Body defense mechanism final

Body Defense Mechanism
By, Shristi shrestha
M.sc.Nursing 1st year 2016 batch
Medical Surgical Nursing
ShristiShresth,M.Sc.Nursing

Learning Objectives
• At the end of the seminar the participants
will be able to:
1. define body defense mechanism
2. differentiate the type of body’s defense
mechanism
3. describe in detail about the types of non
specific defense mechanism.
4. describe in detail about the types specific
defense mechanism

Learning Objectives
5. list about the organs involved in specific
defense mechanism.
6. describe about the stage of immune
response
7. identify about the advances in
immunology
8. identify the disease related to immune
system disorder
9. describe role of nurses in immune system
disorder management

Definition
- Action of
defending
 To survive
 To prevent
physiologic and
psychological
alterations that
may result in
disease or illness

Types of Defense
Non-Specific Defense
mechanism
Specific defense
mechanism
First line Second line Third line
external
defense
Internal
defense
Humoral and cell
mediated response

Innate (Non-specific) Defense
mechanism
External defense
 Intact Skin
 Eye
 Mucous Membrane
 Respiratory system
 Gastrointestinal system
 Genitourinary system
 Biological barriers

External Defenses

Innate (Non-specific) Defense
mechanism
Internal defense
 Phagocytic cells
 Molecular defense
 Inflammatory process
 Blood Clotting
 Fever

Phagocytic cells
• Phagocytes (eating cells): neutrophils,
monocytes, macrophages, natural killer cells
• comes from the Greek phagein, meaning "to
devour", and "-cyte", the suffix in biology
denoting "cell".
• main functions of phagocytic cells include
migration, (chemotaxis), ingestion and microbial
killing.

Molecular Defense
• Complement Proteins

• Cytokines
 Tumor necrosis factor (TNF)
 Chemokines
 Interleukins
 Interferons

Inflammatory Process
• series of response inducing inflammation
• holds the spread of pathogen until a specific
adaptive response is initiated.
• Cytokines, prostaglandins and leukoterienes, are
mediators of inflammatory response.

Pathophysiology of Inflammation
Vascular
Response
• transitory vasoconstriction followed immediately by
vasodilation
• increased permeability of the capillary walls,
facilitating fluid and cellular exudation
Fluid
Exudation
• Fluid exudation from the capillaries into the
interstitial spaces begins
• increases the colloid osmotic pressure
• swelling
Cellular
Exudation
• migration of leukocytes
• phagocytosis

Inflammatory Process

Signs of inflammation:
Cardinal Signs
• Dolor
• Calor
• Rubor
• Tumor
• Functio laesa
• Pain
• Heat
• Redness
• Swelling
• Loss of function

Fever
• is triggered by the release of prostaglandins.
• helps the body fight bacterial infections by
slowing the growth of bacteria and stimulating
body defense responses

Adaptive (specific) defense
mechanism
• Is highly specific to a particular pathogens
• Creates immunological memory
• Can provide long lasting protection
• Lymphocytes (B cells and T cells) plays major
role

mechanism
Organs Involved
Primary or central
organs
Secondary or
peripheral organs
Bone marrow
Thymus
Spleen
lymph nodes
Tonsils & Adenoids
Payers patch,
Appendix

mechanism
• Humoral response: response is produced
when the body synthesizes specific
immunoglobulin molecules called antibodies.
• Cell mediated response: cells are activated to
recognize and directly react with foreign
material

Humoral immune response
• B-Lymphocytes are specialized cells responsible
for humoral response
• arise from bone marrow stem cells
• produces antibody (immunoglobulin) and interact
with T cells.

• Antigen: foreign
substance or molecule
entering the body that
stimulates an immune
response
• Antibody: protein
substance that the body
produces in response to
an antigen
• Gamma globulins/
immunoglobulin

Immunoglobulins
• Transferred from mother to
fetusIgG(75%)
• Mainly in body secretionsIgA(15%)
• Stimulates complement
activityIgM(10%)
• Function as an antigen
receptorIgD(0.2%)
• In allergic reactionIgE(0.004%)

Cell mediated immune response
• T lymphocytes are primarily responsible for
cellular immunity.
Helper (CD4+) T cells
Cytotoxic (CD8+) T cells
Suppressor T cells
Memory T cells

Stages of Immune Response
Primary response:
Recognition stage
Proliferation stage
Response stage
Effector stage

Stage of immune response
• Secondary response : also termed as
anamnestic response.
• In an immunized individual the memory
cells elicit the rapid response

Immune system and Stress
• the number of natural killer or NK cells
has been found to be lower among people
who are suffering from chronic stress
• a number of vaccine studies have also
found that the immune system of highly
stressed individuals have sluggish
responses to challenges

• If you're stressed out, you're more likely
to get sick
“A study in the New England Journal of
Medicine actually found that higher
psychological stress levels resulted in a
higher likelihood of catching the common
cold.”

Managing Stress; Role of Nurse
• The study, published in the journal
Psychosomatic Medicine in 2000, found that
women who had greater social support displayed
lower levels of cortisol in their saliva than the
women who had less support. Lower levels of
cortisol, says Spiegel, indicate a healthier
immune system functioning.

Immune system disorders
• Allergies and asthma
• Immunodeficiency disorders
• Autoimmune diseases

Allergies and asthma
• immune responses to substances that are usually
not harmful
• Specific allergic reaction occurs to allergens for
e.g. Dust, pollens, grasses, foods, drugs etc.
• IgE antibodies plays role
• release histamine, a chemical that can cause
hives, runny nose, sneezing and itching.

• Allergic asthma is a chronic allergic condition of
the lungs.
• breathing difficulties such as wheezing, chest
tightness and coughing.
• Drug and food allergy result from specific
immune response to any drug and foods.

Immunodeficiency Disorders
• There are two types of immunodeficiency
disorders: those you are born with (primary), and
those that are acquired (secondary).
• Anything that weakens your immune system can
lead to a secondary immunodeficiency disorder.

Examples of primary immunodeficiency
disorders include:
• X-linked agammaglobulinemia (XLA)
• common variable immunodeficiency
(CVID)
• Combined T- and B-lymphocyte disorders
such as severe combined
immunodeficiency (SCID)
• Phagocytic cell disorder

• Secondary immunodeficiency
disorders happen when an outside
source like a toxic chemical or
infection attacks your body.
• For e.g. severe burns, virus infection,
malnutrition can cause secondary
immunodeficiency

Autoimmune disorders
• When our immune system gets confused, it
can mistakenly target normal tissue causing
damage and disease.
• ‘organ specific’ means one organ is
affected, while in ‘non-organ-specific’
disorders, multiple organs or systems may
be affected.

• Genetic, environmental factors
• It is thought that sex hormones may be at least
partly responsible.
• There is generally no cure, but the symptoms
of autoimmune disorders can be managed.

• Diabetes (type 1)
• Graves’ disease
• Inflammatory bowel disease
• Multiple sclerosis
• Psoriasis
• Rheumatoid arthritis
• Scleroderma
• Systemic lupus erythematosus

Nurses Role in detection and
Management
A study done by Dr. Esther de Vries in Netherlands
(2013) concluded that Nurses can play a crucial
role in the early detection of PIDs, by giving out an
alert when they notice suggestive signals in their
patients
PIDs should be considered in patients with
recurrent or severe infections, because early
diagnosis and treatment can reduce mortality and
morbidity.

Infectious Situations That Should
Alert to Potential PID
• Recurrent (proven) bacterial infections
• Severe infections (e.g. meningitis,
osteomyelitis, pneumonia), especially >1
• Infections that present atypically, are
unusually severe or chronic or fail regular
treatment
• Infections caused by an unexpected or
opportunistic pathogen

Contd..
• Severe or long-lasting warts, generalized
mollusca contagiosa
• Extensive candidiasis
• Complications of vaccination [disseminated
bacille Calmette–Guérin (BCG) or vaccinia
infection, paralytic polio]
• Abscesses of internal organs; recurrent
subcutaneous abscesses
• Prolonged or recurrent diarrhoea

Advances in IMMUNOLOGY
• Vaccination, or immunization
• Genetic engineering
• Stem cells transplantation
• Immunoglobulin Therapy

Role of medical surgical Nurse
• According to the research study entitled
“Immune system function. Implications for
critical care nursing practice.” By Tribett D. in
1989.
• Study suggests that nurses must expand their
physiologic data base to include a nursing
assessment of the immune system.
• After complete immune system assessment
specific individualized nursing care plans can be
developed to provide nursing support to maintain
and enhance the patient's defenses.

A frameworkfor organizingthe data
collectionprocesswouldinclude:
• a survey of factors affecting immune system
function in each patient,
• assessment of the cells and structures of the
immune system,
• monitoring of the status of first line defenses,
• observing for activity of nonspecific defenses,
and
• evidence of specific acquired immune responses.

Role of Medical Surgical
Nurse
• Assessment & History taking
• Gender
• Age
• Nutrition
• Infection and immunization
• Underlying disorder and disease
• Medication and blood transfusion
• Lifestyle

• Physical examination
• Diagnostic evaluation
• Patient teaching
• Supportive care

Summary

References
• Tribett D. Immune system function. Implications
for critical care nursing practice. Crit Care Nurs
Clin North Am. 1989 Dec;1(4):725-40. Review.
PubMed PMID: 2697222. Retrieved from
http://www.ncbi.nlm.nih.gov/pubmed/2697222
• Monash University. (2015, February 3). Skin
based immunity secrets revealed. ScienceDaily.
Retrieved from
www.sciencedaily.com/releases/2015/02/15020
3104133.htm

References
• Jawetz, Melnick & Adelberg’s. (2010) Medical
Microbiology (25th ed.). New york: McGraw Hills 121-
140
• Shafer, K. N., Phipps, W. J., Long, B. C., & Woods, N. F.
(1980). Shafer's medical-surgical nursing (7th ed.).
New delhi: B.I publication Pvt. Ltd; 19-41
• Wilkins, L. W. (2011). Brunner and suddarth's
textbook of medical surgical nursing (11th ed., Vol.
2). New Delhi: Wolters Kluwer (India) Pvt.Ltd.,1545-
1559

Body defense mechanism final

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