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بسم الله الرحمن الرحيم. Principles of Immunology by. S.S.Eghbali ,MD 5/10/1380. IMMUNE SYSTEM. Non specific IMMUNITY Specific Immunity. Specific Immunity. Humoral Immunitiy Cellular Immunity. Humoral Immunity. Cellular Immunity. T CD4/TCD8 ratio Cytokines IL-2, G-IFN, IL-4,IL-5 CTL
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Principles of Immunologyby S.S.Eghbali ,MD 5/10/1380
IMMUNE SYSTEM • Non specific IMMUNITY • Specific Immunity
Specific Immunity • Humoral Immunitiy • Cellular Immunity
Cellular Immunity • T CD4/TCD8 ratio • Cytokines IL-2, G-IFN, IL-4,IL-5 • CTL • NK-Cells
CELL IMMUNITY IS AFFECTED BY • AGE • Malnutrition • Cancers • Chronic diseases
Immuno assays • Precipitation Immunoassay • Particle Immunoassay • Radio Immunoassay • Enzyme Immunoassay • Chemiluminescent Immunoassay
A)Qualitative Single Immunodiffusion Double Immuno diffusion Immuno electro phoresis Electro Immuno Fixation B)Semi-Quantitative Single radial immunodiffusion Single dimension electro immunodiffusion (Rocket electrophoresis) Precipitation Immunoassay
Cont D Ag Ab Con (SRID) (FAHHEY)
Ag Ab Double Imm.Diff.
C C P P C C P P C C P
Particle Immunoassay • Hemaglutination e.g Treponema pal. • Gelatin particle agglutination HBV,HCV,HIV • Latex agglutination HCG
Radio Immuno assay • Competitive RIA • Non competitive RIA (Sandwich or IRMA)
Enzyme Immunoassay • Colorimetric EIA • Fluorescent EIA • Chemiluminscent EIA
PRESENTATION OFPOSSIBLE IMMUNODEFICIENCY * Frequent bacterial infection * Unusually severe systemic reaction to a virus * Development of infection with an unusual organism such as fungus or protozoan * Systemic reaction following live virus vaccination * Family history of recurrent infections * Exposure to the human immunodeficiency virus.
BASIC SCANNING IMMUNOLOGY STUDIES Complete blood count / differential Lymphocyte subpopulation analysis (numbers and percentages of T and B cells) by flow cytometry Lymphocyte activation in vitro to mitogens and microbial activators continued.....
Serum immunoglobulins, including immunoglobulin subclasses if evidence of clinical infections with encapsulated bacteria. In some cases, immunoglobulin levels are normal but heterogeneous nonbinding antibodies are produced; thus, additional studies are needed.
CONFIRMING AND FIRST-STAGEANALYTICAL STUDIES * Radiograph for thymic shadow * Skin test * Natural Killer cell activity ( if child is 6 months or older) * Cytokine production in response to activation T-helper 1, T-helper 2 (IL-2, interferon-y, IL-4, and so on) * Mixed lymphocyte culture reaction with patient as stimulator and patient as responder * Response to immunization continued.....
* Test for presence of age-appropriate specific antibodies*Naturally occurring antibody *Response to isohemagglutinins(anti- A and –B blood group substances) if patient has A, B, or O blood type*Test for adenosine deaminase and purine nucleoside phosphorylase enzyme deficiency
ANALYTICAL ANDIMMUNOREGULATORY STUDIES * Development of activation antigens during ersponse to stimulation, such as Tac antigen, transferrin receptor, up-regulation for MHC class II on T cells, soluble receptor, and so on * Early activation response (e.g., calcium channels) continued.....
ImmunoregulationResponse to IL-1, IL-2, interferonsDevelopment of effector functionsImmunoglobulin synthesis in vitroCytotoxic T-cell activitySuppressor cell/factor analysisGene activation, cell cycle analysisResponse to immunization: de novo immunization