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Immunology/Serology
Immunology and Serology
| Question | Answer |
|---|---|
| Characteristic of immunogens | • Large molecules (molecular weight of at least 10,00) • High complexity ) • Chemical composition (proteins and polysaccharides are better than carbohydrates) • Foreignness (the more different from the host, the more immunogenic) |
| Active immunity | • Individual produces antibody • Following immunization or infection • Memory (lasting) |
| Passive immunity | • Antibody transferred to individual • Ex. Gamma globulin • No memory (temporary) |
| Natural (innate) | • Non-specific • No memory • Ex. Exogenous (skin) Indogenous (stomach acid) NK (natural Killer cells) |
| Adaptive (acquired) | • Specific • Memory • Ex. T cells (Cytokines0 B cells (antibodies) |
| Adaptive: Cellular | • T cell/Lymphokines • Defense against viral/fungal infections (intracellular organisms) • Delayed hypersensitivity (E. Transplant rejections) |
| Adaptive: Humoral | • B cell (Plasma cell)/antibody • Defense against bacterial infections (extracellular organisms) • Antibody dependent cellular cytotoxicity (ADCC) |
| Classes of Immunoglobulins (Based on Heavy Chains) | • IgG • IgM • IgA • IgD • IgE |
| IgG | • Greatest concentration in serum • 4 subclasses • Activates complement (except for IgG4) • Crosses placenta • 75% of total antibody concertation |
| IgM | • Largest antibody (pentamer-a polymer comprising 5 monomer units) • Fixes complement best • Prominent in early immune response • 5-10% of total antibody concentration |
| IgA | • Predominant antibody in body secretions (tears, saliva, nasal mucosa) • Serum IgA and secretory IgA (dimer) • Primary defense against some local infections at mucosal surface • 2 subclasses |
| IgD | • Unknown function • Present on B cell surface |
| IgE | • Allergy • Triggers release of histamines form mast cells |
| Remember: Antibody functions | • IgG-Greatest plasma concentration (70%) Goes across placenta • IgM-Mega (largest) activates coMplement easily • IgA- sAliva, teArs (body secretions) • IgD- Don't know function • IgE- allergEE (allergy) |
| Lymphocytes in the immune response | • T cells • B cells • Third population cells (null cells) |
| Lymphocytes in the immune response: T cells | • Produced in thymus • No immunoglobulins present on cell surface • Possess T cell receptor (TCR-1 or TCR-2) – CD3+ • Rosette with sheep red blood cells (SRBC) – CD2+ • Comprises 80% of circulating lymphocytes |
| Lymphocytes in the immune response: T cells continued-subsets | • Subsets- T helper cell, T cytotoxic cell , T suppressor cell • After presented with antigen by Antigen Presenting Cell (APC) |
| Lymphocytes in the immune response: T cells continued-may | • May become memory cell May release lymphokines (T helper) May be cytotoxic (T cytotoxic) – effector cell • May interact with B cells T helper – CD4+ T suppressor –CD8+ |
| Lymphocytes in the immune response: B cells | • Possess cell surface immunoglobulin (IgD or IgM) • Evolve into plasma cells which secrete specific antibody into plasma • Comprise 5-15% of circulating lymphocytes |
| Lymphocytes in the immune response: Third population cells (null cells) | • No cell surface immunoglobulins or T cell receptor • NK (natural killer), K (killer) cells • CD16+ |
| Characteristics of Lymphocytes: T cells (80%) | • Surface receptor: T cell receptor (TCR-1 or TCR-2) • Surface markers: CD2+- Rosette with sheep RBC CD3+- T cell receptor CD4+- Helper cells CD8+- suppressor cells, cytotoxic cells • Rosette Sheep RBC: Yes |
| Characteristics of Lymphocytes: T cells (80%) continued- function | • Function: become memory cell, release lymphokines, become cytotoxic (CD8+), interact with B cells (CD4+ or CD8+) |
| Characteristics of Lymphocytes: B cells (5-15%) | • Surface receptor: surface immunoglobulin (IgD or IgM) Complement receptors • Surface markers: surface immunoglobulin (IgD or IgM) MHC Class II antigen • Rosette with Sheep RBC: No • Function: evolve into plasma cells which secrete antibody |
| Characteristics of Lymphocytes: Null cells | • Surface receptor: Neither • Surface markers: CD16+ • Rosette with Sheep RBC: No • Function: Natural killer cells |
| Evaluation of T and B cells: Rosette test | • Incubate sheep RBC(SRBC) with known number of purified lymphocytes; SRBCs bind to E-rosette receptor (CD2) on T cells • Count rosetted lymphocytes; percentage of T cells can be calculated |
| Evaluation of T and B cells: Rosette test continued | • Estimate of B cells: 100% minus calculated percentage of T cells • Estimated of absolute counts: multiply patient’s total lymphocyte count by percentage of T or B cells |
| Evaluation of T and B cells: Monoclonal antibodies | • Can be used to differentiate T and B cells by detecting cell surface markers (cluster designation) with flow cytometry |
| Evaluation of T and B cells: Monoclonal antibodies continued | • Produced by immunizing mouse with specific antigen, combining mouse spleen cells with myeloma cells (plasma cells fuse with myeloma cells forming a hybridoma). Hybridoma can produce monoclonal antibodies for indefinite period of time |
| Complement | • Approximately 21 chemically distinct proteins (14 effector, 7 control) • Functions to control inflammation • Cascades- requires calcium and magnesium • Control proteins |
| Complement: Functions to control inflammation | • Activates phagocytes (chemotaxis) • Lyses target cell • Opsonization- attach to complement receptors on neutrophils, monocytes -> enhance phagocytic binding |
| Complement: Cascades- requires calcium and magnesium | • Classical pathway • Alternative pathway |
| Complement: Control proteins | • C1 esterase inhibitor • C4 binding protein • Factor I (degrades C3b) • Factor H (competes with Factor B) |
| Remember: Complement cascades- classical | • Components • Activated by immune complexes (IgG, IgM) • Bind in numerical order except at the beginning (C1, C4, C2, C3, etc.) • Usually "a" fragments go into plasma, "b" fragments attach to cell (exception C2a and C2b) |
| Remember: Complement cascades- alternative | • Factors • Activated by lipopolysaccharides, polysaccharides • Involves C3 at 2 points in cascade • Involves proteins B and D |
| Characteristics of Hypersensitivity reactions: Type I (anaphylactic immediate) | • Mechanism: IgE mediated (antigen binds to IgE-sensitized Mast cell -> Histamine released) • Ex.: Bee sting, Hay fever, asthma |
| Characteristics of Hypersensitivity reactions: Type II (antibody dependent cytotoxicity) | • Mechanism: Antibody attaches to cell bearing corresponding antigen -> cell death • Ex.: transfusion reaction, AIHA (autoimmune hemolytic anemia), Hashimoto's thyroiditis, Goodpasture's disease |
| Characteristics of Hypersensitivity reactions: Type II (Immune complex) | • Mechanism: formation of large immune complexes not cleared by mononuclear phagocytic system • Ex.: RA (Rheumatoid arthritis), SLE (Systemic Lupus Erythematosus), Serum sickness |
| Characteristics of Hypersensitivity reactions: Type IV (delayed) | • Mechanism: Sensitized T cells release IL; monocytes and lymphocyte infiltration; >12hrs to develop • Ex.: Contact dermatitis (poison Ivy, chemicals), TB, Leprosy, GVHD (Graft Vs Host Disease) |
| Remember: Pros have good bodies | Prozone+ antiBODY excess |
| Precipitation | • Soluble antigen + antibody (in proper proportions) ->visible precipitate • Lattice formation (antigen binds with Fab sites of two antibodies) • Ex. Double diffusion (Ouchterlony) Single diffusion (radial immunodiffusion) Immunoelectrophohoresis |
| Agglutination | • Particulate antigen + antibody -> clumping • Lattice formation (antigen binds with Fab sites of 2 antibodies forming bridges between antigens) • Examples Direct agglutination (Blood Bank) Passive hemagglutination (treat RBCs with tannic acid to |
| Inhibition or neutralization reactions | • Antibody-binding Hemagglutination inhibition (serum antibody reacts with known nonparticulate antigen binding occurs) Neutralization (antibody neutralizes toxin) |
| Inhibition or neutralization reactions after binding antibody is not available to react in indicator system: results | • NO agglutination or NO hemolysis = positive reaction • Agglutination or hemolysis – negative reaction (antibody not bound in original reaction and is available to react with indicator cells) |
| Inhibition or neutralization reactions continued | • Generally, positive control samples used in inhabitation or neutralization tests show no reaction and negative control samples show reaction (opposite of results in direct agglutination testing) |
| Example of inhibition | Hemagglutination in test for rubella |
| Example of neutralization | Antistreptolysin O test (ASO) |
| Complement fixation (CF) | • Antibody and antigen allowed to combine in presence of complement • If complement is fixed by specific antigen-antibody reaction, it will be unable to combine with indicator system |
| Complement fixation (CF): precautions | • Serum must be heat inactivated • Stored serum becomes anti-complementary • Elaborate QC/standardization required • Only useful for IgM antibodies |
| Radial Immunodiffusion (RID) Single Immunodiffusion | Unlimited antibody incorporated into agar + serum added to circular well in agar diffusion occurs |
| Radial Immunodiffusion (RID) Single Immunodiffusion: methods | • Fahey (kinetic) • Mancini (end-point) |
| Radial Immunodiffusion (RID) Single Immunodiffusion: Fahey (kinetic) | • Read before ring reaches maximal size (6-12hrs) • Logarithmic relationship between diameter of precipitin ring (d) and antigen concentration read from standard curve |
| Radial Immunodiffusion (RID) Single Immunodiffusion: Mancini (end-point) | • Read at maximal size (24-48hrs) • Linear relationship between area of precipitin ring (d2) and antigen -> concentration read from standard curve |
| Double diffusion (Ouchterlony) | • Places antigens and antibodies in adjacent wells cut in agar, diffusion results in visible precipitate, examine bands formed and compare to standard • Location of bands depends on concentration and rate of diffusion |
| Double diffusion (Ouchterlony) used for | • Used to determine relationships between antigens and antibodies • Used to identify antibodies associated with autoimmune disorders |
| Immunoelectrophoresis (IEP) | • Gel diffusion + electrophoresis • Electrophorese serum proteins, fill trough in agar with antibody • Antigen and antibody diffuse through agar |
| Immunoelectrophoresis (IEP): antigen and antibody diffuse through agar | • In equivalence zone, precipitation appears • Size are determined by antigen concentration • Contour may indicate monoclonal gammopathy |
| Immunoelectrophoresis (IEP) common uses | • Serum IEP: monoclonal gammopthies • Urine IEP: Bence Jones protein |
| Immunofixation | • Protein electrophoresis + immunoprecipitation • Highly sensitive method, easy to read • Used to classify monoclonal gammopthies |
| Immunofixation procedure | • Apply specimen to 6 positions on agarose plate • Electrophorese to separate proteins • Apply monospecific antisera to 5 patterns using the 5th for reference • If antigen is present, antigen-antibody complexes form and precipitate; wash, stain |
| Radioimmunoassay (RIA) | • Very sensitive and specific • Can be used for detecting antigen or antibody (explanation blow detects antigen, but using known antigen to detect serum antibody is also possible) |
| Radioimmunoassay (RIA) competitive binding assay | • Patient Ag & labeled antigen incubated with known amount of specific antibody (unlabeled and labeled Ag compete for binding with Ab) • Wash to remove unbound antigen • Radioactivity counted on a gamma counter; compare to standard curve |
| Radioimmunoassay (RIA) competitive binding assay results | • The lower the radioactive count, the higher the concentration of unlabeled antigen |
| Radioimmunoassay (RIA) examples | • Test for hepatitis antigens and antibodies • Radioimmunosorbent Test (RIST)- measures total IgE • Radioallergosorbent Test (RAST)- measures IgE to specific allergens |
| Enzyme Immunoassay (EIA/ELISA) “Sandwich technique” part 1 | • Monoclonal or polyclonal antibody adsorbed on solid surface (bead or microtiter plate) • Patient serum added; if antigen is present in the serum, it binds to antibody coated bead or plate |
| Enzyme Immunoassay (EIA/ELISA) “Sandwich technique” part 2 | • Excess labeled antibody (antibody conjugate) added; forms antigen-antibody-labeled antibody “sandwich” (conjugate directed to another epitope of antigen being tested) • Substrate added, incubate and read absorbance |
| Enzyme Immunoassay (EIA/ELISA) “Sandwich technique” part 3 | • Washing required between each step • Direct relationship between absorbance and antigen concentration |
| Enzyme Immunoassay (EIA/ELISA) examples | • HIV testing • Serum HCG (pregnancy) • Tests for hepatitis antigens and antibodies |
| Nephelometry procedure | • Serum substance reacts with specific antisera and forms insoluble complexes • Light is passed through suspension • Scattered (reflected) light is proportional to number of insoluble complexes; compare to standards |
| Nephelometry examples | • Complement component concentration • Antibody concentration (IgG, IgM, IgA, etc.) |
| Immunofluorescence | Direct and indirect |
| Immunofluorescence direct | Add fluorescein-labeled antibody patient tissue, wash and examine under fluorescent microscope |
| Immunofluorescence indirect | Patient serum is added to tissue containing known antigen, wash, add labeled antiglobulin, wash, and examine under fluorescent microscope |
| Immunofluorescence example | Testing for Antinuclear Antibodies (ANA) |
| Flow Cytometry | Method of choice for T and B cell analysis (lymphocyte phenotyping) |
| Flow Cytometry principle part 1 | • Specimen incubated with one or two monoclonal antibodies tagged with fluorochrome • Single cells pass through incident light of instrument (laser) which excites fluorochrome and results in emitted light of different wavelength |
| Flow Cytometry principle part 2 | • Intensity of fluorescence is measured to detect cells possessing surface markers for specific monoclonal antibody employed • Forward light scatter indicates cell size or volume • 90° side-scattered indicates granularity |
| Flow Cytometry common uses | • DNA analysis, • Reticulocyte counts • Leukemia/lymphoma classification |
| Serial dilutions | • Testing for infectious diseases is performed on acute and convalescent specimens • Must see 4-fod or 2 tube rise in titer to be clinically significant |
| Sensitivity | • Analytical Sensitivity: ability of a test to detect very small amount of a substance • Clinical Sensitivity: ability of test to give a positive result if patient has the disease (NO false negative results) |
| Specificity | • Analytical Specificity: ability of test to detect substance without interference of cross-reacting substances • Clinical Specificity: ability of test to give negative result if patient does NOT have disease (NO false positive) |
| Remember: test sensitivities non lattice | • Non lattice (more sensitive) • Immunoassays RIA (Radial immunoassay) EIA (Enzyme immunoassay) FIA (Fluorescent immunoassay) • Nephelometry |
| Remember: test sensitivities lattice | • Lattice (Less sensitive) • CIE (Counter Immunoelectr) • (TIONS) CF (Complement fix) Agglutination Flocculation (Precipitation) • Rocket electrophoresis • RID (Radial immunodiffusion) • Ouchteriony • IFE (Immunofix) • IEP (Immunoelectr) |
| Syphilis | Caused by Treponema pallidum |
| Syphilis course of disease | • Primary • Secondary • Latent • Tertiary • Also congenital infections |
| Treponemal test | • Darkfield microscopy used to visualize motile organisms from primary & secondary lesions • Fluorescent treponemal antibody absorption (FTA-Abs) • Treponema pallidum Immobilization (TPI) • Microhemagglutination Assay for T. pallidum (MHA-TP) |
| Treponemal test: Fluorescent treponemal antibody absorption test (FTA-Abs) | • Remove nonspecific antibodies with sorbent • React with Nichol’s strain of T. pallidum • Add fluorescein-labeled antihuman globulin |
| Treponemal test: Treponema pallidum Immobilization Test (TPI) | • Darkfield microscopy • Patient + live treponemes • If antibody present, treponemes immobilized • Expensive, seldom used |
| Treponemal test: Microhemagglutination Assay for T. pallidum (MHA-TP) | • Patient serum + red cells sensitized with T. pallidum • If antibody is present, agglutination occurs |
| Non-treponemal Test (Reagin Test) | • Venereal Disease Research Laboratory (VDRL) • Rapid Plasma Reagin Test (RPR) • Automated Reagin Test (ART): automated version of RPR |
| Non-treponemal Test (Reagin Test) : Venereal Disease Research Laboratory (VDRL) | • Microflocculation(microscopic) • Ag:cardiolipin + lecithin • Ab:IgM/IgG to damaged tissue or organism • Serum requires heat inactivation • Flocculation indicates reactive serum •Choice 4 screening CSF • False + in malaria,Hep,pneumonia,age,mono |
| Non-treponemal Test (Reagin Test): Rapid Plasma Reagin Test (RPR) | • Microflocculation and coagglutination of charcoal particles (macroscopic) • More sensitive, less specific than VDRL • Antigen: cardiolipin + charcoal particles • No heat activation necessary • Reactive test: black clumps • False +: same as VDRL |
| Non-treponemal Test (Reagin Test): Automated Reagin Test (ART) | Automated version of RPR |
| Sensitivity of tests for Syphilis: primary stage | Increased: FTA-ABS, RPR, VDRL |
| Sensitivity of tests for Syphilis: secondary stage | All test equally sensitive |
| Sensitivity of tests for Syphilis: late stage | • Equal sensitivity: FTA-ABS, MHA-TP, TPI • Poor sensitivity: Regain tests |
| What test is the most sensitivity in all stages of Syphilis | FTA-ABS |
| Rheumatoid Arthritis (RA) | • Production of IgM or IgG antibodies to IgG • Diagnosis required radiologic and clinical findings • Affects joints and periarticular tissues |
| Rheumatoid Arthritis (RA) lab findings | • High titers of RF • Low titers of complement • RF titer does not correlate with intensity of disease |
| Rheumatoid Arthritis (RA) lab test | • Lab test: particulate carrier (latex or RBC) attached to IgG; test for serum IgM; read visible agglutination; run positive and negative controls |
| Cold Agglutinin Disease (CAD) | • Antibody agglutinates below 25°C (best at 0-5°C) • IgM antibodies (beta or gammaglobulin); usually anti-I or anti-i |
| Cold Agglutinin Disease (CAD) lab findings | • Marked rise indicates Mycoplasma pneumonia (atypical pneumonia) • Lower titer elevations: influenzas or adenoviruses |
| Cold Agglutinin Disease (CAD): DO NOT blank and why | Do NOT refrigerate specimen (antibody will bind to red cells leaving serum free of antibodies and result in false negative or decreased cold agglutinin titer) |
| Infectious Mononucleosis (I.M.) | • Causative agent: Epstein-Bar Virus (EBV) • Test for heterophile antibodies (Rapid Differential Slide Test: modified Davidsohn) • Single titer not related to intensity of disease; but change in titer may be used to monitor course of disease |
| Infectious Mononucleosis (I.M.) test step 1 and 2 | • Step 1: absorb serum with guinea pig or horse kidney and with beef erythrocytes • Step 2: react each with sheep or horse erythrocytes (indicator) |
| Infectious Mononucleosis (I.M.) test interpretation | Greater agglutination in kidney absorbed serum than in beef RBC absorbed serum -> Positive for I.M. |
| Infectious Mononucleosis (I.M.) test has no blank | No heat inactivation |
| Infectious Mononucleosis (I.M.) false positives | • Leukemia • CMV • Burkett's lymphoma • RA • Viral hepatitis |
| EBV specific tests | • Immunofluorescent tests for IgM/IgG anti-viral capsid Ag (VCA), anti-early Ag (EA), and anti-nuclear Ag (EBNA) • Appearance, duration of specific Ab differentiates acute from past infection • IgG/IgM anti-VCA in absence of anti-EBNA supports diagnosis |
| Antistreptolysin O (ASO) | Streptolysin O: hemolysin produced by Lancefield group A Streptococci |
| Antistreptolysin O (ASO) procedure | • Dilute serum with buffer • Add antigen (Streptolysin O) • Incubate • Add Group O red cells • Incubate, read Todd units (reciprocal of highest dilution showing no hemolysis) |
| Antistreptolysin O (ASO) results | • RBC contro +buffer=no hemolysis • Streptolysin(SLO) control: SLO+buffer+RBC=hemolysis • If Ab is NOT present, SLO not neutralized & will lyse RBC • Normal:<166 Todd units • High titer=streptococcal infection, active rheumatic fever, acute glomeruli |
| Antinuclear Antibodies (ANA) | Present in autoimmune disorders and collagen diseases (SLE, RA, scleroderma, Sjogren’s syndrome), infectious diseases (hepatitis) and aging |
| Antinuclear Antibodies (ANA) lab test | • Indirect immunofluorescence (IIF) • Confirm by assaying for specific antibody |
| Antinuclear Antibodies (ANA) lab test Indirect immunofluorescence (IIF) | Patient serum binds with tissue nuclei (human epithelial cells-HEp2 cells); wash, add fluorescent-labeled anti-human immunoglobulin; wash and read |
| Antinuclear Antibodies (ANA) lab test confirmed by | Confirm by assaying for specific antibody (anti-Sm, anti-ds DNA, anti-Scl-70, etc.) using indirect immunofluorescence (IIF) or double diffusion |
| ANA pattern: Homogeneous (diffused) | • Antibody: Anti-histone • Disease: usually SLE |
| ANA pattern: Peripheral (Rim) | • Antibody: Anti-ds DNA (double stranded DNA) • Disease: SLE |
| ANA pattern: Speckled | • Antibody: Anti-RNA, Anti-ENA (extractable nuclear antigens) • Disease: SLE, Scleroderma, RA, MCTD |
| ANA pattern: Nucleolar | • Antibody: Anti-nucleolar RNA • Disease: Scleroderma, Sjogren's |
| Acquired Immunodeficiency (AIDS) | • HIV-1 retrovirus attacks CD4+ cells (T helper) • Clinical manifestations may include pneumococcus pneumonia, Kaposi sarcoma, recurrent infections |
| Acquired Immunodeficiency (AIDS) lab tests | • Screen using EIA procedure for HIV-1 antibody • Confirm using Western Blot (positive if bands for p24, gp41-43, and gp120 or gp160 are present) • T helper/T suppressor ratio is decreased (1:2) |
| Human T- Lymphotropic Virus 1 (HTLV-1) | • Retrovirus that infects T helper cells • Has little sequence homology with HIV • Usually asymptomatic • Rarely causes a form of T cell leukemia or tropical spastic paraparesis • Transmitted through contact with blood or blood products |
| Human T- Lymphotropic Virus 1 (HTLV-1) testing | • Routine ELISA • Confirm with Western Blot |
| Cytomegalovirus (CMV) | • Asymptomatic infection • Very high incidence in humans • Presence of antibody does not prevent reinfection |
| Cytomegalovirus (CMV) causes problems in | • In immunocompromised patients • In transfusions in infants |
| Cytomegalovirus (CMV) test | Test by ELISA |
| Viral Hepatitis | • Inflammatory disease of liver • Associated with increase in liver enzymes (AST, ALT, GGT) • Diagnosis depends on appearance of antigens and antibodies in serum |
| Viral Hepatitis: HBsAG neg HBeAg neg Anti-HBe neg Anti-HBc (IgM) neg Anti-HAV (IgM) pos Anti-HCV neg Anti-HBs neg | Recent acute hepatitis A infection |
| Viral Hepatitis: HBsAG pos HBeAg pos Anti-HBe neg Anti-HBc (IgM) pos Anti-HAV (IgM) neg Anti-HCV neg Anti-HBs neg | Acute hepatitis B infection (highly infectious) |
| Viral Hepatitis: HBsAG pos HBeAg neg Anti-HBe pos Anti-HBc (IgM) pos Anti-HAV (IgM) neg Anti-HCV neg Anti-HBs neeg | Early acute hepatitis B or chronic or carrier state |
| Viral Hepatitis: HBsAG pos HBeAg pos Anti-HBe neg Anti-HBc (IgM) neg Anti-HAV (IgM) neg Anti-HCV neg Anti-HBs neg | Hepatitis B carrier |
| Viral Hepatitis: HBsAG neg HBeAg neg Anti-HBe pos Anti-HBc (IgM) neg Anti-HAV (IgM) neg Anti-HCV neg Anti-HBs pos | Immunity to hepatitis B |
| Viral Hepatitis: HBsAG neg HBeAg neg Anti-HBe neg Anti-HBc (IgM) neg Anti-HAV (IgM) neg Anti-HCV pos Anti-HBs neg | Hepatitis C infection |
| Remember: Hepatitis (hep b antigens and antibodies) (Hep with a shovel trying to dig to the center of the earth) 1 | First Hep starts at the surface (HBsAg |
| Remember: Hepatitis (hep b antigens and antibodies) (Hep with a shovel trying to dig to the center of the earth) 2 | Next he goes through the earth (HBeAg) |
| Remember: Hepatitis (hep b antigens and antibodies) (Hep with a shovel trying to dig to the center of the earth) 3 | Finally he reaches the core (Anti-HBc) |
| Remember: Hepatitis (hep b antigens and antibodies) (Hep with a shovel trying to dig to the center of the earth) 4 | As Hep backs out he fills the hole with earth (Anti-HBe) |
| Remember: Hepatitis (hep b antigens and antibodies) (Hep with a shovel trying to dig to the center of the earth) 5 | And finally reaches the surface (Anti-HBs) |
| Multiple Sclerosis (MS) | Autoantibodies to myelin sheath of nerves or myelin basic protein |
| Multiple Sclerosis (MS) lab findings | • Oligoclonal IgG bands in CSF • Helpful in diagnosis of MS – oligoclonal bands found in CSF but not in serum (indicates CNS productions) |
| Specificity of autoantibodies: Grave's disease | Autoantibody to: receptors for Thyroid Stimulating Hormone (TSH) |
| Specificity of autoantibodies: Goodpasture's disease | Autoantibody to: Basement membrane (Kidney) |
| Specificity of autoantibodies: Hashimoto's thyroiditis | Autoantibody to: Thyroglobulin |
| Specificity of autoantibodies: Multiple Sclerosis | Autoantibody to: Myelin sheath of nerves or myelin basic protein |
| Specificity of autoantibodies: Myasthenia gravis | Autoantibody to: Acetylcholine receptors at Neuromuscular junctions |
| Specificity of autoantibodies: Rheumatoid arthritis | Autoantibody to: IgG the autoantibody is a 19s anti-IgM known as rheumatoid factor |
| Specificity of autoantibodies: Sjogren's syndrom | Autoantibody to: Salivary duct |
| Impaired immune function: Chronic Granulomatous disease | Dysfunction: Ineffective phagocytosis |
| Impaired immune function: Chediak-Higashi syndrome | Dysfunction: Impaired Neutrophil function |
| Impaired immune function: DiGeorge's syndrome | Dysfunction: T cell deficiency (absence of thymus) |
| Impaired immune function: Human Immunodeficiency Virus (HIV) | Dysfunction: Decreased T-Helper cells, decreased Th/Ts ratio, decreased cell proliferation |
| Impaired immune function: Wiskott-Aldrich syndrome | Dysfunction: Partial combined immunodeficiency |
| Tumor Markers | • Substances synthesized & released by a tumor or produced by host in response to a tumor • Used in diagnosing, determining disease progression, monitoring response to therapy, and detecting recurrence |
| Tumor Markers found in | • Circulation • Body cavity • Fluids • Cell membranes or cytoplasm/nucleus of a cell |
| Tumor Markers common test performed by blank | EIA |
| Tumor Marker and it's associated disease: Alpha-fetoprotein (AFP) | Associated disease: Cancer of liver, ovary, testes (teratoblastoma) |
| Tumor Marker and it's associated disease: Carcinoembryonic antigen (CEA) | Associated disease: Cancer of colon, breast, lung |
| Tumor Marker and it's associated disease: CA 15-3, BR 27,29 | Associated disease: Cancer of breast |
| Tumor Marker and it's associated disease: CA 125 | Associated disease: Cancer of ovary |
| Tumor Marker and it's associated disease: CA 19=9 | Associated disease: Cancer of pancreas |
| Tumor Marker and it's associated disease: Estrogen/progesterone receptors | Associated disease: Cancer of breast |
| Tumor Marker and it's associated disease: Immunoglobulins (M protein, paraprotein) | Associated disease: Multiple myeloma, Waldenstrom's macroglobulinemia |
| Tumor Marker and it's associated disease: Prostate specific antigen (PSA) | Associated disease: Cancer of prostate |
| Tumor Marker and it's associated disease: Prostatic acid phosphatase (PAP) | Associated disease: Cancer of prostate |
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