The immune system has both nonspecific defenses that provide immediate protection against pathogens and specific defenses that develop over time through exposure or vaccination. The specific defenses include B cells and T cells. B cells produce antibodies that identify pathogens for destruction. T cells identify and destroy infected cells. Immunity can be active, developing through natural exposure or vaccination, or passive, providing temporary protection through transfer of antibodies. Vaccines provide active immunity by exposing the immune system to antigens in a controlled way. The immune system defends the body but can also cause allergic reactions and autoimmune diseases when improperly activated.
Adaptive/Acquired Immunity
Antigens – Anything that cases a biological immune response by this system of cells
Specificity – Some antibodies are quite specific to an antigen others are general to a “type” or “form”
Memory – b-memory cells are formed and remain to combat future exposures quickly (Active vs Passive immunity
Antibodies – the proteins formed by b-cells that combat antigens whether chemical or biological
Lymphocytes – cells involved in this response
Adaptive/Acquired Immunity
Antigens – Anything that cases a biological immune response by this system of cells
Specificity – Some antibodies are quite specific to an antigen others are general to a “type” or “form”
Memory – b-memory cells are formed and remain to combat future exposures quickly (Active vs Passive immunity
Antibodies – the proteins formed by b-cells that combat antigens whether chemical or biological
Lymphocytes – cells involved in this response
Adaptive immunity is an immunity that occurs after exposure to an antigen either from a pathogen or a vaccination. This part of the immune system is activated when the innate immune response is insufficient to control an infection. In fact, without information from the innate immune system, the adaptive response could not be mobilized. There are two types of adaptive responses: the cell-mediated immune response, which is carried out by T cells, and the humoral immune response, which is controlled by activated B cells and antibodies.
Adaptive immunity is an immunity that occurs after exposure to an antigen either from a pathogen or a vaccination. This part of the immune system is activated when the innate immune response is insufficient to control an infection. In fact, without information from the innate immune system, the adaptive response could not be mobilized. There are two types of adaptive responses: the cell-mediated immune response, which is carried out by T cells, and the humoral immune response, which is controlled by activated B cells and antibodies.
White blood cells & Immunity (The Guyton and Hall Physiology)Maryam Fida
Leukocytes or WBCs are the mobile units of the body’s immune defense system.
Immunity is the body’s ability to resist or eliminate potentially harmful foreign materials or abnormal cells.
WBC count: 5000 to 11000/ul of blood
GRANULOCYTES
Polymorphonuclear neutrophils 60-70%
Polymorphonuclear eosinophils 2-3%
Polymorphonuclear basophils 0.4%
NON-GRANULOCYTES
Monocytes 5.3%
Lymphocytes 30%
Granulocytes and monocytes are formed and stored only in bone marrow
Lymphocytes and plasma cells are formed and stored mainly in various lymphoid tissue such as lymph node, spleen, thymus and tonsils as well as in bone marrow.
GRANULOCYTES
4 to 8 hours in blood and 4 to 5 days in tissues
MONOCYTES
Monocytes also have a short transit time:
10 to 20 hours in blood and In tissue they swell to much larger size to become tissue macrophages.
LYMPHOCYTES
weeks to months
neutrophil
. 60-70% of leukocytes
nucleus: 2-5 lobes
Counting the number of lobes and grouping them is called Arneth count.
Shift to left means (increase no of young and predominant WBCs) e.g During acute infection.
Shift to right means, old cells are predominant. e.g During recovery phase
NEUTROPENIA
Decrease in neutrophils count
Typhoid
AIDS and viral hepatitis
Kalazar fever
Bone marrow depression by drugs and radiations
NEUTROPHILIA
Increase in neutrophils count
Appendicitis , Tonsillitis, Pneumonia
Burns, Hemorrhage, MI, Pain
Hypoxia, Pregnancy
BASOPHIL
Their cytoplasmic granules take up basic dyes and appear deep blue
MAST CELLS are derived from basophils under the influence of interleukins 3 and 4
Under many allergic conditions basophils and mast cells bursts and releases
Histamine
Bradykinin
Serotonin
Slow reacting substance of anaphylaxis
Heparin
Lysosomal enzymes
It is the capacity of the human body to resist and destroy the invading organisms or toxins.
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- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
2. The Lymphatic System and Body
Defenses
• Nonspecific Defenses
– Do not distinguish one
threat from another
– Physical barriers
– Phagocytic cells
– Immunological surveillance
– Interferons
– Complement
– Inflammation
– Fever
• Specific Defenses
– Protect against particular
threats
– Develop after birth
– Dependent on activity of
lymphocytes
– B cells
– T cells
7. Specific Defense: The Immune
Response
• Respond to specific antigens
• T cells
– Cell-mediated immunity (cellular immunity)
– Provide defense against abnormal cells and
pathogens in living cells
• B cells
– Antibody-mediated immunity (humoral immunity)
– Provide a defense against antigens and pathogens in
body fluids
8. Forms of Immunity
• Either innate or acquired
• Innate
– Genetically determined
• Acquired
– Active or Passive
• Active Immunity
– Naturally acquired immunity
– Induced active immunity
• Passive Immunity
– Induced passive immunity
– Natural passive immunity
13. T Cells and Cell-Mediated Immunity
• T cells recognize antigens when bound to
membranes of other cells
– Membrane receptors called major
histocompatibility complex (MHC) proteins
• 2 classes
– Class I MHC proteins
– Class II MHC proteins
14. Class I MHC Proteins
• Found on the surfaces of all of our cells
• MHC proteins bind small peptide
molecules normally present on cell
membrane
– Normal peptides: T cell ignores
– Abnormal, virus, or bacteria (nonself): T cell
activated
• Destroys abnormal/infected cell
15. Class II MHC Proteins
• Found only on membranes of lymphocytes and
phagocytic antigen-presenting cells (APCs)
– Such as monocyte-macrophage group, free and fixed
macrophages
– Specialized for activating T cells against foreign cells
and proteins
• Phagocytic APCs engulf and break down foreign
antigens or pathogens
– Fragments of foreign antigens displayed on
phagocytic cell’s membrane
• Bind to Class II MHC proteins
• T cells come in contact and become activated, starting the
immune response
20. Neutrophils
• 60% of WBCs
• ‘Patrol tissues’ as they squeeze out of the
capillaries.
• Large numbers are released during
infections
• Short lived – die after digesting bacteria
• Dead neutrophils make up a large
proportion of puss.
21. Macrophages
• Larger than neutrophils.
• Found in the organs, not the blood.
• Made in bone marrow as monocytes,
called macrophages once they reach
organs.
• Long lived
• Initiate immune responses as they display
antigens from the pathogens to the
lymphocytes.
24. Phagocytosis
• If cells are under attack they release histamine.
• Histamine plus chemicals from pathogens mean
neutrophils are attracted to the site of attack.
• Pathogens are attached to antibodies and
neutrophils have antibody receptors.
• Enodcytosis of neutrophil membrane
phagocytic vacuole.
• Lysosomes attach to phagocytic vacuole
pathogen digested by proteases
25. Lymphocytes
• Produce antibodies
• B-cells mature in bone marrow then
concentrate in lymph nodes and spleen
• T-cells mature in thymus
• B and T cells mature then circulate in the
blood and lymph
• Circulation ensures they come into contact
with pathogens and each other
26. B -Lymphocytes
• There are c.10 million different B-
lymphocytes, each of which make a
different antibody.
• The huge variety is caused by genes
coding for abs changing slightly during
development.
• There are a small group of clones of each
type of B-lymphocyte
27. B -Lymphocytes
• At the clone stage antibodies do not leave the B-
cells.
• The abs are embedded in the plasma
membrane of the cell and are
called antibody receptors.
• When the receptors in the membrane recognise
and antigen on the surface of the pathogen the
B-cell divides rapidly.
• The antigens are presented to the B-cells by
macrophages
29. B -Lymphocytes
• Some activated B cells PLASMA
CELLS these produce lots of antibodies,
< 1000/sec
• The antibodies travel to the blood, lymph,
lining of gut and lungs.
• The number of plasma cells goes down
after a few weeks
• Antibodies stay in the blood longer but
eventually their numbers go down too.
30. B -Lymphocytes
• Some activated B cells MEMORY
CELLS.
• Memory cells divide rapidly as soon as the
antigen is reintroduced.
• There are many more memory cells than
there were clone cells.
• When the pathogen/infection infects again
it is destroyed before any symptoms show.
31.
32. Antibodies
• Also known as immunoglobulins
• Globular glycoproteins
• The heavy and light chains are polypeptides
• The chains are held together by disulphide
bridges
• Each ab has 2 identical ag binding sites –
variable regions.
• The order of amino acids in the variable
region determines the shape of the binding
site
33. How Abs work
• Some act as labels to identify
antigens for phagocytes
• Some work as antitoxins i.e. they block
toxins for e.g. those causing diphtheria and
tetanus
• Some attach to bacterial flagella making
them less active and easier for phagocytes to
engulf
• Some cause agglutination (clumping
together) of bacteria making them less likely
35. Type Number of
ag binding
sites
Site of action Functions
IgG 2 •Blood
•Tissue fluid
•CAN CROSS
PLACENTA
•Increase
macrophage activity
•Antitoxins
•Agglutination
IgM 10 •Blood
•Tissue fluid
Agglutination
IgA 2 or 4 •Secretions (saliva,
tears, small intestine,
vaginal, prostate,
nasal, breast milk)
•Stop bacteria
adhering to host
cells
•Prevents bacteria
forming colonies on
mucous membranes
IgE 2 Tissues •Activate mast cells
HISTAMINE
•Worm response
36. T-Lymphocytes
• Mature T-cells have T cell receptors which
have a very similar structure to antibodies
and are specific to 1 antigen.
• They are activated when the receptor
comes into contact with the Ag with
another host cell (e.g. on a macrophage
membrane or an invaded body cell)
37. T-Lymphocytes
• After activation the cell divides to form:
• T-helper cells – secrete CYTOKINES
help B cells divide
stimulate macrophages
• Cytotoxic T cells (killer T cells)
Kill body cells displaying antigen
• Memory T cells
remain in body
38.
39.
40. Active and Passive Immunity
Active immunity
Lymphocytes are activated by antigens
on the surface of pathogens
Natural active immunity - acquired due to
infection
Artificial active immunity – vaccination
Takes time for enough B and T cells to be
produced to mount an effective response.
41. Active and Passive Immunity
Passive immunity
B and T cells are not activated and plasma
cells have not produced antibodies.
The antigen doesn’t have to be encountered
for the body to make the antibodies.
Antibodies appear immediately in blood but
protection is only temporary.
42. Active and Passive Immunity
Artificial passive immunity
Used when a very rapid immune response
is needed e.g. after infection with tetanus.
Human antibodies are injected. In the
case of tetanus these are antitoxin
antibodies.
Antibodies come from blood donors who
have recently had the tetanus vaccination.
Only provides short term protection as abs
destroyed by phagocytes in spleen and
liver.
43. Active and Passive Immunity
Natural passive immunity
A mother’s antibodies pass across the
placenta to the foetus and remain for
several months.
Colostrum (the first breast milk) contains lots
of IgA which remain on surface of the
baby’s gut wall and pass into blood
44.
45. Vaccination
A preparation containing antigenic
material:
• Whole live microorganism
• Dead microorganism
• Attenuated (harmless) microorganism
• Toxoid (harmless form of toxin)
• Preparation of harmless ags
47. Vaccination
Why aren’t they always effective?
• Natural infections persist within the body
for a long time so the immune system has
time to develop an effective response,
vaccinations from dead m-os do not do
this.
• Less effective vaccines need booster
injections to stimulate secondary
responses
48. Vaccination
Why aren’t they always effective?
• Some people don’t respond well/at all to
vaccinations
• Defective immune systems
• Malnutrition particularly protein
49. Vaccination
Why aren’t they always effective?
• Antigenic variation caused by mutation
• Antigenic drift – small changes (still
recognised by memory cells)
• Antigenic shift – large changes (no longer
recognised)
50. Vaccination
Why aren’t they always effective?
• No vaccines against protoctists (malaria
and sleeping sickness)
• Many stages to Plamodium life cycle with
many antigens so vaccinations would
have to be effective against all stages (or
be effective just against infective stage but
given in very small time period).
51. Vaccination
Why aren’t they always effective?
• Sleeping sickness – Trypanosoma has a
thousand different ags and changes them
every 4-5 days
52. Vaccination
Why aren’t they always effective?
• Antigenic concealment parasites live
inside body cells
• Plasmodium – liver and blood cells
• Parasitic worms – cover themselves in
host proteins
• HIV – live inside T-helper cells
53. Smallpox
Symptoms
• Red spots containing transparent fluid all
over body.
• Spots fill with pus
• Eyelids swell and become glued together
55. Smallpox
Eradication programme
• Started by WHO in 1956
• Aimed to rid world of smallpox by 1977
• Involved vaccination and surveillance
• Over 80% of populations at risk of the
disease were vaccinated
• After any reported case everyone in the
household and 30 surrounding
households vaccinated – RING
57. Smallpox
Eradication programme – why was it successful?
• Variola virus stable -> cheap as everyone used
same vaccine
• Vaccine made from harmless strain of similar
virus (vaccinia)
• Vaccine could be used at high temperatures
• Easy to identify infected people
• Smallpox doesn’t lie dormant in body
59. Measles
• Caused by an airborne virus
• 9th
leading cause of death worldwide
• Causes rash and fever
• Can have fatal complications
• Passive immunity from mothers in infants under
8 months
• Now quite a rare disease in developed
countries due to vaccination
60. Measles
• Transmitted easily in overcrowded, insanitary
conditions
• Mainly affects malnourished infants with vitamin
A deficiencies
• Responsible for many cases of childhood
blindness and can cause severe brain damage
• Herd immunity of 93-95% needed to prevent
transmission within a population.
61. Allergies
• When the immune system responds to
harmless substances
• Allergens – antigenic substances which do no
real harm
• Allergens include house dust, animal skin,
pollen, house dust mite and its faeces
62.
63. Allergies
• Histamine causes blood vessels to widen and
become leaky.
• Fluid and white blood cells leave capillaries.
• The area of leakage becomes hot, red and
inflamed
64. Asthma
• Attacks can occur at any time
• Genes play a role in who develops asthma
• Breathing becomes difficult, sufferers
experience wheezing, coughing, a tightness
about the chest and shortage of breath.
• 1/7 children in UK has asthma, number is
increasing.
• >1000 people die each year from asthma every
year in the UK
65. Asthma
• Airways in asthmatics are always inflamed,
during an attack this worsens.
• Fluid leaks from blood into airways and goblet
cells secrete lots of mucus
• Airways can become blocked
• Muscles surrounding trachea and bronchioles
contract which narrows airways further
66. Asthma
• Vaccines are being developed to make allergic
responses less severe
• Designed to desensitise people so they do not
produce antibodies to allergens
• Genetic tests may be used to screen children
and then a vaccine could be given to prevent
them developing asthma