Week 3: Immunity

what is immunity?

a physiological process that results in resistance to infections or toxins

what are the attributes for immunity?

• specific

• adaptive

• protective

• resistance

what is the scope of Immunity?

←Suppression immune response — optimal immune response — exaggerated immune response →

what is the background for suppressed immune response?

weakened immune system that is unable to fight pathogens, lacks sufficient white blood cells or antibodies

what are the symptoms of suppressed immune response?

• frequent infections with severe symptoms

  • high fevers

  • chills

  • weakness

• joint swelling

• skin rashes

what are the causes for suppressed immune response?

• autoimmune disease

  • lupus

  • rheumatoid arthritis

  • type 1 diabetes

• infections

  • HIV → AIDS

  • Pneumonia

• lymphoma

• leukemia

• sickle cell disease

• immune cell deficiency

• medications

  • immunosuppressants

  • chemotherapy

what are the types of hypersensitivity reactions

• IgE-Mediated (within 1 hour onset, ex. anaphylaxis)

• IgC or IgM cytotoxic (hours to days onset, ex. hemolytic anemia)

• immune complex-mediated (1-3 weeks onset, ex. serum sickness SLE)

• T-cell-mediated (days to weeks, ex. Rash SJS)

what is an antigen?

• trigger immune responses

• bacteria, viruses, or fungi, that cause infection and disease

what is an antibody?

• also called immunoglobulins

• Y-shaped molecules

• proteins manufactured by the body

• helps fight against foreign substances (antigens)

what is active immunity?

exposure to a pathogen triggers antibody production (life ex: work for that paycheck

what is an example for natural active immunity?

infection, creating own antibodies by virus or infection

what is an example of artificial active immunity?

vaccination

what is passive immunity?

a person is given antibodies rather than producing them (life ex: getting a pay check without doing the work)

what is an example of natural passive immunity?

maternal antibodies (breast milk)

what is an example of artificial passive immunity?

monoclonal antibodies (getting it from somebody else)

what are the risk factors for suppressed immune response?

• advanced age (decreased immune response, low WBC, Low IG

• fewer T and B lymphocytes

• chronic illness (Cancer, HIV)

• Chemotherapy/radiation treatment

• organ transplant (putting something foeighn in your body and want it to be accepted)

• Immunosuppressive medications

• pregnancy (low immune system)

what are risk factors for exaggerated immune response?

• exposure to allergens which trigger immune response

• exposure to environmental factors which produce allergic reactions (stay away from that immune response)

• autoimmune disease

what are Laboratory tests for immunity?

• skin test

• CBC (RBC, WBC)

• CD4/CD8 cell count (with HIV)

• Serological tests to detect specific antibodies or viruses

• Antigen testing (past infections, if antibodies were made)

• antibody testing (POC) (using rapid diagnostic tests to detect antibodies)

• Antibody titer (booster shot, confirms immunity)

• PCR (DNA/RNA)

What are the measurements for RBCs for cell regulation?

3.6 - 5.4

What are the measurements for hemoglobin for cell regulation?

12-17.4

What are the measurements for hematocrit for cell regulation?

36% - 48%

What are the measurements for WBCs for cell regulation?

4.5 - 10.5

What are the measurements for platelets for cell regulation?

140 - 400

what are some primary preventions for immunity?

• immunization

• adequate nutrition

• exercise

• sleep, rest

  • remember that every age is different

What to pay attention for secondary prevention?

signs and symptoms and risk factors

What are some collaborative interventions for suppressed immune response?

• airway (any issues)

• remove exposure

• antihistamines

• corticosteroids

• allergy shots/protocols

• oral immunotherapy

• biologics

• stem cell and gene therapies

What are some collaborative interventions for exaggerated immune response?

• nutrition: nutrient rich/dense foods, easy to digest

• skin and oral hygiene and care- moisturized, teeth brushed, oral cavity intact

• psychological support

• early intervention with new infections

• stem cell transplants/bone marrow transplants

• pharmacological support and monitoring (chronic illness and autoimmune disease management)

what antivirals is herpes, shingles, and chicken pox use?

acyclovir and valacyclovir

what antiviral does influenza use?

oseltamivir (tamaflu)

what are antivirals for?

they inhibit their development, not destroy the virus

what to assess with antivirals?

• is the med appropriate?

• why are they taking it?

what to be caution about antivirals?

impaired renal function

what are some patient teaching for Acyclovir and Valacyclovir?

• slows the growth

• may lesson symptoms of the infection

• it’s not a cure

what are some patient teachings for oseltamivir?

• blocks the action of influenza virus (A and B types)

• only works in the first 48 hours after symptoms onset

what to evaluate for antivirals?

• how do we know it’s working

• symptoms improve, signs and symptoms decrease

what is the management for HIV/AIDS if used heavily?

• taken in combination of 2-3 drugs (exactly as prescribed)

• lots of side effects

• very expensive

• must be taken exactly as prescribed

• risk of virus developing resistance

what are ways to promote strategies of adherence?

patient support and identify resources

How does the Live attenuated vaccine work?

weaken version of virus

what are some examples of live attenuated vaccines?

MMR, chicken pox, and rotavirus

how does the inactivated vaccines?

killed version of viruswha

what are some examples of inactivated vaccines?

hepatitis A, Influenza, Polio

how does the recombinant, conjugate, subunit, and polysaccharide vaccine works?

pieces of viruses are used (proteins, sugars)

What are some examples of recombinant, conjugate, subunit, and polysaccharide vaccine

Hep B, HPV, pneumonia, and shingles

how does a toxoid vaccine work?

toxin made by the germ that immune system reacts to

what are some examples of toxoid?

tetanus and diphtheria

how does an mRNA vaccine work?

mRNA that codes for piece of virus

what is an example of mRNA vaccine?

COVID

what are some things to keep in mind with vaccines?

• shouldn’t be given to those who are immunocompromised (either because of cancer, flu, and HIV)

• Elderly (immune system weakens)

• Babies

• allergies (history with reaction)

• religion/personal reasons

• pregnant/ breast feeding

What is IV immunoglobin (IgG antibodies)?

provides antibodies to the patient (passive immunity)

what is primary immunodeficiency diseases?

hereditary disorders, caused by mutations of specific genes

what are some examples of primary immunodefiency diseases?

• SCID: severe Combined immunodeficiency

• DiGeorge Syndrome

what is secondary immunodeficiency disease?

acquired, caused by environmental factors

what are examples of secondary immunodeficiency disease?

AIDS caused by HIV, chemotherapy, irradiation, malnutrition, and sepsis

what is autoimmune?

condition when body’s immune system mistakenly attacks its own healthy tissue

what are examples of autoimmune?

• rheumatoid arthritis

• lupus

• multiple sclerosis

• chron’s

• type 1 diabetes mellitus

• thyroid disorders (graves disease, hashimoto thyroiditis)