Notesale: Turn your study into money

Document Preview

Extracts from the notes are below, to see the PDF you'll receive please use the links above

---

Emil von Behring
Robert Koch
Elie Metchnikoff
Paul Ehrlich
Charles Richet
Jules Bordet
Karl Landsteiner
Gerald Edelman
Rodney Porter
Rosalyn Yallow
Snell
Dausset
Benaceraf
Niels Jerne
Kohler
Milstein
Susumu Tonegawa
Thomas
Murray
Peter Doherty
Rolf Zinkernagel
Barré-Sinoussi
Luc Montagner
Pope Innocent VII
Christopher Columbus
1984
1979
US
Russia
Lysozyme
LAK cells
NK/Null/3rd population
lymphocyte
Complement
Phagocytosis
Direct phagocytosis
Indirect phagocytosis
Initiation
Chemotaxis

MUST TO KNOW IN IMMUNOLOGY AND SEROLOGY
IMMUNOLOGY
Serum antitoxins
TB
Phagocytosis
Immunity
Anaphylaxis
Complement
ABO blood group
SSR
Structure of antibodies
RIA
MHC
Immunoregulation
Monoclonal antibody
Antibody diversity
Déjavu
Transplantation
Dual recognition
HIV
1st: blood transfusion
Old world  New world = smallpox
New world  Old world = syphilis
Year of discovery of T cell receptor gene
(-) Small pox
Pure culture of smallpox
Attacks bacterial cell wall
Ineffective against Mycoplasma and Ureaplasma (no cell wall)
NK cells + IL-2
Against cancer
(-) Markers on T/B cells
Kills virus and tumor cells
CD 16, CD 56
Major humoral immunity (natural)
“ICED”: Initiation, Chemotaxis, Engulfment, Digestion
Primitive pattern recognition receptor
Via opsonins
CR3 (3rd C’ component)
Laminin receptor
Leucyl-formyl-methionyl-phenylalanine receptor
C5a (potent chemotaxin)
Job’s syndrome = N-RA/Abn-CA
Lazy leukocyte syndrome = Abn-RA and CA
Boyden Chamber assay = test for chemotaxis
lec
...
influenzae
N
...
pneumoniae
CGD
NBT dye test
Granulocyte concentrate
Hypothalamus
Chronic inflammation
Heterophile antigens
Order of activation (C’)
Properdin
Betalysin
Active immunity
Active natural
Active artificial

Passive immunity
Passive natural

C3b (opsonin)
From eosinophils and mast cells
Vasodilation
Lymphokine activating factor
Secreted by monocytes and macrophages
Mediates fever, APR’s
APR’s
20-1,000x
Young cells
Stabilize the wound area
Leukocyte IFN (Type 1)
Produced by viral-induced leukocyte culture
Major producer: NK cell
Fibroepithelial IFN (Type 1)
Produced by dsRNA fibroblast cells
Immune interferon (Type 2)
Produced by immunologically-stimulated lymphocytes
Cachectin
Produced by macrophages
Lymphotoxin
Produced by CD4+ and CD8+ lymphocytes
Large capsule
Cause meningitis
(-) NADPH oxidase
Test for CGD
Appropriate blood component for CGD patients
Regulates body temperature (fever)
 γ-globulins (plasma cells)
Antigen in unrelated plants and animals but are closely linked that they cross
react with one another
C142356789
Serum protein
Bactericidal and viricidal
Needs C3 and Mg2+
Released by platelets
Against Gram (+) except Streptococcus
Antibody production is done by the body
Advantage: Long term
Disadvantage: slow response
Infection (Ag)
Vaccination (Ag)
Vaccines:
1
...
Attenuated = BCG (M
...
Dead = cholera, typhoid
4
...
tetani
5
...
mt 04 |Page | 220

Passive artificial
Quellung
T
...
anti-rabies
German word: Swelling
Highest eosinophil count
Maturation of T and B cells
Proliferation and differentiation of T and B cells
Spleen = Ag injected IV or IP
Peyer’s patches = Ag ingested
Lymph nodes = Ag injected subcutaneously
Cortex = B cells
Paracortex = T cells
80% of total lymphocytes
CD2 = Sheep RBC receptor, classical T-cell surface marker
CD3 = part of T cell Ag-receptor complex
CD4 = MHC class II (Th)
CD8 = MHC class I (Tc/Ts)
Cortex = Immature (85% )
Medulla = Mature (15%)
NV = 2:1
Abn = 0
...
mt 04 |Page | 221

Cell flow cytometry
Fluorescence microscopy
Rosette test

Function
Organ
Concentration
Lifespan
Soluble substances
ID
Mitogen
Mitogen
Lymphocyte capping
HLA
Class I MHC

Class II MHC

Class III MHC
Dendritic cells
Langerhans cells
IL-2
IL-3
IL-4
IL-5
IL-6
IL-12
Heteroantigen
Graft rejection

Potent antigen
Albumin

Light scatter
Forward LS = cell size
Side/90O LS = cell granularity/complexity
Labeled monoclonal antibodies
E-rosette assay = T cells (CD2)
EAC (Erythrocyte Ab Complement rosette) = B cells
Differentiate T cells and B cells
T cell
B cell
CMI
HI
Thymus
BM (1st: Bursa of Fabricius – birds)
60-80%
20-35% (10-20%)
Longer
Shorter
Lymphokines
Antibodies
E-rosette
Surface immunoglobulins
Concanavalin A
Lipopolysaccharide
Phytohemagglutinin
Pokeweed mitogen
Pokeweed mitogen
Substances that cause cells to divide
B cells
Chromosome 6 (short arm)
Endogenous antigen
Locus/Ag = HLA - A, B, C
Chain structure = α-chain + β2 microglobulin
Cell distribution = all nucleated cells
Presents antigen to CD8+ cells
For antigen found on surface of the cell
Locus/Ag = HLA - DP, DQ, DR
Chain structure = α-chain + β-chain
Cell distribution = B cells and macrophages
Presents antigen to CD4+ cells
“CCTB”
Locus/Ag = C2, C4, TNF, Factor B
Most efficient APC
DC in skin
T cell growth factor
Stimulates lymphocyte proliferation
Growth of stem cells and differentiation of blood cells
B cell growth factor 1
B cell growth factor 2
Differentiates B cell  plasma cell
IL-5: eosinophil differentiation
Enhance antibody production of plasma cell
NK stimulating factor
Activates NK cells and cytotoxic T lymphocytes
 Antigenic
1
...
Accelerated = 2-5 days
3
...
Chronic = >3 months
>10 kDa
40 kDa
Good immunogen
lec
...
CFA = H2O in oil emulsion of M
...
pertussis (MTB), stimulates T
cells
2
...
Synthetic MDP (muranyldipeptide) = stimulates T cells
4
...
Squaline = from shark’s oil, for HIV vaccine (MF59)
Ex
...

(+) Blue
(-) Unstained
ID by elimination
For class II
Mixture of T/B cells ---(Straw w/ nylon wool)---> B cells adhere to nylon wool
B cells + antiserum of known HLA spec
...
lympho
...
(inactivated: irradiated/treated w/mitomycin)
If incompatible  proliferation of patient lymphocytes
Tritiated hydrogen = radioactivity
Glycoproteins
Certain cells had specific receptor for antigen
Antigen will select the cell w/ proper receptor
Antibody-producing cells produce generalized type of antibody
Antigen serves as a mold/template
Most acceptable theory
Individual lymphocyte produces 1 type of Ig
Antigen finds cells capable of responding to that Ig  proliferate
Ex
...
2-mercaptoethanol (2-ME)
2
...
mt 04 |Page | 223

κ:λ ratio
Disulfide bonds
Hinge region
Fab
Fc
Domains
+1 CH (CH4)
Isotype
Allotype
Idiotype
J-chain
Secretory component
Starlike
Crablike
IgA
IgG
IgG 4 subclasses
IgG1
IgG3
IgG2
IgG4
IgM
Agglutination
Precipitation
ADCC
IgD
IgE
Atopy
RAST
Eosinophil
RIST
RAST/FAST
Complement

F(ab)2 = major fragment
Fc’ = (-) disulfide bond
2:1 (65%: 35%)
N = H-H, H-L
Abn = L-L (identical) = Bence-Jones protein (Multiple myeloma)
Proline
Between CH1 and CH2
NH3
COOH
Regions/sections in an immunoglobulin molecule
IgM and IgE
HC that determine Ig chain
Variations in the constant region of HC and LC (Km, Gm)
Variations in the variable region of HC and LC
IgM and IgA
Prevents enzymatic degradation of IgA
Ab (IgM) ≠ Ag
Ab (IgM) = Ag
Monomer (serum/IgA1)
Dimer (secretory/IgA2)
Fix C’ (alternative pathway)
 concentration (80%) > IgA > IgM > IgD > IgE
 half-life (23 days)
Differ in # and arrangement of disulfide bonds
%
Best to cross the placenta
15 HH
(-) bind to protein A
Best to fix C’ > IgG1 > IgG2
(-) Cross placenta
(-) C’ fixation
Largest (900 kDa)
Heaviest (19s)
Best to fix C’ (classical pathway)
IgM (large)
IgG (fine particles)
NK cells (Fc γ receptor) = release perforins w/c are toxic to the virus (Ag)
Immunoregulation
Found on unstimulated but immunocompetent B cell
Regain
Allergic reactions
Against parasites
IgE-mediated allergic reaction
Patient allergic to Rye grass
Release MBP and ECP
Total IgE
Allergen-specific IgE
β-globulin (electrophoresis)
3 anaphylatoxins: C3a, C4a, C5a
C5a: chemotaxin and anaphylatoxin
C3b: opsonin
lec
...
Aggregates of IgA
2
...
LPS
4
...
mt 04 |Page | 225

Type I
Type II
Type III
Type IV
Mechanism
Release of
Cytolysis due to Ab
Deposits of Ag-Ab
Release of
mediators
and C’
complexes
lymphokines
Examples
Anaphylaxis
HTRs
Serum sickness
Low MW
Hay fever
AIHA
Arthus reaction
compounds (ex
...
ionic bond
2
...
hydrophobic bond
4
...
mt 04 |Page | 226

Radial immunodiffusion
Mancini/Endpoint method
(RID)

Fahey and McKelvey/
Kinetic method (RID)
Oudin single diffusion
Ouchterlony double
diffusion
Laurell rocket
immunoelectrophoresis
Countercurrent
immunoelectrophoresis
Immunoelectrophoresis

Immunofixation
electrophoresis
Agglutination
Direct agglutination
Hemagglutination
Passive agglutination
Reverse passive
agglutination
Coagglutination
Agglutination-inhibition
Hemagglutinationinhibition
Grading (agglutination)

DAT

Immunodiffusion: Ag and Ab reaction occurs by diffusion
Ab  Gel
Ag  Well
Ag is allowed to diffuse completely
IgG = 24 hrs
IgM = 50-72 hrs
d2 = Ag concentration
Ex
...
Kauffman and White (Salmonella)
Ag is naturally found on RBC
Ex
...
S
...
β-hCG = classic example (1st trimester)
Red cells: indicator particles
Classic serologic test for viral Ab (Rubella and Influenza Ab)
0 = No agglutination
1+ = 25% Agglutination
2+ = 50% Agglutination
3+ = 75% Agglutination
4+ = 100% Agglutination
In vivo sensitization
Specimen: EDTA/citrated RBC
Investigation of:
lec
...
Drug absorption = Penicillin
2
...
Immune complex formation = Stibophen, Phenacetin, Rifampin
4
...
to Rh) = Methyldopa (Aldomet: Ab to Kidd),
Mefenamic acid (Ponstel)
(+) DAT
(-) DAT
(mf) DAT = some are lysed and some are not lysed by C’
In vitro sensitization
Specimen: Patient serum (common)
Uses:
-Cross-matching
-Ab detection
-Ab identification
-RBC Ag phenotyping (weak D) = Specimen: RBC
To remove unbound globulins
False (-) antiglobulin test
Unbound globulins can neutralize AHG reagent
Confirm by adding Check or Coomb’s cells (O+ RBCs sensitized w/ IgG)
-Valid: Agglutination
-To ensure AHG was added or not neutralized
1
...
Monospecific AHG = contain anti-IgG or anti-C3d
Uses radioactive substances as label
-Tritiated Hydrogen
-125I
Measure radioactivity
β = liquid scintillation counter
γ = crystal scintillation counter
Bound radiolabeled Ag is 1/α to patient Ag present
Bound radiolabeled Ab is α to patient Ag present in supernatant fluid
Measure total IgE
Measure Allergen-specific IgE
1
...
Yellow = infectious
3
...
Green = non-infectious wet waste
5
...
Orange = radioactive waste
Similar to IRMA except that it uses enzymes
1
...
ALP
lec
...
β-galactosidase
4
...
G-6-PD
Ab == Ag == enzyme labeled Ab
Enzyme activity is α to the amount of Ag
Uses fluorophores/fluorochromes
1
...
Tetramethylrhodamine Isothiocyanate (TRITC) = Red
Histopathology
Unknown Ag + FITC/TRITC labeled Ab = (+) Fluorescence
Serology (Ex
...
k
...
Great pox/Evil Pox/French/Italian/Spanish disease
Caused by T
...
pallidum = RIP: Refrigerate blood for 3 days
Hutchinsonian triad: Keratitis, Notched teeth, Deafness
1st: Heavy metals (Ex
...
VDRL, RPR, TRUST, USR, RST
♫ Treponemal Serologic tests = specific
= Detect Treponemal antibodies
= Ex
...
mt 04 |Page | 229

VDRL

Qualitative serum VDRL
(Ag delivery needle)
Quantitative serum VDRL
(Ag delivery needle)
CSF VDRL
(Ag delivery needle)
Rotation (VDRL)
RPR

RPR Antigen delivery
needle
Rotation (RPR)
Treponema pallidum
immobilization test (TPI)

FTA-ABS

Hemagglutination tests
Congenital infections

Specimen: Serum (common) or CSF
Reagent: VDRL Ag (C-L-C):
1
...
Lecithin: Removes anticomplementary activity of cardiolipin
3
...
75mm (depth)
Needle: Gauge 21/22: delivers 100 drops per mL of Ag
Serum = 180 RPM for 4 mins
CSF = 180 RPM for 8 mins
Specimen: Serum
Reagent: Modified VDRL Ag
1
...
Charcoal: makes the reaction easy to read
3
...
Choline chloride: inactivates C’
5
...
Patient serum (Δ 56’C for 30mins) + Reiter strain (nonpathogenic strain)
♫ Reiter strain = Sorbent (removes cross-reactivity w/ other treponemes)
2
...
Toxoplasmosis
b
...
CMV = common
d
...
mt 04 |Page | 230

ASO Tube test

Serum preparation
Titer
RBC control
SLO reagent control
ASO Titer
DNase B Ab testing

Streptozyme
1’ Hepatitis viruses
2’ Hepatitis viruses
Hepatitis A

Hepatitis B

Hepatitis C

Hepatitis D
Hepatitis E
HBsAg

HBeAg
HBcAg
IgM anti-HBc
Total anti-HBc
Anti-HBs

e
...

Infectious hepatitis
PicoRNAviridae (RNA)
MOT: fecal-oral
Short incubation period = 15-40 days
Serum hepatitis
HepaDNAviridae (DNA)
MOT: sexual, parenteral, perinatal
Dane particle = infectious
Non-A, non-B hepatitis
Flaviviridae (RNA)
MOT: sexual, parenteral, perinatal
Major cause of post-transfusion hepatitis (80% HCV || <10% HBV)
Viroid like (RNA)
Require infection w/ HBV (coinfection or superinfection)
Caliciviridae/HepEviridae (RNA)
MOT: fecal-oral, contaminated H2O
 fatality: pregnant
A
...
a
...
mt 04 |Page | 231

Anti-HBe
No HBV infection
Early infection
Acute HBV
Window period
Past infection
Immunization
HCV
IgM anti-HDV
IgM anti-HEV
HEV RNA
PCR
1st generation test (HBsAg)
2nd generation test (HBsAg)
3rd generation test (HBsAg)

HIV-1

HIV-2
HIV
Main structural genes (HIV)
Env (envelope) gene

Gag (Group Ag) gene

Pol (polymerase) gene
Ab to p24
Screening tests (HIV)
Confirmatory tests (HIV)

Tested for vaccination and follow up
Marker of convalescence (recovery)
HBsAg
Anti-HBc
Anti-HBs
+
+
+
+
+
+
+
Surrogate test: ALT, (+) anti-HBc
Specific test: (+) Anti-HCV = ELISA, RIBA
Detected by ELISA
Detected by ELISA, WB, Fluorescent antibody blocking assay
ID by PCR
D>A>E: Denaturation > Annealing > Extension
Ouchterlony double diffusion
Counterelectrophoresis
Rheophoresis
Complement fixation
RIA
ELISA
RPHA
RPLA
A
...
a
...
ELISA = standard screening test
2
...
Dot-Blot testing
1
...
mt 04 |Page | 232

SLE
LE factor
LE cell (buffy coat)
ANA test
FANA
Visible ANA
Hep 2 cells
Homogeneous/Diffuse/
Solid
Peripheral/Ring/Rim/
Membranous
Speckled/Mottled/
Pepperdot
Nucleolar
Anti-centromere

RA
RF
Tests (RA)
Titer (RA)
CRP

C’ fixation (CRP)

- CDC Criteria: 2 out of 3 Ab bands to p24, gp41 and gp120/160 = (+) WB
2
...
FANA = immunofluorescence
2
...
anti-Smith = SLE
b
...
Rose-Waaler test = sheep cell agglutination
2
...
RPLA = latex w/ anti-CRP
2
...
RIA
4
...
mt 04 |Page | 233

Amboceptor (hemolysin)
IM

Paul-Bunnell screening test
Davidsohn differential test
(Tube)
Antibodies to IM
Antibodies to Forssman Ag
Antibodies to Serum
sickness
EBV Ag’s

Monospot/Spot/Rapid
differential slide test
H
...
Adsorption (removal of Ab in serum) w/ Guinea pig kidney cells and beef/ox
erythrocytes
2
...
Agglutination
(+) Adsorption w/ beef/ox erythrocytes
(+) Agglutination after adsorption w/ GPK cells
(+) Adsorption w/ GPK cells
(+) Agglutination after adsorption w/ beef/ox erythrocytes
(+) Adsorption w/ beef/ox erythrocytes and GPK cells
(-) Agglutination after adsorption w/ beef/ox erythrocytes and GPK cells
1
...
EA = Early Ag
a
...
EA-R = Restricted early Ag (cytoplasm)
3
...
dermatitidis
Serine-rich E
...
falciparum
Primary atypical pneumonia
Outer membrane associated protein
Lyme disease
Cryptococcal Ag in CSF
(+) specific Ab  previously undetectable
5-6 months of age
IgG = most affected
Most common congenital immunodeficiency
Most serious congenital immunodeficiency
Affects T and B cells
Children  Enclosed in a plastic bubble (“Bubble boy”)
Congenital thymic aplasia
Bruton’s agammaglobulinemia
 All Ig
(-) B cells
Recurrent bacterial infection and sinusitis
Selective IgG deficiency may occur
Metabolism of purines is affected
lec
...
typhi (Widal)
R
...
These activate T and
B cells
...
Rheumatic heart disease
Chronic inflammatory disease that affects the exocrine glands (lacrimal and
salivary glands)
Triad of arthritis, conjunctivitis and urethritis
SLE
Addison’s disease
Graves’ disease
IDDM
Myasthenia gravis
Sjogren’s syndrome
Atrophic thyroiditis
RA (HLA-Dw4)
IDDM
Ankylosing spondylitis
Reiter syndrome
Pernicious anemia
Goitrous thyroiditis

lec
...


Autoantibody to
Thyroglobulin
TPO (microsomal)
Cytoplasmic TSH receptor
TSH receptor
Intrinsic factor
Parietal cell
Adrenal cells
Steroid producing cells
Spermatozoa
Pancreatic islet β-cells
Insulin receptor
β-adrenergic receptor
Acetylcholine receptor
Muscle
Renal and lung basement
membrane
Desmosomes
Skin basement membrane
Lens protein
Red cells
Platelets
Mitochondria
Neutrophils
Colon
Duct mitochondria
Melanocytes
IgG
DNA, RNA nucleoproteins

lec

---