Weakened Immune System Ebook

Immunity Crisis

Have you ever wondered WHY you get sick from different things, sometimes seemingly for no reason? Haven't you ever wished that you could find some way to stop yourself from getting sick and stay healthy all the time? Well, that might be more possible than you thought at first! Your immune system is an odd system, that many scientists are still struggling to understand. However, there have been some amazing breakthroughs! Once you get access to this detailed and helpful book, you will be able to find REAL and Applicable ways to improve your immune system and keep yourself from getting sick all of the time. This book teaches you everything that you never learned about your immune system Start learning what you can Really do to improve your immune system's health and keep your body healthier for longer! It's not hard at all Get started today! Read more...

Immunity Crisis Summary


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Types of Immune Response

The immune system eliminates foreign material in two ways natural innate immunity and adaptive immunity. Natural immunity produces a relatively unsophisticated response that prevents access of pathogens to the body. This is a primitive evolutionary response that occurs without the need of prior exposure to similar pathogens. For example, macrophages and granulocytes engulf invading microorganisms at the site of entry. Adaptive immunity is an additional, more sophisticated response found in higher forms such as humans. Cells of the innate immune system process phagocytosed foreign material and present its antigens to cells of the adaptive immunity for possible reactions. This immune response is highly specific and normally is potentiated by repeated antigenic encounters. Adaptive immunity consists of two types of immune responses humoral immunity, in which antibodies are produced and, cellular immunity, which involves cell lysis by specialized lymphocytes (cytolytic T cells). Adaptive...

The Role of the Innate Immune System in Pregnancy

During normal pregnancy, several of the cellular components of the innate immune system are found at the site of implantation. Furthermore, from the first trimester onwards, circulating monocytes, granulocytes and NK cells increase in number and acquire an activated pheno-type. This evidence suggests that the innate immune system is not indifferent to the fetus and may have a role not only in host protection to infections, but also as important players in the feto-maternal immune adjustment. Vikki Abrahams, Ulrike Kaemmerer, Ali Ashkar and I discuss the possible roles of cells of the innate immune system during pregnancy.

224 Immunotherapy

Allergen immunotherapy (allergy shots) is an antiallergy therapy in which continuously increasing doses of an allergen arc injected sub-cutaneously. This therapy stimulates the production of immunoglobulins that bind the allergen before it can react with the mast cells. After immunotherapy, the allergic reaction on exposure to the allergen will be diminished because less histamine will be released by the mast cells. Immunotherapy is often effective for those allergic patients in whom the symptoms persist despite optimal environmental control and drug therapy. No specific embryo- or fetotoxic effects are to be expected after immunotherapy in pregnancy (Gilbert 2005, Shaikh 1993). However, a maternal anaphylactic reaction can cause hypotension and decreased uterine perfusion, which may result in fetal damage induced by fetal hypoxia (Luciano 1997), Recommendation. Allergen immunotherapy can be carefully continued during pregnancy in patients who benefit and are not experiencing adverse...

Immune system

In recent years there has been much research into the role of the immune system and the body's inflammatory response during pregnancy. However, many of the new theories remain controversial. For a pregnancy to survive to term, the woman's immune system must recognise what is going on and not reject the fetus. It is thought that recurrent miscarriage may be due to a failure in the immune mechanisms, from either an autoimmune reaction or the inability of the mother's immune system to respond protectively (Balen & Jacobs 2003).

The Immune System

Whitecells Rejecting Organ

The body's overall immune system is known as the systemic immune system. Another immune system, the secretory immune system, invokes surfaces of the body (such as the breast) and acts locally. Lymphocytes in the secretory immune system are different from other lymphocytes. Sensitized to antigens found in the gastrointestinal or the respiratory tracts, these lymphocytes travel through mu-cosal lymphoid tissues (e.g., breasts, salivary glands, bronchi, intestines, and genitourinary tract) where they secrete antibodies. Immunity occurs actively and passively. Maternal antibodies passed to the fetus through the placenta before birth present an example of passive immunity. Passive immunological protection is only temporary, as the infant's immune system has not itself responded. Breastfeeding can also confer long-term protection by stimulating an active immune response. Active immunity is a specific immunity whereby the immune system formulates a long-term memory of exposure to a certain...

The Pregnant Uterus as an Immune Privileged Site

Implantation is the process by which the blastocyst becomes intimately connected with the maternal endometrium decidua. During this period, the semi-allogenic fetus is in direct contact with the maternal uterine and blood-borne cells however, as I pointed above, fetal rejection by the maternal immune system, in the majority of the cases, is prevented by mechanism(s) yet undefined. A number of mechanisms have been proposed to account for the immune-privileged state of the decidua. The different hypothesis can be summarized in five main ideas (i) a mechanical barrier effect of the trophoblast, (ii) suppression of the maternal immune system during pregnancy, (iii) the absence of MHC class I molecules in the trophoblast, (iv) cytokine shift, and more recently (v) local immune suppression mediated by the Fas FasL system. I will discuss some of these hypotheses in brief and refer to the chapter where it is discussed in detail.

The Voice of Experience K

If you're not sure what you want to do, consider giving breast-feeding a try. After all, you can always switch if you don't like it. But if you start out on the bottle and later want to try breast-feeding, you may not be able to get the milk flowing. Besides, even a few weeks of breast milk can help protect your baby from illness at a time when his immune system is not yet fully functioning. If you try, you may find it easier than you expected and more rewarding than you imagined.

The Best Advice I Got Was L

Human milk is uniquely suited for human babies. For most babies, it meets all nutritional needs in easily digested form. It also provides antibodies and live immune-system cells that protect babies from disease. Moreover, each mother's milk is uniquely suited to her baby its Many studies have confirmed the health benefits of breast-feeding. There is strong evidence that babies who are breast-fed for the first six months are less likely than bottle-fed babies to get certain illnesses including diarrhea, lower respiratory infections, ear infections, and urinary tract infections. Most of the studies looked at the first six months of life, when the protection against infection is thought to be most important after that, babies' immune systems have matured, and they are more able to fight infections on their own.

The Role of the Endometrial Cycle

The unique individual that is at the blastocyst stage will invade the receptive endometrium and become essentially an allograft. This occurs in two steps adhesion followed by implantation. The yolk sac-placenta provides nourishment until the definitive placenta develops. The maternal host's reaction to invasion by the embryo includes ancestral innate immune reactions to foreign proteins, modulated by estrogen, progesterone, and other signals from the maternal gonad and or embryo. At this point, immune function is primarily aTHl response.13

Chorioaliantoic placenta 4 types

Endometrial stromal cells and deciduas express insulin, IGF-1, and glucocorticoid receptor, peaking at days 4 and 5 of gestation.17 This suggests a relationship between the regulation of invasion and the immunologic alterations in the progression of pregnancy, i.e., the barrier may be one and the same the immune system.

Placental Contribution and Graft Tolerance

In the case of mammals, fetuses are retained within the reproductive tract for longer periods of time, increasing the temporal challenge to the immune system.24 Comparative amino acid sequence analysis of IgE, G and G2 structure confirms the immunologic divergence of mammals from early reptilian species approximately 300 million years ago. The mammalian immune system appeared approximately 100 million years ago at the time metatherian (marsupial) and eutherian placental lineages emerged (Fig. 3).

271 Vaccination and pregnancy

Protective and booster immunizations should be carried out before pregnancy. Even though no embryotoxic or teratogenic effects have been proven for any vaccine, the indications for immunization, especially in the first Irimester, should be limited strictly to rare situations. With live vaccincs, the risk of a fetal infection from the vaccine is more of a theoretical nature, but routine immunization should be avoided during pregnancy. Another reason for avoiding vaccinations in early pregnancy is the possible risk of maternal hyperthermia (see Chapter 2.6) as a reaction to the vaccine. This risk is moderate, but common to almost all types of vaccines, if fever occurs, it should be treated with paracetamol (acetaminophen) as soon as it occurs. A third reason for avoiding vaccinations, especially in later stages of pregnancy, would be that postnatally the developing child might not recognize the antigen and since the immune system has become tolerant no seroconversion would be the result.

Defining Immunology of Pregnancy

Colbern and Main in 1991 redefined the conceptual framework of reproductive immunology as maternal-placental tolerance instead of maternal-fetal tolerance, focusing the interaction of the maternal immune system on the placenta and not on the fetus.1 The embryo in early development divides into two groups of cells, an internal, the inner cell mass, which give rise to the embryo and an external layer, the embryonic trophoblast that becomes trophoblast cells and later the placenta. The cells from the placenta are the only part of the fetus to interact directly with the mother's uterine cells, and therefore the maternal immune system, and are able to evade immune rejection. The fetus itself has no direct contact with maternal cells. Moreover, the fetus per se is known to express paternal major histocompatibility complex (MHC) antigens and is rejected as allograft if removed from its cocoon of trophoblast and transplanted to the thigh muscle or kidney capsule of the mother. This book we...

Vikki M Abrahams and Gil Mor Abstract

The maternal-fetal interface represents an immunologically unique site that must promote tolerance to the allogenic fetus, whilst maintaining host defense against a diverse array of possible pathogens. Clinical studies have shown a strong association between certain pregnancy complications and intrauterine infections. Therefore, innate immune responses to microorganisms at the maternal-fetal interface may have a significant impact on the success of a pregnancy. There is growing evidence that trophoblast cells are able to recognize and respond to pathogens through the expression ofToll-like receptors, a system characteristic of innate immune cells. This review will discuss the role ofToll-like receptors at the maternal-fetal interface, the potential for trophoblast cells to function as components of the innate immune system and the impact TLR-mediated trophoblast responses may have on a pregnancy.

Genetic markers in autoimmune GDM

To screen for the genetic susceptibility for autoimmune-mediated Type 1A diabetes, HLA typing is most useful. The HLA complex on chromosome 6p21.3 is a major susceptibility locus, IDDM1. The HLA complex contains class I and II genes that code for several polypeptide chains. The class I genes are HLA-A, -B, and -C. The loci of class II genes are designated by three letters the first, -D-, indicates the class, the second (-M,O, P, Q, R-) the family, and the third (-A or B-) the chain. Both classes of molecules are heterodimers class I exhibits an alfa chain and p2-microglobulin class II exhibits alfa and beta chains. The function of the HLA molecules is to present short peptides to T cells to initiate the immune response. Multiple genetic reports have demonstrated an association between various HLA alleles and autoimmune disorders. In caucasian DM-1 patients HLA-D genes contribute as much as 50 of the genetic susceptibility.75

Limiting the Guest List

Because your baby's immune system is immature, it's a good idea to limit his exposure to lots of visitors in the first weeks. Ask your child's doctor when it is appropriate to take your baby into crowds, such as taking a trip to the shopping mall. If a friend or relative has an infection, it only makes sense for that person to delay visiting until he or she is better. If a member of your household becomes ill, limit his or her contact with the baby. (Make sure this person doesn't cough in your baby's face or kiss your baby until he or she is recovered.) Everyone in the household should, as always, practice good hygiene, washing hands thoroughly before touching your baby.

Pregnancy Represents an Allograft

The objective of this book is to review some of the significant events involved in human implantation related to the interaction between the maternal immune system and the fetus. The volume focuses on the main aspects of reproductive immunology, both from basic sciences and clinical points of view. Although there are still gaps in our knowledge, the advances accomplished in the last five years have proved the importance of understanding the role of the immune system during pregnancy. This not only represents a fascinating field for research, but it has the potential for new areas of treatment and diagnosis.

Toll Like Receptor Expression

As expected, TLR are widely expressed throughout the cells of the immune system, specifically those of the innate. Toll-like receptors can also be expressed by non-immune cells, particularly if such a cell can contribute to an inflammatory response, and most tissues express at least one TLR.45 Toll-like receptor expression by mucosal systems is important for host defense against pathogens.46'47 While most studies have focused on the intestinal and respiratory tracts, there is growing evidence that the mucosal epithelium of the female reproductive tract (FRT) is also an important immunological site.48,49 Indeed, Toll-like receptors are expressed by endometrial epithelium and the epithelial cells of the lower reproductive tract.50'51 Furthermore, these cells are able to respond to microorganisms through these receptors.50'52 These studies suggest that TLR play an important role in host defense within the normal cycling FRT, which raises the question of whether TLR also play a role in...

Toll Like Receptors and Pregnancy

At present, little is known about the role ofToll-like receptors during pregnancy. Trophoblast cells from term placenta have been shown to express TLR-1-10 at the RNA level.45 At the protein level TLR-2 and TLR-4 are expressed.54 These findings suggest that trophoblast cells may interact with microorganisms present at the implantation site and initiate an immune response. The trophoblast may, therefore, function as an active member of the innate immune system, as was once proposed by Guleria and Pollard.11 In our studies we have evaluated the expression Toll-like receptors by first trimester trophoblast cells. We have observed that in first trimester placental tissues, TLR-2 and TLR-4 are highly expressed. Interestingly, the trophoblast cell populations expressing these receptors are the villous cytotrophoblast and extravillous trophoblast cells. The syncytiotrophoblast cells do not express these TLR and this suggests that the placenta serves as a highly specialized functional...

Toll Like Receptor Signaling in Trophoblast Cells

The function of Toll-like receptors at the maternal-fetal interface is an area of research still in its infancy. At present we know that trophoblast cells from term placental explants can produce IL-6 and IL-8 following ligation of TLR-2 or TLR-4 by zymosan or LPS, respectively.54 Treatment of term trophoblast cells with LPS has also been shown to induce the production of nitric oxide which has potent anti-microbial properties and MMP-2.72 In addition, studies on first trimester trophoblast cells have shown that treatment with LPS induces the production of G-CSF and RANTES.73 Recent work from our laboratory has focused on the function of Toll-like receptors during the first trimester of pregnancy. We have found that activation ofTLR-4 by LPS triggers trophoblast cells to generate a classical TLR response, characterized by the increased production of both pro- and anti-inflammatory cytokines. Together, these studies suggest that trophoblast cells can indeed function similarly to cells...

Preparing for breastfeeding

Many women notice from early on in pregnancy that their breasts occasionally secrete a yellowish discharge. This discharge is colostrum, and it's what the newborn baby sucks out and swallows in the first few days of life before actual milk comes in. Colostrum has a higher protein and lower fat content than milk most importantly, it contains antibodies from your immune system that help protect your baby against certain infections until her own immune system matures and can take over.

Why Some Children Arent Immunized Even When They Should Be

Newborn babies have temporary partial natural immunity to some serious childhood diseases, a gift from their mothers in the form of antibodies passed through the placenta. Breast-feeding continues to boost the infant's antibodies. Breast-feeding, however, is not a substitute for vaccines. Breast milk does not completely protect a child against all diseases, and, in any case, the natural immunity eventually wears off, making vaccinations just as important for breast-fed children.

Explanation Of Condition

Multiple Sclerosis (MS) is an unpredictable, progressive demyelinating disease that affects the central nervous system (CNS) at different levels and at varying times4. It is a chronic, disabling condition5. The white matter within the brain or spinal cord becomes inflamed then destroyed by the person's own immune system. The inflamed areas of myelin sheaths on neurons deteriorate and become scarred to become scleroses in multiple regions. This destruction of the myelin sheath slows and short-circuits the conduction of nerve impulses5, resulting in neurological symptoms. Often there is an acute onset of symptoms, including

First Trimester Nutrients

Pr eg na nt women need up to 60g of protein a day, so re member to eat a variety of protein foods to get a ba I a nc e of a I I th e a mino acids. Antioxidant foods are vitally i mportant in the body's fight against free radicals (see pa g e 1 5) . Eat plenty of fruit and vegetables containing c a r ote n o i d s th e s e a r e a sa fe s o u r c e o f vi tamin A, which is important for vision as well as cell division and d i ffe re nti a ti o n . S e I en i u m is an antioxidant trace mineral i mportant to the immune system. Certain B vitamins are n e ed ed at th i s sta g e for th e d evel o pment of the baby's bra i n a nd n ervou s syste m. Choline and iodine are important for bra i n d eve I op ment, as is the essential fatty acid DHA. For food sou rce s of a I I th es e n u tr i e nts see pa g es 1 34-7.

Regulatory T Cells in Pregnancy

The Thl Th2 hypothesis has been further developed. T-cell subsets which produced the immunoregulatory cytokines IL-10 and TGF-P have been clarified. Th3 cells predominantly produce TGF-P, whereas Trl cells predominantly produce IL-10 (Fig. 2). Recently, it has been demonstrated that CD4+ CD25+ regulatory T cells play a central role in development of tolerance. The suppressive function of CD4+CD25+ regulatory T cells requires cell-to-cell contact, although they produce IL-10 and TGF-(5. We first showed that the population of CD4+ CD25+ regulatory T cells in decidua from normal pregnancies is increased and they suppress the autologous proliferation of CD4+ CD25 T cells.30 Heikkinen et al31 and Somerset et al32 also reported the same results. In contrast, the population of decidual CD4+ CD25+ regulatory T cells was significantly lower in specimens from spontaneous abortion compared to those from induced abortion.30 These results suggest that decidual CD4* CD25* regulatory T cells might...

Summary and Conclusions

The cytokine profile in the endometrium clearly changes during implantation and pregnancy. These dramatic and synchronized changes are present at the local implantation site. We could not detect these local immunological changes by examination of peripheral blood. We should focus on the localized immune system rather than the systemic immune system. There is a bias in the ratio of Thl Th2 cytokines towards Th2-type cytokines at the materno-fetal interface. The high Thl Th2 ratio (147.5 96.7) in the proliferative phase of the endometrium decreases to 1.3 0.5 in the early pregnancy decidua, suggesting that a Th2-predominant state is present in the pregnant uterus. However, an almost equal number ofThl cells is also present in the pregnant uterus. We should understand the role ofThl cells in implantation and placen-tation. At implantation, the cytokine balance is rather Type 1-dominant. However, during placental formation there is a clear bias towards Th2-type cytokines.40 Although these...

Obstetrical antiphospholipid syndrome

APAs are a type of antibody - 'proteins that are made by the immune system as a primary defense against infection or injury by foreign proteins. (The immune system is able to distinguish between proteins that are self and those which are foreign, or nonself .)' (Sher et al 2005).

Death Receptor Mediated Apoptosis

Along with several others, we have shown that both villous20 24 and extravillous trophoblast cells1'20 express Fas and or Fas Ligand (FasL), but are resistant to Fas-mediated apoptosis under normal conditions.22'27'28 More recently, we also demonstrated that first trimester trophoblast cells secrete functional FasL to induce apoptosis in Fas-bearing immune cells and avoid maternal immune surveillance and rejection. The expression of TNF-R1 has also been localized to villous29 31 as well as extravillous trophoblast, 9 but in contrast to Fas, we and others have shown that trophoblast cells are sensitive toTNF-a, the ligand forTNF-Rl ,22-27'30-31 Even though trophoblast cells do not express TRAIL, it was previously demonstrated that these cells do express TRAIL-R1 andTRAIL-R2 and are resistant to recombinant TRAIL.3132 Since these studies were performed with either trophoblast-derived choriocarcinoma cell lines32 or term trophoblast cells,31 however, whether normal first trimester...

Gil Mor Roberto Romero and Vikki M Abrahams Abstract

During implantation, apoptosis is critical for the appropriate tissue remodeling of the maternal decidua and invasion of the developing embryo. Yet the regulation of apoptosis is also imperative for a successful pregnancy. The quick and effective removal of apoptotic cells by tissue macrophages represents an essential process, which prevents the release of self-antigens and, in the case of pregnancy, paternal alloantigens. Recent studies have shown that the process of apoptotic cell clearance is not a neutral event, but rather an active one which induces macrophage production of anti-inflammatory cytokines and survival factors. Therefore, apoptotic cell clearance is necessary for the resolution of inflammatory conditions, which during pregnancy could have lethal consequences. The function of the maternal immune system during implantation and throughout pregnancy is, thus, an important area of investigation. This review will discuss the role of decidual macrophages in apoptotic cell...

Nonpregnancy Treatment And Care

HIV is now viewed as a chronic disease, and many women do not require drug therapy for many years after contracting HIV. Regular monitoring by their specialist team will ensure that their immune function is monitored, and treatment initiated when their clinical or immunological condition dictates.

Cytokines Th1 and Th2 Type

Immune cells mediate their effects by releasing cytokines and thus establishing particular microenvironments. T helper lymphocytes (Th) that originate from the thymus play a major role in creating a specific microenvironment for a particular organ or tissue. Following an immune challenge, immune cells produce cytokine, the type of which determines their differentiation into T helper-1 (Th-1) or T-helper 2 (Th-2) lymphocytes. For example, Th-1 lymphocytes secrete interleukin-2 (IL-2) and interferon-y (INF-y) setting the basis for a pro-inflammatory environment. Conversely, the Th-2 lymphocytes secrete cytokines such as IL-4 and IL-10 which are predominately involved in antibody production following an antigenic challenge. The actions of the two types of lymphocytes are closely intertwined, both acting in concert and responding to counter regulatory effects of their cytokines. For example Thl cytokines produce pro-inflammatory cytokine that while acting to reinforce the cytoytic immune...

Leukocytes at the Implantation Site

During normal pregnancy the decidua is populated by a variety of leukocytes.1 However, cells of the innate immune system seem to dominate this tissue since the levels of lymphocytes are relatively low (1-3 ).2 At the time of implantation, many of the leukocytes are NK cells, expressing a phenotype distinct from those found in the periphery.3 As gestation proceeds, NK cell numbers decline and at term these leukocytes are absent. Macrophages constitute 20-30 of the decidual cells at the site of implantation2'5 7 and unlike NK cells, remain high throughout pregnancy.2'8 This evidence suggests that the innate immune system is not indifferent to the fetus and may play a role, not only in host protection to infections, but also as important factors in the fetal-maternal immune adjustment. A significant aspect in this process is the establishment of an adequate microenvironment that will promote cell growth and inhibit harmful inflammatory immune reactions.

Clearance of Apoptotic Cells

As discussed above, implantation and trophoblast invasion is characterized by a progressive, continuous induction of apoptosis in the maternal tissue surrounding the fetus.32 During this period, numerous macrophages are present at the implantation site and this was originally thought to represent an immune response against the invading trophoblast. However, we propose that this may not be the case. We suggest that macrophage engulfment of apoptotic cells prevents the release of potentially pro-inflammatory and pro-immunogenic intracellular contents that occurs during secondary necrosis (See Fig. 1). Due to the allogenic nature of the placenta, this process may be essential for the well-being of the fetus. Trophoblast cells are carriers of proteins, which are antigenically foreign to the maternal immune system and if released, as result of cell death, may initiate or accelerate immunological responses with lethal consequences for the fetus. Therefore, the appropriate removal of dying...

52 Fetal Effects of Marijuana

Endogenous cannabinoids appear to be involved in the regulation of human fertility and pregnancy. The first brain-derived endogenous can-nabinoid identified was an arachidonylethanolamide, which was given the name anandamide. Cannabinoid receptors have been found in high abundance in the brain, the immune system, and the human uterine smooth muscle during pregnancy. Anandamide may have a role in the uterine tubes in delaying embryo development until the uterus is ready to receive the implanting blastocyst (43). Anandamide is believed to also have a role in sustaining the embryo once it has been implanted (43). Future studies of the cannabinoid system will most likely reveal details of its importance in reproduction and shed light on the effects of exogenous prenatal cannabinoid exposure.

Key Nutrients For The Third Trimester

A lack of vitamin C has been linked to an increased risk of premature rupture of membranes (see page 9 8) and preterm labor. Vitamin C is needed to boost the immune system and protect against infection during the birth and h elp h ealing afterward. It aids the manufacture of collagen, connective tissue, and blood vessels for wound repair. It also improves the absorption of iron, stores of which need to be built up prior to labor. Garlic boosts circulation by dilating small arteries, improving circulation in the placenta, and decreasing the risk of blood clots. It reduces h igh blood pressure in pregnancy and boosts the immune system, protecting against infection.

Chapter Skin Care during Pregnancy

During your pregnancy, many changes can occur on the skin. These changes are related to the surge of female hormones (estrogen and progesterone) to the skin pigments, blood vessels, glands and your immune system. These changes can be physiological or present as skin disorders. The following are seen during pregnancy and improve after delivery.

4415 Acyclovir antiretroviral drugs and other virustatics

With acyclovir, with an M P ratio of 2-4, the fully breastfed infant takes in 1 of an oral maternal weight-related dosage (Meyer 1988). When 900 mg daily is administered intravenously, this is on average 5 (Bork 1995). Toxic symptoms have not been observed (Taddio 1994, Meyer 1988). The risk of influencing the infant's immune system as a result of exposure via the mother's milk appears, in the light of current experience, to be simply theoretical.

Function and Regulation of uNK Cells

Human decidua contains a large number of NK cells and many of them localize near trophoblasts. Uterine NK cells have been proposed to have several different functions in pregnancy, including to (i) help shield trophoblasts bearing paternal antigens from the maternal immune system, (ii) protect the mother from trophoblast invasion and limit expansion of trophoblasts, (iii) be involved in regulation and restructuring of maternal spiral arteries,

Recurrent Pregnancy Loss

Recurrent pregnancy loss (RPL) is defined as three or more consecutive spontaneous abortions with the same partner. About half of all cases are explained by universally accepted aetiologies. Thus, proposed immune based aetiologies are being studied as a possible explanation for some of the other cases. Activated CD56+ NK cells are present in increased numbers in peripheral blood in women with RPL.106110 NK cells produce IFN-y which is aThl cytokine that is associated with RPL,111'112 and LIF is down-regulated by IFN-y.113 It has been demonstrated that CD56bright NK cells are decreased in the secretory phase endometrium in patients with unexplained recurrent miscarriage114 and in vitro fertilization-embryo transfer failure.115 One possibility is that some of these patients have an influx of CD56dim NK cells that respond against fetal cells. There is evidence that NK cells and PBMCs from women with unexplained RPL respond to trophoblast extracts in vitro by proliferating and releasing...

CRH Promotes Blastocyst Implantation and Early Maternal Tolerance

We have shown that CRH participates in the nidation of the fertilized egg by inhibiting local maternal immune response to the implanted embryo.12 Our data are in agreement with previously published reports suggesting that expression of FasL by fetal extravillous trophoblast cells can induce apoptosis of activated T lymphocytes expressing the Fas receptor. 3,3 '31 It

Prepregnancy Type 1 diabetes

Compared to a population risk of Type 1 diabetes of 0.4 . The critical role of non-genetic factors is made clear in observations in identical twins if one twin has Type 1 diabetes the risks of the second twin developing diabetes is in the region of 40 . The nature of the environmental component is uncertain and might possibly be antigens such as cows' milk and specific viruses or alternatively, reduced exposure to infection resulting in a failure of the immune system to differentiate self and non-self antigens (the hygiene hypothesis).1

IDODependent TCell Suppression by Specific Subsets of Dendritic Cells

In mice, IDO expression is also associated with specific DC (CD1 lc+) subsets. Murine DC subsets expressing CD8a('lymphoid' DCs) suppressed delayed-type hypersensitivity (DTH) responses to tumor-associated peptide antigens displayed by CD8a- ('classic' myeloid) DCs , unless they were incubated with IDO inhibitor before injection into mice.26 28 However, studies by Fallarino and colleagues revealed that murine macrophages and CD8a- and CD8a+ DC subsets expressed IDO protein, but that functional IDO enzyme activity was an exclusive property of CD8a+ DC subsets.29 This suggests that additional biochemical mechanisms influence IDO enzyme activity in certain cell types. For example, IDO activity is affected by hemin availability, oxidation potentials, and nitric oxide,30 and many immune response modifiers, such as cytokines. Mitogens and pathogens either induce, or suppress IDO expression and or enzyme activity in human, or rodent cells.33 40 The mechanisms that explain how these various...

IDO Expression at the Maternal Fetal Interface

The maternal-fetal interface is the initial point of contact between maternal immune cells and fetal cells expressing antigens that are foreign from the perspective of the maternal immune system. Thus, identifying cells that express IDO at the maternal-fetal interface is a key issue that may provide clues to the mechanism of IDO-dependent inhibition of maternal T cell responses to fetal alloantigens. As mentioned previously, several studies have focused on identifying IDO+ cells at the maternal-fetal interface in humans and mice. In humans, extravillous syncytial trophoblast cells express

2322Other Micronutrients

Several trials have failed to identify a consistent benefit of maternal zinc supplementation on pregnancy outcomes such as preterm labor, premature rupture of membranes, postpartum hemorrhage, perinatal mortality, and fetal growth 14, 15 . However, some studies have suggested a beneficial effect of zinc on infant neurobehavioral development and immune function, as well as some role in the prevention of congenital malformations, such as cleft lip or palate 14-17 .

233 micronutrient status and pregnancy outcomes in hivinfected women

(MTCT) of HIV by impairing systemic immune function and by affecting the epithelial integrity of the maternal lower genital tract 27, 28 . Deficiencies of various micro-nutrients may amplify the risk of postpartum HIV transmission by increasing the risk of clinical or subclinical mastitis and subsequent viral shedding, and by impairing the epithelial integrity of the infant gastrointestinal tract 27, 29 . Micronutrient deficiencies may also accelerate clinical, immunologic, and virologic HIV disease progression, and consequently increase maternal morbidity and risk of HIV transmission 3, 27 . Further, HIV infection itself may affect nutrient absorption and contribute to the development of micronutrient deficiencies and wasting, thus perpetuating a vicious cycle 30 .

4186 Breastfeeding despite environmental contaminants

Not enough is known about the long-term effect of the contami nants discussed in this chapter. There are indications that polychlo-rinated dioxins and furans may inhibit the immune system and promote tumor development (WHO 1989, Knutscn 1984), but not yet in connection with average exposure via the mother's milk.

Yeast Candida Infections Thrush Diaper Rash

Cause A yeast infection appears in the mouth (thrush) or as diaper rash in infants and is caused by candida, a yeastlike fungus. The majority of infections are caused by one species, Candida albicans. Oral thrush occurs in 2 to 5 percent of normal new-borns and a higher percentage of low-birthweight babies. Diaper dermatitis is the most common infection caused by candida. Older children who have been treated with oral antibiotics or who have a weakened immune system are also prone to yeast infections. Complications Persistent thrush can be a sign of abnormalities in the body's immune system. Candida infections in people with weakened immune systems can range from minor to life-threatening sepsis (infection of the blood).

Infections and the Innate Immune

The innate immune system represents the immunological first line of defense against invading pathogens through is its ability to distinguish between what is non-infectious self and infectious nonself.12 One way in which the innate immune system achieves this is through an evolutionary conserved system of pattern recognition.13 Cells of the innate immune system express a series of receptors known as pattern recognition receptors (PRR) which recognize and bind to highly conserved sequences known as pathogen-associated molecular patterns (PAMPs). Pathogen-associated molecular patterns are unique to, and expressed on, the surface of microorganisms. Examples of PAMPs include lipopolysaccharide (LPS), the major component of gram-negative bacterial outer membranes, and peptidoglycan, the major component of gram-positive bacterial cell walls.12 The ligation of PRR by PAMPs results in an inflammatory response generated against the invading pathogen.14 Furthermore, activation ofTLR expressed by...

Natural killer NK cells

These cells are part of the immune system's first line of defence against life-threatening diseases such as cancer. In pregnancy there is an abundance of NK cells in the uterine lining, which work with the fetal trophoblast to help develop the placenta (Hanna et al 2006). However, recent research from around the world has shown that an overabundance of NK cells can be toxic to the trophoblast cells and lead to cell death and early abortion (Quenby & Farquharson 2006). Further studies on the immunology of pregnancy have noted that abnormal function of NK cells during pregnancy may lead to pre-eclampsia (Le Bouteiller & Tabiasco 2006, Sargent et al 2006). The present treatment of choice for women who are tested via a blood sample and show raised levels of NK cells is oral steroid - prednisolone and or administration of intravenous immunoglobulin (IVIG) (Clark

2157 Hyperthyroidism and thyrostatics

The adrenal cortex synthesizes two classes of steroids the corticosteroids (glucocorticoids and mineralocorticoids) and the androgens. Corticosteroids act on the carbohydrate, protein, and lipid metabolism the maintenance of fluid and electrolyte balance and the preservation of the normal function of the cardiovascular and immune systems, the kidneys, the skeletal muscle, and the endocrine and nervous systems. In addition, corticosteroids allow the organism to resist stressful circumstances such as noxious stimuli and environmental changes. The effects of glucocorticoids are mediated by genomic and non-genomic mechanisms (Czock 2005). Corticosteroids interact with specific receptor proteins in target tissues to regulate the expression of the corticosteroid-rcsponsive genes, modifying the levels of proteins synthesized by these target tissues. The genomic mechanism includes activation of the cytosolic glucocorticoid receptors that lead to activation or repression of protein synthesis,...

Fetal Risk Summary

Immunosuppression of the newborn was observed in one infant whose mother received 150 mg of azathioprine and 30 mg of prednisone daily throughout pregnancy (10). The suppression was characterized by lymphopenia, decreased survival of lymphocytes in culture, absence of immunoglobulin M, and reduced levels of immunoglobulin G. Recovery occurred at about 15 weeks of age. An infant exposed to 125 mg of azathioprine plus 12.5 mg of prednisone daily during pregnancy was born with pancytopenia and severe combined immune deficiency (38). The infant died at 28 days of complications brought on by irreversible bone marrow and lymphoid hypoplasia. To avoid neonatal leukopenia and thrombocytopenia, maternal doses of azathioprine were reduced during the 3rd trimester in a 1985 study (39). The investigators found a significant correlation between maternal leukocyte counts at 32 weeks' gestation and at delivery and cord blood leukocyte count. If the mother's count was at or below 1 SD for normal...

Chicken Pox Varicella

Treatment Because it is a viral infection, antibiotics are not useful unless there is a secondary bacterial infection. Children with a weakened immune system may be treated with the antiviral medicine acy-clovir. Because it must be started within 24 hours of the first sign of pox and it is usually only mildly beneficial, it is not generally recommended for otherwise healthy children. Contagious Periods People with chicken pox are contagious from two days before blisters appear until all blisters are crusted over. Children with chicken pox should be kept out of child care or school for about a week it's not necessary to wait until the scabs fall off to let the child out of isolation. People with certain chronic diseases or weakened immune systems and pregnant women should avoid contact with chicken pox. Once a child has had chicken pox, she will never get it again.

Babak Baban Phillip R Chandler and Andrew L Mellor Introduction

Viviparity remains an immunological paradox despite increased knowledge of immunological processes that occur during mammalian pregnancy. The maternal immune system protects both mother and fetus from invading pathogens during gestation, but also has to maintain immunological tolerance towards the fetus. Medawar proposed three ways in which this paradox might be resolved physical segregation of maternal and fetal tissues, immunologic immaturity of fetal tissues, and immunological anergy (tolerance) of the maternal immune system towards fetal alloantigens.1 Many biochemical, or immunological mechanisms and distinct cell types have been proposed as potential factors to explain processes that suppress maternal anti-fetal immune responses. These include hormone and cytokine mediated processes that affect maternal T cell elimination, or functional deviation of aggressive Thl-type responses to relatively protective Th2-type responses.2'3 Indeed, a recent report takes this issue a step...

The Chinese viewpoint

In Chinese medicine there is no discourse on the immune system as such. However, according to Professor Yu Jin of Shanghai Medical University, 'The Kidneys are said to be the essence of life, while the Liver has a common source with the Kidneys. Both relate to growth and reproduction, and can thus be associated with the functions of the hypothalamus, pituitary, ovaries, adrenals, and thyroid, which also comprise the body's immuno-neuroendocrine framework' (Yu Jin 1998). There may also a link between the Kidney Essence, jing, the bone marrow and the immune system, as in Western medicine the immune response is thought to come from a stem cell in the bone marrow (Maciocia 1994).

Systemic Immune Suppression

The concept of systemic immunosuppressive has been studied by numerous investigators and for many years became an accepted explanation. Indeed, as described above, a wide array of materials in human serum have been found to have profound in vitro immunosuppressive activity. However, from an evolutionary point of view, it is difficult to conceive pregnancy as a stage of immune suppression. In cultures where a pregnant woman is exposed to poor sanitary conditions, a suppressed immune system would make fetus survival impossible. Furthermore, there are recent studies clearly demonstrating that maternal antiviral immunity is not affected

Nutrition and Health

Feldman, 2005 Epilepsy and the Ketogenic Diet, edited by Carl E. Stafstrom and Jong M. Rho, 2004 Handbook of Drug-Nutrient Interactions, edited by Joseph I. Boullata and Vincent T. Armenti, 2004 Nutrition and Bone Health, edited by Michael F. Holick and Bess Dawson-Hughes, 2004 Diet and Human Immune Function, edited by David A. Hughes, L. Gail Darlington,

Vitamin D

Significant changes in maternal vitamin D and calcium metabolism occur during pregnancy to provide the calcium needed for fetal bone mineral accretion. Fetal 1,25(OH)2D3 levels are low, whereas maternal levels are strikingly elevated during pregnancy before rapidly returning to normal after parturition.48 This increase in maternal 1,25(OH)2D3 levels appears to be caused by increased production rather than decreased clearance, but the precise source of the increased 1,25(OH)2D3 synthesis has yet to be fully defined. There is evidence of 1a-hydroxylase activity in the placenta and deciduas, suggesting that these tissues might also contribute to 1,25(OH)2D3 levels.49 The placenta is a possible site of 1,25(OH)2D3 production, independent of the maternal and fetal kidneys. The presence of a specific vitamin D receptor in placenta and deciduas has also been well documented, underlining the potential for autocrine or paracrine effects of 1,25(OH)2D3 within these tissues.50 The precise...

Vitamin E

During lactation, vitamin E intake through milk is the way of supplying the newborn with an essential defense against oxygen toxicity and of stimulating the development of its immune system. A good supply of vitamin E to the offspring is therefore particularly critical in this period. The increase in vitamin E content in body tissues of the offspring following birth is attributed to the ingestion of colostrums and milk, emphasizing the limited placental vitamin E transfer and the importance of milk consumption. Colostrum contains higher vitamin E concentration than milk,75 which may imply an active uptake by the mammary gland in compensation for the limited placental transport. A decline in maternal circulating vitamin E concentration is noticed at the end of gestation or in early lactation this decrease may be the consequence of a considerable amount of a-tocopherol present in colostrum. The mechanism of transfer from blood into milk is not completely understood. Perhaps the transfer...


Some infectious conditions, of which Human Immune Deficiency Virus (HIV) is the most notable, could be passed on to the baby through breast-feeding, and this is expanded upon in Chapter 12.2. In these cases the midwife may have to educate the mother about formula feeding methods and sterilisation of feeding utensils. Non-pharmacological measures to suppress lactation should be taken.


Histopathology of diabetic and hypertensive placentas as compared with hypertensive placentas alone. In addition, pregnancies complicated by diabetes may have an increased risk for villitis, chorioamnionitis and funisitis. Probably, the interaction of genetic and environmental factors may explain this increased risk recent data support the role of cytokines and immune response in the pathogenetic mechanisms underlying the effect of glucose intolerance in diabetes mellitus.


Candida is found in the gastrointestinal and vaginal tracts of many healthy adults, and babies pick it up in the vaginal canal during birth. In healthy people, it is usually kept in check by other microbes and by the immune system, so no illness results. But even healthy newborns often get thrush, and it may occur later if they have been treated with antibiotics, which can upset the balance of microbes in their bodies. If thrush persists or keeps coming back, your baby should be checked by your child's doctor to make sure he has no other health problem that is making him susceptible. Candida infections can be very serious in premature infants and in children with cancer, HIV infection, or any weakness of the immune system. In these children, candida infection may spread through the blood to attack the lungs and other organs. This is called systemic candidiasis. (For more information, see Chapter 30, Childhood Infections. )


Premature babies are at risk for infection because they have an immature immune system. Often your baby's doctor will obtain samples of blood, urine, and spinal fluid for analysis to help detect infection in your infant. If an infection is found, it will be treated with medication. Common infections in premature babies include these


The maternal-fetal immune interaction is very complex, and it is difficult to perceive the whole process based on one mechanism of action. Clearly there are multiple mechanisms of peripheral and local tolerance induction during pregnancy that prevent fetal rejection while maintaining a strong and active immune surveillance against viral or bacterial infections, which may endanger the successful outcome and the survival of the species. Some of these mechanisms are discussed in this book. In addition the chapters of Drs. Romero, Lockwood, Kr ssel, Kwak-Kim and Richman present a clinical view of the role of the immune system in normal pregnancy and how its alterations may lead to complications of pregnancy.

That interfaces with

Molecular features of invertebrate immune systems such as the immune effector cells have been retained in mammals. Three genes found in echinoderms encode highly conserved transcription factors NF-kB, GATA-2 3, and Runt-1, which are rapidly upregulated in response to bacterial challenges. SRCR family genes structurally resemble the mammalian macrophage scavenger receptors.6 Vertebrates added to this successful strategy by system, while the thymus evolved later, and its ontogeny is from pharyngeal pouch endoderm. In humans, the third pouch develops into the thymus, while the second develops into the palatine tonsil. The thymus also utilizes evolutionarily conserved immune-neuroendocrine effectors, as its mesenchyme develops from neural crest cells. T and B cells, MHC and antibody production constitute the adaptive or specific portion of the immune system.8

Third trimester

During the final 3 months of pregnancy a baby grows faster than ever, doubling in size, laying down fat stores and putting on around an ounce (28 g) of weight a day. Nerve cells increase, the lungs and immune system mature, the digestive tract develops, bones are strengthened, and stores of fat, iron and calcium are laid down. Bones both lengthen and harden and there are crucial growth spurts in the brain. The mother needs approximately 200 extra calories a day, and the need for protein is at an all-time high (Ford 1994). Her blood volume has by now increased by 40 , and she may be suffering from minor problems and discomforts such as breathless-ness, insomnia, back ache, constipation, piles or heartburn.

Placental Evolution

The ubiquitous challenge of balancing protection against invading foreign organisms with the necessity for the maternal immune system to tolerate the presence of a fetal endograft containing 50 nonself antigens is not unique to primates. Most maternal antibodies misdirected against the fetus are directed against paternally inherited MHC.

Toll Like Receptors

Originally discovered in Drosophila, the Toll gene was found to be critical for dorso-ventricular polarization during embryonic development. However, later studies revealed that Toll also have anti-fungal and anti-bacterial properties in the adult fly.19,20 Subsequently, mammalian Toll was identified and to date, 11 7o homologues have been identified and designated, Toll-like receptor (TLR) l-ll.21,22 Ligation ofTLR by microbial products results in an inflammatory immune response characterized by the production of cytokines and anti-microbial factors. Furthermore, through the regulation of co-stimulatory molecules, TLR may also facilitate the development of adaptive immune responses.14 Toll-like receptors are transmembrane proteins which have an extracellular domain containing leucine-rich repeat motifs. Each receptor differs in their ligand specificity. So while individually, TLR respond to limited ligands, collectively the family ofTLR can respond to a wide range of proteins...

Cytokine Shift

The proliferation, invasion and differentiation of trophoblast cells during implantation is a tightly controlled process coordinated by a system of intercellular signals mediated by cytokines, growth factors and hormones.13,14 An extensive array of cytokines is produced at the tropho-blast-maternal interface that contributes to the well being of the feto-placental unit. Furthermore, these cytokines to a great extent regulate maternal immune responses, which play an important role for a successful pregnancy outcome. It is now recognized that cyokines have extremely diverse biological effects which may involve cell growth, differentiation and function. Their role in regulating human placenta development and implantation has been much discussed in recent years. The field of cytokines and implantation could be divided in two aspects, one is their role as regulators of the immune response and second as factors controlling trophoblast cell growth and implantation. This subject is...

864 Other Resources

A larger concern throughout the provision of services to adolescents may be the attitudes of providers. Are they viewed as problems since their pregnancy presents risks Kenneth R. Ginsberg proposes that professionals look to the patient's strengths, build on them, and reframe the issue in terms of what opportunities are present in the situation 43 . This framework is consistent with Motivational Negotiation 39 and the techniques presented in CenteringPregnancy 36-38 . For example, pregnancy gives a young woman and her partner the chance to expand their knowledge of nutrition so they can produce the healthiest child in the neighborhood. They can use that protein to make brain cells, and consume those vitamins to make a healthy immune system. Ginsberg 43 suggests that we consider resilience theory and move beyond the problem to recognize the competency and strengths of the young woman.

Interassay Variation

Nicked Hcg

Many of the clinicians who managed the 54 false-positive cases were misled by transient decreases in the hCG values after chemotherapy or surgery. This is because the decreases in hCG falsely suggested the presence of disease or indicated the success of therapy. The transient decreases were likely an interim weakening of the immune system after chemotherapy or surgery, reducing circulating heterophilic and antianimal antibody concentrations, leading to decreased false-positive hCG results.


Vaccines protect your child by introducing a small amount of a killed or weakened disease-causing germ or substance into his body. This causes your child's immune system to build up antibodies and other defenses to fight the disease. These defenses that are developed in response to a vaccine remain with your child and enable him to fight off the disease if he is ever exposed to it. In this way, he becomes immune to the disease.

121 introduction

In the United States and Canada, one of the fastest growing populations in the profile of acquired immune deficiency syndrome (AIDS) cases is women 1 , and most women who are currently infected with human immunodeficiency virus (HIV) and AIDS are of childbearing age 2 . These facts support the increasing need to consider the implications of HIV and AIDS on pregnancy and lactation. There is no evidence to indicate that pregnancy and lactation have a significant effect on hastening the progression of HIV disease 3, 4 . However, women who are infected with HIV and are pregnant face a double burden in terms of their immune function and face additional potential complications. For example, HIV-infected pregnant women have higher risks of fetal loss 5, 6 ,


Micronutrient deficiencies are seen more frequently in HIV-infected pregnant women than in HIV-uninfected pregnant women 4 . Deficiencies may be due to physiologic losses, malabsorption, inadequate intake, and lack of knowledge regarding appropriate prenatal nutrition 9 . Poor maternal micronutrient status has consequences for both the mother and the developing infant. Micronutrient deficiencies may result in increased risk for opportunistic infections, more rapid disease progression 31-33 , and an increased risk of vertical transmission of the virus as a result of compromised immune status of the mother 17 . Common micronutrient deficiencies that are seen in people with HIV include vitamin A, B-complex, vitamin C, vitamin E, selenium, and zinc, all of which play an important role in immune function and defense against infection 34-37 and Chap. 23, Micronutrient Status and Pregnancy Outcomes in HIV-Infected Women . Iron and folate supplementation is especially important to promote...

1243Iron and Folate

The Dietary Reference Intakes (DRI) suggests an intake of 27 mg of iron daily and 600 mcg of folate daily to prevent anemia 48, 49 . WHO recommendations regarding supplementation include 400 mcg of folate and 60 mg of iron daily during the last 6 months of pregnancy to prevent anemia and twice daily doses to prevent severe anemia 50 . The WHO recommendation is most applicable to women who reside in resource-limited settings because it takes into consideration the bioavailability of dietary iron, which tends to be limited in developing countries 9 . There are concerns about potential adverse effects of iron supplementation in the setting of HIV infection 51 . Iron is important for immune function 52 but it also serves as a substrate for enzymes involved in HIV replication 53, 54 . More research is needed to clarify the role of iron in HIV infection before current recommendations regarding intake are reconsidered.


Iron facilitates the movement of oxygen from the environment to the body's aerobic tissues via hemoglobin and is also intimately associated with the electron transport chain, making this mineral essential for ATP production. Iron is also a component of several other enzymatic and nonenzymatic proteins 70, 71 . Iron deficiency results in a wide variety of signs and symptoms including anemia, poor immune function, compromised work performance, and altered behavior and cognitive function. Iron bioavailability varies greatly and is highest from animal products. Good dietary sources include meat (and organ meats), enriched cereal products, legumes, nuts, and seeds.

1453 Zinc

Much has been learned about the importance of zinc to human health during the past decade. These physiologic functions include its role as a cofactor for over 50 metal-loenzymes as well as a structural element for numerous other proteins such as zinc fingers 78 . As many of these proteins modulate cellular differentiation, proliferation, and adhesion, zinc is a critical element during fetal growth. Adequate zinc status has also been associated with optimal immune function, protection against oxidative damage, and regulation of cellular death (apoptosis) 79-81 . Zinc also appears to be vital in promoting adequate growth and cognitive function in children 82, 83 . In general, good dietary sources of this mineral include meat, fish, whole milk, and whole-grain products although bioavailability of animal products is greater than plant foods.


The cause of preeclampsia is not fully understood but it may be an immune response by the mother. It runs i n families, and is more common i n younger and older mothers. You are also more likely to develop preeclampsia if you are overweight, have kidney disease or diabetes, or you already suffer from high blood pressure. High blood pressure is one of the main symptoms, along with fluid retention ( edema) in the h ands, feet, and legs and the presence of

The Rh factor

This kind of mismatch usually isn't a problem and is almost never a problem in a first pregnancy. If, however, any of the baby's blood leaks into the mother's circulation, her immune system may form antibodies to the Rh factor. And if any such antibodies reach a significant level in a future pregnancy, they can cross through the placenta into the baby's circulation and begin to destroy the baby's red blood cells. It sounds scary, we know. But the problem isn't insurmountable. In order to prevent it, the doctor usually gives the mother an injection of anti-D immune globulin at certain times to prevent the formation of antibodies. Rhogam and Rhophylac are two common preparations of anti-D globulin. If the baby's father is Rh-positive and you're Rh-negative, your doctor may recommend that you receive anti-D immune globulin at the following times

Herpes Simplex

Prevention Herpes sores are contagious until they are completely crusted over. The saliva of someone with active sores is also contagious. Children with cold sores should not kiss others until the sores are fully healed, and they should not be around anyone with immune system problems. Keep

Measles Rubeola

When to Call Your Child's Doctor Call your child's doctor if your child has any symptoms of measles. Also call if your child is an infant or has a weakened immune system and has been exposed to measles. If your child has measles, call your child's doctor if the child's temperature goes above 103 degrees Fahrenheit. Let the doctor know if your child has an earache, because this could be a sign of a bacterial ear infection. Call if there are signs of a lung infection (pneumonia), including breathing difficulty, a cough that brings up discolored mucus, or lips or nails that are bluish. Seek emergency care if your child has a severe headache, stiff neck, seizure, severe drowsiness, or loss of consciousness. Prevention The measles vaccine is given as part of the mumps-measles-rubella (MMR) shot, given at 12 to 15 months and then again at 5 to 6 years or 11 to 12 years. The measles vaccine is not usually given to infants younger than 12 months unless there is a measles outbreak. The vaccine...


Prevention The Hemophilus influenzae type B vaccine, given to infants beginning at two months, is 70 to 100 percent effective in protecting against this cause of meningitis. Children younger than two years and children with weakened immune systems should be vaccinated against Streptococcus


Symptoms Symptoms vary according to age and response of the immune system. With congenital toxoplasmosis, when a pregnant woman is infected, there is a 10 to 90 percent chance she will pass the infection on to her child, depending on the time of infection. Babies whose mothers were infected in the first trimester tend to have the worst symptoms. Although many children born with the infection have no symptoms early in infancy, others are born prematurely, have liver or bleeding problems, or may have severe birth defects. With infection in an otherwise healthy child, the child may have no symptoms or a few swollen lymph nodes (glands), usually in the neck. There also may be a general ill feeling, fever, sore throat, headache, or rash. The symptoms may resemble those of mononucleosis (see Mononucleosis in this chapter). With infection in a child with a weakened immune system because of AIDS, cancer, or other chronic disease, the infection may involve the brain and nervous system, causing...


Test, which indicates the child has been infected. The infection usually resolves on its own as the child develops immunity over a 6- to 10-week period. But in some cases tuberculosis can progress and spread throughout the lungs and to other organs. Symptoms include fever, night sweats, weight loss, fatigue, loss of appetite, and cough, sometimes with blood-tinged mucus. In other cases, more often in older children and adults, the infection remains dormant, sometimes for years, and then is reactivated when the immune system is weakened. Contagious Periods Someone infected with tuberculosis is very contagious to others because tuberculosis is spread through the air, by coughing or sneezing. TB bacteria can remain airborne for a period of time, long enough for an uninfected person to breathe them in. Anyone with active TB should not be around anyone with immune system problems such as someone with HIV or someone who is receiving chemotherapy.


Non-infective mastitis usually occurs when a blocked duct prevents the flow of milk from one area of the breast. If this is not relieved or cleared, the pressure from the blockage forces the milk into the adjacent tissue, which activates the mother's immune system, causing the mother to complain of 'flu-like symptoms. Her breast becomes red and sore and she starts to sweat. The symptoms come on very quickly indeed and the patient can feel very ill.

Celiac Disease

Celiac disease is a digestive disorder in which there is damage to the small intestine that interferes with absorption of nutrients from foods. It is an autoimmune disease, meaning that the body's immune system attacks some of the body's normal tissues. People with celiac disease, also known as celiac sprue, nontropical sprue, and gluten-sensitive enteropathy, cannot tolerate a protein called gluten, found in wheat, rye, and barley. When people with the disease eat foods with gluten, their immune system responds by attacking and damaging the small intestine. The normal small, fingerlike protrusions called villi on the lining of the small intestine, through which nutrients from food are absorbed into the bloodstream, are lost. Without enough villi, a person may become malnourished, regardless of the amount of food eaten.

Diabetes Mellitus

When children develop diabetes, it's usually because the pancreas stops producing enough insulin. This is called insulin-dependent diabetes mellitus, Type 1 diabetes, or juvenile diabetes. The child's own immune system attacks and destroys the beta cells in the pancreas. Although children with diabetes inherit the susceptibility to develop diabetes in their genes, their immune systems appear to need some


HIV can lead to acquired immune deficiency syndrome (AIDS), in which the body's resistance to diseases is lowered, resulting in infections and a number of other health problems. It is possible to be infected with HIV and not have AIDS. Some people are infected with HIV for years before they get sick. blood, will be positive even if the baby has not been infected with the virus because babies will have their mother's antibodies for as long as 18 months. Uninfected babies will gradually lose their mother's antibodies during this time, whereas infected infants will continue to have antibodies in their blood. By using more recently available tests such as polymerase chain reaction (PCR) or the p24 antigen test, the diagnosis can be made in the first few months of life. Although there are no immediate physical signs of HIV infection at birth, children with HIV can develop infections in the first months of life with germs that usually don't cause problems in uninfected infants, like...


Prevention Children younger than two years, those with weakened immune systems, and other high-risk children should be vaccinated against Streptococcus pneumo-niae. The influenza vaccine is also recommended for high-risk children, including those with chronic lung or heart conditions that can make them more likely to develop pneumonia if they are infected with the virus. Pertussis (whooping cough), which can also lead to pneumonia, is the P part of the routine DTaP vaccine. The Hemophilus influenzae type B vaccine, given to infants beginning at two months, is 70 to 100 percent effective in protecting against infection with this germ. If someone in your house has pneumonia or a respiratory infection that could lead to pneumonia, keep your child away and practice good hygiene, keeping eating utensils separate and washing hands frequently. Complications The mortality rate for children with bacterial pneumonia is less than 1 percent with antibiotic treatment. Almost all children with...

Hepatitis B

Pregnant women tend to get more colds and flu due to the weakened immune system during pregnancy. The body has to lower its defenses to make sure that the baby is not rejected. Unfortunately, pregnant women then become more susceptible to minor flu and colds than before.


When to Call Your Child's Doctor Call your child's doctor whenever an area of your child's skin becomes red, warm, and painful, with or without fever and chills, especially if on the face. Call immediately if your child has a chronic illness like sickle-cell anemia or is receiving treatment that weakens the immune system.

Mechanical Barrier

The concept of mechanical barrier was proposed to explain the lack of immune response in organs such as the brain, cornea, testicles and kidneys. We refer to these tissues as immune privileged sites where an immune response represents a dangerous condition for the tissue. Immune privilege sites are also organs or tissues of the body which, when grafted to conventional (nonprivileged) body sites, experience extended or indefinite survival. Whereas foreign grafts placed at nonprivileged sites are rejected promptly. The pregnant uterus is an example of an immune privilege site. The first reasonable explanation of immune privilege was proposed by Peter Medawar in the late 1940s.3 Medawar proposed that organs such as the anterior chamber of the eye and the brain resided behind blood tissue barriers. The existence of a mechanical barrier, (in the brain the blood brain barrier BBB ), prevents the movement of immune cells in and out of the tissue.4 This barrier created a state of immunologic...

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