that resemble a peripheral blood basophil and that contains granules with chemical mediators.
  6. 6. THE IMMUNE SYSTEM An antigen (invading bacteria) enters the body. A macrophage attacks the antigen and retains some of the antigen’s protein on its surface. The macrophage carries the protein markers to lymphoid tissue; T-lymphocytes interpret them as foreign. Antibodies attack the antigens.
  7. 7. FUNCTIONS OF THE IMMUNE SYSTEM  Defend and protect the body from infection by bacteria, viruses, fungi and parasites.  Removing and destroying damaged or dead cells.  Identifying and destroying malignant cells, thereby preventing their further development into tumors.
  8. 8. IMMUNE SYSTEM COMPONENTS 1. Leukocytes 1. Engulf and destroy pathogens (bacteria) 2. Suppress inflammation 3. Fight parasitic infections 4. Produce antibodies and provide immunity a. Granulocytes- immediate response to cell injury • Neutrophils- phagocytic, first cell to site of cell injury • Eosinophils- hypersensitivity reaction • Basophil-inflammatory response b. Agranulocytes- fight infection • Monocytes –phagocytosis • Lymphocytes- production of immunoglobulins
  9. 9. Class Percentage of Total Characteristics and Functions IgG 75% Found in blood, lymph, and intestines Active against bacteria, its toxins and viruses Enhances phagocytosis, crosses placenta and is active in a second response IgA 10-15% Saliva, tears, bronchial, GI, prostatic and vaginal secretions Provides local protection on exposed mucous membrane surfaces and potent antiviral activity Prevents absorption of antigens from food, and protects against respiratory, GI, and GU infections IgM 5-10% Levels decrease during stress Found in blood and lymph First antibody produced with primary immune response High concentrations early in infection, decrease within about a week IgD <1% Unknown function, found in blood and lymph IgE <0.1% Found on mast cells and basophils Involved in immediate hypersensitivity response IMMUNOGLOBULIN CHARACTERISTICS AND FUNCTIONS
  10. 10. IMMUNE SYSTEM COMPONENTS 2. The lymphoid system  Lymph nodes  Spleen  Thymus  Bone marrow
  11. 11. CELLS INVOLVED IN THE IMMUNE SYSTEM  Macrophages  B-cells  T-cells  NK-cells
  12. 12. FACTORS CONTRIBUTING TO HIGH RISK OF INFECTION IN OLDER ADULTS  High prevalence of chronic conditions  High rate of hospitalization and institutionalization  Age-related changes
  13. 13. INTERVENTIONS TO STRENGTHEN THE IMMUNE SYSTEM  Promote good general health.  Assure immunizations are current.  Encourage foods that have positive effect on immunity  Assist patient to maintain skin integrity.  Teach stress management techniques.  Encourage regular exercise.  Counsel against overuse of antibiotics.  Teach infection control measures.  Adhere to strict infection prevention measures.
  14. 14. EFFECTS OF AGING ON THE IMMUNE SYSTEM  Thymus gland progressively declines in size.  Immature T-cells increase.  T-cell function declines.  Cell-mediated immunity is deficient.  Serum distribution of IgA and IgG increase.  Serum distribution of IgM and IgD decrease.  Antibody response to vaccines is reduced.  Skin loses macrophages.
  15. 15. EFFECTS OF FASTING ON THE IMMUNE SYSTEM  Increased:  Macrophage activity  Immunoglobulin levels  Neutrophil antibacterial activity  Improvement of:  Cell-mediated immunity  Ability of monocytes to kill bacteria  Natural killer cell activity  Reductions in:  Free radicals  Antioxidant damage
  16. 16. FACTORS AFFECTING THE IMMUNE SYSTEM  Diet  Exercise  Immunization  Stress  Mind-body connection  Antibiotic use
  17. 17. ORGANS INVOLVED IN STRESS RESPONSE  Thymus  Spleen  Lymph nodes  Stress can affect the function of the immune system.
  18. 18. STRESS REDUCTION MEASURES  Progressive relaxation  Meditation  Prayer  Yoga  Imagery  Exercise  Diversional activity
  19. 19. TRAITS CONSISTENT WITH A STRONG IMMUNE SYSTEM  Assertiveness  Faith in God or a higher power  Ability to trust and offer unconditional love  Willingness to be open and confide in others  Purposeful activity  Control over one’s life  Acceptance of stress as a challenge rather than a threat  Altruism  Development and exercise of multiple facets of personality
  20. 20. PROMOTING SAFE ANTIBIOTIC USE  Assist patients in health promotion efforts.  Adhere to strict infection control practices.  Use alternatives to antibiotics whenever possible.  Educate about the realities and risks of antibiotics.  Advise patients not to save and use antibiotics for future illnesses.
  21. 21. Lymphobla sts Suppressor T- cells DEVELOPMENT OF CELLS IN THE IMMUNE SYSTEM
  22. 22. FACTORS INVOLVED IN INFECTION  Portal of entry  Virulence of organism  Aggressiveness  Toxin production  Dose (number) of pathogens  Individual condition (predisposition) to infection
  23. 23. TYPES OF BODY DEFENSES AGAINST DISEASE  Nonspecific defenses  Effective against any harmful agent  Specific defenses  Effective against a certain agent only
  24. 24. NONSPECIFIC IMMUNITY  Nonspecific immunity is composed of successive lines of defense.  First line of defense: barriers  Second line of defense: internal nonspecific responses  Specific immunity is the final line of defense.
  25. 25. NONSPECIFIC IMMUNITY THE FIRST LINE OF DEFENSE Barriers  Skin  Mucous membranes  Body secretions  Body reflexes  Sneezing  Coughing  Vomiting  Diarrhea
  26. 26. NONSPECIFIC IMMUNITY THE SECOND LINE OF DEFENSE  Nonspecific Reponses Phagocytosis  Neutrophils  Macrophages  Natural killer cells  Inflammation  Fever  Interferon  Complement
  27. 27. NONSPECIFIC IMMUNITY Phagocytosis White blood cells take in and destroy waste and foreign material.  Neutrophils  Macrophages Natural Killer Cell  Type of lymphocyte found in lymph nodes, spleen, bone marrow, blood  Recognizes body cells with abnormal membranes and secretes protein that breaks down cell membrane
  28. 28. NONSPECIFIC IMMUNITY Inflammation  Infection is inflammation caused by pathogens  Inflammatory reaction  Heat, redness, swelling, pain  Cells release histamine  Leukocytes enter tissue  Granulocytes, macrophages, mast cells  Leukocytes and plasma produce inflammatory exudate  Pus is produced  Lymph nodes enlarge
  29. 29. FACTORS THAT MAY IMPAIR HEALING Factors Effect Malnutrition Protein deficient Prolongs inflammation and impairs healing process Carbohydrates and kilocalorie deficient Impairs metabolic process; proteins are used for energy rather than healing Vitamin deficits Vit. A Limits epithelialization and capillary formation B-complex Inhibits enzymatic reaction that contributes to wound healing Vit. C Impairs collagen synthesis Tissue Hypoxia Associated with an increase risk of infection and impaired healing Impaired blood supply Inadequate delivery of Oxygen and nutrients
  30. 30. NONSPECIFIC IMMUNITY FEVER  As phagocytes work, they release substances that raise body temperature.  Stimulates phagocytes  Increases metabolism  Decreases some organisms’ ability to multiply
  31. 31. NONSPECIFIC IMMUNITY INTERFERON  Group of substances that prevent nearby cells from producing more virus  IFN α (alpha)  IFN β (beta)  IFN γ (gamma)  Also acts nonspecifically on immune system cells
  32. 32. NONSPECIFIC IMMUNITY COMPLEMENT Specialized proteins in blood that are activated by immune responses Functions:  Coats foreign cells  Destroys cells  Promotes inflammation  Attracts phagocytes
  33. 33. SPECIFIC IMMUNITY Power to overcome a specific disease agent Characteristics  Specific response to specific pathogens  Acquired over lifetime  Stimulated by antigens
  34. 34. SPECIFIC IMMUNITY Antigens  Foreign substances that  Enter body  Induce immune response of certain lymphocytes  T cells  B cells
  35. 35. SPECIFIC IMMUNITY T Cells  Originate in red bone marrow  Mature in thymus  Become sensitized to specific antigens  Provide cell-mediated immunity
  36. 36. SPECIFIC IMMUNITY Types of T cells  Cytoxic T cells  Helper T cells  Regulatory T cells  Memory T cells Stimulated by antigen-presenting cells  Macrophages  Dendritic cells
  37. 37. SPECIFIC IMMUNITY B Cells  Originate and mature in red bone marrow  Produce antibodies  Provide humoral immunity Cell types  Plasma cells  Secrete antibodies  Memory b cells
  38. 38. SPECIFIC IMMUNITY FUNCTIONS OF ANTIBODIES  Bind antigen  Promote phagocytosis  Activate nk cells  Neutralize toxins  Activate complement
  39. 39. SPECIFIC IMMUNITY TYPES OF SPECIFIC IMMUNITY  Naturally acquired immunity  Natural active immunity  Natural passive immunity  Artificially acquired immunity  Artificial active immunity  Artificial passive immunity
  40. 40. SPECIFIC IMMUNITY NATURALLY ACQUIRED IMMUNITY  Natural active immunity  Acquired through contact with a specific disease organism  Natural passive immunity  Acquired through transmission of maternal antibodies to fetus and baby
  41. 41. SPECIFIC IMMUNITY ARTIFICIALLY ACQUIRED IMMUNITY  Artificial active immunity  Acquired through contact with a vaccine  Artificial passive immunity  Acquired through delivery of manufactured antibodies to individual
  42. 42. SPECIFIC IMMUNITY TYPES OF VACCINES  Live  Attenuated  Toxoid Killed by heat or chemicals  Antigenic component  Genetically engineered
  43. 43. SPECIFIC IMMUNITY BOOSTERS  Active immunity does not always last a lifetime  Repeated inoculations (booster shots) help maintain high titer of antibodies in the blood  Number and timing varies with vaccines
  44. 44. DISORDERS OF THE IMMUNE SYSTEM  Allergy  Hypersensitivity  Anaphylaxis  Autoimmunity  Immune deficiency diseases  Congenital  Acquired (e.g., AIDS)  Multiple myeloma
  45. 45. DISORDERS OF THE IMMUNE SYSTEM ALLERGY  Abnormal reactivity to one’s own tissues  Factors  Disease  Loss of immune system control  Cross-reaction of antibodies and self antigens  Treatments  Immune-suppressing drugs  Chemotherapy/stem cell replacement
  46. 46. DISORDERS OF THE IMMUNE SYSTEM  Failure of immune system  May involve any part of system  Varies in severity  Congenital or acquired (e.g., AIDS)  HIV  A retrovirus; uses reverse transcriptase enzyme
  47. 47. DISEASE DISORDERS OF THE IMMUNE SYSTEM MULTIPLE MYELOMA  Cancer of blood-forming bone marrow cells  Effects of disease  Lowered resistance to infection  Anemia  Bone pain  Bone tissue loss  Kidney failure  Treatment  Chemotherapy  Bone marrow transplants
  48. 48. THE IMMUNE SYSTEM AND CANCER  Immune surveillance  Declines with age  Immunotherapy  T cells activated with interleukin  Vaccines
  49. 49. TRANSPLANTATION AND REJECTION SYNDROME  Rejection syndrome caused by normal antigen– antibody reaction  Reduced by  Tissue typing  Immune suppression drugs