LESSON: BASIC IMMUNOLOGY

DEFINITION OF TERMS • Spleen

- The spleen is a soft, blood-rich organ that
• Immune System filters blood.
- Organs, cells, tissues and molecules that - Instead of filtering lymph, the spleen filters
mediate to infection. and cleanses the blood of bacteria, viruses,
- The major component of the immune system and other debris; it provides a site for
is the lymphatic system, composed of the bone lymphocyte proliferation and immune
marrow, spleen, and thymus gland, as well as surveillance, but its most important function
the lymph nodes and ducts. In addition, there is to destroy worn-out red blood cells and
are specialized blood cells (lymphocytes and return some of their breakdown products to
leukocytes) that work within the immune the liver.
system. • Thymus Gland
• Immunology - The thymus gland functions at peak levels only
- study of structure and function of the immune during youth.
system - The thymus gland produces thymosin and
• Immunity others, that function in the programming of
- body’s specific protective response to a foreign certain lymphocytes so they can carry out their
agent or organism. protective roles in the body.
• Immune response • Tonsils
- collective and coordinated response to the - The tonsils are small masses of lymphoid
introduction of foreign substances in an tissue that ring the pharynx (the throat), where
individual mediated by the immune system they are found in the mucosa.
• Immunoregulation - Their job is to trap and remove any bacteria or
- balances and counterbalances the immune other foreign pathogens entering the throat.
response • Peyer’s Patches
• Immunopathology - Peyer’s patches resemble the look of the
- the study of disease resulting from tonsils.
dysfunctions within the immune system - The macrophages of Peyer’s patches are in an
- ideal position to capture and destroy bacteria
ROLES OF IMMUNE SYSTEM (always present in tremendous numbers in the
intestine), thereby preventing them from
1. Defense against microbes penetrating the intestinal wall.
2. Homeostasis • Bone Marrow
3. Surveillance- defense against the growth of - The white blood cells (WBCs) involved in
tumor cells immunity are produced in the bone marrow.
ORGANS OF THE IMMUNE SYSTEM Like other blood cells, lymphocytes are
generated from stem cells (undifferentiated
• Lymphatic Vessels cells).
- The function of the lymphatic vessels is to form
an elaborate drainage system that picks up ▪ B lymphocyte. The effectors of humoral
excess tissue fluid, now called lymph. immunity, providing defense against
• Lymph Nodes pathogens through different functions
- The lymph nodes in particular help protect the including antibody production. B
body by removing foreign material such as lymphocytes mature in the bone marrow
bacteria and tumor cells from the lymphatic before entering the bloodstream
stream and by producing lymphocytes that ▪ T cells. The rest of the cortical cells are
function in the immune response. lymphocytes “in transit”, the so-called T
▪ Macrophages. Within the lymph nodes are cells that circulate continuously between
macrophages, which engulf and destroy the blood, lymph nodes and lymphatic
bacteria, viruses, and other foreign stream, performing their surveillance role.
substances in the lymph before it is s T lymphocytes mature in the thymus,
returned to the blood. where they also differentiate into cells with
▪ Lymphocytes. Collections of lymphocytes various functions
(a type of white blood cell) are also
strategically located in the lymph nodes CELLS OF THE IMMUNE SYSTEM
and respond to foreign substances in the
lymphatic stream. • Bone marrow
▪ Plasma cells. These centers enlarge when - The site in the body where most of the cells of
specific lymphocytes (the B cells) are the immune system develop from
generating daughter cells called plasma hematopoietic stem cells.
cells, which release antibodies.

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• Stem cells 2. Cytokines
- These cells have the potential to develop and - a type of hormone responsible for
mature into the different cells of the immune communication between cells of the
system. immune system
• Thymus 3. Complement
- An organ located in the chest which instructs - a system of plasma proteins that can be
immature lymphocytes to become mature T activated directly by pathogens or
cells. indirectly by pathogen-bound antibody,
• B cells leading to a cascade of reactions that
- These lymphocytes arise in the bone marrow occurs on the surface of pathogens and
and differentiate into plasma cells which in generates active components with various
turn produce immunoglobulins (antibodies). effector functions.
• Cytotoxic T cells 4. Interleukins
- These lymphocytes mature in the thymus and - are a type of cytokine first thought to be
are responsible for killing cells infected with expressed by leukocytes alone but have
viruses. later been found to be produced by many
• Helper T cells other body cells.
- These specialized lymphocytes help other T 5. Interferons
cells and B cells to perform their functions. - an antiviral factor that interferes with viral
• Plasma Cells replication in mammalian cells.
- These cells develop from B cells and are the - They are secreted from infected cells and
cells that make immunoglobulin (antibodies). activate innate immune response that
• Immunoglobulins promotes not only cytokine production but
- These highly specialized protein molecules, also natural killer cell functions and
also known as antibodies, fit foreign antigens, antigen presentation.
such as polio, like a lock and key. Their variety ANTIBODIES
is so extensive that they can be produced to
match almost all possible microorganisms in • The four-chain structure of an antibody, or
our environment. immunoglobulin, molecule. The basic unit is
composed of two identical light (L) chains and
• Neutrophils
two identical heavy (H) chains, which are held
- (also known as polymorphonuclear cells or
together by disulfide bonds to form a flexible Y
PMN) are a type of white blood cell found in the
shape. Each chain is composed of a variable
bloodstream that rapidly ingest
(V) region and a constant (C) region.
microorganisms and kills them through a
process called phagocytosis. • IgG
- IgG is the most abundant antibody isotype in
• Monocytes
the blood (plasma), accounting for 70-75% of
- These white blood cells are cells found in the
human immunoglobulins (antibodies). IgG
bloodstream that develop into cells called
detoxifies harmful substances and is
macrophages when they migrate into tissues.
important in the recognition of antigen-
Like neutrophils, macrophages also ingest and
antibody complexes by leukocytes and
kill germs via phagocytosis.
macrophages. IgG is transferred to the fetus
• Red Blood Cells
through the placenta and protects the infant
- The red cells in the bloodstream that carry
until its own immune system is functional.
oxygen from the lungs to the tissues.
• Platelets
• IgM
- Small cells in the bloodstream that are
- IgM usually circulates in the blood, accounting
important for blood clotting
for about 10% of human immunoglobulins.
• Dendritic Cells
IgM has a pentameric structure in which five
- These cells instruct T cells on what to attack,
basic Y-shaped molecules are linked together.
also known as antigen-presenting cells.
B cells produce IgM first in response to
microbial infection/antigen invasion.
Molecules of the Immune System - Although IgM has a lower affinity for antigens
than IgG, it has higher avidity for antigens
1. Antibodies
because of its pentameric/hexameric
- also called immunoglobulin, a protective
structure. IgM, by binding to the cell surface
protein produced by the immune system in
receptor, also activates cell signaling
response to the presence of a foreign
pathways.
substance, called an antigen.
- Antibodies recognize and latch onto
antigens in order to remove them from the
body.
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STEPS ON IMMUNE RESPONSE
• IgA
- IgA is abundant in serum, nasal mucus, When the body is invaded or attacked by bacteria,
saliva, breast milk, and intestinal fluid, viruses, or other pathogens, it has three means of
accounting for 10-15% of human defense:
immunoglobulins. IgA forms dimers (i.e., two • The phagocytic immune response
IgA monomers joined together). IgA in breast - primarily involves the WBCs (granulocytes
milk protects the gastrointestinal tract of and macrophages), which have the ability
neonates from pathogens. to ingest foreign particles and destroy the
• IgE invading agent; eosinophils are only
- IgE is present in minute amounts, accounting weakly phagocytic.
for no more than 0.001% of human - Phagocytes also remove the body’s own
immunoglobulins. Its original role is to protect dying or dead cells. Cells in necrotic tissue
against parasites. In regions where parasitic that are dying release substances that
infection is rare, IgE is primarily involved in trigger an inflammatory response.
allergy. - Apoptosis, or programmed cell death, is
• IgD the body’s way of destroying worn-out cells
- IgD accounts for less than 1% of human such as blood or skin cells or cells that
immunoglobulins. IgD may be involved in the need to be renewed
induction of antibody production in B cells, • The humoral or antibody immune
but its exact function remains unknown. response
TYPES OF IMMUNITY - (sometimes called the antibody response),
begins with the B lymphocytes, which can
• Active Immunity transform themselves into plasma cells
- results when exposure to a disease organism that manufacture antibodies.
triggers the immune system to produce - These antibodies are highly specific
antibodies to that disease. Active immunity proteins that are transported in the
can be acquired through natural immunity or bloodstream and attempt to disable
vaccine-induced immunity. invaders.
a. Natural immunity is acquired from • The cellular immune response
exposure to the disease organism through - also involves the T lymphocytes, which can
infection with the actual disease. turn into special cytotoxic (or killer) T cells
b. Vaccine-induced immunity is acquired that can attack the pathogens.
through the introduction of a killed or - The structural part of the invading or
weakened form of the disease organism attacking organism that is responsible for
through vaccination. stimulating antibody production is called
• Passive immunity an antigen (or an immunogen)
- provided when a person is given antibodies to
a disease rather than producing them through STAGES OF IMMUNE RESPONSE
his or her own immune system. 1. Recognition
▪ A newborn baby acquires passive - Recognition of antigens as foreign, or non-self,
immunity from its mother through the by the immune system is the initiating event
placenta. in any immune response.
▪ People can also get passive immunity - Recognition involves the use of lymph nodes
through antibody-containing blood and lymphocytes for surveillance.
products such as immune globulin, which 2. Proliferation
may be given when immediate protection - The circulating lymphocytes containing the
from a specific disease is needed. antigenic message return to the nearest lymph
STEPS ON VIRAL INFECTION node.
- Once in the node, these sensitized
I. The virus recognizes and binds to a host lymphocytes stimulate some of the resident T
cell via a receptor molecule on the cell and B lymphocytes to enlarge, divide, and
surface. proliferate. T lymphocytes differentiate into
II. The virus or its genetic material enters the cytotoxic (or killer) T cells, whereas B
cell. lymphocytes produce and release antibodies.
III. The viral genome is copied and its genes - Enlargement of the lymph nodes in the neck in
are expressed to make viral proteins. conjunction with a sore throat is one example
IV. New viral particles are assembled from the of the immune response.
genome copies and viral proteins.
V. Completed viral particles exit the cell and
can infect other cells.

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3. Response
- the differentiated lymphocytes function in
either a humoral or a cellular capacity. PHYSICAL ASSESSMENT
- This stage begins with the production of (SIGNS AND SYMPTOMS)
antibodies by the B lymphocytes in response Respiratory System Change in RR
to a specific antigen. The cellular response Cough
stimulates the resident lymphocytes to become Abnormal Lung Sound
cells that attack microbes directly rather than Rhinitis
through the action of antibodies. Hyperventilation
- These transformed lymphocytes are known as Bronchospasm
cytotoxic (killer) T cells Cardiovascular Hypotension
4. Effector System Tachycardia
- In the effector stage, either the antibody of the Dysrhythmia
humoral response or the cytotoxic (killer) T cell Vasculitis
of the cellular response reaches and connects Anemia
with the antigen on the surface of the foreign
Gastrointestinal Hepatosplenomegaly
invader.
System Colitis
- These initiates activities involving interplay of
Vomiting
antibodies (humoral immunity), complement,
Diarrhea
and action by the cytotoxic T cells (cellular
Genitourinary System Frequency and
immunity).
burning in urination
THE IMMUNE SYSTEM Hematuria
INNATE (NONSPECIFIC) ADAPTIVE Discharge
DEFENSE MECHANISM (SPECIFIC) Musculoskeletal Joints mobility
DEFENSE System Edema
MECHANISM Pain
FIRST LINE SECOND LINE THIRD LINE Rashes
OF OF DEFENSE OF DEFENSE Lesion
DEFENSE Dermatitis
- Skin - Phagocytic - Lymphocyt Hematomas or
- Mucous cell es purpura
Membra - Natural - Antibodies Inflammation
ne killer cell - Macrophag Discharge
- Secretio - The es and Neurosensory System Cognitive Dysfunction
n of skin inflammato other Hearing Loss
and ry response antigen- Visual change
mucous presenting Headaches and
membra cells migraines
ne Ataxia
Tetany

ASSESSMENT NURSING MANAGEMENT

• Age • It is the nurse’s role to counsel, educate, and
• Nutrition support patients throughout the diagnostic
• Immunization process. Many patients may be extremely
• Allergy anxious about the results of diagnostic tests
• Disorders and diseases and the possible implications of those results.
This is an ideal time for the nurse to provide
counseling and education, should these
interventions be warranted.

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