Immunodeficiency

Immunodeficiency is used synonymously in medical terminology with the expression of immunodeficiency and is a collective term for various disorders of the immune system that are characterized by a temporary or irreversible weakening of the defense function, ie the ability to defend themselves against invading pathogens. As a result, occur more frequently infectious diseases, which can also run more difficult.

Classification

The classification of immunodeficiencies can be done by different criteria. Are the majority of immune cells affected (ie the cellular defense ), one speaks of a cellular immune defect, there are more antibodies and other defense active proteins (ie, humoral ) of a humoral immunodeficiency. Often both systems are affected. One then speaks of a combined immunodeficiency.

On the other hand, the classification can be carried out after the stage of the disease. Is it due to a genetic defect or immunodeficiency malformation since birth, that's called a congenital immunodeficiency ( primary immunodeficiency, PID), the disorder occurs only later on, an acquired immune deficiency.

Causes

Congenital immunodeficiencies are relatively rare diseases. For most of them now, at least the locus was identified on which the genetic information is disturbed. For many of these diseases are even familiar with the so-called gene whose function is disturbed.

The world's most common acquired immunodeficiency is AIDS, caused by the HIV virus. An immune deficiency is also caused by a disorder of the bone marrow, which is associated with an impaired blood formation - eg leukemia or neutropenia. Also, malnutrition, for example, connected with a vitamin deficiency can lead to an acquired reduction function of the immune system.

Cause of an iatrogenic ( = by a doctor -induced ) is immune defect, a medical treatment that affects the immune system

• Deliberately suppressed - immunosuppression in autoimmune disease or to prevent rejection after organ transplantation -

Or

• Damaged as a side effect, for example in the context of cancer therapy by certain drugs ( cytostatics) or radiation.

Diagnostics

An immune deficiency is diagnosed by first a series of screening tests are done in the blood. Depending on the result of more complex functional studies of individual cell lineages of the immune system are then carried out. If a family has an immune deficiency occurred even prenatal diagnosis by examination of the amniotic fluid, chorionic villi, or the collection of blood in the fetus is possible.

Therapy

In some congenital immunodeficiencies, stem cell transplantation is an option for the underlying cause, since it is a new, healthy immune system is transmitted. When symptomatic treatment is mainly for the humoral and combined immunodeficiencies the regular administration of antibody preparations obtained from donor blood, are available. Thus, an antibody deficiency can be compensated. In addition, through a consistent antibacterial ( against bacteria -directed) and antimycotic ( antifungal directed) drug therapy, the emergence of opportunistic infections should be prevented. Among opportunistic infections is understood to infections with pathogens that actually occur anywhere and cause in healthy ( immunocompetent ) people no disease because the immune system is able to protect yourself against these microorganisms.

Vaccinations

Vaccination in persons with immunodeficiency are a special case: the one hand, live vaccines, in which - albeit weakened ( " attenuated " ) - pathogens are administered selectively, cause not as intended protection against the infectious disease in question up, but such a disease is raised. Here the vaccine indication is dependent on the nature and severity of the immune defect. On the other hand, it comes after administration of inactivated vaccines may not (sufficiently) to build up an immune protection. Then closer vaccination intervals should be considered.