MINISTRY OF EDUCATION AND SCIENCE OF KYRGYZ REPUBLIC

OSH STATE UNIVERSITY

INTERNATIONAL MEDICAL FACULTY

DEPARTMENT OF PATOLOGY, BASIC AND CLINICAL PHARMACOLOGY

 
 
 
             
"APPROVED"
at a meeting of the Department of
pathology, basic and clinical
pharmacology from «__» of _______2019.
Head of department Prof. G.V. Belov.
_______________________________
 

 
 
 
 
METHODICAL INSTRUCTIONS FOR TEACHERS
SECTION: GENERAL PATHOPHYSIOLOGY.
TOPIC: The role of reactivity and resistance of the organism in pathology
 

 
 
 
Developed by: Lecturer Zhoroeva A.K.
The methodical instruction was approved at the meeting of the department
«____»__________2019. Protocol No. ____
 
 
 
 
 
 
 
 
 

OSH
 TOPIC: The role of reactivity and resistance of the organism in pathology
 
Purpose of the lesson : is to study the resistance and reactivity of the organism, their interrelation, as
well as the forms and basic mechanisms of reactivity.

Practical Skills
1. Carry out andropometry

Educational goal:
 Strive to foster a sense of humanism, collectivism, respect for elders, mutual assistance,
feelings of subordination, responsiveness, desire for physical health;
 Strive to instill a sense of responsibility for the assigned work, diligence, accuracy,
integrity, a sense of duty;
 Strive to instill a sense of pride in the chosen profession, the ability to manage emotions. 
 
Timing of the lesson: 

No. STAGES OF THE SESSION TIME

1 Introduction:  
Announcement of the lesson theme, methodical and organizational5 5min
instructions of the lesson
2 The relevance of the basic knowledge of students (exercises, game and  
  etc. necessary as a support for learning a new mother):
  A. Benchmark control 10 min
B. Case-method 15 min

3 The initial motivation of educational activity ( to interest in the study of 5 min

the topic: the need for the professional activity.)  

4 Study of new material (consistent presentation "from simple to complex"  

with the opportunity to see visual demonstration)  
A. Oral survey  40 min
B.  Final level control test 10 min

5 Working small groups:  

a. Solving situational cases 10 min
b. Discussion of the results 15 min
c. Practical work 20 min
6 The final part of the session (summarizing the lesson, marks.) 5 min

 
 
 
 
 
 
 
 PRACTICAL CLASS PLAN
1. The content of the lesson:

 Reactivity. Types and forms

 Indicators and mechanisms of reactivity
 Reactivity and biological barriers
 Resistance. Types. Relation with reactivity

2. Place of the lesson: Department of pathology, basic and clinical pharmacology

3. Material and technical support:
I. Equipment:
1. Personal computer (laptop)
2. Multimedia projector
II. Chemical reagents and materials:
III. Animals:
IV. Tables:
V . Media file
1. Slides
2. Video 
 
4. Tasks taking into account the competency approach to training:
 to form and develop the skills of analysis on the material passed,
 to acquaint students with the etiology, pathogenesis and clinical manifestations,
 teach the principles of diagnosis and treatment,
 teach the basic principles of prevention,
 teach to assess the severity of the condition, the outcome of the disease and prognosis,
 to develop the personal qualities of a specialist,
 to form and develop the skill of effective communication between the doctor and the
patient,
 learn to work with information,
 stimulate continuous improvement of knowledge throughout life ...
 
5. Expected Results:
The student should know:
   the role and importance of reactive and resistant
 body properties in the occurrence, development and completion (outcome) of diseases
using information and bibliographic resources;
 types of reactivity and body resistance to solve professional problems
The student should be able to:
o be able to explain the influence of internal and external factors on reactivity and
resistance, heredity and variability using information, bibliographic resources,
biomedical terminology;
o identify the effect of the body’s constitution on the occurrence and disease
development 

METHODICAL   AND ORGANIZATIONAL GUIDELINES FOR THE TEACHER TRAINING

 
1. The teacher explains the procedure for the lesson.
2. The first part includes programmed student knowledge control and a theoretical
survey.
 3. The second part of the lesson is the independent work of students under the
guidance of a teacher and a discussion of the results.
 
 
CONTROL OF THEORETICAL TRAINING OF STUDENTS
 
1. Programmed control (Appendix 1)
2. Problem solving (Appendix 2)
3. A survey on the following issues:
 
Question for the lesson:
1. What is the role of reactivity and body resistance in pathology?
2. What are the types and forms of reactivity. Evolutionary
reactivity aspects. Features of reactivity in childhood and their importance in pathology.
3. Give a definition of resistance. Types of resistance Mechanisms that determine the
reactivity and resistance of the body.
4. Determine the relationship between reactivity and resistance.
5. Describe the effects of heredity, constitution, gender, age, external influences, social
factors, etc.) on the level of reactivity and resistance of the body.
6. What are the types of constitution ?
 
LITERATURE
1. Lee – Ellen C. Copstead and 1 more Pathophysiology 5th edition.
2. Gary D. Hammer and 1 more Pathophysiology of Disease 7th edition
3. Нarold J. Bruyere Jr. PhD 100 Case Studies in Pathophysiology
4. СarolPorth RN MSN Phd – Essentials of pathophysiology 4th edition
5. Ysmeen Agosti and 1 more Med Maps for pathophysiology 1th edition

Educational-methodical manual:
6. Atlas of Pathophysiology / Kalmatov R. K..- OshSU- 2015. -210 С.
 
Abstract :

Reactivity of an organism (that lat. Reactia - counteraction) - the body's ability to change its livelihoods
on the impact of environmental factors. Reactivity is formed in the process of evolution, in phylogenesis
and ontogenesis. It reflects the species, group and individual characteristics of the response. The
organism's reactivity is one of the important factors in the pathogenesis of diseases, since pathological
reactivity is characterized by a decrease in the adaptive capabilities of the organism.
Any pathological process changes the body's reactivity, and at the same time, a change in reactivity that
exceeds the physiological limits can become the basis for the development of the disease. Therefore,
the study of reactivity and its mechanisms is important for understanding the pathogenesis of diseases
and their targeted treatment.

Types of reactivity.

The most common form of reactivity is biological, or species reactivity, which is determined primarily by
hereditary factors and expresses the ability of all members of this species to respond to various
environmental exposures (toxins, hypoxia, radial acceleration, etc.) with single-type changes in vital
activity. adaptive nature. It is also called primary. Specific features of reactivity determine the species
immunity to infectious diseases. Thus, the immunity of a person to cattle plague pathogens is explained
by species immunity. An example of species changes in reactivity is hibernation of animals, seasonal
migration of fish and birds. During winter hibernation, characterized by deep inhibition of the activity of
the nervous and endocrine systems, metabolism and a decrease in body temperature (up to 3–4 ° C in
the rectum), reactivity to many factors is significantly reduced.

On the basis of species reactivity, group and individual forms. Group reactivity have people who are
similar in any hereditary constitutional features. For example, according to the constitutional type,
blood group, leukocyte antigens, etc. It is known that people with blood group I often suffer from gastric
ulcer. Individual reactivity is caused by hereditary and acquired factors. It depends on the environmental
conditions in which the body develops - the nature of nutrition, the climate zone, the oxygen content in
the atmospheric air, etc.

On the basis of species reactivity, group and individual forms. Group reactivity have people who are
similar in any hereditary constitutional features. For example, according to the constitutional type,
blood group, leukocyte antigens, etc. It is known that people with blood group I often suffer from gastric
ulcer. Individual reactivity is caused by hereditary and acquired factors. It depends on the environmental
conditions in which the body develops - the nature of nutrition, the climate zone, the oxygen content in
the atmospheric air, etc.
Reactivity depends on gender. In the female body, reactivity changes due to the menstrual cycle,
pregnancy. The female body is more resistant to hypoxia, blood loss, radial acceleration, starvation.
Individual reactivity can be specific and nonspecific. Specific reactivity is expressed in the ability to form
antibodies against antigenic stimuli. These requirements are satisfied by immune reactivity. It provides
immunity to infectious diseases, or immunity in the proper sense of the word, the reaction of biological
tissue incompatibility, hypersensitivity.
Nonspecific reactivity manifests itself in the action on the body of various environmental factors. It is
implemented using such mechanisms as stress, changes in the functional state of the nervous system,
parabiosis, phagocytosis, biological barriers, etc.

Specific and non-specific reactivity can be physiological and pathological. Physiological reactivity covers
the reaction of a healthy organism in favorable conditions of existence. An example is immunity (specific
reactivity), the body's response to the action of various environmental factors within the limits that do
not violate homeostasis (non-specific reactivity).

Pathological reactivity manifests itself when exposure to disease factors. An example of specific
pathological reactivity are allergies, immunodeficiency and immunosuppressive states. A manifestation
of nonspecific pathological reactivity is a change in reactivity in traumatic shock, anesthesia. When
shock is inhibited reactivity with respect to infectious and other pathogenic effects. Phagocytosis is
inhibited, drug sensitivity is changing.

According to the forms of manifestation, they distinguish between increased (hyperergy), decreased
(hypoergy) and perverted (dysergia) reactivity.
Reactivity at various levels of organization of living systems. Reactivity, forming on the basis of heredity,
constitutional type, a certain level of development of the nervous, endocrine and immune systems, is a
property of the organism as an integral system and at the same time reactivity can be judged at various
levels of organization of this system, starting with the subcellular one. An example of reactivity at the
molecular level is the reaction of the HbS molecule during sickle cell anemia to hypoxia, which results in
a change in the solubility of hemoglobin and the formation of crystals that damage red blood cells.

Cellular reactivity is associated with membrane processes that ensure the interaction of a cell with its
environment through the protein structures built into it, which function as cellular receptors and ion
channels.
Reactivity at the cellular level is observed when phagocytosis is performed by leukocytes, and when
mast cells degranulate with the antigen-antibody complex. The reactivity of an organ is manifested, for
example, in a spasm of smooth muscle organs in response to repeated ingestion of an allergen.
An example of the reactivity of the organ system and the body as a whole is the restructuring of
thermoregulation and the main life-supporting systems in response to the action of pyrogen . In the
development of many pathological processes (allergy, inflammation), changes in reactivity at various
levels can be traced.

Indicators and mechanisms of reactivity

Indicators.

Indicators of nonspecific reactivity are: irritability, excitability, sensitivity - a term similar to excitability,
but applied to more complex processes in the body. Possible changes in sensitivity to pain, temperature
irritation. The sensitivity of the sense organs - sight, hearing, smell, etc. may be impaired. The reactivity
may be indicated by the speed and intensity of development of the general adaptation syndrome, the
ability to respond to stimuli by increased adrenaline secretion, increased respiration, increased
pressure, etc.

To assess the specific reactivity determine the features of the immune response (intensity of antibody
production, the type of immunoglobulins, etc.).

Mechanisms.

Data onto and phylogenesis show that the formation of reactivity is associated with the improvement of
the nervous and endocrine systems. The research of I. P. Pavlov and his school, L. A. Orbeli, established
the importance of various parts of the central and autonomic nervous system in reactivity. For example,
it is known that during deep sleep and anesthesia, the susceptibility of the body to electric current is less
than in the waking state. Using the example of hibernation of animals, the role of the nervous system in
immune reactivity and resistance to infections is well demonstrated.

Kennon and Selye play an important role in reactivity and resistance to the endocrine system. In
conditions that require a certain amount of tension from the body and the inclusion of adaptive
mechanisms, Kennon takes the leading role of adrenaline ("emergency hormone"), Selye - the hormones
of the anterior pituitary and the cortex of the adrenal glands. Particularly significant in this regard is the
participation of corticosteroids in the realization of inflammation, when glycocorticoids act as anti-
inflammatory, and mineralocorticoids act as pro-inflammatory agents.
It is also known that with hyperfunction of the thyroid gland, inflammation occurs more rapidly, and
with hypofunction, it is sluggish. Significantly changes the reactivity in diabetes mellitus (poor wound
healing, permanent pustular skin lesions, often the accession of tuberculosis).
An important role in reactivity is played by the connective tissue, the elements of which participate in
immune reactions, phagocytosis, provide healing of wounds, and have a barrier function.

Environmental conditions are of great importance in reactivity. Thus, with increasing body temperature,
the reactivity increases even in cold-blooded ones. Under these conditions, reptiles (monitor lizards)
manage to cause anaphylaxis, in frogs - tetanus and camphor convulsions. In warm-blooded fever, the
antibody titer increases, phagocytosis increases. Infectious diseases without fever (cold "diphtheria") are
difficult. A decrease in body temperature increases resistance to hypoxia, the action of mechanical
factors. Reactivity decreases with full and especially partial fasting. Interestingly, certain types of
reactivity are inhibited in the opposite way to their development in evolution. So, when fasting, allergic
reactions disappear first, and then immunity is inhibited.

A sharp change in weather, season and climate also determine the state of reactivity and resistance.
The influence of the external environment on a person also includes “the influence of social factors. An
example of social mediation of reactivity in humans is the emergence of new types of communication
such as man — machine, when a person joins the production process. Disruption of this system, for
example, a person lagging behind the pace of the production process, can cause mental disorders.
Disruption of micro-social relations at work, in a family can lead to the development of neurotic states in
which a person begins to react inadequately to the surrounding social and biological environment.

Reactivity and biological barriers.

Biological barriers are specialized tissue structures that protect the body or its individual parts from
pathogenic environmental influences and ensure the preservation of homeostasis. Distinguish external
and internal barriers. External barriers include skin, mucous membranes that protect the body from the
physical, chemical and biological effects of the external environment; respiratory organs that trap
harmful substances in the atmosphere; digestive apparatus (bactericidal action of gastric juice,
deprivation of nutrients of antigenic properties); liver, neutralizing toxic substances from food or formed
in the intestine; spleen, lymph nodes and other organs, including cells of the mononuclear phagocyte
system. Internal barriers regulate the supply of necessary energy substances from the blood to the
organs and tissues and prevent the penetration of foreign and poisonous substances.

The founder of the theory of barrier functions, L. S. Shtern, in 1929, stated that differentiated
protective-regulatory devices are located between the blood and the tissue fluid, which it calls
histohematic barriers.

Resistance. Kinds. Reactivity Relation

Resistance is the body's resistance to the action of pathogenic factors.

In the course of evolution, the organism acquired certain adaptive mechanisms, thanks to which its
existence is ensured in conditions of constant interaction with the environment, many factors of which
could cause not only impairment of vital activity, but also death in the absence or underdevelopment of
these mechanisms.
Resistance of an organism is closely related to reactivity. The body’s ability to withstand the damaging
effects is ultimately determined by its response as a whole, and therefore resistance is one of the main
consequences and expressions of the body’s reactivity.
There are passive and active resistance. Passive is not associated with active reactions to the impact,
and the anatomical and physiological characteristics of the body - the structure of the skin, mucous
membranes, bone tissue, dense integument.
Active resistance due to the inclusion of protective and adaptive mechanisms. Thus, resistance to
hypoxia is associated with an increase in ventilation of the lungs, acceleration of blood flow, an increase
in the content of red blood cells and hemoglobin in the blood, etc. Resistance to infectious effects —
immunity — is associated with the formation of antibodies and the activation of phagocytosis.
Resistance may be primary, associated with hereditary factors, and secondary - acquired.

Acquired resistance can be active and passive. An example of the first form is increased resistance to
hypoxia as a result of acclimatization or increased resistance to infection after vaccination. Acquired
passive resistance occurs with the introduction of serum containing antibodies.

Usually reactivity and resistance change unidirectionally. However, another ratio is also possible, in
which the reactivity decreases, and resistance increases, as it happens in hibernation conditions in
animals, with deep hypothermia, anesthesia.

The state of reactivity should not be considered at all, but specifically in relation to one or several
homogeneous factors. Often, increased reactivity to one stimulus is combined with a decrease in
reactivity to another. With the action of two or more extreme (extreme) stimuli, the body often
responds to only one, remaining “deaf” to the action of the others. It is known, for example, that if an
animal is dealt a drop of lewisite on the skin at the time of cramps, the damage will be relatively weak.
Animals exposed to radial acceleration tolerate a lethal dose of strychnine, reveal greater survival in
conditions of hypoxia, overheating. This form of response cannot be called resistance, since in these
conditions the body cannot actively resist the action of the external environment, maintaining
homeostasis, but only transfers effects in a state of deep inhibition of vital activity.
Portability is usually observed in less perfect organisms, for example, in cold-blooded animals, or in the
early periods of postnatal development, especially in non-breeding animals (rats, mice). As an adaptive
mechanism in these conditions, the transition to a more ancient and stable, although economically and
less advantageous way of energy release is glycolysis.
Resistance, as opposed to portability, provides active resistance of the organism to pathogenic effects
due to the inclusion of protective-adaptive mechanisms, as a result of which the constancy of the
internal environment and an adequate level of vital activity of the organism remain.