Clinical Immunology and Allergology
Program of Study: General Medicine
Course: Clinical Immunology and Allergology
Abbreviation: KIM/ VAA12
Schedule: 9 hours of seminars, 6 hours of exercises
Course Distribution: 4th year, 7th term
Number of Credits: 1
Course Form: Seminars and exercises
Requirements: Attendance of all teaching session is required.
Completed by: Examination
Literature: Will be specified in the lectures
A) THEORETICAL IMMUNOLOGY
- What is immunology, immunity, relation to neuroendocrine system.
- Structure of the lymphatic system - primary lymphatic organs.
- Structure of the lymphatic system - secondary lymphatic organs.
- Cell elements involved in immune response.
- Cell elements involved in non-specific immune response - epithelial cells, leukocytes, and non-haematopoietic cells.
- Antigen presenting cells - involvement in the induction of immune response, classification.
- Dendritic cells, nature and classification; their involvement in the induction of Th1 a Th2 immune response.
- Macrophages - they role in the immune system.
- Cell elements involved in antigen specific immune defense.
- Relationship between cell of the innate and antigen specific immunity.
- Humoral factors of defense in systemic (circulatory), mucosal and skin immunity (specific and non specific).
- Classical and lectin cascade of complement - biological sense, differences.
- Alternative complement pathway - biological sense, activation, regulation.
- Antibodies - isotypes and subclasses, physiological concentrations, function in systemic and mucosal immunity.
- Characteristics of antibody to antigen interaction, affinity, avidity, specificity.
- The course of B cells activation, primary and secondary antibody response.
- IgE - involvement in immune responses, interaction with cell surface receptors.
- Genetic base of antibody variability, genetic recombination, sources of variability of VH a VL.
- Antigens, haptens, carriers, allergen, autoantigen, superantigens.
- Antigenicity, adjuvants, T dependent and independent antigens.
- MHC, genomic localization, cellular distribution, hereditability, biological sense of MHC variability.
- HLA-I a HLA-II - molecular structure, antigen MHC restriction and presentation.
- Cytokines and chemokines - classification, biological sense.
- Adhesive molecules - classification, biological sense.
- T-cells, CD classification, biological sense, functions, physiological concentration in circulation.
- TcR, structure, function, genetic recombination and sources of variability.
- Th cells - classification, functions, cooperation with other cell elements.
- Regulatory CD4, CD8 T cells, the mechanisms of regulatory activity.
- Cytotoxic T cell , effector and memory functions.
- NK cells - effector functions cytotoxic and regulatory.
- Antigen-specific and non-specific cooperation of T a B cells during development of antibody response.
- B1 cells and γδ T cells.
B) LABORATORY INVESTIGATIONS IN CLINICAL IMMUNOLOGY
- Investigation of the patient with suspected allergic/immunological disorder - anamnesis, physical and laboratory examinations.
- Sampling of the patients for immunological laboratory investigation - indication, specimens collection, storage, results interpretation.
- Polyclonal and monoclonal antibodies in laboratory methods - preparation, properties, differences in applicability.
- Laboratory tests for evaluation of humoral immunity - methods, reference values, indication, interpretation.
- Laboratory tests for evaluation of lymphocyte populations counts and functions - methods, reference values, indication, interpretation.
- Laboratory tests for evaluation of phagocytes - methods, reference values, indication, interpretation.
- HLA-typing - methods, indication, interpretation.
- Genotyping tests for clinical immunology - PCR, Sanger sequencing, NGS-based tests - principles, differences.
- Principles of the investigation of the allergic patient - anamnesis, physical investigation, skin tests, exposition, elimination, and bronchoprovocation tests - indication, interpretation.
- Immunological laboratory testing in patients with suspect primary or secondary immunodeficiencies.
- Immunological laboratory testing in patients with cancer.
- Immunological laboratory testing in patients with suspect autoimmunity.
- Immunological laboratory testing in patients with suspect allergy.
- Immunological laboratory testing in patient before and after transplantation.
- HLA- and other molecules-polymorphism testing in patients with cancer, autoimmunity, allergy, and immunodeficiency.
C) CLINICAL IMMUNOLOGY AND ALLERGOLOGY
- Hypersensitivity reactions classification according to Coombs and Gell - principles, differences and clinical manifestation.
- Immediate (type I) hypersensitivity reactions - principles, clinical manifestation. Atopy.
- Cytotoxic (type II) hypersensitivity reactions - principles, clinical manifestation.
- Immune complexes (type III) hypersensitivity reactions - principles, clinical manifestation.
- Delayed hypersensitivity (type IV) reactions - principles, clinical manifestation.
- Pathophysiological role of IgE in allergy and asthma.
- Cell elements involved in allergic reaction, mediators of allergic reaction.
- Seasonal allergic rhinitis (hay fever, polinosis) and persistent (perennial) allergic and non-allergic rhinitis - etiopathology, clinical manifestations, therapy.
- Allergic asthma - classification, clinical manifestation, therapy.
- Anaphylactic reaction, etiopathology, clinical manifestation, therapy.
- Drug allergy - symptoms, diagnosis, treatment.
- Food allergy - symptoms, diagnosis, therapy.
- Food intolerance (histamine, lactose), symptoms, diagnosis, therapy.
- Hymenoptera venom allergy, symptoms, diagnosis, therapy
- Immunodeficiencies - classification, differential diagnosis
- Severe combined immune deficiency (SCID) - etiopathology, clinical manifestations, therapy.
- Inherited immunodeficiency disorders - classification, etiopathology, clinical manifestation.
- Secondary immunodeficiency disorders - classification, etiopathology, clinical manifestation.
- Symptomatic treatments and causative therapy of immunodeficiency disorders.
- Immune stimulation therapy - clinical applications.
- Immunosuppressive drugs - clinical applications.
- Immune modulation therapy.
- Allergen-specific immunotherapy - principles, indications, practice of administering, types.
- Biologic therapy for immunology.