Thursday, December 27, 2007

IMMUNE SYSTEM

The Immune System -- An Overview

The immune system is composed of many interdependent cell types that collectively protect the body from bacterial, parasitic, fungal, viral infections and from the growth of tumor cells. Many of these cell types have specialized functions. The cells of the immune system can engulf bacteria, kill parasites or tumor cells, or kill viral-infected cells. Often, these cells depend on the T helper subset for activation signals in the form of secretions formally known as cytokines, lymphokines, or more specifically interleukins. Such an understanding may help comprehend the root of immune deficiencies, and perceive potential avenues that the immune system can be modulated in the case of specific diseases.

The Organs of the Immune System

Bone Marrow -- All the cells of the immune system are initially derived from the bone marrow. They form through a process called hematopoiesis. During hematopoiesis, bone marrow-derived stem cells differentiate into either mature cells of the immune system or into precursors of cells that migrate out of the bone marrow to continue their maturation elsewhere. The bone marrow produces B cells, natural killer cells, granulocytes and immature thymocytes, in addition to red blood cells and platelets.

Thymus -- The function of the thymus is to produce mature T cells. Immature thymocytes, also known as prothymocytes, leave the bone marrow and migrate into the thymus. Through a remarkable maturation process sometimes referred to as thymic education, T cells that are beneficial to the immune system are spared, while those T cells that might evoke a detrimental autoimmune response are eliminated. The mature T cells are then released into the bloodstream.

Spleen -- The spleen is an immunologic filter of the blood. It is made up of B cells, T cells, macrophages, dendritic cells, natural killer cells and red blood cells. In addition to capturing foreign materials (antigens) from the blood that passes through the spleen, migratory macrophages and dendritic cells bring antigens to the spleen via the bloodstream. An immune response is initiated when the macrophage or dendritic cells present the antigen to the appropriate B or T cells. This organ can be thought of as an immunological conference center. In the spleen, B cells become activated and produce large amounts of antibody. Also, old red blood cells are destroyed in the spleen.

Lymph Nodes -- The lymph nodes function as an immunologic filter for the bodily fluid known as lymph. Lymph nodes are found throughout the body. Composed mostly of T cells, B cells, dendritic cells and macrophages, the nodes drain fluid from most of our tissues. Antigens are filtered out of the lymph in the lymph node before returning the lymph to the circulation. In a similar fashion as the spleen, the macrophages and dendritic cells that capture antigens present these foreign materials to T and B cells, consequently initiating an immune response.

Humans have three types of immunity — innate, adaptive, and passive:

Innate Immunity Everyone is born with innate (or natural) immunity, a type of general protection that humans have. Many of the germs that affect other species don't harm us. For example, the viruses that cause leukemia in cats or distemper in dogs don't affect humans.

Innate immunity works both ways because some viruses that make humans ill — such as the virus that causes HIV/AIDS — don't make cats or dogs sick either.Innate immunity also includes the external barriers of the body, like the skin and mucous membranes (like those that line the nose, throat, and gastrointestinal tract), which are our first line of defense in preventing diseases from entering the body. If this outer defensive wall is broken (like if you get a cut), the skin attempts to heal the break quickly and special immune cells on the skin attack invading germs.

Adaptive Immunity We also have a second kind of protection called adaptive (or active) immunity. This type of immunity develops throughout our lives. Adaptive immunity involves the lymphocytes (as in the process described above) and develops as children and adults are exposed to diseases or immunized against diseases through vaccination.

Passive Immunity Passive immunity is "borrowed" from another source and it lasts for a short time. For example, antibodies in a mother's breast milk provide an infant with temporary immunity to diseases that the mother has been exposed to. This can help protect the infant against infection during the early years of childhood.Everyone's immune system is different. Some people never seem to get infections, whereas others seem to be sick all the time. As people get older, they usually become immune to more germs as the immune system comes into contact with more and more of them. That's why adults and teens tend to get fewer colds than kids — their bodies have learned to recognize and immediately attack many of the viruses that cause colds.

Things That Can Go Wrong With the Immune System

Disorders of the immune system can be broken down into four main categories:
1.immunodeficiency disorders (primary or acquired) autoimmune disorders (in which the body's own immune system attacks its own tissue as foreign matter) allergic disorders (in which the immune system overreacts in response to an antigen) cancers of the immune system Immunodeficiency DisordersImmunodeficiencies occur when a part of the immune system is not present or is not working properly. Sometimes a person is born with an immunodeficiency — these are called primary immunodeficiencies. (Although primary immunodeficiencies are conditions that a person is born with, symptoms of the disorder sometimes may not show up until later in life.) Immunodeficiencies can also be acquired through infection or produced by drugs. These are sometimes called secondary immunodeficiencies.Immunodeficiencies can affect B lymphocytes, T lymphocytes, or phagocytes. Some examples of primary immunodeficiencies that can affect kids and teens are:IgA deficiency is the most common immunodeficiency disorder. IgA is an immunoglobulin that is found primarily in the saliva and other body fluids that help guard the entrances to the body. IgA deficiency is a disorder in which the body doesn't produce enough of the antibody IgA. People with IgA deficiency tend to have allergies or get more colds and other respiratory infections, but the condition is usually not severe. Severe combined immunodeficiency (SCID) is also known as the "bubble boy disease" after a Texas boy with SCID who lived in a germ-free plastic bubble. SCID is a serious immune system disorder that occurs because of a lack of both B and T lymphocytes, which makes it almost impossible to fight infections. DiGeorge syndrome (thymic dysplasia), a birth defect in which children are born without a thymus gland, is an example of a primary T-lymphocyte disease. The thymus gland is where T lymphocytes normally mature. Chediak-Higashi syndrome and chronic granulomatous disease both involve the inability of the neutrophils to function normally as phagocytes. Acquired immunodeficiencies usually develop after a person has a disease, although they can also be the result of malnutrition, burns, or other medical problems. Certain medicines also can cause problems with the functioning of the immune system. Secondary immunodeficiencies include:HIV (human immunodeficiency virus) infection/AIDS (acquired immunodeficiency syndrome) is a disease that slowly and steadily destroys the immune system. It is caused by HIV, a virus which wipes out certain types of lymphocytes called T-helper cells. Without T-helper cells, the immune system is unable to defend the body against normally harmless organisms, which can cause life-threatening infections in people who have AIDS. Newborns can get HIV infection from their mothers while in the uterus, during the birth process, or during breastfeeding. People can get HIV infection by having unprotected sexual intercourse with an infected person or from sharing contaminated needles for drugs, steroids, or tattoos. Immunodeficiencies caused by medications. Some medicines suppress the immune system. One of the drawbacks of chemotherapy treatment for cancer, for example, is that it not only attacks cancer cells, but other fast-growing, healthy cells, including those found in the bone marrow and other parts of the immune system. In addition, people with autoimmune disorders or who have had organ transplants may need to take immunosuppressant medications. These medicines can also reduce the immune system's ability to fight infections and can cause secondary immunodeficiency. Autoimmune DisordersIn autoimmune disorders, the immune system mistakenly attacks the body's healthy organs and tissues as though they were foreign invaders. Autoimmune diseases include:Lupus is a chronic disease marked by muscle and joint pain and inflammation. The abnormal immune response may also involve attacks on the kidneys and other organs. Juvenile rheumatoid arthritis is a disease in which the body's immune system acts as though certain body parts such as the joints of the knee, hand, and foot are foreign tissue and attacks them. Scleroderma is a chronic autoimmune disease that can lead to inflammation and damage of the skin, joints, and internal organs. Ankylosing spondylitis is a disease that involves inflammation of the spine and joints, causing stiffness and pain. Juvenile dermatomyositis is a disorder marked by inflammation and damage of the skin and muscles. Allergic DisordersAllergic disorders occur when the immune system overreacts to exposure to antigens in the environment. The substances that provoke such attacks are called allergens. The immune response can cause symptoms such as swelling, watery eyes, and sneezing, and even a life-threatening reaction called anaphylaxis. Taking medications called antihistamines can relieve most symptoms. Allergic disorders include:Asthma, a respiratory disorder that can cause breathing problems, frequently involves an allergic response by the lungs. If the lungs are oversensitive to certain allergens (like pollen, molds, animal dander, or dust mites), it can trigger breathing tubes in the lungs to become narrowed, leading to reduced airflow and making it hard for a person to breathe. Eczema is an itchy rash also known as atopic dermatitis. Although atopic dermatitis is not necessarily caused by an allergic reaction, it more often occurs in kids and teens who have allergies, hay fever, or asthma or who have a family history of these conditions. Allergies of several types can occur in kids and teens. Environmental allergies (to dust mites, for example), seasonal allergies (such as hay fever), drug allergies (reactions to specific medications or drugs), food allergies (such as to nuts), and allergies to toxins (bee stings, for example) are the common conditions people usually refer to as allergies. Cancers of the Immune SystemCancer occurs when cells grow out of control. This can also happen with the cells of the immune system. Lymphoma involves the lymphoid tissues and is one of the more common childhood cancers. Leukemia, which involves abnormal overgrowth of leukocytes, is the most common childhood cancer. With current medications most cases of both types of cancer in kids and teens are curable.Although immune system disorders usually can't be prevented, you can help your child's immune system stay stronger and fight illnesses by staying informed about your child's condition and working closely with your doctor.

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