George A. Sprecace M.D., J.D., F.A.C.P. and Allergy Associates of New London, P.C.
www.asthma-drsprecace.com

IMMUNOLOGY IN HEALTH AND DISEASE
An Outline for the Layman

A)  THE IMMUNE SYSTEM (within and beyond the blood-vascular system)

B lymphocytes and T lymphocytes
Other cells: antigen-presenting cells; effector cells...

  1. Humoral Immunity: B cells...Antibodies (IgG,A,M,E...and D):cytotoxic, opsonizing.  Also the Complement system of specialized proteins, a system of amplification.  Also mediator chemicals like histamine.  Eg. attack on Streptococcal disease.
  2. Cellular Immunity: T Cells, with mediators including cytokines, leukotrienes, interferons;  mechanism of attack is inflamatory reaction.  Eg. attack on Tuberculosis.


DEFENSE AGAINST INFECTIONS, INFESTATIONS, and other invasions, including cancer



B)  ORIGINS...Heredity  and  Environment.

  1. In Utero:  Mother to fetus
  2. Neonatal:  Mother to fetus, including in breast milk
  3. Early Infancy:  Food allergies; Th2 / Th1 story (“Hygiene Hypothesis”)


C)  IN HEALTH...NATURAL vs ACQUIRED IMMUNITY
            Childhood / Adult Immunizations
            Important because of increasing problem of antibiotic resistance!
 

D)  IN DISEASE (Hereditary and/or environmental - acquired)

  1. B-cell deficiencies:  Sin0-pulmonary disease; meningitis; bacteremia
  2. T-cell deficiencies (including immune suppression from stress, mal-nutrition, anti-cancer agents...);  T.B., AIDS, viral and fungus diseases
  3. Combined deficiencies:  Cancer, etc.
  4. Over -Activity:  Atopic allergies (Bronchial asthma, allergic rhinitis and conjunctivitis, secondary sinus disease, atopic dermatitis (infantile eczema), some hives...; Hyper IgE syndrome; Immune Complex Disease
  5. Abnormal Production: Producing antibodies against “self”, attacking our normal tissues: “Auto-Immune Diseases like S.L.E or ”Lupus”, Myasthenia Gravis, Rheumatoid Arthritis, Scleroderma, various Thyroid Diseases, some Hepatitis....


E)  SPECIAL CASES:

TRANSPLANTATION
CANCER
THE AGING PROCESS
INFERTILITY PROBLEMS
F) TREATMENTS
  1. Immunization (Active, Passive, or both (cf. rabies, hepatitis A)
  2. Anti-Mediators: anti-histamines; anti-leukotrients; anti-interferons....
  3. Replacement Therapy: IVIg for deficiencies; transplantation, autologous and allo-geneic
  4. Immunosupressive Agents: cortico-steroids; methytrexate; cyclosporine...
  5. Anti-Inflamatory agents: Aspirin (but not tylenol-acetaminophen); NSAIDS; cortico-steroids....
  6. Specific Immune Modulation:  Allergy Immunotherapy (“allergy shots”)
  7. Non-Specific Modulation:  IVIg


F)  MYSTERIES

  1. Chronic Fatigue Syndrome
  2. Fibromyalgia
  3. Interstitial Cystitis
  4. etc.


GS

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