N5315 Advanced Pathophysiology
I I
Inflammation, Altered Immunity and Infection
I I I I I
Core Concepts Objectives with Advanced Organizers
I I I I I
Immune ISystem
1. Examine Ithe Istructure Iand Ifunction Iof Ithe Iimmune Isystem.
a. Describe Ihow Ithe Inormal Ifunction Iof IT-lymphocyte Iand IB-lymphocyte Icells Idiffer.
i. T ICells- ICell Imediated Iimmunity.
1. “cluster Iof Idifferentiation”
2. CD4 Icells- It-helper Ior It4 Icells
a. Release Ilymphokines Ito Ibegin Iinflammatory Iprocess
b. Mediate Idelayed Isensitivity. I (TB Iskin Itest).
3. CD8 Icells Iaka It Icells, Ikiller It, Iand It8.
a. Kill Iviruses Iby Ireleasing Icytotoxic Ichemicals
4. Memory IT
a. Remember Ithe Iantigen Iand Irespond Iquicker Iand Istronger
st
Ia fter I1 Iexposure.
5. T IRegulatory
a. Slow Ior Istop Iimmune Iresponse Ionce Iinitiated.
ii. B Icells- Ihumoral Iimmunity.
1. Mature Iinto Iplasma Icells Ithat Iproduce Iantibodies.
a. Differentiate Ibetween Ifunction Iof Ihumoral Iand Icell Imediated Iimmunity Iand
Idescribe Ithe Iimplications Ifor Ipractice.
i. Humoral IImmunity
1. B Icells.
2. Fights Iviral Iinfections, Itoxins, Ipneumococci, Imeningococci, Iand
Ihaemophilus.
ii. Cell IMediated
1. T Icells.
2. Fungal, Iparasitic, Itumors.
3. Responsible Ifor Iorgan Itransplant Irejections.
b. Describe Ithe Idifference Ibetween Iactive Iacquired Iimmunity Iand Ipassive Iacquired
Iimmunity Iand Ithe Iimplications Ifor Ihealth Ipromotion.
i. Active IAcquired IImmunity- I(vaccines)
1. After Iexposure Iin Iantigen.
2. Improves Iwith Irepeat Iexposure.
ii. Passive IAcquired IImmunity.
1. Obtained Iafter Iantibodies I(bcells) Iare Itransferred Ito Irecipient.
2. Ex- Imother Ito Ifetus Ivia Iplacenta Ior Ibreast Imilk.
iii. Artificial IPassive IImmunity. I(fake Iimmunity)
, 1. Receiving Iantibodies IAFTER Iexposure
2. Rabies, Itetanus, Ihepatitis, Isnake Ibites.
3. Lasts Ias Ilong Ias Iantibodies Ilive, I2 Iweeks.
c. Evaluate Ithe Ipurpose Iof Ithe Iterms Iand Idescribe Ithe Iimportance Ito Iclinical Ipractice.
• Antigen
o Molecule Ithat Ican Ireact Iwith Iantibodies Ior Iantigen Ireceptors Ion IB Iand
IT Icells.
• Self-antigen.
o Appropriate Iin Isize, Ihas Iadequate Ichemical Icomplexity, Iand Iis Ipresents
Iin Isufficient Iquantity, Ibut Iisn’t Iforeign Ito Ibody.
o Doesn’t Ielicit Iimmune Iresponse.
• Allergens.
o Produce Iallergic Iresponse.
2. Evaluate Ithe Irole Iand Ifunction Iof Ithe Icells Iof Ithe Iimmune Isystem.
a. Evaluate Ithe Istructure Iand Ifunction Iof Ithe Iantibodies Iproduced Iby Ithe IB-
Ilymphocyte Icells Iand Idescribe Ithe Iimplications Ifor Iclinical Ipractice.
Type Iof IB-Lymphocyte Function Implications Ifor IClinical IPractice
Cells
IgA-CHOO Secretions Iand Imucous A Isecretory Ipiece Iinside Imucosal
Imembranes. Iepithelial Icells Iprotects IIGA
Think Isneezing. Prevents Imicroorganism Iagainst Idegradation Ifrom
Iattachment Ito Imucous IenzymesIin Isecretions.
Imembranes.
IGA1-blood
IIGA2-
secretions
IgM-MEGA Early Iprimary Iimmune High Ilevels= Irecent Iinfection.
Iresponse. ISynthesized Iearly Iin Ineonates,
Think Ilargest. Presents Ias Ia Ipentamer Iand Imay Ibe Iresponsible Ifor
Iis Istabilized Iby Ijoining Ia IinfectionIin Iutero.
Ichain.
IgG-gobs Iand Igobs. Secondary Iimmune Levels Irise Idue Ito Iexposure Ito
Iresponse. Iantigen.
Most Iabundant Viruses, Ibacteria, IToxins. Maternal IIgG Iis Imajor Iantibody
ICROSSES Ifound Iin Ifetus Iand Inewborn.
IPLACENTA
IgE-eetsy Ibeetsy. Binds Ito Imast, Ieosinophils, Mediator Iof Iallergic Ireaction.
and Ibasophils. Defense Iagainst Iparasitic Iinfx’s.
Least Iabundant.
b. Evaluate Ithe Ifunction Iof Ithe Ifollowing IT-Lymphocyte Icells.
Type Iof IT-lymphocyte ICells Function
, T-cytotoxic Icells Kill Ivirus, Itumor, Iand Iallograft I(transplant)
infected Icells.
CD8, IKiller IT, IT8 Release ICytotoxic Ichemicals Ito Idestroy Icell
membrane= Iapoptosis.
NK IKiller Icells Lymphoid Icells Ithat Icompliment IT Icells.
IDon’t Iundergo Imaturation Iin Ithymus Iand Idon’t
Ihave Iantigen Ispecific Ireceptors.
Express Iinhibitory Ireceptors Iand Ibind Ito Icell
Ireleasing IMHC Iclass I1.
T-Regulatory Icells Slow Ior Istop Iimmune Iresponse.
Prevents Ioverreaction Iof Iforeign Iand Iself-
Iantigens.
T-Helper Icells Activate Imacrophages, Ib Icells, Icytotoxic It Icells,
Iand Iother Icd4 Icells.
T4 Icells. TH1 Iand ITH2(subgroup Iof Icells) Irelease
Mediate Idelayed Ihypersensitivity Ilymphokines Ito Ibegin Iinflammatory Iprocess.
I(TB)
c. Differentiate Ibetween Ithe Iroles Iof IB-Lymphocytes Iand IT-lymphocytes Iin Ithe
Irecognition Iand Iprocessing Iof Iantigens.
Type Iof ICell Role Iin Ithe IProcessing Iof IAntigens
B-Lymphocytes B Icell Ireceptor I(BCR) Iis Ion Isurface Iof IB
ILymphocytes.
BCR Irecognizes Iantigen Ithen Icommunicates
Iinfo Ito Icell’s Inucleus.
IgA Iand IIgB Iare Iin Ib Icell Ireceptors Iand
Iprovide Iintracellular Isignals Ito Iactivate Ithe Ib
Icell Iand Icomplete Iits Imaturation Iand
Iproduction Iof Iantibodies.
T-lymphocytes T Icell Ireceptors I(TCR) Iare Icomposed Iof
Iantibody Ilike Itransmembrane Iprotein Iand Ia
Igroup Iof Iaccessory Iproteins Ithat Iinvolve
Iintracellular Isignaling.
TCR-recognizes Iand Ibinds.
Accessory Iproteins-intracellular Isignaling
Inecessary Ifor Iactivation Iand Idifferentiation Iof
It Icell.
d. Describe Ithe Irole Iof IT-Helper ILymphocytes Iin Ithe Iimmune Iresponse.
i. TH Icell Idirectly Iinteracts Iwith Iantigen Ipresenting Icells.
ii. TH Icell Iundergoes Idifferentiation Iprocess Iwhen Icytokine Igenes Iare
Iactivated
iii. Mature IT Icells Iinteracts Iwith Ieither Iimmunocompetent Ib Ior It Icells Ito
Ienhance Iresponse Ito Iantigen Iwhich=plasma Icells Ior Ieffector It Icells.
I I
Inflammation, Altered Immunity and Infection
I I I I I
Core Concepts Objectives with Advanced Organizers
I I I I I
Immune ISystem
1. Examine Ithe Istructure Iand Ifunction Iof Ithe Iimmune Isystem.
a. Describe Ihow Ithe Inormal Ifunction Iof IT-lymphocyte Iand IB-lymphocyte Icells Idiffer.
i. T ICells- ICell Imediated Iimmunity.
1. “cluster Iof Idifferentiation”
2. CD4 Icells- It-helper Ior It4 Icells
a. Release Ilymphokines Ito Ibegin Iinflammatory Iprocess
b. Mediate Idelayed Isensitivity. I (TB Iskin Itest).
3. CD8 Icells Iaka It Icells, Ikiller It, Iand It8.
a. Kill Iviruses Iby Ireleasing Icytotoxic Ichemicals
4. Memory IT
a. Remember Ithe Iantigen Iand Irespond Iquicker Iand Istronger
st
Ia fter I1 Iexposure.
5. T IRegulatory
a. Slow Ior Istop Iimmune Iresponse Ionce Iinitiated.
ii. B Icells- Ihumoral Iimmunity.
1. Mature Iinto Iplasma Icells Ithat Iproduce Iantibodies.
a. Differentiate Ibetween Ifunction Iof Ihumoral Iand Icell Imediated Iimmunity Iand
Idescribe Ithe Iimplications Ifor Ipractice.
i. Humoral IImmunity
1. B Icells.
2. Fights Iviral Iinfections, Itoxins, Ipneumococci, Imeningococci, Iand
Ihaemophilus.
ii. Cell IMediated
1. T Icells.
2. Fungal, Iparasitic, Itumors.
3. Responsible Ifor Iorgan Itransplant Irejections.
b. Describe Ithe Idifference Ibetween Iactive Iacquired Iimmunity Iand Ipassive Iacquired
Iimmunity Iand Ithe Iimplications Ifor Ihealth Ipromotion.
i. Active IAcquired IImmunity- I(vaccines)
1. After Iexposure Iin Iantigen.
2. Improves Iwith Irepeat Iexposure.
ii. Passive IAcquired IImmunity.
1. Obtained Iafter Iantibodies I(bcells) Iare Itransferred Ito Irecipient.
2. Ex- Imother Ito Ifetus Ivia Iplacenta Ior Ibreast Imilk.
iii. Artificial IPassive IImmunity. I(fake Iimmunity)
, 1. Receiving Iantibodies IAFTER Iexposure
2. Rabies, Itetanus, Ihepatitis, Isnake Ibites.
3. Lasts Ias Ilong Ias Iantibodies Ilive, I2 Iweeks.
c. Evaluate Ithe Ipurpose Iof Ithe Iterms Iand Idescribe Ithe Iimportance Ito Iclinical Ipractice.
• Antigen
o Molecule Ithat Ican Ireact Iwith Iantibodies Ior Iantigen Ireceptors Ion IB Iand
IT Icells.
• Self-antigen.
o Appropriate Iin Isize, Ihas Iadequate Ichemical Icomplexity, Iand Iis Ipresents
Iin Isufficient Iquantity, Ibut Iisn’t Iforeign Ito Ibody.
o Doesn’t Ielicit Iimmune Iresponse.
• Allergens.
o Produce Iallergic Iresponse.
2. Evaluate Ithe Irole Iand Ifunction Iof Ithe Icells Iof Ithe Iimmune Isystem.
a. Evaluate Ithe Istructure Iand Ifunction Iof Ithe Iantibodies Iproduced Iby Ithe IB-
Ilymphocyte Icells Iand Idescribe Ithe Iimplications Ifor Iclinical Ipractice.
Type Iof IB-Lymphocyte Function Implications Ifor IClinical IPractice
Cells
IgA-CHOO Secretions Iand Imucous A Isecretory Ipiece Iinside Imucosal
Imembranes. Iepithelial Icells Iprotects IIGA
Think Isneezing. Prevents Imicroorganism Iagainst Idegradation Ifrom
Iattachment Ito Imucous IenzymesIin Isecretions.
Imembranes.
IGA1-blood
IIGA2-
secretions
IgM-MEGA Early Iprimary Iimmune High Ilevels= Irecent Iinfection.
Iresponse. ISynthesized Iearly Iin Ineonates,
Think Ilargest. Presents Ias Ia Ipentamer Iand Imay Ibe Iresponsible Ifor
Iis Istabilized Iby Ijoining Ia IinfectionIin Iutero.
Ichain.
IgG-gobs Iand Igobs. Secondary Iimmune Levels Irise Idue Ito Iexposure Ito
Iresponse. Iantigen.
Most Iabundant Viruses, Ibacteria, IToxins. Maternal IIgG Iis Imajor Iantibody
ICROSSES Ifound Iin Ifetus Iand Inewborn.
IPLACENTA
IgE-eetsy Ibeetsy. Binds Ito Imast, Ieosinophils, Mediator Iof Iallergic Ireaction.
and Ibasophils. Defense Iagainst Iparasitic Iinfx’s.
Least Iabundant.
b. Evaluate Ithe Ifunction Iof Ithe Ifollowing IT-Lymphocyte Icells.
Type Iof IT-lymphocyte ICells Function
, T-cytotoxic Icells Kill Ivirus, Itumor, Iand Iallograft I(transplant)
infected Icells.
CD8, IKiller IT, IT8 Release ICytotoxic Ichemicals Ito Idestroy Icell
membrane= Iapoptosis.
NK IKiller Icells Lymphoid Icells Ithat Icompliment IT Icells.
IDon’t Iundergo Imaturation Iin Ithymus Iand Idon’t
Ihave Iantigen Ispecific Ireceptors.
Express Iinhibitory Ireceptors Iand Ibind Ito Icell
Ireleasing IMHC Iclass I1.
T-Regulatory Icells Slow Ior Istop Iimmune Iresponse.
Prevents Ioverreaction Iof Iforeign Iand Iself-
Iantigens.
T-Helper Icells Activate Imacrophages, Ib Icells, Icytotoxic It Icells,
Iand Iother Icd4 Icells.
T4 Icells. TH1 Iand ITH2(subgroup Iof Icells) Irelease
Mediate Idelayed Ihypersensitivity Ilymphokines Ito Ibegin Iinflammatory Iprocess.
I(TB)
c. Differentiate Ibetween Ithe Iroles Iof IB-Lymphocytes Iand IT-lymphocytes Iin Ithe
Irecognition Iand Iprocessing Iof Iantigens.
Type Iof ICell Role Iin Ithe IProcessing Iof IAntigens
B-Lymphocytes B Icell Ireceptor I(BCR) Iis Ion Isurface Iof IB
ILymphocytes.
BCR Irecognizes Iantigen Ithen Icommunicates
Iinfo Ito Icell’s Inucleus.
IgA Iand IIgB Iare Iin Ib Icell Ireceptors Iand
Iprovide Iintracellular Isignals Ito Iactivate Ithe Ib
Icell Iand Icomplete Iits Imaturation Iand
Iproduction Iof Iantibodies.
T-lymphocytes T Icell Ireceptors I(TCR) Iare Icomposed Iof
Iantibody Ilike Itransmembrane Iprotein Iand Ia
Igroup Iof Iaccessory Iproteins Ithat Iinvolve
Iintracellular Isignaling.
TCR-recognizes Iand Ibinds.
Accessory Iproteins-intracellular Isignaling
Inecessary Ifor Iactivation Iand Idifferentiation Iof
It Icell.
d. Describe Ithe Irole Iof IT-Helper ILymphocytes Iin Ithe Iimmune Iresponse.
i. TH Icell Idirectly Iinteracts Iwith Iantigen Ipresenting Icells.
ii. TH Icell Iundergoes Idifferentiation Iprocess Iwhen Icytokine Igenes Iare
Iactivated
iii. Mature IT Icells Iinteracts Iwith Ieither Iimmunocompetent Ib Ior It Icells Ito
Ienhance Iresponse Ito Iantigen Iwhich=plasma Icells Ior Ieffector It Icells.
