Chapter 19

• Inflammation of infections
• Pregnancy
• Meds (glucose steroids)
• High WBC 
• Smoking 
• Stress/Anxiety/Rage
• Surgery 
• Exercise 

• maximum protection against infection
• reduced by disease, injuries and medical therapies 

recognizing self versus non-self, to prevent healthy body cells from being destroyed along with the invaders

• found on the surface of all body cells of that person and serve as a "universal product code" or a "cellular fingerprint" for that person
• on the surface of most body cells
• determines tissue type of a person

• proteins capable of stimulating an immune response
• key for recognition

• immature undifferentiated cells
• bone marrow
• the cell is not yet committed to maturing into a specific blood cell type 

each cell has more than one potential outcome

• -makes up 55-70% of WBC
• -also called granulocytes 
• -growth requires 12-14 days 
• -lifespan 12-18 hours

• can have many phagocytic events
• -monocytes move from blood to body tissues where they mature into macrophages
• -come from the stem cell

• destruction of bacteria and cellular debris; matures into macrophage
• -stem cell

• 1-2% of WBC
• contains vasoactive chemicals
• -limits inflammatory reaction
• -against infections of parasitic larvae 
• -increased during an allergic response

• causes signs of inflammation 
• -1% of WBC
• -releases chemicals through blood vessels

• becomes sensitized to foreign cells and proteins
• most direct role in AMI
• start as stem cells
• migrate into secondary lymphoid tissues, maturation is completed here

secretes immunoglobulins in response to the presence of a specific antigen

remains sensitized to a specific antigen and can secrete increased amounts of immunoglobulins specific to the antigen on re-exposure

• enhances immune activity through secretion of various factors, cytokines, and lymphokines
• -recognizes self versus non-self cells 
• -increase bone marrow production of stem cells and speed up their maturation 

selectively attacks and destroys non-self cells, including virally infected cells, grafts and transplant organs 

non selectively attacks non-self cells, especially body cells that have undergone mutation and become malignant; also attacks  grafts and transplanted organs

immediate protection against the effects of tissue injury and invading foreign proteins

skin, mucosa, antimicrobial chemicals on the skin, complement, and natural killer cells

• nonspecific body defense to invasion or injury
• symptoms depend on: intensity, severity, duration of exposure to initiating event

• loss of function
• pain
• swelling
• process in response to tissue injury, as well as to invasion by organisms

• bands are usually only 10-12%
• -more circulating bands than mature neutrophils
• -indicates the patient's bone marrow cannot produce mature neutrophils to fight infection into the blood

• provides protection after invadors (bacteria)
• -higher the numbers, the greater the resistance to infection

• provides protection
• -immediate inflammatory responses and stimulates long lasting immune responses
• -long life spans
• -traps invading cells

• heparin-inhibits blood and protein clotting
• histamine-constricts small veins, inhibitin blood flow and decreasing venous return
• kinins-dilate arterioles and increase capillary permeability

the engulfing and destruction of invadors

• exposure/invasion
• -triggered by injury or invasion

• attraction
• -phagocytosis can only occur when the WBC comes into direct contact with the target

• adherence
• -phagocytic cell first binds to the surface
• -during inflammation, coating the target makes it easier for phagocytic cell to bind to the surface

substances that increase contact of the cell with its target by coating the target cell (antigen or organism)

• recognition
• -occurs when the phagocytic cell sticks to the surface of the target cell and "recognizes" it as non-self

• cellular ingestion
• -phagocytic destruction occurs inside the cell
• -phagocytic cell engulfs the target cell to form a vacuole

• phagosome formation
• -occurs when the phagocyte's granules are inside the vacuole
• -granules break and release enzymes that attack the ingested target

• degradation 
• -the phagocyte ingests the engulfed target
• -broken into smaller pieces

• warmth
• redness
• swelling
• pain
• decreased function

• vascular
• changes in blood vessels
• secretes; histamine, serotonin, kinins
• constrict small veins and dilate the arterioles
• edema
• capillary leak
• subsides within 24-72 hours 

• cellular exudate
• pus 
• necrotic tissue
• dead WBC
• fluids that escape from damaged cells
• neutrophil count can increase up to 5 times within 12 hours after onset

• tissue repair and replacement
• begins at the time of injury
• inducing the remaining healthy cells to divide
• scar tissue formation

• adaptive internal protection that results in long term resistance to the effects of invading microorganisms 
• not automatic

• humoral immunity
• involves antigen-antibody interactions to neutralize, eliminate, or destroy foreign proteins

starts immediately to produce antibodies against the sensitizing antigen

• is a clumping action that results from the antibody linking antigens together, forming large and small immune complexes 
• slows the movement of the antigen in body fluids 

is cell membrane destruction, and it occurs now because of antibody binding to membrane-bound antigens of some invaders

circulating antibodies can be transferred from one person to another to provide the receiving person with immediate immunity of short duration 

are actions triggered by some classes of antibodies that can remove or destroy antigen

• exposure or invasion by new antigens
• -must first enter the person
• -must occur in large numbers
• -overwhelms the inflammatory response to get rid of invader

• antigen recognition 
• -started by the macrophages
• -recognizes the invading antigen as non-self and attaches itself to the antigen

• sensitization
• -bell-cell recognizes the antigen as non-self and is not "sensitized" to this antigen
• -allows b-cell to respond to any substance that carries the same antigens

• antibody production and release
• -allow the antibodies to search out specific antigens
• -produced by plasma cells, released into the blood
• -remains in blood for 3-30 days

• antibody-antigen binding
• -antibodies are Y shaped molecules
• -each antibody can bind either to two separate antigens or to tow areas of the same antigen 
• -antibody-antigen binding starts other actions that neutralize, eliminate  or destroy the antigen

• antibody-binding actions
• -actions include:
• agglutination 
• lysis
• complement fixation
• precipitation
• inactivation
• neutralization

antibody molecules bind so much antigen that large antigen-antibody complexes are formed

process of making an antigen harmless without destroying it

• sustained immunity (memory)
• -long lasting immunity to a specific antigen
• -memory b-cells made during sensitization stage

• -responsible for providing long term immunity
• -involved in cell mediated non-self cell killing action of natural killer cells
• -composes at least 75% of circulating antibody population
• -allergic reactions 

• -first responders
• -composes about 10-15% of circulating antibody population
• -effective i actions of agglutination and precipitation
• -10 potential binding sites

is used for antibodies because they are globular proteins that provide immunity 

antibodies are called this because all free antibodies in the plasma separate out in the gamma fraction of plasma proteins during electrophoresis

person's body learns to make as an adaptive response to invasion by organisms

• -you create them
• -occurs when antigens enter the body and the body responds by making specific antibodies against the antigen 

• occurs when an anitgen enters the body without human assistance and the body responds by actively making antibodies against that antigen 
• (ex: chickenpox virus)

• is the protection developed by vaccination or immunization 
• -prevent infections or diseases

• occurs when antibodies against the antigen are in a person's body but were not created there
• -transferred to the person's body after being made in the body of another person or animal

occurs when antibodies are passed from mother to the fetus via the placenta or through breast milk

• involves injection the person with antibodies that were produced in another person or animal
• -prevent diseases or deaths for patients exposed to rabies, tetanus, and poisonous snake bites

• help prevent hypersensitivity on exposure to non-self cells or proteins
• -preventing the formation of antibodies directed against normal, healthy self cells 
•  

• destroy cells that contain a processed antigen's human leukocyte antigens (viruses)
• -recognize the cell as abnormal and binds to it

• "seek and destroy"  missions in the body to eliminate non-self cells
• -most effective in destroying unhealthy, abnormal cells (cancer)

• small protein hormones produced by the many WBCs
• -act like "messengers" that tell specific cells how and when to respond

cytokines made by macrophages, neutrophils, epsinophils, and monocytes

cytokines produced by t-cells

important in preventing the development of cancer and metastasis after exposure to carcinogens