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 ratioCytokines IL-2, G-IFN, IL-4,IL-5CTLNK-Cells

CELL IMMUNITY IS AFFECTED BY

AGEMalnutritionCancersChronic diseases

Immuno assays

Precipitation ImmunoassayParticle ImmunoassayRadio ImmunoassayEnzyme ImmunoassayChemiluminescent Immunoassay

Precipitation Immunoassay

Precipitation 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)

Particle ImmunoassayHemaglutination e.g

Treponema pal.Gelatin particle agglutination

HBV,HCV,HIVLatex agglutination HCG

Radio Immuno assay

Competitive RIA

Non competitive RIA

(Sandwich or IRMA)

Enzyme Immunoassay

Colorimetric EIAFluorescent EIAChemiluminscent 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 cytometryLymphocyte activation in vitro to

mitogens and microbial activators

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

* 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)

ImmunoregulationResponse to IL-1, IL-2,

interferonsDevelopment of effector

functionsImmunoglobulin synthesis in

vitroCytotoxic T-cell activity

Suppressor cell/factor analysisGene activation, cell cycle

analysisResponse to immunization: de

novo immunization