Tissue typing

Covering tissue typing, this chapter describes key elements for tissue matching, a key element for successful transplantation. Methods for detecting pre-formed circulating antibodies, serological tests, and genotyping are all described. Techniques including RFLP, PCR, sequence-specific primer are explained, along with a look forward to next-generation sequencing.

Allergy tests

This chapter describes allergy tests, including their principles for testing, indications, and methods of interpreting the assays and tests. Limitations are also covered, along with key recombinant allergens for common substances that provoke an allergic reaction.

Transplantation

This chapter covers the indications, methods, immunological considerations, and monitoring of various types of transplantation. Covering stem cell transplantation, gene therapy, graft vs host disease, graft failure, and solid organ transplantation, the chapter provides an immunological overview of the subject.

Vasculitis

The term vasculitis implies inflammation affecting predominantly the blood vessels. The effects of the process depend on the location of the inflammatory change and the size and type of the vessel involved. It is unclear why there is selectivity for vessels of a certain type, size, or location. This chapter covers the presentation, immunogenetics, immunopathology, diagnosis, treatment, and testing for a range of primary vasculitides.

Connective tissue disease

This chapter covers the presentation, immunogenetics, immunopathology, diagnosis, treatment, and testing for a range of connective tissue diseases. It covers a range of rheumatic disorders, from rheumatoid arthritis to Raynaud’s phenomenon, and also covers the undifferentiated diseases, overlap syndromes, and mixed connective tissue disease.

Allergic disease

Allergic diseases are common: it has been estimated that 15% of the population will suffer from some sort of allergic reaction during their lifetime. There has been an increase in atopic diseases since the Second World War. This chapter discusses the presentation, immunological features, diagnosis, testing, and treatment for a wide range of allergic diseases. When appropriate, differential diagnoses are included.

Quality and managerial issues

Clinical and laboratory services do not operate in isolation but are integrated into the clinical and managerial framework of a hospital, and in the UK into a nationwide network (the NHS). This provides a constraint in both managerial and financial terms and also provides a legal framework in which services are delivered. It is essential that no matter where the patient is treated the right diagnosis is reached and the appropriate treatment is given. This chapter describes quality and managerial issues related to immunology and allergy, and gives an overview of the structure of the NHS.

Cellular investigations

This chapter covers cellular investigations, including identification of cell surface phenotype, intracellular proteins, cellular function, secreted products, and abnormal constituents. Techniques are described, along with principles for testing and interpretation of the results.

Immunotherapy

This chapter gives an overview of the complex area of immunotherapy. It covers the major mechanisms of immunomodulation, the generation of the immune response, modern approaches to vaccine development, and the basics of replacement therapy. It highlights immunosuppressive or immunomodulatory drugs and biologicals by type, as well as allergy interventions.

Autoimmune skin disorders

This chapter covers the presentation, immunogenetics, immunopathology, diagnosis, treatment, and testing for a range of skin disorders. The skin is a very easy organ in which to investigate autoimmune disease, due to its accessibility for biopsy. It covers fourteen separate skin disorders.