Clinical Imunology

biomolekuler , imunologi ,

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Clinical immunology is a discipline with a distinguished history, rooted in the prevention and treatment of infectious diseases in the late nineteenth and early twentieth centuries. The conquest of historical scourges such as smallpox and (substantially) polio and relegation of several other diseases to the category of medical curiosities is often regarded as the most important achievement of medical science of the past fifty years. Nevertheless, the challenges facing immunologists in the efforts to control infectious diseases remain formidable; HIV infection, malaria and tuberculosis are but three examples of diseases of global import that elude control despite major commitments of monetary and intellectual resources. Although firmly grounded in the study and application of defenses to microbial infection, since the 1960s clinical immunology has emerged
as a far broader discipline. Dysfunction of the immune system has been increasingly recognized as a pathogenic mechanism that can lead to an array of specific diseases and failure of virtually every organ system. Pardoxically, although the importance of the immune system in disease pathogenesis is generally appreciated, the place of clinical immunology as a practice discipline has been less clear. As most of the non-infectious diseases if the human immune system lead eventually to failure of other organs, it has been organ-specific subspecialists who have usually dealt with their consequences. Recently, however, the outlook has begun to change as new diagnostic tools increasingly allow the theoretical
possibility of intervention much earlier in disease processes, often before irreversible target organ destruction occurs. More importantly, this theoretical possibility is increasingly realized as clinical immunologists find themselves in the vanguard of translating molecular medicine from laboratory bench to patient bedside.
In many settings, clinical immunologists today function as primary care physicians in the management of patients with inmune-deficiency, allergic, and autoimmune diseases. Indeed many influential voices in the clinical disciplines of allergy and rheumatology support increasing coalescence of these traditional subspecialities around their intellectual core of immunology. In addition to his or her role as a primary care
physician, the clinical immunologist is increasingly being looked to as a consultant, as scientific and clinical advances enhance his or her expertise. The immunologist with a ‘generalist’ perspective can be particularly helpful in the application of unifying principles of diagnosis and treatment across the broad spectrum of immunologic diseases. Clinical Immunology: Principles and Practice has emerged from this concept of the clinical immunologist as both primary care physician and expert consultant in the management of patients with immunologic diseases. It opens in full appreciation of the critical role of fundamental
immunology in this rapidly evolving clinical discipline. Authors of basic science chapters were asked, however, to cast their subjects in a context of clinical relevance. We believe the result is a well-balanced exposition of basic immunology for the clinician.