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Chapter 12:
Immunity and Healing
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Introduction
• Pathogens: disease-causing agents
• Immunity: protection from or resistance to infection and
disease
• Immune system: group of organs and tissues throughout
body
• Immunity and healing processes profoundly affected by
stress, emotions, beliefs, and attitudes
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Organs and Tissues of Immune System
• Not physically connected, but scattered throughout body
• Some structural components of cardiovascular,
lymphatic, and endocrine systems
• 2 broad groups:
– Primary lymphoid organs and tissues where
lymphocytes are produced
– Secondary lymphoid organs and tissues: sites where
most immune responses occur
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Organs and Tissues of Immune System
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Primary Lymphoid Organs and Tissues
• Organs and tissues that produce lymphocytes:
– Red bone marrow
– Thymus
• Lymphocytes target specific pathogens
• 2 types of lymphocytes:
– B cells
– T cells
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Secondary Lymphoid Organs and Tissues
• Sites where most specific immune responses occur
• Mucosa-associated lymphoid tissue (MALT):
– Lymph nodes
– Spleen
– Tonsils (see Figure 12-3)
– Peyer patches
• Manual therapy contraindicated with enlarged spleen or
severe infection
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Pathology Alert: Tonsillitis
• Inflammation of tonsils
• Viral or bacterial infection
• Common signs and symptoms:
– Red, swollen tonsils, may have white patches
– Sore throat, pain or difficulty swallowing
– Headache, fever, and chills
• Manual therapy contraindicated
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Nonspecific Immune Defenses
• Generic and universal immune responses
• Also called innate immune defenses
• Responses not stimulated by or directed toward single
type of pathogen or foreign invader
• Include physical and chemical barriers
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Physical Barriers
• Physical barriers:
– Epidermis of skin
– Mucous membranes lining respiratory, digestive, and
reproductive tracts
• Barriers that physically block microbes from entering
body
• If barrier is broken, pathogens can enter
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Chemical Barriers
• Sebum: protective acidic barrier on skin surface
• Sweat: enzymes and pH discourage microbial growth
• Tears, saliva: wash away microbes, contains antimicrobial
protein lysozyme
• Gastric juice: destroys pathogens that reach stomach
• Urine: flushes urethra, pH inhibits microbial growth
• Vaginal secretions: flushes vagina, acidic pH inhibits
bacterial growth
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Internal Antimicrobial Proteins
• Interferons: protect surrounding uninfected cells from
viral infection
• Complement proteins: support phagocytosis, microbe
destruction, inflammation
• Transferrins: bind with iron to inhibit bacterial growth
• Antimicrobial peptides: cause cytolysis of microbes
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Phagocytes and Natural Killer Cells
• Neutrophils and macrophages
– Eat microbes and cellular debris
– Phagocytosis (see Figure 12-4)
• NK cells
– Lymphocytes found in blood
– Kill infected cells through cytolysis
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Inflammation and Fever
• Inflammation
– Fights infectious agents by increasing vasodilation,
capillary permeability, and phagocytosis
– Prepares tissue for repair
• Fever
– Speeds up metabolism to facilitate tissue repair
– Kills or inhibits growth of certain bacteria
– Increases effect of interferons
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Pathology Alert: Allergies
• Allergic reaction: excessive immune response to an
antigen (allergen)
• Allergens can be inhaled, ingested, injected, implanted,
or contact skin
• Reaction marked by massive histamine and heparin
release with several physiological effects
• Most allergic responses localized
• Anaphylaxis: widespread response, can be fatal
• Manual therapists: avoid substances that may stimulate
allergic response
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Antibody-Mediated Immune Responses
• Specific immune responses:
– Triggered by specific pathogens
– B and T lymphocytes
– Create immunological memory
• Antibody-mediated immunity (humoral immunity)
– Activation of B lymphocytes to produce antibodies
that render antigens harmless
– See Figure 12-5
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Pathology Alert: Autoimmune Disease
• Autoimmune disorder or disease: immune system attacks
person’s own cells
• Common autoimmune disorders:
– Multiple sclerosis (MS), rheumatic fever, rheumatoid
arthritis
– Systemic lupus erythematosus, scleroderma,
ulcerative colitis, type 1 diabetes, myasthenia gravis
• Exact causes not well understood
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Cell-Mediated Immune Responses
• Cell-mediated immunity (see Figure 12-6)
– Activates several categories of T lymphocytes
• Cytotoxic T cells that directly destroy the antigen
• Memory T cells “remember” particular antigen
• Helper T cells, suppressor T cells
• Manual therapy: precautions for immune-compromised
clients
• Vaccinations recommended for manual therapists
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Acquisition of Immunity
• Immunological memory
– Memory cells produced with each episode of specific
immune response
– Accounts for how individuals acquire immunity to
many diseases
• Immunity acquired naturally or artificially
– Both have active and passive mechanisms
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Naturally Acquired Immunity
• Naturally acquired active immunity
– Exposure to antigen initiates specific response
resulting in formation of cells
– Once recovered, body retains resistance through
immunological memory
• Naturally acquired passive immunity
– Antibody transfer from mother to baby across
placenta and through breast-feeding
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Artificially Acquired Immunity
• Artificially acquired active immunity
– Vaccination delivers dead or altered pathogens or
synthesized antigens
– Results in formation of antibodies and long-lasting
resistance through immunological memory
• Artificially acquired passive immunity
– Immunization delivers antibodies - immediate but
short-term immunity
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Aging and the Immune System
• Immune defenses generally decline with age
– Less responsive
– Slower response
– Decreasing T and NK cells
– Less responsive to vaccinations
• Incidence of cancer and autoimmune disorders increases
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Psychoneuroimmunology
• PNI: the study of links among nervous, endocrine,
digestive, and immune systems
• Research supports mind–body connection
• 2 body-wide communication networks:
– Autonomic nervous system
– Vast chemical network of “information molecules”
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Peptide Communication Network
• Peptides travel throughout body
• Hundreds of chemicals communicate and stimulate cells
• Collectively called ligands
• Communication web of peptides and receptors:
– Strong functional link between immune responses
and emotional states
– Mind–body–spirit connection
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Holistic Healing
• Disease: any disruption to dynamic balance of body,
mind, and spirit causing physical, mental, or emotional
trauma
• Clients’ belief in value manual therapy can have powerful
benefits even when not explained by medical science
• Some benefits of manual therapy subjective and difficult
to measure
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