IMMUNE SYSTEM

CINDY B. SAN BUENAVENTURA, RN

OBJECTIVES:

In this chapter, you’ll learn:

 The four structures of the immune system

 Cell-mediated immunity, humoral immunity, and the complement system, and how they work
 The pathophysiology, signs and symptoms, diagnostic tests, and treatments for common immune system disorders.
UNDERSTANDING THE IMMUNE SYSTEM

 The body protects itself from infectious organisms and other harmful invaders through an elaborate network of
safeguards called host defense system. This system has three lines of defense:

 Physical and chemical barriers to infection

 The inflammatory response
 The immune system response
 Physical barriers, such as the skin and mucous membranes, prevent the most organisms from invading the
body. Organisms that penetrates this first barriers simultaneously trigger the inflammatory and immune
responses. Both responses involve stem cells in the bone that form blood cells.
STRUCTURE OF THE IMMUNE SYSTEM

These four structures in the body make up the immune system:

 Lymph nodes
 Thymus
 Spleen
 tonsils
LYMPH NODES
The lymph nodes also remove bacteria and toxins from the circulatory system. This means that, on
occasion, infectious agents can be spread by the lymphatic system.

THYMUS
The thymus, located in the mediastinal are (between the lungs), secretes a group of hormones that
enable lymphocytes to develop into mature T cells.
T cells attack foreign or abnormal cells and regulate cell-mediated immunity.
SPLEEN
The largest lymphatic organ, the spleen functions as reservoir for blood. Cells in the splenic tissue, called
macrophages, clear cellular debris and process hemoglobin.

TONSILS
The tonsils consist of lymphoid tissue and also produce lymphocytes.
The location of the tonsils allows them to guard the body against airborne and ingested pathogens.
TYPES OF IMMUNITY

 Certain cells have the ability to distinguish between foreign matter and what belongs
to the body –a skill known as immunocompetence. When foreign substances
invades the body, two types of immune responses are possible: cell-mediated
immunity and humoral immunity.
CELL-MEDIATED IMMUNITY

 In cell-mediated immunity, T cells respond to antigens ( foreign substances, such as bacteria or toxins, that induce
anti-body formation). This response involves destruction of target cells-such as virus-infected cells and cancer
cells-through the secretion of lymphokines (lymph proteins). Example of cell-mediated immunity are rejection of
transplanted organs and delayed immune responses that fight disease.
 Thirty-six percent of white blood cells ( WBCs) are T cells. They are thought to originate from stem cells in the
bone marrow; the thymus gland controls their maturity. In the process, a large number of antigen-specific cells are
produced.
A LICENSE TO KILL, HELP, OR SUPPRESS

 T cells can be a killer, helper or suppressor T cells.

 Killer cells bind to the surface of the invading cell, disrupt the membrane, and destroy it by altering its internal
environment.
 Helper cells stimulate B cells to mature into plasma cells, which begin to synthesize and secrete immunoglubolin
(proteins with known antibody activity).
 Suppressor cells reduce the humoral responses
HUMORAL IMMUNITY

 B cells act in a different way than T cells to recognize and destroy antigens. B cells are
responsible for humoral or immunoglobulin-mediated immunity. B cells originate in
the bone marrow and mature into plasma cells that produce antibodies
(immunoglobulin molecules that interact with a specific antigen). Antibodies destroy
bacteria and viruses, thereby preventing them from entering host cells.
5 MAJOR CLASSES OF IMMUNOGLOBULIN

 Immunoglobulin G ( IgG) makes aup about 80% of plasma antibodies. It appears in all body fluids and in the major
antibacterial and antiviral antibody.
 Immunoglobulin M ( IgM) is the first immunoglobulin produced during an immune response. It’s too large to easily
cross membrane barriers and is usually present only in the vascular system.
 Immunoglobulin A ( IgA) is found mainly in the body secretions, such as saliva, sweat, tears, mucus, bile and
colostrum. It defends pathogens on the body surfaces, especially those that enter the respiratory and GI tracts.
 Immunoglobulin D ( IgD) is present in plasma and is easily broken down. It’s the predominant antibody on the
surface of B cells and is mainly an antigen receptor.
 Immunoglobulin E ( IgE) is the antibody involved in immediate hypersensitivity reactions, or allergic reactions that
develop within minutes of exposure to an antigen. IgE stimulates the release of mast cell granules, which contain
histamine and heparin.
COMPLEMENT SYSTEM

 Complement system is the major mediator of the inflammatory response. It consists of 30 proteins
circulating as functionally inactive molecules.

The System causes inflammation by:

 Vascular permeability
 Chemostaxis ( movement of additional WBCs to an area of inflammation )
 Phagocytosis ( engulfing of foreign particles by cells called phagocytes)
 Lysis of the foreign cell ( in most case, an antigen-antibody reaction is necessary for the
complement system to activate, a process called the complement cascade.
IMMUNE DISORDERS

COMMON IMMUNE DISORDERS INCLUDE:

 Allergic rhinitis
 Anaphylaxis
 human immunodeficiency virus ( HIV)
 Lupus erythematosus
 rheumatoid arthritis
DISORDERS OF THE IMMUNE RESPONSE ARE OF 3 MAIN TYPES:

 Immunodeficiency disorders
 Hypersensitivity disorders
 Autoimmune disorders
 Immunodeficiency disorders result from an absent or depressed immune system. Some examples include HIV
disease, DiGeorges syndrome, chronic fatigue syndrome, and immune dysfunction syndrome.
 When an allergen ( a substance the person is allergic to) enters the body, a hypersensitivity reaction occurs. It
may be immediate or delayed. Hypersensitivity reactions are classified as:
 Type I ( IgE-mediated allergic reactions)
 Type II ( cytotoxic reactions)
 Type III ( immune complex reactions)
 Type IV ( cell-mediated reactions)
 With autoimmune disorders, the body launches an immunologic response against itself. This leads to a sequence
of tissue reactions and damage that may produce diffuse systemic signs and symptoms.
 Examples of autoimmune disorders include rheumatoid arthritis, lupus erythematosus, dermatoyositis, and
vasculitis.
LUPUS ERYTHEMATOSUS

 A chronic, inflammatory, autoimmune disorder affecting the connective tissues, lupus erythematosus takes two
forms: discoid and systemic. The first type affects only the skin; the second type affects multiple organs and can be
fatal.
 Discoid lupus erythematosus causes superficial lesions-typically over the cheeks and bridge of nose-that leave
scars after healing. Systemic lupus erythematosus ( SLE) is characterized by recurrent remissions and
exacerbations.
 About 6000 new cases of SLE are diagnosed each year. Lupus erythematosus strikes women 8 times ore often
than men and occurs 15 times more often during childbearing years. It occurs worldwide but is most prevalent
among Asians and blacks.
 Although there’s no cure for lupus, the prognosis improves with early detection and treatment. Prognosis remains
poor for patients who develop cardiovascular, renal, or neurologic complications or severe bacterial infections.
HOW IT HAPPENS?

 The exact cause of lupus erythematosus remains a mystery, but autoimmunity is probably the primary cause,
along with environmental, hormonal, genetic and possibly, viral factors.
 In auto immunity, the body produces antibodies against its own cells. The formed antigen-antibody complexes can
suppress the body’s normal immunity and damage tissues. A significant feature of patients with SLE is their ability
to produce antibodies against many different tissues components, such as red blood cells, neutrophils, platelets,
lymphocytes, or almost any organ or tissue in the body.
SIGNS AND SYMPTOMS
 Skin
As many as 70% of people with lupus have some skin symptoms. The three main categories of lesions are chronic
cutaneous (discoid) lupus, subacute cutaneous lupus, and acute cutaneous lupus. People with discoid lupus may
exhibit thick, red scaly patches on the skin. Similarly, sub-acute cutaneous lupus manifests as red, scaly patches of skin
but with distinct edges. Acute cutaneous lupus manifests as a rash. Some have the classic malar rash (or butterfly rash)
associated with the disease.This rash occurs in 30 to 60% of people with SLE.
 Muscles and bones
 The most commonly sought medical attention is for joint pain, with the small joints of the hand and wrist usually
affected, although all joints are at risk. More than 90 percent of those affected will experience joint and/or muscle pain
at some time during the course of their illness.
 Unlike rheumatoid arthritis, lupus arthritis is less disabling and usually does not cause severe destruction of the joints.
Fewer than ten percent of people with lupus arthritis will develop deformities of the hands and feet. People with SLE are
at particular risk of developing osteoarticular tuberculosis.