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    Immunology

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    Immunoglobulins: Produced by B lymphocytes in response to foreign or self antigens. Two light chains: kappa or lambda. Two heavy chains: alpha, gamma, delta, epsilon or mu.

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    Immunology

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    api-3773559
    511 views44 pages
    Immunoglobulins: Produced by B lymphocytes in response to foreign or self antigens. Two light chains: kappa or lambda. Two heavy chains: alpha, gamma, delta, epsilon or mu.

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    Immunoglobulins: Produced by B lymphocytes in response to foreign or self antigens. Two light chains: kappa or lambda. Two heavy chains: alpha, gamma, delta, epsilon or mu.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    511 views44 pages

    Immunology

    Uploaded by

    api-3773559
    Immunoglobulins: Produced by B lymphocytes in response to foreign or self antigens. Two light chains: kappa or lambda. Two heavy chains: alpha, gamma, delta, epsilon or mu.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 44

    Unit 22 Clinical laboratory

    immunology
    The body
    against others
    and itself.
    Objectives, to know the
    tests in
     Immune disease
     Autoimmune disease
     Infectious disease
     Allergies
     Inflammatory diseases
     Complement diseases
     Arthritis.
    Immunoglobulins:
     Produced by B lymphocytes in
    response to foreign or self antigens.
     Two light chains: kappa or lambda.
     Two heavy chains: alpha, gamma,
    delta, epsilon or mu.
     Immunoglobulins: IgA, IgG, IgD,
    IgE and IgM.
    Immunoglobulins:
    Form Found in Function
    IgM Penta ECF,membrane 1st response.
    IgG Mono ECF Toxin, activates
    complement.
    IgA Dimer ECF, secretions Antimicrobial.
    IgE Mono ECF Anti allergic/
    anti parasites.
    IgD Mono ECF,membrane Unknown.
    Immunoglobulin deficiency:
     Normal: IgM and IgA are low at
    birth and for months after.
     Inherited agammaglobulinaemia:
    the “boy in the bubble”.
     Acquired: malnutrition, malignancy,
    infections, drugs, overstress.
    Immunoglobulin excess
     Paraproteins in cancers –
    monoclonal. Unit 13.
     Autoimmune disease –
    polyclonal. Units 15, 21, 22,
    24,25
     Infections –polyclonal. Unit
    22.
    Some autoimmune diseases
    and laboratory tests:
    Systemic lupus Anti nuclear antibodies
    erythematosus ANA
    Arthritis ANA,Rheumatoid factor
    Sjogren’s,scleroderma Extractable Nuclear Ag
    Vasculitis Antineutrophil
    cytoplasmic antibodies
    Anti self Human leukocyte Antig
    Thyroiditis Antithyroid antibody
    Infections, symptoms:
     Pain, heat, redness, swelling.
     Toxic reactions: rashes , muscle pains,
    cardio respiratory, gastrointestinal.

     Acute: fever, chills, flushing, increased


    pulse.
     Chronic: fatigue, lassitude, weight loss.
    Infective organisms:
     Viruses
     Bacteriophage, plasmids, transposons.
     Bacteria
     Chlamydia, rickettsia, mycoplasma.
     Fungi,
     Protozoa
     Helminths
     Ectoparasites.
    Infections, laboratory work:
     Erythrocyte sedimentation rate, ESR
     Complete blood count, CBC
     Serum C-reactive protein, CRP
     Serum IgG, IgM.
     Serology – specific tests for
    organisms.
     DNA and RNA based tests.
    Laboratory work in
    infectious diseases:
     Most bacteria found by culture.
     Serological test for antibodies against
    bacteria are used for:
    3. Population studies post infection.
    4. Current or recent infection where culture
    is negative.
    5. Fever of unknown origin > 2-3 weeks.
    6. Unique applications.
    Immunology issues:
     Is there an antibody?
     Can it be measured?
     Is it increasing or decreasing
    in amount?
    Infections, serology and
    other NPLEx tests:
    1. Antistreptolysin O:
    streptococcus pyogenes.
    Note: this is by titration.
    Increases a week after infections
    Peaks at 3-5 weeks.
    6-12 months to normal.
    NPLEx infectious serology:
    2. Chlamydia.

    Note: may be STD or from


    parrots.
    50% men 70% women have no
    symptoms.
    NPLEx infectious serology:
    3. Cytomegalovirus IgG and
    IgM.
    4. Epstein Barr virus:
    Monospot IgG.
    5. Escherichia coli:
    NPLEx infectious serology:
    6. Helicobacter pylori.

    IgG and IgA seen in 80-100%


    with infection.
    Elderly 60% positive.
    NPLEx infectious serology:
    7. Hepatitis viruses A, B, C, D,
    E.
    8. Herpes simplex: HSV1,
    HSV2.
    Most adults have had this.
    Infectious disease testing
    (continued)
    9. Human Immunodeficiency virus:
    HIV-IgG, HIV load, CD4, CD8.
    P24 soon after infections but fades
    away.
    HIV-1 Ab 4-12 weeks after infection.
    No Ab just before death and p24 etc
    antigens increase.
    CD4 and CD8 response to treatment.
    NPLEx serology
    10. Human papilloma virus. 16 type
    causes cancer. A success!
    11. Rubella. Very serious to foetus in
    pregnant women.
    12. Syphilis: VDRL, RPR (screening
    test). Tests positive 2-3 weeks after
    infection.
    NPLEx infectious serology:
    13. Tuberculosis: BCG,
    Bovine TB given. Skin test
    1-3 days later see reaction
    14. Lyme disease.
    Allergy testing:
    1. RAST: serum IgE,
    general and specific
    tests.
    2. Skin prick test.
    Inflammation markers:
     Erythrocyte sedimentation rate (ESR).
     Plasma viscosity.
     Serum C-reactive protein- acute phase
    reactant.
     Other serum acute phase reactants:
    complement, ceruloplasmin,
    haptoglobulin, fibrinogen, alpha-1-
    antitrypsin, alpha-1-acid glycoprotein
    (orosomucoid).
    Acute phase reactants:
     Illness
     Infection
     Trauma
     Tissue necrosis.
    Serum C-reactive protein
     Always: rheumatic fever, rheumatoid
    arthritis, acute bacterial infections, viral
    hepatitis, myocardial infarction – high
    sensitivity version
     Frequent: active tuberculosis TB, gout,
    advanced malignancy, leprosy, active
    cirrhosis, burns, peritonitis.
     Sometimes: multiple sclerosis, Guillain-
    Barre, scarlet fever, varicella, post
    surgery, intrauterine contraception.
    Serum complement
     Classical – triggered by
    antigen/antibody.
     Alternate – triggered by foreign and
    cell surfaces.
     Recognition: C1q, C1r, C1s,
     Activation: C2, C3, C4.
     Membrane attack: C5, C6, C7, C8,
    C9.
    Serum complement, clinical
     Systemic lupus erythematosus-
    deficiency in serum C1q, C1r,
    C1s, C2 or C4.
     Rheumatoid arthritis - some
    have decreased serum C1.
     Most have decreased serum C2
    and C4.
    Complement, laboratory
    measurements:
     Whole system: serum CH50.
     Assay of individual
    components; serum C3 and
    C4.
     Activation: serum C1q, C2,
    C3 and C4.
    7 elite Swedish orienteers
    aged 25-29 years from Dala
     Sudden unexplained
    deaths (really 20)
    Possible explanations:
     Viral infection TWAR
     Coronary disease
     Lyme disease
     Inbreeding
     Dope: amphetamines,
    cocaine, steroids.
    EPO…
    Official explanation
     Virus infection.

    But
     Why is this not seen in parallel
    sports and activities.
     The consequence of official action….
    SUD, what the Swedes did
     No orienteering competition allowed
    for 6 months (1992).
     National team disbanded.
     No foreign visitors for training or
    competition.

     No further cases reported.

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