Unit #6C – Clinical Unit #6C – Clinical Laboratory Testing – Laboratory Testing –

Basic Basic Serology/ImmunologySerology/Immunology

Cecile Sanders, M.Ed., Cecile Sanders, M.Ed., MT(ASCP), MT(ASCP),

CLS (NCA)CLS (NCA)

Unit #6C – Clinical Laboratory Unit #6C – Clinical Laboratory Testing - Basic Testing - Basic

Serology/ImmunologySerology/ImmunologyThe Immune SystemThe Immune System

– Complex system of tissues, cells, Complex system of tissues, cells, cell products, & biologically active cell products, & biologically active chemicalschemicals

– Produces an Produces an Immune ResponseImmune Response– Defense mechanism against Defense mechanism against

foreign substances called foreign substances called “antigens” (ag)“antigens” (ag)

Unit #6C – Clinical Laboratory Unit #6C – Clinical Laboratory Testing - Basic Testing - Basic

Serology/ImmunologySerology/Immunology Natural Resistance vs. Specific Natural Resistance vs. Specific

ImmunityImmunity– Natural ResistanceNatural Resistance

Includes physical barriers (skin, mucous Includes physical barriers (skin, mucous membranes, etc.), white blood cells like membranes, etc.), white blood cells like neutrophils, and proteins that cause neutrophils, and proteins that cause inflammationinflammation

Non-specificNon-specificDoes not require exposure to an antigenDoes not require exposure to an antigen

Unit #6C – Clinical Laboratory Unit #6C – Clinical Laboratory Testing - Basic Testing - Basic

Serology/ImmunologySerology/Immunology– Specific Immune ResponseSpecific Immune Response

Recognition – recognizes foreign antigens Recognition – recognizes foreign antigens and distinguishes them from “self”and distinguishes them from “self”

Specificity – reacts with a specific antigen Specificity – reacts with a specific antigen without reacting with otherswithout reacting with others

Memory – “anamnestic response”Memory – “anamnestic response”

Unit #6C – Clinical Laboratory Unit #6C – Clinical Laboratory Testing - Basic Testing - Basic

Serology/ImmunologySerology/Immunology Cells, Tissues, and Organs of Immune Cells, Tissues, and Organs of Immune

SystemSystem– Lymphocytes – B Cells and T CellsLymphocytes – B Cells and T Cells– Primary Lymphoid Organs = Bone Primary Lymphoid Organs = Bone

Marrow and Thymus (glandular Marrow and Thymus (glandular

tissue locatedtissue located

at the base of theat the base of the

sternum)sternum)

Unit #6C – Clinical Laboratory Unit #6C – Clinical Laboratory Testing - Basic Testing - Basic

Serology/ImmunologySerology/Immunology– Secondary Lymphoid Tissue = Spleen, Lymph Secondary Lymphoid Tissue = Spleen, Lymph

Nodes, Appendix, and TonsilsNodes, Appendix, and Tonsils Humoral ImmunityHumoral Immunity

– B Lymphocytes produce antibodies against B Lymphocytes produce antibodies against specific antigensspecific antigens

– Good protection against bacteria, toxins, and Good protection against bacteria, toxins, and circulating antigenscirculating antigens

Cell-Mediated ImmunityCell-Mediated Immunity– T Lymphocytes protect against viruses, fungi, T Lymphocytes protect against viruses, fungi,

tumor cells, and intracellular organismstumor cells, and intracellular organisms

Unit #6C – Clinical Laboratory Unit #6C – Clinical Laboratory Testing - Basic Testing - Basic

Serology/ImmunologySerology/Immunology Immunoglobulins (Ig)Immunoglobulins (Ig)

– Also called “antibodies” (ab)Also called “antibodies” (ab)– Named by placing the prefix Named by placing the prefix antianti before before

the name of the antigen with which the the name of the antigen with which the antibody reacts antibody reacts

Unit #6C – Clinical Laboratory Unit #6C – Clinical Laboratory Testing - Basic Testing - Basic

Serology/ImmunologySerology/Immunology Primary vs. Secondary Antibody ResponsePrimary vs. Secondary Antibody Response

– Primary occurs after first exposure to an Primary occurs after first exposure to an antigenantigen

– Secondary ResponseSecondary Response Sometimes called “anamnestic response”Sometimes called “anamnestic response” Lymphocytes remember the antigenLymphocytes remember the antigen Immunizations or vaccinations (such as for measles, Immunizations or vaccinations (such as for measles,

tetanus, etc.) are effective because of the Secondary tetanus, etc.) are effective because of the Secondary ResponseResponse

– Seroconversion = when an antibody is detectable in Seroconversion = when an antibody is detectable in patient who has previously tested negative for the patient who has previously tested negative for the antibodyantibody

Unit #6C – Clinical Laboratory Unit #6C – Clinical Laboratory Testing - Basic Testing - Basic

Serology/ImmunologySerology/ImmunologyFirst and Second Responses to First and Second Responses to

AntigensAntigens

Unit #6C – Clinical Laboratory Unit #6C – Clinical Laboratory Testing - Basic Testing - Basic

Serology/ImmunologySerology/Immunology Categories of Conditions Associated Categories of Conditions Associated

with Immune System Abnormalitieswith Immune System Abnormalities– Autoimmune Disease (RA, Lupus, Autoimmune Disease (RA, Lupus,

Juvenile Type I Diabetes, Myasthenia Juvenile Type I Diabetes, Myasthenia Gravis)Gravis)

– Hypersensitivies (Hay fever, Asthma, Hypersensitivies (Hay fever, Asthma, Dermatitis)Dermatitis)

– Malignancies (Lymphomas, Leukemias, Malignancies (Lymphomas, Leukemias, Multiple Myeloma)Multiple Myeloma)

Unit #6C – Clinical Laboratory Unit #6C – Clinical Laboratory Testing - Basic Testing - Basic

Serology/ImmunologySerology/Immunology Categories of Conditions Associated Categories of Conditions Associated

with Immune System Abnormalities with Immune System Abnormalities (cont’d)(cont’d)– Acquired Immunodeficiencies (Infections, Acquired Immunodeficiencies (Infections,

Systemic Disease, Malignancies, Systemic Disease, Malignancies, Reactions to Drugs, Irradiation)Reactions to Drugs, Irradiation)

– Congenital Immunodeficiencies Congenital Immunodeficiencies (DiGeorge Syndrome, (DiGeorge Syndrome, Aggamaglobulinemia, SCID – Severe Aggamaglobulinemia, SCID – Severe Combined Immune Deficiency)Combined Immune Deficiency)

Unit #6C – Clinical Laboratory Unit #6C – Clinical Laboratory Testing - Basic Testing - Basic

Serology/ImmunologySerology/Immunology Tests of Immune FunctionTests of Immune Function

– Based on Antigen-Antibody ReactionsBased on Antigen-Antibody ReactionsMay be qualitative (positive or negative) May be qualitative (positive or negative) May be quantitative (Titer = Reciprocal of May be quantitative (Titer = Reciprocal of

the highest dilution of patient’s serum the highest dilution of patient’s serum showing a positive reaction with antigen)showing a positive reaction with antigen)

– Principles of Immunological TestsPrinciples of Immunological TestsAgglutination and Agglutination Inhibition – Agglutination and Agglutination Inhibition –

visible clumping of cells or particles due to visible clumping of cells or particles due to their reaction with an antibodytheir reaction with an antibody

Unit #6C – Clinical Laboratory Unit #6C – Clinical Laboratory Testing - Basic Testing - Basic

Serology/ImmunologySerology/ImmunologyAgglutination of Red Blood Cells with Agglutination of Red Blood Cells with

AntibodyAntibody

Unit #6C – Clinical Laboratory Unit #6C – Clinical Laboratory Testing - Basic Testing - Basic

Serology/ImmunologySerology/Immunology– Principles of Principles of

Immunological Immunological Tests (cont’d)Tests (cont’d)

Precipitation – Precipitation – formation of an formation of an insoluble complex insoluble complex when a specific when a specific antibody is reacted antibody is reacted with a soluble with a soluble antigen (usually in a antigen (usually in a gelatin-like gelatin-like substance)substance)

Unit #6C – Clinical Laboratory Unit #6C – Clinical Laboratory Testing - Basic Testing - Basic

Serology/ImmunologySerology/Immunology– Principles of Immunological Tests Principles of Immunological Tests

(cont’d)(cont’d)Labeled Antibody Techniques – Molecules Labeled Antibody Techniques – Molecules

(labels) are attached to the antibodies, (labels) are attached to the antibodies, producing a visible reaction. Labels may be producing a visible reaction. Labels may be dyes, enzymes or radioisotopes. dyes, enzymes or radioisotopes.

Unit #6C – Clinical Laboratory Unit #6C – Clinical Laboratory Testing - Basic Testing - Basic

Serology/ImmunologySerology/ImmunologyEnzyme Linked Immunoassay (ELISA)Enzyme Linked Immunoassay (ELISA)

Unit #6C – Clinical Laboratory Unit #6C – Clinical Laboratory Testing - Basic Testing - Basic

Serology/ImmunologySerology/ImmunologyVisit this website for a virtual Visit this website for a virtual

immunology lab visit and immunology lab visit and experiment:experiment:

http://www.hhmi.org/biointeractive/vlahttp://www.hhmi.org/biointeractive/vlabs/immunology/index.htmlbs/immunology/index.html

Try to complete the lab by following Try to complete the lab by following website directions! Very cool!website directions! Very cool!