2 SC.912.L Explain the basic functions of the human immune system, including specific and nonspecific immune response, vaccines, and antibiotics. Explain the significance of genetic factors, environmental factors, and pathogenic agents to health from the perspectives of both individual and public health. HE.912.C.1.4 Analyze how heredity and family history can impact personal health. HE.912.C.1.8 Analyze strategies for prevention, detection, and treatment of communicable and chronic diseases.
3 Benchmark Clarifications Students will identify and/or explain the basic functions of the human immune system, including specific and nonspecific immune responses. Students will describe how the human immune system responds to vaccines and/or antibiotics. Content Limits Items assessing the significance of genetic factors, environmental factors, and pathogenic agents to health are limited to a conceptual understanding. Stimulus Attribute Scenarios are limited to those commonly included in a biology course.
4 Introduction An animal must defend itself against unwelcome intruders - the many potentially dangerous viruses, bacteria, and other pathogens it encounters in the air, in food, and in water. It must also deal with abnormal body cells, which, in some cases, may develop into cancer, often due to carcinogens in the environment. What is cancer, again? How do you think carcinogens cause cancer?
5 Three cooperative lines of defense have evolved to counter these threats. Two of these are nonspecific - that is, they do not distinguish one infectious agent from another. Fig. 43.1
6 1. The skin and mucous membrane provide first-line barriers to infection Intact skin is a barrier that cannot normally be penetrated by bacteria or viruses, although even minute abrasions may allow their passage. Likewise, the inside skin - mucous membranes that line the digestive, respiratory, and genitourinary tracts - bar the entry of potentially harmful microbes.
7 Beyond their role as a physical barrier, the skin and mucous membranes counter pathogens with chemical defenses. In humans, for example, secretions from sebaceous and sweat glands give the skin a ph ranging from 3 to 5, which is acidic enough to prevent colonization by many microbes. Microbial colonization is also inhibited by the washing action of saliva, tears, and mucous secretions that bathe the exposed epithelium. All these secretions contain antimicrobial proteins. One of these, the enzyme lysozyme, digests the cell walls of many bacteria, destroying them.
8 Mucus, the viscous fluid secreted by cells of mucous membranes, also traps microbes and other particles that contact it. In the trachea, ciliated epithelial cells sweep out mucus with its trapped microbes, preventing them from entering the lungs.
9 Microbes present in food or water, or those in swallowed mucus, must contend with the highly acidic environment of the stomach. The acid destroys many microbes before they can enter the intestinal tract. One exception, the hepatitis A virus, can survive gastric acidity and gains access to the body via the digestive tract.
10 2. What if the intruders get past the gates? Microbes that penetrate the first line of defense face the second line of defense, which depends mainly on phagocytosis, the ingestion of invading organisms by certain types of white cells. Phagocyte function is coupled with an effective inflammatory response and also with certain antimicrobial proteins.
11 After a few hours in the blood, some white cells migrate into tissues and develop into macrophages: large, longlived phagocytes. These cells extend long pseudopodia that can attach to polysaccharides on a microbe s surface, engulfing the microbe by phagocytosis, and fusing the resulting vacuole with a lysosome. Fig. 43.3
12 Fig. 43.4a
13 Damage to tissue by a physical injury or by the entry of microorganisms triggers a localized inflammatory response. Damaged cells or bacteria release chemicals that cause nearby capillaries to dilate and become more permeable, leading to clot formation at the injury. Increased local blood supply leads to the characteristic swelling, redness, and heat of inflammation.
14 Fig. 43.5
15 One of the chemical signals of the inflammatory response is histamine. Histamine triggers both dilation and increased permeability of nearby capillaries. Leukocytes and damaged tissue cells also discharge prostaglandins and other substances that promote blood flow to the site of injury.
16 Enhanced blood flow and vessel permeability have several effects. First, they aid in delivering clotting elements to the injured area. Clotting marks the beginning of the repair process and helps block the spread of microbes elsewhere. Second, this also enhances the migration of phagocytic cells from the blood into the injured tissues. Phagocyte migration usually begins within an hour after injury.
17 The pus that accumulates at the site of some infections consists mostly of dead phagocytic cells and the fluid and proteins that leaked from capillaries during the inflammatory response. This pus is usually absorbed by the body within a few days. Mmmmm
18 Fever, another systemic response to infection, can be triggered by toxins from pathogens or by pyrogens released by certain leukocytes. This resets the body s thermostat and the higher temperature helps by inhibiting growth of some bacteria, facilitating phagocytosis, and speeding up repair of tissues.
19 Too much of a good thing. Certain bacterial infections like MRSA can induce an overwhelming systemic inflammatory response leading to a condition known as septic shock. Characterized by high fever and low blood pressure, septic shock is the most common cause of death in U.S. critical care units. Clearly, while local inflammation is an essential step toward healing, widespread inflammation can be devastating.
20 Introduction: specific defense While pathogens are under assault by phagocytic cells, the inflammatory response, and antimicrobial proteins, they inevitably encounter lymphocytes, the key cells of the immune system - the body s third line of defense. Lymphocytes are WBC s that generate efficient and selective immune responses that work throughout the body to eliminate particular invaders. This includes pathogens, transplanted cells, and even cancer cells, which they detect as foreign.
21 1. Lymphocytes provide the specificity and diversity of the immune system The vertebrate body is populated by two main types of lymphocytes: B lymphocytes (B cells) and T lymphocytes (T cells). Both types of lymphocytes circulate throughout the blood and lymph and are concentrated in the spleen, lymph nodes, and other lymphatic tissue.
22 Because lymphocytes recognize and respond to particular microbes and foreign molecules, they are said to display specificity. A foreign molecule that elicits a specific response by lymphocytes is called an antigen. Antigens include molecules belonging to viruses, bacteria, fungi, protozoa, parasitic worms, and nonpathogens like pollen and transplanted tissue.
23 One way that an antigen elicits an immune response is by activating B cells to secrete proteins called antibodies. Each antigen has a particular molecular shape and stimulates certain B cells to secrete antibodies that interact specifically with it. Antibodies attach to antigens. Now, where do antibiotics fit in to this topic? Very confusing in the EOC benchmarks!
24 B and T cells recognize specific antigens through their plasma membrane-bound antigen receptors. A single T or B lymphocyte bears about 100,000 receptors for antigen, all with exactly the same specificity.
25 Fig. 43.6
26 In this process of clonal selection, each antigen, by binding to specific receptors selectively, activates a tiny fraction of cells from the body s diverse pool of lymphocytes. This relatively small number of selected cells gives rise to clones of thousands of cells, all specific for and dedicated to eliminating only that antigen. Let s look at animation
27 The selective proliferation and differentiation of lymphocytes that occur the first time the body is exposed to an antigen is the primary immune response. Let s look at it in graph form.
28 Fig. 43.7
29 3. Lymphocyte development gives rise to an immune system that distinguishes self from nonself Lymphocytes, like all blood cells, originate from pluripotent stem cells in the bone marrow or liver of a developing fetus.
30 Early lymphocytes are all alike, but they later develop into T cells or B cells, depending on where they continue their maturation. Lymphocytes that migrate from the bone marrow to the thymus develop into T cells. Lymphocytes that remain in the bone marrow and continue their maturation there become B cells. Fig. 43.8
31 There are two main types of T cells Cytotoxic T cells (T C ) have antigen receptors that bind to protein antigen fragments displayed by infected body cells. Helper T cells (T H ) have receptors that bind to antigens displayed by macrophages that have engulfed a pathogen and digested it and brought them to their surface.
32 Fig. 43.9
34 1. Helper T lymphocytes function in both humoral and cell-mediated immunity: Both types of immune responses are initiated by interactions between antigen-presenting cells (APCs) and helper T cells. The APCs, including macrophages and some B cells, tell the immune system, via helper T cells, that a foreign antigen is in the body. See animation por favor.
36 2. In the cell-mediated response, cytotoxic T cells counter intracellular pathogens: a closer look Antigen-activated cytotoxic T lymphocytes kill cancer cells and cells infected by viruses and other intracellular pathogens.
37 If the cell contains a replicating virus, class I MHC molecules expose foreign proteins that are synthesized in infected or abnormal cells to cytotoxic T cells. Fig a
38 The death of the infected cell not only deprives the pathogen of a place to reproduce, but it also exposes it to circulating antibodies, which mark it for disposal. Once activated, the T C cells kills other cells infected with the same pathogen. Animation
39 In the same way, T C cells defend against malignant cancerous tumors. Because tumor cells carry distinctive molecules not found on normal cells, they are identified as foreign by the immune system.
40 B cells and the antibodies they make are the basis of what is called the humoral response. See animation Review: Antibodies are molecules, not cells. They are made by B cells, which are lymphocyte type white blood cells. Antigens are molecules, not cells. They stick out of the surface of pathogens like viruses, and cancer cells. Antibiotics are molecules, not cells, and they aren t part of your defense system. They kill only bacteria cells, unless resistance has evolved. Remember?
41 1. Immunity can be achieved naturally or artificially Immunity conferred by recovering from an infectious disease such as chicken pox is called active immunity because it depends on the response of the infected person s own immune system. Active immunity can be acquired naturally, as above, or artificially by immunization, also known as vaccination. Watch the story of the first one. Vaccines must include the antigen molecules of the bad guy so that your immune system is stimulated, but not the whole bad guy.
42 Routine immunization of infants and children has dramatically reduced the incidence of infectious diseases such as measles and whooping cough, and has led to the eradication of smallpox, a viral disease. Unfortunately, not all infectious agents are easily managed by vaccination, and there are dangers such as the risk of being infected by the vaccine as well as side effects such as were suspected with vaccines causing autism. This however, has been show to NOT BE TRUE!!!!
43 Antibodies can be transferred from one individual to another, providing passive immunity. This occurs naturally when antibodies of a pregnant woman cross the placenta to her fetus. In addition, antibodies are passed from mother to nursing infant in breast milk. Passive immunity persists as long as these antibodies last, a few weeks to a few months. This protects the infant from infections until the baby s own immune system has matured.
44 Passive immunity can be transferred artificially by injecting antibodies from an animal that is already immune to a disease into another animal. This confers short-term, but immediate protection against that disease. For example, a person bitten by a rabid animal may be injected with antibodies against rabies virus because rabies may progress rapidly, and the response to an active immunization could take too long to save the life of the victim. Actually, most people infected with rabies virus are given both passive immunizations (the immediate fight) and active immunizations (longer term defense).
45 2. The immune system s capacity to distinguish self from nonself limits blood transfusion and tissue transplantation In addition to attacking pathogens, the immune system will also attack cells from other individuals. For example, a skin graft from one person to a nonidentical individual will look healthy for a day or two, but it will then be destroyed by immune responses. We all have different molecules on the surfaces of our cells. Another person s will be recognized as a foreign pathogen by your immune system.
46 In ABO blood groups, a person with type A blood has A antigens on the surface of red blood cells. This is not recognized as an antigen by the owner, but it can be identified as foreign if placed in the body of another individual. B antigens are found on type B red blood cells. Both A and B antigens are found on type AB red blood cells (an example of codominance, remember). Neither antigen is found on type O red blood cells.
47 A person with type A blood already has antibodies to the B antigen, even if the person has never been exposed to type B blood. These antibodies arise in response to bacteria that have antigens very similar to blood group antigens. Thus, an individual with type A blood does not make antibodies to A-like bacterial antigens - these are considered self - but that person does make antibodies to B-like bacterial antigens. If a person with type A blood receives a transfusion of type B blood, the preexisting anti-b antibodies will induce an immediate and devastating transfusion reaction.
48 Allergies are when a non-dangerous substance like pollen triggers the inflammatory response. High levels of histamines cause dilation and increased permeability of small blood vessels. These inflammatory events lead to typical allergy symptoms: sneezing, runny nose, tearing eyes, and smooth muscle contractions that can result in breathing difficulty. Antihistamines diminish allergy symptoms by blocking receptors for histamine.
49 Sometimes the immune system loses tolerance for self and turns against certain molecules of the body, causing one of many autoimmune diseases; your immune system attacks your own cells. Rheumatoid arthritis leads to damage and painful inflammation of the cartilage and bone of joints. In insulin-dependent diabetes mellitus, the insulinproducing beta cells of the pancreas are the targets of autoimmune cell-mediated responses.
50 Multiple sclerosis (MS) is the most common chronic neurological disease in developed countries, In MS, T cells reactive against myelin, a kind of fatty covering of some nerve cells, infiltrate the central nervous system and destroy the myelin of neurons. People with MS experience a number of serious neurological abnormalities.
51 4. AIDS is an immunodeficiency disease caused by a virus In 1981, increased rates of two rare diseases, Kaposi s sarcoma, a cancer of the skin and blood vessels, and pneumonia caused by the protozoan Pneumocystis carinii, were the first signals to the medical community of a new threat to humans, later known as acquired immunodeficiency syndrome, or AIDS. Both conditions were previously known to occur mainly in severely immunosuppressed individuals. People with AIDS are susceptible to opportunistic diseases.
52 In 1983, a retrovirus, now called human immunodeficiency virus (HIV), had been identified as the causative agent of AIDS. Here s how it works Fig
53 With the AIDS mortality close to 100%, HIV is the most lethal pathogen ever encountered. Molecular studies reveal that the virus probably evolved from another HIV-like virus in chimpanzees in central Africa and appeared in humans sometimes between 1915 and These first rare cases of infection and AIDS went unrecognized.
55 After an initial peak, virus levels in the blood fall as anti-hiv antibodies, produced 1 to 12 months after infection, rise. A person who is HIV-positive is infected, having tested positive for the presence of antibodies to the virus, but it is not very active yet. This lasts for an average of 10 years. When they become active, the HIV start killing helper T cells, and effectively destroy the immune system. Death comes not from HIV directly, but from some other pathogen that you can t fight off anymore.
56 At this time, HIV infection cannot be cured, and the progression to AIDS cannot be prevented. New, expensive drug therapies can slow this progression. These drugs slow viral replication by inhibiting DNA synthesis, reverse transcriptase, and protease. Protease inhibitors prevents a key step in the synthesis of HIV proteins. Combinations of these drugs decrease viral load and therefore allow the number of helper T cells to rise. Other drugs treat the myriad of opportunistic diseases as they develop. Good time for a video clip, eh?
57 Transmission of HIV requires the transfer of body fluids containing infected cells, such as semen or blood, from person to person, because HIV dries out and dies when in the open air. Luckily. Unprotected sex is the main way HIV is transmitted. Just what is protected sex? In Africa and Asia, transmission has been primarily by heterosexual sex, especially where there is a high incidence of genital sores from other diseases.
58 HIV is not transmitted by casual contact. Transmission of HIV from mother to child can occur during fetal development or during nursing. HIV screening has virtually eliminated blood transfusions as a route of transmission in developed countries.
59 The best approach for slowing the spread of HIV is to educate people about the practices that transmit the disease, such as using nonsterile needles and having sex without a condom.
60 Herd immunity occurs when a high enough percentage of a population becomes protected against a disease so that the disease cannot spread in that population. Which of the following is the best example of herd immunity? A. A school reduces the number of colds in children by encouraging frequent hand-washing B. Polio is unknown in the Americas today because most children receive polio vaccines C. Employees at a company are encouraged to get flu shots to avoid becoming sick and missing work D. A county sprays trees to kill mosquitoes in order to prevent people from becoming sick after being bitten
61 Many diseases have been nearly eliminated because of widespread vaccination. How do vaccines help the body to resist disease? A. They alter the shapes of antigens B. They stimulate the production of antibodies C. They kill bacteria or prevent them from reproducing D. They transfer antibodies from one organism to another
62 Antibiotics can be used to treat some infectious diseases. Which pathogens cause these diseases? A. Bacteria B. Viruses C. Toxins D. Fungi
63 By which process can a person acquire active immunity to a disease? A. Healthy eating B. Treatment with antibiotics C. Vaccination D. Following hygienic procedures
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