Arthur G. Johnson, Ph.D.
Professor and Head
Department of Medical Microbiology and Immunology University of Minnesota
Lippincqtt Williams & Wilkins
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Copyright © 1999 By Lippincott Williams & Wilkins.
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Library of Congress Cataloging-in-Publication Data.
Johnson, Arthur G.
High-yield immunology / Arthur G. Johnson.
1. Immunology—Outlines, syllabi, etc. I. Title. II. Series. [DNLM: 1. Immunity outlines. 2. Immunologic Factors outlines. 3. Hypersensitivity outlines. 4- Immunotherapy outlines. QW 18.2 J66h 1999] QR182.55.J64 1999 616.07,9—dc21 DNLM/DLC
for Library of Congress 98-31653
Care has been taken to confirm the accuracy of the information presented and to describe generally accepted practices. However, the authors, editors, and publisher are not responsible for errors or omissions or for any consequences from application of the information in this book and make no warranty, express or implied, with respect to the contents of the publication.
The authors, editors, and publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accordance with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions.
Some drugs and medical devices presented in this publication have Food and Drug Administration (FDA) clearance for limited use in restricted research settings. It is the responsibility of the health care provider to ascertain the FDA status of each drug or device planned for use in their clinical practice.
1 Overview 1
I. Synopsis 1
11. Concerns in medicine 1
III. Host-parasite equilibrium 2
IV. Development of the immune system 2 V. Clonal selection theory 5
2 Antigens 6
I. Definitions 6
II. Factors determining antigenicity 6 III. Examples of antigens 6
3 Antibodies 8
I. General properties 8
III. IgM 12
IV. IgA 12
VI. IgD 14
4 Immunologic Assays 15
I. Overview 15 II. Protection tests 15
III. Agglutination tests 15
IV. Precipitation reactions 16
V. Complement fixation 18 VI. Fluorescent antibody 20
VII. Western blot 20
I. Genetic control of immunoglobulin chain synthesis 21 II. Genetic control of human leukocyte antigens (HLAs) 21 III. Genetic control of the T-cell antigenic receptor (TCR) 25
6 The Immune Response 27
I. Humoral immunity 27 II. Cell-mediated immunity (CMI) 32
7 Inflammation 35
I. Introduction 35 II. Inflammation process 35
III. Kinetics 36
IV. Mediators of inflammation 39
8 Hypersensitivities 40
I. Overview 40
II. Anaphylaxis (type I) reactions 40
III. Cell surface antigen-antibody (Ag-Ab) cytotoxicity (type II) reactions
IV. Antigen-antibody (Ag-Ab) complex (type III) reactions 44
V. Delayed-type hypersensitivity (type IV) reactions 46
9 Immunodeficiency Diseases 47
I. Overview 47
II. Developmental immunodeficiency disorders 47
III. Acquired immunodeficiency syndrome (AIDS) 49
IV. Cytokine and chemokine deficiencies 51
V. Senescence (aging) of the immune response 51
10 Autoimmune Disorders
I. Overview 52
II. Immunoregulation breakdown 52
III. Systemic autoimmune disorders 53
IV. Organ-specific autoimmune disorders 54
11 Immunologic Aspects of Transplantation
I. Histocompatibility 57 II. Complications of Organ Transplantation 58 III. Immunosuppress ion 5 9
12 Cancer Immunology
I. Definition 61 II. Oncogenes 61
III. Cancer and the immune system
IV. Cancer immunotherapy 62
I. Overview 64 II. Specific vaccines III. Adjuvants 68
High-Yield In National Bo; the United S pervades mo includes basi-areas to incli uate students outline" forrr
Numerous ta and clarifying
This book is: is my hope th the reader in ing and rapid
High-Yield Immunology is a compendium of the knowledge considered necessary by the National Board of Medical Examiners (NBME) to achieve competence in immunology for the United States Medical Licensing Examination (USMLE). Immunology is a science that pervades most medical disciplines; this volume spans the breadth of the discipline and includes basic science, as well as clinical, information. I based my selection of what subject areas to include on the experience I have gleaned from years of teaching medical and graduate students. Topics, which include the following, are presented in a concise, "narrative outline" format:
• Development and function of the organs and cells involved in the immune response
• Properties of antigens and antibodies and the way they interact with each other
• Synthesis, genetic control, and regulation of antibody
• Cell-mediated immunity (CMI) and inflammation
• Immunologic disorders, including hypersensitivity disorders, immunodeficiency disorders, and autoimmune diseases
• The role of the immune system in transplantation and cancer
• Currently available vaccines and recommended immunization schedules
Numerous tables and illustrations round out the presentation by summarizing information and clarifying difficult concepts.
This book is not meant to replace the many excellent textbooks of immunology. Rather, it is my hope that the concise presentation of information in High-Yield Immunology will assist the reader in the quick recall of the facts considered essential for understanding this exciting and rapidly changing science.
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