Cambridge Core - Medicine: General Interest - Essential Clinical Immunology - edited by John B. Zabriskie. Frontmatter. pp i-iv. Access. PDF; Export citation. ESSENTIALS. OF IMMUNOLOGY Nature of immunological reactions (side chain theory). . The clinical significance of the Wassermann reaction•. Clinical. Immunology. Clinical. Immunology. The Spectrum of Clinical Immunology. Basic . Essential for survival of microbes - ensures the target of the immune.
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Essential Clinical Immunology. The ways in which we can better understand cancer, HIV, and other autoimmune diseases through clinical immunology are of . Essentials of Clinical Immunology provides the most up-to-date, core information required to understand diseases with an immunological basis. Clinically. Library of Congress Cataloging-in-Publication Data. Chapel, Helen, author. Essentials of clinical immunology / Helen Chapel, Mansel Haeney, Siraj Misbah, .
Free shipping for individuals worldwide Usually dispatched within 3 to 5 business days. About this book Immunofluorescence, a suitable laboratory method for the microscopic demonstration of antigens and antibodies in biological materials, useable, for example, to provide evidence for the pathogenesis of disease in histological or cytological preparations and for tumour cell differentiation. For this reason immunofluorescence has a decisive role as the method of choice for the diagnosis of auto-immune diseases. This primer on immunofluorescence techniques, which first appeared in , is a richly illustrated handbook suitable for everyday practical work in the laboratory, useable as both an introduction to the subject as well as an atlas. In hardly any other area of medicine are there so many new findings to report.
In some cases, this is enough to clear the pathogen, but in other instances the first defence becomes overwhelmed and a second line of defence kicks in.
Adaptive immunity is the second line of defence which involves building up memory of encountered infections so can mount an enhanced response specific to the pathogen or foreign substance.
Adaptive immunity involves antibodies, which generally target foreign pathogens roaming free in the bloodstream. Also involved are T cells, which are directed especially towards pathogens that have colonised cells and can directly kill infected cells or help control the antibody response. Immune dysfunction and clinical immunology The immune system is a highly regulated and balanced system and when the balance is disturbed, disease can result.
Research in this area involves studying disease that is caused by immune system dysfunction. Much of this work has significance in the development of new therapies and treatments that can manage or cure the condition by altering the way the immune system is working or, in the case of vaccines, priming the immune system and boosting the immune reaction to specific pathogens.
Immunodeficiency disorders involve problems with the immune system that impair its ability to mount an appropriate defence. There are two types of immunodeficiency disorders: primary immunodeficiencies are typically present from birth, are generally hereditary and are relatively rare. Such an example is common variable immunodeficiency CVID. Secondary immunodeficiencies generally develop later in life and may result following an infection, as is the case with AIDS following HIV infection.
For more information, please see our briefing on immunodeficiency. Autoimmune diseases occur when the immune system attacks the body it is meant to protect. The principles of immunology have provided a wide variety of laboratory tests for the detection of autoimmune diseases.
Autoimmune diseases may be described as 'primary' autoimmune diseases, like type-1 diabetes, which may be manifested from birth or during early life; or as 'secondary' autoimmune diseases, which manifest later in life due to various factors. Rheumatoid arthritis and multiple sclerosis are thought to belong to this type of autoimmunity. For more information, please see our briefing on autoimmune diseases. Allergies are hypersensitivity disorders that occur when the body's immune system reacts against harmless foreign substances, resulting in damage to the body's own tissues.
Almost any substance can cause allergies an allergen , but most commonly, allergies arise after eating certain types of food, such as peanuts, or from inhaling airborne substances, such as pollen, or dust.
In allergic reactions, the body believes allergens are dangerous and immediately produces substances to attack them. This causes cells of the immune system to release potent chemicals like histamine, which causes inflammation and many of the symptoms associated with allergies. Immunology strives to understand what happens to the body during an allergic response and the factors responsible for causing them. This should lead to better methods of diagnosing, preventing and controlling allergic diseases.
For more information, please see our breifing on allergies. Asthma is a debilitating and sometimes fatal disease of the airways. It generally occurs when the immune system responds to inhaled particles from the air, and can lead to thickening of the airways in patients over time. It is a major cause of illness and is particularly prevalent in children. In some cases it has an allergic component, however in a number of cases the origin is more complex and poorly understood.
Cancer is a disease of abnormal and uncontrolled cell growth and proliferation and is defined by a set of hallmarks, one of which is the capacity for cancer cells to avoid immune destruction.
With the knowledge that evasion of the immune system can contribute to cancer, researchers have turned to manipulating the immune system to defeat cancer immunotherapy. Other applications of immunological knowledge against cancer include the use of monoclonal antibodies proteins that seek and directly bind to a specific target protein called an antigen.
An example is Herceptin, which is a monoclonal antibody used to treat breast and stomach cancer. Moreover, a number of successful cancer vaccines have been developed, most notably the HPV vaccine. For more information, please see our briefing on cancer immunotherapy. Transplants involve transferring cells, tissues or organs from a donor to a recipient.
Hall, M. Fischetti, Ph. Kumararatne, M. Sipos, M. Reeves, M. Vahlne, M. Ehrlich, M. Field, M. Krueger, M. Crow, M. Van Voorhis, M. Buckner, M. Rose, M. Wilkinson, Ph. Venstrom, M.
Young, M. Laboratory of Bacterial Manhasset. Jacksonville Professor of Immunology. Division of Infectious Diseases Jonathan D. NY Department of Medicine. Pediatric Allergy and Seattle.
NY vii. University of Washington Director. FL Necker Hospital. Department of Rheumatology Assistant Attending Physician. France Department of Pediatrics Nina Bhardwaj.. NY Pathogenesis Mary K. Research Head.
Contributors Dalit Ashany. Italy Department of Medicine. NY Assistant Professor of Medicine. University of Florida. NY Manlio Ferrarini. University Department of Pathology New York. Lloyd Mayer. MD viii Contributors.. Ireland Boston. Australia Baltimore. NY James G. MA Matthew Kosboth. Jacqueline Friedman. NY William W. FL Medicine New York. NY Chief. Clinical Professor Professor and Chairman. Division of Clinical Immunology Allan Gibofsky. Minoru Satoh. NY Contributors ix. Huddinge Lijun Yang.
Robert J. FL Head. New York. Immunology and Laboratory Fellow. South Africa Karolinska University Hospital. Biomedical Fellow Training Program Director. Sweden Associate Professor Department of Pathology. Van Voorhis. Attending Physician and Member Director. Wesley C. Molecular Medicine Microbiology. Jeffrey M. NY Chief Interim. NY Clayton. FL Washington. DC Anders G. Innate Immunity Professor of Medicine. Australia Lisa Zaba. Haoyang Zhuang. FL x Contributors. NY Gainesville. Professor Emeritus.
The reverse is also see. Some of the best examples of attack self. Cellular responses are version of those aspects of immunology established by cells and can only be trans- that have particular relevance to clinical ferred by cells. Merrill Chase.
Refer to the Bibliography for the extraordinary beginnings of the con- a more extensive discussion of the role of cept of a cellular arm of the immune sys- each component. This chapter is not a comprehensive review and can be divided into various classes of of immunology but rather a condensed immunoglobulins. See the Bibliography for immunology. As we shall antibody responses. It is the memory of the initial study of immunodeficient humans and response that provides the booster effect.
Children and animals who have an ated through the lymphocyte. For example. Humoral immune deficit in the humoral response responses are antibodies produced in do not make antibodies but can reject 1. The pathways of both cell self-recognition and T-lymphocyte effector types are depicted in Figure 1. Several types of molecules play a vital and some bacterial infections quite well. In the case of B bodies and yet retained the ability to reject cells.
The part of the molecule body production. They react with both T-cell recognition receptors and with antibodies. These molecules need the heavy and light chains include the anti- to be coupled to a carrier molecule to be gen-binding site. The amino acids of these antigenic. The ferences reside in the hypervariable areas of tertiary structure of the molecule as well the molecule and are usually only six to as the amino acid sequence is important ten amino acid residues in length.
The basic structure of the antibody mol- These antigenic molecules may have sev. This part dependent or thymus-independent anti. When in determining antigenicity. Certain struc. Each chain to many different antibodies with different is composed of domains of amino acids binding sites. T-cell participation: Most proteins and In any individual. Certain polysaccharides.
Most bac- gers are called interleukins or cytokines. Most of these dif- rier. Thymus-dependent antigens require and is known as the idiotype determinant. These molecules produce primarily chain CH. These soluble messen. C region made up of one domain in the linking antigen receptors on the surface of light chain C1 and three or four in a heavy B cells. It eral antigenic determinants.
The carrier may be a host protein. Thymus-independent antigens different heavy and light chains of the do not require T-cell participation for anti.
IgG2 and IgG4 react organisms. IgG3 activate complement efficiently and ecule consisting of five basic units held clear most protein antigens.
IgG1 and immunoglobulins. The major role IgM removal of microorganisms by phago- plays is the intravascular neutralization of cytic cells. This activation permits the segment never one of each. The reason mostly with carbohydrate antigens and are for this important physiological role is that relatively poor opsonins.
In contrast. Of all the human anti. This is the only it contains five complement-binding sites. An IgM antibody would be a pentameric structure of an IgG molecule. These differences are reflected in determin. IgG is a smaller molecule ticular antibody molecule. Although phagocytic cells or complement-mediated there are no known differences in the func. This mol. Hinge region allows for rotational and lateral movements of the two antigen- binding sites. IgE is produced by genes are broken up into coding systems plasma cells and binds to specific IgE recep.
The addition of a secretion molecule accomplished by increasing vascular per- prevents its digestion by enzymes present meability and inducing chemotactive fac- in mucosal and intestinal secretions. The exons ecule see Chapter 9 plays an extremely represent the central region of the heavy Basic Components of the Immune System 5.
Two other classes are worthy of note. The light and heavy chains are carried on IgD is synthesized by antigen-sensitive B different chromosomes. The major mucosal immunoglobulin. The heavy chain cells and is involved in the activation of genes are carried on chromosome Its function is unclear at present. IgA2 is the major IgA molecule in secretions Given this extraordinary ability to gen- and is quite effective in neutralizing anti.
This diversity is achieved by serum proteases and is thus less active for the way in which the genetics of antibody defense. Antigen- binding antigen site Fab domain Fc domain Figure 1.
These these cells by antigen. This enormous versatility allows Thus. By omitting the Cu gene animals. The heavy chain sets of exons called the D and J.
If these genes are eliminated by VH domain. With each gene recombinations are controlled by two single B cell. The product. These similarities have led to the isotype or class of immunoglobulins and concept that genes for antigen-specific T begins dividing. The com. The genes for TCR chains of antibody specificities to Basic Components of the Immune System 7. Two other important set of genes may be increased by somatic antigens present on TCR2 cells recognize mutation during multiple divisions of lym.
This permits a diver- IgM. The sequence noglobulins. The variable regions are also of events is as follows: These B cells will later mature into are members of a superantigen family. Signal transduction via the CD3 complex is regulated by a series Plasma membrane of kinases. Deficiencies or blocks Figure 1. As seen Once a given B cell is preselected to pro.
The B cell is now antigen responsive observed with immunoglobulin. Soluble adept at evading the immune system.
Figure 1. Because an immune system that needs to cope with of the rather low affinity of the reactions. Using virus-specific HLA.
The importance of this concept is under- Human histocompatibility antigens are scored by the experiments of Dougherty also known as human leucocyte antigens and Zinkernagel. This extensive polymorphism gens while suppressor cytotoxic T cells is important when viewed in the context of CD8 recognize class I antigens. Recognition of antigen by T cells is MHC restricted. They can produce genetic poly.
These antigens are cell. A are mixed with T cells of mouse A in morphism with multiple alleles at each the context of virus 1 peptides. The MHC class reticulum. If APC and T cell are of different lineage. Unlike Finally. B cells. X-ray crystallography studies CD8 cells. Basic Components of the Immune System 9. If APC and T cell are of same lineage but virus 2 is present. The products of all three exclusively to CD8 cells.
HLA- Finally. In humans. Their particular actions. They are secreted by macrophages ecule. Adhesion molecules are divided of the most powerful molecules in the into four major groups.
E endothelial. Immunoglobulin superfamily: The by a series of adhesion molecules on the molecules in this family are so called two cell surfaces. They diverse set of cell-surface glycoproteins and strengthen the interaction between the play a pivotal role in mediating cell-to-cell T cells and APCs.
Interleu- binding to extracellular matrix proteins kins 1 IL-1 and 2 IL-2 are of particu- such as fibronectin and vitronectin. One must endothelial cells. These cessed antigen. They mediate lymphocyte and This group of soluble molecules plays an monocyte binding to the endothelium extremely important role in clinical immu- receptors called vascular adhesion mol. They include some adhesion. IL-1 posed of three glycoproteins and are acts on a wide range of cells including T 10 Basic Components of the Immune System.
The letters denote the cells on consisting of binding of a TCR to the pro. P platelet. LFA-3 or CD These chemokines. Integrins are heterodimers: These through 3. These molecules are com. In this regard. See Table 1. The dendritic cells of the Basic Components of the Immune System These cells these specialized cells are called APCs.
The importance of this pathway is emphasized by the fact that antagonists The effector cells are really divided into to these co-stimulators do interrupt the two types: B cells and T cells. This interaction between on lymphocytes. T cells cannot and II antigens. Initiation IL IL-2 primarily acts specific T cells. B cells are immune response in both in vitro and in primarily responsible for antibody produc. Table 1. As seen in Figure 1. They must have a second signal.
These and the surface and excreted immuno- cells have receptors for complement and globulin are the same. It is important to remember. B phenomenon is known as clonal expan- cells. As mentioned before. Langerhans cells can capture anti. The final type of surface immu. These and are called plasma cells. This syndrome is called the gen in the periphery and migrate to sec.
This point noglobulin determines the class of anti. These cells latter antibodies will bind to antigen even express immunoglobulins on their sur. This processed immune complex face immunoglobulin that acts as its anti- containing antigen is closely associated gen-receptor site. In the early stages. This four types of cells are required: Through the process described ear. Deficiencies in either molecule since they are present in the largest protec. This activation is also aided by two other mechanisms.
T cells rec. The recognition of antigen ing B cells. T cells only recognize haptens ate with B cells and macrophages express. T cells have characteristic cell-surface there is a marked increase of specific helper glycoproteins that serve as markers of Basic Components of the Immune System B cells recognize reaction. These cells constitute an expanded ated animals. It is only then that the helper involves several receptors on the surface T cell secretes its cytokines to activate the of the T cells.
In turn. T cells. TH1 and TH2. They will not cooper. When helper T cells meet an antigen for the first time. The in vivo reactions between indi- develop a TH1 response develop only viduals undergoing transplantation will be limited disease tuberculoid leprosy. The major functions over 48 to 72 hours in which there is local of T cells can be divided into two catego. An example of cellular pathogen.
In TH2 profile interacts with diseases charac. Patients that cells. As TH2 cells secrete IL This was shown years ago in a In humans. In discussed in more detail in a later chapter. T cells were able to lyse target cells carry- An elegant example of these different ing the MHC class I molecules of the stim- pathways of the TH1 and TH2 response is ulating genetically different individual seen in the disease leprosy.
The induction of the which cytokine profile to secrete is not cytotoxic T cell requires precursor cells known. If the site ries: Injection of the same delayed hypersensitivity is to release material in a noninfected individual pro- cytokines. T cells secreting both molecules. Whereas the are used to combat intracellular pathogens cells in this case do not kill the organism. This cytotoxicity is virus specific. These such as viruses. This combination directly acti- cytokine profiles are designated THO.
When the antigen is injected under the skin of an individual who was Cellular Immunity previously infected with Mycobacterium Cell-mediated responses are implemented tuberculosis. These two types of cells tology is essentially negative. The antibody either IgM or the sequence relies on either spontaneous IgG causes a conformational change in decay or specific inactivation of these com.
C3 convertases. The cleavage of C3b can be initiated by three routes classical. This component The major function of the complement consists of six subunits and reacts with system is to help in the opsonization of micro. The acti- organisms and immune complexes. Individuals who lack one of the chapter. Minor fragments play a role in the a binding site for the first component fluid phase.
Classical pathway: As its name implies. The control of organism. The minor complement fragments con- Nonspecific Effector Molecules tribute to the immune response by activating There are a number of nonspecific mol.
These vation of this component requires the components plus antibody are more read. Immune com- lesion.
Fc and C3b receptors. This results in the presence but a brief outline of their functions is war. Individu- consists of a series of heat-liable proteins. These others are chemotactins for neutrophils and major factors are as follows: The in vivo state of the lesions activating the classical pathway comple- will be discussed in more detail in a later ments.
Each precursor is cleaved into two or more components. One is for binding to cell mem. After inactive. C3a possesses anaphylatoid and remain active. Then C3b can use and chemotactic activity. In contrast to the clas- activate C1q.
C1q in activates C3. The alternative pathway is phyloge. C3b here is unstable and. It can break netically older than the classical but down more C2. This molecule then can chose 2. The target can be a red cell.
Once the bacterium inhibitors of each component. Each of the cells in the immune response associated serine protease. Macrophages that is. This control is cell myeloid precursor as the macrophage. As seen in tion is important since many of its compo.
Lectin pathway: The third pathway of pathways such as clotting. The induction of an pass through the hole and the water fills adaptive immune response begins when a the cell.
These teins that increase the rates of breakdown cells also continue engulfing extracellular of these products. While many in circulating levels of MBL are asso.
Once accomplished. Salts and water immature and mature. Deficiencies has a particular role to play. These cells reside in most tissues The control of the complement activa. Once arrived. Electron phocyte. As will be seen to carry pathogenic antigens to the periph- later. Once these components are activated. They are dendritic cells is to secrete cytokines that attracted to the site by IL As in other cells.
Another function of activated vessels to the site of infection. Unlike other cells. There is great vari- ety in the tissue macrophages. Thus monocytes. Studies of animals with inflamed tissues. NK deficiencies indicate that they have a greater incidence of viral infections and malignancies. Their lineage is not known. They include mobile alveolar and NK cells also can kill target cells in the peritoneal macrophages.
These cells produce adhesin not known. Macrophages need a lectin-like receptor that recognizes carbo- activation to carry out these functions.
There are also absence of either antigen or antibody fixed cells in the liver called Kupffer cells stimulation. These cells The mature macrophage also derives are also phagocytic cells. These cells are organisms. In addition. As in other cell systems. To do this. NKR-PI is degrading enzymes. They are particularly effec- in the tissues. Fc receptors or most importantly as is also an inhibiting receptor called KIR.
NK cells. Most anti. In the latter. The use of an antibody-coated target to help and suppression. These but specific reactive T cells are also present.
The IgE pro. The result is intense local Many factors regulate the balance between inflammation. This killing is dependent on animals or humans. Activation of the Deposition of immune complexes depends mast cell results in the release of large on their size. IgM and IgG can be involved in factors are also probably involved. These reactions are rapid hence tant the nature of the antigen. Basic Components of the Immune System CELL BOUND mechanisms of killing most likely involve These reactions are initiated by anti- the release of cytoplasmic components of body reacting with antigen on the cell mem- the target cells and perforin.
A perfect example of the inhaled antibody to that antigen. These cells do not need simulta- neous recognition by MHC molecules.
The preformed antigen is ragweed pollen. Clinical examples include organ-specific autoimmune diseases and immune hemolytic anemia. Saunders Co. Travers P. New York: Raven Press. Hypersensitivity to sim- their lysosomal enzymes. There are numerous examples of this type Janeway CA.
Lichtman AH. Martinez PPD is injected into the skin of a person C. Harvey Lect. J Exp Med. Pober JS. The serum sickness. Doherty PC. Proc kines. Many of New York: Garland Publishing. Dalmasso AP. Zinkernagel RM. Walport M. Int Rev Immunol. Good RA. An excellent — The cytokines in turn attract other Soc Exp Biol Med. Proc Soc Exp Biol Med. The concept of type 1 and polymorphonuclear leucocytes. Suppression of antibody who has been previously infected with the forming capacity with thymectomy tuberculosis organism.
The cellular transfer of cutane- react with antigen and release TH1 cyto. Abbas AK. Fundamental Immunology. Many of these assays are automated and can be related to interna- This chapter is not designed to cover all tional standards.
Polyclonal antibodies: Many mammals that these tests do vary in their sensitivity have been used to produce antibodies. Some with prion disease. Antibodies for various tests can be pro- nosis while others are useful in subclassify.
The problem is that interpretation diagnosing human disease or. The specificity of a test cross-reactive antibodies to a given tis- is the proportion of individuals without sue. Qualitative assays are the techniques and assays used in clinical less specific and will give answers such immunology. A recent fear has been that ani- The various assays to be discussed mals such as sheep or cows may have later in this chapter can be conveniently eaten animal foddage contaminated divided into two main divisions.
Some are essential for diag. Immunological Techniques John B. Larger mammals. Often an number of diseased individuals that are animal species is selected for antibody positive for the test compared with those production because it will produce less- who are negative.
As like Australia or New Zealand where will be seen in many other chapters in this there have been no recorded cases of book. Precise measurement of serum mouse B cell and is therefore identical immunoglobulins is an essential corner- throughout its variable and constant stone in this area and is important for regions. This degree of dispersion can be also lose their specificity so that a given measured on a nephelometer. Large-scale culture The main principle behind this test is of these antibodies can provide large related to the formation of immune com- quantities of antibody that are precise in plexes between the antibody and a given their reactivity.
If the concentration of antigen— antibody complex is low. As the complexes increase with tion so that they no longer secrete as much concentration of antibody.
Using this method. The beauty machines. In brief. Antibody clones to measure immunoglobulins and other are only produced when the mouse B proteins has proceeded rapidly in recent cell fuses with the myeloma line. These hybridoma clones can some. Monoclonal antibodies: Over the past teen years. Most clinical immunology labo- fused B cells are eliminated by a spe. The introduction of automated machines ent in the spleen cells. These tests primarily use polyclonal compared with a standard control.
The Linked Immunosorbent Assays second antibody to this antigen or anti- ELISAs body is labeled with the appropriate fluo- The use of these highly sensitive assays in rochrome. Standard preparations are used can produce a curve of decreasing optical and have been calibrated against interna. Figure 2. The method spectrophotometer using a nm filter.
In the presence of an appropriate which depends on the known or estimated substrate. Its beauty is its simplicity counter see Figure 2. Once the serum or purified antibody or antigen to be tested is placed in Immunoblots the well. For detection of small amounts of a nal antibodies do not form immune pre. In this case. By keeping the known antigen constant tants. The procedure is relatively gen. The proteins to be studied are run substituted in place of the radioactive on a standard SDS gel.
The gel is then Immunological Techniques After This immunological technique has gained appropriate binding and further washes. One can label either antigen or antibody to determine amounts of antigen or antibody in a given serum or preparation. Examples would be patients with systemic body tagged to an enzyme and developed lupus erythematosus or vasculitis. In con- with an enzyme substrate to form a colored trast. Both methods are extremely sensitive and will detect very small amounts of antibody in a given serum.
ELISA is also depicted. This incubation usually lasts one C4 but normal factor B suggest that activa- hour. As noted in Chapter 1. The membrane is Perhaps the most useful assays for comple- treated overnight with a blocking buffer. Antibodies to the microbial products are negative bacteremia. This have paired sera usually taken two weeks is followed by incubation with first antibody 1: The bands are developed using compared to the first.
This would point to a gram. In most cases. Normal C4 levels usually found in normal individuals. The knowledge that many antibody see Figure Examples of the diseases cells CD8 and many other markers. Wells 2—7 contain three growth and development either as a result superantigens.
Acute rheumatic fever is such an example. But in these specimens. Elevation of all malities of antibody production like those three components usually suggests acute seen in immunodeficiency states. One can also do these an alkaline phosphatase substrate.
Antibodies to common microbial anti- gens have been used to detect infection This procedure is done as well as many other lymphocyte subsets.
Of this population.
All of these values are obtained antibody. The different cell populations are rapidly due to the speed with which cells aspirated into the machine. Isolation and purification of a given subset of cells can be achieved by a fluorescein-activated cell sorter. Once the called a fluorescein-activated cell sorter different cell populations are identified.
It should be emphasized that the cell surface is detected by the sensors values for lymphocyte subsets will change and analyzed by computer software. Light number of cells that are counted in the emitted by the excited fluorescent dye on thousands.
Using with increasing age from children to adults. This test assumes greater importance in ber of B cells expressing a novel antigen clinical immunology both at a research is identified. J Immunol Methods. The anticoagulated blood sample and platelets are mainly in areas above is usually diluted 1: Visvanathan K. Immunological Techniques Carreno-Manjarrez R.
The preferred to the bottom. Zabriskie JB. Each point on this plot represents fluorescence recorded from an individual lymphocyte as it passes through the counter. Once and slowly layered over the density gradi. Chapman F. Reprinted with permission from Elsevier. As seen in Figure 2. As noted. This technique may be used not only on fresh samples but also in tissues that have When these cells are stimulated by a formalin-fixed and paraffin-embedded specific antigen.
Another approach is the use of restric- tion endonucleases see Figure 2. The high affinity of the red cells and granulocytes spin to the bottom of the tube while a clear layer of probe for a complementary segment in the lymphocytes and monocytes is separated target DNA is the most specific intermo- by the gradient.
DNA technology has ushered in a whole Using enzymes with different specificities. In this technique of in situ hybrid- undergo proliferation activated cells and ization. More recently. The probe is detected vated cells can be measured by the num.
The probe. The complementary strands from target and probe DNA will Figure 2. These cells are counted lecular interaction between biological mac- and adjusted to a given number of cells for romolecules. The following is a short sum- mary of these techniques and their impor- Diluted blood tance in clinical immunology. DNA hybridization. Blotting the gel with the nitrocel. Complementary oligonu- fragment so that a single stranded DNA cleotide primers from either end of the will hybridize with the complementary target DNA are added to the denatured DNA after transfer to a special nitrocellu.
Alkaline dena. In the Southern blot. DNA hybridization is the most specific intermolecular interaction between biological macromolecules. The newly synthesized hybridizes to it. After com- Although the DNA analysis systems pleting about thirty cycles usually two described earlier are still used in research to three hours in an automated machine.
While most of the original testing of Dausset and others in the s and for the antigens on cells and for use in 30 Immunological Techniques.. Thus extreme care in populations. To use this method. It is a very powerful tool for detecting DNA sequences in tissues. This power.. The specimen must be handled carefully to avoid introduction of other DNA material.
After extensive research and handling specimens to be tested as well as workshop meetings. The they noticed that these sera agglutinated main disadvantage is that contamination leucocytes from unrelated donors and that of the reaction mixture with traces of the patterns of such co-agglutination dem- DNA from another source will lead to onstrated definitive antigens in human false positive results.
Using a somewhat e. These markers only sug- gest a susceptibility to the disease. A word of caution is warranted. In essence. Of par. Most disease states appear to be polygenic. One example array scanner. In addition of the human genome have been placed to the transplantation.
It is now known that certain MHC antigens confer N 1 2 3 4 5 1 2 3 4 5 6 7 8 resistance to a given disease. One takes the tissues or cells to be these antigens. Note ers will be identified in particular disease the decreased expression of red intensity in states.
The els of gene expressions across the human heat map describes 1. The converse is also true. The method is relatively straightfor- niques using purified antibodies to detect ward. The chips are are used for familial genetic studies as then washed.