IMMUNOLOGIE SAMENVATTING
1: inleiding tot de hematologie ......................................................................................... 5
1.1 Functies van bloed............................................................................................................... 5
1.2 Samenstelling van het bloed ................................................................................................ 5
2.1 Bloedcellen ......................................................................................................................... 6
Rode bloedcellen = erytrocyten ..................................................................................................................... 6
Witte bloedcellen = leukocyten ...................................................................................................................... 6
Bloedplaatjes = trombocyten ......................................................................................................................... 6
2.2 bloedplasma ....................................................................................................................... 6
2.3 Verdeling van de bloedcellen in het bloed ....................................................................... 7
3 Bloedafname en soorten bloedstalen ..................................................................................... 7
H2: De verschillende BLOEDCELLEN ................................................................................... 9
1. Witte bloedcellen of leukocyten ............................................................................................ 9
1.1. Neutrofielen ........................................................................................................................................... 11
1.1.1 Morfologie van neutrofielen ..................................................................................................... 11
1.1.2 Functie van neutrofielen ........................................................................................................... 13
1.2 Eosinofielen ............................................................................................................................................. 13
1.2.1 Morfologie van eosinofielen ..................................................................................................... 13
1.2.2 Functie van eosinofielen ................................................................................................................. 13
1.3 Basofielen ................................................................................................................................................ 14
1.3.1 Morfologie van basofielen ........................................................................................................ 14
1.3.2 Functie van basofielen .................................................................................................................... 14
1.4 Monocyten .............................................................................................................................................. 15
1.4.1 Morfologie van monocyten ....................................................................................................... 15
1.4.2 Functie van monocyten ................................................................................................................... 15
1.5 Lymfocyten .............................................................................................................................................. 15
1.5.1 Morfologie van lymfocyten ....................................................................................................... 16
1.5.2 Functie van lymfocyte ..................................................................................................................... 17
1.6 Analyses op witte bloedcellen .......................................................................................................... 17
2. Rode bloedcellen of erytrocyten .......................................................................................... 17
2.1 Morfologie .............................................................................................................................................. 17
2.2 Bloedgroepsystemen.............................................................................................................................. 19
2.2.1 Het ABO systeem....................................................................................................................... 20
2.2.1.1 De antigenen en antilichamen van het ABO systeem ........................................................... 20
2.2.1.2 Genetische basis van het ABO systeem ................................................................................ 22
2.2.2 Het Rhesussysteem ................................................................................................................... 24
2.2.2.1 De rhesus antigenen ( vanaf hier samen met notities: NEEN) .................................................. 24
2.2.2.2 Genetische basis van het rhesussyteem: De Fisher - Race theorie ....................................... 25
2.2.3 Belang van bloedgroepbepalingen ............................................................................................ 26
2.3 Functie van de rode bloedcellen ............................................................................................................ 27
Transport van zuurstof .............................................................................................................................. 27
Transport van koolstofdioxide ...................................................................................................................... 27
2.3.1 Hemoglobine ............................................................................................................................. 28
Immunologie 1 1
, 2.4 Analyses op rode bloedcellen ................................................................................................................. 29
3. Bloedplaatjes of Trombocyten .......................................................................................... 30
3.1 Morfologie .............................................................................................................................................. 30
3.2 Functie van de trombocyten ............................................................................................................. 31
3.2.1 Mechanisme van de primaire hemostase ................................................................................. 33
3.2.2 Secundaire Hemostase .............................................................................................................. 34
3.3 Analyses op trombocyten....................................................................................................................... 36
HOOFDSTUK III : Inleiding tot het immuunsysteem .......................................................... 37
1. Het niet-specifieke of aangeboren immuunsysteem ............................................................ 38
2. Het verworven, adaptieve of specifieke immuunsysteem vc ................................................ 42
2.1 De start van het specifiek immuunsysteem ........................................................................................... 42
2.2 De humorale immuunrespons................................................................................................................ 43
2.3 De cellulaire immuunrespons ................................................................................................................ 44
2.4 Kenmerken van de specifieke immuunrespons ................................................................................ 45
3. Een immuunrespons met niet-specifieke en specifieke componenten ................................ 45
HOOFDSTUK IV : Antigenen en hun immunogeniciteit ..................................................... 48
Factoren die de immunogeniciteit van een antigeen beïnvloeden ............................................ 48
Factoren die de immunogeniciteit van antigeen beïnvloeden ..................................................................... 49
Chemische natuur ..................................................................................................................................... 49
2. Molecuulmassa .................................................................................................................................... 50
3. Moleculaire diversiteit ......................................................................................................................... 50
4. Ruimtelijke structuur ............................................................................................................................ 50
5. Toegediende dosis................................................................................................................................ 50
6. Manier van binnendringen of toedienen in het lichaam ...................................................................... 51
11 Immuuntolerantie .............................................................................................................. 51
12 Antigeendeterminanten of epitopen ................................................................................... 52
HOOFDSTUK V : Immunoglobulinen of antilichamen ........................................................ 54
De structuur van een antilichaam ............................................................................................ 54
Variabele en constante gedeelten ................................................................................................................ 55
Hinge region .................................................................................................................................................. 56
Moleculaire basis van de antigeen-antilichaam interactie ........................................................ 57
Affiniteit en aviditeit van de antilichaam-antigeeninteractie .................................................... 60
affiniteit ......................................................................................................................................................... 60
adiviteit ......................................................................................................................................................... 60
Kruisreactie: ALTIJD OP EXAMEN! ............................................................................................ 61
DEZELFDE EPITOPEN ZIJN AANWEZIG OP VERSCHILLENDE ANTIGENEN. ..................................................... 61
vERWANTE EPITOPEN ZIJN AANWEZIG OP VERSCHILLENDE ANTIGENEN .................................................... 62
Verschillende klassen immunoglobulines................................................................................. 62
Structurele verschillen tussen de verschillende klassen immunoglobulines ................................................ 63
.2 Functionele verschillen tussen de verschillende klassen immunoglobulines. .......................................... 65
Isotype, allotype en idiotype van een antilichaam.................................................................... 69
Isotypen diversiteit ....................................................................................................................................... 69
19 onoklonale en polyklonale antilichamen........................................................................ 70
HOOFDSTUK VI: Immunologische laboratoriumtoepassingen: aantonen van de interactie
tussen antigeen en antilichaam. ..................................................................................... 71
20 Agglutinatietechnieken ............................................................................................................................ 72
20.1 Hemagglpriutinatie ............................................................................................................................... 72
20.1.1 ABO en Rhesus bloedgroepbepaling .............................................................................................. 72
20.1.2 Complete en incomplete antilichamen .......................................................................................... 73
20.1.3 Coombs testen ............................................................................................................................... 74
20.2 Latexagglutinatie ................................................................................................................................... 75
20.3 Bacteriële agglutinatie .......................................................................................................................... 76
Precipitatiereactie................................................................................................................... 77
21.1 De Heidelberger-precipitatiecurve........................................................................................................ 77
21.2 Neerslagtechnieken in de vloeibare fase .............................................................................................. 78
21.3 Neerslagtechnieken in de vaste fase..................................................................................................... 79
21.3.1 Eenzijdige radiale immunodiffusie (RID) volgens Mancini ........................................................ 79
21.3.2 Radiale tweezijdige immunodiffusie volgens Ouchterlony ............................................................ 79
21.3.3 Immuno-elektroforese ................................................................................................................... 80
21.3.4 Raketelektroforese ......................................................................................................................... 81
21.3.5 Elektro-immunodiffusie met omgekeerde elektroforese .................................................................. 82
Testen gebaseerd op de biologische activiteit van de antilichaam-antigeen interactie .............. 82
22.1 Complementfixatietest ......................................................................................................................... 82
22.2 Virusneutralisatietest ............................................................................................................................ 84
22.3 Haemagglutinatie-inhibitietest ............................................................................................................. 84
Aantonen van de aanwezigheid van antigenen in serum of andere vloeibare fasen, met behulp
van gemerkte antilichamen. .................................................................................................... 86
23.1 Algemeen principe: ............................................................................................................................... 86
23.2 Enzyme-linked Immunosorbent Assay of ELISA ................................................................................ 87
23.3 Kwantitatieve ELISA........................................................................................................................... 89
23.3.1 Capture (of sandwich) ELISA .......................................................................................................... 89
23.3.2 Competitieve inhibitie assay .......................................................................................................... 90
23.4 Enzyme Multiplied Immunoassay Technique (EMIT) .......................................................................... 91
23.5 Radio-immunoassay of RIA ................................................................................................................... 93
23.6 Immunofluorescentie ............................................................................................................................ 97
23.7 Chemiluminescente labels .................................................................................................................... 98
Aantonen van de aanwezigheid van antigenen op cellen met behulp van gemerkte antilichamen
............................................................................................................................................. 100
24.1 Cellulaire ELISA of FIA.......................................................................................................................... 100
Flow cytometrie .......................................................................................................................................... 102
Algemeen principe .................................................................................................................................. 103
24.2.2 Meten van lichtverstrooiing - principe ......................................................................................... 103
24.2.3 Differentiatie en tellen van bloedcellen adhv lichtverstrooiing ................................................... 105
24.2.3.1 Tellen van erytrocyten .......................................................................................................... 105
24.2.3.2 Tellen en differentiëren van leukocyten ............................................................................... 106
24.2.4 Meten van fluorescentie .............................................................................................................. 107
24.2.4.1 Principe ................................................................................................................................. 107
Immunologie 1 3
, 24.2.4.2 Aantonen van antigenen op cellen ....................................................................................... 108
24.2.4.3 Aantonen van verschillende antigenen tegelijk .................................................................... 108
Aantonen van antigenen in weefsels met behulp van gemerkte antilichamen:
immunohistochemische kleuringen ....................................................................................... 112
25.1 Directe methode ................................................................................................................................. 113
25.2 Tweestaps indirecte methode ............................................................................................................ 114
Driestaps indirecte methode ...................................................................................................................... 114
25.4 Oplosbaar enzyme-immunocomplexmethode ................................................................................... 115
25.5 (strept)avidine-biotine methodes ....................................................................................................... 117
Immunologie 1 4
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