immunity pt 2 Flashcards
cell mediated immunity
T-lymphocytes - start in pone marrow, mature in thymus
activated with Ag –> sensitized T cell
activated T cell roles
production of lympohkines cytotoxic T cells T helper cells T suppressor cells T memory cells
CD4 T - cells
75% of all T cells
secrete lymphkines
lymphokines - MIF
migration inhibitory factor
inhibits microphages from leaving
lymphokines - MCF
macrophage chemotactic factor
attracts macrophages to site of Ag
lymphokines - BF
blastogenic factor
induces proliferation of more specific T cells and B cells
lymphokines - interferon
antiviral agent
interferes w/ viral replication
suppressor or regulator T cells
suppress activation of the immune system and prevent pathological self reactivity or autoimmune diease
cytotoxic T cells (CD8)
helps other T cells recognize and destroy virally infected cells
T memory cells
repsond to second exposure of the same Ag must chaster as a rule
cell mediate immunity involved in
viral infections fungal infections some bacterial infections delayed hypersensititivies graft rejection cancer suveillance
HI review
directly from bone marrow
larger cells
shorter life span (days)
non circulating
CMI review
starts in bone marrow - mature in thymus
small cells
longer life span (weeks)
circulating cells
innate states of immunity
physiological
anatomical
acquired states of immunity
artificial
natural
active
passive
active acquired immunity
protection acquired by introduction of an Ag
intended to last a lifetime BUT some mutate too quickly for vaccine to keep up (flu)
passive acquired immunity - naturally
Ab transplacentally or through colostrum and breast milk
passive acquired immunity - artificially
Ab or sensitized lymphocytes produced by one person are transferred to another
usually short duration - until Ab are degrated
two phases in generation of an immune reponse
primary and secondary
primary response
when Ag is first encountered
slow
weak response allows invader enough time to cause illness
IgM first to be produced
secondary response
the next time the antigen is encountered
quicker and stronger each time
memory B cells recognize antigen and all begin to divide quickly
lots of plasma cells - esp IgG
immune response will end when
the antigen that caused it is no longer present.
aging and immune system
immune fx declines w/ increasing age
changes are observed in both innate and acquired immunity defenses
end result is reduced resistance to pathogens and increased incidence of tumors and autoimmune disorders
iatrogenic
medical disorder caused by diagnosis manner or treatment of a physician
urinary catheters, nasogastric tubes, chest tubes, external fixations devices, implanted prostheses
exercise
can suppress immune function depending on intensity, activity or exercise
moderate exercise can enhance the immune system
strenuous/long duration ex followed by impairment of the immune system
mild respiratory infections
don’t need to restrict training/competition
but many report increase in symptoms after stenuous training and a decline in symptoms after moderated training
AIDS
HIV 1 and 2
characterized by progressive destruction of Cmi changes in HI
leaves infected person susceptible to opportunistic infections
HIV infection spectrum
- asymptomatic HIV seropositive - State I
- early symptomatic HIV - stage II
- HIV advanced disease (AIDS) - stage III
does everyone who is exposed to HIV develop AIDS?
no
AIDS pathogenesis
infection by HIV retrovirus (only detectable by lab tests) infects human T4 (destroys or inactivates them). Macrophages and B cells are also infected. CD4 cells have receptors allowing direct passage of infection to target cells. viral genome eventually becomes integrated into host DNA and duplicated –> cell death.
seroconversion (HIV +)
usually takes place during first 3-6 weeks of viral replication but can take longer
after a few months, very little HIV virus is found - only HIB Ab remain in serum
asymptomatic HIV seropositive (Stage I)
CD4 > 500 cells / mL
demonstrates lab evidence of seroconversion but remains asymptomatic
clinically healthy; normal activities, work habits and unrestricted level and duration of exercise
early symptomatic HIV (stage II)
CD4 count 200-500 cells / m:
immune system more compomised
variedy of symptoms - diarrhea, weight loss, fatigue, night sweats, fevers
more than half of the adults w/ HIV report fatigue that limits physical and recreation activities (half unable to attend school/work)
HIV advanced disease (Stage III)
CD4 < 200 cells/mL
neuro manifestations are many and can involve central, peripheral, autonomic NS
HIV or AIDS encephalophaty primary infection of brain
more advanced: severe dementia, mutism, incontinence, paraplegia may occur
dermatological conditions - malignancies, bacterial, viral, fungal
AIDs pain syndromes
- pain directly related to HIV infection or immunosuppression
- pain caused by HIV diagnostic procedures and tx
- pain unrelated to AIDS or its tx
AIDS and rehab
should be like a chronic illness on a continuum
physical fitness and strength training, ADL’s pain management, posture, gait, balance; be aware of seizures and cognitive deficits
advanced stages will find CP complications; muscles and joint mobe tenchinqiues and breathing exercises
HIV and exercise
exercise does not exacerbate the progression of HIV and may slow it
moderate aerobic exercise can increase helper T cell and NK cell counts
no limitations in individuals in Stage I
exercise and HIV Stage II and III
will require more individualized exercises prescriptions and lower intensities
Stage III strenuous exercise not reocommended
Chronic fatigue syndrome
unexplained fatigue > 6 months
initially flu like: sore throat, fever, muscle pain, etc
progresses: muscle pain and forgetfulness increase as well as prolonged and overwhelming fatigue]
cyclical pattern of remission and relapse
CFS medical management
no physical signs or dx lab test to ID
no known cure
tx aimed at symptom relief and improved function
FCS and exercise
reduced stress diet, prevent overexertion.
MODERATE EXERICSE
monitor vitals
autoimmune disease
conditions which cause the immune system to turn on itself and become destructive
failure to distinguish from self and non self
systemic or just a single organ
organ specific autoimmune disorders
addison's disease crohn's disease chronic active hepatities DM grave's disease hasimoto's diease
systemic autoimmune disorders
ankylosis spondylitis MS myasthenia gravis RA systemic lupus arythematosus
fibromyalgia syndrome
falls under rheumatology and commonly associated with other conditions
trigged by emotional stress, viral infection, or trauma.
pain is main issue
FMS and exercise
lifestyle, ADLS and monitoring of vital
CV fitness training, flexibility exercises, and strength training can improve symptoms
acute: aquatic therapy
avoid overexertion
