The common four immune tests in clinical practice include four tests for infectious disease immunity, four tests for immune function, and four tests for autoimmune liver disease. Different inspection methods represent different inspection results.
So, how should we view the four immune test reports?
1、 Four Items of Infectious Disease Immunization
Four Items of Infectious Disease Immunization is a relatively common four items of immunization tests, including hepatitis B surface antigen, hepatitis C virus antibody, human immunodeficiency virus antibody and syphilis antibody. If the test result is negative, it means that they are not infected with infectious diseases. If the four items of infectious disease immunization are positive, they should consider the possibility of suffering from hepatitis B, hepatitis C, AIDS and syphilis. Take hepatitis B as an example:
1. When hepatitis B surface antigen is positive, it means that the patient may be an infected person or carrier of hepatitis B virus at this time.
2. Hepatitis C virus antibodies refer to the antibodies generated by the immune inflammatory response in the body of patients infected with hepatitis C. A positive hepatitis C virus antibody indicates that the patient is infected with hepatitis C virus, and there is a high possibility of chronic infection.
3. Human immunodeficiency virus antibody refers to the corresponding antibody produced against AIDS virus (HIV). If AIDS virus is infected, it usually takes 4-6 weeks for the human body to produce antibodies against AIDS virus. When antibodies appear, it is proved that the person has become infected.
4. Syphilis antibodies are usually divided into non specific antibodies against Treponema pallidum and specific antibodies against Treponema pallidum, namely trust and tppa. If both trust and tppa are positive, it can be diagnosed as syphilis. If TPPA is positive and Trust is negative, it indicates a previous infection with syphilis that has been cured.
2、 The four tests of immune function include the detection of immunoglobulin IgG, IgA, IgM, and IgE. Immunoglobulin is mainly produced by B cells in the human body and can help the body resist foreign viruses and antigens. If immunoglobulin levels decrease, the patient's immune function may decline. When immunoglobulin is significantly elevated, it is necessary to consider whether the patient is infected. In addition, if it is a monoclonal immunoglobulin elevation, it is also necessary to consider whether it is caused by malignant tumors, such as multiple myeloma.
The normal range for IgG is 7.0-16.6 g/l. IgG is an immunoglobulin in the secondary immune response, and its elevation is common in various chronic infections, chronic liver diseases, lymphomas, and autoimmune diseases.
The normal value of IgA is 0.7-3.5g/l. Elevated IgA is seen in rheumatoid arthritis, cirrhosis, eczema, and kidney disease. IgA reduction can be observed in recurrent respiratory infections, primary and secondary immunodeficiency diseases, autoimmune diseases, and metabolic diseases.
The normal range for IgM is 0.5-2.6g/l. IgM is an immunoglobulin involved in primary immune response, and its elevation usually indicates primary infection. An increase in IgM can be observed in early viral hepatitis, cirrhosis, and rheumatoid arthritis. A decrease in IgM can be observed in congenital immunodeficiency, immunosuppressive therapy, lymphatic system tumors, nephrotic syndrome, and metabolic diseases. If three abnormal immune results are found, seek medical attention promptly.
The normal value of IgE is between 20-200IU/ml. If IgE levels are higher than normal, it is necessary to be alert to hypersensitivity diseases such as chronic urticaria, allergic dermatitis, allergic asthma, allergic rhinitis, etc. In addition, parasitic infections, eczema, rheumatoid arthritis and other diseases can also cause an increase in IgE levels. If the value of this item decreases, it should be noted that it is caused by diseases such as primary agammaglobulinemia.
3、 The four tests for autoimmune liver disease include anti nuclear antibodies, anti smooth muscle antibodies, anti liver and kidney microsomal antibodies, and anti soluble liver antigen antibodies, which are indicators used to diagnose autoimmune liver disease. If there is a positive result of autoantibodies and an increase in transaminase, it can be clinically diagnosed as autoimmune hepatitis.
In addition, for other types of autoimmune liver disease, such as primary biliary cholangitis, the main diagnosis is to detect anti mitochondrial antibodies, anti actin autoantibodies, etc.
1. Anti nuclear antibodies: Anti nuclear antibodies are a general term for autoantibodies in the nucleus of the cell, which can be detected by indirect immunofluorescence method. The normal reference range is<1:100. Abnormal anti nuclear antibodies are more common in autoimmune liver disease, other immune diseases, and connective tissue diseases;
2. Anti smooth muscle antibodies: Anti smooth muscle antibodies are generally detected by indirect immunofluorescence, with a normal reference range of<1:100. Abnormal anti smooth muscle antibodies may be related to lupus hepatitis, acute hepatitis, and other diseases. Combined with anti nuclear antibodies, diagnosis of autoimmune liver disease type 1 can be considered;
3. Anti liver and kidney microsomal type 1 antibody: It can be detected by immunoblotting. Anti liver and kidney microsomal type 1 antibody is an autoantibody and should be negative under normal circumstances. It is a serological diagnostic reference indicator for type 2 autoimmune liver disease;
4. Antihepatic cytoplasmic type 1 antibody: It can be detected by immunoblotting. Antihepatic cytoplasmic type 1 antibody is normally negative and is also a serological diagnostic reference indicator for type 2 autoimmune liver disease.