08 - 09 Immunology, Serology, Blood Banking

• Immunology

  • Defined as the study of the reactions of a host when foreign substances are introduced into the body.
• Antigen

  • these are foreign substances that can induce immune response
  • It can be harmful/harmless
• Antibody

  • Serum factors in the blood formed in response to foreign substance exposure.
  • produced by plasma cells
• Serology

  • Study of serum
  • known for the qualitative detection or quantitative analysis of antibodies or antigens concerning infection or disease diagnosis
• Immunity

  • can be defined as the way in which the body can protect itself from invasion by pathogenic microorganism and provide a defense against their harmful effect
• Immunity is classified in to two major groups:

  • Non-specific immunity
  • Specific immunity
• TWO TYPES OF ADAPTIVE IMMUNITY:

  • Active - (Natural Active ; Artificial Active)
  • Passive - (Natural Passive ; Artificial Passive)
• ACTIVE ADAPTIVE IMMUNITY

  1.Natural Active

  • Exposure to sub-clinical infections

  2.Artificial Active

  • Vaccination
• PASSIVE ADAPTIVE IMMUNITY

  1.Natural Passive

  • Placental transfer of IgG
  • Colostral transfer of IgA

  2.Artificial Passive

  • Antibodies or immunoglobulins
  • Immune cells
• Antigens

  • molecules that reacts with antibodies
  • Compound that does not necessarily elicit an immune response
  • Target of response
• PROPERTIES OF ANTIGENS

  • Immunogenicity
  • Antigenicity / Specificity
• Immunogenicity

  • ability to induce specific response resulting to formation of antibodies or immune lymphocytes
• Antigenicity/Specificity

  • the ability to react specifically with the antibody or cell that caused it to be produced
• Immunogens

  • Molecule that induce an immune response
  • Non-self
  • At least 2 antigenic determinant
• Haptens

  • Molecule that is NOT IMMUNOGENIC by itself but can react with a specific antibody: (1) Incomplete antigen , (2) Small molecules , (3)Univalent , and (4) High molecular weight nucleic acids
• Antibody

  • A.K.A. IMMUNOGLOBULINS (A gamma globulin protein)
• Antibody

  • Produced by “Plasma Cells”
• ANTIBODY

  • They play an essential role during "Antigen recognition ” and in biological activities related to immune response such as "opsonization ” and " complement activation ”
• Major Ig Classes:

  5 classes/ Isotypes (constant heavychain)

  • IgG: gamma heavy chain
  • IgA: alpha heavychain
  • IgM: mu heavychain
  • IgE: epsilon heavy chain
  • IgD: Delta heavychain
• Blood is collected aseptically by venipuncture into a clean, dry, sterile tube.
• Care must be taken to avoid hemolysis, since this may produce a false positive test.
• Serum should be promptly separated into another tube without transferring any cellular elements.
• Fresh, non-heat inactivated serum is usually recommended for testing.

  • There are certain serological test that requires inactivated serum.
  • Like VDRL and FTA-Abs
  • Serum should be heated at 56 degrees C for 30 minutes
• If testing cannot be performed immediately...

  • 2 - 8 degrees C for up to 72 hrs, -20 degrees C if > 72 hours delay.
• Depending on the scope of testing performed in an immunology laboratory, transporting and receiving patient specimens must be considered.
• Regulations for packaging and labeling developed by the U.S. Department of Transportation (DOT), the International Air Transport Association (IATA), and the United Nations must be followed.
• Characteristic of a transport container suspected infectious specimen

  (DOT and IATA rules)

  • Watertight primary containers made of glass, metal, or plastic with a positive (screw-on) cap.
• Characteristic of a transport container suspectedinfectious specimen

  (DOT and IATA rules)

  • The primary container must be wrapped with enough absorbent material to be capable of absorbing all of its contents. Multiple specimens must be wrapped individually prior to placing them in the leak-proof secondary container.
• Characteristic of a transport container suspectedinfectious specimen

  (DOT and IATA rules)

  • The secondary container is placed in a sturdy outer container made of corrugated fiberboard, wood, metal, or rigid plastic.
  • An itemized list of contents in a sealed plastic bag is also placed in the outer container.
  • Ice packs are placed between the secondary and the outer container.
  • Additional measures must be taken when using ice and dry ice.
• In January 2007, labeling of the outer container changed. Theterms clinical specimen and diagnostic specimen have beenreplaced with biological substances, Category B. This wording is placed next to the label UN 3373.
• Tests performed in the Immunology/Serology Section:

  Anti-HIV

  • Screening test for human immunodeficiency virus
• Tests performed in the Immunology/Serology Section:

  Antinuclear antibody (ANA)

  • Detects nuclear autoantibodies
• Tests performed in the Immunology/Serology Section:

  Antistreptolysin O (ASO) screen

  • Detects a previous Streptococcus infection
• Tests performed in the Immunology/Serology Section:

  C-reactive Protein (CRP)

  • Elevated levels indicate inflammatory disorders
• Tests performed in the Immunology/Serology Section:

  Cold agglutinins

  • Elevated levels indicate a typical (Mycoplasma) pneumonia
• Tests performed in the Immunology/Serology Section:

  Tests that evaluate the function of the immune system:

  • Complement Levels
  • Immunoglobulin (IgG, IgA, IgM) levels
• Tests performed in the Immunology/Serology Section:

  Cytomegalovirus antibody (CMV)

  • Detects cytomegalovirus infection
• Tests performed in the Immunology/Serology Section:

  Febrile agglutinins

  • Detect antibodies to microorganism causing fever
• Tests performed in the Immunology/Serology Section:

  Fluorescent antinuclear antibody (FANA)

  • Detects and identifies nuclear autoantibodies
• Tests performed in the Immunology/Serology Section:

  Fluorescent treponemal antibody-absorbed (FTA-ABS)

  • Confirmatory test for syphilis