Clinical Immunology and Serology: A Laboratory Perspective

Editor/Author Stevens, Christine Dorresteyn
Publication Year: 2017
Publisher: F.A.Davis Company

ISBN: 978-0-8036-4466-3
Category: Health & Medicine - Medicine
Image Count: 263
Book Status: Pending
Predicted Release Month: Sept 2017
Table of Contents

Here’s the must-have information you need to understand the essential principles of immunology and to master the serology techniques most commonly used in the laboratory. Easy-to-read, student-friendly coverage focuses on the direct application of theory to clinical laboratory practice, preparing you for the real world in which you will practice.

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Table of Contents

  • Preface
  • Art Consultant
  • Contributors
  • Reviewers
  • Acknowledgments
  • SECTION I Nature of the Immune System
  • 1 Introduction to Immunity and the Immune System - Christine Dorresteyn Stevens
  • IMMUNITY AND IMMUNIZATION
  • INNATE VERSUS ADAPTIVE IMMUNITY
  • CELLS OF THE INNATE IMMUNE SYSTEM
  • Leukocytes in Peripheral Blood
  • Tissue Cells
  • CELLS OF THE ADAPTIVE IMMUNE SYSTEM
  • B Cells
  • T Cells
  • Natural Killer (NK) Cells
  • ORGANS OF THE IMMUNE SYSTEM
  • Primary Lymphoid Organs
  • Secondary Lymphoid Organs
  • SUMMARY
  • CASE STUDIES
  • REVIEW QUESTIONS
  • 2 Nature of Antigens and the Major Histocompatibility Complex - Christine Dorresteyn Stevens
  • FACTORS INFLUENCING THE IMMUNE RESPONSE
  • TRAITS OF IMMUNOGENS
  • EPITOPES
  • HAPTENS
  • ADJUVANTS
  • RELATIONSHIP OF ANTIGENS TO THE HOST
  • MAJOR HISTOCOMPATIBILITY COMPLEX
  • Genes Coding for MHC Molecules (HLA Antigens)
  • Structure of Class I and II MHC Molecules
  • Role of Class I and II Molecules in the Immune Response
  • Clinical Significance of MHC
  • SUMMARY
  • CASE STUDY
  • REVIEW QUESTIONS
  • 3 Innate Immunity - Christine Dorresteyn Stevens
  • EXTERNAL DEFENSE SYSTEM
  • INTERNAL DEFENSE SYSTEM
  • Pathogen Recognition Receptors
  • Acute-Phase Reactants
  • Inflammation
  • Phagocytosis
  • Action of Natural Killer Cells
  • SUMMARY
  • CASE STUDIES
  • REVIEW QUESTIONS
  • 4 Adaptive Immunity - Christine Dorresteyn Stevens
  • T-CELL DIFFERENTIATION
  • Double-Negative Stage
  • Double-Positive Stage
  • Mature T Cells
  • STAGES IN B-CELL DIFFERENTIATION
  • Pro-B Cells
  • Pre-B Cells
  • Immature B Cells
  • Mature B Cells
  • Plasma Cells
  • THE ROLE OF T CELLS IN THE ADAPTIVE IMMUNE RESPONSE
  • Action of T Helper Cells
  • Action of Cytotoxic T Cells
  • THE ROLE OF B CELLS IN THE ADAPTIVE IMMUNE RESPONSE
  • Response to T-Dependent Antigens
  • Response to T-Independent Antigens
  • LABORATORY IDENTIFICATION OF LYMPHOCYTES
  • SUMMARY
  • CASE STUDIES
  • REVIEW QUESTIONS
  • 5 Antibody Structure and Function - Christine Dorresteyn Stevens
  • TETRAPEPTIDE STRUCTURE OF IMMUNOGLOBULINS
  • THE NATURE OF LIGHT CHAINS
  • HEAVY-CHAIN SEQUENCING
  • HINGE REGION
  • THREE-DIMENSIONAL STRUCTURE OF ANTIBODIES
  • Immunoglobulin G (IgG)
  • Immunoglobulin M (IgM)
  • Immunoglobulin A (IgA)
  • Immunoglobulin D (IgD)
  • Immunoglobulin E (IgE)
  • THEORIES TO EXPLAIN ANTIBODY DIVERSITY
  • Ehrlich’s Side-Chain Theory
  • Clonal Selection Hypothesis
  • GENES CODING FOR IMMUNOGLOBULINS
  • Rearrangement of Heavy-Chain Genes
  • Light Chain Rearrangement
  • MONOCLONAL ANTIBODY
  • Hybridomas
  • Clinical Applications
  • SUMMARY
  • CASE STUDIES
  • REVIEW QUESTIONS
  • 6 Cytokines - Rita M. Heuertz and Uthayashanker R. Ezekiel
  • INTRODUCTION TO CYTOKINES
  • CYTOKINES IN THE INNATE IMMUNE RESPONSE
  • Interleukin-1 (IL-1)
  • Tumor Necrosis Factors
  • Interleukin-6
  • Chemokines
  • Transforming Growth Factor-β
  • Interferon-α and Interferon-β
  • CYTOKINES IN THE ADAPTIVE IMMUNE RESPONSE
  • Th1 Cytokines
  • Th2 Cytokines
  • Cytokines Associated With T Regulatory Cells
  • TH17 CYTOKINES IN INNATE AND ADAPTIVE IMMUNE RESPONSES
  • HEMATOPOIETIC GROWTH FACTORS
  • CYTOKINE AND ANTICYTOKINE THERAPIES
  • CLINICAL ASSAYS FOR CYTOKINES
  • SUMMARY
  • CASE STUDY
  • REVIEW QUESTIONS
  • 7 Complement System - Ashley Frazer-Able and Christine Dorresteyn Stevens
  • PATHWAYS OF THE COMPLEMENT SYSTEM
  • The Classical Pathway
  • The Lectin Pathway
  • The Alternative Pathway
  • SYSTEM CONTROLS
  • Regulation of the Classical and Lectin Pathways
  • Regulation of the Alternative Pathway
  • Regulation of Terminal Components
  • COMPLEMENT RECEPTORS AND THEIR BIOLOGICAL ROLES
  • BIOLOGICAL MANIFESTATIONS OF COMPLEMENT ACTIVATION
  • COMPLEMENT AND DISEASE STATES
  • COMPLEMENT DEFICIENCIES
  • Major Pathway Components
  • Regulatory Factor Components
  • LABORATORY DETECTION OF COMPLEMENT ABNORMALITIES
  • Immunologic Assays of Individual Components
  • Assays for the Classical Pathway
  • Alternative Pathway Assays
  • Interpretation of Laboratory Findings
  • SUMMARY
  • CASE STUDIES
  • REVIEW QUESTIONS
  • SECTION II Basic Immunologic Procedures
  • 8 Safety and Quality Management - Marjorie Schaub Di Lorenzo
  • LABORATORY HAZARDS
  • Biological Hazards
  • Sharps Hazards
  • Chemical Hazards
  • Radioactive Hazards
  • Electrical Hazards
  • Fire and Explosive Hazards
  • Physical Hazards
  • QUALITY MANAGEMENT
  • Procedure Manual
  • Preexamination Variables
  • Examination Variables
  • Postexamination Variables
  • REGULATORY ISSUES
  • Clinical Laboratory Improvement Amendments (CLIA)
  • Clinical and Laboratory Standards Institute (CLSI)
  • The Joint Commission (TJC)
  • College of American Pathologists (CAP)
  • QUALITY MANAGEMENT SYSTEMS
  • Quality System Essentials
  • The Lean System
  • Six Sigma
  • SUMMARY
  • CASE STUDIES
  • REVIEW QUESTIONS
  • 9 Principles of Serological Testing - Christine Dorresteyn Stevens
  • BLOOD SPECIMEN PREPARATION AND MEASURING
  • DILUTIONS
  • Simple Dilutions
  • Compound Dilutions
  • Test Parameters
  • SUMMARY
  • CASE STUDY
  • REVIEW QUESTIONS
  • 10 Precipitation and Agglutination Reactions - Christine Dorresteyn Stevens
  • ANTIGEN-ANTIBODY BINDING
  • Affinity
  • Avidity
  • Law of Mass Action
  • PRECIPITATION CURVE
  • Zone of Equivalence
  • Prozone and Postzone
  • MEASUREMENT OF PRECIPITATION BY LIGHT SCATTERING
  • PASSIVE IMMUNODIFFUSION TECHNIQUES
  • Radial Immunodiffusion
  • Ouchterlony Double Diffusion
  • ELECTROPHORETIC TECHNIQUES
  • COMPARISON OF PRECIPITATION TECHNIQUES
  • PRINCIPLES OF AGGLUTINATION REACTIONS
  • TYPES OF AGGLUTINATION REACTIONS
  • Direct Agglutination
  • Passive Agglutination
  • Reverse Passive Agglutination
  • Agglutination Inhibition
  • INSTRUMENTATION
  • QUALITY CONTROL AND QUALITY ASSURANCE
  • SUMMARY
  • CASE STUDIES
  • REVIEW QUESTIONS
  • 11 Labeled Immunoassays - Christine Dorresteyn Stevens
  • FORMATS FOR LABELED ASSAYS
  • Competitive Immunoassays
  • Noncompetitive Immunoassays
  • HETEROGENEOUS VERSUS HOMOGENEOUS ASSAYS
  • RADIOIMMUNOASSAY
  • ENZYME IMMUNOASSAYS
  • Heterogeneous Enzyme Immunoassays
  • Homogeneous Enzyme Immunoassays
  • Rapid Immunoassays
  • FLUORESCENT IMMUNOASSAYS
  • Direct Immunofluorescent Assays
  • Indirect Immunofluorescent Assays
  • Fluorescence Polarization immunoassays
  • CHEMILUMINESCENT IMMUNOASSAYS
  • SUMMARY
  • CASE STUDY
  • REVIEW QUESTIONS
  • 12 Molecular Diagnostic Techniques - Lela Buckingham
  • CHARACTERISTICS OF DEOXYRIBONUCLEIC ACID AND RIBONUCLEIC ACID
  • Nucleotides
  • The Nucleic Acid Polymer
  • DNA Replication
  • RNA Synthesis
  • Protein Synthesis
  • Mutations
  • Polymorphisms
  • MOLECULAR ANALYSIS
  • Strand Cleavage Methods
  • Hybridization Methods
  • Amplification Methods
  • DNA SEQUENCING
  • Sanger (Chain Termination) Seguencing
  • Pyroseguencing
  • Next Generation Seguencing (NGS)
  • SUMMARY
  • CASE STUDIES
  • REVIEW QUESTIONS
  • 13 Flow Cytometry and Laboratory Automation - Candace Golightly and Jeannie Guglielmo
  • CELL FLOW CYTOMETRY
  • Instrumentation
  • Data Acquisition and Analysis
  • Sample Preparation
  • Clinical Applications
  • IMMUNOASSAY AUTOMATION
  • Validation
  • SUMMARY
  • CASE STUDIES
  • REVIEW QUESTIONS
  • SECTION III Immune Disorders
  • 14 Hypersensitivity - Linda E. Miller
  • TYPE I HYPERSENSITIVITY
  • Immunologic Mechanism
  • Genetic and Environmental Influences on Type I Hypersensitivity
  • Clinical Manifestations of Type I Hypersensitivity
  • Treatment of Type I Hypersensitivity
  • Testing for Type I Hypersensitivity
  • TYPE II HYPERSENSITIVITY
  • Clinical Examples of Type II Hypersensitivity
  • Testing for Type II Hypersensitivity
  • TYPE III HYPERSENSITIVITY
  • Arthus Reaction
  • Serum Sickness
  • Autoimmune Diseases and Other Causes of Type III Hypersensitivity
  • Testing for Type III Hypersensitivity
  • TYPE IV HYPERSENSITIVITY
  • Contact Dermatitis
  • Hypersensitivity Pneumonitis
  • Skin Testing for Delayed Hypersensitivity
  • SUMMARY
  • CASE STUDIES
  • REVIEW QUESTIONS
  • 15 Autoimmunity - Linda E. Miller
  • ETIOLOGY OF AUTOIMMUNE DISEASE
  • Self-Tolerance
  • Genetics
  • Other Endogenous and Environmental Factors
  • SYSTEMIC AUTOIMMUNE DISEASES
  • Systemic Lupus Erythematosus (SLE)
  • Antinuclear Antibodies (ANAs)
  • Antiphospholipid Antibodies
  • Rheumatoid Arthritis (RA)
  • Granulomatosis With Polyangiitis (Wegener’s Granulomatosis)
  • Antineutrophil Cytoplasmic Antibodies (ANCAs)
  • ORGAN-SPECIFIC AUTOIMMUNE DISEASES
  • Autoimmune Thyroid Diseases (AITDs)
  • Type 1 Diabetes Mellitus (T1D)
  • Celiac Disease
  • Autoimmune Liver Diseases
  • Multiple Sclerosis (MS)
  • Myasthenia Gravis (MG)
  • Goodpasture’s Syndrome
  • SUMMARY
  • CASE STUDIES
  • REVIEW QUESTIONS
  • 16 Transplantation Immunology - John L. Schmitz
  • HISTOCOMPATIBILITY SYSTEMS
  • Major Histocompatibility Complex (MHC) Antigens
  • Minor Histocompatibility Antigens (mHAs)
  • MHC Class I-Related Chain A (MICA) Antigens
  • ABO Blood Group Antigens
  • Killer Immunoglobulin-Like Receptors (KIRs)
  • Self-Antigens
  • ALLORECOGNITION
  • TRANSPLANT REJECTION
  • Hyperacute Rejection
  • Acute Rejection
  • Chronic Rejection
  • GRAFT-VERSUS-HOST DISEASE (GVHD)
  • IMMUNOSUPPRESSIVE AGENTS
  • CLINICAL HISTOCOMPATIBILITY TESTING
  • HLA Typing
  • HLA Phenotyping
  • HLA Genotyping
  • HLA Antibody Screening, Identification, and Crossmatching
  • SUMMARY
  • CASE STUDIES
  • REVIEW QUESTIONS
  • 17 Tumor Immunology - Linda E. Miller
  • INTRODUCTION TO TUMOR BIOLOGY
  • TUMOR ANTIGENS
  • Tumor-Specific Antigens (TSAs)
  • Tumor-Associated Antigens (TAAs)
  • CLINICALLY RELEVANT TUMOR MARKERS
  • Clinical Uses of Tumor Markers: Benefits and Limitations
  • Serum Tumor Markers
  • LABORATORY DETECTION OF TUMORS
  • Tumor Morphology
  • Immunohistochemistry
  • Immunoassays for Circulating Tumor Markers
  • Molecular Methods in Cancer Diagnosis
  • INTERACTIONS BETWEEN THE IMMUNE SYSTEM AND TUMORS
  • Immune Defenses Against Tumor Cells
  • Innate Immune Responses
  • Adaptive Immune Responses
  • IMMUNOEDITING AND TUMOR ESCAPE
  • Elimination
  • Equilibrium
  • Escape
  • IMMUNOTHERAPY
  • Active Immunotherapy and Cancer Vaccines
  • Passive Immunotherapy
  • Adoptive Immunotherapy
  • SUMMARY
  • CASE STUDIES
  • REVIEW QUESTIONS
  • 18 Immunoproliferative Diseases - Donald C. Lehman
  • MALIGNANT TRANSFORMATION OF HEMATOLOGIC CELLS
  • Cell Properties
  • Genetic Changes
  • CLASSIFICATION OF HEMATOLOGIC MALIGNANCIES
  • LEUKEMIAS
  • Acute Lymphocytic Leukemia (ALL)
  • Chronic Lymphocytic Leukemia or Lymphoma
  • Hairy Cell Leukemia
  • LYMPHOMAS
  • Hodgkin Lymphoma (HL)
  • Non-Hodgkin Lymphoma (NHL)
  • PLASMA CELL DYSCRASIAS
  • Monoclonal Gammopathy of Undetermined Significance (MGUS)
  • Multiple Myeloma
  • Waldenström Macroglobulinemia
  • Heavy-Chain Diseases
  • ROLE OF THE LABORATORY IN EVALUATING IMMUNOPROLIFERATIVE DISEASES
  • Immunophenotyping by Flow Cytometry
  • Evaluation of Immunoglobulins
  • Serum Protein Electrophoresis (SPE)
  • Immunofixation Electrophoresis (IFE)
  • Serum Free Light Chain Analysis (sFLC)
  • Evaluation of Genetic and Chromosomal Abnormalities
  • SUMMARY
  • CASE STUDIES
  • REVIEW QUESTIONS
  • 19 Immunodeficiency Diseases - Thomas S. Alexander
  • CLINICAL EFFECTS OF PRIMARY IMMUNODEFICIENCIES
  • THE NINE CATEGORIES OF PRIMARY IMMUNODEFICIENCIES
  • Category 3: Predominantly Antibody Deficiencies
  • Category 1: Combined Immunodeficiencies
  • Category 2: Combined Immunodeficiencies With Associated or Syndromic Features
  • Category 4: Diseases of Immune Dysregulation
  • Category 5: Congenital Defects of Phagocyte Number, Function, or Both
  • Category 6: Defects in Innate Immunity
  • Category 7: Autoinflammatory Disorders
  • Category 8: Complement Deficiencies
  • Category 9: Phenocopies of Primary Immunodeficiencies
  • LABORATORY EVALUATION OF IMMUNE DYSFUNCTION
  • Screening Tests
  • Confirmatory Tests
  • Newborn Screening for Immunodeficiencies
  • Evaluation of Immunoglobulins
  • Bone Marrow Biopsy
  • Family History
  • SUMMARY
  • CASE STUDIES
  • REVIEW QUESTIONS
  • SECTION IV Serological and Molecular Diagnosis of Infectious Disease
  • 20 Serological and Molecular Detection of Bacterial Infections - James L. Vossler
  • HUMAN-MICROBE RELATIONSHIPS
  • BACTERIAL VIRULENCE FACTORS
  • Structural Virulence Features
  • Extracellular Virulence Factors
  • Endotoxin and Exotoxins
  • IMMUNE DEFENSES AGAINST BACTERIAL INFECTIONS AND MECHANISMS OF EVASION
  • Immune Defense Mechanisms
  • Bacterial Evasion Mechanisms
  • LABORATORY DETECTION AND DIAGNOSIS OF BACTERIAL INFECTIONS
  • Bacterial Culture
  • Microscopic Visualization
  • Antigen Detection
  • Molecular Detection
  • Serological Diagnosis
  • GROUP A STREPTOCOCCI (STREPTOCOCCUS PYOGENES)
  • Classification and Structure
  • Virulence Factors
  • Clinical Manifestations of Group A Streptococcal Infection
  • Group A Streptococcal Sequelae
  • Laboratory Diagnosis
  • HELICOBACTER PYLORI
  • Helicobacter H pylori Virulence Factors
  • Pathology and Pathogenesis
  • Diagnosis of H pylori Infection
  • MYCOPLASMA PNEUMONIAE
  • Mycoplasma Pneumoniae Pathogenesis
  • Dermatological Manifestations
  • Immunology of Mycoplasma Pneumoniae Infection
  • Laboratory Diagnosis of Mycoplasma Pneumoniae Infection
  • RICKETTSIAL INFECTIONS
  • Agents of Rickettsia-Related Disease
  • Rocky Mountain Spotted Fever
  • SUMMARY
  • CASE STUDIES
  • REVIEW QUESTIONS
  • 21 Spirochete Diseases - Marc Golightly, Candace Golightly, and Christine Dorresteyn Stevens
  • SYPHILIS
  • Characteristics of the Organism
  • Mode of Transmission
  • Stages of the Disease
  • Congenital Syphilis
  • Nature of the Immune Response
  • Laboratory Diagnosis
  • LYME DISEASE
  • Characteristics of the Organism
  • Stages of the Disease
  • Nature of the Immune Response
  • Laboratory Diagnosis
  • Treatment
  • RELAPSING FEVER GROUP—BORRELIA MIYAMOTOI
  • Characteristics of the Organism
  • Stages of the Disease
  • Laboratory Diagnosis
  • SUMMARY
  • CASE STUDIES
  • REVIEW QUESTIONS
  • 22 Serological and Molecular Diagnosis of Parasitic and Fungal Infections - James L. Vossler
  • PARASITIC IMMUNOLOGY
  • Immune Responses to Parasites
  • Parasite Survival Strategies
  • Serodiagnosis of Parasitic Diseases
  • Molecular-Based Diagnosis of Parasitic Disease
  • FUNGAL IMMUNOLOGY
  • Characteristics of Fungi
  • Classification of Mycotic Infections (Mycoses)
  • Immune Responses to Fungi
  • Laboratory Diagnosis of Fungal Infections
  • Fungal Pathogens
  • SUMMARY
  • CASE STUDIES
  • REVIEW QUESTIONS
  • 23 Serology and Molecular Detection of Viral Infections - Linda E. Miller
  • IMMUNE DEFENSES AGAINST VIRAL INFECTIONS
  • VIRAL ESCAPE MECHANISMS
  • LABORATORY TESTING FOR VIRAL INFECTIONS
  • HEPATITIS VIRUSES
  • Hepatitis A
  • Hepatitis E
  • Hepatitis B
  • Hepatitis D
  • Hepatitis C
  • HERPES VIRUS INFECTIONS
  • Epstein-Barr Virus
  • Cytomegalovirus
  • Varicella-Zoster Virus
  • OTHER VIRAL INFECTIONS
  • Rubella
  • Rubeola
  • Mumps
  • Human T-Cell Lymphotropic Viruses
  • SUMMARY
  • CASE STUDIES
  • REVIEW QUESTIONS
  • 24 Laboratory Diagnosis of HIV Infection - Linda E. Miller
  • HIV TRANSMISSION
  • CHARACTERISTICS OF HIV
  • Composition of the Virus
  • Structural Genes
  • Viral Replication
  • IMMUNOLOGIC MANIFESTATIONS
  • Immune Responses to HIV
  • Effects of HIV Infection on the Immune System
  • CLINICAL SYMPTOMS OF HIV INFECTION
  • TREATMENT AND PREVENTION
  • LABORATORY TESTING FOR HIV INFECTION
  • SCREENING AND DIAGNOSIS
  • Testing Algorithms
  • Serological Test Principles
  • Qualitative Nucleic Acid Tests (NATs)
  • DISEASE MONITORING
  • CD4T-Cell Enumeration
  • Quantitative Viral Load Assays
  • Drug Resistance Testing
  • TESTING OF INFANTS YOUNGER THAN 18 MONTHS
  • SUMMARY
  • CASE STUDIES
  • REVIEW QUESTIONS
  • 25 Immunization and Vaccines - Linda E. Miller
  • VACCINES
  • Historical Evolution of Vaccines
  • Conventional Vaccines
  • Factors Influencing Immunogenicity
  • Next Generation Vaccines
  • Benefits and Adverse Effects of Vaccines
  • PASSIVE IMMUNIZATION
  • Passive Immunization as Therapy for Infectious Diseases
  • Advantages and Limitations of Passive Immunization
  • Immunosuppressive Effects of Passive Immunization
  • Monoclonal Antibodies
  • ADOPTIVE IMMUNOTHERAPY
  • SUMMARY
  • CASE STUDIES
  • REVIEW QUESTIONS
  • Glossary
  • References
  • Answer Key