Recovering from Hernia Surgery

hernia surgery
Hernias of any type do not self-correct – they require surgery to be properly repaired. One of the most common hernias in males is the inguinal hernia, which occurs near the groin area when part of the intestine protrudes through a weak spot in the abdomen.

If left uncorrected, a hernia will become larger in size, as well as more uncomfortable. The hernia is typically caused by heavy lifting or straining, paired with a weakness in the abdominal wall. Further lifting or straining can make the hernia worse, but as time goes on, even small amounts of strain such as blowing the nose or having a bowel movement can cause the hernia to expand.

The true danger in a hernia lies in the possibility that a part of the bowel will also poke out through the abdominal wall, leading to a strangulation of that part of the bowel and possibly death for the patient. While this is an unlikely outcome, patients who are suffering severe nausea and a sharp pain in the area of their hernia, rather than the usual sense of pressure, should consult a doctor immediately.

The hernia repair itself is quite simple – the intestine is pushed back into the abdominal wall and sealed up with a mesh. This is a day surgery procedure and usually takes less than an hour.

After the surgery is completed, there are several things which patients should expect to experience.

Pain and Swelling

A pain medication such as Tylenol 3 is usually prescribed for after surgery, and can do wonders in the first few days to alleviate pain. There will have been a small incision made above the groin, which will have been stitched up and is usually covered with small strips that will come off in approximately one week.

There will be pain from the incision itself, as the body has undergone a moderate trauma in being cut open, and there is usually swelling of the incision area as well as one or both of the testicles. Tylenol 3 or other pain medication is used to both assist in the management of the pain and also to reduce the swelling. The time spent on the medication varies from person to person with some using it only for a few days and some for a week or more.

The important thing to know is that any heavy lifting or vigorous activity is out of the question for at least four weeks, or else the patient risks rupturing the same hernia again.

Stiffness

This is a natural consequence of the surgery. As the incision heals, it will become tight and stiff, and the patient will feel discomfort if they try to straighten up fully or walk around. Both of these things are key, however. Walking around not only gets the blood flowing, but helps the body adjust to the incision and the new state of affairs.

The temptation is to remain seated or lying down for the bulk of the recovery time, and while this is necessary to give the body a chance to rest, it is important to move around as well. A few walks around the house can make all the difference in helping to speed recovery.

When initially standing up, most people feel a "pulling" sensation, and will often feel a sharp pain as the incision shifts around. It is important to use the arms and legs as much as possible, rather than the abdominal muscles when getting up, sitting down or any other usual movement – this will prevent strain on the incision and limit the possibility of a re-tearing of the abdominal wall.

As mentioned above, walking around will usually result in a pulling sensation as the body will have become used to sitting or reclining. As long as movements such as standing up or walking are done in a slow and controlled motion, this pulling can be a good thing as the body gets used to the new incision site.

Trouble with Bowel Movements

This is something that isn't always mentioned, but is almost a certainty, according to the May 8, 2008 article at UWhealth. Medication which is taken after hernia surgery, especially anything with codeine, tends to clog up the system. Add to that the fact that the abdominal muscles have been traumatized and that no "straining" should take place when in the process of a bowel movement and it can become quite a challenge.

The first thing to remember is that walking around will help alleviate this by getting the bowels moving. As well, eating foods high in fiber and drinking more water than normal will also be of benefit. If need be, a fiber supplement such as Metamucil can be used, but be careful if choosing to go this route.

Metamucil requires that even more extra water be consumed in order to work, or else the psyllium fiber in the capsules will make matters even worse. Any "harsher" products such as Ex-Lax should be avoided as they could put unnecessary strain on the stomach and abdominal region. A few days without a bowel movement after surgery is quite common, but if it reaches the four day mark, a call to the doctor may be in order.

While recovering from hernia surgery is a slow and sometimes painful process, knowing what to expect can make it a speedier and less intimidating process.

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Post-Traumatic Stress Disorder

post-traumatic stress disorder

Someone may develop post-traumatic stress disorder when he experiences or witnesses an event that causes intense fear and helplessness.

What Are the Symptoms of PTSD?

PTSD symptoms typically begin within three months of a traumatic event. It is important to get treatment as soon as possible after symptoms develop to prevent PTSD from becoming a long-term condition. Symptoms are commonly grouped into three types: Re-experiencing symptoms (flashbacks), avoidance, and increased anxiety or emotional arousal (hyperarousal):
  • Re-experiencing symptoms: flashbacks, bad dreams and repeated frightening thoughts-reliving the trauma over and over
  • Avoidance symptoms: avoiding places, events, or objects that are reminders of the experience.
  • Hyperarousal symptoms: being easily startled, feeling tense, having difficulty sleeping, and/or having angry outbursts.

The symptoms that children or teenagers experience may not be the same as with adults. In very young children, these symptoms can include:
  • Bedwetting, when they'd learned how to use the toilet before
  • Forgetting how or being unable to talk
  • Acting out the scary event during playtime
  • Being unusually clingy with a parent or other adult.

Older children and teens usually show symptoms more like those seen in adults. They may also develop disruptive, disrespectful, or destructive behaviors.

What Causes PTSD?

People of all ages can have post-traumatic stress disorder. But it's more common among adults, with about 8 percent of the population having PTSD at some time in their lives. PTSD is especially common among those who have served in combat, and it's sometimes called "shell shock," "battle fatigue" or "combat stress."

Women are four times more likely than men to develop PTSD. Women are at increased risk of experiencing the kinds of interpersonal violence - such as sexual violence - most likely to lead to PTSD.

Many other traumatic events also can cause PTSD, including a fire or natural disasters; mugging, assault or robbery; a car, train or plane crash; torture, kidnapping or terrorist attack; a life-threatening medical diagnosis, or any other extreme or life-threatening events.

Symptoms of PTSC can come and go, and may resurface under times of stress or when a person experiences a reminder of a traumatic event. A war veteran may hear a car backfire and relive combat experiences. Or a woman may see a report on the news about a rape, and feel again the horror and fear of her assault.

When Should Someone With PTSD See a Doctor?

When someone has these disturbing feelings for more than a month, if they're severe, or if she feels she is having trouble getting her life under control, it is likely time to see a health care professional.

The main treatments for people with PTSD are psychotherapy ("talk" therapy), medications, or both. Everyone is different, so a treatment that works for one person may not work for another. It is important for anyone with PTSD to be treated by a mental health care provider who is experienced with PTSD. Some people with PTSD need to try different treatments to find what works for their symptoms.

If someone with PTSD is going through an ongoing trauma, such as being in an abusive relationship, both of the problems need to be treated. Other ongoing problems can include panic disorder, depression, substance abuse, and feeling suicidal. If someone has thoughts of suicide, she should go to an emergency room or call 911 immediately.

For less urgent symptoms of PTSD, patients should make an appointment with their family doctor or general practitioner. The doctor can help begin the process of understanding whether symptoms may be related to a traumatic experience. In many cases, this doctor will refer a patient to a mental health professional for ongoing treatment.

Are There Ways to Cope With PTSD?

While waiting to see a doctor, some for PTSD patients to cope include learning more about the disorder as well as talking to friends, family, and PTSD survivors for support. Joining a support group may be helpful.

Other tips include reducing stress by using relaxation techniques (for example, breathing exercises, positive imagery), increasing positive lifestyle routines (for example, exercise, healthy eating, distracting oneself through a healthy work or volunteer) and minimizing negative lifestyle practices like substance abuse, drinking alcohol, social isolation, working to excess, and other self-destructive behaviors.

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Salicylates

All types of salicylates (from the main ingredient acetylsalicylic acid or ASA), have been implicated in a condition called Reye’s Syndrome, associated with ASPIRIN® ingestion, especially by children, used to treat feverish colds or viral diseases.

salicylates

Drugs studies using acetaminophen (paracetamol outside N. A.), as well as ibuprofen and others, have only shown some unproven implications for Reye’s. With the advent of alternative pain killers, Reye’s has become less common in recent years. Nonetheless, it is important to realize that even such routinely used over-the-counter medications must be used sparingly and wisely. Headache and pain sufferers sometimes have to make tough choices.

Awareness of Reye's Syndrome is Key to Prevention

Reye's can strike quickly, affecting all body organs, especially the brain and the liver (although usually without jaundice). It is frequently associated with the use of any form of salicylate-containing drugs (ASPIRIN®-type medications) for treating colds, fevers, and influenza-like illnesses.

In 1974, the National Reye's Syndrome Foundation was the first citizens' group to generate an organized lay movement to eradicate Reye's. The U.S. Surgeon General, the Food and Drug Administration, the Centers for Disease Control and Prevention, and the American Academy of Pediatrics, all issued recommendations to avoid using ASPIRIN®-type products in anyone under 19 years of age (although no age group is immune) to treat episodes of fever-causing illness, especially flu or chicken pox. Most cases of Reye’s occur in children ages 4–12, usually following an upper respiratory or feverish infection by about one week.

User’s Must Check Drug Labeling for Safety

Words that might appear on drug labels containing salicylates could be any of the following: ASPIRIN®, acetylsalicylate, acetylsalicylic acid, salicylic acid, or salicylate, salicylamide, or phenyl salicylates. Having Reye’s Syndrome uncaused by the ingestion of ASPIRIN® has not been ruled out, but all documented cases have been traced back to that connection, so recommendations were developed on that basis, although there is no data that salicylate other than ASPIRIN® has been associated with Reye's.

Reye's Symptoms to Watch For

Reye’s presents with sudden and acute brain damage (often mistaken for encephalopathy) and liver inflammation, and symptoms that may include long bouts of vomiting. This is followed by disorientation, irritability, and aggression, and as the condition progresses, may include lethargy, confusion, loss of consciousness, delirium, and coma, as well as seizures or personality changes with ultimate permanent brain damage.

Also noticed have been unusual placement of arms and legs, with arms extended straight and turned inward toward the body, and legs held straight with toes pointed downward. Other symptoms may mimic a stroke, including double vision, hearing loss, paralysis or muscle weakness in extremities, and speech difficulty. Immediate emergency care is necessary for early diagnosis, and prevention of brain damage or death.

There is no specific treatment for this disorder, other than to monitor the symptoms to confirm the individual’s condition. A comatose victim is considered to have suffered an acute episode, and if recovering, the overall outcome is considered good.

Only Give a Child ASPIRIN® On a Doctor’s Instructions

Reye's syndrome can result in death in children, and the usual brain inflammation and liver damage caused indicate the body reacting as if to poisoning. Few cases of Reye’s have been documented in adults, with most completely recovering within a few weeks. But in children, results have been serious, with permanent brain damage and an average of 30 percent fatalities.

Connection to Chicken Pox

Any ASPIRIN®-like drugs should be avoided if a person has been diagnosed with chicken pox, or for several weeks after a child has received a chickenpox vaccination or any fever symptoms. In addition, the treating doctor must be given this information. OTC medications like Pepto-Bismol® or anything containing Wintergreen oil generally contain salicylates and should not be given to someone with either a cold or fever.

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Respiratory Syncytial Virus

respiratory syncytial virus

When an adult has cardiac related issues, there are numerous factors that may be the cause. Heart disease, high cholesterol, obesity and high blood pressure can all contribute to emergency cardiac incidents. In children and infants whose hearts are typically young and strong, a cardiac event is troubling because it is unexpected. Most cardiac arrests in the very young can be attributed to an alternate cause that is usually respiration related, like RSV.

Respiratory Syncytial Virus (RSV)

A surveillance study published in the Feb. 05, 2009 issue of the New England Journal of Medicine showed that RSV is linked to substantial morbidity in US children. The study, "The Burden of Respiratory Syncytial Virus Infection in Young Children," conducted by Dr. Caroline Breese Hall et al, from the University of Rochester School of Medicine and Dentistry, also showed that most children who presented with RSV were previously healthy.

Worldwide, RSV is the most common cause of lower respiratory infections in children less than three years of age. RSV begins as an upper respiratory disorder but when it moves into the lungs or the airways (bronchioles) of the lower respiratory tract, it can cause pneumonia and bronchiolitis. Infants are the ones most affected by RSV and seem to incur the more significant complications. In some areas, RSV can be seasonal, being more prevalent in the fall.

Long term, RSV is a virus that can reoccur for life. Repeated bouts of RSV have been linked to the development of pediatric asthma, ear infections and in later life, chronic obstructive pulmonary disorder (COPD).

RSV is highly contagious and is passed from one child to another through sneezing, coughing, direct contact and contaminated toys. Keeping children isolated from RSV is a near impossible feat which explains the high rate of incidents.

RSV Symptoms

In older children or adults, RSV presents with symptoms similar to the common cold. Symptoms typically begin to emerge four to six days after transmission and include:
  • a runny or congested nose
  • sneezing
  • a dry cough and irritated throat
  • a low-grade fever
  • a general feeling of being unwell, malaise or irritability in infants
If RSV transitions into the lower respiratory tract and causes pneumonia or bronchiolitis, additional symptoms will occur. These will include:
  • wheezing
  • a high fever
  • a severe almost constant cough
  • difficulty breathing and rapid shallow breathing that includes, sucked in ribs and chest (retractions); see-saw breathing (abdomen moves opposite to the chest) and nasal flaring
  • a bluish tinge to the skin (cyanosis) from insufficient oxygen

Diagnosis and Treatment of RSV

Diagnosis of RSV is typically established through a visit to the doctor. X-rays, blood tests, nasal secretion tests and auscultation (listening to the lungs) is usually sufficient to confirm RSV. Being a virus, RSV does not respond to antibiotics, but they may be prescribed if the virus causes a bacterial complication.

Severe cases may require hospitalization and treatments with IV fluids, humidified oxygen therapy and albuterol administered through a nebulizer to open the airways. If a doctor deems the infant stable enough to be treated at home, then recovery may be aided by:
  • the use of a portable humidifier
  • over-the-counter acetaminophen
  • nasal saline for congestion or a suction bulb for a runny nose
  • keeping the infant propped semi-upright
  • pushing fluids

Some infants are more prone to complications of RSV and should be evaluated by a medical professional as soon as possible. These include premature babies or those less than six weeks of age; infants that have chronic health issues such as cystic fibrosis; infants with established lung conditions and congenital heart defects.

Prevention of RSV includes basic hygiene, avoiding exposure to the virus and keeping the home smoke free. The medication Synagis can be effective in preventing RSV. It is given by injection, once per month during the peak season of RSV. Synagis is a preventative medication and will not treat RSV once it has been contracted.

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RNA Interference

rna interference

RNA interference (RNAi), discovered by Andrew Fire and Craig Mello in 1998, is essentially the use of small fragments of RNA, known as small interfering RNAs (siRNAs) to block, or interfere with, the production of specific genes. These occur naturally in mammalian cells, but can also be generated artificially and delivered into cells. Each RNA fragment has a sequence that is complementary to a part of the target gene, in that it is exactly complementary to the sequence of the gene. When it binds, it effectively blocks that part of the gene, by preventing interaction with the machinery of the cell whose job it is to translate that DNA sequence into protein. As a result, the protein is not made.

Since its discovery, RNAi has been used extensively in the laboratory to research which genes are responsible for what functions. By blocking a gene, and observing the effect it has on a cell or organism, the function on that gene can be deduced. Prior to RNAi, this kind of research was only possible using laborious and expensive gene knockout techniques.

The Potential of RNAi in Medicine

The ability to switch on or off specific genes on demand has important implications for the treatment of genetic disorders. For example, some genetic disorders are caused by the over-production of certain proteins, while others, such as cancer, are caused by genetic mutations that are not inherited. By using RNAi sequences that are specific to the gene that codes for the wrongly-expressed protein, its production can be significantly reduced, potentially even to normal levels (1).

Naturally produced RNAi, especially in lower organisms, is very important in the defense against viruses, and acts by blocking the RNA that is the viral genetic code as soon as it enters the cell. Similarly, siRNAs can be generated against human viruses such as HIV, and therapies are currently being developed for this infection as well as hepatitis B and C amongst others.

However, there are a number of hurdles that must be overcome before RNAi can be used routinely as a therapeutic agent for disease in humans.

Delivery of siRNAs to Tissues

One of the main problems with RNAi is the problem of delivery to the correct cells, especially to those tissues deep in the body. Delivery to deeper tissues is hampered by the body’s defense system, including nucleases that degrade nucleic acids (DNA and RNA) (2,3).

There are few organs that are easily accessible to RNAi, including the eye and the respiratory tract. In both these cases, RNAi can be delivered via saline solution to result in effective knockdown of the target genes. Indeed, one of the first conditions to be investigated for RNAi therapy was age-related macular degeneration.

siRNAs can also be delivered systemically via intravenous injection using liposomal particles to aid uptake into the cells. This may be effective for delivery to the liver and jejunum, but is not appropriate for other organs (2). Viruses are perfectly designed to rapidly and efficiently invade cells, and infect them with their own genetic material, RNA. By replacing viral RNA with the RNAi sequence, the virus is able to deliver the ‘drug’ directly to the cell in which it is needed.

Additional barriers to the use of RNAi therapy in humans include safety and tolerability issues, tissue-specific targeting and duration of effect, and research is ongoing into identifying ways in which these barriers may be overcome. Resolution of these issues could ensure that RNAi becomes the mainstay of treatment of genetic diseases.

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Risks of Tanning

tanning

No matter the season, indoor tanning remains a habitual practice for many individuals. According to the American Academy of Dermatology (AAD), around one million people in the United States tan on average each day, with 28 million tanning indoors annually. Due to the consistent increase in these numbers, many questions have been raised regarding the potential risks of this popular trend.

Skin Cancer and Tanning

The practice of indoor tanning is most often associated with young girls, with the AAD reporting that 70 percent of salon goers are females between the ages of 16 and 29. However, there is no “typical” characteristic of a tanner, as both men and women, young and old, attend salons every day. Throughout the year, there are a number of occasions that patrons use as an excuse to get a tan, including prom, weddings, vacation, graduation, senior pictures, spring break, and more.

With the increased use of tanning beds comes an increase in the research conducted. Organizations such as the U.S. Food and Drug Administration, the World Health Organization, the Center for Disease Control, the American Medical Association, the National Cancer Institute, the Federal Trade Commission, and the AAD have all released statements and fact sheets regarding the risk of skin cancer that comes from UV radiation in the forms of melanoma, basal cell carcinoma, and squamous cell carcinoma.

Some adamant tanners choose to completely ignore the warnings that those who tan indoors before the age of 35 have a 75 percent increased chance of developing melanoma or that there is a significant increase in the risk of skin cancer for those who tan indoors more than just 10 times per year. However, it is often overlooked that the physical act of tanning may come with another set of problems.

Tanning Bed Disinfectant

In the state of Illinois, the Illinois General Assembly provides standard requirements for the sanitation of indoor tanning salons. Before providing information regarding the sanitation of the actual beds, the Tanning Facilities Code also provides specific details on the cleanliness of the restrooms, the floors, and the showers, when provided.

In regards to the cleaning of the tanning beds, the Illinois General Assembly states that all surfaces touched by clients should be sanitized after each use with a U.S. Environmental Protection Agency registered disinfectant, and that the cloth towels used for cleaning or drying must also be washed after each use with soap or detergent. However, each individual state has its own tanning facility regulations.

The problem with the mentioned requirements is that enforcement and attention to detail are not always present. Many tanning facilities are on or near college campuses, and even when not, it is often young adults who are working in or managing the salons. Although not necessarily true for everyone, this demographic tends to focus less on the cleaning portion of the job and more on the sales and commission aspect. Also, some salons do not provide the proper training, and cases have occurred where the same cleaning rag was used on more than one bed, causing the spread of sweat, germs, and bacteria from one bed to the next.

Bacteria and Infection

Although it is difficult to track where certain skin infections come from, there are many issues aside from skin cancer that can come as a result of indoor tanning. In January 2010, research was published in the Journal of the American Academy of Dermatology regarding the issue at hand.

During the study, researchers took a culture from one tanning bed at each of 10 top-rated salons in New York City. Although no cleaning was witnessed, at least one of the sampled beds held a sign stating that the unit had been cleaned. Out of the 10 cultures, all of them grew pathogens, including pseudomonas spp. (aeruginosa and putida), Bacillus spp., enterobacter cloacae, staphylococcus aureus (MRSA), enterococcus species, and klebsiella pneumonia.

While this was a simple study, the results still show that dirty tanning beds are something to be concerned about. Other potential risks mentioned by dermatologists include warts, human papillomavirus, herpes, and tinea versicolor. Many of these thrive in warm, damp environments, and tanning beds should not be excluded.

Although it is said that there is no “safe” tan, millions of individuals will continue to make use of indoor tanning facilities. In order to best avoid risks associated with bacteria and infections, tanning in a vertical or stand-up bed is one possible option. Also, sunless spray tans are a better alternative to beds that contain UV radiation. Regardless of the occasion, tanners should be aware of the potential risk factors and make sure to weigh options before hopping into a bed for a 10 to 20 minute fake bake.

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Non-Opioid Pain Management to Prevent Painkiller Addiction

non-opioid pain management
Even for those without an addictive disorder, the long-term use of opioids will result in an increased tolerance to them and withdrawal symptoms when coming off of them. This has led many primary care physicians to avoid prescribing opioids for chronic pain and instead refer their patients to pain management programs for treatment. For patients in addiction recovery, it is wise to consider the many alternatives to opioid-based pain management.

Addiction versus Dependence

According to the Journal of American Psychiatry, the word "dependence" was introduced in an effort to combat the stigma associated with the word "addiction," differentiating between patients with psychological cravings for a drug and those with isolated physical dependence. Instead of clarifying, however, this distinction has become confusing for patients. The continued interchangeability of the terms in the media compounds the problem.

The New England Journal of Medicine defines physical dependence as a physiological problem, a problem stemming from the body’s organ systems, and addiction as a psychological problem. While physical dependence is the expected outcome of chronic opioid use and involves the acute onset of withdrawal symptoms when they are stopped, those suffering from addiction exhibit an additional psychological craving for the drug. Addiction involves a pattern of behavior, both drug-seeking and drug-abusing, that is not found in those who are simply physically dependent.


Non-Opioid Pain Treatment Options

Fortunately, opioids are not the only option for pain relief. Additional treatments are available and can be used by themselves or as adjunct therapies to pain medications. Options range from non-opioid analgesics to simple exercises done at home. Used alone or in combination, they give each patient a wide array of options to control their pain.

Physical therapy modalities for pain may include ultrasound, paraffin wax, massage therapy, traction and instruction in specific pain-relieving exercises. Patients may be instructed in biofeedback techniques or receive electroanalgesia from TENS, PENS, or CES. Some therapy locations offer aquatic therapy on site, or instruction on water exercises to do at home. Occupational therapists can offer instruction in ergonomics to prevent poor posture and positioning that leads to pain problems.

Many health insurance companies are now covering the cost of acupuncture and chiropractic office visits to treat pain. Herbal remedies and supplements are not generally covered by insurance, but are an alternative treatment option to consider. Vitamin D supplements have recently been used successfully to treat musculoskeletal pain, and aromatherapy and music therapy have proven successful in some patients.

Psychological interventions for pain include hypnosis and behavior modification techniques. Pain associated with depression or anxiety may be eliminated with an antidepressant or anti-anxiety medication; and Lyrica has recently been introduced specifically for fibromyalgia treatment. Medications for pain include the non-opioid analgesics such as tramadol or Tylenol; muscle relaxants such as Flexeril or Skelaxin; and the topical analgesics like capsaicin. There are a wide variety of medications for specific pain conditions such as migraines, postherpetic neuralgia and peripheral neuropathy. For those seeking arthritis pain relief, it may be as simple as choosing the best NSAIDs for their needs.

If surgical treatment is not an option, interventional therapies such as spinal cord stimulator placement or Botox injections might be considered. Local sympathetic blocks have proven effective for chronic regional pain syndromes, and there are a variety of options available depending on the cause and location of the pain.

With the prevalence of hydrocodone addiction, non-opioid pain treatment options provide both patients and physicians with alternatives to consider. However, if pain cannot be managed with such interventions, opioids are still a safe and effective option when managed correctly. Inadequate pain relief will encourage patients to self-medicate, and a doctor-monitored program that includes opioids is preferable to self-medicating patients. Chronic pain management programs allow patients to explore all the alternatives available, including opioids, while remaining under the management of a single physician.

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Immune System Basics

immune system
The human immune system is a multifaceted entity that is designed to fulfill two tasks: it distinguishes what is “us” from what is “not us,” and then eliminates what is “not us.” Any molecule that can be recognized by the immune system – whether it is self or non-self – is called an antigen. A healthy immune system is capable of effectively handling potentially harmful antigens, including infectious organisms, allergens, and abnormal cells (such as cancer cells).

While not technically part of the immune system, there are several anatomic barriers that must be surmounted by foreign antigens before the immune system is activated: The skin, with its germ-inhibiting sheen of oils and sweat; the mucus that coats the respiratory, gastrointestinal, and urogenital tracts; and specialized, hair-like cilia projecting from respiratory epithelial cells all serve as obstacles that help prevent attacks on the human organism. Any antigen that breaches these barriers can trigger two types of immune response: innate and acquired.

The Innate Immune Response

Innate immunity (also called “natural” or “nonspecific” immunity) does not require prior exposure to a particular antigen in order to be activated. The various components that make up the innate immune response simply recognize foreign antigens as “non-self,” and they react accordingly.

Important components of the innate immune system include:
  • Phagocytic cells (neutrophils and monocytes in the bloodstream; dendritic cells and macrophages in the skin and other tissues) are responsible for “eating” and destroying invading antigens. They also “show” these antigens to other immune cells, thus initiating a cascade of events that ultimately eradicates the antigen and leads to long-lasting immunity.
  • Natural killer (NK) cells are specialized lymphocytes that detect and kill tumor cells and cells infected by viruses.
  • Polymorphonuclear leukocytes (PMNs) release cellular messengers called cytokines that trigger the inflammatory response and recruit more immune cells to areas where they are needed.

The Acquired Immune Response

Acquired immunity (also known as “learned,” “specific,” or “adaptive” immunity) is that component of the immune response that confers immune memory. Following a first encounter with a given antigen, acquired immunity affords a quicker response to that antigen in the future. Vaccinations trigger an acquired immune response, as do initial infections with certain infectious organisms, like chickenpox, measles, or mumps.

Components of the acquired immune response include:
  • T lymphocytes process antigens that are presented to them by phagocytic cells so the antigens can be effectively eliminated. Mature T cells typically only recognize a single, specific antigen; since there are billions of antigens in the environment, the capacity for T cell specialization is nearly limitless. Furthermore, some T cells will heighten the immune response (they secrete cytokines that stimulate other immune cells); others help to suppress the immune cascade once a threat has been addressed; still others are “cytotoxic” and help to kill other cells that are infected, malignant, or foreign (e.g., transplanted tissue).
  • B lymphocytes produce antibodies that bind to foreign antigens, thus making them more easily recognizable to other immune cells. B cells can produce one class of antibody by simply encountering an antigen in the circulation, but this process is slow and only confers limited immunity. However, when B cells encounter specialized T cells, they can be “educated” to produce different classes of antibodies that are manufactured much more quickly and that afford much better immune protection.
  • Antibodies are highly specific and complex proteins that are produced by B cells following exposure to circulating antigens or specialized helper T cells. Each antibody molecule matches only one antigen so, like T cells, B cells have an unlimited capacity to produce antigen-specific antibodies; they are also capable of remembering their uniquely-assigned antigens. Antibodies are ubiquitous: They are dispersed throughout the bloodstream and other tissues or attached to the membranes of immune cells.

Interaction between Innate and Acquired Systems Heightens Immune Response

In order to provide maximum protection against harmful antigens, evolution has conferred a significant degree of overlap between the innate and acquired systems. For example, antibodies that are produced as part of the acquired response will bind to cells that are part of the innate system, thereby accelerating the activity of the latter. Complement, an array of serum proteins that adheres to foreign antigens like butter on bread, stimulates phagocytic cells to engulf the antigens (innate system); at the same time, complement triggers the release of cytokines and the production of antibodies (acquired system).

Together, then, the various constituents of the innate and acquired immune systems cooperate to generate the critical activities of successful immune defense: recognition of harmful antigens; rapid response to those antigens; immune regulation and resolution once the threat has been addressed; and memory of specific antigens to afford effectual responses to future exposures.

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