Chapel and Haeney's Essentials of Clinical Immunology (eBook)
384 Seiten
Wiley (Verlag)
978-1-119-54242-1 (ISBN)
The Essentials are an international, best-selling series of textbooks, all of which are designed to support lecture series or themes on core topics within the health sciences. See www.wiley.com for further details.
The fully updated new edition of the classic textbook, introducing the pathophysiology and management of immunological disorders
Chapel and Haeney's Essentials of Clinical Immunology contains the knowledge necessary to understand the diagnosis and treatment of immunological disorders. With easy-to-read text and a wealth of colour clinical images and diagrams, this well-regarded textbook introduces complex concepts using effective pedagogical tools such as bulleted lists, key point boxes, real-life case studies, practical examples, figures and tables, chapter introductions, and keywords in bold integrated in each chapter.
Fully updated throughout, the seventh edition provides up-to-date coverage of the clinical relevance that immunology has in medicine. These new and revised sections examine current research trends, the implementation of automation in laboratories, the emerging field of neuro-psychiatric disorders such as NMDA receptor encephalitis and more. This edition includes new end-of-chapter summaries, updated clinical information, additional real-life case histories illustrating key concepts, and linking immunological testing to diseases. The new edition also includes:
- Covers the investigations required for diagnosis of immunological disorders and for management of patients
- Describes what occurs when diagnosing conditions in real-world laboratories
- Features case studies highlighting the connections between immunological theory and clinical cases
- Includes an updated companion website that features: case studies, interactive questions, photographs, illustrations, web links and review articles from the journal Clinical and Experimental Immunology
Chapel and Haeney's Essentials of Clinical Immunology is an ideal resource for clinical medical students, junior doctors, medical residents and other medical professionals who are looking to expand or refresh their knowledge in clinical immunology, as well as being an excellent introductory textbook for undergraduate courses in the subject.
For more information on the complete range of Wiley medical student and junior doctor publishing, please visit: www.wiley.com
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This title is also available as an e-book. For more details, please see www.wiley.com/buy/9781119542384
SIRAJ A. MISBAH, Consultant, John Radcliffe Hospital, Oxford, UK.
GAVIN P. SPICKETT, Consultant Clinical Immunologist, Royal Victoria Infirmary, Newcastle, UK.
VIRGIL A.S.H. DALM, Clinical Immunologist, Erasmus University Medical Center Rotterdam, The Netherlands.
CHAPEL AND HAENEY S ESSENTIALS OF CLINICAL IMMUNOLOGY The Essentials are an international, best-selling series of textbooks, all of which are designed to support lecture series or themes on core topics within the health sciences. See www.wiley.com for further details. The fully updated new edition of the classic textbook, introducing the pathophysiology and management of immunological disorders Chapel and Haeney s Essentials of Clinical Immunology contains the knowledge necessary to understand the diagnosis and treatment of immunological disorders. With easy-to-read text and a wealth of colour clinical images and diagrams, this well-regarded textbook introduces complex concepts using effective pedagogical tools such as bulleted lists, key point boxes, real-life case studies, practical examples, figures and tables, chapter introductions, and keywords in bold integrated in each chapter. Fully updated throughout, the seventh edition provides up-to-date coverage of the clinical relevance that immunology has in medicine. These new and revised sections examine current research trends, the implementation of automation in laboratories, the emerging field of neuro-psychiatric disorders such as NMDA receptor encephalitis and more. This edition includes new end-of-chapter summaries, updated clinical information, additional real-life case histories illustrating key concepts, and linking immunological testing to diseases. The new edition also includes: Covers the investigations required for diagnosis of immunological disorders and for management of patients Describes what occurs when diagnosing conditions in real-world laboratories Features case studies highlighting the connections between immunological theory and clinical cases Includes an updated companion website that features: case studies, interactive questions, photographs, illustrations, web links and review articles from the journal Clinical and Experimental Immunology Chapel and Haeney s Essentials of Clinical Immunology is an ideal resource for clinical medical students, junior doctors, medical residents and other medical professionals who are looking to expand or refresh their knowledge in clinical immunology, as well as being an excellent introductory textbook for undergraduate courses in the subject. For more information on the complete range of Wiley medical student and junior doctor publishing, please visit: www.wiley.com To receive automatic updates on Wiley books and journals, join our email list. Sign up today at www.wiley.com/email All content reviewed by students for students Wiley Medical Education books are designed exactly for their intended audience. All of our books are developed in collaboration with students. This means that our books are always published with you, the student, in mind If you would like to be one of our student reviewers, go to www.reviewmedicalbooks.com to find out more. This title is also available as an e-book. For more details, please see www.wiley.com/buy/9781119542384
SIRAJ A. MISBAH, Consultant, John Radcliffe Hospital, Oxford, UK. GAVIN P. SPICKETT, Consultant Clinical Immunologist, Royal Victoria Infirmary, Newcastle, UK. VIRGIL A.S.H. DALM, Clinical Immunologist, Erasmus University Medical Center Rotterdam, The Netherlands.
Preface to the Seventh Edition vi
Preface to the First Edition vii
Key to Illustrations viii
About the Companion Website ix
1 Basic Components: Structure and Function 1
2 Infection 35
3 Immunodeficiency 55
4 Anaphylaxis and Allergy 87
5 Autoimmunity 106
6 Lymphoproliferative Disorders 122
7 Immune Manipulation 138
8 Transplantation 158
9 Kidney Diseases 172
10 Joints and Muscles 195
11 Skin Diseases 221
12 Eye Diseases 238
13 Chest Diseases 246
14 Gastrointestinal and Liver Diseases 263
15 Endocrinology and Diabetes 287
16 Non-malignant Haematological Diseases 298
17 Neuroimmunology 310
18 Immunological Diseases in Pregnancy 322
19 Techniques in Clinical Immunology 330
Appendix: Further Resources 349
Index 351
CHAPTER 1
Basic Components: Structure and Function
Key topics
- 1.1 Introduction
- 1.2 Key molecules
- 1.3 Functional basis of innate responses
- 1.4 Functional basis of the adaptive immune responses
- 1.5 Physiological outcomes of immune responses
- 1.6 Tissue damage caused by the immune system
- 1.7 Organization of the immune system: an overview
- 1.8 Conclusions
Visit the companion website at www.wiley.com/go/misbah/immunology to download cases on these topics.
1.1 Introduction
The immune system evolved as a defence against infectious diseases. Individuals with markedly deficient immune responses, if untreated, succumb to infections in early life. There is, therefore, a selective evolutionary pressure for a really efficient immune system. Although innate systems are fast in response to pathogens, the evolution to adaptive responses provided greater efficiency. However, a parallel evolution in pathogens means that all species, plants, insects, fish, birds and mammals have continued to improve their defence mechanisms over millions of years, giving rise to some redundancies as well as resulting in apparent complexity. The aim of this chapter is to provide an initial description of the molecules involved, moving on to the role of each in the immune processes rather than the more traditional sequence of anatomical structure, cellular composition and then molecular components. It is hoped that this gives a sense of their relationship in terms of immediacy and dependency as well as the parallel evolution of the two immune systems. An immune response consists of five parts:
- Recognition of material as foreign and dangerous.
- An early innate (non‐specific) response to this recognition.
- A slower specific response to a particular antigen, known as an adaptive response.
- Non‐specific augmentation of this response.
- A memory of specific immune responses, providing a quicker and larger response when that particular antigen is encountered the second time.
Innate immunity, though phylogenetically older and important in terms of speed of response, is less efficient. Humoral components (soluble molecules in the plasma) and cells in blood and tissues are involved. Such responses are normally accompanied by inflammation and occur within a few hours of stimulation (Table 1.1).
Adaptive immune responses are also divided into humoral and cellular responses. Adaptive humoral responses result in the generation of antibodies reactive with a particular antigen. Antibodies are proteins with similar structures, known collectively as immunoglobulins (Ig). They can be transferred passively to another individual by injection of serum. In contrast, only cells can transfer cellular immunity. Good examples of cellular immune responses are the rejection of a graft by lymphoid cells as well as graft‐versus‐host disease, where viable transferred cells attack an immunologically compromised recipient that is unable to fight back.
Antibody‐producing lymphocytes, which are dependent on the bone marrow, are known as B cells. In response to antigen stimulation, B cells will mature to antibody‐secreting plasma cells. Cellular immune responses are dependent on an intact thymus, so the lymphocytes responsible are known as thymus‐dependent (T) cells. The developmental pathways of both cell types are fairly well established (Fig. 1.1).
The recognition phase is common to both adaptive and innate immunity. It involves professional cells, known as classical dendritic cells (DCs), that recognize general pathogen features or specific antigenic molecules, process the antigens and present antigen fragments to the other cells of the immune system, as well as initiating non‐specific inflammation to the pathogen. In the effector phase, neutrophils and macrophages (innate immunity) and antibodies and effector T lymphocytes (adaptive immunity) eliminate the antigen.
In terms of disease, like other organs, the immune system may fail (immunodeficiency), may become malignant (lymphoid malignancies) or may produce aberrant responses (such as in autoimmunity or allergy). This chapter describes the normal immune system in order to lay the basis for discussing these ways in which it can go wrong and so cause disease.
1.2 Key molecules
Many types of molecules play vital roles in both phases of immune responses; some are shared by both the innate and the adaptive systems. Antigens are substances that are recognized by immune components. Detection molecules on innate cells recognize general patterns of ‘foreignness’ on non‐mammalian cells, whereas those on adaptive cells are specific for a wide range of very particular molecules or fragments of molecules. Antibodies are not only the surface receptors of B cells (BCRs) that recognize specific antigens, but, once the appropriate B cells are activated and differentiate into plasma cells, antibodies are also secreted into blood and body fluids in large quantities to prevent that antigen from causing damage. T cells have structurally similar receptors for recognizing antigens, known as T‐cell receptors (TCRs). Major histocompatibility complex (MHC) molecules provide a means of self‐recognition and also play a fundamental role in T lymphocyte effector functions.
Effector mechanisms are often dependent on messages from initiating or regulating cells; soluble mediators, which carry messages between cells, are known as interleukins, cytokines and chemokines.
Table 1.1 Components of innate and adaptive immunity
Features | Innate | Adaptive |
---|
Foreign molecules recognized | Structures shared by microbes, recognized as patterns (e.g. repeated glycoproteins), PAMPs | Wide range of very particular molecules or fragments of molecules on all types of extrinsic and modified self‐structures |
Nature of recognition receptors | Germline encoded – limited PRRs | Somatic mutation results in a wide range of specificities and affinities |
Speed of response | Immediate | Time for cell movement and interaction between cell types |
Memory | None | Efficient |
Humoral components | Complement components | Antibodies |
Cellular components | Dendritic cells, neutrophils, macrophages, NK cells, NKT cells, B1 cells, epithelial cells, mast cells | Lymphocytes – T (Th1, Th2, Th17, Tregs), B |
iNKT cells, γδ T cells |
NK, natural killer; PAMPs, pathogen‐associated molecular patterns; pattern‐recognition receptors (PRRs); Tregs, regulatory T cells.
Fig. 1.1 Development of different types of blood cells from a pluripotential stem cell in the bone marrow. The developmental pathway for natural killer (NK) cells is shown separately because it is thought that NK cells may develop in both the thymus and the bone marrow.
1.2.1 Molecules recognized by immune systems
Foreign substances are recognized by both the innate and adaptive systems, but in different ways, using different receptors (see section 1.2.2). The innate system is activated by ‘danger signals’, due to pattern‐recognition receptors on DCs recognizing conserved microbial structures directly, often repeated polysaccharide molecules, known as pathogen‐associated molecular patterns. Toll‐like receptors (receptors that serve a similar function to toll receptors in drosophila) make up a large family of non‐antigen‐specific receptors for a variety of individual bacterial, viral and fungal components such as DNA, lipoproteins and lipopolysaccharides. Activation of DCs by binding to either of these detection receptors leads to inflammation and subsequently activation of the adaptive system.
Phagocytic cells also recognize particular patterns associated with potentially...
Erscheint lt. Verlag | 5.8.2022 |
---|---|
Reihe/Serie | Essentials |
Sprache | englisch |
Themenwelt | Medizin / Pharmazie ► Allgemeines / Lexika |
Studium ► Querschnittsbereiche ► Infektiologie / Immunologie | |
Schlagworte | Allergieforschung u. Klinische Immunologie • Allergy & Clinical Immunology • Clinical Immunology • Immunologie • immunology • Klinische Immunologie • Medical Science • Medizin |
ISBN-10 | 1-119-54242-1 / 1119542421 |
ISBN-13 | 978-1-119-54242-1 / 9781119542421 |
Haben Sie eine Frage zum Produkt? |
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