immune-system101-2-1

 

The immune system has evolved to protect the host from pathogens while minimising damage to self tissue.Despite the ancient observation that recovery from some diseases results in protection against that condition,the existence of the immune system as a functional entity was not recognised until the end of the 19thcentury. More recently, it has become clear that the immune system not only protects against infection, but also influences healing and governs the responses that can lead to autoimmune diseases. Dysfunction or deficiency of the immune response leads to a wide variety of diseases, involving every organ system in the body.

PROF. PARK HAS LABELLED IMMUNE SYSTEM AS THE NEUTRO OF THE NEUTRO.(Except during pregnancy when it becomes neuto and reproductive system becomes neutro).

 

FUNCTIONAL ANATOMY AND
PHYSIOLOGY OF THE IMMUNE SYSTEM

The immune system consists of an intricately linked network of cells, proteins and lymphoid organs that are
strategically placed to ensure maximal protection against infection. Immune defences are normally categorised
into the innate immune response, which provides immediate protection against an invading pathogen, and the
adaptive or acquired immune response, which takes more time to develop but confers exquisite specificity and long-lasting protection.

SO INNATE IMMUNE SYSTEM WHICH IS COMMOM TO ALL HUMAN BEINGS AND IS PRESENT SINCE BIRTH IS HOMO IMMUNE SYSTEM WHILE ACQUIRED IMMUNE SYSTEM WHICH DEVELOPS AFTER BIRTH AND IS SPECIFIC AND DIFFERENT FOR A PARTICULAR HUMAN BEING IS HETERO TYPE IMMUNE SYSTEM.

INNATE IMMUNE SYSTEM

Outer constitution barriers are Hetero and inner phagocyte cells present in blood are homo.

Hetero innate immune system as further divided into outer skin barriers are hetero…

(The tightly packed, highly keratinised cells of the skin constantly undergo renewal and replacement, which
physically limits colonisation by microorganisms.Microbial growth is inhibited by physiological factors,such as low pH and low oxygen tension, and sebaceous glands secrete hydrophobic oils that further repel water and microorganisms. Sweat also contains lysozyme, an enzyme that destroys the structural integrity of bacterial
cell walls; ammonia, which has antibacterial properties;and several antimicrobial peptides such as defensins.)

Learning point-so in recurrent skin infections simply you can tone neutro as immune system or rent Ne of skin as immune system and tone HE or do functional tonification there.In skin allergies or rashes either do Ne sedation in skin as immune system or rent Ne and sedate He or do functional sedation there.

Inner mucous membrane barriers are Ho of He part of innate immune system i.e……

(Similarly, the mucous membranes of the respiratory,gastrointestinal and genitourinary tract provide a constitutive
barrier to infection. Secreted mucus acts as a physical barrier to trap invading pathogens, and immunoglobulin A (IgA) prevents bacteria and viruses attaching to and penetrating epithelial cells. As in the skin, lysozyme and antimicrobial peptides within mucosal membranes can directly kill invading pathogens,and additionally lactoferrin acts to starve invading bacteria of iron. Within the respiratory tract, cilia directly trap pathogens and contribute to removal of mucus, assisted by physical manoeuvres, such as sneezing and coughing. In the gastrointestinal tract, hydrochloric acid and salivary amylase chemically destroy bacteria, while normal peristalsis and induced vomiting or diarrhoea assist clearance of invading organisms.)

Learning point-In allergies of respiratory system or food allergies of Digestive system and itching rashes in reproductive tracts just rent HE as the skin (mucous membrane coating of that system) then rent Its Ne as immune system and do functional sedation or He sedation there.If we have recurrent Respiratory,Digestive and reproductive tract infections then you need to tone immune system of mucous membrane  of  that systeem.Skin is He in which He is outer skin and mucous membrane is inner skin.

Now we talk about inner innate immune system which is Homo of innate immune system and consists of cells called as phagocytes (ho) and special proteins (He).
Cells of many types called as phagocytes are Neutrophils , Monocyte, macrophages, mast cells, basophils, natural killer cells(prevention of cancer), dendritic cells. All these cells main function is in defence so they need to be tonified in all chronic infections specially like Tuberculosis and prevention of cancers.
For ex. In a pt of Tuberculosis of whole body we open Ho as body in which He is systems in which Ne of Ne is immune system in which Ho is innate immune system in which Ho is inner immune system in which Ho is phagocytes which need to be functionally tonified or you can choose to tone HE sedate Ho tone Ne in them.This will be a very good general treatment for tuberculosis.

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Now proteins of special type are Complement proteins produced by liver and Cytokines produced by immune cells and stroma. There basic character is hetero and they are seen generally in self tissue destruction in autoimmune diseases. So in all autoimmune diseases like SLE,Rheumatoid arthritis,scleroderma etc they are required to be sedated as a general treatment.

interleukin                         123456

ACQUIRED (ADAPTIVE) IMMUNE SYSTEM

If the innate immune system fails to provide effective protection against an invading pathogen, the adaptive immune system (Fig. 4.4) is mobilised. This has three key characteristics:
¢ It has exquisite specificity and is able to discriminate between very small differences in molecular structure.
¢ It is highly adaptive and can respond to an unlimited number of molecules.
¢ It possesses immunological memory, such that subsequent encounters with a particular antigen produce a more effective immune response than the first encounter.
There are two major arms of the adaptive immune response: humoral immunity involves antibodies produced
by B lymphocytes; cellular immunity is mediated by T lymphocytes, which release cytokines and kill immune targets. These interact closely with each other and with the innate immune system, to maximise the effectiveness of the response.

Lymphoid organs

¢ Primary lymphoid organs. The primary lymphoid organs are involved in lymphocyte development.They include the bone marrow, where both T and B lymphocytes are derived from haematopoietic stem cells (p. 993) and where B lymphocytes also mature, and the thymus, where T lymphocytes mature.
¢ Secondary lymphoid organs. After maturation, lymphocytes migrate to the secondary lymphoid organs. These include the spleen, lymph nodes and mucosa-associated lymphoid tissue. These organs trap and concentrate foreign substances, and are the major sites of interaction between naïve lymphocytes and microorganisms.
The thymus
The thymus is a bilobed structure organised into cortical and medullary areas. The cortex is densely populated
with immature T cells, which migrate to the medulla to undergo selection and maturation. The thymus is most
active in the fetal and neonatal period, and involutes after puberty. Failure of thymic development is associated
with profound T-cell immune deficiency (p. 80), but surgical removal of the thymus in childhood (usually in
the context of major cardiac surgery) is not associated with significant immune dysfunction.
The spleen
The spleen is the largest of the secondary lymphoid organs. It is highly effective at filtering blood and is an
important site of phagocytosis of senescent erythrocytes, bacteria, immune complexes and other debris. It is also
a major site of antibody synthesis. It is particularly important for defence against encapsulated bacteria,and asplenic individuals are at risk of overwhelming Streptococcus  infection by capsulated bacteria.

Lymph nodes and mucosa-associated lymphoid tissue
Lymph nodes are positioned to maximise exposure to lymph draining from sites of external contact. Their structure is highly organised.

Lymphatics
Lymphoid tissues are physically connected by a network of lymphatics, which has three major functions: it provides
access to lymph nodes, returns interstitial fluid to the venous system, and transports fat from the small
intestine to the blood stream (see Fig. 16.14, p. 452). The lymphatics begin as blind-ending capillaries, which
come together to form lymphatic ducts. These enter and then leave regional lymph nodes as afferent and efferent ducts respectively. They eventually coalesce and drain into the thoracic duct and thence into the left subclavian vein. Lymphatics may be either deep or superficial, and, in general, follow the distribution of major blood vessels.

 

Humoral immunity
B lymphocytes
These specialised cells arise in the bone marrow. Mature B lymphocytes (also known as B cells) are found in bone
marrow, lymphoid tissue, spleen and, to a lesser extent,the blood stream. They express a unique immunoglobulin(antibody) receptor on their cell surface (the B-cell receptor),which binds to soluble antigen. Encounters with antigen usually occur within lymph nodes, where, if provided with appropriate signals from nearby T lymphocytes,
stimulated antigen-specific B cells respond by proliferating rapidly in a process known as clonal expansion. This
is accompanied by a highly complex series of genetic rearrangements, which generates B-cell populations that express receptors with greater affinity for antigen than the original. These cells differentiate into either longlived
memory cells, which reside in the lymph nodes, or plasma cells, which produce antibody.

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Cellular immunity
T lymphocytes (also known as T cells) mediate cellular immunity and are important for defence against viruses,
fungi and intracellular bacteria. They also play an important immunoregulatory role, orchestrating and regulating the responses of other components of the immune system. T-lymphocyte precursors arise in bone marrow and are exported to the thymus while still immature . Within the thymus, eachcell expresses a T-cell receptor with a unique specificity.These cells undergo a process of stringent selection to ensure that autoreactive T cells are deleted. Mature T lymphocytes leave the thymus and expand to populate other organs of the immune system. It has been estimated that an individual possesses 107“109 T-cell clones, each with a unique T-cell receptor, ensuring at least partial coverage for any antigen encountered.

Triorigin classification of acquired immune system…..

Cellular immunity is Hetero and Humoural immunity of antibodies which has a memory is Homo.

Humoural immunity…Immunoglobulin or antibody released by B cells is Neutro it is of many types i.e IgM,IgG,IgA,IgE ,IgD etc.Many disoders are associated with overproduction or less production of these immunoglobulins which a sujok practicioner will encounter in his/her practice.

For example FOOD allergy…..Food allergies are immune-mediated disorders, most commonly due to type I hypersensitivity reactions with production of IgE antibodies, although type IV delayed hypersensitivity reactions are also seen. Up to 20% of the population perceive themselves as suffering from food allergy but only 1“2% of adults and 5“7% of children have genuine food allergies. The most common culprits are peanuts, milk, eggs, soya and shellfish.So one can treat food allergies by regulating function of immunoglobulins i.e Ho is body He is system Ne of Ne is immune system in which He is acquired immunity of which Ho is humoral immunity of which Ne is immunoglobulin of which He is food related immunoglobulin(digestive system is He in functional systems) —sedate He, Tone Ne and Ho or open digestive system rent Ne as immune system of which He is acquired immunity of which Ho is humoral immunity of which Ne is immunoglobulin —-sedate He, Tone Ne and Ho .

Layer classification criteria when applied to Acquired immune system shows Ne as the Internal organs of immune system(function wise internal organs are Ne) —4 internal organs of acquired immune system are No as Bone marrow(which produces B cell and T cell of immune system),Ne as Thymus where final maturation of cells occur,Ho as spleen and He as Lymph nodes.

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AUTOIMMUNE DISEASE
Autoimmunity can be defined as the presence of immune responses against self tissue. This may be a harmless
phenomenon, identified only by the presence of low titre autoantibodies or autoreactive T cells. However, if these
responses cause significant organ damage, this results in autoimmune diseases, which are a major cause of chronic
morbidity and disability, affecting up to 1 in 30 adults at some time .
Pathophysiology of autoimmunity

Immunological tolerance
Autoimmunity results from the failure of immunological tolerance, the process by which the immune system
recognises and accepts self tissue. There are a number of mechanisms of immune tolerance. Central tolerance
occurs during lymphocyte development, when T and B lymphocytes that recognise self antigens are eliminated
before they differentiate into fully immunocompetent cells. This process is most active in fetal life, but continues throughout life as immature lymphocytes are generated. Inevitably some autoreactive cells evade deletion and reach the peripheral tissues, where they are controlled by peripheral tolerance mechanisms. These
include suppression of autoreactive cells by regulatory T cells, generation of functional hyporesponsiveness
(anergy™) in lymphocytes which encounter antigen in the absence of the co-stimulatory signals that accompany
inflammation, and T cell death by apoptosis. Autoimmune diseases develop when self-reactive lymphocytes escape from these tolerance mechanisms and become activated.
Factors predisposing to autoimmune disease
Autoimmune diseases are much more common in women than in men, for reasons which remain unclear.
Most autoimmune diseases have multiple genetic determinants . Many are associated with variation at specific HLA loci, reflecting the importance of HLA genes in shaping lymphocyte responses. Other important susceptibility genes include those determining cytokine activity, co-stimulation and cell death. Even though some of these associations are the strongest that have been identified in polygenic diseases (p. 68), they have limited predictive value, and are not useful in determining disease risk for individual patients. Several acquired factors can trigger autoimmunity in genetically predisposed individuals, including infection, cigarettesmoking and hormone levels. The most widely studied of these is infection, as occurs in acute rheumatic fever following streptococcal infection or reactive arthritis following bacterial infection. A number of mechanisms have been postulated, such as cross-reactivity between the infectious pathogen and self antigens (molecular mimicry), and release of sequestered antigens, which are not usually visible to the immune system, from damaged tissue. Alternatively, infection may result in the production of inflammatory cytokines, which overwhelm the normal control mechanisms that prevent bystander damage. Occasionally, the development of autoimmune disease is a side-effect of drug treatment. For example, the metabolic products of the anaesthetic agent halothane bind to liver enzymes, resulting in a structurally novel protein. This is recognised as a new (foreign) antigen by the immune system, and the autoantibodies and activated T cells directed against it may cause hepatic necrosis.

So to control autoimmune disease we need to work on Central tolerance by Functional tonification or He tonification of Thymus gland and Peripheral tolerance by functional tonification or He tonification of  Regulatory T cells .

How to reach T regulatory cells …we need to classify cellular immunity.

Cellular immunity is He of acquired immune system . In this CD8 cells are He as they are directly involved in killing viruses, bacteria and other microbes,CD4 cells are Ho and are the main target of HIV virus.The main function of CD4 cells is to regulate immune system and to help CD8 and B cells to work properly.Further CD4 cells are divided into TH1(He) cells involved in allergies,TH2 cells (Ho) involved in delayed type hypersensitivity reactions i.e rejection of a transplant organ,Type 1 diabetes,Hashimoto thyroiditis,Ne is Regulatory T cells which prevent development of autoimmunity.

Role of Adrenals in autoimmunity……..

Structure of adrenal gland —Functionally inner part is Medulla of adrenals made up of chromaffin cells which secrete epinephrine and norepinephrine when stimulated by sympathetic nerves so it becomes Hetero.

adrenal layers

 

adrenals

Outer cortex functionally becomes Homo and has three parts as shown above …these 3 parts secrete different hormones.

Outer zona glomerulosa secretes hormone called aldosterone which controls urine output and BP it becomes HO.

Middle Zona fasciculata secretes Cortisol a natural steroid which suppresses and regulates Immune system so it becomes Ne.

Inner Zona reticularis becomes He as it secretes  the zona reticularis produces androgens, mainly dehydroepiandrosterone(DHEA), DHEA sulfate (DHEA-S), and androstenedione (the precursor to testosterone) in humans.So it produces male anabolic hormones so it is hetero.

So in all autoimmune disease in modern medicine we give steroids which have a lot of side effects but if we tone zona fasciculata of adrenal gland then the natural steroid cortisol will be reducing the autoimmune disease naturally without side effects.

After opening adrenal glands via internal organs functional sequence Ho is cortex of adrenals,Ne is zona fasciculata –functional tonification or He tonification will work wonderfully.

Also dont forget to give emotional treatment as in most autoimmune disease anxiety,fear,agony,resentment,jealousy etc are main culprits.