IMMUNOLOGY TEXTBOOK - Mercury Podillia 2013

Preface

Clinical immunology is a rapidly evolving science that provides insight into the mechanisms of immune responses within the body, as well as The Role of immune and immunopathological reactions in the Pathogenesis of both immune-dependent and immune-independent diseases.

The issue of immune-dependent pathology is highly relevant today. According to the World Health Organization (WHO), the prevalence of immunodeficiencies and allergic diseases continues to rise globally. Data from the Ukrainian Research Center for Clinical Immunology and Immunoprophylaxis of the National Academy of Medical Sciences and the Ministry of Health of Ukraine indicate that the prevalence of diagnosed primary, genetically determined immunodeficiencies is approximately 1% of the population, while acquired immunodeficiencies account for up to 20%; moreover, between 30% and 38% of the Ukrainian population suffers from immune system disorders. It is projected that in the 21st century, allergic and immunodeficient diseases will rank first in prevalence.

Key factors contributing to the growth of immune system pathologies include environmental pollution, the USE OF Vaccines and sera, stressful conditions, alcohol abuse, smoking, drug use, and viral infections, including HIV.

Consequently, immune deficiency is defined as a congenital or acquired defect of The Immune System manifested by the body's inability to mount Cell-mediated and/or humoral immune responses. Immune deficiency is characterized by a decrease in the number or activity of immunocompetent Cells resulting from The impact of both exoantigens and endoantigens. It is manifested by clinical signs of impaired immune function associated with foreign Antigens exerting their pathogenic properties. Clinically, immune deficiency presents with a sluggish course of inflammatory processes, a tendency toward relapse, and the persistence of infectious agents.

Immune deficiency can be relative—when the quantity and quality of antigenic aggression exceed the functional capacity of the immune system—or absolute, occurring when the functional capacity of the immune system is reduced in immunocompromised individuals (immunodeficiency).

Targeted Diagnostics, study, and Treatment of human diseases caused by immune deficiency began to develop following the 1952 publication by British researcher O.C. Bruton of a case history of a young man with agammaglobulinemia and recurrent bacterial infections. The positive therapeutic effect of regular administration of serum immunoglobulin fractions established a link between impaired antibody production and The Development of chronic bacterial infections in humans.

During the 1950s and 1960s, numerous diseases characterized by Various Forms of immune deficiency were described, such as conditions associated with thymic aplasia or hypoplasia: DiGeorge syndrome, Nezelof syndrome, the Swiss type of severe combined immunodeficiency, and others.

Significant progress in understanding the pathogenesis of immune deficiency emerged in the late 1960s, when two effector mechanisms of the Immune Response were identified—cellular (associated with T-lymphocyte activity) and humoral (associated with B-lymphocyte activity)—and fundamentally new Methods for Assessing human immune reactivity were developed. A major contribution to The Study of immune deficiency diseases was made by a research group led by American pediatrician and immunologist R.A. Good. In 1971, a panel of experts published a Classification of Congenital immune deficiency disorders.

Recent decades have been marked by revolutionary Changes in the theoretical and applied foundations of clinical immunology, driven by the development of novel Research Methods such as immunocytochemistry, cytofluorimetry, laser flow cytometry, Polymerase Chain Reaction, HLA typing, and Gene polymorphism analysis (including genes encoding Major Histocompatibility Complex molecules). These advancements have enabled a more detailed exploration of immune tolerance and tumor immunosurveillance, fostered theories of helper-suppressor and idiotypic regulation, and deepened our understanding of cytokines, Histocompatibility Antigens, and type 1 and type 2 T-helper immune responses, as well as the theories of autoimmunity and immunodeficient states. This progress has laid the groundwork for novel methods of immunotherapy, immunoprophylaxis, and immunorehabilitation based on the targeted Regulation of Immune responses.

In recent years, an increasing number of human diseases have been identified in which the impairment of immune mechanisms plays a critical role. Consequently, issues related to immune pathology are relevant to virtually every medical discipline: internal medicine (the chronization of inflammatory processes in Internal Organs among immunocompromised patients, autoimmune diseases, and The Use of modern immunotropic drugs); surgery (postoperative complications, Peritonitis, Sepsis, and effective wound healing); otolaryngology (Pathology of the Waldeyer's ring, Paranasal Sinuses, and allergic rhinitis); ophthalmology (allergic, infectious, and autoimmune eye diseases); neurology (demyelinating disorders, autoimmune vascular pathology, and autonomic dysfunctions); endocrinology (Diabetes Mellitus and its complications, autoimmune thyroiditis); hematology (autoimmune anemias, lymphoproliferative disorders, and allogeneic and autologous Bone Marrow transplantation); transplantology (Prevention and treatment of graft rejection syndrome); and dentistry (periodontal disease, stomatitis, and dental implants). Therefore, it is evident that studying the diagnostics and treatment of immune system disorders is central to the practice of physicians across nearly all specialties.

Impairment of immune mechanisms is also frequently observed in A number of diseases that seemingly present with a hyperimmune component (autoimmune diseases, allergic processes). Accordingly, it is hypothesized that in some patients, the elevated production of autoantibodies against A wide variety of endogenous antigens (e.g., erythrocytes, Nucleic Acids, etc.) may be linked to a deficiency of suppressor T lymphocytes that normally exert a regulatory function over antibody-producing cells.

Immunodiagnostics is a cornerstone of clinical immunology, providing a characterization of individual Links of the immune system and their functional status. To assess a patient's immune status, specialized immunological tests are performed and compiled into a single document known as an immunogram. Immunogram data allow clinicians to deduce the potential cause of a pathological condition, develop an immunotherapy regimen, and predict treatment outcomes.

In this regard, the publication of this textbook is a timely initiative dedicated to the Diagnosis and treatment of immune deficiency, developed in alignment with current trends in the advancement of clinical and laboratory immunology.

This textbook will be valuable for physicians across various medical specialties, clinical and laboratory immunologists, students of higher medical educational institutions and university medical faculties, and medical interns in their practical work.