Contemporary Clinical Immunology and Serology

Welcome
	Title page
	Copyright
	Dedication
	Foreword
	Preface
	Acknowledgments
	About the Authors
	Reviewers
Part 1 The System and Components
	Part 1 The System and Components
1: Introduction to Immunology
	Introduction: Introduction to Immunology
	The Innate Immune System
		The Innate Immune System Internal Components
		The Molecules of the Innate Immune System
		The Processes of the Innate Immune System
	The Acquired Immune System
		Antibody Introduction—General Structure
		The Cellular Arm
	The Lymphoid Organs
		The Secondary Lymphatic Organs
	Associated Laboratory Method
	Case Study: Introduction to Immunology
	Summary: Introduction to Immunology
	Review Questions: Introduction to Immunology
	References: Introduction to Immunology
2: Antibody
	Introduction: Antibody
	General Structure
	Classes, Subclasses, and Light Chains
	Diversity
		Antigen-Independent Diversity
		Antigen-Dependent Somatic Mutation and Affinity Maturation
	Monoclonal Antibodies
	Antibody Purification
	Case study: Antibody
	Summary: Antibody
	Review Questions: Antibody
	References: Antibody
3: Antigens, Epitopes, and Immunogenicity
	Introduction: Antigens, Epitopes, and Immunogenicity
	Requirements for Immunogenicity
	Antigenic Determinants (Epitopes)
	Cross-Reactivity
	Major Histocompatibility Complex
	T-cell Receptors
	Antigen Processing
	Different Roles for MHC Classes I and II Molecules in an Immune Response
	The Exquisite Specificity of the Immune System
	Case Study: Antigens, Epitopes, and Immunogenicity
	Summary: Antigens, Epitopes, and Immunogenicity
	Review Questions: Antigens, Epitopes, and Immunogenicity
	References: Antigens, Epitopes, and Immunogenicity
4: Cellular Immunity
	Introduction: Cellular Immunity
	Cellular Interactions
	Antigen-Presenting Cells
	Subsets of T Cells
	T-cell Development in the Thymus
	Immunological Tolerance
	Antigen Presentation to T Cells
		Antigen Presentation to CD4+ T Cells
		Antigen Presentation to CD8+ T Cells
	Activation of T Cells
	Cytokines
		General Properties of Cytokines
		Functions of Cytokines
		Cytokines That Regulate Adaptive Immunity
	Assays for Measuring T-Cell Function
	Case Study: Cellular Immunity
	Summary: Cellular Immunity
	Review Questions: Cellular Immunity
	References: Cellular Immunity
5: Complement
	Introduction: Complement
	Functions of Complement
	The Formation of C3 Convertase by Each Pathway
		Alternative Pathway
		Lectin Pathway
	C5-9
	Biological Effects of Fragments
	Regulators of Complement
	Additional Functions
	Measurement of Components
	Complement Deficiencies
	Case Study: Complement
	Summary: Complement
	Review Questions: Complement
	References: Complement
Part 2 The Assays
	Part 2 The Assays
6: Agglutination and Precipitation Reactions: The Unlabeled Immunoassays
	Introduction: Agglutination and Precipitation Reactions: The Unlabeled Immunoassays
	Immunodiffusion Techniques
		Ouchterlony
		Radial Immunodiffusion
		Instrumental Methods to Enhance Sensitivity
	Agglutination Techniques
		Effect of a Charge on the Particle
		Instrumental Methods to Enhance Agglutination Sensitivity
	Case Study: Agglutination and Precipitation Reactions: The Unlabeled Immunoassays
	Summary: Agglutination and Precipitation Reactions: The Unlabeled Immunoassays
	Laboratory Exercise: Agglutination and Precipitation Reactions: The Unlabeled Immunoassays
	Review Questions:Agglutination and Precipitation Reactions: The Unlabeled Immunoassays
	References: Agglutination and Precipitation Reactions: The Unlabeled Immunoassays
7: Labeled Immunoassays
	Introduction: Labeled Immunoassays
	Types of Heterogeneous Assays
		Indirect Immunoassay
		Sandwich or Capture Immunoassay
		Competitive Assays
		Western Blot
		Flow Cytometry
		Multiplexed Fluorescent Microbead Assays
	Labels for Heterogeneous Assays
		Enzyme Immunoassays: Enzymes and Substrates
		Fluorescent Immunoassays
	Types of Homogeneous Assays
	Interfering Substances
	Sensitivity Comparisons
	Case Study: Labeled Immunoassays
	Summary: Labeled Immunoassays
	Review Questions: Labeled Immunoassays
	References: Labeled Immunoassays
8: Serology Laboratory Math
	Introduction: Serology Laboratory Math
	Laboratory Dilutions
	Sensitivity and Specificity Determinations
	Efficiency
	Positive and Negative Predictive Values
	Short Refresher on Units
	Case Study: Serology Laboratory Math
	Summary: Serology Laboratory Math
	Laboratory Exercise: Serologu Laboratory Math
	Review Questions: Serology Laboratory Math
	References: Serology Laboratory
Part 3 Serology of Noninfectious Clinical Disorders
	Part 3 Serology of Noninfectious Clinical Disorders
9: Hypersensitivity Reactions
	Introduction: Hypersensitivity Reactions
	Hypersensitivity Reactions
	Type I (Immediate) Hypersensitivity
		Clinical Manifestations and Molecular Mechanisms
		Why Are Only Certain People Allergic?
		Why Are Some Antigens Allergenic?
		Testing for Type I Hypersensitivity
		Skin Testing
		Prophylaxis and Treatment
	Type II Hypersensitivity
		Transfusion Reactions
		Hemolytic Anemia
		Hemolytic Disease of the Fetus and Newborn
	Type III Hypersensitivity
	Type IV Hypersensitivity
	Case Study: Hypersensitivity Reactions
	Summary: Hypersensitivity Reactions
	Review Questions: Hypersensitivity Reactions
	References: Hypersensitivity Reactions
10: Systemic Autoimmunity
	Introduction: Systemic Autoimmunity
	Mechanisms of Autoimmunity
	Genetic Factors
	Gender
	Infection and Environmental Factors
	Mechanisms of Pathology
	Types of Autoimmune Diseases
	Systemic Lupus Erythematosus
		Signs and Symptoms
		Pathophysiology
		Diagnosis and Testing
		Subsets of ANA
		Treatment
	Rheumatoid Arthritis
		Pathophysiology
		Diagnosis and Testing
		Treatment
	Other Common Tests
	Case study: Systemic Autoimmunity
	Summary: Systemic Autoimmunity
	Laboratory Exercise 1: Systemic Autoimmunity
	Laboratory Exercise 2: Systemic Autoimmunity
	Review questions: Systemic Autoimmunity
	References: Systemic Autoimmunity
11: Organ and Tissue Specific Autoimmunity
	Introduction: Organ and Tissue Specific Autoimmunity
	Endocrine System
		Thyroid Gland
		Pancreas
		Adrenal Gland
		Reproductive Organ Failure
	Digestive System
		Intestinal Diseases
		Pernicious Anemia
		Inflammatory Bowel Disease
		Hepatic Diseases
	Integumentary System
		Pemphigus and Pemphigoid Disorders
		Dermatitis Herpetiformis
	Musculoskeletal System
	Nervous System
	Vascular System
	Pulmonary and Renal Systems
	Exocrine Glands
	Case Study 1: Organ and Tissue Specific Autoimmunity
	Case Study 2: Organ and Tissue Specific Autoimmunity
	Summary: Organ and Tissue Specific Autoimmunity
	Review Questions: Organ and Tissue Specific Autoimmunity
	References: Organ and Tissue Specific Autoimmunity
12: Tumor Immunology
	Introduction: Tumor Immunology
	Diagnosis and Screening
	Monitoring Patients for Response and Recurrence
	Staging Use of Tumor Markers in Blood or Tissues
		Serum Markers for Screening, Diagnosis, Monitoring, and Staging
		Tissue Markers by Immunohistochemistry and Fluorescence in situ Hybridization
	Detection of Circulating or Disseminated Tumor Cells
	Immunolocalization and Radioimmunotherapy
	Immunotherapy
	Genetic Markers
	Case Study: Tumor Immunology
	Summary: Tumor Immunology
	Review Questions: Tumor Immunology
	References:Tumor Immunology
13: Immunoproliferative Diseases
	Introduction: Immunoproliferative Diseases
	Leukemias
	Lymphomas
	Plasma Cell Dyscrasias
		Multiple Myeloma
		Heavy Chain Disease
		Light Chain Disease
		Waldenström Macroglobulinemia
	Laboratory Analysis of Lymphoproliferative Disorders
		Laboratory Analysis of Myeloma and Macroglobulinemia
		Immunofixation Electrophoresis
	Case study 1: Immunoproliferative Diseases
	Case study 2: Immunoproliferative Diseases
	Summary: Immunoproliferative Diseases
	Review Questions: Immunoproliferative Diseases
	References: Immunoproliferative Diseases
14: Immunology of Transplantation
	Introduction: Immunology of Transplantation
	Blood Transfusions and Blood Groups
	Blood Grouping
	Tissue and Organ Transplantation
	The Concept of Histocompatibility
	Mechanisms of Rejection
	Clinical Manifestation of Rejection
	Graft-Versus-Host Disease
	Laboratory Testing
		HLA Typing
		Detection of Anti-HLA Antibodies
	Cytomegalovirus
	Survival and Success
	Xenotransplantation
	Immunosuppressive Therapy
	Specific Immunosuppressive Therapies
	An Allograft We Do Not Reject
	Case Study: Immunology of Transplantation
	Summary:Immunology of Transplantation
	Review Questions:Immunology of Transplantation
	References: Immunology of Transplantation
15: Primary Immunodeficiency Diseases
	Introduction: Primary Immunodeficiency Diseases
	Primary Immunodeficiencies
	Immunoglobulin Deficiencies
		Selective IgA Deficiency
		Common Variable Immunodeficiency
	T-Cell Immunodeficiencies
		DiGeorge Syndrome
		Purine Nucleoside Phosphorylase Deficiency
	Severe Combined Immunodeficiencies
	Complement Deficiencies
	Defects In Phagocyte Function
		Chronic Granulomatous Disease
		Leukocyte Adherence Deficiency
	Diagnostic Tests
	Treatment
	Case study: Primary Immunodeficiency Diseases
	Summary: Primary Immunodeficiency Diseases
	Review Questions: Primary Immunodeficiency Diseases
	References: Primary Immunodeficiency Diseases
Part 4 Serology of Infectious Clinical Disorders
	Part 4 Serology of Infectious Clinical Disorders
16: Acquired Immunodeficiency
	Introduction: Acquired Immunodeficiency
	Malnutrition
	Metabolic Defects, Genetic Implications, and Drugs
	HIV Infection and AIDS
		Virology
		Viral Infection and Replication
		HIV and Immune Responses
		Pathogenesis
		Symptoms and Clinical Characteristics
		Classification of AIDS
		Treatment
		The Hope for an AIDS Vaccine
	Laboratory Tests for HIV
		CD4+ Counts
		Testing for Antibodies
		Screening Tests
		Confirmatory Tests
		Testing for Viral Components
		Testing Algorithms
	Case study: Acquired Immunodeficiency
	Summary: Acquired Immunodeficiency
	Review Questions: Acquired Immunodeficiency
	References: Acquired Immunodeficiency
17: Hepatitis
	Introduction: Hepatitis
	Fecal-Oral Hepatitis: Hepatitis A and E
		Hepatitis E
	Bloodborne Hepatitis: Hepatitis B, D, and C
		Treatment
		Hepatitis D
		Hepatitis C
		Diagnosis
	Case Study: Hepatitis
	Summary: Hepatitis
	Review Questions: Hepatitis
	References: Hepatitis
18: Herpesviridae Family and Other Serologically Diagnosed Viruses
	Introduction: Herpesviridae Family and Other Serologically Diagnosed Viruses
	The Herpesviridae Family
		Epstein-Barr Virus
		Cytomegalovirus
		Herpes Simplex 1 and 2
		Varicella Zoster
	Other Serologically Diagnosed Viruses
		Rubella
		Measles (rubeola)
		Mumps
		West Nile Virus
		Influenza Virus
	Case study 1: Herpesviridae Family and Other Serologically Diagnosed Viruses
	Case study 2: Herpesviridae Family and Other Serologically Diagnosed Viruses
	Summary: Herpesviridae Family and Other Serologically Diagnosed Viruses
	Review Questions: Herpesviridae Family and Other Serologically Diagnosed Viruses
	References: Herpesviridae Family and Other Serologically Diagnosed Viruses
19: Bacterial Serology
	Introduction: Bacterial Serology
	Host Defense Mechanisms
	Specific Microorganisms
	Streptococci
		Group A Strep
		Clinical Implications of S. pyogenes Infections
		Rheumatic Fever
		Detection and Diagnostics for Streptococci
	Helicobacter Pylori
		Diagnosis and Testing
	Mycoplasma Pneumoniae
		Diagnosis and Testing
	Rickettsia
		Serology and Diagnostics
	Clostridium Difficile
		Testing
	Spirochetes
		Treponema Pallidum Pallidum
		Syphilis
		Stages of Syphilis
		Prevention
		Diagnostic Tests and Serology
		Lyme Disease
		Immunopathology
		Diagnosis and Laboratory Testing
		Polymerase Chain Reaction
	Case study 1: Bacterial Serology
	Case study 2: Bacterial Serology
	Case study 3: Bacterial Serology
	Case study 4: Bacterial Serology
	Summary: Bacterial Serology
	Review Questions: Bacterial Serology
	References: Bacterial Serology
20: Fungi and Parasites
	Introduction: Fungi and Parasites
	Introduction to Fungi
		Aspergillus
		Blastomyces Dermatitidis
		Candidiasis
		Coccidioides Immitis
		Diagnosis and Treatment
		Cryptococcosis
		Histoplasmosis
		Pneumocystis Jiroveci (Formerly Known as Pneumocystis carinii)
	Introduction to Parasites
		Cryptosporidium Parvum
		Giardia Lamblia
		Toxoplasma gondii
		Diagnosis and Treatment
	Case Study 1: Fungi and Parasites
	Case Study 2: Fungi and Parasites
	Summary: Fungi and Parasites
	Review Questions: Fungi and Parasites
	References: Fungi and Parasites
Part 5 Additional Information Related to Clinical Laboratory Immunology
	Part 5 Additional Information Related to Clinical Laboratory Immunology
21: Forensic Serology
	Introduction: Forensic Serology
	History
	Chain of Custody
	Drug Screening Using Serological Techniques
	Other Forensic Analysis Using Serological Techniques
		Blood
		Semen
		Saliva
		Future
	Case study: Forensic Serology
	Summary: Forensic Serology
	Review Questions: Forensic Serology
	References: Forensic Serology
22: Basic Laboratory Safety
	Introduction: Basic Laboratory Safety
	Safety Equipment
	Personal Protection Equipment
	Safety Procedures and Universal Precautions
	Safety and The law
	Needlestick Injuries
	Postexposure Treatment
	Chemical and Radioactive Hazards
	General Safety
	Case Study: Basic Laboratory Safety
	Summary: Basic Laboratory Safety
	Review Questions: Basic Laboratory Safety
	References: Basic Laboratory Safety
23: Molecular Biology Techniques
	Introduction: Molecular Biology Techniques
	Nucleic Acids, Transcription, and Translation
	Nucleic Acid Probes
	Hybridization Using Solid Matrices
	In Situ Hybridization
	Single-Strand Conformational Polymorphism
	Microarrays
	Polymerase Chain Reaction
	Non-Pcr Amplification
	Pros and Cons of Amplification Techniques
	Case Study 1: Molecular Biology Techniques
	Case Study 2: Molecular Biology Techniques
	Summary: Molecular Biology Techniques
	Review Questions: Molecular Biology Techniques
	References: Molecular Biology Techniques
Answers to Review Questions
	Answers to Review Questions
Answers to Case Studies
	Answers to Case Studies
Answers to Checkpoints
	Answers to Checkpoints
Glossary
	Glossary