Immunology Today, voL 7, No. 10, 1986
news and features
In the early 1970s, Whittingham and Mackay proposed the structure of a Clinical Immunology Department in Venezuela; technical report 496 of the World Health Organization (WHO), published later, stressed the need to establish clinical immunology as an autonomous medical discipline. As a result, in 1972 we opened Clinical Immunology Units (CUI) committed to patient care (both at the clinical and immunodiagnostic level), research in applied immunology, and extramural teaching programs and training of human resources in clinical and experimental immunology. In 1975, a National Health Program in Clinical Immunology conducted by my group received official backing from the Venezuelan Government. The purpose of the Program was to create a regionalized and decentralized structure in order to offer the benefit of clinical immunology n~tionwide. In 1978, the Venezuelan Federation of Medical Colleges appointed clinical immunology as an autonomous medical speciality. Finally, in 1982, the WHO and the Venezuelan Government agreed upon the designation of our Center as the 'WHO Collaborative Center in Clinical Immunology'.
Clinical immunology in Venezuela
Ten years work (1975-1985) There are nine CIU in operation in Venezuela's largest cities (Fig. 1). In addition, a close relationship with local schools of medicine has been established. Each CIU is coordinated by a clinical immunologist, fully trained to be an active clinician and competent in using and supervising the immunodiagnostic laboratory facilities. The clinical spectrum covered by a CIU is broad, but most of the work is connected with chronic diseases (Table 1). Clinical research into chronic and tropical diseases propelled our Center towards an exten-
N.E. Bianco sive interdisciplinary network, further supporting the role of immunology in clinical medicine. Two-thirds of our patients belong to the allergy-atopy complex (bronchial asthma, allergic rhinitis, atopic dermatitis, urticaria-angioedema and hypersensitivity to food, drugs and insect toxins). The next largest group is of patients with collagen-vascular and auto-allergic diseases. Primary and secondary immunodeficiencies are also seen: within this context, our Center set up a National Health Technical Commission to monitor acquired immune deficiency syndrome in Venezuela. In the country as a whole over 16 500 patients have been seen (both out- and in-patients) during the last four years, and 200000 immunodiagnostic procedures including HLA testing for renal transplants have been performed. CIU three year training programs lead to an MSc in clinical immunology from the Central University. In addition, a two-year post-graduate course in laboratory immunology is offered to biologists. So far, we have trained 25 immunologists, 20 of whom are working for our health system. WHO Collaborative Center As the WHO Collaborative Center in Clinical Immunology, our Institution trains scientists from other Latin American countries, participates in extramural teaching activities in the region, and recently (October 1985) acted as Pan American Health advisor in the foundation of the Central American Clinical Immunology Center which has its headquarters in San Jos~, Costa Rica. The main objectives
of this Center are the setting-up of Clinical Immunology National Units in Panama, Honduras, Guatemala, El Salvador and Nicaragua. All these regional activities are discussed at the Latin American Clinical Immunology Symposia (Caracas, 1981 and 1986; Costa Rica, 1988; Cuba 1990) which are fully backed up by WHO, Pan American Health Organization, and recently by the International Union of Immunological Societies.
Clinical immunology in Venezuela is progressing; the knowledge and skills of the clinical immunologists are systematically requested. We all expect to overcome the formidable task posed by the modern molecular clinical immunology and to continue cooperating for better health in Latin America.
Clinical Immunology National Center, The Pathology Institute and WHO Collaborative Center in ClinicalImmunology, Caracas, Venezuela.
Table 1. Areasof concernin clinical immunology
Primarycarelevel Allergy-atopy complex Primaryand secondaryimmunodeficiencies SystemicLupusErythematosus Progressivesystemicsclerosis Mixedcollagenvasculardiseases Sjogrensyndrome Systemicvasculitis Extrinsicallergicalveolitis Auto-allergicchronichepatitis Primarybiliarycirrhosis 1986, Elsevier Science Publishers B.V., Amsterdam
0167 - 4919186/$02.00
Secondarycarelevel Lymphoproliferativedisorders Organ-specificauto-allergicdiseases Non-organspecificdiseases(i.e. rheumatoidarthritis, glomerulonephritis,etc.) Immunoclinical aspectsof: Malignanttumors Organallograft Infectiousdiseases 289
news and features
In the early 1970s, Whittingham and Mackay proposed the structure of a Clinical Immunology Department in Venezuela; technical report 496 of the World Health Organization (WHO), published later, stressed the need to establish clinical immunology as an autonomous medical discipline. As a result, in 1972 we opened Clinical Immunology Units (CUI) committed to patient care (both at the clinical and immunodiagnostic level), research in applied immunology, and extramural teaching programs and training of human resources in clinical and experimental immunology. In 1975, a National Health Program in Clinical Immunology conducted by my group received official backing from the Venezuelan Government. The purpose of the Program was to create a regionalized and decentralized structure in order to offer the benefit of clinical immunology n~tionwide. In 1978, the Venezuelan Federation of Medical Colleges appointed clinical immunology as an autonomous medical speciality. Finally, in 1982, the WHO and the Venezuelan Government agreed upon the designation of our Center as the 'WHO Collaborative Center in Clinical Immunology'.
Clinical immunology in Venezuela
Ten years work (1975-1985) There are nine CIU in operation in Venezuela's largest cities (Fig. 1). In addition, a close relationship with local schools of medicine has been established. Each CIU is coordinated by a clinical immunologist, fully trained to be an active clinician and competent in using and supervising the immunodiagnostic laboratory facilities. The clinical spectrum covered by a CIU is broad, but most of the work is connected with chronic diseases (Table 1). Clinical research into chronic and tropical diseases propelled our Center towards an exten-
N.E. Bianco sive interdisciplinary network, further supporting the role of immunology in clinical medicine. Two-thirds of our patients belong to the allergy-atopy complex (bronchial asthma, allergic rhinitis, atopic dermatitis, urticaria-angioedema and hypersensitivity to food, drugs and insect toxins). The next largest group is of patients with collagen-vascular and auto-allergic diseases. Primary and secondary immunodeficiencies are also seen: within this context, our Center set up a National Health Technical Commission to monitor acquired immune deficiency syndrome in Venezuela. In the country as a whole over 16 500 patients have been seen (both out- and in-patients) during the last four years, and 200000 immunodiagnostic procedures including HLA testing for renal transplants have been performed. CIU three year training programs lead to an MSc in clinical immunology from the Central University. In addition, a two-year post-graduate course in laboratory immunology is offered to biologists. So far, we have trained 25 immunologists, 20 of whom are working for our health system. WHO Collaborative Center As the WHO Collaborative Center in Clinical Immunology, our Institution trains scientists from other Latin American countries, participates in extramural teaching activities in the region, and recently (October 1985) acted as Pan American Health advisor in the foundation of the Central American Clinical Immunology Center which has its headquarters in San Jos~, Costa Rica. The main objectives
of this Center are the setting-up of Clinical Immunology National Units in Panama, Honduras, Guatemala, El Salvador and Nicaragua. All these regional activities are discussed at the Latin American Clinical Immunology Symposia (Caracas, 1981 and 1986; Costa Rica, 1988; Cuba 1990) which are fully backed up by WHO, Pan American Health Organization, and recently by the International Union of Immunological Societies.
Clinical immunology in Venezuela is progressing; the knowledge and skills of the clinical immunologists are systematically requested. We all expect to overcome the formidable task posed by the modern molecular clinical immunology and to continue cooperating for better health in Latin America.
Clinical Immunology National Center, The Pathology Institute and WHO Collaborative Center in ClinicalImmunology, Caracas, Venezuela.
Table 1. Areasof concernin clinical immunology
Primarycarelevel Allergy-atopy complex Primaryand secondaryimmunodeficiencies SystemicLupusErythematosus Progressivesystemicsclerosis Mixedcollagenvasculardiseases Sjogrensyndrome Systemicvasculitis Extrinsicallergicalveolitis Auto-allergicchronichepatitis Primarybiliarycirrhosis 1986, Elsevier Science Publishers B.V., Amsterdam
0167 - 4919186/$02.00
Secondarycarelevel Lymphoproliferativedisorders Organ-specificauto-allergicdiseases Non-organspecificdiseases(i.e. rheumatoidarthritis, glomerulonephritis,etc.) Immunoclinical aspectsof: Malignanttumors Organallograft Infectiousdiseases 289
