1. Definition:
The amount or concentration of a substance in
solution. The term is often used to described
concentrations of biological molecules (bioproducts)
such as antibodies and other proteins. The titer is an
indication of the number of times the solution can
be diluted and still contain detectable amounts of
the molecule of interest. In fact, when calculating
titer, the numerical value assigned to a titer is
directly indicative of the dilution factor.

2.  Normal individuals generally do not produce
destructive responses to their own tissue
antigens.
 Disorders occur in which tissue injury is
primarily caused by an apparent immunologic
reaction of the host to his own tissue.
 Loss or deficiency of
Immunoregulation=Loss of “tolerance”.
Recognizing embryonic tissue antigens as
“self”. ( Immunologic deficiency theory)
AUTOIMMUNE DISEASE

3.  Is a chronic inflammatory disease, primarily
affecting the joints and periarticular tissues.
 Apart from the joints the other areas affected
are the synovium-lined spaces such as
tendon sheaths, subcutaneous tissues at
sites of pressure or friction-heart, lungs,
blood vessels.
 Inflammation of the synovial membrane with
formation of granular tissue. (macrophages &
lymphoctes) enzymatic destruction of the
cartilage.
 Stiffness, joint pain-loss of fxn or permanent
deformity
Rheumatoid arthritis(RA)

4.  Abnormal proteins circulating in the blood of
pts with RA.
 Collectively known as RF; they are a group of
immunoglobulins that interact specifically
with the Fc portion of IgG molecules(anti-
antibodies).
 Immune complexes are formed, either IgG
aggregates or IgM-IgG
complexes+Complement activation+ aid of T-
cells.
 The inflammatory cells enter the synovial
space and release intracellular products that
damage the synovium
 Abnormal growth of synovial cells with
enzymatic destruction of the cartilage

5.  RF can occur in chronic disease of
nonrheumatoid individuals such as
 Polyarthritis nodosa, SLE, hepatitis,
chronic hepatic disease, syphilis
 Latex fixation test- Singer and Plotz, 1956

6.  Produced entirely by the liver parenchymal cells
(hepatocytes)
 Thermolabile, being destroyed by heating at
70˚C for 30mins. And does not cross the
placenta
 It is made up of 100% peptide and has an amino
acid composition similar to that of
immunoglobulin. MW 120,000d
 It appears in the sera of individuals in response
to a variety of inflammatory conditions or tissue
necrosis or both.
 They can provide an excellent means of
assessing disease activity and guiding therapy.
C-reactive protein (CRP)

7.  CRP levels increases within 4-6 hrs after an
acute tissue injury or during an active
inflammation.
 They are known to enhance phagocytosis
 CRP test can be useful as a means of
evaluating the prognosis of surgical patients.
 Post-op=ꜛ4-6hrs; reach peak value w/in 48-
72hrs. Then begin to decrease on the 3rd
post-op and reach normal values between
the 5th and 12th post-op.
 CRP is an ideal test in evaluating the course
of bacterial and viral infections, rheumatic
diseases, myocardial infarction, burn injuries,
and renal transplantation

8.  The most frequently used test and most
sensitive rapid latex agglutination test.(
Fishel,1967)