chapter 16 - inflammation/immunity

immunoglobin 'secretory' antibody that is present in high concentrations in the secretions of mucous membranes and the intestinal mucosa to provide mucosal immunity most responsible for preventing infection in the upper and lower respiratory tracts, the GI tract, and the genitourinary tract

IgA

immunoglobin acts as b cell antigen receptor

IgD

immunoglobin -associated with antibody-mediated immediate hypersensitivity reactions -provides protection against parasite infestations, especially helminths

IgE

immunoglobin -accounts for the largest amount of circulating antibodies -is heavily expressed on second and subsequent exposures to antigens to provide sustained, long-term immunity against invading microorganisms -activates classic complement pathway and enhances neutrophil and macrophage actions

IgG

immunoglobin -first antibody formed on a newly sensitized b-lymphocyte plasma cell -effective at the antibody actions of agglutination and precipitation because of having 10 binding sites per molecule -activates complement pathway

IgM

*any natural protective feature of a person* provides immediate protection against effects of tissue injury and foreign proteins -- critical to health and well being causes visible symptoms and can rid the body of harmful organisms -- tissue damage may result from excessive response

innate native immunity

cytokine -induces fever -triggers inflammation and coagulation

interleukin 1

cytokine -secreted by macrophages and regulator t cells -suppresses release of pro-inflammatory cytokines -helps maintain self tolerance

interleukin 10

cytokine -increases pro-inflammatory cytokine production, especially GM-CSF and G-CSF

interleukin 17

cytokine -increases growth, differentiation, and activation of all t lymphocytes and b lymphocytes -enhances natural killer cell activity against cancer cells

interleukin 2

cytokine -increases differentiation and expansion of Th17 cells, which direct bacterium-specific killing actions in the intestinal tract

interleukin 23

cytokine -secreted by helper t cells and targets eosinophils -increases activity of eosinophils triggering local inflammation -increases reproduction of eosinophils

interleukin 5

cytokine -stimulates liver to produce fibrinogen and protein c -increase rate of bone marrow production of stem cells -increases numbers and activity of sensitized b lymphocytes

interleukin 6

common term for an alteration in the distribution of leukocytes in which there are increases in banded neutrophils usually in response to severe bacterial infection

left shift

white blood cell consist of: -humoral immunity (b cell) -cellular immunity (t cell)

lymphocyte

from committed myeloid stem cells in the bone marrow and form the mononuclear-phagocyte system until they are mature they have limited activity monocytes help with phagocytosis and antigen processing

macrophage

all microorganisms of normal flora that coexist in and on a person

microbiome

_________________ immunity is the *most effective* type of adaptive immunity and is the longest lasting.

natural active

occurs when an antigen enters your body naturally without human assistance and your body responds by actively making antibodies against that antigen ex. influenza virus processes occurring in your body at the same time as infection create immunity to that antigen so illness does not occur again after a second exposure to same antigen

natural active immunity

this type of immunity occurs when antibodies are passed from the mother to the fetus via the placenta or to the infant through colostrum and breast milk

natural passive immunity

make up between 55-70% of the normal total wbc count come from the stem cells and complete the maturation process in the bone marrow aid in phagocytosis

neutrophils

occurs when the antibodies against an antigen are transferred to a human after first being made in the body of another human or animal the body recognizes these antibodies as foreign and non-self so they are eliminated quickly -- providing only immediate, short term protection against the antigen

passive immunity

this process includes: 1. exposure/invasion 2. attraction 3. adherence 4. recognition 5. cellular ingestion 6. phagosome formation 7. degradation

phagocytosis

CMI helps protect the body through the ability to differentiate _____________.

self from non-self

prevents the different immune system cells and products from harming healthy body cells possible because of the different proteins present on cell membranes and the actions of t-lymphocytes (t regulator cells/ tregs.)

self tolerance

include: -infected body cells -cancer cells -cells from other people -invading organisms

self v. non-self

antigen-antibody interactions occurs when b cell recognizes the antigen as. non-self and is now "sensitized" to this antigen -ex. allergic response to pollen

sensitization

the purpose of this cell is to interact with the surface of any invading organism and allow recognition of non-self, especially microorganisms, so that appropriate actions are taken to rid the body of this invader

toll-like receptors (TLRs)

t/f AMI works with inflammation to protect against infection.

true

t/f HLAs are only identical to those HLAs of an identical sibling.

true

t/f in artificial active immunity the client may need repeated smaller doses of the original antigen as a "booster" to retain protection.

true

process of producing antibodies in response to a foreign antigen *acquired immunity* long term immunity; uses b cells

antibody-mediated immunity (AMI)

antigen-antibody interactions recognition of antigen by unsensitized b cells

antigen recognition

proteins capable of triggering an immunity response

antigens

immunity that is developed by a vaccine or immunization used to prevent serious and potentially deadly illnesses (tetanus, diphtheria, polio) small amounts of specific antigens are placed in the body the immune system responds by making antibodies

artificial active immunity

this immunity is most commonly used to prevent disease or death in a patient exposed to rabies, tetanus, poisonous snake bites, or other serious diseases to which he/she has little or no active immunity receiving immunoglobins produced in another animal

artificial passive immunity

from myeloid stem cells and make up about 1% of the total circulating wbc count cause s/s of inflammation

basophils

how do macrophages contribute to the neutrophilia that occurs in response to an acute bacterial infection? a) when an invasion occurs, macrophages mature into neutrophils, increasing their circulating numbers b) macrophages have only an indirect role in neutrophilia by secreting substances that reduce bone marrow production of erythrocytes and platelets c) at the onset of invasion, macrophages secrete a colony-stimulating factor to induce the bone marrow to increase production and release of neutrophils d) inflammatory damage to macrophages allows release of proteolytic enzymes that enhance liver production of all white blood cell types, including mature segmented neutrophils

c - at the onset of invasion, macrophages secrete a colony-stimulating factor to induce the bone marrow to increase production and release of neutrophils

which cells, products, or actions are involved in long-lasting immunity resulting from exposure to a specific antigen? *SATA* a) antibody attenuation b) interleukin 10 (IL-10) c) memory b cells d) monocyte maturation e) neutrophilia f) phagocytosis

c - memory b cells d - monocyte maturation

CMI helps to prevent the development of __________ and metastasis after exposure to carinogens

cancer

-warmth -redness -swelling -pain -decreased function

cardinal symptoms of inflammation

this type of immunity involves many white blood cell actions and interactions adaptive, long-lasting immunity that is provided by lymphocyte stem cells that mature in the secondary lymphoid tissues of the thymus and pericortical areas of lymph nodes responses influence and regulate the activities of AMI and innate immunity by producing and releasing cytokines

cell-mediated immunity (CMI)

-lower t cell function -b lymphocytes take longer to become sensitized and begin to make antibodies to new antigen exposures -memory cells much slower to respond to re-exposure of antigen

changes in adaptive immunity

-proteins found on surface of most body cells -determine tissue type of a person (determines the universal product code) -key for recognition and self tolerance

human leukocyte antigens (HLA)

protection from illness or disease, maintained by body's physiologic defense mechanisms

immunity

________________ drugs can help the body prevent rejection when having an organ transplant.

immunosuppressant

occurs in response to tissue injury, invasion of organisms usually accompanied by inflammation

infection

normal tissue responses to cellular injury, allergy, or pathogen presence

inflammation

the percentage and actual number of mature circulating neutrophils are used to measure a patient's risk for infection - the higher the numbers the greater the resistance to infection

absolute neutrophil count (ANC)

occurs when the antigens enter a human and he/she responds by making specific antibodies against the antigen long term

active immunity

which change would the nurse expect to see in the white blood cell differential of a client who has a prolonged, severe intestinal helminth infestation? a) band neutrophils outnumber segmented neutrophils b) macrophage count is low c) monocyte count is high d) eosinophil count is high

d - eosinophil count is high

from the myeloid line and contain many vasoactive chemicals 1-4% of total wbc count allergic reactions

eosinophils

t/f when a patient has inflammation it *ALWAYS* means that there is an infection

false