Fundamental necessity of the disciplines
A deep understanding of microbiology (which includes such branches as bacteriology, virology, mycology, and protozoology) and immunology is not a narrowly specialized skill, but a strict professional requirement for every medical worker. Regardless of their field of activity, a physician faces daily tasks whose solution is impossible without relying on these sciences.
Role in oncology and reproductive medicine
Immunological research methods have become an integral part of managing patients with neoplastic and reproductive pathologies:
- In oncology: immunology is critically important for the diagnosis, treatment, and prevention of neoplasms. Physicians actively use specific immunological research methods, and prescribe adaptogens and immunomodulators (e.g., interleukins and interferons) as therapeutic agents.
- In reproductive medicine: the central issue is the immunological conflict in the "mother-fetus" system, which can arise at absolutely any stage of gestation. That is why obstetrician-gynecologists and pediatricians must master the fundamentals of reproductive immunology. This allows for the timely prevention of pathological conditions and the competent management of pregnancy.
Challenges in transplantology and environmental microbiology
Despite the fact that the technical (surgical) side of organ and tissue transplantation has been developed quite successfully in modern medicine, the main obstacle remains transplant rejection. It arises due to the immunological incompatibility of the donor and recipient. The task of the transplant surgeon is a deep understanding of the mechanisms of immunotransplantation and a masterful command of methods to overcome tissue incompatibility.
On the other hand, physicians of sanitary and preventive profiles focus on environmental and sanitary microbiology. They study how various factors (climatic, social, occupational) affect not only the macroorganism (human), but also the microflora. The objects of close control are both the normal microflora of the human body and the microflora of the environment.
Essential arsenal of medicines
A physician of any specialization without exception must thoroughly know the properties and principles of use of two global groups of drugs:
- Immunobiological agents:
- Vaccines;
- Immunoglobulins;
- Immunomodulators;
- Diagnostic preparations.
- Antimicrobial agents:
- Antibiotics;
- Chemotherapeutic agents.
Without understanding the mechanisms of action of these agents, it is impossible to ensure effective etiotropic and pathogenetic therapy.
Briefly: answers to topical questions
What classes of immunomodulators are prescribed as therapeutic agents in oncology?
Immunomodulators from the cytokine group are prescribed as therapeutic agents in oncology. These include:
- Interferons — interferon-alpha preparations are used for Kaposi's sarcoma, leukemias, and melanoma.
- Interleukins — specifically, interleukin-2 is used in the complex treatment of tumor-related pericarditis.
Adaptogens may also be used in oncological practice.
What types of immunological conflict can arise in the "mother-fetus" system?
The following types of immunological conflict, caused by blood group incompatibility, can arise in the "mother-fetus" system:
- Rhesus incompatibility — develops when the mother has Rh-negative blood and the fetus has Rh-positive blood.
- ABO incompatibility — occurs if the mother has blood group 0(I) and the fetus has A(II) or B(III). It is more common than Rhesus incompatibility, but is predominantly mild.
- Double incompatibility — a situation where the mother has 0(I) Rh(-) and the fetus has A(II) Rh(+) or B(III) Rh(+).
What immunological mechanisms underlie the transplant rejection reaction?
Cellular and humoral immunological mechanisms arising from a mismatch of histocompatibility antigens underlie the transplant rejection reaction.
- Cellular immunity — predominates in acute and chronic rejection. It includes the action of CD8+ cytotoxic T lymphocytes, NK cells, and type 2 T-helper cells.
- Humoral immunity — causes hyperacute rejection in the presence of preformed antibodies. It includes complement-dependent cytotoxicity, antibody-dependent cellular cytotoxicity, and the deposition of immune complexes in the transplant vessels.
Which classes of drugs belong to antimicrobial chemotherapeutic agents?
The following main classes of drugs belong to synthetic antimicrobial chemotherapeutic agents:
- Sulfonamides — purine-pyrimidine synthesis inhibitors.
- Quinolone derivatives (including fluoroquinolones) — inhibit DNA replication.
- Nitrofuran derivatives — affect DNA functions.
- Nitroimidazole derivatives (and imidazoles) — possess antibacterial and antiprotozoal activity.
- 8-Hydroxyquinoline derivatives.
- Quinoxaline derivatives.
- Oxazolidinones.
Trimethoprim also belongs to chemotherapeutic agents.
What types of vaccines are included in the group of immunobiological agents?
The following types of vaccines are included in the group of immunobiological agents:
- Genetic engineering vaccines — created on the basis of recombinant DNA (e.g., against hepatitis B).
- Synthetic vaccines — consist of antigenic determinants and polymeric carriers or adjuvants.
- Live vector vaccines.
- Virus-like particle-based vaccines (e.g., CombiHIVvac injection vaccine).
- Attenuated (weakened) vaccines — contain live weakened cells (e.g., mucosal vaccine based on Salmonella enteritidis).
Antitumor preventive vaccines (e.g., against papillomavirus) are also distinguished.
To remember the two main groups of drugs, use the "IP" rule: I — Immunobiologicals (vaccines, modulators), P — Antimicrobials (antibiotics, chemotherapeutic agents).
Class and exam questions
What is the main challenge of modern transplantology?
The main obstacle is the rejection reaction of the transplanted organ or tissue, which arises due to immunological incompatibility between the recipient and the donor.
Why does an obstetrician-gynecologist need knowledge in immunology?
This knowledge is necessary for the early detection, prevention, and competent management of immunological conflict in the "mother-fetus" system, which can threaten pregnancy at any gestational age.
What classes of microorganisms does microbiology study?
The discipline includes bacteriology, virology, mycology (the study of fungi), and protozoology (the study of protozoa).
What else to study on this topic
- Mechanisms of development and ways to overcome tissue incompatibility in transplantology.
- Basics of reproductive immunology and pathogenesis of the "mother-fetus" conflict.
- Classification and clinical use of immunomodulators in oncology.
- Impact of climatic and social factors on the normal human microflora.
- Principles of action of immunobiological diagnostic agents.
Study the full topic in the «Microbiology» course
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