Evaluation of the results of a comprehensive study of immune status

The basic principle of evaluating the results of a comprehensive study of the immune status in a patient is the quantitative and functional evaluation of all its links( antigen-specific and antigen-specific factors) and their comparison with normal values. Under the normal state of the immune status is meant the immune system indicators, determined in practically healthy individuals of different age groups. Determination of the parameters of the immune system in various pathological states makes it possible to divide the latter into three main groups:

without significant changes in immune status;

■ with a deficiency of the immune system( immunodeficiencies);

■ with hyperactivation of immunocompetent cells( autoimmune pathology, allergy).

Using the methods of clinical immunology, it is necessary to identify the level of disorders in a patient, and then to monitor the restoration of the immune status of the organism during treatment. The most frequent violations of the immune system in humans - immunodefitsity. The term "immunodeficiencies" refers to violations of the normal immunological status caused by a defect in one or more immune response mechanisms. There are primary and secondary immunodeficiencies. As primary, there are those states in which disorders of immune mechanisms( production of Ig and / or T-lymphocytes) are caused by genetic factors. Depending on the level of disorders and localization of the defect, immunodeficiencies are divided into humoral, cellular, non-specific system-induced resistance( in particular, phagocytosis) and combined.

Evaluation rules for immunograms

■ Complex immunogram analysis is more informative than evaluating each indicator separately.

■ A complete immunogram analysis can be carried out only in conjunction with an assessment of the clinical picture of the patient.

■ The real information in the immunogram carries strong shifts in the indices;weak shifts only allow to increase confidence in the correctness of the conclusion made.

■ Immunogram analysis in dynamics is always more informative both in diagnostic and prognostic relation than once received immunogram.

■ In the overwhelming majority of cases, the analysis of the immunogram makes it possible to make approximate and not unconditional conclusions of a diagnostic and prognostic nature.

■ The ratios of different populations and subpopulations of immunocompetent cells are of primary practical importance in the immunogram, and not their absolute values.

To facilitate a comprehensive assessment of the immune status, we present algorithms for evaluating each link of immunity( Figure 7-4).In evaluating the adhesive,

Fig. Algorithm for assessing the system of phagocytosis in immunodeficiencies

Fig. Algorithm for assessing the system of phagocytosis in immunodeficiencies

Fig. Algorithm for assessing the cellular immunity in immunodeficiencies

Fig. Algorithm for assessing the cellular immunity in immunodeficiency

Fig. Algorithm for assessing the humoral immunity in immunodeficiencies.

Fig. Algorithm for assessing the humoral immunity in immunodeficiencies.

Fig. Algorithm for evaluating the complement system for immunodeficiencies.

Fig. Algorithm for evaluating the complement system for immunodeficiencies.