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Rheumatologist, immunologist

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Analysis of the complex study of immune status

Alexey Portnov, medical expert
Last reviewed: 23.04.2024

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The basic principle of evaluating the results of a comprehensive study of the immune status in a patient is the quantitative and functional evaluation of all its links (antigen-specific and antigen-specific factors) and their comparison with normal values. Under the normal state of the immune status is meant the immune system indicators, determined in practically healthy individuals of different age groups. Determination of the parameters of the immune system under various pathological conditions makes it possible to divide the latter into three main groups:

without significant changes in immune status;
with a deficiency of the immune system (immunodeficiencies);
with the hyperactivation of immunocompetent cells (autoimmune pathology, allergy).

Using the methods of clinical immunology, it is necessary to identify the patient's level of violations, and then monitor the restoration of the immune status of the body during treatment. The most frequent violations of the immune system in humans are immunodeficiencies. The term "immunodeficiencies" refers to violations of the normal immunological status caused by a defect in one or more immune response mechanisms. There are primary and secondary immunodeficiencies. As primary, there are those states in which disorders of immune mechanisms (production of Ig and / or T-lymphocytes) are caused by genetic factors. Depending on the level of disorders and localization of the defect, immunodeficiencies are divided into humoral, cellular, non-specific system-induced resistance (in particular, phagocytosis) and combined.

Rules for evaluating immunograms

Complex analysis of the immunogram is more informative than the evaluation of each indicator separately.
A complete immunogram analysis can be carried out only in conjunction with an assessment of the clinical picture in this patient.
Real information in the immunogram carries strong shifts in indicators; weak shifts only allow to increase confidence in the correctness of the conclusion made.
The analysis of the immunogram in dynamics is always more informative both in diagnostic and in prognostic relation than once received immunogram.
In the overwhelming majority of cases, the analysis of the immunogram makes it possible to make approximate, and not unconditional, conclusions of a diagnostic and prognostic nature.
The paramount practical significance in the immunogram is the ratio of different populations and subpopulations of immunocompetent cells, rather than their absolute values.

To facilitate a comprehensive assessment of the immune status, we present algorithms for evaluating each link of immunity. When evaluating the cell link of immunity, in addition to the T-helper / T-suppressor ratio (Tx / Tc), the ratio of the total number of leukocytes in the blood to the total number of T-lymphocytes is important - the leukocyte-T-lymphocyte index, which normally is 4- 7.

trusted-source [1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13]