The immune status is extended which is included. All about the analysis for the immune status

Date: 08.03.2020

Immune status (IS) is a set of quantitative and functional indicators that reflect the state of the human immune system at a given time. This concept was introduced for an objective assessment of the state of the human immune system. The study of indicators of immunity in immune disorders should include studies of the amount and functional activity of the main components of the immune system. All disorders of the immune system are classified based on the manifestations of various diseases. There are primary and secondary immunodeficiencies, autoimmune, allergic and lymphoproliferative diseases.

To assess the functioning of all components of the immune system, T and B systems of the immune system, phagocytic and complement systems, quantitative and functional methods should be included. To assess the humoral link of immunity, the following studies are performed: determination of the production of immunoglobulins of different classes in blood serum; determination of the relative and absolute content of B-lymphocytes and their subpopulations, complement components and circulating immune complexes, functional tests (blast transformation reaction with mitogens), determination of specific antibodies, skin tests.

To assess the T-cell link, studies are carried out to determine the relative and absolute number of T-lymphocytes and their subpopulations (T-helpers, CTLs), natural killer cells, their activation markers, functional tests (blast transformation reaction with mitogens), determination of cytokine production.

The state of the phagocytic system is assessed by many tests: the adhesive ability of neutrophils to adhere to nylon fibers; migration, chemotaxis in the reaction of inhibition of neutrophil migration; metabolic activity and the formation of reactive oxygen species for the reduction of nitro blue tetrazolium; phagocytic activity of neutrophils in tests of spontaneous phagocytosis and stimulated by microbial polysaccharides; immunophenotyping of neutrophils.

Previously, these methods were divided into Level 1 and Level 2 tests. Level 1 tests are indicative and aimed at identifying gross defects in the immune system. Level 2 tests are aimed at identifying a specific “breakdown” in the immune system.

Level 1 tests

determination of the relative and absolute number of leukocytes, neutrophils, monocytes, lymphocytes and platelets in peripheral blood;
determination of the functional activity of neutrophils (NBT test);
immunophenotyping tests to determine the relative and absolute number of T- and B-lymphocytes, natural killer cells;
determination of the concentration of immunoglobulins of the main classes (IgA, IgM, IgG, IgE);
determination of hemolytic activity of complement.

Using a minimal set of tests, you can diagnose primary immunodeficiencies: chronic granulomatous disease, X-linked agamma globulinemia, hyper-IgM syndrome, selective IgA deficiency, Wiskott-Aldrich syndrome, severe combined immunodeficiency.

Level 2 tests

immunophenotyping tests to determine the relative and absolute number of populations and subpopulations of T-, B-, NK-lymphocytes;
activation markers of lymphocytes;
assessment of various stages of phagocytosis and the receptor apparatus of phagocytic cells;
definition of the main classes and subclasses of immunoglobulins;
circulating immune complexes;
determination of the concentration of complement components in blood serum (C3, C4, C5, C1-inhibitor);
functional activity of various subpopulations of lymphocytes;
assessment of the proliferative activity of T- and B-lymphocytes;
study of interferon status;
skin tests, etc.

The set of indicators obtained during immunological examination is called immunogram.

It should be emphasized that a full analysis of the immunogram is possible only in combination with the patient's clinical condition and history. The absence of characteristic shifts in the immunogram with severe clinical symptoms should be considered an atypical reaction of the immune system, which is an aggravating symptom of the disease. The patient data obtained are compared with the average values for the given analyte obtained in the patient's region of residence. Average statistical indicators differ depending on the region and are subject to climatic and geographical conditions, environmental conditions, living conditions. The patient's age and circadian rhythms must also be considered.

The study of IP indicators is of great importance for diagnosis and differential diagnosis, especially in primary immunodeficiencies and lymphoproliferative diseases, for assessing the severity, activity, duration of the course and prognosis of various diseases, and assessing the effectiveness of treatment.

Content

In the event of allergies, diseases of the immune system and a deficiency of protection, a person should be analyzed to assess the immune status. This will help identify irregularities in the system, prescribe treatment, assess its effectiveness and predict the outcome of the disease. The most complete picture of the state of human immunity is given by an immunogram.

What is immune status

The medical term immune status was introduced to assess the state of a person's immunity. Doctors say that the immune status is a number of indicators by which it is possible to objectively assess how the human defense system works in a given period of time. Nuances:

For assessment, a blood test is performed for the presence and amount of immunoglobulins, protective proteins, lymphocytes.
As part of the procedure and subsequent analysis, it is revealed how active the protective components are in their function.
In addition to blood, cells of the mucous membranes, skin, urine, and cerebrospinal fluid can be taken for analysis.

Why do you need an immunological blood test

Assessment of the immune status will help the doctor to clarify the diagnosis, determine the severity of the disease and think over the tactics of therapeutic therapy. The main tasks that the immunity test helps to solve are:

identification in the biological environment of specific antigens, antibodies, which can be used to determine the origin of oncology, pneumonia, hepatitis, influenza, HIV;
identification of allergens during the manifestation of allergic reactions;
determination of immunological shifts, according to which autoimmune diseases, disorders of cellular immunity are detected;
diagnostics of primary, secondary immunodeficiency states;
control of the effectiveness of immunosuppressive and cytotoxic therapy, its side effects;
selection of adequate therapy for modulating immunity;
control over the immune system during tissue or organ transplantation.

If abnormalities are found in the work of immunity, the doctor prescribes immunotropic drugs. These include immunostimulants, immunomodulators, or immunosuppressants. A treatment option is substitution treatment with the introduction into the body:

special serums;
immunoglobulins to support the system;
additional mass of leukocytes;
interferons that strengthen the body.

When a blood test for immunity is prescribed

The indications for donating blood for immune status are:

violations in the work of immunity;
immunodeficiency;
hyperresponsiveness of the immune system;
autoimmune reactions in which the immune system attacks its own tissues;
severe course of infectious diseases;
chronic or recurrent with an increased frequency of colds;
chronic inflammation;
connective tissue diseases;
an increase in the body temperature of a child or adult for an unclear reason;
swollen lymph nodes, otitis media;
a chronic state of fatigue in a child;
a sudden decrease in body weight.

An immunogram is rejected when:

expecting a child;
sexually transmitted diseases;
diagnostics for AIDS;
acute viral infection.

Preparation for immunogram

You can assess your immunological status in the laboratory. First, the patient undergoes a medical examination to identify complaints and symptoms of diseases. After that, the therapist prescribes an expensive immunogram with subsequent decoding. Preparation for analysis is as follows:

blood is donated on an empty stomach - any food is excluded in 8-12 hours, you can only drink non-carbonated water;
one day before the procedure, you cannot drink alcohol, and 2-3 hours before the procedure, smoke;
the analysis is given from 7 to 10 in the morning;
stop taking any medications in a few days, if it is impossible - notify the doctor;
on the day of donating blood, you need to be calm, not nervous, do not exercise;
pay the price of the procedure indicated by the institution in advance.

What does the study of the immune status mean?

The complex and time-consuming analysis of the immune status includes several stages, each of which carries out its own tests. Level 1 includes research:

phagocytic function is the calculation of the norm of phagocytes, an assessment of their intensity of absorption of microbes, the ability of digestion;
complement systems - the so-called hemotest;
T-systems are the count of lymphocytes, the percentage of mature T-lymphocytes and their populations, the response to mitogens;
B-systems - studying the concentration of immunoglobulins, the percentage of B-lymphocytes.

Level 2 tests include research:

phagocytic function - on the intensity of chemotaxis, expression, NBT test;
T-systems - study of cytokines, necrosis, response to specific antigens, allergic reactions;
B-systems - determination of the norm of immunoglobulins, specific antibodies, lymphocyte response.

Assessment of the immune status for humoral immunity

Humoral immunity will help to understand how much immunoglobulins and other protective proteins are in the blood. To evaluate it, a blood serum analysis is used, which determines the relative and absolute content of B-class lymphocytes, their subpopulations. The analysis also includes the identification of complement components, circulating immune complexes, functional tests. At the last stage, specific antibodies are determined and skin tests are performed.

Cellular immunostatus

The analysis of cellular immunity complements the study of the immune status. It is carried out on the basis of an assessment of blood, gives an idea of the content and qualitative ratio of lymphocytes. These white blood cells provide antiviral immunity in the body. During the analysis, the number of B, T-lymphocytes, double-cells is counted. At the end of the procedure, the leukocyte-T-lymphocyte and immunoregulatory indices will be indicated.

How is the nonspecific resistance of the organism determined?

The defenses of the human body work at the moment of penetration of any pathogen, therefore they do not depend on preliminary contact with microbes and viruses. These immunochemical mechanisms are called nonspecific factors that determine the resistance of the body. Its study is carried out by allergic methods of introducing histamine under the skin, the activity of blood serum is determined, and the amount of proteins is counted.

What the immunogram shows

A special test that helps determine the immune status is called an immunogram. According to its results, one can understand the state of the immune system and its main components. The main indicators are the number of leukocytes and antibodies, the ability of cells to phagocytosis. An important indicator of the state of the immune system is the presence of antibodies or immunoglobulins. There are several of their groups responsible for certain properties:

type A - fights toxins, protects the mucous membranes of a healthy person;
type M - first responds to contact with a microbe, the presence shows an acute inflammatory process;
type G - shows chronic inflammation;
type E - indicates the presence of allergies.

How to correctly decipher a blood test for immune status

Only an immunologist can correctly decipher the obtained analysis of the immune status, because it takes into account the indications of the symptoms and the individual characteristics of the patient. For a layman, the readings of the immunogram will look like a set of symbols or numbers, but some of the readings can be made out:

if phagocytosis is reduced, this indicates inflammation or a purulent process;
reduced rate of T-lymphocytes - AIDS is likely;
an increased level of type E immunoglobulins - allergies, worms;
increased white blood cell count - acute inflammation;
excessive concentration of lymphocytes is a viral infection.

A properly qualified doctor will decipher the readings of the analysis, but for the reliability of the diagnosis, a second examination will be required after a few weeks. This is done to ensure that there is no error in the analysis. A random jump in indicators can be affected by:

taking medications;
patient stress;
incorrect analysis.

The price of the analysis for the immune status

Not all indicators will be included in the analysis for the immune status, but only necessary and prescribed by the doctor. The cost of performing an immunogram will depend on this. The price for a separate test starts from 100 rubles, and for the most expensive indicator - from 1000. If we take the extended complex analysis, then its price will be about 6000 rubles, a standard package will cost 4000 rubles. If the analysis is required urgently, then it will not be possible to do it inexpensively - for the time they take plus 50% of the price.

Video: immunogram - what it shows in children

Attention! The information presented in the article is for informational purposes only. The materials of the article do not call for self-treatment. Only a qualified doctor can diagnose and give recommendations for treatment, based on the individual characteristics of a particular patient.

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The immune system helps our body to resist negative influences, serious diseases, and block various processes associated with the development of tumors. When it fails, there can be serious health problems, and to identify and eliminate the "weak points" of the immune system, there is a special blood test, which allows you to study the immune status and shows the patient's ability to resist various infections.

When an immunogram is made in the laboratory, several tests of the main indicators are carried out at once, clarifying the state of individual parameters.

Determination of antibodies of various classes demonstrates the presence of infections in the body and the level of their development. Looking at the status of different groups, you can determine the duration of the infection and draw a conclusion about the course of the disease.
Determination of subpopulations of lymphocytes allows you to find out the composition of each of the two existing groups of lymphocytes, and to notice a possible lack of them.
An analysis of the phagocytic activity of leukocytes shows the activity of phagocytosis - the process of absorbing bacteria and harmful viruses to prevent their influence on the body.
The C3 and C4 components of complement are proteins from the complement system that play an important role in the process of inflammation, facilitating phagocytosis.
The analysis for CEC (circulating immune complexes), examines the antigen-antibody chain, which is formed as a response of the immune system to the ingress of foreign microorganisms.

Blood test

When making an immunogram, mainly blood taken from a finger or from a vein is used. The taken amount of blood is distributed in two test tubes, in one of which the blood immediately coagulates, and contains the molecules required for analysis and a clot containing shaped cells; another test tube contains a substance that prevents blood from clotting, so that the necessary cells are kept in suspension.

In the case when the doctor is interested in the immune status of the mucous membranes, saliva, mucus or tear fluid is taken for analysis. If you need to find out the immune status of the nervous system, take cerebrospinal fluid (cerebrospinal fluid), but this happens in rare cases.

Indications for a blood test for immunity

If there are diseases of viral origin, allergic reactions, frequent pneumonia, long-term fungal infections, inflammatory chronic pathologies (bronchitis, sinusitis), autoimmune diseases (diabetes mellitus, etc.), oncology, pustular skin pathologies, secondary and primary immunodeficiencies, gastrointestinal diseases - the intestinal tract of an infectious origin, in which weight loss occurs, if you are after chemotherapy or after organ transplantation - you need to check the immune status.

There are also separate indications for a blood test for pregnant women if they have HIV, frequent relapses of herpes simplex, autoimmune pathologies, pregnancy with rhesus conflict, incessant relapses of cytomegalovirus infection, pathology of tissue interaction during pregnancy.

Immune status - normal / not normal

A blood test is deciphered only by an immunologist, and not just a layman or a familiar nurse, since it looks like a long list of abbreviations with the corresponding numbers that are understandable only to a specialist.

If the immune status, visible on a blood test, shows that most of the indicators are normal, with the exception of a few, you will be asked to donate another portion of blood after 1.5-3 weeks in order to compare the results and obtain a more accurate diagnosis. If the blood test shows a decrease in the level of phagocytes and their functional activity, it is possible that there is a suppurative process. When a defect in T-lymphocytes can be observed, AIDS is most likely diagnosed. In case of exceeding the norm of IgE immunoglobulins, one can judge about helminthic invasions or allergies, and if

Why does it often happen in life, one person never gets sick with anything, but the second one should be “looked at”, and he is already lying with a fever? The reason for this is a weak immune status. What is it and how to check it?

Let's talk about the term itself

In order to talk about something in more detail, you need to know at least a little about what this conversation will be about. So what is immune status? These are quantitative and functional indicators that reflect the position of the immune system at a certain point in time. This indicator is interconnected with the age characteristics of the human body. It changes under the influence of internal and external factors. These include:

pregnancy;
lactation;
various diseases;
violations in the work of internal organs.

If the immune system fails, then the causes of this violation should be considered in combination. Both quantitative and qualitative changes in indicators should be taken into account. Two large systems, humoral and cellular, are interconnected and reflect the state of the human immune system. Only by joint efforts, these two systems can protect the body from a variety of infections.

When is the analysis done?

An assessment of the immune status must be carried out if:

It is necessary to make a correct diagnosis. Usually, such a need arises in primary immunodeficiency, myeloma, AIDS, transplantation and some other severe and minor illnesses. Differential diagnosis should be carried out within a group of diseases such as: leukemia, lymphoma, autoimmune diseases and others.
The temperature lasts more than two weeks for no reason.

The study of the immune status also has relative indications if:

There is a violation of the state of health of children after they have taken immunomodulating drugs.
Diseases often occur: ARVI, viral infections, herpes infections.
There are non-chronic foci of infections. These include: purulent otitis media, recurrent bronchitis, sinusitis. To this list can be added and bronchitis, the treatment of which does not respond well to traditional therapy.

Features of the study of the immune status

Are there any peculiarities in the analysis of the immune status? Yes, and now it will be about them.

The normal values obtained during the procedure have a wide range. Their deviation from the norm can vary from twenty to forty percent, and this figure is acceptable.
A blood test for immune status should be performed several times. How much depends on the symptoms.
The test results depend on a large number of factors: time of day, time of year, living conditions, race, social well-being, medication intake. Especially the results are influenced by glucocorticoid drugs and antibiotics. The list goes on and on. Indeed, the outcome of the research is influenced by any other therapeutic and diagnostic measures. We are talking about radiography, surgery, radioisotope scanning.

Assessment of the immune status

The immune status is assessed based on tests. The screening standard test includes:

Counting the number of platelets, leukocytes, neutrophils, lymphocytes.
Determination of the presence of immunoglobulins of different classes.
Determination of the activity of the hemolytic kit CH50.
Delayed hypersensitivity skin tests are being analyzed.

When conducting a more thorough study of the immune system, a detailed study of the functional and quantitative activity of the humoral and cellular systems is required.

Phagocytic function analysis.
Analysis of the complement system.
Analysis of the T-system of immunity.
Analysis of the B-system of immunity.

More accurate results will be obtained if the research is carried out in several stages.

Indicative research. On its basis, significant defects of the immune system are determined - this is the first level.
A more detailed analysis is carried out - the second level.

Tests conducted at the first level

Phagocytic features are being studied:

The absolute number of monocytes and neutrophils is calculated.
The number of absorbed microbes by phagocytes is studied.
The ability of cells that have absorbed phagocytes to digest microbes.

The analysis of the T-system is carried out:

The number of lymphocytes is counted.
The percentage of mature lymphocytes and their subpopulations is calculated.

The B-system is being studied:

The concentration in the blood serum of immunoglobulins of different classes is established.
The ratio of the percentage and the absolute number of B-lymphocytes in the peripheral blood is established.

But the assessment of the immune status at the first level may give incomplete results. That is why it is imperative to conduct second-level research.

Tests conducted at the second level

Phagocytic function analysis:

The activity of chemotaxis of phagocytes is determined.
The expression of adhesion molecules on the surface of neutrophils is determined.

T-system analyzes are carried out:

Investigate the resulting production of cytokines.
Determination of the activity of T-lymphocytes on the membrane surface.
Detection of adhesion molecules.
The proliferative response to diphtheria and tetanus toxoid is analyzed.
An allergic reaction is determined. Skin tests are performed.

Analysis of the B-system. The research subjects:

Immunoglobulins, IgG subclass.
Secretory IgA subclass.

Investigated:

The ratio of chains of immunoglobulins kappa and lambda.
Specific antibodies are determined, their relation to protein and polysaccharide antigens.
The ability of lymphocytes for a proliferative response is analyzed.

As mentioned above, the study of the immune status is a complex undertaking. Only after carrying out the required analyzes of the first and second level, it is possible to accurately establish the diagnosis. An analysis for the immune status, the rate of which can vary within twenty to forty percent of the established indicators, is also useful for prescribing treatment.

Before going on research, you need to visit a doctor. After your story, he will decide which of the indicators is most important to you. After all, research on the immune status is very expensive.

Now how to prepare for the procedure:

The analysis is taken from seven to ten in the morning.
Food should not be consumed for eight to twelve hours before analysis.
You can only drink non-carbonated water.
Alcoholic drinks are not consumed twenty-four hours before the analysis. If suddenly this cannot be prevented, then be sure to warn the doctor.
Do not be nervous.
Don't exercise.

An analysis of the immune status is not carried out if an infectious disease is suspected. It will show incorrect results. Plus, it is not prescribed in the following cases:

With sexually transmitted diseases.
During pregnancy, which is proceeding quite normally.
If you suspect HIV infection. First, the disease itself is diagnosed, and then the analysis can be carried out.
With frequent skin rashes.

Conclusion

Remember, if you have the slightest doubt about the functioning of the immune system, you should do an analysis of the immune status. Only then will you be fully convinced whether your suspicions are correct or not. And only in this case, the diagnosis will be established correctly, which means that the necessary treatment will be prescribed.

The immune status of a person is a complex indicator of the state in which he is. The need to study it arises when there is a suspicion of the failure of the defense system. At the same time, the nature of violations is revealed and a method for their elimination is determined. Changes to which the immune status is exposed must be detected in a timely manner. Otherwise, the occurrence of rather serious diseases (allergies, tumors and other pathologies) is likely.

Humoral (associated with fluid in the body) and cellular immunity affects the immune status, the analysis of their condition is carried out using separate tests included in the immunogram. The study allows you to determine the state of the body's defense system. As a result of the analysis, the specialist evaluates the usefulness of the various links that make up the immune status. In this case, all tests are important, since the protective function of the body is provided by their joint actions.

The humoral link of a healthy immune system is able to prevent the spread of pathogens (extracellular) viral and bacterial infections at the initial period of their penetration into the body. Humoral reactions are provided by B-lymphocytes and are carried out in Recognizing the pathogen (foreign agent), B-lymphocytes are differentiated (transferred) into which they produce (produce) antibodies - immunoglobulins (serum proteins). Immunoglobulins bind to a penetrated foreign agent, block its biological activity, and then remove it from the body. Thus, the direct action of immunoglobulins is carried out.

Participate in the activation of other immunological reactions that maintain a normal immune status. For example, "killer cells" (NK and K cells) lyse (dissolve) completely foreign cells that are coated with immunoglobulins (Ig G).

By binding to the antigen, immunoglobulins also activate a set of eleven serum proteins (complement system). Some elements of the complement system have the ability to attack the cell membrane, provoking the death of a foreign cell, other elements can delimit the area of inflammation and attract more leukocytes into it.

The humoral link, which is included in the immune status, is assessed by detecting and counting B-lymphocytes in the blood (in percentage and absolute numbers). Their functional activity (B-lymphocytes) is determined by the immunoglobulins synthesized by them in response to B-cell stimulation. Determination of the presence of antibodies to the most common viruses and bacteria, the concentration of autoantibodies or immune complexes is carried out by measuring the total level of immunoglobulins and the amount in different classes (IgA, IgG, IgM).

It is important when diagnosing congenital immunodeficiencies with defects in this system. In other cases, for example, with autoimmune pathologies, data on the C4 and C3 components of complement are important.