Current Challenges In Complement Diagnostics

The complement system is an important innate immune surveillance network that has a key role in protecting our bodies against pathogens and other threats. It is a highly complex system consisting of approximately 50 soluble and cell surface-bound proteins that interact to eliminate danger signals. These signals include factors such as invading microorganisms, necrotic cells, and immune complexes. Furthermore, complement can link innate and adaptive immune responses by regulating T cell and B cell responses. The complement system is tightly regulated to avoid uncontrolled activation. Dysregulation of the complement system has been linked to numerous diseases, both rare and common. Uncontrolled or exaggerated activation can lead to life-threatening conditions such as dysregulation of coagulation, fibrinolysis, systemic inflammation and shock, and possible failure of a variety of organs such as the eyes, kidneys, skin, brain, and vascular system. In recent years, the complement system has gained increased interest, especially as a promising candidate for therapeutic intervention. Eculizumab, the first approved complement inhibitor, is highly effective for treating atypical hemolytic uremic syndrome (aHUS) and paroxysmal nocturnal hemoglobinuria (PNH). Many more drug candidates are currently evaluated in ongoing clinical trials.

Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.

Early detection is essential to the control of emerging, reemerging, and novel infectious diseases, whether naturally occurring or intentionally introduced. Containing the spread of such diseases in a profoundly interconnected world requires active vigilance for signs of an outbreak, rapid recognition of its presence, and diagnosis of its microbial cause, in addition to strategies and resources for an appropriate and efficient response. Although these actions are often viewed in terms of human public health, they also challenge the plant and animal health communities. Surveillance, defined as "the continual scrutiny of all aspects of occurrence and spread of a disease that are pertinent to effective control", involves the "systematic collection, analysis, interpretation, and dissemination of health data." Disease detection and diagnosis is the act of discovering a novel, emerging, or reemerging disease or disease event and identifying its cause. Diagnosis is "the cornerstone of effective disease control and prevention efforts, including surveillance." Disease surveillance and detection relies heavily on the astute individual: the clinician, veterinarian, plant pathologist, farmer, livestock manager, or agricultural extension agent who notices something unusual, atypical, or suspicious and brings this discovery in a timely way to the attention of an appropriate representative of human public health, veterinary medicine, or agriculture. Most developed countries have the ability to detect and diagnose human, animal, and plant diseases. Global Infectious Disease Surveillance and Detection: Assessing the Challenges-Finding Solutions, Workshop Summary is part of a 10 book series and summarizes the recommendations and presentations of the workshop.

Along the last several decades, it has been progressively appreciated that immunology plays an overwhelming role in the physiology and pathophysiology of most organs, tissues, and biological systems in multicellular organisms. Accordingly, several immunological parameters are used in research and clinical laboratories with the purpose of investigating, diagnosing, and monitoring a variety of pathological conditions. The rapidly evolving field of laboratory testing in immunology poses several challenges to professionals working in research and clinical laboratories, medical practice, educational activities, in vitro diagnostic industry, and regulatory agencies. Regular analytes, such as albumin, glucose, and insulin, are homogeneous among individuals of the same species. This property represents an advantage when it comes to optimize the determination methods as well as to establish standardization and quality assessment strategies. In contrast, several immunologic analytes present tremendous variability across individuals in the same species. In fact, some are unique at the individual level. For example, the repertoire of immunoglobulins specific for a given pathogen (e.g., rubella) is specific for each individual in terms of the balance of targeted antigens and epitopes, immunoglobulin isotypes, antibody avidity, Fc glycosylation rate, and so on. As a corollary, the panel of anti-rubella antibodies is necessarily different from one to other individual. This also applies to autoantibodies and to IgE to allergens. Polymorphism is prevalent for other immunologic parameters, such as Complement components, cell receptors (cluster differentiation molecules - CD) and downstream signal transduction mediators.

Advances in Clinical Chemistry, Volume 77, the latest installment in this internationally acclaimed series, contains chapters authored by world-renowned clinical laboratory scientists, physicians, and research scientists. The serial discusses the latest and most up-to-date technologies related to the field of clinical chemistry and is the benchmark for novel analytical approaches in the clinical laboratory. Provides the most up-to-date technologies in Clinical Chemistry and Clinical Laboratory Science Authored by world renowned clinical laboratory scientists, physicians, and research scientist Presents the international benchmark for novel analytical approaches in the clinical laboratory

This issue of Surgical Pathology Clinics, edited by Dr. Vickie Jo, focused on Cytopathology. Topics include--but are not limited to--Head and Neck Cytology: HPV-Associated Carcinomas; Updates in Thyroid Cytology; Salivary Gland Cytopathology; Pulmonary Cytopathology; Updates in Effusion Cytology; Updates in Gynecologic Cytology; Diagnostic Advances in Urine Cytology; Renal Neoplasms; Pancreaticobiliary Cytology; Carcinoma of Unknown Primary; Soft Tissue Neoplasms; Primary Bone Tumors; Pediatric Cytopathology; Advances in Molecular Testing Techniques in Cytological Specimens; and Circulating Tumor Cells: Applications in Cytopathology.

We acknowledge the initiation and support of this Research Topic by the International Union of Immunological Societies (IUIS). We hereby state publicly that the IUIS has had no editorial input in articles included in this Research Topic, thus ensuring that all aspects of this Research Topic are evaluated objectively, unbiased by any specific policy or opinion of the IUI.

Malaria is one of the most important tropical diseases in the history of the world. This vector-borne disease has been a significant cause of morbidity and mortality in tropical countries of Africa, Asia, and Latin America. As such, this book provides updated information on epidemiological and public health research of malaria conducted in the last decade. Over four sections, chapters discuss such topics as diagnosis, epidemiology and surveillance, policy and prevention, and vector control and vaccines.