Chapter 9: Immunnodiagnostics Flashcards
Meaning of allotype? (Examples)
an allelic difference in the same ab isotypes that differ between people (subtle difference amongst individuals in their immunoglobulins due to heterogeneity)
(a person receiving pooled gamma globulins might react to these allotypic differences in the constant regions which may result in a type III HSR)
If an ab molecule is digested with papain, where does cleavage occur?
above the disulfide bonds that hold the heavy chains together
General function of Papain and Pepsin.
proteolytic enzymes that aid in digestion
If an ab molecule is digested with pepsin where does cleavage occur?
generates one large fragment called F(ab’)2 and digested Fc fragment (think Pepsi in martini glass)
Describe this figure
- Start of infection the patient is in a state of ag excess
- As patient begins to make an adequate ab response, he enters equivalence zone; all available ag is complexed with ab, and neither free ag nor free ab can be detected in serum (zone of equivalence)
- Infection is resolved, patient enters ab excess zone
Describe polyclonal antiserum.
It is generally produced in an individual naturally and represents many different clones of B cells that are making ab to many different epitopes on an ag; therefore a heterogenous complex mixture of ab is produced
Describe monoclonal ab.
produced by one clone of B cells with specificity for the exact same epitope on an ag. They are produced in the lab
Compare and contrast direct vs indirect serologic testing.
Direct serologic testing utilizes a known antiserum in order to detect an unknown ag, either foreign or self (they are qualitative and provide results relatively quickly)
Indirect serologic tests utilize ab from the patient that may be specific for either self or foreign ag (may be qualitative or quantitative)
Which is more specific owing to fewer false-positives? Direct or indirect serologic test?
indirect tests
Describe agglutination test.
a variation on precipitation reactions.
Ag is a particulate ag such as RBCs or latex beads. Both will clump up to form a lattice of ab-bound particles in the presences of appropriate ab.
What are latex bead agglutination tests available for the diagnosis of?
cerebrospinal infections such as Haemophilus, pneumococcus, meningococcus, and Cryptococcus
RBC agglutination reactions are important in what cases?
defining ABO blood groups, diagnosing EBV infection (the monospot test), and identifying Coombs test for Rh incompatibility
Direct Coombs test
designed to identify maternal anti-Rh ab that are already bound to infant RBCs or antibodies bound to RBCs in patients with autoimmune hemolytic anemia
Indirect Coombs test.
designed to identify Rh- negative mothers who are producing anti Rh ab of the IgG isotype, which may be transferred across the placenta harming Rh- positive fetuses.
What type of graft rejection is caused by ABO incomaptibility?
hyperacute