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Immune System Case Study 6: Splinter Response

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Brian Wu

on 24 February 2013

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Transcript of Immune System Case Study 6: Splinter Response

Case Study 6 A splinter from your display ends up in your hand. You pull it out, but later that night your finger becomes swollen and red. A few days later, the entire hand is swollen, the pain is intense, and you develop a fever What is going on? Initial Contraction Brian was just making the finishing touches to his science fair project display that was to be presented in a few days when he felt a sharp prick in his hand. He looked down to see a small wooden splinter from the display stuck in his right hand. He quickly pulled it out and continued his work. Later that night, Brian noticed that his right hand had swollen a little and noticeably more red than the left. He shrugged it off and went to bed. Development of Symptoms A couple days passed, and Brian didn't mention the splinter to anyone having completely forgotten about it. However, when the day of the science fair came, Brian had no intention of making it as he lay in bed dealing with a lot of pain. He had developed a fever while his right hand had also become completely swollen. As Brian lay in bed, he kept asking himself, "What is going on? Why is this happening?" Bacterial Infection The splinter that had pierced Brian's hand a few days before had broken through his skin, a part of the first line of defense against bacteria and viruses. Upon further research, Brian realized that he must have contracted the bacterial infection Cellulitis from the splinter having shown the symptoms characterizing it. In his case, the invading bacteria would be Group A streptococcus.

Streptococcus bacteria exists on the skin and throats of people without any ill effect, however, the splinter gave the bacteria access to Brian's body. The bacteria makes enzymes that break down the skin while also allowing the bacteria to spread and also producing toxins that initiate an immune response.

bacteria- A member of a large group of unicellular microorganisms lacking organelles and an organized nucleus, including some that can cause disease. Nonspecific Immunity: Inflammatory Response Brian's body responded to the bacteria with a
form of nonspecific immunity known as
inflammatory response, caused by multiple
chemical signals triggered by the bacteria's entry
into the body. The splinter Brian had aided the
bacteria past the first line of defense of
external defense including the skin and its
secretions, as well as any mucous membranes
as it is evident that the bacteria was not

nonspecific immunity- immediate defense
against nonspecific infection and pathogens

inflammatory response- response of vascular
tissues to harmful stimuli such as pathogens,
damaged cells, or irritants The inflammatory response begins
when the mast cells present in the
connective tissues of the body release
histamine in response to being damaged
by the splinter and streptococcus

histamine- an organic nitrogen compound
involved in local responses; triggers the
inflammatory response The release of histamine triggers the dilation and increased permeability of nearby capillaries of the splinter. Activated macrophages and other cells then release their additional signals to further promote blood flow at the injured site. This increased local blood supply causes the redness found on Brian's right hand. The blood engorged capillaries leak fluid into neighboring tissues around the injured area, causing the initial swelling in Brian's hand. Heating and swelling from this capillary dilation help deliver antimicrobial proteins and clotting elements to the splintered area.

marophages- cells which protect teh body by ingesting foreign particles, bacteria, and dead or dying cells through phagocytosis

capillary dilation- the widening of blood vessels Several activated complement proteins may promote the release of histamine and attract other phagocytes to the splintered area. Blood clotting that occurs helps begin the reparation process around the wound and helps block the spread of the bacteria from the injured area to other
parts of the body.

Increased local blood flow around the splintered area and vessel permeability allow more neutrophils and macrophages to move from the blood into the injured tissue. These are
responsible for the phagocytosis of the invading
bacteria. Chemokines secreted by the
endothelial cells and blood vessels
direct the migration of these phagocytes to the
splintered area. They are also responsible for signaling the increased production of microbe killing compounds. neutrophils- the most abundant of the four types of white blood cells (leukocytes) that are phagocytotic

chemokines- Small cell signaling protein molecules that are secreted by numerous cells and are a category of signaling molecules used extensively in intercellular communication.

complement proteins- proteins that make up the complement system that help to lead to lysis of invading microbes/cells The bacterial infection had become more severe over the course of the few days that had passed after the initial contraction (previous local inflammation) of bacteria from the splinter, thereby launching a systemic response. Because of this, injured cells secreted chemicals that stimulated the release of additional neutrophils. A fever may occurred when certain toxins produced by the bacteria and substances (pryogens) released by macrophages set the hypothalamus’ internal thermostat at a higher temperature. The fever that sets in facilitates phagocytosis of the neutrophils and macrophages. Speeding up the body reactions by the heat should also hasten the repair process of the affected tissues. Nonspecific Immunity: Systemic Response Resolution: Antibiotics

Brian, having gained an understanding of his body’s immune response to the splinter and Group A streptococcus that was causing his cellulitis, went to see Dr. Sohn. He prescribed an antibiotic called dicloxacillin (DYNAPEN) to be taken for 10 days to prevent Brian’s cellulitis from spreading to other parts of the body. Dr. Sohn also told Brian to make sure whenever possible, to allow his swelled up hand to be kept immobile and elevated to reduce swelling. Dr. Sohn recommends...
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