SEROLOGY SECTION

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• Immunology - study of individual’s reactions when foreign

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body is introduced

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• Immunity - state of being protected or resistant from

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infectious disease.

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• Antigen - foreign

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non-self substance bound by an

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antibody molecule. May range from small

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simple

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intermediary metabolites (lipids

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sugars

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complex macromolecules (carbohydrates

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proteins

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acids). Not necessary to invoke immune response.

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Immunogens - antigens that stimulate immune response

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: Antibody - protein (immunglobulin) round in blos

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plasma

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produced by plasma cell derived from B

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lymphocytes

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response against a specific antigen.

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Five types: IgG

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IgM

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Serology - division of immunology specialized in

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laboratory detection and measurement of specific antibody

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as response to an antigen. In-vitro reactions.

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History of Serology

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• Thucydides

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Outbreak in Athens

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430 BC. Found out that people

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previously had the plague could only nurse the sick

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• Ancient China

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Started variolation or insufflation for smallpox

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• Variolation - inhalation of dried crusts of smallpox

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Smallpox - caused by Variola virus

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plague of 13th

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and 17” century

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characterized by fever

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filled with pus and fluid.

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• Ancient England

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• Variolation method is wounding the patient and putting

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the pus from smallpox carrier to the wound site.

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• Edward Jenner

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Started the practice of vaccination (vacca

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meaning

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“cow”) against smallpox

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• Sarah Nelms - milkmaid that had cowpox from her

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cow Blossom and was immune from smallpox

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• James Phipps - son of Jenner’s gardener that was

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inoculated by cowpox lesions of Nelms by Jenner

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then was introduced smallpox lesion. He developed a

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reaction at the inoculation site but showed no signs of

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smallpox

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• Louis Pasteur

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Page 4 of 11

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• Coined the term vaccine and first to observe

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attenuation

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• Attenuation - process of making something weaker.

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• First to demonstrate attenuation of a pathogen and

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administer this attenuated strain as vaccine

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• Succeeded in growing Pasteurella multocida

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bacterium causing fowl cholera in culture

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and

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chickens injected cultured bacterium developed fowl

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cholera

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• Observed that old cultures injected was not the cause

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of the cholera

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and injected chickens were becoming

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immune when injected with fresh culture of bacterium

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• Proved that aging would lower the virulence (ability

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to cause disease) of a causative agent

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thus injecting

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this attenuated strain is a protection against disease.

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• Named the attenuated strain vaccine after Jenner’s

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cowpox inoculation

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• Vaccine - suspension of weak/inactivated/attenuated

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cells or microorganisms to induce immunity

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• First to vaccinate sheep using heat-attenuated

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anthrax bacillus

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• Injected untested rabies vaccine to a 9-year-old boy

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named Joseph Meister

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who was mauled and beaten

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by a rabid dog. Treatment lasted for 10 days and the

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boy was recovered.

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Because attenuated viruses cannot be cultured

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without a host

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Pasteur injected live rabies virus in

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rabbits in order for them to multiply.

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Emil Roux - tested rabies vaccine to dogs and

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observed vaccinated animals were immunized from

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rabies exposure.

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Humoral and Cellular Immunity

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Emil von Behring and Shibasaburo Kitasato

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Serum from animals immunized to diphtheria could

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transfer immunity to unimmunized animals

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• Elvin Kabat

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-

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A fraction of serum called gammaglobulin (now

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immunoglobulin) is responsible for immunity. Believed

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that humors or body fluids mediated by antibodies was

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solely responsible of certain diseases and immunity

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it

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was called humoral immunity

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• Eli Metchnikoff

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Observed that WBCs

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termed as phagocytes

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able to ingest microorganisms (phagocytosis)

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therefore concluded that cells contributed in immunity

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of an animal

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and became the first proponent of

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cellular immunity

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• Merril Chase

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Transferred WBCs against Mycobacterium

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tuberculosis to guinea pigs

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reinforcing claims of

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cellular immunity.

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• Improved Cell Culture Techniques in 1950’s

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Lymphocyte was identified as both responsible for

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humoral and cellular immunity

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• Bruce Glick

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Performed experiments on chickens and identified two

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types of lymphocytes

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T Cells derived from thymus

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and B Cells from bursa of Fabricious of the chicken

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• Mnemonic for lymphocytes responsible for what

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immunity: Tatay Co nasa Barangay Hall

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> In humans

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both B and T lymphocytes are produced in the

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bone marrow. Immature T lymphocytes migrate to thymus

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for maturation and B lymphocytes mature in the bone

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marrow

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Innate and Adaptive Immunity

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Innate or Native Immunity

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Cellular and biochemical defense mechanisms already

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placed before infection

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prepared in case of infection

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• Response is the same for all pathogens/foreign

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substances

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No prior exposure is required

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Response doesn’t change with subsequent exposures.

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• Adaptive or Acquired Immunity

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Produced after introduction of antigenic challenge to a

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host

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• Ability to remember prior exposure

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resulting to

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increased response in repeated exposure

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• Characterized by specificity for each individual

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pathogen or microbial agents

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Two types of adaptive immunity

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a.

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Cellular immunity - mediated by T

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lymphocytes

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principal defense against

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intracellular microbes

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responsible in killing

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infected cells.

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b.

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Humoral immunity - mediated by antibodies

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produced by plasma cells derived from B

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lymphocytes

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principal defense against

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extracellular microbes

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Lines of Defenses

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Anatomic barriers: skin

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mucous

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membranes

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Physiologic processes:

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sneezing

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coughing

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reflex

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diarrhea

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epithelium

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First

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Line of

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Defense

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Normal microbiota/flora:

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healthy

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nonpathogenic bacteria

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found in respiratory tract and

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intestines

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INNATE

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IMMUNITY

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Secretions: tears

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mucus

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cerumen

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saliva

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sweat

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stomach acid

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Second

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Line of

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Defense

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Very low pH of vagina and

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stomach

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Phagocytes: Neutrophils

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Monocytes/Macrophages

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NK

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cells

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Inflammatory reaction

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ADAPTIVE

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IMMUNITY

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Third

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Line of

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Defense

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ACTIVE

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immunity

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host makes

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own

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antibodies

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Natural

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Complement System: assisting

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phagocytes in clearing foreign

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bodies

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promotes inflammation

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Cellular components:

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Lymphocytes - T (helper &

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cytotoxic) lymphocytes

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B

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lymphocytes

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Plasma cells

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Humoral components:

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antibodies and cytokines (protein

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secreted by immune cells to

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mediate and regulate immunity)

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Antibody

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produced

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Infections

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by host?

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Duration

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immune

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response

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YES

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LONG

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Artificial

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Vaccination

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PASSIVE

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immunity

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Antibodies

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are passed

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from donor

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to host

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Natural

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Colostrum

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(mother’s milk)

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NO

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SHORT

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Artificial

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Infusion of

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serum/plasma

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Routine Tests in Serology

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1. Non-Treponemal Antibody Tests

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• Usually for detection of Syphilis (Treponema

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pallidum)

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-

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Detects presence of reagin antibodies against

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cardiolipin

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Cardiolipin - found in mitochondrial membrane.

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When membrane breaks

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cardiolipin is secreted

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triggering production of regain Abs

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Although seen in syphilis patients

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regain antibodies

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are not specific in syphilis only as it is also observed

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in infectious diseases such measles

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Tb

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leprosy

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malaria

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Includes: Rapid Plasma Reagin (RPR) Test and

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Venereal Disease Research Laboratory (VDRL)

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Test

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2. HBsAg (Hep. B Surface Antigen) Test

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Detects infection of Hepatitis B virus by presence of

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HBsAg. Indicative of being infectious of a patient.

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3. Anti-HBs (Hep. B Surface Antibody) Test

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• Detecting presence of Anti-HBs

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sign of being immune

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from Hepatitis B virus.

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• Production of Anti-HB is observed from vaccinated

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persons and patients recovered from Hepatitis B.

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4. Widal Test

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Detection of presence of antibodies against disease

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causing Salmonella organisms (most known is

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Salmonella typhi) which further diagnoses enteric and

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typhoid fever.

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5. Dengue IgG/IgM Test

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Screening test for dengue viral infection and aid in

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differential diagnosing of primary and secondary

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infection

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• IgG - first to respond

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IgM - responsible for

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memory/anamnestic response

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Results reads:

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IgG positive ONLY: past dengue infection

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• IgM positive ONLY: primary (first-time) infection

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• BOTH IgG and IgM positive: secondary (second-

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time) infection

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6. Dengue NS1 Test

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Detects non-structural protein NS1 of dengue virus.

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NS1 antigen is detectable in the acute phase of

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dengue infection

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especially in the first 7 days of

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symptoms

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7. Dengue Duo Kit

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Contains both dengue IgG/IgM and NS1 antigen tests.