INFLAMMATION AND IMMUNITY

absolute neutrophil count (ANC)

Actual number of mature circulating neutrophils.

active immunity

Type of immunity that occurs when the body is exposed to a disease organism through infection, and the immune systems produces antibodies to that disease.

adaptive immune system

Second part of the immune system; provides a specific response when the body is exposed to microbes or chemicals. Acquired immunity.

adaptive immunity

Type of immunity acquired via antibody-mediated immunity (AMI) or cell-mediated immunity (CMI); also called acquired immunity.

antibody

Immunoglobulin produced by sensitized B lymphocytes (plasma cells or memory cells) that bind to a specific antigen.

antibody-mediated immunity (AMI)

Type of adaptive immunity that uses antigen-antibody interactions to neutralize, eliminate, or destroy foreign proteins; also known as humeral immunity.

antigens

Proteins (usually) considered as non-self by a person's immune system that will stimulate the immune system to have an immunity response and make antibodies directed against the antigen.

artificial active immunity

Type of immunity gained when a killed or weakened form of a disease organism is introduced into the body through vaccination. Also known as vaccine-induced active immunity.

artificial passive immunity

Type of immunity gained following injection of antibodies created in one person or animal into someone without those antibodies.

cell-mediated immunity (CMI)

Type of adaptive immunity that is provided by lymphocyte stem cells that mature in the secondary lymphoid tissues.

cytokines

Small hormonelike proteins produced by the many leukocytes (and some other tissues) that help modify inflammation and immunity.

erythrocytes

Red blood cells (RBCs). Production stimulated by erythropoietin.

five cardinal symptoms of inflammation

Warmth, redness/hyperpigmentation, swelling, pain, and decreased function.

human leukocyte antigens (HLAs)

Unique surface proteins that present on all of a person's cells that are specific to that person. Also known as a person's tissue type, histocompatibility antigens, class I antigens. "Barcode" for cells of self.

immunity

Protection from illness or disease that is maintained by the body's physiologic defense mechanisms.

immunocompetent

Having maximum protection against infection.

infection

Invasion of pathogens into the body that multiply and cause disease or illness.

inflammation

A syndrome of normal tissue responses to cellular injury, allergy, or invasion by pathogens. Nonspecific. Immediate but short term.

innate immune system

First part of the body's immune system; provides a nonspecific, quick action in response to an invading organism. Skin, mucosa, skin microbiome, complement, natural killer (NK) cells.

innate immunity

Type of immunity that is present at birth.

leukocytes

White blood cells (WBCs). Variety of actions to provide immunity.

memory cell

A sensitized B lymphocyte that produces specific antibodies on all subsequent exposures to the initial sensitizing antigen.

natural active immunity

Immunity gained after an antigen enters the body naturally and the body responds by actively making antibodies against that antigen.

natural passive immunity

Immunity gained when antibodies are passed from a mother to the fetus via the placenta or to the infant via colostrum or breast milk.

neutrophilia

Increased number of circulating neutrophils.

passive immunity

Type of immunity that develops when people are given antibodies to a disease after first being made in the body of another human or animal instead of producing them within their own immune system.

phagocytosis

Cellular engulfment and destruction of invading microorganisms and debris.

plasma cell

A sensitized B lymphocyte that immediately starts to produce antibodies against the sensitizing antigen.

self-tolerance

The special ability of immune system cells to recognize self versus non-self and avoid actions that would harm self cells. Due to proteins on T-regulator cells or Tregs.

stem cells

Immature undifferentiated cells produced in the bone marrow that are pluripotent with the potential to mature into any blood cell type.

t-regulator cells

T-lymphocytes that regulate self-tolerance. React with cells lacking the human leukocyte antigens (HALs).

toll-like receptors (TLRs)

Interact with the surface of invading organism and allow recognition of non-self.

pluripotent

Cell has more than one potential outcome.

granulocytes

Have granules in cytoplasm. Neutrophils, basophils, eosinophils, tissue mast cells.

agranulocytes

Fine granules in cytoplasm. Monocytes, macrophages, lymphocytes.

function of neutrophil in inflammation

Nonspecific ingestion and phagocytosis of microorganisms and foreign proteins.

function of macrophage in inflammation

Nonspecific recognition of foreign proteins and microorganisms. Ingestion and phagocytosis. Assists with antibody-mediated immunity and cell-mediated immunity.

function of monocyte in inflammation

Destruction of bacteria and cellular debris. Matures into macrophage.

function of eosinophil in inflammation

Releases vasoactive amines during allergic reactions and in response to parasite infestations.

function of basophil in inflammation

Releases histamines, kinins, and heparins in areas of tissue damage.

function of B lymphocyte in antibody mediated immunity

Becomes sensitizes to foreign cells and proteins with the assistance of macrophages and helper T cells.

function of plasma cell in antibody-mediated immunity

Secretes immunoglobulins in response to the presence of specific antigen.

function of memory cell in antibody-mediated immunity

Remains sensitized to a specific antigen and can secrete increased amounts of immunoglobulins specific to the antigen on reexposure.

function of helper T cell in cell-mediated immunity

Enhances immune activity of all parts of general and specific immunity through secretion of various factors, cytokines, and lymphokines.

function of cytotoxic T cell in cell-mediated immunity

Selectively attacks and destroys non-self cells, including virally infected cells, grafts, and transplanted organs.

function of regulator T cell in cell-mediated immunity

Regulates the balance between offensive and defensive inflammation and immunity actions and maintains self-tolerance.

function of natural killer cell in cell-mediated immunity

Nonselective attacks on non-self cells, especially mutated body cells that have become malignant. Attacks grafts and transplanted organs.

three processes needed for immunity

Inflammation, antibody-mediated immunity, cell-mediated immunity.

age-related changes to inflammation

Neutrophil function reduced. Leukocytosis does not occur during acute infection. May not produce fever.

age-related changes to antibody-mediated immunity

Total number of B lymphocytes decreased. Ability of B lymphocytes to mature decreased. Natural antibody response declined.

age-related changes to cell-mediated immunity

Total number of T lymphocytes decreased.

cell involved in inflammation

Neutrophils, macrophages, eosinophils, basophils, tissue mast cells.

neutrophil

55-70% of total WBC count. Granulocytes. Stimulated by GM-CSF and G-CSF. Phagocytosis and enzymatic digestion.

macrophage

Mature monocyte. May be fixed or free. Helps stimulate inflammation and longterm immunity. Phagocytosis, repair, antigen presenting/processing, cytokine secretion.

basophil

Cause signs and symptoms of inflammation. Secrete vasoactive amines (heparin, histamine, serotonin, kinins, leukotrienes). Binds to IgE.

heparin

Inhibit blood and protein clotting.

histamine

Dilates arterioles and constricts small veins. Causes blood to collect in area.

kinins

Dilate arterioles, increase capillary permeability. Causes plasma to leak into interstitial space.

eosinophil

Secrete vasoactive chemicals. Most active against parasitic larvae. Prolongs inflammation.

tissue mast cells

Similar to basophils and eosinophils. Do not circulate as mature cells. Binding sites for IgE. Maintain and prolong allergic inflammation.

Not a leukocyte.

complement system

Part of innate immunity. System of 20 different inactive plasma proteins. Activation leads to enhancing/complementing innate immunity. Membrane attack complex on antigen surface.

the nurse is caring for a client experiencing sneezing, rhinorrhea, and a dry throat associated with a change in the pollen count. which laboratory finding would the nurse anticipate?

Elevation in eosinophils.

phagocytosis steps (7)

Exposure/invasion. Attraction. Adherence. Recognition. Cellular ingestion. Phagosome formation. Degradation.

inflammation stage I

Vascular response. Leukocytes and tissue mast cells secrete histamine, serotonin, kinins. Causes redness, hyperpigmentation, warmth, hyperemia, capillary leak. Macrophages secrete cytokines for more macrophages and neutrophils. Subsides in 24-72hrs.

inflammation stage II

Cellular exudate. Neutrophilia. Neutrophils, basophils, eosinophils, tissue mast cells active. Macrophages release cytokines. Cyclooxygenase coverts arachidonic acid into parts of inflammation mediators.

if an infection stimulates inflammation for longer than a few day:

Bone marrow will begin releasing immature neutrophils.

inflammation stage III

Tissue repair and replacement. Begins at time of injury but completed last. Induces surrounding healthy cells to divide and/or new blood vessel growth and scar tissue formation.

the nurse is assessing an older adult with a 4-inch reddened wound on the abdomen. when pus is noted draining from the wound, what actions should the nurse take?

Take temperature. Contact primary healthcare provider to request antibiotic. Photograph and document the wound appearance in the health record.

IgA function

High concentration in mucous membrane secretions. Upper/lower respiratory tract, GI tract, GU tract.

IgD function

B-cell antigen receptor.

IgE function

Antibody-mediated immediate hypersensitivity reaction. Parasite infestations.

IgG function

Largest amount of circulating antibodies. Sustained longterm immunity. Activates complement pathways. Enhance neutrophil and macrophage action.

IgM function

First antibody formed by sensitized B-lymphocyte. 10 binding sites. Activate complement pathway.

cytotoxic T cells

Destroy cells that contain a processed antigen's HLAs while maintaining self-tolerance through CTLA-4.

proinflammatory cytokines

IL1, IL2, IL5, IL6, IL17, IL23.

inhibitory-suppressive cytokines

IL10, tumor necrosis factor (TNF).

growth factors

G-CSF, GM-CSF, erythropoietin, thrombopoietin

interleukin-1 action

Induce fever. Trigger inflammation and coagulation.

interleukin-2 action

Increase T lymphocyte and B lymphocyte growth/activation. Enhance NK cell activity with cancer cells.

interleukin-5 action

Secreted by T-helper cells. Targets eosinophils. Increases activity of eosinophils triggers local inflammation. Increase eosinophil production.

interleukin-6 action

Stimulate liver production of fibrinogen and protein C. Increase rate of stem cell production. Increase numbers and activity of sensitized B lymphocytes.

interleukin-17 action

Increases proinflammatory cytokine production

interleukin-23 action

Increase differentiation and expansion of Th17 cells

interleukin-10 action

Secreted by macrophages and regulator T cells. Suppress release of proinflammatory cytokines. Maintain self-tolerance.

tumor necrosis factor action

Induce fever. Involved in RA, acute inflammatory response, sepsis, graft rejection. Stimulates delayed hypersensitivity reactions and allergy. Induces cell death.

granulocyte colony-stimulating factor (G-CSF) action

Increases numbers and maturity of neutrophils.

granulocyte-macrophage colony-stimulating factor (GM-CSF) action

Increases growth and maturation of myeloid stem cells.

erythropoietin action

Increases growth and differentiation of erythrocytes.

thrombopoietin action

Increases growth and differentiation of platelets.

_ immunity is important in preventing the development of cancer and metastasis after exposure of carcinogens.

Cell-mediated