Chapter 11- immune system disorders

antigens

mark self “non-harmful” or non-self “harmful”

3 main types of disorders

immunodeficiency

autoimmunity

hypersensitivity

immunodeficiency

weakened immune system

autoimmunity

attack “self” cells

hypersensitivity

over-active immune system

monocytes create

macrophages

cytokines

chemical signals produced by WBC’s

the 3 cytokines

TNF-alpha

interleukins

prostaglandins

Natural killer cells (NK cells)

granular lymphocytes, destroy tumor cells ad virus infected cells without previous exposure

innate immunity is

nonspecific

adaptive immunity is

acquired

the memory response of adaptive immunity

recognize and remember antigens

adaptive immunity is comprised of what cells

T and B

what helps recognize and keep the body from attacking it’s “self cells”

MHC- major histocompatibility complex

MHC is also called

HLA- human leukocyte antigen

antigens activate a specific B cell and it becomes a ________ cell that produces ______

plasma

antibodies

activated b cells also form _______ ______, which have a quicker and stronger response

memory cells

antigen presenting cells (APC’s)

macrophages and dendritic cells

present antigen to activate T cells

t cells-types

CD4- helper

CD8-cytotoxic

what damages CD4 cells

HIV

Ig’s are produced by

b cells

5 subtypes of Ig’s

IgG

IgA

IgM

IgE

IgD

what is the first Ig to respond

IgM

in a secondary exposure what Ig levels increase rapidly

IgG

where is IgA found

secretions such as tears, saliva, respiratory secretions, GI fluid, and breast milk

what Ig elevates during an allergic reaction

IgE

what iG is seen in hypersensitivity reactions

IgD

active acquired immunity

comes from exposure to antigen through illness or vaccine

passive acquired immunity

individual receives premade antibodies

not permanent

history of Hep c infection is what type of acquired immunity

active

covid 19 IVIG infusion is an example of

passive acquired

vaccines stimulate immune response and produce memory cells….

without disease contraction

anergy panel

test immunocompetence

lacking response may indicate immunodeficiency

antibody titer

antibody screening tests indicating presence and level of antibodies

what Ig could demonstrate previous exposure and immune competence

IgG

what Ig would you expect to see i an acute new infection

IgM

allergy testing - serology tests

ELISA – enzyme linked immunosorbent assay – detect allergen protein molecule

RAST – Radioallergosorbent test – detect IgE levels in response to allergens

overreaction ex.

hypersensitivity and autoimmune disorders

underreacting ex.

immunodeficiency

hypersensitivity has 4 types an they are

1. immediate (allergies)

2. cytotoxic

3. immune complex

4. delayed hypersensitivity

primary immunodeficiency

congenital- present of birth

secondary immunodeficiency

develops due to infection, chemotherapy, immunosuppressive drugs

type hypersensitivity

immediate

immediate hypersensitivity occurs when ____ binds to ___________ and combines with the __________

IgE

mast cells

antigen

type 1 immediate hypersensitivity is also known as

allergy or atopic disorder

immediate hypersensitivity can be 1 of 2 types

localized or systemic

examples of localized immediate hypersensitivity

hives (urticaria) and allergic rhinitis

symptoms of allergic rhinitis

watery eyes

sneezing

rhinorrhea (white/clear)

may progress to coughing

bronchospasm

example of a systemic immediate hypersensitivity reaction

anaphylaxis

anaphylaxis is a

severe, life-threatening response

symptoms of anaphylaxis

urticaria

bronchoconstriction

laryngeal edema

angioedema (swelling of facial area)

anaphylaxis is considered a

medical emergency

death can happen within minutes

counteract medicine for anaphylaxis

epipen

type 2 hypersensitivity is

cytotoxic

cytotoxic hypersensitivity is when Ig’s

attack antigens on cell surface

example of a cytotoxic hypersensitivity

blood transfusion reaction

type 3 hypersensitivity is

immune complex

immune complex hypersensitivity is when

antigen- antibody complex is deposited into tissues and tissue damage is the result

immune complex hypersensitivity may be

systemic or localized

example of systemic immune complex hypersensitivity

lupus

example of localized immune complex hypersensitivity

rheumatoid arthritis

type 4 hypersensitivity is

delayed hypersensitivity

delayed hypersensitivity is ______ cell mediated

T

in a delayed hypersensitivity response, previous exposure to an antigen will

prime the t cell

just like it’s name, t cell attack is _________ in delayed hypersensitivity

delayed!— days after initial exposure

examples of delayed hypersensitivity

poison ivy or a transplant rejection

an autoimmune disorder is an example of what type of reaction disorder

overreaction

an autoimmune disorder means that the body will attack

self cells

why does the body attack itself in autoimmune disorders

due to molecular mimicry

molecular mimicry

body’s antigens resemble infectious agent and the immune system mistakenly attacks body cells

systemic lupus erythematosus (SLE)

multisystem and chronic disease

has remissions and exacerbations

in SLE ________ _________ are deposited in the tissues

antibody complexes

diagnosis of SLE

antinuclear antibodies (ANAs) are present

95% of lupus cases contain elevated ANA

symptoms of SLE

skin rash- butterfly rash

joint inflammation

vasculitis

although it can be a key indicator to SLE, ANA elevation is not

specific to lupus

treatment for SLE

NSAIDS

Corticosteroids

Methotrexate

rheumatoid arthritis (RA) is

chronic joint inflammation

symptoms of RA

symmetrical, tender, swollen joints

painful stiff joints for 30 mins or more in the morning

swan neck (fingers) and boutonniere (knuckles) deformities

RA diagnosis

rheumatoid factor (RF)

ESR and CRP elevation

elevated anti-citrullinated protein antibodies (Anti-CPP)

treatments for RA

NSAIDS, methotrexate, DMARD’s, immunosuppressants

Sarcoidosis is a

multi-system disorder

in sarcoidosis, chronic inflammation causes

granulomas

most frequent place of sarcoidosis involvement

lungs

• skin and eyes too

symptoms of sarcoidosis

granulomas

erythema nodosum

erythema nodosum

tender, erythematous nodules on anterior legs

diagnosis of sarcoidosis

chest x ray

biopsy of sarcoid lesion

treatment of sarcoidosis

glucocorticoids, chemo, immunosuppressive agents

disease clears spontaneously in 50% of patients

Sjogren’s syndrome is

the immunological destruction of lacrimal and salivary glands

women more commonly affected

symptoms of Sjogren’s syndrome

dry eyes and dry mouth

word for dry eyes

keratoconjunctivitis sicca

word for dry mouth

xerostomia

diagnosis of Sjogren’s syndrome

ANA’s elevated

anti-R o/SSA and anti-L a/SSB (autoantibodies) present

scleroderma is the

abnormal accumulation of fibrous tissue in skin and organs

scleroderma can cause

inflammatory reaction with injury to endothelium

symptoms of scleroderma

most noticeable change is tightening of skin

how will the skin appear in scleroderma

smooth shiny and stretched

scleroderma can cause _______ of the fingers

contractures

type of scleroderma

CREST

diagnosis of scleroderma

elevated ANAs

different lung appearance

what do the lungs look like in scleroderma

ground glass