The document discusses various methods of immune regulation, including both immunosuppressive drugs and immunopotentiation techniques. It describes several classes of immunosuppressive drugs like corticosteroids, thiopurines, alkylating agents, cyclosporine, and tacrolimus that work by suppressing cytokines, inhibiting cell division, or blocking T-cell activation. The document also covers methods to potentiate the immune system through cytokines, adoptive immunotherapy, or vaccination. It outlines several immunological assays used in clinical practice like measuring immunoglobulins, radioimmunoassays, ELISAs, and analyzing complement levels and DNA through techniques like PCR.
The document discusses modern diagnostic methods for autoimmune diseases. It describes initial laboratory evaluations including routine tests of blood cells and proteins. Immunological studies like ELISA, immunofluorescence, and line immunoassays are used to detect autoantibodies. Inflammatory markers like C-reactive protein and cytokines are also measured. Flow cytometry and histocompatibility complex testing provide additional immunological information. Together these diagnostic methods aim to detect abnormalities and identify autoimmune conditions through laboratory analysis of antibodies and markers of inflammation.
This document discusses the diagnosis of autoimmune diseases. It describes several markers that provide evidence of autoimmune diseases, such as a positive family history, presence of other autoimmune diseases, infiltrating cells in affected tissues, and improvement with immunosuppressive drugs. It also discusses several mechanisms that can lead to autoimmunity, including antigenic alteration, sequestered antigens, molecular mimicry, and polyclonal B cell activation. Common diagnostic methods are also summarized, including initial laboratory evaluation, immunological studies, and detection of autoantibodies through enzyme-linked immunosorbent assays (ELISAs).
This document discusses immunopotentiation and immunosuppression. It describes three ways to potentiate the immune system: vaccination, adjuvants, and lymphokines. Adjuvants work by affecting antigen presentation or stimulating macrophages. Common adjuvants include Freund's incomplete adjuvant, liposomes, muramyldipeptide, levamisole, and isoprinosine. Lymphokines that can be used include interferons and interleukins. The document also discusses general immunosuppression therapies like cytotoxic agents, glucocorticoids, cyclosporine, tacrolimus, and rapamycin, as well as specific therapies such as monoclonal antibodies and blocking co-stimulatory signals to induce T cell anergy
This document discusses antigens, vaccines, and recent advances. It covers topics such as:
- Types of antigens including exogenous and endogenous antigens.
- Factors that influence immunogenicity including foreignness, molecular size, and adjuvants.
- The concept of vaccine development including pre-clinical trials in animals and clinical trials in humans.
- Methods of vaccine manufacturing to ensure safety, including propagation, purification, and formulation according to good manufacturing practices.
- Major types of vaccines including live attenuated, inactivated, subunit, toxoid, recombinant, mRNA, DNA, and recombinant vector vaccines.
This document provides an overview of veterinary clinical immunology. It begins with an introduction to immunomodulatory drugs that can increase or decrease immune responses. It then discusses the different types of immunity, including active and passive immunity. The document also covers topics like homeostasis and immunotherapy in the immune system, the inflammatory response process, and differences between innate and adaptive immunity. It provides examples of cell-mediated and humoral immune responses during adaptive immunity. In summary, the document provides a comprehensive but concise overview of key immunology concepts.
The document provides an overview of basic immunology. It discusses the immune system and its components, including innate and acquired immunity. The innate immune system provides non-specific defenses and includes physical barriers, phagocytes, complement proteins, cytokines, and natural killer cells. Acquired immunity develops from exposure to antigens and provides long-lasting, pathogen-specific protection in the form of antibodies and T-cells. Key cellular responses include inflammation, antigen presentation, complement activation, and the roles of B-cells and T-cells in humoral and cellular immunity.
This document discusses antigens and concepts in vaccine development. It begins by defining antigens and classifying them as exogenous or endogenous. It then discusses the differences between immunogenicity and antigenicity, and lists factors that influence immunogenicity such as molecular size, chemical composition, and adjuvants. The document also covers epitopes, mitogens, and superantigens. Finally, it discusses the different stages of vaccine development from pre-clinical to clinical trials and licensing, and methods used in vaccine manufacturing.
Antigens, haptens and immunogens were discussed. Key points:
- Antigens are molecules that induce an immune response through binding antibodies or T cells. Immunogens can induce immune responses while antigens may only bind antibodies/T cells.
- Antigens are classified based on origin (exogenous, endogenous, autoantigens), chemical structure (proteins, polysaccharides etc.), and type of immune response generated (T cell dependent/independent).
- Immunogenicity depends on antigen properties like size, structure and degradability as well as the exposed biological system. Larger complex molecules tend to be more immunogenic.
The document discusses modern diagnostic methods for autoimmune diseases. It describes initial laboratory evaluations including routine tests of blood cells and proteins. Immunological studies like ELISA, immunofluorescence, and line immunoassays are used to detect autoantibodies. Inflammatory markers like C-reactive protein and cytokines are also measured. Flow cytometry and histocompatibility complex testing provide additional immunological information. Together these diagnostic methods aim to detect abnormalities and identify autoimmune conditions through laboratory analysis of antibodies and markers of inflammation.
This document discusses the diagnosis of autoimmune diseases. It describes several markers that provide evidence of autoimmune diseases, such as a positive family history, presence of other autoimmune diseases, infiltrating cells in affected tissues, and improvement with immunosuppressive drugs. It also discusses several mechanisms that can lead to autoimmunity, including antigenic alteration, sequestered antigens, molecular mimicry, and polyclonal B cell activation. Common diagnostic methods are also summarized, including initial laboratory evaluation, immunological studies, and detection of autoantibodies through enzyme-linked immunosorbent assays (ELISAs).
This document discusses immunopotentiation and immunosuppression. It describes three ways to potentiate the immune system: vaccination, adjuvants, and lymphokines. Adjuvants work by affecting antigen presentation or stimulating macrophages. Common adjuvants include Freund's incomplete adjuvant, liposomes, muramyldipeptide, levamisole, and isoprinosine. Lymphokines that can be used include interferons and interleukins. The document also discusses general immunosuppression therapies like cytotoxic agents, glucocorticoids, cyclosporine, tacrolimus, and rapamycin, as well as specific therapies such as monoclonal antibodies and blocking co-stimulatory signals to induce T cell anergy
This document discusses antigens, vaccines, and recent advances. It covers topics such as:
- Types of antigens including exogenous and endogenous antigens.
- Factors that influence immunogenicity including foreignness, molecular size, and adjuvants.
- The concept of vaccine development including pre-clinical trials in animals and clinical trials in humans.
- Methods of vaccine manufacturing to ensure safety, including propagation, purification, and formulation according to good manufacturing practices.
- Major types of vaccines including live attenuated, inactivated, subunit, toxoid, recombinant, mRNA, DNA, and recombinant vector vaccines.
This document provides an overview of veterinary clinical immunology. It begins with an introduction to immunomodulatory drugs that can increase or decrease immune responses. It then discusses the different types of immunity, including active and passive immunity. The document also covers topics like homeostasis and immunotherapy in the immune system, the inflammatory response process, and differences between innate and adaptive immunity. It provides examples of cell-mediated and humoral immune responses during adaptive immunity. In summary, the document provides a comprehensive but concise overview of key immunology concepts.
The document provides an overview of basic immunology. It discusses the immune system and its components, including innate and acquired immunity. The innate immune system provides non-specific defenses and includes physical barriers, phagocytes, complement proteins, cytokines, and natural killer cells. Acquired immunity develops from exposure to antigens and provides long-lasting, pathogen-specific protection in the form of antibodies and T-cells. Key cellular responses include inflammation, antigen presentation, complement activation, and the roles of B-cells and T-cells in humoral and cellular immunity.
This document discusses antigens and concepts in vaccine development. It begins by defining antigens and classifying them as exogenous or endogenous. It then discusses the differences between immunogenicity and antigenicity, and lists factors that influence immunogenicity such as molecular size, chemical composition, and adjuvants. The document also covers epitopes, mitogens, and superantigens. Finally, it discusses the different stages of vaccine development from pre-clinical to clinical trials and licensing, and methods used in vaccine manufacturing.
Antigens, haptens and immunogens were discussed. Key points:
- Antigens are molecules that induce an immune response through binding antibodies or T cells. Immunogens can induce immune responses while antigens may only bind antibodies/T cells.
- Antigens are classified based on origin (exogenous, endogenous, autoantigens), chemical structure (proteins, polysaccharides etc.), and type of immune response generated (T cell dependent/independent).
- Immunogenicity depends on antigen properties like size, structure and degradability as well as the exposed biological system. Larger complex molecules tend to be more immunogenic.
Regulation of Hypersensitivity Responses.pptxDr.Kanury Rao
The term “hypersensitivity” refers to the overreaction to an antigen. Intake of certain antibiotics or exposure to some metals are the causes of type 4 hypersensitivity. Dr. Kanury Rao has been involved with the analysis of immune responses for the decade.
Autoimmune encephalitis is caused by antibodies targeting neuronal cell surface or synaptic proteins. It accounts for around 20% of encephalitis cases without an identifiable infection. Key symptoms include seizures, altered mental status, and movement disorders. Diagnosis involves detecting antibodies in serum or CSF using live or fixed cell-based assays. Treatment aims to remove or suppress antibodies through immunotherapies like steroids, IVIG, and plasma exchange. Prompt treatment often leads to recovery, though some deficits may persist. Outcomes depend on the specific antibody and targeted brain regions.
This document discusses various laboratory methods for evaluating cellular immunity, including leukocyte phenotyping using flow cytometry to identify cell surface markers, delayed type hypersensitivity skin testing to assess memory T cell responses, lymphocyte activation assays to measure proliferation and cytokine production following stimulation, and assays of monocyte and neutrophil function like chemotaxis and phagocytosis. Flow cytometry is highlighted as the most widely used method for immunophenotyping and allows rapid identification and quantification of leukocyte subsets.
This document discusses multidrug resistance bacteria and contains information on antigens, immunogens, epitopes, types of antigens, properties that influence immunogenicity, and factors that determine antigenicity. It defines antigens and immunogens, and describes different types of antigens such as exogenous, endogenous, autoantigens, complete vs incomplete antigens. It also discusses epitopes, chemical nature of antigens, and properties like molecular size, chemical composition, and physical form that influence immunogenicity.
This document discusses the history and key concepts of immunology. It describes some of the earliest observations of immunity in the 4th century BC by Thucydides. It then outlines major developments in vaccination by Jenner in 1790 and the later proposals of the germ theory of disease by Pasteur and the concept of acquired cellular immunity by Metchnikoff and Ehrlich in the late 19th century. The document also summarizes the three lines of defense in the immune system (non-specific, specific, and adaptive immunity), the roles of antibodies, B cells and T cells, and the processes of humoral and cell-mediated immunity.
1. Rheumatoid arthritis results from a complex interplay between genetic and environmental factors that lead to a breakdown of immune tolerance. This allows the immune system to attack citrullinated proteins in the joints.
2. The HLA-DRB1 locus is a major genetic risk factor, and smoking can interact with these risk alleles to increase levels of anti-citrullinated protein antibodies (ACPAs).
3. Inflammation initially develops in the synovium due to local factors that are not fully understood. This drives further immune cell infiltration and joint damage through processes like neoangiogenesis and an imbalance of T cell subsets.
This document discusses different types of immunotherapy used to treat tumors. It begins by explaining how the immune system normally fights cancer and defines immunotherapy as treatments that boost the immune system's ability to find and destroy cancer cells. The main types of immunotherapy discussed are monoclonal antibodies and checkpoint inhibitors, oncolytic virus therapy, T-cell therapy, and cancer vaccines. Checkpoint inhibitors work by blocking checkpoints that normally stop the immune system from attacking cells, allowing it to destroy cancer cells. Oncolytic virus therapy uses genetically modified viruses to selectively infect and kill cancer cells. T-cell therapy removes and genetically alters T cells to target specific cancer cells. The document concludes that immunotherapy can produce anti-tumor responses in patients.
The document discusses transplantation and rejection. It aims to explain the benefits of transplantation, the immunological mechanisms that lead to rejection, and methods to prevent rejection. Key points include: T cells and MHC molecules play important roles in rejection; understanding rejection has led to discoveries like MHC and improved drugs; common transplants include kidneys, hearts, and livers; barriers include genetic differences between donor and recipient; and methods to prevent rejection include immunosuppression with steroids, cyclosporine, and radiation.
The document discusses immunological memory, which allows the adaptive immune system to remember specific pathogens and provide long-lasting protection against reinfection. Memory is maintained through periodic reexposure to pathogens, the production of antibodies by long-lived plasma cells and memory B cells, and the persistence of memory T cells in the absence of antigen through cytokines like IL-7 and IL-15. Studies in humans show antibody and T cell memory can last decades after vaccination or infection.
The document discusses the immune response, including defining immune response, the consequences and types of immune response such as humoral and cell-mediated immunity. It also covers topics like antigen processing, T cell activation, the roles of cytokines and immune cells like B cells, T cells, and antibodies in the immune response.
This document discusses vaccination in patients with chronic kidney disease (CKD). It outlines how CKD affects both the innate and adaptive immune systems, leading to impaired immunity. It describes alterations in end-stage renal disease that impair response to vaccines. Guidelines recommend vaccines for hepatitis B, pneumococcus, and influenza for CKD patients, with some vaccines requiring higher doses or more doses. Methods to potentially improve vaccine efficacy include use of immunomodulators like interleukin-2 administered with vaccines.
LEC#3.1 Cell-Mediate ALL THE HPOES ARE d Immunity.pptxMuhammadAfrazNuman
Cell-mediated immunity is primarily responsible for defending against intracellular bacteria, viruses, fungi, parasites, and tumors. It is also important for rejecting transplanted organs. When cell-mediated immunity is suppressed, such as during HIV/AIDS infection or with immunosuppressive drugs, opportunistic infections and tumors often overwhelm the host. The key cells of cell-mediated immunity include macrophages, helper T cells, natural killer cells, and cytotoxic T cells. Tests to evaluate cell-mediated immunity include delayed-type hypersensitivity skin tests and in vitro assays measuring T cell proliferation, macrophage migration inhibition factor production, and T cell enumeration using flow cytometry.
This document discusses autoimmunity and autoimmune diseases. It begins by defining autoimmunity as a breakdown of self-tolerance mechanisms that leads to an adaptive immune response against self-antigens. This can result in chronic inflammation and autoimmune disease. Several proposed mechanisms for how autoimmunity occurs are described, including defects in central and peripheral tolerance. Factors like genetics, hormones, infections, and environmental exposures are thought to contribute to loss of self-tolerance. The document then classifies and describes some examples of organ-specific and systemic autoimmune diseases in more detail.
Nursing care for patients with immune disorders.pptxEstibelMengist
The document provides information on nursing care for patients with immune disorders. It discusses the body's immune response, types of immunity including innate and acquired, cells involved in immunity like T cells, B cells, and macrophages. It covers topics like HIV/AIDS, immune system assessment, diagnostic tests done to evaluate the immune system, immunodeficiencies, hypersensitivities, autoimmune diseases, and more. The document is a comprehensive guide on the immune system and nursing considerations for patients with immune disorders.
This document provides information on types of antigens and factors that determine antigenicity. It discusses different types of antigens, including exogenous, endogenous, autoantigens, and alloantigens. It also covers the chemical nature of antigens, including proteins, polysaccharides, nucleic acids, and lipids. Additionally, it examines factors that influence immunogenicity, such as foreignness, molecular size, chemical nature, physical form, antigen specificity, and others. Superantigens are also discussed as a class of antigens that cause non-specific polyclonal activation of T-cells.
This document discusses immunomodulators, which are substances that affect the immune system by either suppressing or stimulating it. It describes two main types: immunosuppressants, which decrease immune response, and immunostimulants, which increase immune response. Common immunosuppressants discussed include cyclosporine, tacrolimus, azathioprine, methotrexate, mycophenolate mofetil, glucocorticoids, and antibodies. These work by interfering with cytokine production, lymphocyte proliferation, antibody synthesis, and other immune mechanisms. Immunosuppressants are used for organ transplantation and autoimmune diseases but can have side effects like infection, cancer, and nephrotoxicity
...Serological Technique Presentation Group 8 th.pptxBIOGENLABS
This document discusses key concepts related to antigens and immunogens. It defines antigens and immunogens, and notes that immunogens are molecules capable of activating lymphocytes to stimulate an immune response. Epitopes are described as the immunologically active regions of antigens that bind to antibodies or lymphocyte receptors. The document then discusses the chemical nature, types, properties, and factors influencing the immunogenicity of antigens.
This document discusses antigens and their classification. It defines antigens as substances that can induce an immune response. Antigens are classified as either exogenous (external) or endogenous (internal) antigens. Exogenous antigens enter the body from the external environment, while endogenous antigens are further divided into xeno-genic, allogenic, and autologous antigens based on their origin. The document also discusses the properties of immunogens and antigens, as well as factors that contribute to immunogenicity.
This document provides an overview of antibiotics, including their sources, classifications, mechanisms of action, and principles of antimicrobial therapy and selection. It focuses on penicillins as a class of antibiotics that act by inhibiting bacterial cell wall synthesis. Penicillins were discovered from the mold Penicillium and their basic structure consists of a beta-lactam ring. They work by inhibiting the bacterial enzyme DD-transpeptidase and preventing cell wall synthesis, ultimately causing bacterial cell lysis. Factors such as acid stability, spectrum of activity, and resistance are considered in developing different penicillin derivatives.
Fetal monitoring aims to assess fetal wellbeing during pregnancy and labor. This document provides guidelines for interpreting cardiotocography (CTG) traces and responding to patterns. CTGs should consider gestational age, fetal growth, movements, and any conditions affecting fetal wellbeing. Antenatally, reduced fetal movements or abnormal fundal height measurements may warrant further assessment. During labor, CTG is recommended for high-risk pregnancies and can identify non-reassuring patterns like late decelerations indicating possible hypoxia. Interpretation requires evaluating baseline rate, variability, decelerations, and accelerations in the context of the clinical situation.
This document provides guidance on antenatal care. It discusses the importance of preconception care, screening and risk assessment during pregnancy, and the essential components of antenatal visits. The goals of antenatal care are to ensure the best outcomes for women and babies by screening for problems, assessing risk, treating issues, providing medications and information. Key aspects covered include taking a medical history, conducting physical exams, estimating gestation, performing essential screening tests, discussing medications and vaccines, creating a management plan, and covering topics for subsequent routine prenatal visits.
Regulation of Hypersensitivity Responses.pptxDr.Kanury Rao
The term “hypersensitivity” refers to the overreaction to an antigen. Intake of certain antibiotics or exposure to some metals are the causes of type 4 hypersensitivity. Dr. Kanury Rao has been involved with the analysis of immune responses for the decade.
Autoimmune encephalitis is caused by antibodies targeting neuronal cell surface or synaptic proteins. It accounts for around 20% of encephalitis cases without an identifiable infection. Key symptoms include seizures, altered mental status, and movement disorders. Diagnosis involves detecting antibodies in serum or CSF using live or fixed cell-based assays. Treatment aims to remove or suppress antibodies through immunotherapies like steroids, IVIG, and plasma exchange. Prompt treatment often leads to recovery, though some deficits may persist. Outcomes depend on the specific antibody and targeted brain regions.
This document discusses various laboratory methods for evaluating cellular immunity, including leukocyte phenotyping using flow cytometry to identify cell surface markers, delayed type hypersensitivity skin testing to assess memory T cell responses, lymphocyte activation assays to measure proliferation and cytokine production following stimulation, and assays of monocyte and neutrophil function like chemotaxis and phagocytosis. Flow cytometry is highlighted as the most widely used method for immunophenotyping and allows rapid identification and quantification of leukocyte subsets.
This document discusses multidrug resistance bacteria and contains information on antigens, immunogens, epitopes, types of antigens, properties that influence immunogenicity, and factors that determine antigenicity. It defines antigens and immunogens, and describes different types of antigens such as exogenous, endogenous, autoantigens, complete vs incomplete antigens. It also discusses epitopes, chemical nature of antigens, and properties like molecular size, chemical composition, and physical form that influence immunogenicity.
This document discusses the history and key concepts of immunology. It describes some of the earliest observations of immunity in the 4th century BC by Thucydides. It then outlines major developments in vaccination by Jenner in 1790 and the later proposals of the germ theory of disease by Pasteur and the concept of acquired cellular immunity by Metchnikoff and Ehrlich in the late 19th century. The document also summarizes the three lines of defense in the immune system (non-specific, specific, and adaptive immunity), the roles of antibodies, B cells and T cells, and the processes of humoral and cell-mediated immunity.
1. Rheumatoid arthritis results from a complex interplay between genetic and environmental factors that lead to a breakdown of immune tolerance. This allows the immune system to attack citrullinated proteins in the joints.
2. The HLA-DRB1 locus is a major genetic risk factor, and smoking can interact with these risk alleles to increase levels of anti-citrullinated protein antibodies (ACPAs).
3. Inflammation initially develops in the synovium due to local factors that are not fully understood. This drives further immune cell infiltration and joint damage through processes like neoangiogenesis and an imbalance of T cell subsets.
This document discusses different types of immunotherapy used to treat tumors. It begins by explaining how the immune system normally fights cancer and defines immunotherapy as treatments that boost the immune system's ability to find and destroy cancer cells. The main types of immunotherapy discussed are monoclonal antibodies and checkpoint inhibitors, oncolytic virus therapy, T-cell therapy, and cancer vaccines. Checkpoint inhibitors work by blocking checkpoints that normally stop the immune system from attacking cells, allowing it to destroy cancer cells. Oncolytic virus therapy uses genetically modified viruses to selectively infect and kill cancer cells. T-cell therapy removes and genetically alters T cells to target specific cancer cells. The document concludes that immunotherapy can produce anti-tumor responses in patients.
The document discusses transplantation and rejection. It aims to explain the benefits of transplantation, the immunological mechanisms that lead to rejection, and methods to prevent rejection. Key points include: T cells and MHC molecules play important roles in rejection; understanding rejection has led to discoveries like MHC and improved drugs; common transplants include kidneys, hearts, and livers; barriers include genetic differences between donor and recipient; and methods to prevent rejection include immunosuppression with steroids, cyclosporine, and radiation.
The document discusses immunological memory, which allows the adaptive immune system to remember specific pathogens and provide long-lasting protection against reinfection. Memory is maintained through periodic reexposure to pathogens, the production of antibodies by long-lived plasma cells and memory B cells, and the persistence of memory T cells in the absence of antigen through cytokines like IL-7 and IL-15. Studies in humans show antibody and T cell memory can last decades after vaccination or infection.
The document discusses the immune response, including defining immune response, the consequences and types of immune response such as humoral and cell-mediated immunity. It also covers topics like antigen processing, T cell activation, the roles of cytokines and immune cells like B cells, T cells, and antibodies in the immune response.
This document discusses vaccination in patients with chronic kidney disease (CKD). It outlines how CKD affects both the innate and adaptive immune systems, leading to impaired immunity. It describes alterations in end-stage renal disease that impair response to vaccines. Guidelines recommend vaccines for hepatitis B, pneumococcus, and influenza for CKD patients, with some vaccines requiring higher doses or more doses. Methods to potentially improve vaccine efficacy include use of immunomodulators like interleukin-2 administered with vaccines.
LEC#3.1 Cell-Mediate ALL THE HPOES ARE d Immunity.pptxMuhammadAfrazNuman
Cell-mediated immunity is primarily responsible for defending against intracellular bacteria, viruses, fungi, parasites, and tumors. It is also important for rejecting transplanted organs. When cell-mediated immunity is suppressed, such as during HIV/AIDS infection or with immunosuppressive drugs, opportunistic infections and tumors often overwhelm the host. The key cells of cell-mediated immunity include macrophages, helper T cells, natural killer cells, and cytotoxic T cells. Tests to evaluate cell-mediated immunity include delayed-type hypersensitivity skin tests and in vitro assays measuring T cell proliferation, macrophage migration inhibition factor production, and T cell enumeration using flow cytometry.
This document discusses autoimmunity and autoimmune diseases. It begins by defining autoimmunity as a breakdown of self-tolerance mechanisms that leads to an adaptive immune response against self-antigens. This can result in chronic inflammation and autoimmune disease. Several proposed mechanisms for how autoimmunity occurs are described, including defects in central and peripheral tolerance. Factors like genetics, hormones, infections, and environmental exposures are thought to contribute to loss of self-tolerance. The document then classifies and describes some examples of organ-specific and systemic autoimmune diseases in more detail.
Nursing care for patients with immune disorders.pptxEstibelMengist
The document provides information on nursing care for patients with immune disorders. It discusses the body's immune response, types of immunity including innate and acquired, cells involved in immunity like T cells, B cells, and macrophages. It covers topics like HIV/AIDS, immune system assessment, diagnostic tests done to evaluate the immune system, immunodeficiencies, hypersensitivities, autoimmune diseases, and more. The document is a comprehensive guide on the immune system and nursing considerations for patients with immune disorders.
This document provides information on types of antigens and factors that determine antigenicity. It discusses different types of antigens, including exogenous, endogenous, autoantigens, and alloantigens. It also covers the chemical nature of antigens, including proteins, polysaccharides, nucleic acids, and lipids. Additionally, it examines factors that influence immunogenicity, such as foreignness, molecular size, chemical nature, physical form, antigen specificity, and others. Superantigens are also discussed as a class of antigens that cause non-specific polyclonal activation of T-cells.
This document discusses immunomodulators, which are substances that affect the immune system by either suppressing or stimulating it. It describes two main types: immunosuppressants, which decrease immune response, and immunostimulants, which increase immune response. Common immunosuppressants discussed include cyclosporine, tacrolimus, azathioprine, methotrexate, mycophenolate mofetil, glucocorticoids, and antibodies. These work by interfering with cytokine production, lymphocyte proliferation, antibody synthesis, and other immune mechanisms. Immunosuppressants are used for organ transplantation and autoimmune diseases but can have side effects like infection, cancer, and nephrotoxicity
...Serological Technique Presentation Group 8 th.pptxBIOGENLABS
This document discusses key concepts related to antigens and immunogens. It defines antigens and immunogens, and notes that immunogens are molecules capable of activating lymphocytes to stimulate an immune response. Epitopes are described as the immunologically active regions of antigens that bind to antibodies or lymphocyte receptors. The document then discusses the chemical nature, types, properties, and factors influencing the immunogenicity of antigens.
This document discusses antigens and their classification. It defines antigens as substances that can induce an immune response. Antigens are classified as either exogenous (external) or endogenous (internal) antigens. Exogenous antigens enter the body from the external environment, while endogenous antigens are further divided into xeno-genic, allogenic, and autologous antigens based on their origin. The document also discusses the properties of immunogens and antigens, as well as factors that contribute to immunogenicity.
This document provides an overview of antibiotics, including their sources, classifications, mechanisms of action, and principles of antimicrobial therapy and selection. It focuses on penicillins as a class of antibiotics that act by inhibiting bacterial cell wall synthesis. Penicillins were discovered from the mold Penicillium and their basic structure consists of a beta-lactam ring. They work by inhibiting the bacterial enzyme DD-transpeptidase and preventing cell wall synthesis, ultimately causing bacterial cell lysis. Factors such as acid stability, spectrum of activity, and resistance are considered in developing different penicillin derivatives.
Fetal monitoring aims to assess fetal wellbeing during pregnancy and labor. This document provides guidelines for interpreting cardiotocography (CTG) traces and responding to patterns. CTGs should consider gestational age, fetal growth, movements, and any conditions affecting fetal wellbeing. Antenatally, reduced fetal movements or abnormal fundal height measurements may warrant further assessment. During labor, CTG is recommended for high-risk pregnancies and can identify non-reassuring patterns like late decelerations indicating possible hypoxia. Interpretation requires evaluating baseline rate, variability, decelerations, and accelerations in the context of the clinical situation.
This document provides guidance on antenatal care. It discusses the importance of preconception care, screening and risk assessment during pregnancy, and the essential components of antenatal visits. The goals of antenatal care are to ensure the best outcomes for women and babies by screening for problems, assessing risk, treating issues, providing medications and information. Key aspects covered include taking a medical history, conducting physical exams, estimating gestation, performing essential screening tests, discussing medications and vaccines, creating a management plan, and covering topics for subsequent routine prenatal visits.
This document provides guidelines for preventing mother-to-child transmission of HIV (PMTCT) in antenatal care settings. There are four key elements of PMTCT care: primary HIV prevention, preventing unintended pregnancies among HIV+ women, preventing transmission from mother to child, and treatment/support for HIV+ women and their families. The goals of PMTCT in antenatal care are to identify all HIV+ women, provide same-day ART to optimize health and prevent transmission, and ensure viral suppression through treatment. All pregnant women should be tested for HIV and receive counseling. HIV+ women initiate lifelong ART regardless of CD4 count or clinical stage, while HIV- women receive repeat testing during pregnancy and breastfeeding.
This document provides guidance on performing and managing caesarean deliveries. It discusses:
- The need for caesarean delivery capabilities 24/7 at district hospitals and ability to perform emergency c-sections within 1 hour.
- Testing fetal lung maturity before elective c-sections if gestational age is uncertain.
- Preparation steps like consent, blood availability, and ensuring an experienced surgeon.
- Precautions against hemorrhage like oxytocin administration and careful surgical technique.
- Managing hemorrhage through measures like massaging the uterus, giving uterotonics, exploring for bleeding sources, and considering compression sutures.
- Postoperative orders around analgesia, fluids, thrombosis
Induction of labour is the artificial initiation of labour to achieve a vaginal delivery. Common indications include post-term pregnancy, hypertension disorders, and pre-labour rupture of membranes. The document discusses assessing the need for induction and balancing risks to the mother and baby. It provides guidance on methods for induction including membranes sweeping, prostaglandins, misoprostol, and oxytocin administration. Risks like uterine hyperstimulation are addressed. Special considerations for fetal demise, ruptured membranes, and scarred uteruses are also covered.
This document provides guidance on diagnosing and treating infections during pregnancy and the postpartum period. It discusses abnormal vaginal discharge, sexually transmitted infections like candidiasis, gonorrhea, chlamydia and trichomoniasis. It also addresses genital warts, ulcers, syphilis, urinary tract infections, acute pyelonephritis, and malaria. For each condition, it describes signs and symptoms, recommended testing, and treatment guidelines. It emphasizes treating sexually transmitted infections syndromically and the importance of notifying partners for examination and treatment.
This document provides guidelines for managing medical disorders in pregnancy, including anemia, diabetes mellitus, and cardiac disease. For anemia, it outlines screening, prevention, and treatment protocols. It describes gestational and pregestational diabetes and their management. For cardiac disease, it discusses referral criteria and managing labor and delivery for high-risk patients. The overall aim is to provide optimal care for both mother and baby's health outcomes.
1) Tuberculosis (TB) is a major cause of maternal mortality in South Africa. All pregnant women, especially those with HIV, should be screened for TB at antenatal visits.
2) Symptom screening involves asking about cough, fever, night sweats, and weight loss. A TB test (GeneXpert) is also required for pregnant women with new HIV diagnoses or known HIV.
3) If TB is diagnosed, treatment should begin promptly according to national guidelines. For drug-resistant TB, consultation with infectious disease specialists is recommended due to high mortality risk.
1) Bleeding in early pregnancy, defined as before 22 weeks, can be caused by miscarriage, ectopic pregnancy, molar pregnancy, or other issues. A rapid assessment including vital signs and exam is needed.
2) Miscarriages are categorized as safe, unsafe, threatening, inevitable, incomplete, or septic and management depends on the category and gestational age. Manual vacuum aspiration is preferred for evacuating the uterus under 16 weeks.
3) Post-miscarriage care involves screening for physical and mental health issues, providing counseling and information, and discussing family planning options.
Pregnant and postpartum women with COVID-19 should receive supportive care. While pregnant women are not more likely to get infected, those who do contract COVID-19, especially in the third trimester, are at higher risk of severe outcomes. COVID-19 testing criteria are the same for pregnant women as non-pregnant adults. Preventative measures include vaccination, masks, distancing, and hygiene. COVID-19 vaccination is recommended in pregnancy to protect both mother and baby. Mild cases can be isolated at home but moderate or severe cases require hospital admission. Mode of delivery depends on obstetric needs and maternal stability.
This document provides guidance on the management of antepartum haemorrhage (APH), or bleeding during pregnancy prior to delivery. It discusses causes of APH including placental abnormalities, infections, trauma, and unknown causes. It provides recommendations for emergency management at clinics, community health centers, and hospitals. Specific guidance is given for managing placenta praevia, abruptio placentae, and APH of unknown origin. Recommendations include IV fluids, blood transfusions, ultrasound exams, monitoring vital signs, and determining need for transfer or delivery.
Hypertensive disorders in pregnancy (HDP) are a common cause of maternal and infant health problems and death. HDP include gestational hypertension, preeclampsia, and eclampsia. Risk factors include being young, older than 35, having previous HDP, obesity, diabetes, or kidney disease. Symptoms of severe preeclampsia include headaches, vision issues, low platelets, elevated liver enzymes, pain in the upper right abdomen, HELLP syndrome, or high creatinine. All pregnant people should take calcium and those at higher risk may benefit from low-dose aspirin. HDP requires frequent monitoring, control of blood pressure, delivery by 38 weeks for gestational hypertension or earlier for pre
This document discusses gender-based violence and provides guidance for health workers in responding to GBV. It begins by defining GBV and noting that 1 in 4 women in South Africa experience GBV during pregnancy. It then outlines the negative health impacts of untreated GBV for women and children. The document describes possible signs that a woman is experiencing violence and provides a screening tool for health workers. It provides guidance on first line support, safety planning, and self-care for health workers responding to disclosures of GBV.
The document summarizes various abnormalities that can occur during labour and their management. It discusses prolonged latent phase of labour, poor progress in the active phase, meconium staining of amniotic fluid, prolonged second stage of labour, vacuum extraction, fetal distress, cord prolapse, and shoulder dystocia. For each issue, it provides details on how to assess and manage the situation, including administering drugs, changing positioning, accelerating delivery, or transferring to a hospital if needed. The goal is to safely resolve any problems and deliver a healthy baby.
1. The document discusses fetal maturity and intrauterine growth restriction (IUGR), including definitions, clinical symptoms, signs, biochemical markers, and fetal maturity tests. Fetal maturity tests assess surfactant levels in amniotic fluid to predict risk of respiratory distress syndrome in newborns.
2. IUGR is defined as fetal weight below the 10th percentile and can be symmetric or asymmetric, early or late onset. It increases risks of complications. Management depends on gestational age and Doppler ultrasound results, with delivery generally between 34-37 weeks.
3. There is no worldwide consensus on specific management strategies for IUGR, and guidelines from organizations like RCOG and ACOG have some differences.
The document discusses how the fetus is able to survive as a semi-allograft within the mother's uterus despite having different genetic material. It was first proposed in 1953 that the fetus is able to evade maternal immune detection through lack of fetal antigen expression or maternal lymphocyte suppression. The document then explores various mechanisms by which the fetal-maternal interface avoids rejection, including lack of MHC class I expression on trophoblast cells, shifts in maternal immune cell profiles toward anti-inflammatory responses, and expression of inhibitory ligands on trophoblasts. Immune cells in both the peripheral maternal system and local decidua are adapted to tolerate the semi-allogeneic fetus through these various mechanisms.
Teratology is the study of birth defects and their causes. Some key points:
- Around 5% of newborns have a detectable birth defect, though the cause is unknown for 70% of cases. Less than 1% are due to medications.
- Teratogens are agents that cause permanent changes to embryonic or fetal development, and can cause malformations (teratogen), altered growth (trophogen), or interference with organ maturation (hadegen).
- Studying teratogenicity in humans is difficult due to ethical concerns, so animal studies are also used but not definitive. Counseling women exposed to potential teratogens is important to avoid anxiety.
- Amniotic fluid serves several important roles in fetal development including allowing movement, swallowing, breathing and protecting the fetus.
- The normal volume of amniotic fluid increases throughout pregnancy reaching around 800mL by the mid-third trimester. Abnormally low (oligohydramnios) or high (hydramnios) volumes can occur.
- Hydramnios, which complicates 1-2% of pregnancies, has many potential causes including fetal anomalies, diabetes or infections. It can lead to pregnancy complications like cesarean delivery. Oligohydramnios also has various causes like renal abnormalities and medications and is associated with adverse outcomes such as pulmonary hypoplasia
This document discusses various fetal disorders, focusing on fetal anemia, hydrops fetalis, and thrombocytopenia. It describes the main causes of fetal anemia as red blood cell alloimmunization and various infections. Doppler evaluation and fetal blood sampling are used to identify and monitor anemia. Left untreated, anemia can lead to heart failure, hydrops, and death. However, intrauterine transfusions have dramatically improved survival rates. Hydrops fetalis refers to fluid accumulation and can result from immune or nonimmune causes. For immune hydrops, the main cause is red blood cell alloimmunization, while aneuploidy and infections are common nonimmune causes. Thrombocytopenia can
Genetics is the study of genes, heredity, and inherited traits. Medical genetics deals with genetic causes of human diseases. The document discusses several types of chromosomal abnormalities including trisomies like Down syndrome, Edwards syndrome, and Patau syndrome. It also discusses sex chromosome abnormalities such as Turner syndrome, Klinefelter syndrome, and other conditions. Structural abnormalities of chromosomes including deletions, duplications, translocations, and microdeletions are also summarized. Chromosomal abnormalities are a major cause of genetic diseases and pregnancy complications.
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
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These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
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Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
2. INTRODUCTION
• The immune system in general responds appropriately to the
presence of foreign antigens.
• However, there are certain diseases that arise from either a defective
or overresponsive immune system on the part of the host.
• Two major therapeutic approaches are possible: either
immunosuppression or immunopotentiation of the immune system
4. Immunosuppressive Drugs
Corticosteroids
• Modulate inflammation by suppressing cytokine- and chemokine-
encoding genes, which inhibits the activation and recruitment of
inflammatory cells
• The side effects of steroids are numerous and often depend on both
the dose used and duration of treatment.
• These include an increased susceptibility to infection, osteoporosis,
and growth disturbances in children, as well as gastric ulcers,
hypertension, acne, and hirsutism
5. Immunosuppressive Drugs
• The development of the thiopurines in the 1950s ushered in a new
group of immunosuppressive agents, the most important of them
being azathioprine
• It is inactive until it is metabolized in the liver and takes three to four
weeks to be effective.
• The metabolites work by inhibiting DNA synthesis in dividing cells
(such as activated lymphocytes).
• Like many other drugs, it has side effects, mainly in bone marrow
toxicity, and long-term use eventually results in granulocytopenia and
thrombocytopenia
6. Immunosuppressive Drugs
• Another group is the alkylating agents, of which cyclophosphamide is one
of the best examples.
• This drug also requires activation by the liver. It inhibits cell division and
can suppress antibody production, and it decreases delayed-type
hypersensitivity
• Methotrexate, which inhibits cell division by disrupting folic acid
metabolism, has similar immunomodulatory effects
• Cyclosporin, a naturally occurring fungal metabolite, also inhibits T-cell
activation and cell-mediated immunity
• Tacolimus is a newer-generation drug with a similar mechanism of action.
7. OTHER IMMUNOSUPPRESSIVE METHODS
• There are a number of instances in which antibodies have been used
to suppress the immune response
• Among the earliest measures has been the use of anti-RHD antibodies
• More recently, monoclonal antibodies are being used to suppress the
immune system
• Antibodies that target the immune system can target cell surface
molecules on T or B cells or can target soluble mediators of
inflammation such as cytokines
• Other methods of immunosuppression are plasmapheresis or plasma
exchange
8. IMMUNOPOTENTIATION
• Chronic infections such as HIV and hepatitis C are characterized by an
inability of the host to control viral replication
• The ability to potentiate the host immune response to control chronic
infections is an important goal and is under active investigation.
• At least some types of cancer can be controlled by the host immune
system, so potentiation of the host immune system may prove useful
in treating these cancers
• There are three principal ways to potentiate the immune response in
humans: through cytokines, adoptive immunotherapy, or vaccination
9. IMMUNITY
• The two ways to achieve immunity are actively and passively
• Active immunity is achieved when exposure to a foreign stimulus triggers
an immunological response to the agent by the host
• Artificial active immunization is the administration of an immunogen as a
vaccine
• Vaccines may be live organisms, killed organisms, or modified toxins.
• Although no vaccine is ideal and each has its problems
10. CYTOKINE IMMUNOMODULATION
• There is increasing interest in targeting T cells or the cytokine
regulators to regulate the elimination of autoreactive T cells, tumor
cells, and the maintenance of a specific memory response to these
pathogens
• Such immune responses are normally regulated by cytokines, and the
activities of the cytokines have a high degree of redundancy.
• There are several distinct differences in the functions of IL-2 and IL-5.
IL-2 is involved in checkpoints or brakes on the immune system.
12. Immunological Techniques
• Laboratory tests vary widely in clinical immunology.
• Some are essential for diagnosis while others are useful in subclassifying
disorders
• These tests do vary in their sensitivity and specificity.
• Some assays are quantitative in that they produce precise results
• Qualitative assays are less specific and will give answers such as normal–
abnormal, or positive–negative results
13. ANTIBODY PRODUCTION
• Antibodies for various tests can be produced in a number of different
ways
A. Polyclonal antibodies: Many mammals have been used to produce
antibodies
B. Monoclonal antibodies
14. IMMUNOLOGICAL ASSAYS
• The introduction of automated machines to measure
immunoglobulins and other proteins has proceeded rapidly in recent
decades.
• Precise measurement of serum immunoglobulins is an essential
cornerstone in this area and is important for repeated and serious
infections
• The main principle behind this test is related to the formation of
immune complexes between the antibody and a given antigen.
• These tests primarily use polyclonal antibodies for each antigen since
monoclonal antibodies do not form immune precipitates because
there are too few relevant epitopes
15. Radioimmunoassay and Enzyme Linked
Immunosorbent Assays (ELISAs)
• The use of these highly sensitive assays in human disease has virtually
exploded in the past two decades
• They can be used to detect the levels of a given antibody or hormone
in human serum, and they are extremely sensitive methods of
detecting low levels of autoantibodies.
• Once the serum or purified antibody or antigen to be tested is placed
in the well, a second radio labeled antihuman IgG antibody is placed
in the well
• After appropriate binding and further washes, the degree of activity
of the antibody to a given antigen can be determined
16. Complement Assays
• Perhaps the most useful assays for complement are the
immunochemical assays of C3 and C4.
• The alternative and classical modes of complement breakdown, a low
C3 and C4 but normal factor B suggest that activation of the classical
pathways has occurred
• Examples would be patients with systemic lupus erythematosus or
vasculitis
• In contrast, if C3, C4, and factor B are all low, the alternative pathway
is also activated via either feedback loops or simultaneous activation
• This would point to a gram negative bacteremia.
18. DNA ANALYSIS
• Known unique segments of nucleic acid sequences can be used as
DNA probes to determine the presence of complementary sequences
of DNA in a sample from a given patient
• The probe, which is a single strand of a given DNA, is presented to the
target DNA, which is composed of thousands of nucleotides
• The complementary strands from target and probe DNA will anneal to
each other, a process known as DNA hybridization
• The high affinity of the probe for a complementary segment in the
target DNA is the most specific intermolecular interaction between
biological macromolecules
Among the oldest of these drugs are the corticosteroids, which have long been known to alter immune responses.
When corticosteroids are given, the result is a transient lymphopenia peaking at four hours and lasting up to twenty-four hours.
Helper T cells are predominantly affected, and at higher doses of steroids inhibition of interleukin-2 (IL-2) production by helper T cells becomes increasing important
Another major effect in humans is on resting macrophages (activated macrophages are not sensitive)
In humans, steroids are used for two main purposes. One is the prevention or reversal of graft rejection
The other is in the treatment of autoimmune and malignant diseases
Cyclosporin:The drug becomes active only when complexed to its intracellular receptor cyclophilin, and it inhibits early calcium-dependent events, especially the activation of several cytokine genes.
Its major effect is the inhibition of IL-2 production and the CD4+ proliferation responses. Cyclosporin has been extremely useful in the control of transplant rejection and is also used in several autoimmune diseases such as psoriasis and severe rheumatoid arthritis
However, long-term use has demonstrated severe toxicity such as nephrotoxicity and hepatotoxicity and particularly lymphoma induction.
several antibodies are now approved for the treatment of autoimmune diseases
These antibodies are typically “humanized” mouse monoclonals, created by transposing the mouse antigen-binding sites onto a human antibody framework
This technique retains the full range of effective properties of human Fc while minimizing the immunogenicity of the mouse component
Among the most effective uses of monoclonal antibodies has been in treating severe rheumatoid arthritis, using monoclonal antibody directed against tumor necrosis factor (TNF-α)
The drawback to this therapy is that the infusions must be repeated frequently to sustain results
Monoclonal antibodies can also be used as antitumor agents
Specific targeting and killing of tumor cells can be enhanced by linking tumor antigenspecific monoclonal antibodies to agents as follows:
a cytotoxic drug such as methotrexate,
a radioisotope such as iodine131 or ytrium-90, or (3) a toxin such as ricin.
Monoclonal antibodies are now approved for the treatment of non-Hodgkin’s lymphoma, myeloid and lymphocytic leukemia, breast cancer, and colorectal cancer
Total lymphoid irradiation produces longterm suppression of helper T cells and has been used in some severe autoimmune diseases like lupus or rheumatoid arthritis.
The side effects of this treatment may be severe and sometimes fatal.
Cytokine Therapy Interferons are antiviral glycoproteins, which are secreted as a result of a viral infection and have wide-ranging antitumor and immunomodulatory effects. They have attracted much interest as immunotherapeutic agents.
Interferons bind to cell surface receptors and activate secondary intracellular changes which inhibit viral replication.
They can be divided into three groups: alpha (α), beta (β), and gamma(γ) interferons
IFN-α is the treatment of choice for hepatitis B and C; when given systemically, it produces significant clearing of hepatitis B in chronic carriers.
IFN-α has some side effects, mainly flu-like symptoms such as fever, malaise, and anorexia – all symptoms that can be tolerated.
More severe effects are reversible: bone marrow depression, liver dysfunction, and cardiotoxicity
IFN-β has been shown to be of benefit in patients with relapsing-remitting multiple sclerosis, and IFN-β1 appears to decrease the rate of progression of disability.
Despite these results, the precise therapeutic role of IFN-β is still controversial.
IFN-γ is a potential activator of macrophages and is most often used in conditions in which defective macrophage function occurs.
Examples of these disorders are lepromatous leprosy, leishmaniasis, and chronic granulomatous disease.
IFN-γ works by increasing phagocytic bactericidal activity, but only some patients show enhanced superoxide activity, implying that IFN-γ works by several different mechanisms
Adoptive Immunotherapy Adoptive immunotherapies involve the transfer of either cells or antibodies into a host.
These are also referred to as passive therapies, since the host does not actively mount its own immune response
Immunization Prevention of infectious diseases depends on many factors.
Foremost is the presence of a clean water supply, development of sanitary facilities, good nutrition, and good personal hygiene.
More recently, immunization against a particular agent has been the most effective
The best immunity to an agent is achieved by natural infection, which evolves with a clinical or subclinical response to the agent by the host.
problems of live vaccines are generally related to their safety, while the problems of killed vaccines are related mainly to their effectiveness
Live attenuated vaccines are useful because they infect, replicate, and immunize in a manner similar to natural infection but with milder clinical symptoms
Examples include many of the childhood infections such as measles, mumps, and rubella (MMR vaccine), chicken pox (varicella) and Bacille Calmette-Guérin (BCG) for tuberculosis.
Although millions of doses have been administered with no complications, if given to an immunocompromised host (such as primary immunodeficiency or secondary to HIV infection), these live vaccines may cause serious disease.
Killed vaccines consist of suspensions of killed organisms such as typhoid, cholera, and pertussis (although there is now an acellular vaccine) or one of the products or fractions of the organism.
These include toxoids of diphtheria and tetanus and subunits of viruses such as surface hepatitis B antigen. Among the most successful of these types of vaccines has been the use of polysaccharides in the pneumococcal, meningococcal, and Haemophilus influenza vaccines.
In general, the killed vaccines are not as effective as the live viruses because they do not give long-lasting immunity as a live infection does.
most interesting new vaccines has not been developed to eliminate the infectious agent but rather to prevent the development of another far more serious disease – a complication of the initial infection.
This is the Gardisal vaccine manufactured by Merck to protect against human papilloma virus (HPV). HPV infection
The common cytokine receptor γ chain is used by IL-2, IL-4, IL-7, IL-9, IL-15, and IL-21
The IL-2R and the IL-15R have a second (β chain) subunit in common as well, but have unique α subunits (see Figure 3.3).
These two cytokine receptors use a common signaling pathway that involves JAK1, JAK3, and STAT5
Thus, the unique feature of IL-2 is to prevent T-cell immune response to self that would lead to autoimmunity. In contrast, IL-15 expression has no effect on regulatory T cells but is an anti-apoptotic factor in several systems.
Furthermore, IL-15 promotes the maintenance of CD8+ CD44 memory T cells. Thus, IL-15 has as its primary role the maintenance of a robust memory response to invading pathogens
The sensitivity of a test is defined as the number of diseased individuals that are positive for the test compared with those who are negative.
The specificity of a test is the proportion of individuals without a given disease that are negative. Thus, a positive test is really restricted to the disease in question
A, Often an animal species is selected for antibody production because it will produce less cross-reactive antibodies to a given tissue.
Larger mammals, such as goats and sheep, are used to obtain larger volumes of serum to be used therapeutically in humans.
A recent fear has been that animals such as sheep or cows may have eaten animal food age contaminated with prion disease.
Thus, polyclonal antibody production for therapeutic uses has often been limited to countries like Australia or New Zealand where there have been no recorded cases of prion disease in mammals
B, In brief, the key to this remarkable advance was the ability to obtain spleen cells from mice that had been immunized with a given antigen and fuse these cells to a non-secreting myeloma cell line, which then produces a single antibody clone when fused with a given B cell present in the spleen cells.
Antibody clones are only produced when the mouse B cell fuses with the myeloma line
Large-scale culture of these antibodies can provide large quantities of antibody that are precise in their reactivity.
Most clinical immunology laboratories rely almost exclusively on these machines, and research labs are also introducing these automated techniques at a rapid pace.
If the concentration of antigen– antibody complex is low, then the immune complexes remain in suspension as fi ne particles, which can disperse a beam of light.
As the complexes increase with concentration of antibody, the complexes will precipitate, and light scattering will decrease.
This degree of dispersion can be measured on a nephelometer
In the radioimmunoassay, one can radiolabel a particular antigen or antibody using either 125I or 14C tagged to the antigen or antibody
The description of ELISAs; (Figure 2.1 top right) is similar to that described for the radioimmunoassay, but in place of the radioactively labeled antibody or antigen, various fluorochromes have been substituted in place of the radioactive label.
Normal C4 levels with low C3 and factor B levels suggest the alternative pathway alone.
Elevation of all three components usually suggests acute or chronic infection.
Acute rheumatic fever is such an example
Assays for immune complexes are best directed toward an analysis of the immune complexes or their deposition in various human disease tissues.
In most cases, the best approach is to receive freshly biopsied nonfrozen material that is then snap frozen and sections cut and stained to test for the presence of appropriate antigen or antibody
This technique may be used not only on fresh samples but also in tissues that have formalin-fixed and paraffin-embedded tissues.
In this technique of in situ hybridization, the probes can be applied directly to tissue sections on microscope slides.
However, this technique works only after deparaffi nization and proteolytic digestion are performed to expose intracellular nucleic acid targets.
The probe is detected in the sample either by radiolabeling the probe or radiolabeling an antibody to the probe DNA.
a major revolution in detecting DNA material occurred with the introduction of the PCR assay
This method is particularly valuable since it can markedly amplify a small piece of DNA before cleavage with a restriction enzyme
Complementary oligonucleotide primers from either end of the target DNA are added to the denatured sample, along with a heat-resistant DNA polymerase
The newly synthesized double-stranded DNA is then denatured by heating and exposed again to the polymerase enzyme at a lower temperature
In this way, newly synthesized molecules and original DNA can reassociate with the primer and act as templates for further rounds of DNA synthesis
After completing about thirty cycles (usually two to three hours in an automated machine), the specific target sequence is amplified
more than 1-million-fold. This powerful and sensitive technique can detect a specific DNA sequence from a single cell (e.g., lymphocyte, sperm), fixed pathological specimens, and dried blood spots.
The main disadvantage is that contamination of the reaction mixture with traces of DNA from another source will lead to false positive results.
Thus extreme care in handling specimens to be tested as well as in the test itself is obligatory
MAJOR HISTOCOMPATIBILITY (MHC) ASSAYS
MICROARRAY ASSAYS