Sistema immunitario: gli esami da fare per non ammalarci / Immune system: Exams to be done to not get ill.
Segnalato dal Dott. Giuseppe Cotellessa / Reported by Dr. Giuseppe Cotellessa
Il sistema immunitario è quello scudo che ci protegge e consente di non ammalarsi durante il corso dell’anno. Ecco gli esami da fare per evitare di ammalarci. Il suo funzionamento, però, non è dei più semplici e alcune volte capita che le nostre difese si abbassino e l’organismo inizi a risentire di malanni e acciacchi vari. Il sistema immunitario è formato da un insieme di cellule, i globuli bianchi, e di molecole che hanno come compito principale quello di individuare ed eliminare qualsiasi elemento estraneo dal nostro corpo, come virus, funghi, batteri e protozoi che potrebbe rivelarsi pericoloso facendo insorgere alcune malattie all’interno del nostro organismo. «Il sistema di difesa reagisce sempre contro gli ospiti indesiderati – spiega il dott. Fabrizio Pregliasco, virologo del dipartimento di Scienze Biomediche dell’Università degli studi di Milano – ma funziona meglio e più velocemente se ha già incontrato i germi in questione, perché li riconosce e li attacca immediatamente». Come facciamo a capire quando il nostro sistema immunitario è a rischio?
Per recuperare le nostre difese basta fare cinque semplici esami mirati:
1) l’emocromo (che misura i globuli bianchi ed è il primo da effettuare),
2) la conta dei linfociti,
3) la tipizzazione linfocitaria (che valuta la presenza di un deficit di alcune cellule specifiche),
4) a VES (velocità di eritrosedimentazione, che serve a verificare se all’interno del nostro organismo c’è in corso un’infiammazione o infezione) e
5) il dosaggio delle immunoglobuline (che calcola la quantità di ogni singola classe d’immunoglobuline all’interno del nostro sangue).
L’emocromo (abbreviazione di esame emocromocitometrico) è un insieme di esami del sangue richiesti dal medico o dallo specialista che permette di ottenere informazioni sulle cellule presenti nel sangue di un paziente, in particolare
CONTA DEI LINFOCITI
Linfociti: i valori medi di riferimento
Linfociti alti (linfocitosi): le possibili cause
Bastano, quindi, pochi piccoli accorgimenti per tenere sotto controllo il nostro sistema immunitario, che è alla base del nostro stato di salute.
Solitamente si parla di linfocitosi quando il numero dei linfociti supera le 4000 unità per microlitro di sangue. Un elevato numero di linfociti può essere indicativo di infezioni virali ma anche di infezioni batteriche intracellulari e patologie ben più gravi.
Linfociti bassi (linfocitopenia): le possibili cause
Linfociti T: che cosa sono e come agiscono
Linfociti B: che cosa sono e come agiscono
Linfociti NK: che cosa sono e come agiscono
Linfociti: quando viene richiesto l’esame
Linfociti: fattori che influenzano l’esame
Valori di riferimento
Tipologie di linfociti
VES come si misura
VES, i valori di riferimento
VES: quando viene richiesto l’esame
VES: cosa può influenzare l’esito degli esami?
DOSAGGIO DELLE IMMUNOGLOBULINE (Ig)
Le Gammaglobuline o Immunoglobuline sono globuline che hanno la funzione di anticorpi. Queste aumentano quando ci sono infezioni nel corpo o comunque un processo infiammatorio in corso e si concentrano nel plasma del sangue.
Valori superiori di Gammaglobuline rispetto a quelli ritenuti normali possono indicare malattie bene precise e conclamate (malattie infettive coe la varicella, ad esempio) oppure da malattie occulte o autoimmuni.
La misurazione delle Gammaglobuline
o immunoglobuline avviene sia attraverso un comune esame del sangue sia attraverso un esame specifoco che viene prescritto dal medico e si chiama elettroforesi delle siero-proteine
The immune system is the shield that protects us and allows you to not get sick during the course of the year. Here are the examinations to avoid getting sick. However, its operation is not the simplest and sometimes it happens that our defenses decrease and the body begins to suffer from various maladies and ailments. The immune system is made up of a set of cells, white blood cells, and molecules that have as their main task the identification and elimination of any foreign matter from our body, such as viruses, fungi, bacteria and protozoa, which could be dangerous by some Diseases within our body. "The defense system always responds to unwanted guests - explains Dr. Fabrizio Pregliasco, a virologist at the Department of Biomedical Sciences at the University of Milan - but works better and faster if he has already met the germs in question because he recognizes and attacks them immediately. " How do we understand when our immune system is at risk?
In order to recover our defenses, you need to do just five simple exams:
1) the hemorrhoid (which measures the white blood cells and is the first to do),
2) the count of lymphocytes,
3) Lymphocyte typing (which evaluates the presence of a deficit of some specific cells),
4) VES (erythrocyte rate, which is used to check whether there is an inflammation or infection in our body) and
5) the immunoglobulin assay (which calculates the amount of each individual immunoglobulin class within our blood).
The hemorrhoid (abbreviation for hemocromocytometer) is a set of blood tests required by the physician or specialist to provide information on the cells present in a patient's blood, in particular
Red blood cells,
White blood cells,
Hemorrhoids measure how many blood cells and their physical characteristics, such as size, shape, and content.
Red blood cells
Red blood cells, or erythrocytes, are blood cells that carry oxygen and carbon dioxide (or carbon dioxide) through the body. They contain hemoglobin, a substance that in its structure hosts an iron atom. The amount of oxygen linked to hemoglobin helps to make these red cells. Hemoglobin transport oxygen to tissues from which carbon dioxide (a slag) is removed, which is removed from the body by the air exhaled by the lungs. Red blood cells are measured in millions per cubic millimeter (mil / mm3) of blood.
Related to these cells are also analyzed:
Hematocrit (HCT) is the percentage of red blood cells in the total volume of blood.
Hemoglobin, that is, the amount of this precious molecule in the blood, which is indispensable to the diagnosis of anemia.
Average corpuscolaneous hemoglobin (MCH) is the mean amount of hemoglobin contained in a red blood cell.
The average cellular concentration of hemoglobin (MCHC) is the average amount of hemoglobin contained in a red blood cell. The MCHC parameter gives the physician an estimate of the pallor of the cell, for example from very pale to deeply dark red. The level of pallor can be helpful for diagnosis.
The average corpuscular volume (MCV) is the average size of red blood cells. Macrocytosis is a condition with red blood cells larger than normal, microcytosis (microcytosis) is a framework with smaller red blood cells. The average size of red blood cells can be helpful for diagnosis.
The width of the erythrocyte distribution (RDW) is the measure of the variation in the size of the red blood cells.
White blood cells
White blood cells, or leukocytes, are the blood cells that fight infections. White blood cells are measured in thousands per milliliter cube (K / ml3) of blood.
The result shows the total amount, but the leukocyte (or leukocyte differential counting) is usually performed. This exam focuses on the various types of white blood cells, each having their own distinct role to keep us healthy. The various types are:
Neutrophils (also called granulocytes),
An increase in the amount of these cells allows to highlight the activation of the immune system, usually towards some actual (infection) or potential threat; From the analysis of individual types of leukocytes it is possible to get a fairly precise idea of the nature of possible infection (viral, bacterial, parasitic, ...) or other disorder (eg a tumor).
Platelet count is the number of platelets in thousands per milliliter cube (K / ml3) of blood; Platelets are core cells involved in the blood clotting process.
Average platelet volume (MPV) is also calculated, which is the mean platelet size. This data is important because the young platelets are larger than the old ones, so a higher MPV value indicates higher platelet production.
Your doctor may prescribe hemorrhoid when a subject has signs of infection, is weak or tired, or has inflammation (swelling), bruising or bleeding. Some of these conditions may require therapies, others may resolve spontaneously. Hemorrhoids may also be affected by various medications and food deficiencies.
The large family of white blood cells also include lymphocytes, specialized cells that play a very important role in the immune system, as they help to counteract external antigens selectively. Products in the bone marrow, lymphocytes are predominantly present in lymphatic tissues, thus in the lymph nodes, spleen and thymus, where they have the ability to mature and act promptly against external antigens. Given their role is normal, especially in the presence of severe infection, record temporary increases in the amount of lymphocytes, usually not more than 5%, in the bloodstream. As a result, the increase or decrease of lymphocytes can be a warning of something that does not go into the body.
These cells are divided into three groups: T, B and NK lymphocytes, which we will discuss later in the specific.
Lymphocytes: the mean reference values
Lymphocytes usually account for 20-50 percent of global leukocytes. Thus, regardless of the lab, the normal lymphocyte values are more or less equal to 1500-3000 units per mm3 of blood.
High Lymphocytes (Lymphocytosis): Possible Causes
So little is enough to keep our immune system under control, which is the basis of our health.
It is usually referred to as lymphocytosis when the number of lymphocytes exceeds 4000 units per microlitre of blood. A high number of lymphocytes can be indicative of viral infections but also of intracellular bacterial infections and much more serious pathologies.
Low Lymphocytes (Lymphocytopenia): Possible Causes
Lymphocytopenia is intended to reduce the number of lymphocytes in the blood, usually below 1000-1500 units per microliter in adults and 2500 units per microliter in children.
When the number of lymphocytes is low, the risk of getting sick is greatly increased as the immune system's ability to counteract infections is drastically reduced.
T lymphocytes: what they are and how they act
T lymphocytes play a key role in cell-mediated immunity as they intervene at various levels to stimulate the immune response and counteract intracellular pathogens such as viruses and specific bacteria, in some cases participating in the direct elimination of intracellular antigen.
T lymphocytes consist of four lymphocytic subpopulations:
Cytotoxic or T killer (Tc) lymphocytes that dissolve target cells and promote phagocytic action, which in turn destroys pathogens;
T helper or T4 (Th) lymphocytes that stimulate the action of recognition and response of T and B lymphocytes, promoting the production of antibodies;
T suppressor lymphocytes (Ts) blocking the activity of Tc and Th lymphocytes;
T Delayed Type Hypersensitivity (T DHT) lymphocytes acting as mediators of inflammatory phenomena and delayed hypersensitivity that occurs when an antigen is trapped in macrophages, phagocytic cells that have the task of cleansing the body by incorporating foreign substances, which But they can not eliminate it.
Lymphocytes B: what they are and how they act
Unlike T lymphocytes, which survive for months and even years, B lymphocytes have an average life of a few days, except for obviously for memory cells. Responsible for humoral immunity against extracellular antigens, these lymphocytes are comparable to sentinels specializing in the recognition of a particular enemy.
Basically, when a lymphocyte B encodes its antigen, it divides into plasma cells that produce antibodies in high amounts that bind to the target cell, indicating it is hostile. Subsequently, other cells are involved in the elimination of the antigen, which, once eliminated, will remain imprinted in the so-called memory cells that will be able to respond more quickly and effectively to any future infection by the same enemy.
NK Lymphocytes: what they are and how they act
Natural Killer Lymphocytes (NK) intervene in the early immune response, causing target cell suicide, especially virus-infected cancer cells. They also secrete various protein molecules, known as cytokines, that stimulate cells that are not yet infected to inhibit virus replication through specific mechanisms.
Lymphocytes: when exam is required
Your doctor may require a complete hemocromo with a formula to check the number of lymphocytes in case of routine checks, symptoms of infection and / or inflammation and suspected autoimmune disease, but also to distinguish between a tumor and no tumor, especially in cancer cases Blood and bone marrow, and to determine the effectiveness of a treatment.
Lymphocytes: factors that influence the examination
Lymphocyte count may be affected by factors such as stress, cortisone and immunosuppressive medication, surgical operations and chemotherapy and radiotherapy cycles.
Lymphocytes are a type of white blood cells responsible for the immune response of our body. It follows that when the lymphocyte values are generally higher than the reference thresholds, it may be that our body's active response to an ongoing infection may be ongoing. Precisely for this reason, the test is remarkably useful: in primitive immunodeficiencies it will be useful to demonstrate the reduction or absence of certain populations of circulating lymphocytes, whereas in secondary immunodeficiencies, the variations that may occur due to old age, Viral infections, neoplasms, sarcoidosis, and so on. The lymphocyte typing test can then go to understand what the activated lymphocyte subtype is, thus defining the antigen that the lymphocytes express on their cell membrane in order to know the function to which they are responsible.
Reference values depend on the subpopulation of lymphocytes. Although they may vary from laboratory to laboratory analysis, the following may be taken as references:
Single T3 lymphocyte typing (CD3 +): 72 - 92%
Single lymphocyte T3 (CD3 +) typing: Val / μl
T4 Helper-Inducer (CD3 + CD4 +) single lymphocyte typing: 32 - 60%
T4 Helper-Inducer (CD3 + CD4 +) single lymphocyte typing: Val / μl
T8 Suppressor-Cytotoxic (CD3 + CD8 +) Lymphocyte Typization: 16 - 40%
Single T8 Suppressor-Cytotoxic Lymphocyte Typing (CD3 + CD8 +): Val / μl
Helper / Suppressor Index (CD4 / CD8): 0.50 - 2.60
Single T Natural Killer Lymphocyte (CD3-CD56 +): 2 - 25%
Lymphocyte B totalization (CD3 + CD19 +): 3 - 17%
Types of lymphocytes
As for the aforementioned abbreviations, the T3 indicator refers to total T lymphocytes, called CD3 lymphocytes, since they can express the CD3 antigen on the surface of the cell membrane and are essential to cell-mediated immunity.
The T4 indicator refers instead to T helper lymphocytes, which are referred to as CD + 3 / CD4 + lymphocytes because they express the CD3 antigen on the cell membrane and also possess the CD4 antigen that gives lymphocytes the property to stimulate or aid (helper ) In lymphocytes B to produce antibodies.
Still, the T8 indicator refers to T8 supressor lymphocytes, called CD3 + / CD8 +. Their usefulness is to act directly on viruses, bacteria or antigens alien to the body by destroying them with cytotoxic effect. CD8s have the main effect of suppressing the immune response as opposed to the action of CD4 lymphocytes (immune system balance).
Additionally, c.d. T lymphocytes have the ability to express CD4 + / CD25 + antigens on the surface of the cell membrane, giving them a regulatory function on the production of T helper or CD3 + / CD4 + lymphocytes. Lymphocytes B are also identified by CD3 + / CD19 +, CD19 antigen. Their number may be useful to the physician in order to evaluate their maturity and to diagnose chronic and prolinocytic B leukemia.
Finally, the NK indicator refers to c.d. "Natural Killer" cells, already identified with the CD3 + / CD56 +. These cells are capable of constituting a specific subpopulation of lymphocytes capable of producing cytokines (in particular interferon gamma) and suppressing cells infected with viruses and tumor cells. Their action is predominantly cytotoxic, with particular reference to neoplastic proliferation and transplant rejection mechanism. Not only that: these particular NK cells are capable of knowing and damaging cells that belong to different types of cancer, especially of lymphoid origin.
Therefore, their detection may be useful in assessing the immune status of the patient during pathologies or immunodepressive treatments and to verify antiretroviral reactivity in organ transplant patients.
Given the variety and depth of the assessments that can be made through the typing test, in order to have more information on this analysis and its usefulness, we recommend that you contact your referral physician and understand together with him how to make the appropriate assessment of the results Which can be recovered from the above test.
VES is an abbreviation for erythro-sedimentation speed, that is, the rate at which the red blood cells in the blood suspension lose their negative charge and lean back to the bottom. Measuring VES helps us understand if there are any major inflammations in our body.
VES is an abbreviation for erythro-sedimentation speed, that is, the rate at which the red blood cells in the blood suspension lose their negative charge and lean back to the bottom.
The rate at which red blood cells pass from the suspension to the stasis at the bottom of the test tube depends on whether or not there are ongoing infections: during infections it increases the concentration of proteins in the blood and there is a crowd of corpuscles that causes Red blood cells tend to collide more easily between them by aggregating themselves into rouleax (heavy aggregates that tend to precipitate due to their high weight).
The VES is therefore a speed measure and is expressed in millimeters per hour. VES is a little specific and not sensitive, but is still widely used because it is very cheap and easy to run. What does a test specificity and sensitivity mean?
Specificity: the ability of a test to detect a specific pathology in progress. The VES is not very specific because it only indicates that an inflammation is ongoing without giving any further indication of the type of pathology that causes it.
Sensitivity: the ability of a test to measure the severity of the pathology that is being investigated. In this case, VES is unattractive because it can only say if an inflammation is ongoing, but it just tells us how serious or extensive is that inflammation, not how serious it is the disease that causes it.
VES as measured
Measurement of VES occurs following the collection of a venous blood sample, usually from the arm. Once the blood sample is taken, an anticoagulant is added and placed in a cylindrical transparent pipette with a very narrow diameter, in a vertical position. After 60 minutes measure how much red blood cells have gone down in millimeters, looking at how many millimeters of plasma (yellow and transparent part) are visible at the top of the column.
VES, reference values
The VES is measured in millimeters per hour and the reference values are differentiated by sex and age:
Men between 20 and 49 years: average VES = 5 mm / h, with a range of 0-13 mm / h
Men between 50 and 69 years: VES average = 7 mm / h, with a range of 0-19 mm / h
Women between 20 and 49 years: VES average = 9 mm / h, with a range of 0-21 mm / h
Women between 50 and 69 years: VES average = 12 mm / h, with a range of 0-28 mm / h
VES is an indicator telling us how large an infection is, but it does not tell us how serious the disease that triggered that infection. In addition, VES can be increased or decreased also due to some conditions that are not necessarily pathological or are not related to ongoing inflammation.
VES: When exam is required
As we said, VES is a very limited examination, but it is still used in specific situations, as well as to ascertain the general presence of an inflammation. It is useful when looking for a possible infection, accompanying it to other examinations, and is used in the diagnosis of Hodgkin's lymphoma since it can estimate the likelihood of a recurrence after the chemotherapy cycle. It is also used as a check for chronic or long-term disease control such as arthritis or recurrent fevers for which the cause is not identified.
VES: what can affect the outcome of exams?
The result of VES may be affected by some non-pathological conditions or in any case not related to inflammation.
Factors that increase VES:
MCV high (red blood cells larger than average, eg in macrocytosis)
Tissue necrosis (as a result of trauma)
Inflammations already overcome (return to normal values may take a few days)
In the presence of these conditions, the value of VES may appear elevated even when there is actually no inflammation that increases its value.
Factors that Decrease VES:
MCV low (red blood cells smaller than average, eg in microcytosis)
DOSAGE OF IMMUNOGLOBULINS (Ig)
Gammaglobulins or Immunoglobulins are globulins that function as antibodies. These increase when there are infections in the body or anyway an ongoing inflammatory process and focus on blood plasma.
Gammaglobulins or Immunoglobulins are globulins that function as antibodies. Gammaglobulins increase when there are infections in the body or anyway a current inflammatory process and focus on blood plasma. Gammaglobulins They belong to 5 different classes: IgG, IgA, IgM, IgD, IgE.
Normal Gammaglobulin values are considered those between 600-2300 / dl;
For each of the five classes the normal values of Gammaglobuline are as follows:
IgG 800-1800 mg / dl;
IgA 9-450 mg / dl;
IgM 60-28 mg / dl;
- IgD less than 15 mg / dl;
- IgE less than 150 I.U./l
Gammaglobulin's superior values than those considered normal may indicate well-defined and accidental diseases (infectious diseases such as varicella, for example), or occult or autoimmune diseases.
Gammaglobulins or immunoglobulins are measured either through a common blood test or through a specific examination that is prescribed by the physician and is called electrophoresis of serum proteins