FUNDAMENTALS OF IMMUNOLOGY  IgM- pentameric (10 antigen-

binding sites); most efficient in

Immune system- includes tissues, organs, cells,
protein complement activation.
and biological mediators that coordinate to
 First produced
defend a host organism against intrusion by a
 Detected by direct or
foreign substance or abnormal cells of self-
immediate spin
origin.
agglutination in tube
Immunity- host organism protects itself from testing.
the attacks by external and internal agents  IgG- a monomer that possess
two antigen-binding sites; has
- protection from non self and abnormal the highest concentration
self-elements among immunoglobulins in
- nonself organisms includes unicellular serum.
and multicellular organisms such as  antiglobulin test is
viroids, viruses, bacterial, mycoplasma, required to detect IgG
fungi and parasites.  New born immunity
- Tumor cells are abnormal self-elements. (IgG crosses placenta)
Characteristics of Antigen  IgA - first line of defense in the
resistance against infection, via
-foreign molecules that combine with an inhibiting bacterial and viral
antibody or immunoglobulin adhesion to epithelial cells and
by neutralization of bacterial
-Epitope or antigenic determinant is part of
toxins and virus, both extra-
antigen that binds with antibody’s binding site
and intracellularly.
-Red cells, white cells, and platelets have  Produced at mucosal
antigens that trigger immune response after surfaces and is the
exposure from transfusions, pregnancy and predominant class of Ig
transplantation. found in human
external secretions and
in tears
 Has 4 binding sites
 Dimer (2 Y binding
sites)
 IgD- monomeric antibody
isotype that is expressed in the
plasma membranes of
immature B-lymphocytes
 signal the B cells to be
activated
Characteristics of Antibody  No protective function.
Still a mystery.
-consist of: heavy chains and light chains,
 IgE- synthesised by plasma cells.
constant regions and variable regions, disulfide
Monomer in structure with two
bonds, and a hinge region
binding sites.
- five types of immunoglobulins are  main function is
immunity to parasites
such as helminths like
Schistosoma mansoni,
 Trichinella spiralis, and
Fasciola hepatica.
 Also activated during
allergic reactions.
Antigen- antibody Interactions
Immune Complex- an antibody bound to an
antigen. Immune complexes are formed in vivo
and eventually cleared by the body.
Laboratory testing- immune complexes are
formed in vitro to determine identity of an
antigen or antibody or to predict the reaction
after transfusion of a blood product
Antigen is on the red cells and the antibody is
on the patient’s serum or plasma or in the
reagent
Hemagglutination
- two-step process involving: antibody binding
to red cells and the formation of lattices
between sensitized red cells
- fit or the complementary nature of the
antibody for its specific epitope determines the
strength and rate of the reaction (affinity of the
bond)
- immune complex is held together by attractive
forces, including:
 electrostatic forces
 hydrogen bonding
 hydrophobic bonding
 van der Waals forces
Antigen- Antibody Binding In Vitro
-Antigen- antibody reactions occurring in vitro
are detected by visible agglutination of red cells
or evidence of hemolysis
-absence of hemagglutination in
immunohematologic testing is a negative
reaction that shows lack of antigen-antibody
complex.
-Negative reaction means antibodies are not
specific for the antigen.
-Positive reaction indicates that an antigen-
antibody immune complex was formed
 Agglutination and Hemolysis
- The symptoms of transfusion reactions result
from the agglutination (blocking small blood
vessels) and the activation of the complement
system (leading to hemolysis of the
erythrocytes).
- agglutination test: detects presence of antigen
or antibody
 clumping of particles; process that
occurs if an antigen is mixed with its
corresponding antibody called
isoagglutinin. This term is commonly
used in blood grouping.
- Hemolysis is also an indicator of the reactivity
of antigen and antibody in vitro
 rupturing (lysis) of red blood cells
(erythrocytes) and the release of their
contents (cytoplasm) into surrounding
fluid
 If the complement system is activated
by an immune complex, hemolysis of
the red cells along with agglutination
can occur
- final process in complement activation initiate
the membrane attack complex, causing
membrane damage
 Consequence: intracellular fluid is
released to the reaction environment
 pinkish to reddish supernatant
observed after the tubes have been
centrifuged
 Hemolysis only detected in fresh in
vitro serums
 anticoagulant bind calcium (necessary
for complement activation) which is
present in serum samples, plasma
samples do not demonstrate
complement activation