This document provides an overview of immunological disorders and hypersensitivity reactions. It begins by outlining the learning objectives, which are to review concepts of the immune system and discuss disorders of the immune response such as hypersensitivities. It then covers topics like the components of the immune system, including cells and molecules involved. The four types of hypersensitivity reactions - Type I, II, III, and IV - are defined and examples of each are provided. Pathophysiology and mechanisms of different hypersensitivity types are also explained over multiple pages.
Studying the Adaptive Immune Response - Tools for T & B Cell Research: Host D...QIAGEN
Adaptive immunity, powered by T cells and B cells, provides specific, long-lasting protection of the host from harmful invaders. This slidedeck provides an overview of T cells and B cells and their role in cell-mediated immune responses and antibody responses, respectively, against pathogens. There is also information on tools that enable analysis of T and B cell gene expression and regulation, genotyping and signal transduction pathway activation.
By DR. MANPREET KAUR BEHL.
Description of classificaton of immune system, immune cells, HLA, MHC complexes, antigen presentation, t-cell responses and b-cell responses, antibody, isotype switching, hypersenstivity reactions etc.
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.
This presentation provides an overview of cell and humoral immunity, two important components of the immune system. Cell-mediated immunity is mediated by T cells, while humoral immunity is mediated by B cells and antibodies. The presentation discusses the different types of cells and molecules involved in each type of immunity, as well as the roles they play in protecting the body from infection.
Studying the Adaptive Immune Response - Tools for T & B Cell Research: Host D...QIAGEN
Adaptive immunity, powered by T cells and B cells, provides specific, long-lasting protection of the host from harmful invaders. This slidedeck provides an overview of T cells and B cells and their role in cell-mediated immune responses and antibody responses, respectively, against pathogens. There is also information on tools that enable analysis of T and B cell gene expression and regulation, genotyping and signal transduction pathway activation.
By DR. MANPREET KAUR BEHL.
Description of classificaton of immune system, immune cells, HLA, MHC complexes, antigen presentation, t-cell responses and b-cell responses, antibody, isotype switching, hypersenstivity reactions etc.
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.
This presentation provides an overview of cell and humoral immunity, two important components of the immune system. Cell-mediated immunity is mediated by T cells, while humoral immunity is mediated by B cells and antibodies. The presentation discusses the different types of cells and molecules involved in each type of immunity, as well as the roles they play in protecting the body from infection.
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
Telehealth Psychology Building Trust with Clients.pptxThe Harvest Clinic
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One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
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Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
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The Importance of Community Nursing Care.pdfAD Healthcare
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Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
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India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...Kumar Satyam
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Growing Prevalence of Lifestyle Diseases
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ICH Guidelines for Pharmacovigilance.pdfNEHA GUPTA
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2. By the end of this unit the learners will be able to;
1. Review the following concepts of immune system:
Components of immune response
Humoral versus cell mediated immunity
Antigen processing, presentation and recognition
Immediate and delayed hypersensitivity
2. Discuss the disorder of immune response including.
Hypersensitivity ( allergies)
3. Discuss the pathophysiology of different types of
hypersensitivity (Type I, Type II, Type III & Type
IV)
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4. Cells
Lymphocytes
B Lymphocytes
T Lymphocytes
Antigen presenting cells(APCs)
Molecules
Major Histocompatibility Complex
CD (clusters of differentiation)
CD4
CD8 4
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5. B lymphocytes (B cells) :- They get mature in
the bone marrow, and are responsible for
antibody mediated immune response.
T lymphocytes(T cells):- They get mature in
the thymus gland, and are responsible for cell
mediated immune response. There are 4 types
of T cells
Both T & B are found in lymph nodes, spleen,
skin and mucosal surface.
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8. Cytotoxic or killer T cells do their work by
releasing lymphotoxins, which cause cell
lysis.
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9. Helper T cells serve as managers, directing the
immune response (e.g. B cells)
T cells recognize a specific antigen, and
several T cells produced cytokines which
interact with B cells and
provide additional
support.
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10. Suppressor T cells
inhibit the production
of cytotoxic T cells
when they are not
needed.
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11. Memory T cells are programmed to recognize
and respond to a pathogen once it has invaded
and has been repelled.
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12. APC acts as antigen presenters. They engulf
foreign particle (antigens) and present fragments
of these antigens, like signal flags, on their own
surfaces. These AP are located strategically at
locations where antigens are likely to penetrate,
e.g. epidermis and lymph nodes.
APC include:
Macrophages,
B lymphocyte
Dendritic cells.
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16. The external surfaces of all non-immune cells of
the body are dotted with a huge variety of
protein (self-antigens). Amongst these a specific
group of glycoprotein are called MHC proteins
(self-antigens).
There are two types of MHC molecules:
MHC I
MHC II
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17. MHC I MHC II
Located in which
cell types
All nucleated cells in the
body
Only antigen presenting cells
• Dendritic cells
• Macrophages
• B cells
Presents antigen
from which cellular
compartment?
From within the cytosol From within the vesicles
Recognize
primarily by
receptors on which
type of T cell?
CD8 + Cytotoxic T cells CD4 + Helper T cells
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19. T & B cell display additional membrane
molecules called CD molecules. These
molecules aid the function of immune cells and
also serve to define functionally distinct sub sets
of cells such as:
CD4 helper T cell
CD8 cytotoxic T cells
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22. B cells make up the branch of humoral immunity;
Humoral immunity deals with the extracellular microbes.
Humoral immune response begins with the recognition of
antigens by naïve B cells. These cells then undergo a
process of clonal expansion and differentiation. Through
this process, the B cell matures into antibody secreting
plasma cells, which secrete antibodies. Antibodies are the
effector products of humoral immunity. Finally, as this
response declines, a pool of memory cells remains
behind. If the body is re-exposed to the antigen, these
memory cells will recognize the antigen and respond
much more quickly and effectively.
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23. Cell-mediated immunity is much better at
recognizing and eliminating microbes that are
within cells. MHC molecules display the
antigens from microbes within cells and T cells
are the only cells that recognize these displayed
antigens.
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25. CD4+ helper T cells CD8+ cytotoxic T cell
Antigen recognition:
Antigen-presenting cells travel to lymphoid
tissues and display the microbe's peptide
antigens Via MAC II molecules on their
surface. Naive CD4+ helper T cells that are
specific for that antigen will respond by
activating.
Antigen recognition:
Antigens from microbes that enter the cytosol
of cells in the body Will be displayed Via
MAC Naive CDS+ T cells that are specific for
that antigen will respond by activating
Clonal expansion:
Once a clone of helper T cells has been
selected, it Secretes factors that cause rapid
division As a result, the clone expands so that
can mount a potent response.
Clonal expansion:
Clonal expansion proceeds in CD8+ cells in
much the same Way as it does in and CD4+ T
Once a Clone has been selected bv an antigen,
it secretes factors that cause a rapid expansion
of the population of cells specific for the
antigen.
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26. CD4+ helper T cells CD8+ cytotoxic T cell
Differentiation:
Once a clone of CD4 helper T cells has been
stimulated, it expands by secreting factors
that promote proliferation and
differentiation. Some of the offspring of this
expanded pool of T cells differentiate into
effector cells that can secrete different sets of
cytokines and thus perform different These
subsets Of helper T cells have been named
Th•l, Th.2 and Th.ll_
Differentiation:
After encounter with an antigen, CD8* cells
divide and differentiate into mature cytotoxic T
cells.
Antigen elimination:
Different subsets of helper T cells are
specialized for different functions. These
functions have been listed below. The
cytokines that each subset produces have
been included for completeness
Antigen elimination:
Activated CD8+ lymphocytes also expand in
number and differentiate into cytotoxic T cells
(also known as cytolytic T These cells directly kill
cells that have been infected by microbes by
releasing enzymes that enter target cells and
activate the apoptotic death signal in those
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27. CD4+ helper T cells CD8+ cytotoxic T cell
Memory: The initial activation of naive
lymphocytes also stimulates the proliferation
Of long-lived memory cells, Which survive for
years after an infection. This pool of memory
cells is much larger than the pool of naive
lymphocytes specific for any one antigen that is
present before encounter with that antigen.
These memory cells respond faster and more
effectively against the antigen than naïve
lymphocytes.
Memory: See the description to the left.
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28. Allergy (exaggerated against environmental antigens)
Autoimmunity (misdirected against host’s own cells)
Alloimmunity (directed against beneficial foreign
tissue e.g. transplants or transfusions)
Immuno deficiency (insufficient protection)
The inappropriate immune responses of allergy,
autoimmunity, and alloimmunity can be
collectively classified as Hypersensitivity
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29. Hypersensitivity reactions – ‘over reaction’ of the
immune system to harmless environmental antigens
Or
Altered immunological reactivity to an antigen that
results in a pathologic immune response after re-
exposure
Or
Undesirable (damaging, discomfort-producing and
sometimes fatal) reactions produced by the normal
immune system
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30. Type I: classical immediate hypersensitivity
Type II: cytotoxic hypersensitivity
Type III: immune-complex mediated
hypersensitivity
Type IV: cell mediated or delayed
hypersensitivity
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31. Types of Hypersensitivity Time Category
Type I
Classical immediate hypersensitivity
(anaphylactic)
<30 Sec Immediate
Type II
Cytotoxic hypersensitivity
5-12 Hours Delayed
Type III
Immune-complex mediated
hypersensitivity
3-8 Hours Delayed
Type IV
Cell mediated or delayed
hypersensitivity
24-48 Hours Delayed
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32. It is mediated by IgE antibodies and requires
previous exposure to specific antigen. It usually
affects on skin, lungs and gastrointestinal tract
E.g. are food allergies, hay fever.
Also called Anaphylactic reactions. It can be
systemic (generalized), or cutaneous (localized)
.
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37. MAST CELL
Allergen bind to IgE on the
surface of mast cells
Allergen
Granules
MAST CELL
Degranulation of pre-formed factors
e.g. histamine
Cross-binding of IgE by
allergen leads to activation and
degranulation of mast cell
1 2
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38. intestinal & bronchial smooth muscle
contraction
blood vessel dilation and increased
permeability
increase in mucus secretion
influx of leukocytes
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40. 40
Allergen Interaction with IgE on the Surface of
Mast Cells triggers the Release of Inflammatory
Mediators
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41. It occurs as a result of direct interaction between
IgG Or IgM antibodies and tissue or cell surface
antigens. Many autoimmune diseases result from
type II hypersensitivity reactions. E.g. are
1. Autoimmune hemolytic anemia (Antibody-
complement Dependent Mediated Lysis)
2. Myasthenia gravis (Antireceptor antibody)
3. Antibody-dependent cell mediated
cytotoxicity
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42. 42
Type II Hypersensitivity
Antibody-Complement Dependent Mediated Lysis
Animation: Epitope on a normal cell being mistakenly recognized by IgG or
IgM as non-self. IgG or IgM reacts with epitopes on the host cell membrane
and activates the classical complement pathway. This activation leads to the
formation of Membrane attack complex (MAC) that causes lysis of the cell.
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44. 44
Type II Hypersensitivity
Antibody Dependent Cell Mediated Cytotoxicity
Animation: Antibodies react with epitopes on the host cell membrane and
NK cells bind to the Fc of the antibodies. The NK cells then lyse the cell with
pore-forming perforins and cytotoxic granzymes (proteases that are
released by cytoplasmic granules within cytotoxic T cells and natural killer
cells, they induce apoptosis.)
apoptosis Immunological Disorders
46. This reaction occurs as a result of formation of
insoluble antigen-antibody complexes that activates
the complement. Activated complement generates
vasoactive and chemotactic mediators that causes
tissue damage through:
Alteration in blood flow and vascular permeability
Destructive action of inflammatory cells.
E.g. Arthus reaction, serum sickness.
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47. 47
Type-III Hypersensitivity: Immune Complex
Animation: When large quantities of soluble antigen-antibody complexes formed in the blood
are not completely removed by macrophage, these antigen-antibody complexes lodge in the
capillaries between the endothelial cells and the basement membrane. This antigen-antibody
complexes activate the classical complement pathway which generate vasoactive and
chemotactic mediators that attract inflammatory cells like neutrophils to the area. The
neutrophils then discharge killing agents and promote massive inflammation. This leads to
hemorrhage and tissue death .
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49. Involve reactions by T(delayed type hypersensitivity)
memory cells. First contact sensitizes person, and
subsequent contacts elicit a reaction. The reactions are
delayed by one or more days. Delay is due to migration
of macrophages and T cells to site of foreign antigens.
Reactions are frequently displayed on the skin:
itching, redness, swelling, pain. E.g. are
Tuberculosis skin test
Poison ivy
Metals
Latex in gloves and condoms
Anaphylactic shock may occur
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52. Norris, T. L. (2019). Porth's Pathophysiology Concepts of
Altered Health States (Tenth Edition ed.). Philadelphia:
Wolters Kluwer.
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