IMMUNOLOGY & ONCOLOGY

EMERITA C. MENDOZA, R.N., M.D.

Immune System The body’s special
defense against foreign organisms Includes: lymphoid organs (lymph nodes, spleen, & thymus gland) and their products (lymphocytes & antibodies) and macrophages (phagocytes found in the blood, brain, liver, lymph nodes, &

Defense Mechanisms

Nonspecific  Inflammation

Phagocytosis Interferons

Specific  T Lymphocytes  B lymphocytes  Cell-mediated Immunity  Antibodymediated Immunity

Inflammation
a response of body tissues to injury or irritation; characterized by pain and swelling and redness and heat

Phagocytosis

One of the main functions of inflammation is to bring large numbers of phagocytes to the affected area. Once there, phagocytes ingest bacteria by flowing around them and engulfing them; this is phagocytosis. As a bacterium is ingested, it is neatly packaged within a vacuole formed by membrane pinched off from the cell membrane. One or more lysosomes adhere to the vacuole and release enzymes into it that kill the bacterium.

Interferons

When infected by viruses or other intracellular parasites (some types of bacteria, fungi, and protozoa], certain types of cells respond by secreting proteins called interferons. These proteins trigger other cells to produce antiviral proteins. Viruses produced in cells exposed to interferon are not effective at infecting new cells.

2 Major Disease Fighters of the Immune System
T-cell lymphocytes  differentiate primarily in the thymus and are central to the control and development of immune responses. B-cell lymphocytes  immune system cells released from the bone marrow, which produce antibodies.

T-cell lymphocytes

Involved in cell-mediated immunity Originate from bone marrow stem cells & are processed in the thymus gland When an Ag is encountered, the T-cell multiplies rapidly to produce cells that destroy the Ag

T Cell Lymphocytes
1. 2.

3.

4.

Attach to Ag & directly destroy them (cytotoxic T-cell or T8 cells) Secrete proteins (cytokines: interferons & interleukins) that help other cells respond to Ag Act as helper cells (T4 cells) to promote antibody synthesis by B cells and stimulate T cells. Act as suppressor cells to inhibit B and T cells.

B-cell lymphocytes
  

Involved in humoral immunity (Ab-mediated) Originate from bone marrow stem cells When confronted with a specific type of Ag, Bcells transform into plasma cells  produce antibodies called immunoglobulins:  IgA – mainly found in secretions  IgG – most abundant, crosses the placenta to
provide immunity to newborn infection
 

IgE – important in allergic reaction & parasitic

IgM – produced in the primary response to Ag  IgD – no known antibody function

 Cell-mediated

the surface of other cells that display the antigen and trigger a response. The response may involve other lymphocytes and leukocytes.

Immunity -bind to

 Antibody-mediated

-Antibodies, dissolved in blood, lymph and
other body fluids bind the antigen and trigger a response to it.

Immunity

Immunity

the body’s ability to resist foreign organisms and toxins (poisons) that damage tissues & organs 2 types:
 

Natural immunity - nonspecific Acquired immunity - specific
1. 2.

Acquired active immunity Acquired passive immunity

Graft Rejection

  

It is an immune response aimed at transplanted tissues Due to incompatibility of histocompatibility genes and antigens 1/1 match in autografting & between identical twins ¼ match in siblings 1/1000 match in unrelated persons Prevention: use of drugs & xrays to kill Tlymphocytes (side effect: suppress immune system)

Hypersensitivity

an allergy; an exaggerated or inappropriate immune response categorized based on which part of the immune system that is involved and the onset of response

ONCOLOGY

The science dealing with the physical, chemical and biological properties and features of cancer, including the causes and progression of the disease. Doctors who specialize in oncology are called oncologists.

Introduction to ONCOLOGY

  

Cancer (CA) – a disease characterized by unrestrained & excessive growth of cells in the body CA cells compress, invade, & ultimately destroy surrounding normal tissue may have local & metastatic growth in females: lung CA, breast & colorectal CA in males: lung, colorectal, & prostate CA

Carcinogenesis
I.

Theory of Immunosurveillance
failure of the immune system to eradicate abnormal cells

II.

Malignant transformation resulting from damage to the genetic material, or DNA, of the cell

the processes of mitosis and protein synthesis are disturbed altered DNA & altered cellular programs make new signals that lead to movement of cells, invasion of adjacent tissue, and metastasis changes established in a CA cell is passed on to daughter cells  mutation

Environmental Agents or carcinogens

Chemical carcinogens:

hydrocarbons in cigarettes, cigars, pipe smoke, & auto exhaust insecticides, dyes, industrial chemicals, insulation hormone: Diethylstilbestrol (DES) – synthetic oestrogen prescribed in the 1950s, 1960s, and early 1970s to women to prevent miscarriage causes malignant tumor CA of the vagina drugs: estrogen – causes CA by stimulating proliferation of cells in target organs such as uterine lining

Radiation: wave of energy

sunlight, x-rays, radioactive substances, nuclear fission leukemia – occupational hazard of radiologists Hiroshima & Nagasaki atomic bomb survivors ultraviolet radiation in sunlight – especially for Caucasians or fairskinned individuals

Viruses: Oncogenic viruses
    

caused by RNA viruses (aka retroviruses) & DNA viruses Human T-Lymphocytic Virus (HTLV) – leukemia in adults Human Immune Deficiency Virus (HIV) – Kaposi sarcoma associated with AIDS Papilloma virus – cervical CA Epstein Barr Virus (EBV) – Burkitt lymphoma

1.

Oncogene or CA causing gene

  

a piece of DNA whose activation is associated with the conversion of a normal cell into a cancerous cell ras oncogene– colon cancer myc – lymphoma bcr-abl – chronic myelogenous leukemia

Heredity

Susceptibility to some CA forms is transmitted from parents to offspring through defects in the DNA of the egg & sperm cells tumors arise because of inherited or acquired abnormalities in suppressor genes (regulate growth, promote differentiation, & suppress oncogenes from causing cancer) ex.: retinoblastoma, polyposis coli syndrome, & certain forms of colon, breast, & kidney CA genetic screening – to determine presence of cancer-causing gene