NUR 631 Topic 2 DQ 1

The immune system consists of 3 lines of defense that include external barriers, inflammatory activation, and adaptive immunity- that can also be subdivided into passive acquired and active acquired immunity (McCance & Huether, 2018). Furthermore, in passive acquired immunity preformed antibodies or T- Lymphocytes are transferred from a donor to a recipient, occurs naturally or artificially, and is temporary in short memory lived and active acquired- antibodies or T cells are produced after either a natural exposure to antigen or after immunization and has long lived.

           Passive acquired immunity is seen naturally when passage of antibodies from maternal to fetus via placenta or in the use of immunotherapy in clinical setting to either prevent or treat infection like Hepatitis A.

           Active acquired immunity the client will be exposed to antigen or by immunizations.

The role of Antibody/ Immunoglobulin are one of the most important molecules in the body that protects and initiates memory cells from pathogenic and microbes. Furthermore, antibodies arise from plasma protein of B-lymphocyte once differentiated and fully functional in body system. Antibodies are divided into classes (IgG, IgA, IgM, IgE, and IgD).

IgG is the most abundant class of immunoglobulins that make up to 80-85% of the circulation in the body and provides a defense against pathogenic infections.

IgA- in addition, antibodies can be divided into two classes IgA1 and IgA2. IgA1 is found in the blood and IgA2 found in normal body secretions also known as (secretory IgA) a molecule that are dimers that hold 4 antigens at antigen binding site.

IgM- considered one of the most important and primary responders in the immune system. In addition, microbes are said to be antigenically mosaic and it is considered pentameric decavalent.

IgE- normally a low concentration in circulation system. The molecule is seen as mediator of allergic and parasitic infections.

IgD- seen in limited and found in very low concentrations in circulatory system. IgD function as antigen receptor on B-Lymphocytes at early stages (Megha & Mohanana)

Catecholamine is “extremely” important in multi organ function and clinical practice. The two endogenous catecholamine, organic compound, CNS- PNS- ANS- sympathetic system cells in preganglionic system neurons are usually releasing NE on effector cells and small amounts of Epinephrine. In addition, epinephrine is released by adrenal medulla from the chromaffin cells and usually 80% is released in am and 20% NE (McCance & Huether, 2018).

Cortisol- in the PVN of hypothalamus secret- corticotropin releasing hormone (CRH)- binds with receptors on APC- produce ACTH- transport through blood to adrenal gland and receptors of the glucocorticoid from adrenal cortex release CORTISOL a hormone with dominant control on metabolic changes at cellular level.

In combination of catecholamines and cortisol the question is what area it will not drastically affect. Moreover, from triggering RAAS and metabolic function in the body will display systemic inflammation, sx/sx of Cushing syndrome, HTN crisis, metabolic syndrome, vascular changes- hemodynamic imbalance, the stress-induced dramatic changes in the brain and cognitive changes with AMS and a cascade of body deterioration (McCance & Huether, 2018).

References

Megha, K. B., & Mohanan, P. V. (2021). Role of immunoglobulin and antibodies in disease management. International Journal of Biological Macromolecules, https://doi.org/10.1016/j.ijbiomac.2020.12.073

McCance, K. L., & Huether, S. E. (2018). Pathophysiology (8th ed.). Elsevier Health Sciences.

Complete all of the following for your discussion response.

Immunity is necessary to prevent infectious diseases from spreading. Differentiate between passive-acquired and active-acquired immunity. Provide two examples of each type of immunity.

Immunoglobulins are necessary to protect the human physiology from diseases and pathological disorders. Explain the role of IgA, IgG, IgE, IgD, and IgM.

Stress is a component that affects the normal regulations of human physiology. Neuroendocrine regulation is important in this abnormality. How does increased catecholamine and cortisol affect the immune system?

Active-acquired immunity occurs when antibodies are formed after natural exposure to an infectious disease. There are two subunits of active-acquired immunity: natural and vaccine-induced immunity. The Center for Disease Control defines natural immunity development from exposure to the illness organism or virus. Additionally, vaccine-induced immunity injects a deceased or weakened organism into the individual by vaccination (CDC, 2021). McCance et al verifies immunizations are forms of active-acquired immunity (2019). If a non-vaccinated child were to develop and overcome measles, they would create a natural active response or active-acquired immunity to the measles virus. Active-acquired immunity is life-long immunity, yet passive-acquired immunity is temporary (McCance et al, 2019). Passive-acquired immunity occurs when pre-formed antibodies are transferred from donor to recipient (McCance et al, 2019). Examples of passive-acquired immunity include a newborn who acquires antibodies from its mother via placenta.

IgA or immunoglobulin (A) is an antibody found in most secretions. IgA is essential to protecting the mucosal surface by either neutralization or prevention of binding from viruses, bacteria, or toxins, expresses Schroeder in the journal, Structure and function of immunoglobulins (2010). 

IgG is the most predominant antibody found in the human body accounting for eighty to eighty-five percent of all immunoglobulins, summarizes McCance et al in the book Pathophysiology: The Biological Basis for Disease in Adults and Children (2019). Immunoglobulin G are the most protective antibodies against infections by neutralization of toxins and viruses (Schroeder, 2010).

IgE is the least concentrated immunoglobulin, but the most potent antibody in circulation (Schroeder, 2010). Immunoglobulin E is linked to hypersensitivities or allergic reactions and parasitic infections (McCance et al, 2019). 

There are very low levels of IgD within the body’s serum. The function of immunoglobulin D is somewhat unknown. McCance et al explains IgD operates as a B-cell antigen receptor (2019).

The largest antibody, IgM, is generated during fetal life (McCance, 2019). Immunoglobulin M is the body’s first line of defense against a virus, toxin or bacteria. Antibodies IgM are the primary immune response and often the serum marker for acute exposure to a pathogen or immunogen (Schroeder, 2010).

Stress causes both physiological and psychological changes within the human body. Once an individual experiences an event they cannot personally cope with, stress is produced. When cumulative amounts of stressors occur, the individual goes into a state of allostatic load. This is where the term “fight or flight” response stems from. The central nervous system and endocrine system then responds physiologically, by releasing catecholamines and cortisol. The catecholamines released consist of norepinephrine and epinephrine. McCance et al describes norepinephrine manifestations by increased blood pressure, dilated pupils, and increased sweat gland secretion. Furthermore, epinephrine vasodilates the blood vessels and increases metabolic regulation creating a surge in blood glucose (McCance, 2019). Simultaneously, the sympathetic nervous system is aroused by the allostatic load causing the adrenal gland to release the glucocorticoid, cortisol. Cortisol quickens gluconeogenesis creating the increase in blood sugar as mentioned previously. Cortisol is an immunosuppressive agent and causes an increased susceptibility to infection (McCance, 2019). With chronic levels of cortisol, there is an increased risk of obesity and diabetes. As practitioners, we know diabetes even worsen patients ability to heal and increases their susceptibility to infections or illnesses. 

Center for Disease Control and Prevention (CDC). (2021). Vaccines and Immunizations. Retrieved on May 12, 2023 from the website https://www.cdc.gov/vaccines/vac-gen/immunity-types.htm

McCance, K., Huether, S., Valentina, B., Neal, S. (2019). Pathophysiology: The Biologic Basis for Disease in Adults and Children (7th ed.). Elsevier.

Schroeder, H. W., Jr, & Cavacini, L. (2010). Structure and Function of Immunoglobulins. The Journal of Allergy and Clinical Immunology, 125(2 Suppl 2), S41-S52. https://doi.org/10/1016/j.jaci.2009.09.046