Antigen (Immunogen) Process by which serum proteins

any substance (as a toxin or (C3b) attach to foreign substances and

enzyme) that stimulates the production of enhance phagocytosis.
antibodies Adjuvant
Antibody (Immunoglobulin) An immunological agent that
Specific glycoproteins produced in increases the antigenic response.
response to an antigenic challenge. Inflammation
Antigenicity Tissue reaction injury by physical or
ability of an antigen to stimulate an chemical agents, including microorganisms.
immune response. Specificity, Memory, Mobility, Replicability,
Immunity Cooperativity (SMMRC)
Process of being protected against Characteristics of an immune
foreign antigens. system?
Auto-immunity Recognize self from non-self; Defend body
Condition where the body's own against non-self
antigenic structures stimulate an immune Functions of the immune system?
response and react with self-antigens in a Lymphocytes
manner similar to the destruction of foreign What are the specific elements of
antigens. the immune system?
Antigenic determinants Mononuclear phagocytosis,
Combining sites or sites with which polymorphonuclear leukocytes,
antibodies react. complements
Epitope What are the essential components
A single antigenic determinant. of the immune system (non-specific)?
Portion of an antigen that combines with an Helps amplify the immune system's
antibody paratope. functions
Paratope What do non-specific components
Part of the antibody molecule that do?
makes contact with the antigenic Helps recover from disease, provides
determinant. natural and acquired resistance to infectious
Hapten disease
Very small molecules that can bind What does the immune system want
to a larger carrier molecule and behave as to accomplish?
an antigen. These substances are Allergy, rejection of transplanted organ,
ANTIGENIC ONLY when coupled to a auto-immune disorder (ARA)
protein carrier. Undesirable consequences of the
Carrier immune system?
A molecule when coupled with a Skin, mucosal membrane surface
hapten, renders the hapten immunogenic. Body's first line of defense?
Lymphokine (aka cytokine) Body fluids, specialized cells, resident
Soluble protein mediator that is bacteria (BSR)
released by sensitized lymphocytes in Other body defenses?
contact with an antigen. Immunity
Opsonization
 Process of being protected against Contact sensitivity (poison ivy), delayed
foreign antigens sensitivity (contact dermatitis), viral and
Active, Passive (Natural, Artficial) fungal immunity, rejection foreign tissue
2 types of Immunity? graft
Cell mediated (mast cells, macrophages, Cell-mediated immunity responsible for the
WBC's); Humoral mediated (antibodies, immunologic events
complements)
2 mechanisms of immunity T-lymph, neutrophil, eosinophil,
Active immunity monocytes/macrophage, basophil
Generated by the actual production Components of cell-mediated immunity?
of antibodies in response to a foreign Humoral Immunity
antigen Results from formation and release
Active Natural Immunity of antibodies into the bloodstream.
Antibodies are produced after being
exposed to a disease that develops B-lymph, Antibodies, Lymphokines,
resistance. Complements
Active Artificial Immunity Components of Humoral Immunity?
Injection of live, killed, or attenuated
microorganisms. Immune response
Passive Immunity Any reaction demonstrating specific
Results from transfer of antibodies response production to antigenic stimulus.
from one individual to another.
Passive Natural Immunity Cell-mediated, humoral-mediated, Many
During pregnancy, IgG antibodies reactions display both
are able to pass from maternal to fetal Forms of immune response
circulation, antibodies also pass in the
breast milk. Primary, secondary
Passive Artificial Immunity 2 types of immune responses
Person is injected with
serum/plasma containing antibody (gamma Primary response
globulin) IgM is the first antibody class produced

70-80% Natural Killer cells 1. Lag - no antibody detectable 2. Log -

These cells have the appearance of large antibody titer rises 3. plateau - titer
granular lymphocytes that destroy target stabilizes 4. decline - titer declines
cells through cytotoxic reaction. Phases of primary immune response

1. Link between T-lymph and phagocytes 2. Secondary/Anamnestic response

Involves direct cell to cell contact between Subsequent exposure to the same antigen.
the macrophages and the invading antigen
Theory of cell-mediated immunity Secondary/Anamnestic response
Phagocytosis IgG antibody is the predominant class
Function of cell-mediated immunity? formed, antibody titer will be higher.
1. Lag - (shorter) no/some antibody They can induce antibodies that can "cross
detectable 2. log - antibody titer rises 3. react" with self-antigens.
plateau - (longer) titer stabilizes 4. (gradual)
titer declines Foreignness (must be more foreign),
`Phases of secondary/anamnestic degradability (must be easily degraded),
response. molecular weight (must be heavier),
structural stability, complexity (FDMSC)
Autoantigens, histocompatibility, blood 5 Factors that affect antigenicity
group, microbial/heterophile
4 types of antigen Foreignness
Degree to which an antigen is recognized
Autoantigen as non-self by the individual's immune
One's own antigen stimulates the production system.
of autoantibody
Degradability
Histocompatibility Foreign molecules that are rapidly
Antigens from the surface of nucleated cells destroyed will not be present long enough to
that readily provoke an immune response in provide adequate antigenic exposure.
a genetically different individual of the same
species. Molecular weight
The higher the _____________, the better
Major histocompatibility complex the molecule will function as an antigen.
Referred to as the human leukocyte antigen
(HLA) system in humans because its gene
products were originally identified on WBC's Structural stability
HLA, ABO Stability of the molecular structure is
____ antigens are second only to ____ mandatory, unstable molecules make poor
antigens in influencing the survival or graft antigens.
rejection of transplanted organs.

Complexity
Tissues, blood cells, body fluids Simple repeating units do not make good
Blood group antigens widely distributed immunogens. The more complex an
throughout? (3) antigen, the more immunogenic it will be.

Microbial antigens Peptide bond

Pathogenic organisms (bacteria, virus, Immunoglobulin consists of the sequence of
fungi, etc) that induce an immune response amino acid residues linked together
that can also become heterophile antigens. by_____________?

Heterophile antigens Heavy chains

It serve as the basis in classifying Amino acid sequence is identical, light
antibodies. Only one type per antibody chains have one constant region, heavy
structure. chains have one or more constant region.

Gamma, Mu, Alpha, Delta, Epsilon IgG (gamma)

5 types of heavy chains. Major IG in normal serum, binds to
microorganisms in extravascular spaces.

Light chains
Only one class per antibody structure. IgG1
Immunoglobulin that is most efficient at
crossing the placenta.
Kappa (65% molecules), Lambda (35%
molecules)
2 classes of light chains. Monomer shape
IgG shape.

FAB, FC, Hinge, variable, constant

5 regions of fragments. Provide immunity to newborn, neutralize
toxins, protect against circulating bacteria
and viruses, opsonization
FAB IgG functions (4)
Capable of antigen binding, made of one
whole light chain and half of heavy chain.
Pentamer shape (5 monomers)
IgM shape
FC
This portion will crystallize, only contains the
constant region of the heavy chain IgM
It accounts for 10% of the Ig pool, confinced
to blood due to its LARGE size, 1st antibody
Hinge region produced in immune response.
Allows antibody to be flexible and attach to
the antigen.
Activates complements, neutralizes toxins,
opsonization
Variable region Functions of IgM (3)
Located in FAB portion, amino acid
sequences vary widely between types.
15-20%
IgA accounts for about _______% of Ig
Constant region pool.
 ___________system is part of the humoral
Tears, saliva, colostrums/milk, intestinal immunity.
secretions
IgA is predominant in? (4)
C1q, C1r, C1s, C4, C2, Factor B, Factor D,
Properdin, C3, C5, C6, C7, C8, C9, C1 INH,
IgA1, IgA2 Factor I, Factor H, C4 binding protein
Subclasses of IgA? (2) 18 components of the complement system.

Can be monomer, dimer, trimer (dimer is C1q, C1r, C1s, C4, C2

held by a J chain) 5 proteins unique to classic pathway.
IgA shape?

Factor B , factor D, Properdin

Known to produce anaphylactic reactions, 3 proteins unique to alternate pathway.
protects body against invading
microorganisms
Functions of IgA? C3, C5, C6, C7, C8, C9
6 proteins used in both pathways.

IgD
Accounts for less than 1% of C1 INH, Factor I, Factor H, C4 binding
immunoglobulin pool, primarily a cell protein
membrane Ig found on the surface of 4 control proteins.
B-lymph in association with IgM.

WBC, RBC, Thrombocyte, Gram negative

IgE bacteria
Its major importance is in allergic reactions 4 cells that are naturally most fragile to
and parasitic infections, provides immunity complement.
to invading parasites. It mediates the
release of histamines/heparin from basophil
and mast cells. IgG, IgM
The only antibodies react with complement.

Neutralizes toxic substances, facilitate

phags, kill microbes, combine with antigens 56 degree C for 30 minutes
on cellular surfaces. Heating serum requirement to destroy
Functions of immunoglobulins? (4) complement activity.

Complement system
Complement protein proceeds in a T. pertenue common in Caribbean, Latin
cascading sequence of activation, results in America, Central Africa, and the Far East.
cell lysis and also controls inflammation
Functions of complement system.
Pinta
T. carateum found in Latin America,
Bacterial cell walls, fungal cell walls, infection limited to the skin.
viruses, virally infected cells, some
parasites
5 factors capable of affecting alternate False positive
pathway. Antibodies from bejel, yaws, and pinta can
cause __________________ in
non-treponemal tests.
Treponema Pallidum
Syphilis is caused by what sperochete type
bacteria? Chancre
Characteristic called ______________
develops at the point of initial inoculation.
Gastrointestinal and genital tract of humans
Where does the genus treponema and its
species reside? Around the genitalia (90%)
Chancre is usually located where in the
Darkfield microscopy body?
What do you use to perform direct
examination of treponema?
1-5 weeks, 4-6 weeks
Chancre will persist in _____ weeks, will be
fine, spiral organisms, has a characteristic completely healed in _____.
corkscrew motility
Microscopically, how does syphilis appear
like? 2-8 weeks
Secondary syphilis occurs within _____
weeks after the appearance of chancre and
8-24 coils; 6-15 um long can be as long as 6 months.
how many coils and how long is a syphilis?

General illness: headache, sore throat,

Bejel fever, lesions on skin and mucous
T. pallidum found in North Africa, Eastern membrane, rash on palms and soles
Mediterranean, the Balkans. Symptoms of a secondary syphilis
suggesting a viral infection.

Yaws
2-6 weeks
Lesions on skin in secondary syphilis of the palate, collapse of nasal bones,
spontaneously subside after ____ weeks. interstitial keratitis and nerve deafness.

2-4 years of infection Congenital syphilis

Latent syphilis lasts for _______ years of It is caused by maternal spriochetemia and
infection. transplacental transmission of
microorganism.

Serological methods
Latent syphilis non-infectious state in which RPR, VDRL
diagnosis can only be made by What are the 2 non-treponemal tests?
_________________.

Reagin
Placenta to a fetus What is the antibody-like substance in a
Where does the spirochetes pass through non-treponemal test?
during a relapse?

Cardiolipin
3-10 years What is the carbon particle antigen used to
Tertiary syphilis usually lasts _______ years detect the presence of reagin?
after primary infection.

FTA-ABS, MHA TP
Tertiary syphilis What are the 2 treponemal tests?
It is characterized by the presence of
destructive granulomas called gummas.
Flocculation
What occurs if reagin is present in RPR
Skin, mucous membranes, bone, muscles test?
Where do gummas be located? (4)

2-8 degree C, Unopened antigen for 12

Develops cardiovascular manifestations and months, opened antigen for 3 months, 18G
involve the CNS, brain tissue causing needle w/o bevel, 60 +/-3 drops, 50 ul/0.05
general paresis, dementia, delusion ml, 100 RPM, 0.9% saline
What happens if patient is untreated from Reagents and equipments for RPR testing?
tertiary syphilis?

180 RPM
Congenital syphilis What is the speed of the rotator for VDRL?
Its characteristics include fissure around the
mouth and anus, skeletal lesion, perforation
FTA-ABS
What is the most sensitive serological
procedure in the detection of primary
syphilis and has 95% sensitivity in
diagnosing tertiary syphilis?

2 ml serum from clotted blood heated at 56

degree C for 30 min.
FTA temperature when heating the serum.

Killed T. pallidum
What is mixed with the patient's serum for
FTA-ABS?

Anti-Human Globulin is added, killed T.

pallidum will fluoresce or glow
What is added in the patient's serum and
killed T. pallidum? What will happen if T.
pallidum antibodies are present when
viewed under a fluorescent microscope?

T. pallidum sensitized RBC's

What antigen is used for performing
MHA-TP?

They will agglutinate with the RBC's coated

with T. pallidum antigens
What happens when T pallidum
antibodiesare present in the serum when
performing MHA-TP?