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DefinitionImmunosuppression is a disorder or condition where the immune response is reduced or absent.
Causes, incidence, and risk factors
The immune system protects the body from potentially harmful substances ( antigens ) such as microorganisms, toxins , cancer cells, and blood or tissues from another person.
The immune response consists of general actions, such as phagocytosis, in which white blood cells engulf and destroy foreign material. It also protects against specific antigens by producing antibodies (immunoglobulins), which are molecules that attach to a specific antigen and make destruction of the antigen more efficient.
It also protects against specific antigens by producing lymphocytes (a group of white blood cells) that become specialized (sensitized). The sensitized lymphocytes recognize and destroy the foreign substance.
Lymphocytes (the specialized white blood cells that provide acquired immunity) are produced or mature in various lymphoid tissues. Lymphocytes are divided into two groups: T lymphocytes and B lymphocytes.
T lymphocytes become the sensitized lymphocytes that directly attack antigens ( cellular immunity ).
B lymphocytes produce antibodies ( humoral immunity ) that attach to the antigen and make phagocytes and body chemicals, such as complement proteins, much more efficient in the destruction of the antigen.
This causes persistent or recurrent infections, severe infections by organisms that are normally mild, incomplete recovery from illness or poor response to treatment, and an increased incidence of cancer and other tumors. Opportunistic infections are widespread infections by microorganisms that are usually controllable.
Congenital disorders affecting the T lymphocytes may cause increased susceptibility to fungi, resulting in repeated Candida (yeast) infections. Inherited combined immunodeficiency affects both T lymphocytes and B lymphocytes. It is often fatal within the first year of life because there is no resistance to disease or infection.
Immunosuppression is also a common side-effect of chemotherapy to treat many types of cancer, because the chemotherapy often reduces the number of white blood cells available to fight infection.
Those who have had a splenectomy (spleen removal) face a higher risk of infection from certain encapsulated bacteria which the spleen would normally help fight.
SymptomsThe symptoms vary with the specific disorder.
Signs and testsPersistent, recurrent infections, or severe infection by microorganisms that do not usually cause severe infection, may be clues that an immunodeficiency disorder is present. Other clues include:
Usually, the immune response is a desired effect. Even deliberate immunosuppression (in the treatment of autoimmune disorders for example) attempts to maintain a balance between suppression of parts of the immune system and the ability to fight disease and infection.
Persons with HIV and AIDS may take combinations of drugs to reduce the amount of virus in their immune systems, thus improving their immunity.
Patients undergoing a planned splenectomy should be vaccinated 2 weeks prior to the surgery against encapsulated organisms, such as Streptococcal pneumonia.
Expectations (prognosis)Some immunodeficiency disorders are mild and result in occasional illness. Others are severe and may be fatal. Immunosuppression that results from medications is often reversible once the medication is stopped.
Calling your health care provider
Call your health care provider immediately if you are taking immunosuppressive drugs (e.g., chemotherapy or prednisone), and you develop a fever greater than 100.5F, or have cough with shortness of breath. If a stiff neck and headache accompany your fever, go directly to an emergency department.
Contact your health care provider if you have recurrent yeast infections or oral thrush.
PreventionThere is no known prevention for congenital immunodeficiency disorders. Safe sex practices and avoiding the sharing of body fluids may help to prevent HIV infection and AIDS. Good nutrition may prevent acquired immunodeficiency caused by malnutrition.
Suppression of the immune system may be desired in the treatment of certain disorders, or it may be a side effect of some treatments.
Update Date: 8/18/2003David Webner, M.D., Sports Medicine Fellow, Crozer-Keystone Family Practice Program, Springfield, PA. Review provided by VeriMed Healthcare Network.
Last updated: Tue, 06 Jan 2009 00:20:03 GMT