Immunologic and Allergic Diseases 1.

Lymphocytic system
2. Phagocytic system
 Our bodies are exposed continually to bacteria, viruses, fungi, 3. Compliment system
and parasites, all of which occur normally and to varying degrees
in the skin, mouth and respiratory passageways, the intestinal Lymphocytic System
tract, the lining membranes of eyes and even urinary tract
- Derived from pluripotent bone marrow stem cells
 In addition, we are exposed intermittently to other highly infectious
A. B Cells
bacteria and viruses besides these that are normally present.
o Matures in bone marrow
They can cause:
o Acute Lethal Diseases: o Proliferates and differentiates into plasma cell that produces
 Pneumonia antibodies
 Streptococcal Infection B. T Cells
 Typhoid Fever o Originates in bone marrow and leaves and matures in thymus
 Our bodies have a special system for combating different Important defense against:
infectious and toxic agents. This is comprised of leukocytes o Viruses
(WBC)
o Mycobacteria
o These cells work together in 2 ways to prevent disease:
o Fungi
 By actually destroying invading bacteria or
viruses by phagocytosis Responsible for
o Tumor immunity
By forming antibodies and sensitized lymphocytes, one or
o Graft rejection
both of which may destroy or inactivate the invader
T cell Activation
BONE MARROW
 Antigen presenting cell (APC) (Macrophages) reacts with antigen first
 The blood cells begin their lives from a single type of cell called
PLURIPOTENT HEMATOPOIETIC STEM CELL (PHSC) form Roles of APC in T cells response
which all cells are derived 1. Prevents antigen to T lymphocyte receptors specific for that
 Differentiation into 2 stem cells: given antigen
PHSC 2. Produce substance called interleukin 1 (1L1) which results in
activation of T cells
RBC WBC  Antigen and 1L1 are needed for initiation of T cell mediated
response
B Lymphocyte  For antigen to stimulate a T cell mediated to the T cell as complex
w/in close proximity to surface
T Lymphocyte
MHC
WHITE BLOOD CELL
- A group of closely linked genetic loci that are usually inherited as
 2 Major Lineage
one unit in humans this complex is found in chromosome G.
o Myelocytic
o Lymphocytic Activated T cell

Types of WBC: - Produce substance called lymphokines

- Lymphokines are responsible for continued proliferation of T cell
PMN Neutrophils 62 % -- Bacterial and are responsible for amplification of initiated response
Eosinophils 2.8 % - During the activation process, T cells differentiate into cells that
Basophils 0.4 % have distinct functions.
Monocytes 5.3 % -- Parasitic 1) Cytotoxic t cells
Lymphocytes 30 % 2) Helper t cells
Plasma Cells 1. Cytotoxic Cells (TK)
- Can recognize
 ANTIGEN: foreign stimuli in immunologic reaction
- Cell associated antigens (such as tumor)
 Immune system’s 2 features: Specificity, Memory
2. T Helper Cells
o Specificity- immune cells recognize and generate response
- Release lymphokines that can affect B lymphocytes and T
against antigen but not against other.
lymphocytes
o Memory- on the subsequent exposure to same antigen,
3. T Cells that mediate delay types
immune response is generated more quickly and vigorously 4. Suppressor T cells
2 Major Divisions of Immune System - Down regulates immune response ****

1. Humoral – Immune reaction is mediated by antibodies HYPERSENSITIVITY

2. Cellular – Mediated by lymphocytes, macrophages (e.g skin A. Type 1 – IgE mediated
reactivity, tuberculoprotein) Ex. Asthma, Eczema, Food
Elements of Immune System: B. Type 2 - IgG or IgM
Ex. Anemia, Blood- related
C. Type 3 – Immune complex mediated o Guidelines for therapy
Ex. Systemic Disease
D. Type 4 – Cell mediated Red flag Symptoms of Cancer
Ex. Contact dermatitis; amalgam (skin test, tuberculine)
1. Persistent cough
- Delayed Reaction!
2. Persistent change in bowel/ bladder habits
*Drug allergies can manifest all these types 3. Non-healing ulcers
4. Persistent difficulty in swallowing
NEOPLASTIC DISEASES 5. Unexplained weight loss
6. Unexplained Lump
 The duration of symptoms may reveal the chronicity of disease 7. Persistent unexplained pain, unexplained bleedind, and change in
 The past medical history may alert the physician to the presence of appearance of male
underlying disease that may affect the choice of therapy or the side
effects of treatment Staging – to determine the extent of the disease
 The social history ay reveal occupational exposures to carcinogen and
TNM Classification
their habits
 Family history may suggest or underlying familial cancer predisposition - Anatomically based system
and point out the need to begin surveillance or either preventive
therapy for unaffected siblings of patient Important prognostic factor within each histologic type
 Review of systems may suggest early symptoms of metastatic disease
- Degree of tumor
Did you know?
Major determinant of treatment outcome
Cancer, is the second leading cause of death behind heart
disease. Significant factor overall is age (due to exposure) - Tumor burden (stage of tumor)
- Physiologic reserve (can px tolerate the tx)
CARCINOGENS
TREATMENT
 Accumulation of genetic changes that are potential points of
intervention to prevent cancer  Localized: surgery and radiation
 The initial genetic change are termed initiation  Disseminated: Chemotherapeutic agents malignancies
 The alteration can be inherited/acquired through the action of physical,
SIDE EFFECTS
infectious.
 Interaction between the genetics and the environment (exposure)  Nausea/ vomiting
 Febrile Neutropenia
1. Physical  Myelosuppression
2. Infectious
3. Chemical COMMON CAUSE OF DEATH

Reduce cancer risk:  Infection

 Respiratory failure
o Do not smoke, or use any tobacco products
 Hepatic failure
o Maintain healthy diet
 Renal failure
o Exercise at least 3x per week
o Prevent sun exposure STAGE OF ADJUSTMENT
o Pratice safe sex; use condoms
 Denial
Cancer Chemoprevention  Isolation
 Anger
- Use of specific natural or synthetic agents to reverse, suppress or
 Bargaining
prevent carcinogens
 Depression
Clinical Manifestation:  Acceptance/ Hope

1. Obstruction/ compression
2. Loss/ alteration of organ function
3. Tumor secretion
 The specific symptoms will depend on
o State of involvement
o Particular substance
 The most important factor in obtaining optimal cure is EARLY
DETECTION AND DIAGNOSIS
 The sine qua non for diagnosis of cancer is histologic proof of
malignancy (tissue biopsy)
 Histologic classification also provides:
o Prognosis information