Page 6 - Clinical Immunology_ Principles and Practice ( PDFDrive )

viii Part one Principles of Immune Response
PREFACE TO THE FIFTH EDITION

Each edition of Clinical Immunology: Principles and Practice has reminiscent of that served by infectious disease physicians,
documented important changes in the discipline from the preced- particularly during the era of antibiotic proliferation in the last
ing one. This fifth edition is emphatically not an exception to quarter of the previous century. It is consequently our hope that
that pattern. Indeed, advances in both the Principles and Practice the book will find a place near the desk of most persons whose
of clinical immunology have been remarkable. The constant practice relies on the science or practice of clinical immunology
theme of every edition has been to emphasize that our discipline as we have broadly defined it. We further trust that it will be
touches virtually all organ systems. The diseases that are covered especially useful to trainees and practitioners preparing for
range from too little to too much immunity; and from dysregu- certification or recertification in an immunology-related sub-
lated, malignant or replaced immunological systems and functions. specialty. In an effort to assist the latter group and as an aid to
Fundamental concepts that are essential to a precise understanding continuing education of all readers, we have added to the online
of normal and disordered immune function and disease patho- version of the text, which all purchasers of the book can readily
genesis are again balanced by clinical descriptions, diagnostic access, multiple choice questions relevant to every chapter.
approaches and therapeutic options. Additionally, we continue to believe that a comprehensive text
Several examples of particularly notable advances are worth on clinical immunology can be a valuable asset for generalists
highlighting: Our increasing appreciation of the importance of in any specialty, particularly internists, pediatricians and family
the microbiota to normal immune system development and to physicians, who regularly care for patients across the broad
the pathogenesis of immunologic and inflammatory diseases; spectrum of immunological disorders, offering an opportunity
dissection of relationships between the innate and adaptive for physicians in all disciplines to upgrade their skills and educa-
immune systems that has served to further clarify the expres- tion, and to benefit from the onward rush of science and practice
sion of inflammatory processes and their interaction in defenses improvement in modern clinical immunology.
against infectious agents; progress in rapid and cost-effective The book continues features that have been well received in
genomics that has led to the definition of numerous new primary previous editions. Chapters are generously illustrated and all
immune deficiencies and provided new insights into the genetic chapters contain summary Boxes (commonly in bulleted form)
aspects of many other immunologic diseases; understanding of that provide Key Concepts and a Box labeled as On the Horizon,
immune deficiencies that reflect development of anti-cytokine in which authors look to research opportunities for important
auto-antibodies; detailed definition of cell signaling pathways advances over the next 5-10 years. Furthermore, due to the
and the structure of cell-surface molecules that have contributed extraordinarily cross-disciplinary nature of clinical immunology,
enormously to the treatment of cancer and autoimmunity with it is our hope that investigators working in one area might find
a virtual explosion in novel therapeutics including check-point new ideas and opportunities in the On the Horizon Boxes outside
inhibitors and other recently developed immunomodulators; their primary area of focus. Other Boxes similarly summarize
availability of many new humanized and human monoclonal content with Clinical Relevance, Clinical Pearls, and Therapeutic
antibodies and development of novel therapeutic approaches Principles.
such as chimeric-antigen-receptor T cells; wide use of T cell As always, we are immensely grateful to the hundreds of
excision circle receptor (TREC) assay to diagnose serious immune physicians and scientists whose contributions are the essence of
deficiencies of the newborn; and exploration of in vivo therapeutic the book. Finally, we recognize the diligence and commitment
editing of pathological mutations. With these new tools the of our colleagues at Elsevier who have supported all aspects of
practice of clinical immunology has become more interesting the book’s development and production, particularly Ms. Joanne
yet more complex, while offering important improvements in Scott who has worked with both authors and editors from concept
patient care. to birth to completion of every chapter.
Our goal with this edition is to enhance the interest of
practitioners in the many specialties and subspecialties that the Robert R. Rich
discipline impacts and to assist them in understanding this Thomas A. Fleisher
increasing complexity. With the increasing availability of powerful William T. Shearer
new therapeutic agents, the expert clinical immunologist today Harry W. Schroeder, Jr.
may function as a primary care physician or consultant in the Anthony J. Frew
management of patients with immune deficiencies, allergic, and Cornelia M. Weyand
autoimmune diseases involving multiple organ systems – a role

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