Inflammation and Inflammation and Immune responseImmune response

Jerry AxsomJerry Axsom

HM2/ NREMT-PHM2/ NREMT-P

Purpose of Inflammation and Purpose of Inflammation and immunutyimmunuty

to protect the body from micro-to protect the body from micro-organismsorganisms

Invading cells and micro organisms Invading cells and micro organisms are foreign proteins called Antigensare foreign proteins called Antigens

The bone marrow is the source of all The bone marrow is the source of all blood cellsblood cells

Including the cells of the immune Including the cells of the immune systemsystem

They are formed there and released They are formed there and released into the blood streaminto the blood stream

Bone marrow cells start out as stem Bone marrow cells start out as stem cells, then mature into specific cellscells, then mature into specific cells

The immune system cells start are The immune system cells start are white blood cells or leukocyteswhite blood cells or leukocytes

The immune process requires 3 The immune process requires 3 responsesresponses

1.) inflammation1.) inflammation 2.) antibody-mediated 2.) antibody-mediated

immunity( humoral immunity)immunity( humoral immunity) 3.) cell- mediated immunity3.) cell- mediated immunity

InflammationInflammation

It is immediateIt is immediate It offers short-term protectionIt offers short-term protection It is a non-specific defenceIt is a non-specific defence

Inflammation differs from antibody- Inflammation differs from antibody- mediated immunity and cell- mediated immunity and cell- mediated immunity in several waysmediated immunity in several ways

Inflammation can occur without Inflammation can occur without infectioninfection

Infection is usually accompanied by Infection is usually accompanied by inflammationinflammation

Cells involved in inflammationCells involved in inflammation

Leukocutes involved in inflammationLeukocutes involved in inflammation NeutrophilsNeutrophils MacrophagesMacrophages EosinophilsEosinophils BasophilsBasophils

NeutrophilsNeutrophils

ACCOUNT FOR 67% Of WBCACCOUNT FOR 67% Of WBC Function: phagocytosis of foreign Function: phagocytosis of foreign

protiensprotiens Mature neutrophils are called segs, Mature neutrophils are called segs,

polyspolys Immature neuts are called bands, Immature neuts are called bands,

stabsstabs

NeutrophilsNeutrophils

Neuts are the first line of defenceNeuts are the first line of defence Neuts take about 12-14 days to Neuts take about 12-14 days to

maturemature Only live about 12-18 hrsOnly live about 12-18 hrs Only take part in one episode of Only take part in one episode of

phagocytosisphagocytosis

NeutrophilsNeutrophils

A left shift in the WBC refers to an A left shift in the WBC refers to an increase in immature neutsincrease in immature neuts

It also refers to a bacterial infectionIt also refers to a bacterial infection

MonocytesMonocytes

3% of WBC3% of WBC When matured they are called When matured they are called

MacrophagesMacrophages Can live for months to yearsCan live for months to years Can be involved in multiple episodes Can be involved in multiple episodes

of phagocytosisof phagocytosis

EosinophilsEosinophils

1.5% of WBC1.5% of WBC Main function: to release chemicals Main function: to release chemicals

which control inflammationwhich control inflammation Elevated in allergic reactions/ Elevated in allergic reactions/

parasitic infectionsparasitic infections

BasophilsBasophils

.5% of WBC.5% of WBC Responsible for s/s of inflammationResponsible for s/s of inflammation

PhagocytosisPhagocytosis

1.) exposure1.) exposure 2.) attraction2.) attraction 3.) adherence3.) adherence 4.) recognition4.) recognition 5.) cellular ingestion5.) cellular ingestion 6.) phagosome formation6.) phagosome formation 7.) degration7.) degration

Stages of inflammationStages of inflammation

Manifestations of inflammationManifestations of inflammation WarmthWarmth RednessRedness SwellingSwelling PainPain Decreased functionDecreased function

Stage 1Stage 1

Phase 1- rapid short term blood Phase 1- rapid short term blood vessel constrictionvessel constriction

Phase 2- vascular (blood vessels)Phase 2- vascular (blood vessels) Increased blood flow to areaIncreased blood flow to area Increased capillary permeabilityIncreased capillary permeability s/s warmth, redness, swelling, pains/s warmth, redness, swelling, pain

Stage 2Stage 2

Cellular exudate stageCellular exudate stage Formation of exudate (pus)Formation of exudate (pus) Most active WBC in this stage are the Most active WBC in this stage are the

NEUTSNEUTS NEUTS attack and destroy foreign NEUTS attack and destroy foreign

substancessubstances

Stage 3Stage 3

Tissue repair and replacement stageTissue repair and replacement stage

Antibody- mediated immunityAntibody- mediated immunity(humoral immunity)(humoral immunity)

Involves antigen- antibody Involves antigen- antibody interaction to destroy foreign interaction to destroy foreign protiensprotiens

The leukocyte with the most active The leukocyte with the most active role in humoral immunity is the B- role in humoral immunity is the B- lymphocytelymphocyte

B- lymphocyteB- lymphocyte

Fromed from stem cells in the bone Fromed from stem cells in the bone marrowmarrow

Released into the bloodReleased into the blood Mature in the spleen, lymph nodes, Mature in the spleen, lymph nodes,

tonsils, and intestinal tracttonsils, and intestinal tract

Acquiring immunityAcquiring immunity

Immunity can be natural or acquiredImmunity can be natural or acquired

Adaptive (acquired ) immunityAdaptive (acquired ) immunity

Can be active or passiveCan be active or passive Can be natural or artificialCan be natural or artificial

ActiveActive

From our own antibodiesFrom our own antibodies Can be natural or artificalCan be natural or artifical Long term immunityLong term immunity

ActiveActive

Natural/ active: active- antigen/ Natural/ active: active- antigen/ antibody responseantibody response

Ex: person has measlesEx: person has measles

ActiveActive

Artificial/ activeArtificial/ active active- antigen/antibody responseactive- antigen/antibody response Ex: vaccine for measlesEx: vaccine for measles

PassivePassive

Natural/ passive: mother to fetusNatural/ passive: mother to fetus Artifical/ passive: antibodies are Artifical/ passive: antibodies are

injectedinjected Ex: tetnus shotEx: tetnus shot

Cell mediated immunityCell mediated immunity

Lymphocytes 28% of WBCLymphocytes 28% of WBC shift to right = viral infectionshift to right = viral infection main lymp T-lympmain lymp T-lymp Cell mediated immunity involves the Cell mediated immunity involves the

ability to differentiate self from non ability to differentiate self from non selfself

Cell mediated immunityCell mediated immunity

Natural killer cells destroy cells from Natural killer cells destroy cells from other people or animals. This results other people or animals. This results in rejection of transplanted organs/ in rejection of transplanted organs/ tissuestissues

These people need to take These people need to take immunosuppressants or anti immunosuppressants or anti rejection medsrejection meds

Connective tissuesConnective tissues

Connective tissue disorders are auto Connective tissue disorders are auto immune disorders that cause chronic immune disorders that cause chronic pain, loss of function, and are pain, loss of function, and are cripplingcrippling

OsteoarthritisOsteoarthritis

NoninflammatoryNoninflammatory Non systemicNon systemic Not auto immuneNot auto immune Joints lose cartilage and rub on each Joints lose cartilage and rub on each

other, may have bone sours, or other, may have bone sours, or subluxation (dislocation)subluxation (dislocation)

Also have crepitusAlso have crepitus Or ballottment “ floating patella”Or ballottment “ floating patella”

OAOA

Total hipTotal hip most common joint replacedmost common joint replaced can last about 20 yearscan last about 20 years

Rheumatoid ArthritisRheumatoid Arthritis

Most common connective tissue Most common connective tissue disease and is most destructive to disease and is most destructive to jointsjoints

RARA

Chronic, progressive, systematic, Chronic, progressive, systematic, inflammatory auto immune diseaseinflammatory auto immune disease

Antibodies (RF’s) are formed and Antibodies (RF’s) are formed and attack healthy tissueattack healthy tissue

RARA

RA is caused by a combination of RA is caused by a combination of genetic and environmental factors genetic and environmental factors not clearly understoodnot clearly understood

With RA you usually feel better with With RA you usually feel better with activitry unlike OAactivitry unlike OA

Pattern of joint involvement is Pattern of joint involvement is typically bilateral and symmetrictypically bilateral and symmetric

Pain, decreased ROM, joints feel like Pain, decreased ROM, joints feel like jellyjelly

Lupus erythematosusLupus erythematosus

Discoid lupus erythematosus(DLE)= Discoid lupus erythematosus(DLE)= butterfly rash on facebutterfly rash on face

SLE- chronic, progressive, SLE- chronic, progressive, inflammatory connective tissue inflammatory connective tissue disorder that attacks major body disorder that attacks major body tissuestissues

GoutGout

Systemic disease which urate Systemic disease which urate crystals deposit in the joints causing crystals deposit in the joints causing inflammationinflammation

Primary gout: most common, an end Primary gout: most common, an end product of this metabolism is uric product of this metabolism is uric acid, which is usually excreted by the acid, which is usually excreted by the kidneyskidneys

The acid is deposited in the The acid is deposited in the synoviumsynovium

FibromyalgiaFibromyalgia

Chronic pain syndrome, not Chronic pain syndrome, not inflammatory diseaseinflammatory disease

Unknown what causes disease, Unknown what causes disease, though to be a dysfunction in the though to be a dysfunction in the brain r/t pain centerbrain r/t pain center