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Experiment 12: Rheumatoid Factor Determination (Latex Slide test)

1) Characterize the Rheumatoid Factor


 immunoglobulins of any isotype with antibody activity directed against antigenic sites on the Fc region
of human or animal IgG
 associated with three major immunoglobulin classes, IgM, IgG, and IgA
 Immunoglobulin M rheumatoid factor is manifested in approximately 70% of adults but is not
specific for RA.
 Being RF-positive correlates with the following:
 Severity of the disease (in general)
 Nodules
 Other organ system involvement (e.g., vasculitis, Felty’s syndrome, Sjögren’s syndrome)
 Agglutination tests for RF, such as the sensitized sheep cell test and latex agglutination, generally
detect IgM RFs.
 Latex agglutination is sensitive but can produce a fairly high number of false-positive results. Because
conventional procedures are semiquantitative, they may be insensitive to changes in titer and may
detect only those RFs that agglutinate.
 associated:
 hepatitis  parasitic disease
 infectious mononucleosis  subacute bacterial endocarditis
 tuberculosis  cancer
 Elevated values may also be observed in the normal older population.
 The concentration of RF tends to be highest when the disease peaks and tends to decrease during
prolonged remission.
RESEARCHER:
REFERENCE/S: Turgeon, M. L. (2014). Immunology & Serology in Laboratory Medicine (5th ed.).
Missouri: Elsevier Inc. page 429.

2) Describe the pathophysiology of Rheumatoid Arthritis


 a chronic, multisystemic, autoimmune disorder and a progressive inflammatory disorder of the joints
 a highly variable disease that ranges from a mild illness of brief duration to a progressive destructive
polyarthritis associated with a systemic vasculitis
 Prevalence
 increases significantly with age
 Persons with the human leukocyte antigen (HLA)–DR4 haplotype have a significantly higher
incidence of RA.
 Females > males
 Non- Hispanic whites, blacks, Native Americans, and Alaska Natives > Hispanics, Asians, and
Pacific Islanders.
 Obese and overweight people > underweight or normal weight individuals.
 Physically inactive people > physically active people.
 Progression:
a. Initiation of synovitis by the primary causative factor
b. Subsequent immunologic events that perpetuate the initial inflammatory reaction.
c. Transition of an inflammatory reaction in the synovium to a proliferative, destructive tissue
process
 Pathogenesis
 an infective agent or other stimulus binds to receptors on dendritic cells (DCs), which activates the innate
immune system
 DCs migrate into lymph nodes and present antigen to T lymphocytes, which are activated by two signals—
the presentation of antigen and costimulation through CD28.
 Activated T lymphocytes proliferate and migrate into the joint.
 Subsequently, T lymphocytes produce interferon-γ (IFN-γ) and other proinflammatory cytokines.
 This in turn stimulates macrophages and other cells, including B lymphocytes. B cells appear to be pivotal in
the pathogenesis of RA because they can be 10,000 times as potent as DCs in presenting antigen.
 Stimulated macrophages and fibroblasts release cytokines, including tumor necrosis factor-α (TNF-α), a
central component in the cascade of cytokines.
 This results in the production of additional inflammatory mediators and further recruitment of immune and
inflammatory cells into a joint.
 Anti–TNF-α treatment strategies (e.g., monoclonal) prevent interaction with receptors on cell surfaces.
 The leukotrienes play a major role in the inflammatory response to injury. This class of biologically active
molecules has been implicated in the pathogenesis of RA and in other inflammatory diseases.

RESEARCHER: COLTING, Frilyn Joyce S.


REFERENCE/S: Turgeon, M. L. (2014). Immunology & Serology in Laboratory Medicine (5th ed.). Missouri:
Elsevier Inc. pages 425-428.

3) Describe the nature of autoimmune disease


Autoimmunity represents a breakdown of the immune system’s ability to discriminate between
self and nonself. The term autoimmune disorder refers to a varied group of more than 80 serious, chronic
illnesses that involve almost every human organ system. In all these disorders, the underlying problem is
similar; the body’s immune system becomes misdirected, attacking the organs it was designed to protect.
The term autoimmune disorder is used when demonstrable immunoglobulins (autoantibodies) or
cytotoxic T cells display specificity for self antigens, or autoantigens, and contribute to the pathogenesis
of the disorder. Autoimmune disorders are characterized by the persistent activation of immunologic
effector mechanisms that alter the function and integrity of individual cells and organs. The sites of organ
or tissue damage depend on the location of the immune reaction. The variety of signs and symptoms seen
in patients with autoimmune disorders reflects the various forms of the immune response.

RESEARCHER:
REFERENCE/S: Turgeon, M. L. (2014). Immunology & Serology in Laboratory Medicine (5th ed.). Missouri:
Elsevier Inc. page 383.

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