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81 Cards in this Set
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Recognition and Response of immune system
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required for the success of the immune response
utilize CD/cluster diferrentiation |
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Cluster of Differentiation
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originally describe proteins found on the surface of lymphocetes
now used as labeling system to ID family of proteins on many cells |
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Types of antigen
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Immunogenic
Antigenic Antigenic determinant (epitote) |
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Antigenic determinant
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portion of the antigen that is configured to recognize and bind to an antibody
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Immunogenic
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antigen's crteria in influencing degree of immunogenic: foreigness, size, complexity and qty.
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Self-Antigen
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missing immunogenic criteria of foreigness
we are tolerant of our own antigen |
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Administration of antigen
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body receive antigen via vaccination at a specific/preferrential route (IM, SC, intraperitoneal, oral)
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Tolerance
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state of nonresponsivenss to immune system; passively allow self-antigen to persist; state of homeostasis
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2 types of tolerance
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Central and Peripheral tolerance
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Central Tolerance
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during differentiation, lymphoctes w/ receptors for self-antigen is eliminated/suppressed/deleted
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Peripheral Tolerance
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maintained in the secondary lymphoid organs through action of Treg
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Haptens
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small molecule structure of an antigent that doesn't elicit response unless it binds to a carrier protein called
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Antibodies
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aka immunoglobulins, challenges immunogens, produce by plasma cells
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5 Classes of Antibody
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IgG, IgA, IgM, IgE, IgD
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IgG
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most abundant (80-85%), it trasferred via placenta, 4 classes--IgG1-4
account for most protective activity against infection |
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IgA
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2 types: IgA1 found in blood, IgA2 found in body secretions (tears, sweat, saliva, mucus and breastmilk)
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IgM
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largest immunoglobulins, 1st antibody during the primary response to an antigen, sythesized during fetal life
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IgD
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low in concentration, little info about it, found in the surface of developing B lymphocytes, functions as the type B cell antigen receptor
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IgE
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least concentration, mediator of common allergic responses, provides protection f/ large parasites
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how does IgE provides protection from large parasites?
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initiates inflammatory rxn to attract esosinophils
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2 Typse of Immune System Response
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Primary Response
2ndary Response |
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Primary Response of Immune System
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slow, has a lag/delayed period where memory cells are differentiating; after 5-7 days IgM for specific antigen is detected; followed by IgG response in equal/slightly less
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Secondary Response
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more rapid, no differentiation of b cells, large amount of antibody is produced; IgM is produced in equal amounts as primary response by IgG is produced in great#
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Antibody Function
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Direct: naturalization, agglutination and precipitation
INDIRECT: opsonization |
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Secretory(mucosal) Immune System
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lymphoid tissues that protect the external surfaces of the body where antibody is present in body secretions mainly containing IgA1 and small amt of IgG and IgM
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Killing Mechanism of Secretory(mucosal) Immune system
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cytotoxic T lymphoytes destroys cancer cells or infected virus by utilizing degrative enzymes (perforins and granzymes) or direct-receptor interaction
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Other Cells involve in Immune system
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Natural Killer cells--same mechanism as cytotoxic T cell
T reg--regulates the peripheral tolerance by affecting the recognition of antigen and the proliferative steps of antigen recognition |
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Fetal and Neonatal Immunity
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antibody is defficient; capable of producing Igm response but incable of producing IgG challenge
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Immunity provided by maternal antibody by:
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trophoblastic cells transport maternal IgG across the placenta by birth/newborn IgG levels is near adult levels
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Aging and Immune Function
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Decease T cells activity; thymus size is 15% max size; decrease in circulating antibodies/memory cells and decrease production of specific antibodies; increase antigen-antibody complexes and autoantibodies
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Hypersensitivity
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Altered immunologic response to an antigen that results in disease or damage to the host;
characterized by immune mechanism |
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3 Types of Hypersensitivity rxn
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allergy, autoimmunity, alloimmunity
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Allergy
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Deleterious effects of hypersensitivity to environmental (exogenous) antigens;
environmental antigen that causes atypical immunologic response to a genetically predisposed individual; allergen is contained in a particle too large to be phagocytosed or protected w/ anonallergenic coat; original insult is apparent |
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Alloimmunity
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Immune reaction to tissues of another individual
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Autoimmunity
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Disturbance in the immunologic tolerance of self-antigens;
Breakdown of tolerance |
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Hypersesitivity is characterized by
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immune mechanism
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4 Types of Hypersensitivity Reaction
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Type I, II, III, IV
Reactions: immediate/delayed |
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Type 1 Hypersensitivity
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IgE mediated against environmenta antigens/allergens; IgE binds to the Fc receptors on the surface of mast cells w/c are cytotoic antibody;
degranulation of mast cells causes histamine release; has genetic predisposition |
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Manifestation of Type 1 Hypersensitivity
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itching, uticaria, conjunctivitis, rhinitis, hypotention, bronchospasm, dysrhythmia, GI crams and malabsorption
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Mast Cell degranulation
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releases histamines that binds to either H1 receptor (proinflammatory) or H2 receptor (anti-inflammatory)
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Type 1 Hypersensitivity can be evaluated through:
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food challenges, skin test, lab test (RAS, ElISA)
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Desensitation
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IgG blocking antibodies produced by introducing incremental doses of antigen; allows person to build tolerance to environmental allergen
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Type II Hypersensitivity
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Tissue specific in w/c specific tissue/cell's antigen is target of immune response
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Mechanism of Type II Hypersensitivity Response
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cell is destroyed by antibodies and complement; cell destruction through phagocytosis; soluble antigen enter circulation and gets deposited on tissues; antigen-dependent cell mediated cytotoxicyt; cause target malfunction
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TYPE III Hypersensitivity
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immune complex mediated w/c are antigen-antibody complexes that enters circulation and deposited into vessel walls or extravascular tissue
NOT organ specific |
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Immune Complex Clearance
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Large—macrophages
Small—renal clearance Intermediate—deposit in tissues |
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Immune Complex Diseases
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Serum Sickness (systemc)
Arthus Rxn (localized/vascular response) caused by repeated exposure to antigen that reacts w/ preformed AB and forms complexes that gets deposited on local vessel walls |
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Type IV Hypersensitive
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cell-mediated; doesn't involve antibody;
involves cytotoxic T lymphocytes or lymphokine producing Th1 cells Direct killing by Tc or recruitment of phagocytic cells by Th1 cells |
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Direct killing of Tc cells
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by toxins/Tc cells releases soluble factors, lysosomal enzymes, toxic ROS f/ macrophage activity
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Example of Type IV Hypersensitivity
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Graft skin rejection, skin test TB, contact allergic rxn; autoimmune disease
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Example of Type IV Hypersensitivity
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rxn from tuberculin TB skin test; causes infiltration of lymphocytes and macrophages causing induratin (bubble) and erythema (redness)
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Allergy
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caused by environmental antigens that causes atypical immunologic responses in genetically predisposed individuals
Pollens, molds and fungi, foods, animals, etc. Allergen is contained within a particle too large to be phagocytosed or is protected by a nonallergenic coat Original insult is apparent |
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Autoimmunity
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Breakdown of tolerance
Body recognizes self-antigens as foreign Sequestered antigen self-antigens not normally seen by the immune system |
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Autoimmunity Theories
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Infectious disease, neoantigen, forbidden clone, ineffective peripheral tolerance, original insult and genetic factor
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Infectious Disease
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works on molecular mimicry; where antigen of m.o. is similar to self-antigen
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Neoantigen
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involves haptens that attaches to host protein and elicit immune response
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Forbidden Clone
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during differentiation, lymphocytes produce have receptors that react to self-antigen; these lymphocytes are forbidden to mature but those that survice can later on proliferate
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Ineffective peripheral tolerance
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defective regulatory T cells; leads to expansion of clones of autoreactive cells
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Original insults
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like allergy; cause is known; like known m.o. that causes immune response
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Genetic Factor
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easier to ID; deffective HLA alleles and variety of non MHC genes
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Autoimmunity Examples
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SLE-sytemic lupus erythematous and graft rejection
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Systemic lupus erythematosus (SLE)
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Chronic multisystem inflammatory disease
Autoantibodies against: Nucleic acids, erythrocytes, coagulation proteins, phospholipids, lymphocytes, platelets, etc. Deposition of circulating immune complexes containing antibody against host DNA More common in females |
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Graft Rejection/transplant rejection is classified
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according to time; amount of time elapse between transplantation and rejection
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3 Classification of Graft Rejection
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Hyperacute:Immediate and rare; Preexisting antibody to the antigens of the graft
Acute: Cell-mediated immune response against unmatched HLA antigens Chronic: Months or years Inflammatory damage to endothelial cells of vessels due to a weak cell-mediated reaction against minor HLA antigens |
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Transfusion Reactions
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Antibodies against blood group antigens
ABO system Two major carbohydrate antigens A and B (co-dominant) Individuals have naturally occurring antibodies to the A and B antigens they lack Anti-A and anti-B antibody production is induced by similar antigens on naturally occurring bacteria in the intestinal tract Antibodies are usually of the IgM class O blood type (universal donor) AB blood type (universal recipient) |
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Immune Deficiencies
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Failure of immune mechanisms of self-defense
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2 Types of Immune Deficiency
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Primary (congenital) immunodeficiency
Genetic anomaly Secondary (acquired) immunodeficiency Caused by another illness More common |
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Clinical Presentation of Immune Deficiency
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Development of unusual or recurrent, severe infections
T cell deficiencies Viral, fungal, yeast, and atypical microorganisms B cell and phagocyte deficiencies Microorganisms requiring opsonization Complement deficiencies Secondary Deficiencies: Also referred to as acquired deficiencies Far more common than primary deficiencies |
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Secondary Deficiencies are caused by
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Normal physiology conditions
Psychological stress Dietary insufficiencies Malignancies Physical trauma Medical treatments Infections Acquired immunodeficiency syndrome (AIDS) |
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Anaphylaxis
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immediate, rapid immune response; life threatening and needs immediate attention;
caused by systemic rxn from ingestion/injestion/inhalation of substance by a sensitive individual Onset: min to no more than 1 hr |
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Signs and Symptoms of Anaphylaxis
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Uneasy, lightheaded, itching (uticaria), swelling(angioedema) of eyelids, lips, tongue, hands, feet, genitalia, uvulva, larynx, bronchioles, hypotention
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Tissue response of anaphylaxis
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sudden, multifocal rxn, mast cells bound to IgE, histamines release causing vasodilation, increased permeability, leakage
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Treatment of Anaphylaxis
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ABC: airway, breathing, circulation and definitive action is giving antihistamines such as benadryl IV or epinepherine
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Prevention of Anaphylaxis
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Teaching about known offenders, epi pen and medical bracelets
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Evaluation of Immunity
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Basic Lab test: CBC w/ differentials, quatitative determination of immunoglobulins, assay for total complement and skin test
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Immunocompormised are at risk for
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GVHD; Graft vs Host Disease where the T cells in the graft are mature and capable of cell-mediated destruction of tissues w/in the recipient
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GVHD
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T cells in the graft are mature and capable of cell-mediated destruction of tissues w/in the recipient
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Treatment for Immune deficiencies
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gamma-globulin therapy, transplantation and transfusion; treatment with soluble immune mediators; gene therapy
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Immunocompormised are at risk for
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GVHD; Graft vs Host Disease where the T cells in the graft are mature and capable of cell-mediated destruction of tissues w/in the recipient
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GVHD
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T cells in the graft are mature and capable of cell-mediated destruction of tissues w/in the recipient
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Treatment for Immune deficiencies
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gamma-globulin therapy, transplantation and transfusion; treatment with soluble immune mediators; gene therapy
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