Some basic info on Lupus and immunology

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Butterflake
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Date Joined Jun 2006
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   Posted 3/23/2014 11:20 AM (GMT -6)   
Hi Everyone. I bought a great immunology book last year and decided to share some info with you. If you have any questions, please feel free to ask.

Immunology is the study of a body’s reactions to foreign substances introduced into the body. Foreign substances, such as bacteria, viruses, and parasites that are introduced into the body and cause an immune response are called ANTIGENS.

To fight off these foreign substances the body has EXTERNAL DEFENSE SYSTEMS such as unbroken skin, which is the major structural barrier, mucous secretions, tears, saliva, and lactic acid in sweat and the female genital tract.

Some of the INTERNAL DEFENSE SYSTEMS follow:

WHITE BLOOD CELLS (WBCs) seek out foreign cells or particulate matter, then engulf (think eat)the foreigners. Some of these cells move from the circulating blood, through the blood vessels to the infected issues and back to the blood. WBCs include neutrophils, lymphocytes, basophils, mast cells, monocytes and macrophages.

LYMPHOCYTES are the key WBCs involved in the immune response. They are divided into T lymphocytes which help regulate immunity and B lymphocytes which produce ANTIBODIES to the foreign ANTIGENS. Both types of cells recirculate continuously form the bloodstream to the lymph nodes, spleen, appendix, tonsils, and lymphoid tissue and back to the bloodstream in an effort to increase contact with foreign antigens.

CYTOKINES are cell messengers that are proteins produced by several types of cells. Cytokines regulate white blood activity.

C-REACTIVE PROTEIN (CRP) is a trace substance in the blood that increases rapidly within 4 to 6 hours following infection, surgery, or other trauma to the body. CRP acts somewhat like an antibody and is capable of coating foreign particles. It also activates Complement.

COMPLEMENT is a complex series of proteins in the blood that interact in a very specific way to enhance the body’s defense mechanisms against foreign cells. While complement promotes coating and destruction of foreign cells, chronic activation of Complement can lead to inflammation and tissue damage.

In SYSTEMIC LUPUS ERYTHEMATOSUS, T and B lymphocytes (WBC) are uncontrolled leading to the production of autoantibodies. Additionally when the body’s cells and foreign cells break up, the cell debris is not engulfed and cleared which can lead to excess amounts DNA and RNA. Now it is known that Lupus is associated with more than 25 autoantibodies such as Anti-ds-DNA, Anti-ss-A (Ro), Anti-ss-B (La), and Anti-Sm. The immune system is so overwhelmed by the autoantibodies that the antigen-antibody complexes deposit into the tissues. There they bind complement, causing damage to the particular tissue in which they are deposited. Sites in which this typically occurs include the kidneys, joint linings, blood vessel cells, and lungs.

Benlysta stops B lymphocytes from producing autoantibodies.

Love, Butterflake
SLE '05, Sjogrens, fibro, Raynaud's, major depressive disorder, CNS problems, diastolic heart dysfunction, GERD, 1st stage kidney disease. Many meds: better living through chemistry

Donna
Sjogren's Moderator

couchtater
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Date Joined Jul 2009
Total Posts : 14475
   Posted 3/23/2014 1:34 PM (GMT -6)   
Thanks, Donna. I knew some of the basics but this really helped me on seeing the whole picture.

On my last bloodwork my lymphocytes were higher than normal. Does that mean I'm getting worse in build up of B cells?
Joy
Lupus, Fibromyalgia, Glaucoma, Asthma, Hypothyriodism, Sleep Apnea, OA, Depression, Allergies, and benign familia tremors

When life throws you lemons....
Pick them up and throw them right back at them! :))

oreo11
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Date Joined Feb 2011
Total Posts : 399
   Posted 3/23/2014 1:51 PM (GMT -6)   
Hi Donna,

Thanks for the information!! That was awesome and helped my understanding of the process behind autoimmunity a little more. And Joy, lymphocytes can also go up when you have an infection. My white counts always seem to go down when I am experiencing a moderate to severe flare. Have a great Sunday! It's beautiful here in Northern California.

Laura

acquiesce
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Date Joined Jan 2014
Total Posts : 360
   Posted 3/24/2014 6:03 AM (GMT -6)   
Thanks Donna! What's the name of the book?
UCTD , livedo reticularis, Raynauds, cold urticaria, endometriosis, bursitis, arthritis, Sjorgens, anemia, leukocytosis, vasculitis, pleurisy, asthma and all that fun stuff!

Plaquenil, celebrex, advair, flovent, dovobet, vitamin A,B,C,D,E fghijklmnop ;)

Be who you are and say what you feel because those who mind don't matter and those who matter don't mind - Dr. Seuss

Butterflake
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Date Joined Jun 2006
Total Posts : 1650
   Posted 3/25/2014 4:13 PM (GMT -6)   
The name of the book is Clinical Immunology & Serology A Laboratory Perspective third edition by Christine Stevens.

As for understanding the lymphocyte count and infection, when a Complete Blood Count (CBC) is run the White Blood Cell (WBC) portion (usually at the top of the CBC) is the total number of WBCs. Many, many years ago to get a total WBC count, a diluted sample of blood was placed in a counting chamber and the WBCs were counted under a microscope. The fancy machines of today automatically dilute, count, and calculate just as if you were counting under the microscope.

The analyzers of today also simultaneously run several other portions of the CBC. A very important part of this is the Differential. In the Diff the technologist or machine starts counting the kinds of WBCs seen until 100 is reached. That gives you a percentage most of which are Neutrophils and Lymphocytes. So if you count 90 Neutrophils you can only have 10 Lymphocytes (90+10 = 100 I'm disregarding the other types of WBCs for this example.)

If you have a bacterial infection your total WBC count is elevated and you almost always have increased Neutrophils.

If you have a viral infection your total WBC count is lower than normal and you usually have increased Lymphocytes.

Joy, I re-read what I wrote and it sounds like I said with Lupus all the lymphocytes are out of control. Well our differential is about the same as anyone else, unless like Laura said you have an infection of some sort. What's very abnormal in lupus is the lymphocytes producing all those autoantibodies. The other very abnormal thing for us is the cell debris left that has nothing to clean it up and since all cells contain DNA and RNA this debris increases the amount of DNA and RNA that we have.

Thanks for the question! Love, Donna
SLE '05, Sjogrens, fibro, Raynaud's, major depressive disorder, CNS problems, diastolic heart dysfunction, GERD, 1st stage kidney disease. Many meds: better living through chemistry

Donna
Sjogren's Moderator

couchtater
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Date Joined Jul 2009
Total Posts : 14475
   Posted 3/25/2014 6:29 PM (GMT -6)   
I'm sorry I got mixed up on my lymphocytes count. It has slowly been dropping. It's now below normal (17.2/ range 18-48). Four years ago it was 23.4 and it hit 27 around the time I got sick. Since then it has slowly dropped.
Joy
Lupus, Fibromyalgia, Glaucoma, Asthma, Hypothyriodism, Sleep Apnea, OA, Depression, Allergies, and benign familia tremors

When life throws you lemons....
Pick them up and throw them right back at them! :))

Butterflake
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Date Joined Jun 2006
Total Posts : 1650
   Posted 3/26/2014 9:30 AM (GMT -6)   
Some of the meds we take cause the total WBC count to drop. If it drops dangerously low you can't fight any infections which, of course, is a very bad thing. I don't know how long it has taken for your lymphocyte count to drop from 27 to 17, but if it's been a couple of years I wouldn't worry about it. To put your mind at ease, ask your doc. I'll see if I can find anything. Love, Donna
SLE '05, Sjogrens, fibro, Raynaud's, major depressive disorder, CNS problems, diastolic heart dysfunction, GERD, 1st stage kidney disease. Many meds: better living through chemistry

Donna
Sjogren's Moderator
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