Question

Purpose: To strengthen and demonstrate your knowledge of the Immune and Lymphatic System and its systemic relationship in the body. The ability to apply this content and think systemically with physiology processes will benefit you as a healthcare student and practitioner.

Criteria for Success: To be successful you will make sure you complete diagrams as instructed in the tasks, including proper values (if required) on the x & y-axis as well as labeling those. You also need to make sure to list or provide explanation where necessary or where it is asked in the tasks. A successful submission would be very clear and easy to read and it would be easy to identify antibodies, immune responses, etc. For submission, you can submit them as a pdf or image from a phone if you are drawing these at home. I also suggest looking at the homework you have completed and the provided examples to help you in completing these tasks.

Case Studies Tasks:

Daniel: Susan and Joe had a wonderful little boy named Daniel, but he had been having an awful lot of bacterial infections and he was barely a year old. It seemed that the antibiotics cleared up one bacterial respiratory infection only to have another follow shortly. The scary thing was that Daniel had just fought off a case of pneumonia caused
by Pneumocystis carnii, a fungal infection that was usually found in people with HIV. Waiting for the test
results of an HIV test for their little boy was one of the worst experiences ever. Thank goodness it came back negative.
However, it seemed that their troubles were just beginning. After this last lung infection, the fungal one, and
a negative HIV test, their doctor had ordered a number of other blood tests, including a genetic test that
Susan didn’t fully understand. Apparently the doctor was worried about Daniel’s immune system functions.
Susan had also met with a genetic counselor who collected a family history of any immune disorders. The
details were vague, but Susan’s mother, Helen, knew that one of her three brothers had died young from an
unexplained lung infection. Unfortunately, Grandma Ruth had passed away a few years ago, leaving them
with numerous unanswered questions. Susan and Joe had an appointment with their doctor that afternoon to go over the results. When they arrived Dr. Dresdner led them into an office where Ms. Henchey, the genetic counselor, waited. This can’t be good, thought Susan. The doctor began by explaining that they had analyzed Daniel’s blood and found that while he had normal levels of B cells and T cells, his antibody levels were anything but normal. The levels of
IgG, IgA, and IgE were very low, almost undetectable, and Daniel had abnormally high levels of IgM and IgD.
It appears that his immune system failed to undergo immunoglobulin isotype switching due to a CD40 ligand mutation in Daniel's DNA.

1. Diagram an antibody response graph for a normal 1st and 2nd exposure with the antibodies correctly labeled for each exposure. Then diagram what Daniel's graph would look like, based on his situation.
2. Diagram and/or explain why IgG is low and what CD40's role is? Why is a mutation in that gene a problem? (There is no specific diagram I am looking for here, either diagram it or explain it, depending on which you prefer.)

Charlotte: A 60-year-old woman was fit and well until late in the summer she was out tending to her lovely tulip garden when she was stung on the back of her right hand by a pesky wasp. This was nothing new, unfortunately as she had been stung a couple times in the last two weeks. With in minutes after this sting Charlotte fell to the ground and looked as though she was becoming pale/grayish and was gasping for air. After five minutes it was getting worse, but likely a neighbor doctor rushed over and administered an epinephrine shot, which provided support until the ambulance could arrive.

1. Which antibodies and cells are involved in this allergic reaction and how does it lead to anaphylaxis? Why didn't this happen on the first stings?
2. How does anaphylaxis impact the body and how did the epinephrine help?

Jessalyn: Jessalyn regularly goes in for blood transfusions. Jessalyn's blood type is O+. Normally her blood transfusions go well and her nurse, Traci, does a great job of double checking the blood type she is receiving. This time Traci is out of town and she gets a nurse who was able to skate through school doing the bare minimum and doesn't really care that much about his job. He doesn't double check the blood type for her transfusion and . . .

1. The blood type was incorrect. Diagram and/or explain what happened.
2. Which blood types could Jessalyn receive, why?

Answer 1

Answer: Antibodies like

IgG- Comes from the maternal origin,

IgA- Forms after birth, it coats and seals baby's respiratory and intestinal tract to prevent germs from entering his body and his ​bloodstream.

IgE- Cells are produced by plasma cells located in lymph nodes. This indicates an allergic process.

IgM- In an infant's body, this antibodies presence suggests infection in utero, a baby has encountered.

IgD- It is present in the plasma membranes of immature B-lymphocytes. It is present in the blood circulation as well.

In the normal scenario, the primary and secondary antigen response can be

In Daniel's case, this graph would show that after secondary exposure, IgG levels are very low and IgM levels are too higher. Initially, there are normal antibodies, after the flush out, there is an undetectable response of their graph, so the middle section is flat and then the IgG is very low with the IgM getting largely produced. This IgM also will produce IgD antibodies.

We know that the IgM is “the default class in which all antibodies are born, so after the higher production of the IgM antibodies, if there is a problem to switch to a different version of antibodies, then there will be no or lesser number of the IgG antibodies.

In an infant body, after birth, cells grow rapidly and the body has to equipped with the defense mechanism. The antibody production in the B-immune cells is one of the fascinating phenomena. A process called isotype switching help in the process. It is a biological mechanism that changes a B cell's production of antibodies or Immunoglobulin from one type to another, such as from the isotype IgM to the isotype IgG. This process change helps the effector function of the antibody, which in turn improves its ability to eliminate the pathogen that induced the response.

One of the important gene in the body, CD40, one of its ligand CD40L gene lead to X-linked hyper-IgM syndrome (X-HIGM). [X is the male sex chromosome]. This leads to primary immunodeficiency (PID) characterized by decreased serum levels of IgG and IgA and normal or elevated IgM levels.

Charlotte:

1. IgE antibodies and cells are involved in this allergic reaction.

During the first couple of bites, the body tries to think it is new and responds to the allergen as if it were a threat. When it is exposed to the allergen again, by this time body is adjusted and ready to produce a particular antibody (IgE) in large numbers along with the histamine. This caused her to have an anaphylactic shock.

IgE is generally found less in quantity in the blood, but after an allergic reaction they are rapidly produced and start to fight the allergic reaction. When this sudden change occurs, inside the body cells certain immune system response molecules form in large numbers. These are histamine, also another substance called tryptase is released into the bloodstream. Their presence causes the body to have a shock while fighting the allergen; thus we call it an anaphylactic reaction.

These causes also cause the immune system to release a flood of chemicals, blood pressure drops, and suddenly and the airways narrow, blocking breathing.

Epinephrine is one of the first-aid for the treatment of anaphylaxis. It generally works in the blood vessels as a vasoconstrictor, it prevents or decreases upper airway mucosal edema, hypotension, and shock.