The Immunology Service participates in the following Units:

The healthcare activity of the Service is structured in three sections that perform a total of 180,000 analyses annually.

Clinical Immunology Section. With the aim of providing a comprehensive service for the laboratory diagnosis of immunomediated diseases, the Clinical Immunology Section develops its activity in six specialized areas to support the study of these diseases.

• Autoimmunity
• Immunodeficiencies
• Immunochemistry
• Innate Immunity
• Autoinflammatory diseases
• Immunoneurology
   

Having areas dedicated to Autoinflammatory Diseases and Immunoneurology makes the Section the only one in Spain that maintains a comprehensive diagnostic offering for these diseases and a national reference center for diagnosis.
 

Dra. Mariona Pascal – Jefa de Sección

Esta sección engloba las siguientes áreas:

• Autoinmunidad
• Inmunoneurología
• Respuesta inmunitaria a fármacos, hipersensibilidad e inmunoalergia
• Respuesta celular a virus y vacunas

En el ámbito de la respuesta a fármacos y la inmunoalergia, el equipo multidisciplinar trabaja en el diagnóstico y seguimiento de enfermedades alérgicas, así como en la monitorización de terapias con fármacos biológicos. Mediante técnicas analíticas avanzadas, como el diagnóstico molecular y los estudios funcionales in vitro, se ofrece una atención personalizada y eficiente.

En cuanto a las enfermedades neurológicas de origen inmunitario, el equipo de inmunoneurología combina la asistencia clínica con la investigación para profundizar en el conocimiento y diagnóstico de estas patologías complejas. El uso de técnicas para la detección de autoanticuerpos y la identificación de biomarcadores permite orientar mejor el tratamiento y comprender la fisiopatología de estos trastornos.

En lo que respecta a la respuesta celular a virus y vacunas, se llevan a cabo estudios in vitro con técnicas como ELISPOT y citometría de flujo para analizar la actividad de los linfocitos T. Estas pruebas son especialmente útiles en pacientes inmunodeprimidos, ya que permiten evaluar la inmunidad celular incluso cuando la serología es negativa, ayudando a determinar el riesgo de infección o reactivación.

Finalmente, el área de autoinmunidad se centra en la detección de autoanticuerpos implicados en enfermedades autoinmunes sistémicas y específicas de órgano. A través de técnicas como ELISA, inmunoblot y citometría de flujo, se pueden identificar biomarcadores clave para el diagnóstico y seguimiento de patologías como la miositis por cuerpos de inclusión, el lupus eritematoso sistémico o el síndrome antifosfolípido.

The Transplant Immunology Section is the Histocompatibility Laboratory (HLA) of Catalonia, which is the reference center for immunological studies in organ transplantation in Catalonia. The laboratory acts as the depository, and maintains and manages the waiting list of all renal receptors in Catalonia. For this reason, the HLA classification of all solid organ receptors in Catalonia and the determination of antiHLA antibodies in these patients are performed. In the last year, 1,221 immunological studies have been performed on patients on a waiting list for organ transplants and 659 HLA types from donors.

On the other hand, the immunology laboratory acts as a transplant guard center and performs the HLA classification of all donors generated in the different hospitals of the Catalan network, for which it maintains a permanent guard team 24 hours a day, 365 days a year. In the case of a kidney transplant, assistance is also offered to the on-call nephrologist for the assignment of the appropriate recipient for each donor.

In addition, the Service performs post-transplant immunological monitoring with rejection monitoring.

It also performs high-resolution HLA typing for different hematopoietic progenitor transplant equipment and all types of HLA and disease studies. The Laboratory of Histocompatibility of Catalonia is accredited by the European Federation of Immunogenetics. The areas of the Transplant Immunology section are as follows:

• Aloresposta
• HLA Classification Low Resolution and Disease Association
• High Resolution HLA Typification
• Organ transplant guards

It also has a strategic alliance with the Blood and Tissue Bank (BST) Immunogenetics and Histocompatibility Laboratory.

Immunotherapy Section. With this section, created in 2016, the Immunology Service expands its services with derivatives in the field of immunotherapy, therapies that have an immune base. In parallel with the development of analytical studies, which allow a better understanding and management of conventional commercial immunotherapies (especially biological drugs), this section manages the facilities of advanced therapies, the so-called clean rooms. The aim is to offer personalized cellular therapeutic products, focused on cancer immunotherapy, but without losing sight of other proposals such as anti-infective immunotherapy. It is the only center in Europe that has been granted a hospital exemption for CART-19 therapy.

There are two major suggestions in this section:

• Monitoring of its own or third party immunotherapies. Studies of the phenotypic definition of leukocyte subpopulations, the evaluation of cytokine profiles, the quantification of levels of immunomodulatory biological drugs and their immunogenicity ("anti-drug antibodies") stand out as the main causes of the loss of function of a previously effective treatment.
• The development of personalized cell therapeutic products. In this group the treatments that have been developed are the following:
• Vaccines with antitumor or tolerogenic dendritic cells
• Adoptive transfer of T lymphocytes or TIL therapy in solid tumors, which selects the antitumor T lymphocytes present in the tumor
• Genetically modified lymphocytes. Of note is CART therapy (chimeric antigenic receptors modified in T lymphocytes), specifically CART19 for the treatment of leukemias and CD19 + B lymphomas. The section is working on other similar proposals.
• Antiviral immunopotentiation with self or donor specific T lymphocytes

The Immunotherapy Section has a strategic alliance with the Hospital Sant Joan de Déu in Barcelona, ​​with which it works on a Joint Immunotherapy Platform and in the Joint and Multidisciplinary Unit in Oncohematology, Immunomediated Diseases and CART Therapy.