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Chapter 19 DISORDERS ASSOCIATED with the IMMUNE SYSTEM Dr. Reitano DISORDERS ASSOCIATED with the IMMUNE SYSTEM FAILURES of the IMMUNE SYSTEM: – _____________ – _____IMMUNITY – ex. lupus, multiple sclerosis – _______________________ HARMFUL IMMUNE REACTIONS – -HYPERSENSITIVITY//ALLERGIC REACTIONS Response to antigens (allergens) to an extreme degree leading to damage Requires ___________ dose(s) -_____________________ HYPERSENSITIVITY REACTIONS • Type I - Anaphylactic Reactions – Involves _____ antibodies • Type II – _________ Reactions – Involves IgG or IgM Abs and complement • Type III – ____________ Reactions – Involves IgG Abs and antigen complexes that lodge in basement membranes of blood vessels • Type IV – Cell-Mediated Reactions – Involves delayed _________________ TYPE I - ______________ REACTIONS Involve IgE antibodies binding to mast cells or basophils with release of reactive substances (histamines) • Localized: ________(food) or inhaled(pollen) antigens-common allergic reactions such as hay fever, asthma • Systemic: Shock, breathing difficulties from injected antigens (______________) Figure 19.1a TYPE II - CYTOTOXIC REACTIONS • Involve IgG or IgM antibodies and complement • Complement activation causes ________ or damage by macrophages – Ex. BLOOD TRANSFUSIONS ___________ DISEASE of NEWBORN TYPE III - IMMUNE COMPLEX REACTIONS • __________ and antigens form complexes that lodge in basement membranes of blood vessels. Figure 19.6 TYPE IV – CELL MEDIATED or DELAYED TYPE HYPERSENSITIVITY REACTIONS • Ags attract Tc cells which destroy target cells • ____________ attract macrophages and initiate tissue damage • Ex. __________ rejection _________________ Figure 19.8 REACTIONS to TRANSPLANTATION • Transplants may be attacked by T cells, macrophages, and complement-fixing antibodies. • Transplants to ____________ sites do not cause an immune response. • Stem cells may allow therapeutic cloning to avoid rejection. TYPES of GRAFTS • ______GRAFT: Use of one's own tissue • ____GRAFT: Use of ____________ tissue • ALLOGRAFT: Use of tissue from another person • XENOTRANSPLANTATION: Use of ____________ tissue • GRAFT-VERSUS-HOST DISEASE: Can result from transplanted ___________ that contains immunocompetent cells IMMUNOSUPPRESSIONprevents immune response to transplanted tissues 1. CYCLOSPORINE – suppresses IL-2 2. MYCOPHENOLATE MOFETIL – inhibits T cell and B cell reproduction 3. SIROLIMUS – blocks IL-2 IMMUNE DEFICIENCIES CONGENITAL: Due to defective or missing __________ _____________: Develop during an individual's life, due to drugs, cancers, infections Artificial: Immunosuppressive drugs _______: ____ infections THE IMMUNE SYSTEM and CANCER • Cancer cells possess tumor-specific ___________ • TC cells recognize and lyse cancer cells • Cancer cells may lack tumor antigens or kill TC cells Figure 19.11 ACQUIRED IMMUNODEFICIENCY SYNDROME (_________) Figure 19.12a _____ INFECTION Capsid Reverse transcriptase RNA Virus Two identical + stands of RNA 1 Retrovirus penetrates host cell. Host cell DNA of one of the host cell’s chromosomes 5 Mature retrovirus leaves host cell, acquiring an envelope as it buds out. Reverse transcriptase Viral RNA Identical strands of RNA 2 Virion penetrates cell and its DNA is uncoated 4 Transcription of the Viral proteins RNA provirus may also occur, producing RNA for new retrovirus genomes and RNA that codes for the retrovirus capsid and envelope proteins. Provirus 3 The new viral DNA is tranported into the host cell’s nucleus and integrated as a provirus. The provirus may divide indefinitely with the host cell DNA. Figure 13.19 ____ INFECTION Figure 19.13 STAGES of HIV INFECTION • Category A Asymptomatic or persistent lymphadenopathy • Category B Persistent ________________ infections • Category C Clinical AIDS. CMV, Herpes sp, tuberculosis, Pneumocystis sp. cryptosporidiosis, Kaposi's sarcoma COMMON DISEASES ASSOCIATED with AIDS Table 19.5 DIAGNOSTIC METHODS for HIV • Seroconversion - takes up to 3 months • _____ – for HIV antibody detection • _______ blotting – for detection of HIV antigens • PCR or nucleic acid hybridizationto determine viral load in plasma GLOBAL TRANSMISSION of HIV • • • • Male to male homosexual conduct ___________sexual transmission ________ use Infected body fluids transmit HIV via: – Sexual contact – Breast milk – Transplacental infection of fetus – Blood-contaminated needle – Organ transplant – Artificial insemination – Blood transfusion Worldwide Distribution of AIDS and HIV Figure 19.17 TREATMENT of HIV • Vaccines • Chemotherapy • Highly Active Anti-Retroviral Therapy (___________) – Ex.:Combinations of reverse ___________ inhibitors + ________ __________ of AIDS • Homosexual conduct* • Use of _______ and sterile needles • Health-case workers use universal precautions – Wear gloves, gowns, masks, goggles – Do not recap needles – Risk of infection from infected needlestick injury is 0.3%