Transplant Rejection

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The immune system recognizes and attacks anything different from the substances normally present within an individual, even substances that are only slightly different, such as transplanted tissues and organs (see Medical Transplantation).

When an organ is transplanted, the MHC of the donor organ is recognized as foreign and attacked by the recipient’s immune system. To minimize the chances of transplant rejection, physicians seek transplant donors who share as many MHC genes as possible with the transplant recipient. Even then, most transplant recipients are given drugs to suppress their immune response and prevent rejection of the transplant.

If the transplanted tissue contains T lymphocytes from the donor, as in bone marrow transplants, these donor T lymphocytes may recognize the recipient’s tissues as foreign and attack them. Physicians can reduce or prevent this potentially fatal graft-versus-host (GVH) reaction by removing all mature T lymphocytes from the organ or tissue before performing the transplant.

Allergy

Allergy, sometimes called hypersensitivity, is caused by immune responses to some antigens. Antigens that provoke an allergic response are known as allergens. The two major categories of allergic reaction, rapid and delayed, correspond to the two major types of immune responses.

Rapid allergic reactions, such as those to bee venom, pollen or pets, are caused by humoral immune mechanisms. These immediate hypersensitivity reactions result from the production of IgE antibodies when a person is first exposed to an allergen. The IgE antibodies become attached to mast cells—white blood cells containing histamine, the chemical that causes the familiar allergic symptoms of runny nose, watery eyes, and sneezing. Mast cells are particularly abundant in the lungs and intestine. If the antigen-binding sites of mast cells become filled with an allergen, the mast cells release histamine.

Allergic reactions that are slow in onset (known as delayed-type hypersensitivity, or DTH), such as those to poison ivy or poison oak, are cell mediated. Extreme examples of DTH occur when macrophages cannot easily destroy invading substances. As a result, T cells are activated, leading to inflammation of the body tissue. This inflammation continues for as long as the T cells are activated. The bacterium that causes tuberculosis also falls into this category because this bacterium is covered with a waxy coat that macrophages cannot destroy. The resulting DTH leads to the lung and liver damage associated with tuberculosis.

Immune System Disorders

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Disorders of the immune system can range from the less serious, such as mild allergy, to the life threatening, such as more serious allergy, transplant rejection, immune deficiencies, and autoimmune diseases.

A. Allergy
B. Transplant Rejection
C. Immune Deficiency
D. Autoimmune Diseases

Vitamin and Mineral Chart

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Vitamins and Minerals

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Both vitamins and minerals are needed by the body in very small amounts to trigger the thousands of chemical reactions necessary to maintain good health. Many of these chemical reactions are linked, with one triggering another. If there is a missing or deficient vitamin or mineral—or link—anywhere in this chain, this process may break down, with potentially devastating health effects. Although similar in supporting critical functions in the human body, vitamins and minerals have key differences.

Among their many functions, vitamins enhance the body’s use of carbohydrates, proteins, and fats. They are critical in the formation of blood cells, hormones, nervous system chemicals known as neurotransmitters, and the genetic material deoxyribonucleic acid (DNA). Vitamins are classified into two groups: fat soluble and water soluble. Fat-soluble vitamins, which include vitamins A, D, E, and K, are usually absorbed with the help of foods that contain fat. Fat containing these vitamins is broken down by bile, a liquid released by the liver, and the body then absorbs the breakdown products and vitamins. Excess amounts of fat-soluble vitamins are stored in the body’s fat, liver, and kidneys. Because these vitamins can be stored in the body, they do not need to be consumed every day to meet the body’s needs.

Water-soluble vitamins, which include vitamins C (also known as ascorbic acid), B1 (thiamine), B2 (riboflavin), B3 (niacin), B6, B12, and folic acid, cannot be stored and rapidly leave the body in urine if taken in greater quantities than the body can use. Foods that contain water-soluble vitamins need to be eaten daily to replenish the body’s needs.

In addition to the roles noted in the VITAMIN AND MINERAL CHART, vitamins A (in the form of beta-carotene), C, and E function as antioxidants, which are vital in countering the potential harm of chemicals known as free radicals. If these chemicals remain unchecked they can make cells more vulnerable to cancer-causing substances. Free radicals can also transform chemicals in the body into cancer-causing agents. Environmental pollutants, such as cigarette smoke, are sources of free radicals.

Minerals are minute amounts of metallic elements that are vital for the healthy growth of teeth and bones. They also help in such cellular activity as enzyme action, muscle contraction, nerve reaction, and blood clotting. Mineral nutrients are classified as major elements (calcium, chlorine, magnesium, phosphorus, potassium, sodium, and sulfur) and trace elements (chromium, copper, fluoride, iodine, iron, selenium, and zinc).

Vitamins and minerals not only help the body perform its various functions, but also prevent the onset of many disorders. For example, vitamin C is important in maintaining our bones and teeth; scurvy, a disorder that attacks the gums, skin, and muscles, occurs in its absence. Diets lacking vitamin B1, which supports neuromuscular function, can result in beriberi, a disease characterized by mental confusion, muscle weakness, and inflammation of the heart. Adequate intake of folic acid by pregnant women is critical to avoid nervous system defects in the developing fetus. The mineral calcium plays a critical role in building and maintaining strong bones; without it, children develop weak bones and adults experience the progressive loss of bone mass known as osteoporosis, which increases their risk of bone fractures.

Vitamins and minerals are found in a wide variety of foods, but some foods are better sources of specific vitamins and minerals than others. For example, oranges contain large amounts of vitamin C and folic acid but very little of the other vitamins. Milk contains large amounts of calcium but no vitamin C. Sweet potatoes are rich in vitamin A, but white potatoes contain almost none of this vitamin. Because of these differences in vitamin and mineral content, it is wise to eat a wide variety of foods.

Fats

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Fats, which provide 9 calories of energy per gram, are the most concentrated of the energy-producing nutrients, so our bodies need only very small amounts. Fats play an important role in building the membranes that surround our cells and in helping blood to clot. Once digested and absorbed, fats help the body absorb certain vitamins. Fat stored in the body cushions vital organs and protects us from extreme cold and heat.

Fat consists of fatty acids attached to a substance called glycerol. Dietary fats are classified as saturated, monounsaturated, and polyunsaturated according to the structure of their fatty acids (see Fats and Oils). Animal fats—from eggs, dairy products, and meats—are high in saturated fats and cholesterol, a chemical substance found in all animal fat. Vegetable fats—found, for example, in avocados, olives, some nuts, and certain vegetable oils—are rich in monounsaturated and polyunsaturated fat. As we will see, high intake of saturated fats can be unhealthy.

To understand the problem with eating too much saturated fat, we must examine its relationship to cholesterol. High levels of cholesterol in the blood have been linked to the development of heart disease, strokes, and other health problems. Despite its bad reputation, our bodies need cholesterol, which is used to build cell membranes, to protect nerve fibers, and to produce vitamin D and some hormones, chemical messengers that help coordinate the body’s functions. We just do not need cholesterol in our diet. The liver, and to a lesser extent the small intestine, manufacture all the cholesterol we require. When we eat cholesterol from foods that contain saturated fatty acids, we increase the level of a cholesterol-carrying substance in our blood that harms our health.

Cholesterol, like fat, is a lipid—an organic compound that is not soluble in water. In order to travel through blood, cholesterol therefore must be transported through the body in special carriers, called lipoproteins. High-density lipoproteins (HDLs) remove cholesterol from the walls of arteries, return it to the liver, and help the liver excrete it as bile, a liquid acid essential to fat digestion. For this reason, HDL is called “good” cholesterol.

Low-density lipoproteins (LDLs) and very-low-density lipoproteins (VLDLs) are considered “bad” cholesterol. Both LDLs and VLDLs transport cholesterol from the liver to the cells. As they work, LDLs and VLDLs leave plaque-forming cholesterol in the walls of the arteries, clogging the artery walls and setting the stage for heart disease. Almost 70 percent of the cholesterol in our bodies is carried by LDLs and VLDLs, and the remainder is transported by HDLs. For this reason, we need to consume dietary fats that increase our HDLs and decrease our LDL and VLDL levels.

Saturated fatty acids—found in foods ranging from beef to ice cream, to mozzarella cheese to doughnuts—should make up no more than 10 percent of a person’s total calorie intake each day. Saturated fats are considered harmful to the heart and blood vessels because they are thought to increase the level of LDLs and VLDLs and decrease the levels of HDLs.

Monounsaturated fats—found in olive, canola, and peanut oils—appear to have the best effect on blood cholesterol, decreasing the level of LDLs and VLDLs and increasing the level of HDLs. Polyunsaturated fats—found in margarine and sunflower, soybean, corn, and safflower oils—are considered more healthful than saturated fats. However, if consumed in excess (more than 10 percent of daily calories), they can decrease the blood levels of HDLs.

Proteins

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Dietary proteins are powerful compounds that build and repair body tissues, from hair and fingernails to muscles. In addition to maintaining the body’s structure, proteins speed up chemical reactions in the body, serve as chemical messengers, fight infection, and transport oxygen from the lungs to the body’s tissues. Although protein provides 4 calories of energy per gram, the body uses protein for energy only if carbohydrate and fat intake is insufficient. When tapped as an energy source, protein is diverted from the many critical functions it performs for our bodies.

Proteins are made of smaller units called amino acids. Of the more than 20 amino acids our bodies require, eight (nine in some older adults and young children) cannot be made by the body in sufficient quantities to maintain health. These amino acids are considered essential and must be obtained from food. When we eat food high in proteins, the digestive tract breaks this dietary protein into amino acids. Absorbed into the bloodstream and sent to the cells that need them, amino acids then recombine into the functional proteins our bodies need.

Animal proteins, found in such food as eggs, milk, meat, fish, and poultry, are considered complete proteins because they contain all of the essential amino acids our bodies need. Plant proteins, found in vegetables, grains, and beans, lack one or more of the essential amino acids. However, plant proteins can be combined in the diet to provide all of the essential amino acids. A good example is rice and beans. Each of these foods lacks one or more essential amino acids, but the amino acids missing in rice are found in the beans, and vice versa. So when eaten together, these foods provide a complete source of protein. Thus, people who do not eat animal products can meet their protein needs with diets rich in grains, dried peas and beans, rice, nuts, and tofu, a soybean product.

Some health conditions, such as illness, stress, and pregnancy and breast-feeding in women, place an enormous demand on the body as it builds tissue or fights infection, and these conditions require an increase in protein consumption. For example, a healthy woman normally needs 45 grams of protein each day. Experts recommend that a pregnant woman consume 55 grams of protein per day, and that a breast-feeding mother consume 65 grams to maintain health.

A man of average size should eat 57 grams of protein daily. To support their rapid development, infants and young children require relatively more protein than do adults. A three-month-old infant requires about 13 grams of protein daily, and a four-year-old child requires about 22 grams. Once in adolescence, sex hormone differences cause boys to develop more muscle and bone than girls; as a result, the protein needs of adolescent boys are higher than those of girls.