In this presentation you can find some basic sentences and expressions, which you should know, when you will be going to take the history of the patient and examine him.
It should help you in the time, when you are starting your clinical practise, where the communication with the patient in slovak language is very important. Later there will be situations, where you will need to speak with the patient by your own withou having somebody for translation.
Presentation provides basic facts on allergic reactions - mechanism, symptoms, allergens. Main accent is put on diagnostic possibilities, both laboratory and in vivo (skin tests). Basic information about anaphylaxis and its management is included as well.
Presentation provides basic information on the HLA-complex and transplantation immunology, with focus on kidney and haematopoetic stem cell transplantations. Most important HLA-typing methods are explained as well as other techniques used in donor-recipient pair selection.
Serological methods are basic diagnostic methods used to identify antibodies and antigens in patient sample (serum, plasma). Agglutination and precipitation belong to classical serological methods that are used in diagnosis of infectious diseases (antibodies screening), serotyping of microorganisms and human blood group typing. Agglutination is based on reaction of particular (insoluble) antigen with antibodies, whereas precipitation involves reaction of colloidal (soluble) antigen and antibodies. In the immunodiagnostics an agglutination method as Coombs test is used to determine anti Rh antibodies in pregnant women (diagnosis of hemolytic disease of newborn). Another agglutination method involves latex agglutination that is used to determine, i.e. rheumatoid factor (diagnosis of autoimmune diseases) and hemagglutination method that can be used in, i.e. antibodies screening against Treponema pallidum, the main cause of syphilis. Radial immunodiffusion assay belongs to the precipitation method. This quantitative assay is based on immunodiffusion of antigens and antibodies in the gel and can be used in level analysis of complement components (C3, C4), inflammation proteins (CRP) and immunoglobulins (IgG, IgM and IgA). Modern precipitation methods performed in fluid involve nephelometry and turbidimetry.
A principal biological role of the immune system is an eradication of both external as well internal violators of integrity of the organism. External „enemies“ are represented mainly by germs; those of internal origin belong especially to potentially malignant cells that appear in our organisms as the results of a breakdown of their replication mechanisms.Under certain circumstances, however, the immune response can have deleterious effects, resulting in significant tissue damage or even death. This inappropriate immune response is termed hypersensitivity. Although the word hypersensitivity implies an increased response, the response is not always heightened but may, instead, be an inappropriate immune response to an antigen.
Several forms of hypersensitive reaction can be distinguished, reflecting differences in the effector molecules generated in the course of the reaction. In immediate hypersensitive reactions different antibody isotypes induce different immune effector molecules. IgE antibodies, for example, induce mast cell degranulation with release of histamine and other biologically active molecules. IgG and IgM antibodies, on the other hand, induce hypersensitive reactions by activating complement. The effector molecules in these reactions are the membrane-attack complex and such complement split products as C3a, C4a and C5a. In delayed-type hypersensitivity reactions, the effector molecules are various cytokines secreted by T helper cells and macrophages. As it became clear that different immune mechanisms can give rise to hypersensitive reactions, P. G. H. Gell and R. R. A. Coombs proposed a classification scheme in which hypersensitive reactions are divided into four types, I, II, III, and IV, each involving distinct mechanisms; later type V was added. Antibodies mediate four types of hypersensitive reactions: IgE-mediated (type I), cytotoxic (type II), immune complex (type III), and stimulatory/inhibitory (type V) hypersensitivity, respectively. T cells initiate the last type of hypersensitivity (type IV) and clinical symptoms appear more days after exposure; it is therefore referred to as delayed-type hypersensitivity (DTH). However, a great deal of com¬plexity exists within each type of reactions that blurs the boundaries between them.
The principal role of the immune system is to protect the organism from principally two the most dangerous events potentially threatening our life, i.e. infection and malignancy. However, sometimes the immune system instead of reacting against foreign and aberrant self-antigens can attack self-molecules. This inappropriate response of the immune system against self-components is termed autoimmunity.
There are 70 - 80 autoimmune disorders known till now and app. 5% of Caucasoid population suffers from them. Our understanding of autoimmunity has improved greatly during the last two decades, mainly because of the development of a variety of animal models of these diseases and the identification of genes that may predispose to autoimmunity. Nevertheless, the aetiology of most human autoimmune diseases remains still obscure.
The term “autoimmunity” is often erroneously used for a disease in which immune reactions accompany tissue injury; they are “a by-product” of a release of self-antigens to circulation without causing any damage; moreover, these “autoimmune reactions” help to degrade them and to remove them from the body.
A success of pregnancy depends on a proper implantation and induction of immune tolerance. The immune system secures it by various mechanisms – special cells, cytokines, HLA molecules, peripheral tolerance take part in.
The immune system of the newborn has also its own specifics as it matures relatively long time till it reaches the same protective ability as characteristic for adults.
The lecture deals with primary and secondary immunodefeciencies. It gives an overview on general clinical manifestations and their divisions according to the type of the immune functions defects. Must of the lecture devotes to AIDS.
Type I hypersensitivity belongs to the most common disorder mediated by immune reactions; it affects app. more than 30% of all individuals in Caucasoid population. Type I hypersensitivity is commonly called allergy. It is characterised by rapid onset (hence the term immediate hypersensitivity), within minutes of antigen challenge, and results in conspicuous clinical symptoms.
Incidence of toxocarosis in Slovakia 1977-1990 showed an exponential increase with an accessory cycling, having 7-8 years period length.