Immunopathology Including Amyloidosis Question And Answers

Immunopathology Including Amyloidosis Question And Answers

Question 1. Write a short note on laboratory diagnosis of AIDS.
Answer: 

Laboratory Diagnosis of AIDS

“Understanding the role of immunopathology in disease mechanisms”

1. Tests for Establishing HIV Infection

• Antibody tests:
  • ELISA
  • Western blot
• Direct detection of HIV
  • p24 antigen capture assay
  • HIV RNA assay `
  • NA—PCR
  • Culture of HIV

“Importance of studying immunopathology for better healthcare outcomes”

2. Tests for Defects in Immunity

• CD4+ T cell count: Fall
• CD8+ cell count: Increased
• Ratio of CD4+ T cell/CD8+T cell count: Reversed
• Lymphopenia
• Hypergammaglobulinemia
• Increased β2 microglobulin level
• Platelet count: Thrombocytopenia

“Common challenges in diagnosing and managing immunopathology conditions”

“Steps to identify common types of immunopathology”

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3. Tests for Detection of Opportunistic Infection and Secondary Tumors

• FNAC/exfoliative cytology
• Biopsy.

1. Tests for Establishing HIV Infection

These include antibody tests and direct detection of HIV

“Role of autoimmune diseases in immunopathology mechanisms”

• Antibody tests: These tests are as under:
  • ELISA:
    
    • Initial screening is done by a serologic test for antibodies by enzyme-linked immunosorbent assay (ELISA) against gag and env proteins.
    • The term window period is used for the initial 2 to 4 weeks period when the patient is infectious but the screening test is negative, while seroconversion is the term used for the appearance of antibodies.

“Asymptomatic vs symptomatic effects of poor communication”

• • Western blot: If ELISA is positive, confirmation is done by Western blot for the presence of specific antibodies against all three HIV antigens: gag, pol, and env.
    • Direct detection of HIV: These tests are as follows:
    • p24 antigen capture assay
    • HIV/RNA assay methods by reverse transcriptase (RT) PCR, branched DNA, and nucleic acid sequence-based amplification (NucliSens).
    • DNA-PCR by amplification of proviral DNA.
    • Culture of HIV from blood monocytes and CD4+ T cells.

“Early warning signs of untreated immunopathology conditions”

2. Tests for Defects in Immunity

These tests are used for diagnosis as well as for monitoring the treatment of cases.

• CD4+ T cell counts. A progressive fall in the number of CD4 + T cells is of paramount importance in diagnosis and staging CDC categories as described above.
• Rise in CD8+ T cells.
• Reversal of CD4+ to CD8+ T cell ratio.
• Presence of Lymphopenia.
• Polyclonal hypergammaglobulinaemia.
• Increased β2 microglobulin levels.
• Platelet counts reveal thrombocytopenia.

“Asymptomatic vs symptomatic stages of immunopathology progression”

3. Tests for Detection of Opportunistic Infections and Secondary Tumors

Diagnosis of organs involved in opportunistic infection and specific tumors secondary to HIV/AIDS is made by aspiration or biopsy methods as for the corresponding primary disease.

Lymph Node Biopsy

In Early Stage

• Presence of marked follicular hyperplasia
• Follicles extend to the medulla and sometimes spread outside the capsule
• The mantle zone thinned out and germinal centers seem to merge with the interfollicular areas
• Presence of mono cytoid B cells in and around sinusoids and in trabecular blood vessels.
• Involvement of the B cell areas of the lymph node supports polyclonal B cell activation and hypergammaglobulinemia

“Steps to educate patients about immunopathology and amyloidosis risks”

During Disease Progression

• Presence of severe follicular involution.
• Follicles are depleted of cells.
• An organized network of follicular dendritic cells is disrupted.
• Germinal centers become hyalinized
• Atrophic and small lymph nodes.
• In this stage, lymph nodes may harbor opportunistic infections.
• The inflammatory response to infections in both nodal and extranodal sites may be atypical and sparse.

“Role of counseling in improving awareness of amyloidosis symptoms”

Question 2. Define antigen­antibody reactions.
Answer:

Antigens and antibodies combine with each other specifically and in an observable manner. Antigen-antibody reactions in vitro are known as serological reactions.