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Drafts > Autoimmine testing > Flashcards

Autoimmine testing Flashcards

1
Q

Def of Autoimmunity

A
  • The process where the host immune system ceases to recognize one or more of the body’s normal constituents as self, creates autoantibodies that starts to attack its own (Cells - Tissues - Organs) causing inflammation & damage.
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2
Q

Examples of Autoimmunity

A
  • Systemic Lupus Erythematosus (SLE).
  • Rheumatoid Arthritis.
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2
Q

Causes of Autoimmunity

A

Mostly Unknown

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3
Q

Def of Autoantibodies

A
  • Proteins created by the immune system when it fails to distinguish between self-antigens & non-self-antigens (foreign antigens) e.g. bacterial or viral.
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4
Q

what are Autoantibodies directed against?

A

These autoantibodies may be directed against a variety of substrates including:

  • Intra-cellular antigens.
  • Cell surface antigens.
  • Extracellular antigens.
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4
Q

SLE

A
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5
Q

Immunological testing for SLE

A
  • Antinuclear antibodies (ANA)
  • SLE specific antibodies
  • Complement proteins
  • Anti-platelet antibodies & Anti-erythrocyte antibodies
  • Anti-histone antibodies
  • RF (Rheumatoid factors)
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6
Q

Antinuclear antibodies (ANA) in Testing for SLE

A
  • Highly sensitive (Seen in large proportion of patients).
  • But not specific (Seen in other autoimmune diseases).
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7
Q

SLE specific antibodies in Testing for SLE

A
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7
Q

Complement proteins in Testing for SLE

A
  • Decrease Serum complement (C3-C4)
  • Due to its consumption.
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8
Q

Anti-platelet antibodies & Anti-erythrocyte antibodies in Testing for SLE

A
  • Present in about 70% of patients.
  • Responsible for hemolytic anemia & thrombocytopenia.
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9
Q

Anti-histone antibodies in Testing for SLE

A
  • Present in drug induces lupus.
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9
Q

RF (Rheumatoid factors) in Testing for SLE

A

+ve in 30% of patients.

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10
Q

Def of Rheumatoid Arthritis

A
  • Chronic systemic inflammatory auto immune disease that affect the joints.
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11
Q

Immunological testing for Rheumatoid Arthritis

A
  • Specific tests
  • Others
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11
Q

Specific tests for Rheumatoid Arthritis

A
  • Rheumatoid factors (RF): Positive in 75% of patients.
  • Anti-CCP autoantibodies (Anti-Cyclic Citrulinated Peptide)
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12
Q

Charaters of Anti-CCP autoantibodies (Anti-Cyclic Citrulinated Peptide) in testing for RA

A
  • Highly specific for RA (96%).
  • They appear before the onset of RA symptoms.
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13
Q

Other tests for RA

A
  • Serum complement: Decrease in presence of vasculitis.
  • Antinuclear antibodies (ANA): May be positive.
  • Hypergammaglobulinemia & Cryoglobulinemia.
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14
Q

Def of Immunodeficiency disorders

A
  • Deficiency of one or more of the 4 major components of the immune system (B lymphocytes - T lymphocytes - phagocytic cells - complement system).
  • Which protect the individual against different viral, bacterial, fungal and protozoal infections.
15
Q

what are Primary Immunodeficiency disorders?

A
  • B cell Immunodeficiency Disorders.
  • T cell Immunodeficiency Disorders.
16
Q

Classification of Immunodeficiency disorders

A
  • Primary immunodeficiency diseases (Presented from birth)
  • Secondary immunodeficiency diseases (Acquired due to infection as AIDS).
17
Q

Examples of B-Cell Immunodeficiency disorders

A
18
Q

Examples of T-Cell Immunodeficiency disorders

A

DIGEORGE’S SYNDROME

(CONGENITAL THYMIC APLASIA)

19
Q

Clinical Features of T-Cell Immunodeficiency disorders

A
20
Q

Laboratory assessment of immune competence

A
  • Complement assay
  • Evaluation of Humoral (B cells) mediated immunity
  • Evaluation of Cellular (T cells) mediated immunity
  • Assessment of phagocytic function
21
Q

Methods of Complement assay

A
  • Immunoassay “Assay of C3 & C4 levels”
  • Functional “Hemolytic assay CH50”
22
Q

Methods of Immunoassay “Assay of C3 & C4 levels”

A
  • Electro immunodiffusion
  • Rate nephelometry
  • ELISA
  • Single radial diffusion
23
Q

Methods for Evaluation of Humoral (B cells) mediated immunity

A
  • Protein electrophoresis
  • Quantitative immunoglobulins level
  • IgG subclasses level
  • Total B cell count
  • Specific antibody response after immunization in vivo
  • Stimulation of B cells in vitro
24
Q

Methods of Quantitative assessment of immunoglobulins level

A
  • Radial immunodiffusion
  • Nephelometry
  • ELISA
24
Q

Methods of assessment of IgG subclasses level

A

ELISA

25
Q

Methods of assessment of Total B cell count

A
  • Using Flow cytometry
  • Normally 10 - 20% of total circulating lymphocytes
26
Q

Specific antibody response after
immunization in vivo

A

Principle: Immunization with tetanus or pneumococcal polysaccharide Antigens

27
Q

Stimulation of B cells in vitro

A
  • By Mitogen or Antigen, and assessment of immunoglobulin release
28
Q

Evaluation of Cellular (T cells)
mediated immunity

A
  • Total Lymphocytes count
  • Monoclonal antibodies to T cell subsets
  • Total T cell count
  • Delayed cutaneous hypersensitivity skin test in vivo
  • Lymphocyte response in vitro
29
Q

MOAs = Method of assessment

MOAs of Total Lymphocytes count

A

Normally > 1200/ul “At any age”

29
Q

MOAs of Monoclonal antibodies to T cell subsets

A

Using Flow cytometry

30
Q

MOAs of Total T cell count

A
  • Using Flow cytometry
  • Normally >60% of total circulating lymphocytes
31
Q

MOAs of Delayed cutaneous hypersensitivity skin test in vivo

A
  • Using PPD
  • Used to evaluate specific cellular immunity to antigen
31
Q

MOAs of Lymphocyte response in vitro

A
  • By Mitogen or Antigen
32
Q

Assessment of phagocytic function

A
  • Nitro-blue tetrazolium test
  • Chemiluminescence
  • Chemotaxis
  • Assessment of superoxide production
  • Enzyme tests
  • Genetic analysis
33
Q

what is Nitro-blue tetrazolium test used in?

A

Used lo diagnosis of CGD

33
Q

Chemiluminescence

A

Albnormal in…
* CGD
* Myeloperoxidase deficiency

34
Q

MOAs of Chemotaxis

A
  • Principle: Measure ability of neutrophils to move in a directed, migratory pattern toward chemotactic substance
35
Q

when is Chemotaxis abnormal?

A
  • Abnormal in various disorders “Not specific”
36
Q

Superoxide production in CGD

A
  • Absenl in CGD
  • Defective in other syndromes
37
Q

Genetic analysis

A

Available for
* CGD
* LAD
* Chediak Higashi syndrome

37
Q

Indication of Enzyme tests

A
  • e.g., G6PD - Myeloperoxidase

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