{"id":147,"date":"2022-05-31T10:22:39","date_gmt":"2022-05-31T08:22:39","guid":{"rendered":"http:\/\/csaki-sli.cz\/?page_id=147"},"modified":"2022-05-31T10:23:49","modified_gmt":"2022-05-31T08:23:49","slug":"definice-imunologicke-laboratore","status":"publish","type":"page","link":"https:\/\/csaki-sli.cz\/?page_id=147","title":{"rendered":"Definice imunologick\u00e9 laborato\u0159e"},"content":{"rendered":"\n<p>\u010cesk\u00e1 spole\u010dnost alergologie a klinick\u00e9 imunologie <strong>definovala imunologickou laborato\u0159<\/strong> n\u00e1sleduj\u00edc\u00edm zp\u016fsobem:<\/p>\n\n\n\n<p>&nbsp;Ka\u017ed\u00e1 laborato\u0159, kter\u00e1 nese ve sv\u00e9m n\u00e1zvu term\u00edn \u201eimunologick\u00e1\u201c by m\u011bla spl\u0148ovat krit\u00e9ria:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>mus\u00ed v\u00a0n\u00ed pracovat person\u00e1l s odpov\u00eddaj\u00edc\u00ed kvalifikac\u00ed a mus\u00ed b\u00fdt spln\u011bna person\u00e1ln\u00ed vyhl\u00e1\u0161ka MZ \u010d.99\/2012 a platn\u00e1 nepodkro\u010diteln\u00e1 minima odborn\u00e9 spole\u010dnosti,<\/li><li>mus\u00ed m\u00edt technick\u00e9 a p\u0159\u00edstrojov\u00e9 vybaven\u00ed odpov\u00eddaj\u00edc\u00ed spektru prov\u00e1d\u011bn\u00fdch vy\u0161et\u0159en\u00ed,<\/li><li>mus\u00ed zajistit odpov\u00eddaj\u00edc\u00ed spektrum metod tak, aby dok\u00e1zala popsat stav a funk\u010dnost imunitn\u00edho syst\u00e9mu a poskytnout indikuj\u00edc\u00edmu l\u00e9ka\u0159i odbornou pomoc p\u0159i interpretaci v\u00fdsledk\u016f a jejich p\u0159\u00edpadn\u00e9m dopln\u011bn\u00ed o dal\u0161\u00ed vy\u0161et\u0159en\u00ed.<\/li><\/ul>\n\n\n\n<p>Mnoh\u00e9 imunologick\u00e9 metody jsou po\u017eadov\u00e1ny jen velmi vz\u00e1cn\u011b, nicm\u00e9n\u011b jsou pro podrobnou laboratorn\u00ed diagnostiku konkr\u00e9tn\u00edch imunopatologick\u00fdch stav\u016f nebo dysfunkc\u00ed imunitn\u00edho syst\u00e9mu nezbytn\u00e9. Proto je mus\u00ed imunologick\u00e1 laborato\u0159 bu\u010f nab\u00edzet, nebo zajistit jejich proveden\u00ed jinde. Metody, kter\u00e9 mus\u00ed imunologick\u00e1 laborato\u0159 prov\u00e1d\u011bt, jsou ozna\u010deny v&nbsp;n\u00e1sleduj\u00edc\u00edm textu indexem 1. Indexem 2 jsou ozna\u010deny metody, kter\u00e9 mus\u00ed b\u00fdt laborato\u0159 schopna prov\u00e1d\u011bt, tj. v&nbsp;p\u0159\u00edpad\u011b po\u017eadavk\u016f je zav\u00e9st do spektra prov\u00e1d\u011bn\u00fdch vy\u0161et\u0159en\u00ed.<\/p>\n\n\n\n<p>&nbsp;Je-li imunologick\u00e1 laborato\u0159 sou\u010d\u00e1st\u00ed klinicko-diagnostick\u00e9ho komplexu (nap\u0159. nemocnice), mohou b\u00fdt v r\u00e1mci integrace a konsolidace laboratorn\u00edch pracovi\u0161\u0165 tohoto komplexu jednotliv\u00e1 vy\u0161et\u0159en\u00ed prov\u00e1d\u011bna tak\u00e9 v laborato\u0159\u00edch jin\u00fdch odbornost\u00ed p\u0159i zaji\u0161t\u011bn\u00ed odborn\u00e9 supervize imunologickou laborato\u0159\u00ed tohoto komplexu.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Imunologick\u00e1 laborato\u0159 mus\u00ed vy\u0161et\u0159ovat a popsat:<\/strong><\/h2>\n\n\n\n<p><strong>1. Zastoupen\u00ed, stav a funkci bun\u011bk imunitn\u00edho syst\u00e9mu v\u010detn\u011b z\u00e1chytu abnormalit s&nbsp;ohledem na hematoonkologick\u00e9 malignity t\u011bmito metodami:<\/strong><\/p>\n\n\n\n<p>Stanoven\u00ed relativn\u00edho<sup>1<\/sup> a absolutn\u00edho<sup>2<\/sup> po\u010dtu z\u00e1kladn\u00edch lymfocyt\u00e1rn\u00edch populac\u00ed a subpopulac\u00ed pomoc\u00ed imunofenotypiza\u010dn\u00edho vy\u0161et\u0159en\u00ed a stanoven\u00ed HLA-B27<sup>2<\/sup> metodou pr\u016ftokov\u00e9 cytometrie (PC), p\u0159i\u010dem\u017e spektrum test\u016f mus\u00ed obsahovat znaky CD3, CD19, CD4, CD8 a CD16\/56.<\/p>\n\n\n\n<p>Funk\u010dn\u00ed testy lymfocyt\u016f zastoupen\u00e9 testy<sup>2<\/sup>:<\/p>\n\n\n\n<p>&#8211; &nbsp;<em>in vitro<\/em> proliferace lymfocyt\u016f po stimulaci mitogeny a\/nebo antigeny,<br>&#8211; &nbsp;m\u011b\u0159en\u00ed produkce cytokin\u016f a\/nebo protil\u00e1tek po stimulaci mitogeny a\/nebo antigeny metodou pr\u016ftokov\u00e9 cytometrie (PC) nebo ELISA, ALBIA, ELISPOT&nbsp; apod.<\/p>\n\n\n\n<p>Funk\u010dn\u00ed testy fagocyt\u016f<sup>2<\/sup>:<\/p>\n\n\n\n<p>&#8211; &nbsp;test schopnosti nitrobun\u011b\u010dn\u00e9ho zab\u00edjen\u00ed a respira\u010dn\u00edho vzplanut\u00ed (redukce tetrazoliov\u00fdch sol\u00ed &#8211; INT, NBT; chemiluminiscence; oxidace fluorogenn\u00edch subtr\u00e1t\u016f).<\/p>\n\n\n\n<p><strong>2. Vy\u0161et\u0159en\u00ed stavu humor\u00e1ln\u00ed imunity stanoven\u00edm t\u011bchto parametr\u016f<\/strong><sup>1<\/sup><strong>:<\/strong><\/p>\n\n\n\n<p>&#8211; &nbsp; koncentrace s\u00e9rov\u00fdch imunoglobulin\u016f IgG<sup>1<\/sup>, IgA<sup>1<\/sup>, IgM<sup>1<\/sup>, IgE<sup>1<\/sup>, IgD<sup>2<\/sup>, podt\u0159\u00edd IgG<sup>2<\/sup>,<br>&#8211; &nbsp; koncentrace slo\u017eek komplementov\u00e9ho syst\u00e9mu a jeho aktivace klasickou cestou (slo\u017eky C3<sup> 1<\/sup>, C4<sup> 1<\/sup>, C1INH<sup>2<\/sup>; CH50<sup>2<\/sup>),<br>&#8211; &nbsp; dal\u0161\u00ed cesty aktivace komplementov\u00e9ho syst\u00e9mu<sup>2<\/sup>,<br><strong>&#8211; &nbsp;&nbsp;<\/strong>stanoven\u00ed cirkuluj\u00edc\u00edch imunokomplex\u016f vazbou C1q<sup>2<\/sup>.<\/p>\n\n\n\n<p><strong>3. Diagnostika gamapati\u00ed<\/strong><sup>2<\/sup><strong>.<\/strong><\/p>\n\n\n\n<p>Laborato\u0159 mus\u00ed prov\u00e1d\u011bt metody, kter\u00fdmi lze detekovat a typizovat paraprotein v&nbsp;s\u00e9ru a mo\u010di (agarofor\u00e9za, imunofixace a\/nebo kapil\u00e1rn\u00ed elektrofor\u00e9za).<\/p>\n\n\n\n<p><strong>4. Monitorov\u00e1n\u00ed a diferenci\u00e1ln\u00ed diagnostika z\u00e1n\u011btliv\u00e9 reakce<\/strong><sup>1<\/sup><strong>.<\/strong><\/p>\n\n\n\n<p>V nab\u00eddce laborato\u0159e mus\u00ed b\u00fdt metody stanovuj\u00edc\u00ed pozitivn\u00ed a negativn\u00ed reaktanty akutn\u00ed f\u00e1ze z\u00e1n\u011btu.<\/p>\n\n\n\n<p><strong>5. Diagnostika stav\u016f okam\u017eit\u00e9 p\u0159ecitliv\u011blosti<\/strong><sup>1<\/sup><strong>:<\/strong><\/p>\n\n\n\n<p>&#8211; &nbsp; kvantitativn\u00edm stanoven\u00edm specifick\u00fdch IgE protil\u00e1tek proti sm\u011bs\u00edm alergen\u016f<sup>1<\/sup>, inhala\u010dn\u00edm, potravinov\u00fdm a hmyz\u00edm alergen\u016fm<sup>1<\/sup>,<br>&#8211; &nbsp; stanoven\u00edm hladiny eosinofiln\u00edho kationick\u00e9ho proteinu (ECP)<sup>2<\/sup>,<br>&#8211; &nbsp; zhodnocen\u00edm schopnosti aktivace bazofil\u016f alergenem<sup>2<\/sup>.<\/p>\n\n\n\n<p><strong>6. Diagnostika autoimunitn\u00edch onemocn\u011bn\u00ed stanoven\u00edm autoprotil\u00e1tek<\/strong><sup>1<\/sup><strong>:<\/strong><\/p>\n\n\n\n<p>Laborato\u0159 mus\u00ed prov\u00e1d\u011bt minim\u00e1ln\u011b vy\u0161et\u0159en\u00ed:<\/p>\n\n\n\n<p>&#8211; &nbsp;ANA screening metodou nep\u0159\u00edm\u00e9 imunofluorescence<sup>1<\/sup>,<br>&#8211; &nbsp;ENA screening a typizaci autoprotil\u00e1tek proti minim\u00e1ln\u011b t\u011bmto autoantigen\u016fm : SSA, SSB, Scl-70, RNP, Sm, Jo-1<sup>1<\/sup>,<br>&#8211; &nbsp;anti-ds-DNA <sup>1<\/sup><br>&#8211; &nbsp;revmatoidn\u00ed faktor (RF), minim\u00e1ln\u011b kvantitativn\u00ed screeningov\u00e9 vy\u0161et\u0159en\u00ed<sup>1<\/sup>,<br>&#8211; &nbsp;stanoven\u00ed autoprotil\u00e1tek proti citrulinovan\u00fdm protein\u016fm\/peptid\u016fm<sup>1<\/sup>,<br>&#8211; &nbsp;stanoven\u00ed ANCA metodou nep\u0159\u00edm\u00e9 imunofluorescence na granulocytech fixovan\u00fdch etanolem a formaldehydem, d\u00e1le typizace autoprotil\u00e1tek proti MPO a PR3<sup>1<\/sup>,<br>&#8211; &nbsp;antifosfolipidov\u00e9 protil\u00e1tky minim\u00e1ln\u011b proti kardiolipinu a beta-2-glykoproteinu I v&nbsp;izotypech IgG a IgM<sup>1<\/sup>,<br>&#8211; &nbsp;stanoven\u00ed autoprotil\u00e1tek proti tk\u00e1\u0148ov\u00e9 transglutamin\u00e1ze<sup>1<\/sup>.<br>&nbsp;<\/p>\n\n\n\n<p><strong>7. Ov\u011b\u0159en\u00ed stavu imunitn\u00edho syst\u00e9mu pomoc\u00ed stanoven\u00ed protil\u00e1tek proti infek\u010dn\u00edmu agens po prod\u011blan\u00e9 infekci nebo vakcinaci<\/strong><sup>2<\/sup><strong> &nbsp;<\/strong><\/p>\n\n\n\n<p>Laborato\u0159 mus\u00ed b\u00fdt schopna prov\u00e9st <strong>stanoven\u00ed postvakcina\u010dn\u00edch hladin protil\u00e1tek a nep\u0159\u00edm\u00fd pr\u016fkaz infek\u010dn\u00edch agens v&nbsp;r\u00e1mci ddg. procesu<\/strong><strong><sup>2<\/sup><\/strong><br>&nbsp;<\/p>\n\n\n\n<p><strong>8. HLA diagnostika<\/strong><sup>2<\/sup><strong>.<\/strong><\/p>\n\n\n\n<p>Problematika HLA je ned\u00edlnou sou\u010d\u00e1st\u00ed odbornosti 813, nicm\u00e9n\u011b je prov\u00e1d\u011bna p\u0159edev\u0161\u00edm ve specializovan\u00fdch imunogenetick\u00fdch laborato\u0159\u00edch, kter\u00e9 jsou sou\u010d\u00e1st\u00ed transplanta\u010dn\u00edch center. Ka\u017ed\u00e1 imunologick\u00e1 laborato\u0159 nemus\u00ed tato vy\u0161et\u0159en\u00ed m\u00edt ve sv\u00e9m spektru.<\/p>\n\n\n\n<p>Schv\u00e1leno v\u00fdborem \u010cSAKI.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u010cesk\u00e1 spole\u010dnost alergologie a klinick\u00e9 imunologie definovala imunologickou laborato\u0159 n\u00e1sleduj\u00edc\u00edm zp\u016fsobem: &nbsp;Ka\u017ed\u00e1 laborato\u0159, kter\u00e1 nese ve sv\u00e9m n\u00e1zvu term\u00edn \u201eimunologick\u00e1\u201c<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":88,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"colormag_page_container_layout":"no_sidebar_full_width","colormag_page_sidebar_layout":"no_sidebar","_price":"","_stock":"","_tribe_ticket_header":"","_tribe_default_ticket_provider":"","_tribe_ticket_capacity":"0","_ticket_start_date":"","_ticket_end_date":"","_tribe_ticket_show_description":"","_tribe_ticket_show_not_going":false,"_tribe_ticket_use_global_stock":"","_tribe_ticket_global_stock_level":"","_global_stock_mode":"","_global_stock_cap":"","_tribe_rsvp_for_event":"","_tribe_ticket_going_count":"","_tribe_ticket_not_going_count":"","_tribe_tickets_list":"[]","_tribe_ticket_has_attendee_info_fields":false,"footnotes":"","_tec_slr_enabled":"","_tec_slr_layout":""},"class_list":["post-147","page","type-page","status-publish","hentry"],"ticketed":false,"_links":{"self":[{"href":"https:\/\/csaki-sli.cz\/index.php?rest_route=\/wp\/v2\/pages\/147","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/csaki-sli.cz\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/csaki-sli.cz\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/csaki-sli.cz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/csaki-sli.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=147"}],"version-history":[{"count":4,"href":"https:\/\/csaki-sli.cz\/index.php?rest_route=\/wp\/v2\/pages\/147\/revisions"}],"predecessor-version":[{"id":151,"href":"https:\/\/csaki-sli.cz\/index.php?rest_route=\/wp\/v2\/pages\/147\/revisions\/151"}],"up":[{"embeddable":true,"href":"https:\/\/csaki-sli.cz\/index.php?rest_route=\/wp\/v2\/pages\/88"}],"wp:attachment":[{"href":"https:\/\/csaki-sli.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=147"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}