copyright © 2013, 2010, 2006, 2002 by saunders, an imprint of elsevier inc

Copyright © 2013, 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc.

Chapter 19

Inflammation and the Immune Response


Meet human need for protection by neutralizing, eliminating, or destroying organisms invading the internal environment

Purpose of Inflammation & Immunity


Proteins on Human Cell Membranes


Self Versus Non-Self


Found on surface of most body cellsDetermine tissue type of personKey for recognition and self-tolerance

Human Leukocyte Antigens


Immune system influenced by many systems (e.g., nervous system, endocrine system, GI system)

Stem cells – Immature, undifferentiated cells; produced by bone marrow

Leukocytes (WBCs) – Protect body from effects of invasion by organisms

Organization of the Immune System


Stem Cell Differentiation and Maturation


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 body of harmful organisms; tissue damage may result from excessive response

Inflammation: “Innate Native Immunity”


Occurs in response to tissue injury, invasion of organisms

Usually accompanied by inflammation, but inflammation can occur without infection

Inflammation does not always mean infection is present!

Infection


NeutrophilsMacrophagesBasophilsEosinophils

Cell Types Involved in Inflammation


Phagocytosis


Five cardinal manifestations of inflammation:◦Warmth ◦Redness◦Swelling◦Pain◦Decreased function

Sequence of Inflammatory Response


Stage I (vascular) – Change in blood vessels:◦Phase I—constriction◦Phase II—hyperemia & edema

Stage II (cellular exudate) – Neutrophilia, pus

Stage III (tissue repair and replacement) – WBCs trigger new blood vessel and growth (angiogenesis) and scar tissue formation

Sequence of Inflammatory Response


Antibody - Mediated Immunity


Agglutination


Adaptive internal protection resulting in long-term resistance to effects of invading microorganisms

Body must learn to generate specific immune responses when infected by or exposed to specific organisms

Immunity


Innate-native immunity—natural immunity

Adaptive immunityActive immunityNatural active immunity

Acquiring Antibody – Mediated Immunity


Artificial active immunityPassive immunityNatural passive immunityArtificial passive immunity

Acquiring Antibody – Mediated Immunity


Also called cellular immunityInvolves many WBC actions and

interactionsAnother type of adaptive/acquired true

immunityFor total immunocompetence, CMI must

function optimally

Cell – Mediated Immunity (CMI)


Helps protect body through ability to differentiate self from non-self

Prevents development of cancer and metastasis after exposure to carcinogens

Protection Provided by CMI


Hyperacute rejectionAcute rejectionChronic rejectionManagement of transplant rejectionMaintenance therapyRescue therapy

Transplant Rejection


Immune function is most efficient when people are which age?

A. InfancyB. Teen yearsC. 20 to 30 yearsD. 50 years and older

QUESTION 1


A 37-year-old man with polycystic kidney disease is on the kidney transplant list. He is to receive 2 units of leukocyte-poor packed red blood cells to treat a low hemoglobin. He asks the nurse why he needs this type of blood. What is the nurse’s best response?

A. “All pre-transplant patients receive leukocyte-poor blood because it is absorbed better by the body.”

B. “It causes fewer blood reactions for pre-transplant patients.”

C. “It is less likely to causes hemolysis, or destruction of the blood cells, after transfusion.”

D. “It will decrease the risk of obtaining white cells from the donor that could make it harder for your transplanted kidney to function.”

QUESTION 2


True or False: Inflammation means that an infection is present.

A. TrueB. False

QUESTION 3

copyright © 2013, 2010, 2006, 2002 by saunders, an imprint of elsevier inc

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