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6. TYPICAL DISORDERS OF THE HOST DEFENCE SYSTEM

Questions to prepare for classes and examination

•  Typical forms of disordered immunological reactivity.

•  Principles of classification of immunodeficiency states.

•  Primary immunodeficiencies: classification and clinical manifestations.

•  Forms of primary immunodeficiency (causes, mechanisms, clinical manifestations):

 —   B-system-dependent;

 —   T-system-dependent;

 —   A-system-dependent;

 —   complement-dependent;

 —   combined.

•  Secondary (acquired) immunodeficiency states. AIDS.

•  Physiological and pathological tolerance.

•  Graft-versus-host disease.

•  The notion of the hypersensitivity reaction, allergy, atopic allergy.

•  Types of allergens. Exogenous and endogenous allergens:

 —   heterologous, homologous and autologous allergens.

•  Stages of allergy:

 —   immunological stage;

 —   pathochemical stage;

 —   clinical manifestations.

•  Anaphylactic (I) type of allergy. The nature of allergen and antibody. Mediators of the anaphylactic reaction.

•  Clinical examples of the IgE-medited diseases. Systemic and local anaphylaxis.

•  Type II hypersensitivity. The nature of allergen and antibody. Mechanisms and clinical examples of type II allergies. Complement-dependent reactions and antibody-dependent cell-mediated cytotoxicity.

•  Type III hypersensitivity. The nature of allergen and antibody.

 —   Mechanisms and clinical examples of type III allergies. Systemic and local immune complex disease.

•  Type IV hypersensitivity. The nature of allergen and antibody.

•  Autoimmune diseases.

•  Principles of diagnostics and therapy of allergic diseases. Desensitization and nonspecific approach in the treatment of anaphylactic diseases.

N 26

A patient who had undergone a surgical intervention for gallstones presented with a slow healing of the postoperative wound, its infection, and fever. The use of antibiotics (after sensitivity tests) had positive effect. Investigation of the patient's blood showed leukopenia due to a decreased neutrophils and monocytes, a decreased mobility of leukocytes and a low activity of leukocytic myeloperoxidase. Similar abnormalities were found in the patient's sister and brother.

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