TY - CHAP M1 - Book, Section TI - Function and Evaluation of the Immune System A1 - Zlott, Daniel A. A1 - Thiele, Geoffrey M. A2 - DiPiro, Joseph T. A2 - Yee, Gary C. A2 - Haines, Stuart T. A2 - Nolin, Thomas D. A2 - Ellingrod, Vicki L. A2 - Posey, L. Michael Y1 - 2023 N1 - T2 - DiPiro’s Pharmacotherapy: A Pathophysiologic Approach, 12th Edition AB - KEY CONCEPTS Cells of the immune system are derived from the pluripotent stem cell. Hematopoiesis is closely regulated to maintain adequate numbers of different cell types. The development of these different cells or cell lineages depends on cell-to-cell interactions and hematopoietic growth factors. Upon activation, dendritic cells (DCs) express higher concentrations of major histocompatibility complex class II molecules, B7-1, B7-2, CD40, ICAM-1, and LFA-3 molecules than other antigen-presenting cells (APCs). They also produce more IL-12. These differences may explain why DCs are the most efficient APC. A T-lymphocyte expresses hundreds of T-cell receptors (TCRs). All the TCRs expressed on the surface of an individual T-lymphocyte have the same antigen specificity. An immature B-lymphocyte expresses thousands of membrane-bound surface immunoglobulin (sIg) as IgM (monomeric) or IgD, all with the same specificity (ie, antigen-binding site). Upon antigen stimulation and T-cell help, the immature B-lymphocyte matures (proliferates, class-switches and becomes a plasma cell) to secrete different isotypes (eg, IgM [pentamer], IgA, immunoglobulin G [IgG], and IgE) with the same specificity as the original membrane-bound sIg. Serum protein electrophoresis determines the total concentration of all circulating proteins, including the immunoglobulins (ie, IgG, IgA, IgM, IgD, and IgE). The concentration of the individual isotypes can be determined with isotype-specific quantification methods. Most clinical laboratories measure only IgG, IgM, and IgA because they are the most prevalent isotypes in the bloodstream. In patients with allergic disorders, measurement of IgE is rarely useful. An understanding of the mechanism of action of immunomodulators allows a clinician to anticipate potential adverse drug reactions. The benefit of manipulating immune responses must be balanced with the potential consequences and long-term sequela (eg, tumor growth, infections, autoimmune reactions) of such manipulation. SN - PB - McGraw Hill CY - New York, NY Y2 - 2024/11/13 UR - accesspharmacy.mhmedical.com/content.aspx?aid=1197556664 ER -