Clinical Immunology and Serology: A Laboratory Perspective 5th Edition by Christine Stevens, ISBN-13: 978-0803694408

Description

Clinical Immunology and Serology: A Laboratory Perspective 5th Edition by Christine Stevens, ISBN-13: 978-0803694408

[PDF eBook eTextbook]

• Publisher: ‎ F.A. Davis Company; Fifth edition (January 28, 2021)
• Language: ‎ English
• 648 pages
• ISBN-10: ‎ 0803694407
• ISBN-13: ‎ 978-0803694408

The perfect balance of theory and practice!

Here’s the practical introduction you need to understand the essential theoretical principles of clinical immunology and the serological and molecular techniques commonly used in the laboratory. You’ll begin with an introduction to the immune system; then explore basic immunologic procedures; examine immune disorders; and study the serological and molecular diagnosis of infectious disease.

An easy-to-read, student-friendly approach emphasizes the direct application of theory to clinical laboratory practice. Each chapter is a complete learning module with learning outcomes, chapter outlines, theoretical principles, illustrations, and definitions of relevant terminology. Review questions and case studies help you assess your mastery of the material. A glossary at the end of the book puts must-know information at your fingertips.

Table of Contents:

Contents

SECTION I

Nature of the Immune System

1 Introduction to Immunity and the Immune System

Christine Dorresteyn Stevens, EdD, MT(ASCP)

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 and Plasma Cells

T Cells

Innate Lymphoid Cells and Natural Killer Cells

Organs of the Immune System

Primary Lymphoid Organs

Secondary Lymphoid Organs

2 Innate Immunity

Christine Dorresteyn Stevens, EdD, MT(ASCP) and Nadine Lerret, PhD, MLSCM(ASCP)

External Defense System

Internal Defense System

Pattern Recognition Receptors

Pattern Recognition Receptors and Disease

Acute-Phase Reactants

Inflammation

Phagocytosis

Action of Natural Killer Cells

Innate Lymphoid Cells

3 Nature of Antigens and the Major Histocompatibility Complex

Aaron Glass, PhD, MBCM(ASCP)

Factors Influencing the Immune Response

Traits of Antigens and Immunogens

Epitopes

Haptens

Adjuvants

Relationship of Antigens to the Host

Major Histocompatibility Complex

Genes Coding for MHC Molecules (HLA Antigens)

Expression of Class I and II MHC Molecules

Structure of Class I MHC Molecules

Structure of Class II MHC Molecules

Role of Class I and II Molecules in the Immune Response

The Class I MHC–Peptide Presentation Pathway

The Class II MHC–Peptide Presentation Pathway

Clinical Significance of MHC

4 Adaptive Immunity

Aaron Glass, PhD, MBCM(ASCP)

T-Cell Differentiation

Double-Negative Stage

Double-Positive Stage

Single-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

Antigen Presentation

Actions of T Helper and T Regulatory Cells

Action of Cytotoxic T Cells

The Role of B Cells in the Adaptive Immune Response

Immune Response to T-Dependent Antigens

Immune Response to T-Independent Antigens

5 Antibody Structure and Function

Linda E. Miller, PhD, MBCM(ASCP)SI

General Structure of Immunoglobulins

Two-Dimensional Structure

Treatment With Proteolytic Enzymes

Hinge Region

Isotypes, Allotypes, and Idiotypes

Three-Dimensional Structure of Antibodies

Antibody Classes

Immunoglobulin G (IgG)

Immunoglobulin M (IgM)

Immunoglobulin A (IgA)

Immunoglobulin D (IgD)

Immunoglobulin E (IgE)

Immunologic Memory: Primary and Secondary Antibody Responses

Antibody Specificity and Diversity

Clonal Selection

Immunoglobulin Genes

Rearrangement of Heavy-Chain Genes

Light-Chain Rearrangement

Additional Sources of Diversity

Immunoglobulin Class Switching

Monoclonal Antibodies

Hybridomas

Clinical and Research Applications

6 Cytokines

Aaron Glass, PhD, MB(ASCP)CM

Introduction to Cytokines

Cytokines in the Innate Immune Response

Cytokines and the Innate Response to Extracellular Microbes

The Interleukin-1 (IL-1) Cytokine Family

Tumor Necrosis Factors

Interleukin-6

Chemokines

Transforming Growth Factor-β

Interferon-α and Interferon-β (Type I Interferons)

Cytokines in the Adaptive Immune Response

Cytokines Produced by Th1 Cells

Cytokines Produced by Th2 Cells

Cytokines Associated With T-Regulatory Cells

Th17 Cytokines in Innate and Adaptive Immune Responses

Hematopoietic Growth Factors

Cytokine and Anti-Cytokine Therapies

Clinical Assays for Cytokines

7 The Complement System

Bradley Dixon, MD and Ashley Frazer-Abel, PhD, D(ABMLI)

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

Abnormalities of Major Pathway Complement Components

Abnormalities of Regulatory Complement Components

Laboratory Detection of Complement Abnormalities

Immunologic Assays of Individual Components

Assays for the Classical Pathway

Alternative and Lectin Pathway Assays

Testing Levels of Complement Activation

Interpretation of Laboratory Findings

Complement Therapeutics

SECTION II

Basic Immunologic Procedures

8 Safety and Quality Management

Marjorie Schaub Di Lorenzo, MT(ASCP)SH

Laboratory Hazards

Biological Hazards

Sharps Hazards

Chemical Hazards

Safety Data Sheets (SDS)

Chemical Hygiene Plan

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

Root Cause Analysis

9 Principles of Serological Testing

Linda E. Miller, PhD, MBCM (ASCP) SI and Christine Dorresteyn Stevens, EdD,

MT(ASCP)

Blood Specimen Preparation and Measuring

Dilutions

Simple Dilutions

Compound Dilutions

Serial Dilutions

Test Parameters

10 Precipitation and Agglutination Reactions

Christine Dorresteyn Stevens, EdD, MT(ASCP) and Linda E. Miller, PhD,

MBCM(ASCP)SI

Antigen–Antibody Binding

Affinity

Avidity

Law of Mass Action

Precipitation Curve

Three Zones of the Precipitation Reaction

Prozone and Postzone

Immunoturbidimetry and Nephelometry

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 Result Interpretation

11 Labeled Immunoassays

Paul R. Johnson, PhD, MBA, MT(ASCP), DABCC

Immunoassay Labels

General Immunoassay Formats

Heterogeneous Versus Homogeneous Immunoassays

Competitive Versus Noncompetitive Immunoassays

Radioimmunoassay (RIA)

Enzyme Immunoassays (EIAs)

Heterogeneous Enzyme Immunoassays

Competitive Enzyme Immunoassays

Noncompetitive Enzyme Immunoassays

Capture (Sandwich) Immunoassays

Biotin-Avidin Labeling

Interferences in Immunoassays

Antigen Interference

Antibody Interference

Biotin Interference

Other Technical Concerns

Homogeneous Enzyme Immunoassays

Chemiluminescent Immunoassays

Chemiluminescent Microparticle Immunoassay

Electrochemiluminescence Immunoassay

Fluorescent Immunoassays

Direct Immunofluorescence Assays

Indirect Immunofluorescence Assays

Multiplex Immunoassay (MIA)

Fluorescence Polarization Immunoassays

Rapid Immunoassays

12 Molecular Diagnostic Techniques

Lela Buckingham, PhD, MB(ASCP), DLM(ASCP)

DNA and RNA

Substituted Nucleotides

The Nucleic Acid Polymer

DNA Replication

RNA Synthesis

Protein Synthesis

DNA Sequence Changes

Polymorphisms

Electrophoresis

Gel Electrophoresis

Capillary Electrophoresis

Molecular Analysis

Strand Cleavage Methods

Specific Procedures

Hybridization Methods

Specific Procedures

Amplification Methods

Specific Procedures

DNA Sequencing

Specific Procedures

Chain Termination (Sanger) Sequencing

Pyrosequencing

Next-Generation Sequencing

Bioinformatics

13 Flow Cytometry and Laboratory Automation

Jeannie Guglielmo, MS, MAT, MLSCM(ASCP) and Songkai Hu, MA, MLSCM(ASCP)

Flow Cytometry

Instrumentation

Sample Preparation

Data Acquisition and Analysis

Clinical Applications

Immunoassay Automation

Validation

SECTION III

Immune Disorders

14 Hypersensitivity

Linda E. Miller, PhD, MBCM(ASCP)SI

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

Immunologic Mechanism

Clinical Examples of Type II Hypersensitivity

Testing for Type II Hypersensitivity

Type III Hypersensitivity

Immunologic Mechanism

Clinical Examples of Type III Hypersensitivity

Testing for Type III Hypersensitivity

Type IV Hypersensitivity

Immunologic Mechanism

Clinical Manifestations of Type IV Hypersensitivity

Skin Testing for Delayed Hypersensitivity

Interferon Gamma Release Assays (IGRAs)

15 Autoimmunity

Linda E. Miller, PhD, MBCM(ASCP)SI

Etiology of Autoimmune Disease

Self-Tolerance

Genetics

Other Endogenous and Environmental Factors

Systemic Autoimmune Diseases

Systemic Lupus Erythematosus (SLE)

Anti-Nuclear Antibodies (ANAs)

Anti-Phospholipid Antibodies

Rheumatoid Arthritis (RA)

Other Systemic Autoimmune Rheumatic Diseases (SARDs)

Granulomatosis With Polyangiitis (Wegener’s Granulomatosis)

Anti-Neutrophil 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)

Anti-Glomerular Basement Membrane Disease (Goodpasture’s Syndrome)

16 Transplantation Immunology

John L. Schmitz, PhD, D(ABMLI, ABHI)

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

Post-Transplant Testing

17 Tumor Immunology

Linda E. Miller, PhD, MBCM(ASCP) SI

Introduction to Tumor Biology

Tumor Antigens

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

18 Immunoproliferative Diseases

Linda E. Miller, PhD, MBCM(ASCP) SI

Malignant Transformation of Hematologic Cells

Cell Properties

Genetic Changes

Classification of Hematologic Malignancies

Leukemias

Acute Lymphoblastic Leukemias (ALLs)

Chronic Lymphocytic Leukemia (CLL)/Small Lymphocytic Lymphoma (SLL)

Hairy-Cell Leukemia

Lymphomas

Hodgkin Lymphomas (HLs)

Non-Hodgkin Lymphomas (NHLs)

Plasma-Cell Dyscrasias

Monoclonal Gammopathy of Undetermined Significance (MGUS) and Smoldering

Multiple Myeloma (SMM)

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 (sFLC) Analysis

Evaluation of Genetic and Chromosomal Abnormalities

19 Immunodeficiency Diseases

Thomas S. Alexander, PhD, D(ABMLI)

Clinical Effects of Primary Immunodeficiency Diseases

The Nine Categories of Primary Immunodeficiency Diseases

Category 3: Predominantly Antibody Deficiencies

Category 1: Immunodeficiencies Affecting Cellular and Humoral Immunity

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 Intrinsic and 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

Primary Immune Deficiencies in a Computer App

SECTION IV

Serological and Molecular Diagnosis of Infectious Disease

20 Serological and Molecular Detection of Bacterial Infections

James L. Vossler, MS, MLSCM(ASCP) SMCM

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

Proteomics

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 pylori Virulence Factors

Pathology and Pathogenesis

Diagnosis of H. pylori Infection

Mycoplasma pneumoniae

Mycoplasma pneumoniae Pathogenesis

Dermatological Manifestations

Immunology of Mycoplasma pneumonia Infection

Laboratory Diagnosis of Mycoplasma pneumoniae Infection

Rickettsial Infections

Agents of Rickettsia-Related Disease

Rocky Mountain Spotted Fever

21 Spirochete Diseases

Hamida Nusrat, PhD, PHM

Syphilis

Characteristics of Treponema pallidum

Mode of Transmission

Stages of the Disease

Congenital Syphilis

Nature of the Immune Response

Laboratory Diagnosis

Direct Detection

Treatment

Lyme Disease

Characteristics of Borrelia Species

Mode of Transmission

Stages of the Disease

Nature of the Immune Response

Laboratory Diagnosis

Treatment

Leptospirosis

Characteristics of Leptospira Species

Mode of Transmission

Stages of the Disease

Laboratory Diagnosis

Treatment

22 Serological and Molecular Diagnosis of Parasitic and Fungal Infections

James L. Vossler, MS, MLSCM(ASCP)SMCM

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

23 Serological and Molecular Detection of Viral Infections

Linda E. Miller, PhD, MBCM(ASCP)SI and Deborah Josko, PhD, MLT(ASCP)M, SM

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 (EBV)

Cytomegalovirus (CMV)

Varicella-Zoster Virus (VZV)

Other Viral Infections

Rubella

Rubeola

Mumps

Human T-Cell Lymphotropic Viruses

24 Laboratory Diagnosis of HIV Infection

Linda E. Miller, PhD, I, MBCM(ASCP)SI

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

CD4 T-Cell Enumeration

Quantitative Viral Load Assays

Drug-Resistance and Tropism Testing

Testing of Infants Younger Than 18 Months

25 Immunization and Vaccines

Linda E. Miller, PhD, MBCM(ASCP)SI

Vaccines

Historical Evolution of Vaccines

Types of Vaccines

Factors Influencing Immunogenicity

Challenges and Future Directions in Vaccine Development

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

Adoptive Immunotherapy for Cancer

CAR-T–Cell Therapy

Other Applications of Adoptive Immunotherapy

Glossary

References

Answer Key

Index

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