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Samenvatting - Medische Immunologie
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samenvatting van alle lessen + cursus en tekeningen van medische immunologie (MLT)
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2023Medische immunologie
2022-2023
KHAYLA POTIERS
,INHOUD
hoofdstuk 1: inleiding tot het imuunsysteem ......................................................................................................... 4
1. het niet-specifieke of aangeboren immuunsysteem ...................................................................................... 5
1.1. het verloop van de aangeboren immuunrespons .................................................................................... 5
1.2. acute fase eiwitten ................................................................................................................................... 6
2. het verworven, adaptieve of specifieke immuunsysteem .............................................................................. 6
2.1. de start van het specifiek immuunsysteem ............................................................................................. 6
2.2. de humorale immuunrespons .................................................................................................................. 7
2.3. de cellulaire immuunrespons ................................................................................................................... 7
2.4. kenmerken van de specifieke immuunrespons........................................................................................ 8
3. een immuunrespons met niet-specifieke en specifieke componenten .......................................................... 8
hoofdstuk 2: antigenen en hun immunogeniciteit.................................................................................................. 9
1. factoren die immunogeniciteit van een antigeen beïnvloeden .................................................................... 10
2. immuuntolerantie ......................................................................................................................................... 11
3. antigeendeterminanten of epitopen............................................................................................................. 12
hoofdstuk 3: Immunoglobulinen of antilichamen................................................................................................. 13
1. structuur van een antilichaam ...................................................................................................................... 13
1.1. variabele en constante gedeelten .......................................................................................................... 14
7.2. hinge region ........................................................................................................................................... 14
2. Moleculaire basis van de antigeen-antilichaam interactie ........................................................................... 15
3. Affiniteit en aviditeit van de antilichaam-antigeeninteractie ....................................................................... 16
4. kruisreactie .................................................................................................................................................... 17
4. Verschillende klassen immunoglobulines ..................................................................................................... 18
4.1. Structurele verschillen tussen de verschillende klassen immunoglobulines ......................................... 18
4.2. Functionele verschillen tussen de verschillende klassen immunoglobulines ........................................ 19
5.1. Isotypen diversiteit................................................................................................................................. 20
5.2. allotype diversiteit.................................................................................................................................. 20
5.3. idiotype diversiteit ................................................................................................................................. 20
6. monoklonale en polyklonale antilichamen ................................................................................................... 20
hoofdstuk 4: Immunologische laboratoriumtoepassingen: aantonen van de interactie tussen antigeen en
antilichaam ............................................................................................................................................................ 21
1. agglutinatietechnieken .................................................................................................................................. 21
1.1. Hemagglutinatie ..................................................................................................................................... 21
1.2. latexagglutinatie ..................................................................................................................................... 27
1.3. bacteriële agglutinatie ........................................................................................................................... 27
2. precipitatiereactie ......................................................................................................................................... 28
2.1. heidelberger-precipitatiecurve .............................................................................................................. 29
1
, 2.2. neerslagtechnieken in de vloeibare fase ................................................................................................ 29
3. testen gebaseerd op de biologische activiteit van de Ag-al interactie ......................................................... 30
3.1. complementfixatietest ........................................................................................................................... 30
3.2. virusneutralisatietest ............................................................................................................................. 31
3.3. haemagglutinatie-inhibitietest ............................................................................................................... 31
4. aantonen van de ag met behulp van gemerkte al (belangrijk) ..................................................................... 32
4.1. algemeen principe .................................................................................................................................. 32
4.2. capture techniek .................................................................................................................................... 33
4.3. enzym-linked immunosorbent assay of elisa ......................................................................................... 34
4.4. kwantitatieve elisa ................................................................................................................................. 34
4.5. Enzyme Multiplied Immunoassay Technique (EMIT) ............................................................................. 35
4.6. Radio-immunoassay of RIA .................................................................................................................... 36
4.7. Immunofluorescentie ............................................................................................................................. 39
4.8. Chemiluminescente labels ..................................................................................................................... 40
5. Aantonen van de aanwezigheid van antigenen op cellen met behulp van gemerkte antilichamen ............ 41
5.1. cellulaire elisa ......................................................................................................................................... 41
5.2. flow cytometrie ...................................................................................................................................... 42
6. Aantonen van antigenen in weefsels met behulp van gemerkte antilichamen: immunohistochemische
kleuringen ......................................................................................................................................................... 44
6.1. Histologische immuno-enzymatische methodes ................................................................................... 44
6.2. Directe methode: ................................................................................................................................... 44
6.3. Indirecte methode = tweestapsmethode............................................................................................... 45
6.4. Driestaps INDIRECTE methode ............................................................................................................... 45
6.5. Oplosbaar enzyme-immunocomplexmethode ...................................................................................... 45
6.6. (strept)avidine-biotine methodes .......................................................................................................... 46
6.7. technieken met grote amplificatie van signaal ...................................................................................... 48
hoofdstuk 5: het niet specicfiek immuunsysteem meer in detail ......................................................................... 49
1. De onmiddellijke en vroeg-geïnduceerde respons ....................................................................................... 49
1.1. het complementsysteem ....................................................................................................................... 49
1.2. controlemechanisme.................................................................................................................................. 53
1.3. de cellulaire respons .................................................................................................................................. 53
2. rol van de cytokines of signaalmolecules ...................................................................................................... 57
2.1. wat zijn cytokines ................................................................................................................................... 58
2.2. Enkele belangrijke cytokines in niet-specifiek immuunsysteem ............................................................ 59
2.3. Groeifactoren zorgen voor de aanmaak van meer witte bloedcellentijdens een acute infectie ........... 60
hoofdstuk 6: Antigeenpresentatie als start van het specifieke immuunsysteem ................................................. 60
1. Het Major Histocompatibiliteits Complex (MHC) .......................................................................................... 61
2
, 1.1. moleculaire structuur van de Hla-antigenen.............................................................................................. 61
1.2. Functie van de MHC moleculen ................................................................................................................. 63
1.2.1. Antigeenopname uit het extracellulair milieu –MHC II ....................................................................... 63
1.2.2. Genetische organisatie van het MHC (HLA) ........................................................................................ 64
hoofdstuk 7: De lymfocyten en hun rol in het specifiek immuunsysteem............................................................ 66
1. Ontwikkelingvan de lymfocyten .................................................................................................................... 66
2. T-lymfocyten ................................................................................................................................................. 66
2.1. verschillende soorten T-lymfocyten ....................................................................................................... 66
2.2. antigeenherkenning via de antigeenreceptor of T-cel receptor (TCR) ................................................... 69
2.3. de ontwikkeling van T-lymfocyten en de rol van de thymus ................................................................. 70
2.4. de moleculaire mechanismen van de T-lymfocytenactivatie ................................................................. 74
3. B-lymfocyten ................................................................................................................................................. 77
3.1. Antigeenherkenning door de B-lymfocyt ............................................................................................... 77
3.2. ontwikkeling van B lymfocyten .............................................................................................................. 77
3.3. Genetische codering van antilichamen .................................................................................................. 78
3.4. de ontwikkelingsfasen van de B-lymfocyt in het beenmerg .................................................................. 79
3.5. Antigeenstimulatie van naïeve B-lymfocyten ........................................................................................ 81
3.6. T-cel afhankelijke activatie van de B-cel resulteert in proliferatie, isotype switch en affiniteitsmaturatie
...................................................................................................................................................................... 82
3.7. De geproduceerde antilichamen kunnen nu hun functie uitoefenen, dit is de humorale
immuunrespons ............................................................................................................................................ 83
3.8. Het verloop van de antilichaamproductie ifv de tijd .............................................................................. 84
hoofdstuk 8: Passieve en actieve immunisatie ..................................................................................................... 85
1. passieve immunisatie .................................................................................................................................... 85
2. actieve immunisatie of vaccinatie ................................................................................................................. 85
hoofdstuk 9: Afwijkende reacties van het immuunsysteem ................................................................................. 86
1. Overgevoeligheidsreacties of allergieën ....................................................................................................... 86
1.1. reacties van type 1, overgevoeiligheidsreacties van het onmiddelijke type.......................................... 86
1.2. behandeling van allergie ........................................................................................................................ 89
2. auto-immuunziekten (aiz) ............................................................................................................................. 90
2.1. mechanismen die aanleiding geven tot AIZ ........................................................................................... 90
2.2. genetische voorbestemdheid voor AIZ .................................................................................................. 91
2.3. mechanismen van weefselbeschadiging ................................................................................................ 91
2.4. ziektebeelden ......................................................................................................................................... 93
2.5. genetische voorbestemdheid voor het ontwikkelen van aiz ................................................................. 93
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