diagnosis of infectious diseases reza mirzaei immunology department tums
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Diagnosis of Infectious Diseases
Reza Mirzaei
Immunology Department
TUMS
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Serology?
• the scientific study of blood serum and other bodily fluids.
• In practice, the term usually refers to the diagnostic identification of antibodies in the serum.
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• Group A streptococcus (Streptococcus pyogenes):
– Pharyngitis
– Rheumatic fever
– acute glomerulonephritis
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عوامل ایمونوژن باکتری تحریک کننده تولید آنتی بادی
توکسین های اریتروژنیک•استرپتوکیناز••DNaseهیالورونیداز•Oاسترپتولیزین •
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تشخیص آزمایشگاهی تب روماتیسمی و گلومرولونفریت حاد
( آزمایش های تشخیص دهنده آنتی بادی ضد 1آنتی ژن های استرپتوکوک
– ASO–Anti-DNase-B
( آزمایش های تشخیص دهنده التهاب2–CRP, ESR
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Streptococcal Antibody Test
Streptolysin O: An exotoxin which is sensitive to oxygen.
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Principle of ASO test?
• Enzyme neutralization
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Tube NO. 1) 8/1000(
2 )6/1000(
3 )4/1000(
4 )3/1000(
Red cells
control
SO control
ASO Buffer
0.2 0.4 0.6 0.7 1.5 1( ml)
Serum 0.8 0.6 0.4 0.3 -- --
SO 0.5 0.5 0.5 0.5 -- 0.5
15 min
Red blood cells
0.5 0.5 0.5 0.5 0.5 0.5
Titer (Todd)
125 166 250 333 No lysis lysis
ASO an enzyme inhibition test
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واحد تاد
: Oبیان تیتر آنتی بادی علیه استرپتولیزین •(Toddواحد تاد )•
عکس باال ترین رقت سرم که مانع از عمل •همولیز کامل گلبول های قرمز توسط
می شود.oاسترپتولیزین
آخرین لوله ای که فاقد همولیز باشد.•
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Interpretation of the result
Different factors such as age, previous infection, immune system status & society affect the ASO interpretation
Titer in adults: 250 unit
300-1500 Acute rheumatic fever (85%)
Todd Acute post streptococcal glomerulonephritis
(ADNaseB)
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CRPC-Reactive Protein
Acute Phase Protein
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The increase of CRP serum concentrations observed in
• Microbial infections
• Acute rheumatic fever
• Acute myocardial infarction
• Rheumatoid Arthritis
• Cancer
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CRP• Severity of the disease & effectiveness of therapy
• Latex agglutination
• Passive agglutination
• 1µg/ml
• False negative:– Corticosteroids– Prozone
• False positive:– Old serum
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Syphilis (Treponema Pallidum)
• Primary syphilis
• Secondary syphilis
• Latent syphilis
• Tertiary/ late latent syphilis
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سه نوع آنتی بادی در سرمرآژین سیفیلیسی )آنتی بادی غیر اختصاصی(•
– VDRL )Venereal Disease Research Laboratory(– RPR )Rapid Plasma Reagin(
• same antigen as the VDRL• Ags bound to carbon particle to allow visualization of the flocculation
reaction without the need of a microscope.
ضد میکروب های گروه ترپونما•– Kolmer or RPCFT )Reiter Protein Complement Fixation Test)
ضد ترپونما پالیدوم )آنتی بادی اختصاصی(•– Nelson-Mayer– TPI )treponema pallidum immobilization(– FTA-ABS )fluorescent treponemal antibody-absorption(– ELISA
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Laboratory diagnosis
Microscopic TestsDark fieldImmunoflurescense
Serologic Tests (STS)Screening non-Treponema tests (non-specific/VDRL, RPR)
Confirming Treponema tests (specific/FTAabs)
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Syphilis (Treponema Pallidum)
• Primary syphilis
•Microscopic Tests
•FTA-ABS first pos then VDRL
• Secondary syphilis
•VDRL
• Tertiary/ late latent syphilis
•FTA-ABS
•VDRL is neg
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VDRL Test)Venereal Disease Research Laboratory(
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؟VDRLاساس تست
فلوکوالسیون•
آنتی ژن رآژین: سوسپانسیون کاردیولیپین، •لسیتین، کلسترول
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VDRLکاربردهای تست
غربالگری•
پیگیری سیر درمان )کمی(•
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تفسیر نتیجه آزمایش راژین سیفیلیسی
منفی:•بیمار مبتال به سیفیلیس نیست.–هنوز در ابتدای بیماری است.–معالجه ناقص–سیفیلیس نهفته یا غیر فعال–مبتال به نقص ایمنی–
مثبت:•تست تائیدی-