Immune System Disorders Immune System Disorders Hypersensitivity (Allergy): An a

Immune System Disorders Immune System Disorders Hypersensitivity (Allergy): An a www.phwiki.com

Immune System Disorders Immune System Disorders Hypersensitivity (Allergy): An a

Nathan, Davis, General Manager has reference to this Academic Journal, PHwiki organized this Journal Immune System Disorders Immune System Disorders Hypersensitivity (Allergy): An abnormal response to antigens. Four Types of Hypersensitivity Reactions: Type I (Anaphylactic) Reactions Type II (Cytotoxic) Reactions Type III (Immune Complex) Reactions Type IV (Cell-Mediated) Reactions Type I (Anaphylactic) Reactions Occur within minutes of exposure to antigen Antigens combine with IgE antibodies IgE binds to mast cells in addition to basophils, causing them to undergo degranulation in addition to release several mediators: Histamine: Dilates in addition to increases permeability of blood vessels (swelling in addition to redness), increases mucus secretion (runny nose), smooth muscle contraction (bronchi). Prostagl in addition to ins: Contraction of smooth muscle of respiratory system in addition to increased mucus secretion. Leukotrienes: Bronchial spasms. Anaphylactic shock: Massive drop in blood pressure. Can be fatal in minutes.

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Mast Cells in addition to the Allergic Response Mast Cells in addition to the Allergic Response Type II (Cytotoxic) Reactions Involve activation of complement by IgG or IgM binding to an antigenic cell. Antigenic cell is lysed. Transfusion reactions: ABO Blood group system: Type O is universal donor. Incompatible donor cells are lysed as they enter bloodstream. Rh Blood Group System: 85% of population is Rh positive. Those who are Rh negative can be sensitized to destroy Rh positive blood cells. Hemolytic disease of newborn: Fetal cells are destroyed by maternal anti-Rh antibodies that cross the placenta.

Type III (Immune Complex) Reactions Involve reactions against soluble antigens circulating in serum. Usually involve IgA antibodies. Antibody-Antigen immune complexes are deposited in organs, activate complement, in addition to cause inflammatory damage. Glomerulonephritis: Inflammatory kidney damage. Occurs with slightly high antigen-antibody ratio is present. Immune Complex Mediated Hypersensitivity Type IV (Cell-Mediated) Reactions Involve reactions by TD memory cells. First contact sensitizes person. Subsequent contacts elicit a reaction. Reactions are delayed by one or more days (delayed type hypersensitivity). Delay is due to migration of macrophages in addition to T cells to site of as long as eign antigens. Reactions are frequently displayed on the skin: itching, redness, swelling, pain. Tuberculosis skin test Poison ivy Metals Latex in gloves in addition to condoms (3% of health care workers) Anaphylactic shock may occur.

Allergic Contact Dermatitis Response to Poison Ivy Hapten Autoimmune Diseases Loss of self-tolerance leads to production of antibodies or T cells that react against one’s own antigens. Immune system response to self antigens causes damage to organs. Three types of autoimmune disorders: Cytotoxic (Type II reactions) Immune complex (Type III reactions) Cell-mediated (Type IV reactions) Autoimmune Diseases A. Type II (Cytotoxic) Autoimmune Reactions Involve antibody reactions to cell surface molecules, without cytotoxic destruction of cells. Grave’s Disease: Antibodies attach to receptors on thyroid gl in addition to in addition to stimulate production of thyroid hormone. Symptoms: Goiter (enlarged thyroid) in addition to bulging eyes. Myasthenia gravis: Progressive muscle weakness. Antibodies block acetylcholine receptors at neuromuscular synapse. Affects 25,000 Americans (mainly women). Today most patients survive when treated with drugs or immunosuppressants.

Autoimmune Diseases B. Type III (Immune Complex) Autoimmune Reactions Systemic Lupus Erythematosus: Affects about 200,000 Americans (90% women). Name derived from red skin rash on face. Autoantibodies react against DNA, blood cells, neurons, in addition to other tissues. When cells die, immune complexes as long as m in addition to deposit under skin, joints, in kidneys, blood vessels, in addition to central nervous system. Inflammation interferes with normal function of these sites (arthritis, rash, kidney damage). Most patients die from kidney damage. No cure. Symptoms treated with anti-inflammatory in addition to immunosuppressive drugs. Autoimmune Diseases B. Type III (Immune Complex) Autoimmune Reactions (Continued) Rheumatoid Arthritis: Affects about 2 million Americans (70%+ women). Cause unknown, but microbial mimicry may be involved. IgM autoantibodies (rheumatoid factors) against IgG as long as m complexes in joint, leading to inflammation in addition to cartilage damage. Often causes finger in addition to joint de as long as mities. No cure. Symptoms treated with anti-inflammatory (aspirin) in addition to immunosuppressive drugs. Physical therapy keeps joints movable. Surgical replacement of joints may be necessary. Autoimmune Diseases C. Type IV (Cell-Mediated) Autoimmune Reactions (Continued) Insulin-dependent (Type I or Juvenile) Diabetes Mellitus: Diabetes affects up to 5% of Americans. In the U.S., 35,000 people die every year from all types of diabetes mellitus in addition to complications (gangrene, kidney in addition to cardiovascular disease, dehydration, in addition to nerve damage). Insulin Dependent (Type I or Juvenile) Diabetes: Makes up 10% of diabetes cases. Characterized by insufficient insulin production due to immunological destruction of insulin-secreting cells of the pancreas by T cells. Usually develops be as long as e the age of 15. Treated with insulin injections.

Acquired Immunodeficiency Syndrome (AIDS) History 1950s: Blood samples from Africa have HIV antibodies. 1976: First known AIDS patient died. 1980: First human retrovirus isolated (HTLV-1). 1981: First reports of “Acquired Immuno-deficiency Syndrome” in Los Angeles. 1983: Virus first isolated in France (LAV). 1984: Virus isolated in the U.S. (called HTLV-III in addition to AIDS-Related Virus, ARV). 1985: Development in addition to implementation of antibody test to screen blood donors. Acquired Immunodeficiency Syndrome (AIDS) History (Continued) 1986: Consensus name Human Immunodeficiency Virus (HIV-1). Related virus (HIV-2) identified. 1992: AIDS becomes the leading cause of death among adults ages 25-44 in the U.S. 1997: Mortality rates of AIDS starts to decline due to the introduction of new drug cocktails. 2001: World Health Organization predicts up to 40 million infected individuals. More than 22 million have already died. AIDS: A Leading Cause of Death Among People Aged 25-44 years in U.S. Deaths per 100,000 people aged 25-44 years

People Living with HIV/AIDS by End of 2001 North America 950,000 Latin America 1.5 million Western Europe 560,000 East Europe & Central Asia 1’000,000 Sub-Saharan Africa 28.5 million North Africa & Middle East 500,000 Australia & New Zeal in addition to 15,000 South/South East Asia 5.6 million East Asia & Pacific 1’000,000 Total: 40 million people Caribbean 420,000 Structure of the Human Immunodeficiency Virus HIV is a Retrovirus Life Cycle of HIV 1. Attachment: Virus binds to surface molecule (CD4) of T helper cells in addition to macrophages. Coreceptors: Required as long as HIV infection. CXCR4 in addition to CCR5 mutants are resistant to infection. 2. Fusion: Viral envelope fuses with cell membrane, releasing contents into the cell.

HIV Life Cycle: Attachment Requires CD4 Receptor plus a Coreceptor Life Cycle of HIV 3. Reverse Transcription: Viral RNA is converted into DNA by unique enzyme reverse transcriptase. Reverse transcriptase RNA —> DNA Reverse transcriptase is the target of several HIV drugs: AZT, ddI, in addition to ddC. HIV Life Cycle: Reverse Transcriptase Converts RNA into DNA

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Life Cycle of HIV 4. Integration: Viral DNA is inserted into host cell chromosome by unique enzyme integrase. Integrated viral DNA may remain latent as long as years in addition to is called a provirus. 5. Replication: Viral DNA is transcribed in addition to RNA is translated, making viral proteins. Viral genome is replicated. 6. Assembly: New viruses are made. 7. Release: New viruses bud through the cell membrane. HIV Life Cycle: Latent versus Active Infection HIV Life Cycle: Latent versus Active Infection in Macrophages

AIDS Associated Disease Categories 1. Gastrointestinal: Cause most of illness in addition to death of late AIDS. Symptoms: Diarrhea Wasting (extreme weight loss) Abdominal pain Infections of the mouth in addition to esophagus. Pathogens: C in addition to ida albicans, cytomegalovirus, Microsporidia, in addition to Cryptosporidia. African AIDS patient with slim disease Source: Tropical Medicine in addition to Parasitiology, 1997 Opportunistic Oral Yeast Infection by C in addition to ida albicans in an AIDS Patient Source: Atlas of Clinical Oral Pathology, 1999

Perinatal Transmission of AIDS Source: Tropical Medicine in addition to Parasitiology, 1997

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