Bogomolets National Medical University
HONOR, MERCY, GLORY

Department of Clinical Immunology and Allergy Section of Medical Genetics

Information for students

IMMUNOLOGY 2017

 Theme-based plan for lectures

LECTURES ON CLINICAL IMMUNOLOGY AND ALLERGOLOGY

FOR STUDENTS OF THE 5TH COURSE

LECTURE No 1: Main tasks and problems of clinical immunology and allergology. Principles for functions of immune system, clinical laboratory evaluation of its disorders.

Questions to lecture:

  • Main tasks for clinical immunology and allergology in modern stage in development of medicine.
  • Peculiarities for training of doctor-clinical immunologist in Ukraine and in the world.
  • Place of immune system in support for homeostasis of organism.
  • Antigen as a leading factor of immune regulation.
  • Role of modern knowledge about principles for functions of different chains of immunity for preservation of health and correct curation of patients.
  • New possibilities for modern immunodiagnostics in clinical and scientific practice. Importance for evaluation of patient’s immune status for determination of his/her health status and construction of diagnostic algorithms and choice for treatment schemes.

LECTURE No 2: Diseases of immune system. Principles for immunodiagnostics, immunotherapy, immunorehabilitation and immunoprevention.

Questions to lecture:

  • Place for diseases of immune system in general sickness rate among population in Ukraine and in the world.
  • Role of heredity and environmental factors in development of immune pathology.
  • Necessity in primary diagnostics for immune pathology by general practitioners.
  • Immunotherapy and immunoprevention on example of HIV/AIDS.

LECTURE No 3: Basics for transplantation immunity. Immunology of reproductions.

Questions to lecture:

  • Modern aspects in transplantation of organs and cells. Ethic problems at performance of transplantation.
  • Genetic control for transplantation mechanisms.

3. New groups of immunosuppressors, based on monoclonal antibodies, peculiarities and complications of their use in clinical practice.

4. Essential weight of immune-dependent forms for infertility among other variants for disorders in reproduction.

  • Use of modern diagnostic and treatment methods in immunology of reproduction.

LECTURE No 4: Immunological surveillance. Clinical immunological aspects of autoimmune diseases.

Questions to lectures:

  • Role for cells of congenital immunity in antitumoral protection.
  • Immunological methods in early diagnostics of tumors.
  • Importance for methods on immunorehabilitation for oncologic patients.
  • Modern concepts about mechanisms for formation of tolerance.
  • Basics for theory of tolerance breaking and clinical examples.

LECTURE No 5: Modern views on atopic diseases as on system diseases. Allergic diseases. Classification, clinical examples.

Questions to lectures:

  • Reasons for increase in amount of allergic diseases in the world and forecast for their prevalence in the future.
  • Atopy, importance of early diagnostics and algorithm to render the aid at emergencies.
  • Clinical examples for other allergic diseases, importance of correct diagnostics algorithm to render the proper aid to patient.
  • Modern possibilities for allergic diagnostics.
  • Modern approaches to therapy of allergic diseases, perspective directions.

Individual work of students:

  • Reporting the essay at practical class on extracurricular topics:
  • Immuno-neuro-endocrine regulation for functions of organism
  • Apoptosis as regulation for immune response
  • Immunology of mucous membranes.
  • Immunopathogenesis and immunotherapy of sepsis;
  • Epstein-Barr viral infection: immunopathogenesis, immunotherapy
  • Pollen disease. Specific immunotherapy: principles for prescription. Indications and contraindications, development of complications.
  • Medicamental allergy.
  • Curation of patient with immune-dependent or allergological pathology.
  • Report about clinical history of patient at practical class.
  • Reporting the essay at practical class
  • Writing theses, articles

APPROXIMATE LIST OF PRACTICAL WORKS AND TASKS FOR FINAL MODULAR CONTROL

  1. To perform the survey and physical examination of patients with immune deficient diseases (to take immunological anamnesis, to determine the genetic predisposition to development of immunodeficiencies, evaluation of data from physical methods of examinations, etc.).
  2. To be able to fill in the immunological questionnaire of patient, on its basis to determine “risk group” for immunopathology.
  3. Mastering the skills for determination of necessary range of immunological tests for examination of patients with immune dependent pathology.
  4. To detect available main clinical symptoms and syndromes of immune disorders.
  5. To make the differential diagnosis, to ground and to formulate the diagnosis at main immunodeficient syndromes pursuant to analysis of data from laboratory and instrumental examination.
  6. To perform clinical immunological differential diagnostics of congenital and acquired immunodeficiency.
  7. Mastering skills to interpret data and main principles for interpretation of data from leucogram and immunogram taking into consideration the clinic, period of disease, immunological anamnesis, etc.
  8. Mastering skills for assessment of influence from negative actions of environmental factors on immunological indices.
  9. To detect clinical features for decompensation of local immunity.
  10. To detect the features for irritation of immune system due to data of leucogram.
  11. To prescribe immunotropic treatment, to determine the forecast, to perform primary and secondary immunoprevention at immune dependent diseases.
  12. To know the main principles for prescription of immunotropic therapy in complex treatment of immune dependent diseases.
  13. To be able to perform preventive measures at vaccination. To possess principles for immunoprevention.
  14. Mastering skills for determination of necessity in performance of clinical allergological examination.
  15. To perform the survey and physical examination of patients with allergopathology (be able to take allergological anamnesis, to determine available genetic disposition to formation of allergological pathology).
  16. To compose the plan for examination of patients with allergological diseases.
  17. Mastering the skills to perform skin allergological tests (prick tests).
  18. Mastering the skills to assess the data from laboratory allergological tests.
  19. Mastering the skills to determine allergens with similar antigenic determinants for composition of recommendations for allergological prevention.
  20. Mastering the skills to perform peakflowmetry and assessment of its indices.
  21. To perform the differential diagnosis, to ground and to formulate the diagnosis at main allergological diseases pursuant to analysis of data from laboratory and instrumental examination.
  22. To prescribe treatment, to determine the forecast, to perform primary and secondary prevention at allergological diseases.
  23. To render the emergency aid at acute allergic and pseudoallergic pathology.
  24. To apply the standards for diagnostic and treatment of allergological diseases in practice.
  25. To master skills to prescribe the antiallergic drugs, to know the prescription of main antiallergic drugs.
  26. To master skills for assessment of laboratory results from determination of immunological criteria for autoimmune pathology.
  27. To apply the standards for immunodiagnostics and prescription of immunosuppressive therapy with assessment of its efficiency in autoimmune diseases.
  28. To master skills for determination of necessity in performance of clinical immunological examination for spouses at suspicion for immune dependent infertility.
  29. To possess the principles for immunodiagnostics and immunotherapy of infertility, stipulated by immunodeficient diseases of women.
  30. To possess principles for immunodiagnostics and immunotherapy of infertility, stipulated by antigermline immune conflict.
  31. To possess principles for immunodiagnostics and immunotherapy of infertility, stipulated by higher histocompatibility of spouses.
  32. To interpret data of tests on selection of donor and recipient for performance of transplantation.
  33. To master skills to diagnose super acute, acute and chronic crises of rejection at transplantation of organs and tissues.
  34. To perform the differential diagnostics for crisis of rejection and infectious complications in patients after transplantation.
  35. To prescribe immunosuppressive therapy and to assess its efficiency after transplantation of organs and tissues.
  36. To interpret the indices of immunograms in oncologic patients with evaluation of antineoplastic factors of protection.
  37. To assess the results from determination of tumor-associated antigens in early immunodiagnostics of tumors and early detection of recurrences.
  38. To possess principles for immunotherapy and immunoprevention of tumors.
  39. To render emergency aid at acute allergic or pseudoallergic pathology.
  40. To prescribe the immunotropic therapy at complex treatment of infectious diseases.
  41. To assess the efficiency in prescribed immunotherapy in dynamics.
  42. To master principles for immunoprevention and to use them in clinic.
  43. To perform replacement therapy with immunoglobulin drugs.
  44. To perform antiviral immunotherapy with prescription of medicine interferon and inductors of interferon.
  45. To prescribe and to assess the efficiency in specific immunotherapy at treatment of pollen disease and allergic rhinitis.

Study guides for students
to practical classes on clinical immunology
and allergology

Module 1

BASICS FOR CLINICAL IMMUNOLOGY AND ALLERGOLOGY

Informative module 1: IMMUNOLOGICAL STATUS, PRINCIPLES FOR ASSESSMENT AND WAYS FOR IMMUNE CORRECTION

TOPIC No 3: Immune inflammation and infectious diseases. HIV-infection: immunopathogenesis, immunodiagnostics, immune correction.

<palign=”center”>5th course, medical faculty 2.5 hours

I. Actuality of topic: The infectious diseases remain the main reason for sickness and mortality rates all over the world. The new causative agents were identified, more and more often it is stated that the clinical course of “old” infectious diseases does not correspond to the classical clinical picture. The number of patients with secondary immune deficient diseases, stipulated by iatrogenic reasons that are the risk factor for development of opportunist infection in them was increased. It was determined that the atypical immune response to microorganisms was the reason for development of somatic autoimmune pathology.

HIV-infection is a long infectious disease, which is developed as a result from infection with human immunodeficiency virus (HIV) and is characterized by progressive injury of immune system. The incurable disease, caused by HIV, starts from infection, after which “acute retroviral syndrome” often occurs, after that the disease progresses until late stage of spread HIV-infection. The persons, infected with HIV, never have the virus in real latency state and it is actively reproduced. The viral loading is the highest one in lymph nodes and other organs that have lymphoid tissue.

The injury of immune system also starts since infection. Slowly, the irreplaceable components of host immune system are ruined and the development of efficient immune response not only to HIV but to other causative agents is excluded at a certain stage. The phase of opportunistic infections and malignant tumors, which characterizes the acquired immune deficiency syndrome (AIDS), occurs.

II. Tasks for homework: To know the characteristic genealogical, anamnestic, clinical and laboratory features, inherent to different disorders of patient’s immune status, dynamics for changes in laboratory indices during different stages of acute inflammatory process, main principles for interpretation of immunograms.

III. Questions to self-control

  • Mechanisms for immune protection at bacterial and viral infections.
  • Role of immune system in antifungal immunity and protection against helmints.
  • Importance for state of immune system in development of opportunistic and protozoan infections.
  • Immunological methods in diagnostics of infectious diseases.
  • Immune response at acute inflammatory process.
  • Dynamics in indices of leucogram, proteinogram and immunogram at acute, recurrent and chronic inflammations.
  • Kinds and peculiarities for specific immunoprevention of infectious diseases.
  • Immune dependent reactions and complications at vaccination.
  • Etiology, immunopathogenesis, diagnostics and immunotherapy of AIDS.
  • Immunological methods in diagnostics of AIDS.
  • Dynamics in immunogram of HIV-infected persons and patients with AIDS.
  • Immunoprevention of HIV-infection.

 

IV. Scope of independent work: To learn to detect clinical and laboratory evidences for immune dependent pathology. To carry out the independent clinical examination of patient with immune dependent pathology (anamnesis, examination, work with medical documentation) and pursuant to received data correctly to determine the set of examinations and to prescribe the adequate therapy.

 

V. LIST OF ACADEMIC METHODOLOGICAL LITERATURE

MAIN:

  • “Clinical immunology and allergology”. Textbook under editorship of professor G.M. Drannik, – K.: Zdorovye, 2006.-888 p.
  • Drannik G.M. Clinical immunology and allergology: guide for students, doctors-interns, immunologists, allergologists, doctors of medical profile in all specialties. – 3rd amended edition. – K.: “Poligraf plus” LLC, 2006 – 482 p.
  • Kazmirchuk V.Ye., L.V. Kovalchuk Clinical immunology and allergology. – Vinnytsia: NOVA KNYHA, 2006. 528 p.
  • Lectures by professor Drannik G.M.

 

ADDITIONAL LITERATURE

  • Bazhora Yu.I. “Clinical immunology” – Odessa, Odessa state medical university. – 2000.- 384 p.
  • Belozerov Ye.S. Diseases of immune system Elista: APP “Jangar”, 2005, – 267 p.
  • Immunology in clinical practice / Lebedev K.A., Poniakina I.D., Edited by K.A. Lebedeva. M., TsPI “IEMK”, 1996. – 354
  • Kyshkun A.A. “Immunological and serological researches in clinical practice”, M.: Medinform agency, – 2006, – 532 p.
  • “Clinical immunology”. Edited by Sokolova E.I. – M., “Medicine” – 1998. – 272 p.
  • “Clinical protocol of antiretroviral therapy for HIV-infection in adults and teenagers. – MHC of Ukraine, dd. 20.12.2003.
  • Novikov D.K. Antiviral immunity. Immunopathology, allergology, infectology. – 2002. – No 1. P. 5-15
  • Basics for clinical immunology (study guide for medical higher schools), translated from English E. Chepel, M. Hayni, S. Misbach, N. Snowden, M.: GEOTAR – Media, 2008, – 416 p.
  • Rabson A. Basics for medical immunology: translated from English. M.: Mir, – 2006, – 319 p.
  • Khaitov R.M. “Immunology” textbook for medical higher schools – M., Publishing House GEOTAR Media – 2006. – + CD ROM.

 

 

 


Study guides for students

to practical classes on clinical immunology

and allergology

Module 1

BASICS FOR CLINICAL IMMUNOLOGY AND ALLERGOLOGY

Informative module 2: IMMUNE DEFICIENT DISEASES AND IMMUNE DEPENDENT PATHOLOGY

TOPIC No 8: Immunology of tumors

5th course, medical faculty 2.5 hours

I. Actuality of topic:The issue on struggle against malignant neoplasms is one of the main issues in modern medicine and is the national task. Thus it is the development and implementation of new modern methods for immunodiagnostics, immunotherapy and immunoprevention of oncopathology into practice that is one of the most urgent issues in modern medicine.

The successes in experimental oncology and immunology, rich clinical experience allowed achieving the significant successes in solution of many issues in practical oncology. The confirmation for this fact is the increase in the number of patients that were practically treated from cancer with every coming year. The success and results from treatment of oncologic patients directly depends on timely diagnostics of malignant tumor. The study on immune dependent mechanisms for development of tumors, knowledge of role for proneoplastic and antineoplastic factors in origin and growth of tumor provides with possibilities for timely detection and choice for method on treatment of oncopathology.

II. Tasks for homework : To be able to interpret the indices of immunograms in oncologic patients with assessment of antineoplastic factors of protection.

To be able to assess the results from determination of tumor-associated antigens in immunodiagnostics of tumors and early detection of recurrences. To be able to prescribe the immunotropic therapy in complex therapy of tumors.

III. Questions to self-control

  • Antineoplastic and proneoplastic mechanisms for interaction of immune system “host” organism and “tumor”.
  • Factors for immunological resistance of tumor.
  • Concept on tumor-associated antigens
  • Immunosuppressive action of tumors.
  • Immune changes in oncologic patients.
  • Immunodiagnostics, including differential one according to CD-phenotype of tumor cells.
  • Modern approaches to immunotherapy of patient with oncologic diseases.

IV. Scope of independent work: To master the methods on clinical and laboratory diagnostics of immune disorders and immune deficient diseases underlaying oncopathology.
To master the principles for immunotherapy and immunoprevention of oncologic diseases.

V. LIST OF ACADEMIC METHODOLOGICAL LITERATURE

MAIN:

  • “Clinical immunology and allergology”. Textbook under editorship of professor G.M. Drannik, – K.: Zdorovye, 2006.-888 p.
  • Drannik G.M. Clinical immunology and allergology: guide for students, doctors-interns, immunologists, allergologists, doctors of medical profile in all specialties. – 3rd amended edition. – K.: “Poligraf plus” LLC, 2006 – 482 p.
  • Kazmirchuk V.Ye., L.V. Kovalchuk Clinical immunology and allergology. – Vinnytsia: NOVA KNYHA, 2006. 528 p.
  • Lectures by professor Drannik G.M.

ADDITIONAL LITERATURE

  • Belozerov Ye.S. Diseases of immune system Elista: APP “Jangar”, 2005, – 267 p.
  • Volodin N.N., Degtyareva M.V., Dmytruk S.V. et al. Handbook on immunotherapy for practitioner. – SPb.: Dialog, 2002-478 p.
  • Immunology in clinical practice / Lebedev K.A., Poniakina I.D., Edited by K.A. Lebedeva. M., TsPI “IEMK”, 1996. – 354
  • Dobrytsa V.P., Boterashvili N.M., Dobrytsa Ye.V. Modern immunomodulators for clinical application: Manual for doctors. – SPb.: Politekhnika, 2001 – 249 p.
  • Kyshkun A.A. “Immunological and serological researches in clinical practice”, M.: Medinform agency, – 2006, – 532 p.
  • Novikov D.K. Medical immunology. – Vitebsk: BAAKI, 2002 – 175 p.
  • Basics for clinical immunology (study guide for medical higher schools), translated from English E. Chepel, M. Hayni, S. Misbach, N. Snowden, M.: GEOTAR – Media, 2008, – 416 p.
  • Rabson A. Basics for medical immunology: translated from English. M.: Mir, – 2006, – 319 p.
  • Handbook on immunotherapy for practitioner. / Volodin N.N., Degtyareva M.V., Dmytruk S.V.; Edited by Volodin N.N. – SPb.: Dialog, 2002-476 p.
  • Khaitov R.M. “Immunology” textbook for medical higher schools – M., Publishing House GEOTAR Media – 2006. – + CD ROM.
  • Periodical journals “Immunology and allergology”, “Immunology”, “Clinical immunology”, 2006-2010.


Study guides for students to practical classes on clinical immunology and allergology

Module 1

BASICS FOR CLINICAL IMMUNOLOGY AND ALLERGOLOGY

Informative module 3:

ALLERGIC DISEASES

TOPIC No 11: Other allergic (non-atopic) diseases

5th course, medical faculty 2.5 hours

I. Actuality of topic: The number of people that have allergic diseases has been increased in all countries for recent decades. It is known that today 10-20% of all people suffer from them. The structure of sickness rate has certain differences in children and adults: the allergic skin injuries prevail among allergic diseases during the first years of life, while in teenagers and adults – allergic diseases of ENT organs and respiratory system.

As the first doctors, to whom the patients address, are district (family) doctors, the latter ones shall be able to perform the differential diagnostics for allergy and pseudoallergy, for further determination of tactics on management of patients or sending him (in serious cases) to corresponding specialists. The graduates from medical higher schools shall possess the knowledge about pathogenesis, clinical course, modern methods on diagnostics at allergic and pseudoallergic diseases in order to perform the differential diagnostics and further prescription of adequate therapy of diseases.

II. Tasks for home work: To be able to take allergic anamnesis; to perform the differential diagnostics for allergy and pseudoallergy pursuant to anamnestic data; to compose the plan for additional examination using allergological and immunological methods; to prescribe the adequate therapy taking into consideration the allergic or pseudoallergic genesis of disease.

ІІІ. Questions to self-control

  • Medicamental allergy: reasons, immunopathogenesis, clinic, allergic diagnostics and prevention.
  • Non-atopic diseases: kinds, immunopathogenesis, immunodiagnostics, clinical evidences and differential diagnostics.
  • Cell-mediated allergic disease (serum disease, Arthus phenomenon, allergic alveolitis, etc.): immunopathogenesis, clinic, immunodiagnostics, immunotherapy.
  • Differential diagnostics of diseases, stipulated by allergic processes and pseudoallergic reactions.
  • Principles for antiallergic therapy and immunotropic methods of treatment in allergology.

 

 

IV. Scope of independent work: To be able to determine etiological (groups of allergens) and pathogenic (types of immune reactions) factors for allergological diseases; to ground and to formulate the diagnosis at main allergic syndromes pursuant to analysis of data from laboratory and instrumental examination; to perform the differential diagnostics between allergic and pseudoallergic diseases, to prescribe antiallergic therapy, to assess its efficiency.

V. LIST OF ACADEMIC METHODOLOGICAL LITERATURE

MAIN:

  • “Clinical immunology and allergology”. Textbook under editorship of professor G.M. Drannik, – K.: Zdorovye, 2006.-888 p.
  • Drannik G.M. Clinical immunology and allergology: guide for students, doctors-interns, immunologists, allergologists, doctors of medical profile in all specialties. – 3rd amended edition. – K.: “Poligraf plus” LLC, 2006 – 482 p.
  • Kazmirchuk V.Ye., L.V. Kovalchuk Clinical immunology and allergology. – Vinnytsia: NOVA KNYHA, 2006. 528 p.
  • Lectures by professor Drannik G.M.

 

ADDITIONAL LITERATURE

  • Belozerov Ye.S. Diseases of immune system Elista: APP “Jangar”, 2005, – 267 p.
  • Immunopathology and allergology. Standards for diagnostics and treatment / Ilyina N.I., Gushchin I.S.; edited by R.M. Khaitova. – M.: Medicine, 2001. – 95 p.
  • Dobrytsa V.P., Boterashvili N.M., Dobrytsa Ye.V. Modern immunomodulators for clinical application: Manual for doctors. – SPb.: Politekhnika, 2001 – 249 p.
  • Clinical immunology and allergology / T. Fisher, D. Adelman et al.; Edited by G. Lopor junior: translated from English – M.: Practice, 2000. – 806 p.
  • Basics for clinical immunology (study guide for medical higher schools), translated from English E. Chepel, M. Hayni, S. Misbach, N. Snowden, M.: GEOTAR – Media, 2008, – 416 p.
  • Pukhlik B.M. “Elementary allergology” / Publishing House “Veles”. 2002 – 152 p.
  • Rabson A. Basics for medical immunology: translated from English. M.: Mir, – 2006, – 319 p.
  • Handbook on immunotherapy for practitioner. / Volodin N.N., Degtyareva M.V., Dmytruk S.V.; Edited by Volodin N.N. – SPb.: Dialog, 2002-476 p.
  • Fedorovich S.V., Zharin V.A., “Alimentary allergy” / Publishing House “Harvest”, – 2007 – 352 p.
  • Khaitov R.M. “Immunology” textbook for medical higher schools – M., Publishing House GEOTAR Media – 2006. – + CD ROM.
  • Periodical journals “Immunology and allergology”, “Immunology”, “Clinical immunology”, 2006-2010.