General Vaccination Flashcards

1
Q

What are the primary cell types that vaccination is targeting?

A

Memory cells; Th, Tk, and B cells

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2
Q

How do you create memory with a memory B cell?

A

The antigen goes to a secondary lymph organ via lymph or blood

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3
Q

How do you create memory with a memory helper T cell?

A

The antigen presenting cell must present the antigen on a MHC II

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4
Q

How do you create memory with a killer T cell?

A

An infected cell must present the antigen on a MHC I

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5
Q

What are some features of vaccines?

A

Safe, protective, gives sustained protection, induces neutralizing antibodies, induces protective T cells, practical considerations

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6
Q

What part of the innate immune system can regulate the persistence of the germinal center-memory B cell differentiation pathway?

A

TLR Triggering

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7
Q

Innate programming of dendritic cells in lymph nodes may provide instructive cues for what?

A

For the migration of activated T and B cells to mucosal tissues

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8
Q

What innate cell may regulate the differentiation of antigen- specific T and B cells at mucosal sites?

A

Macrophages

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9
Q

What are the 3 main types of immunization discussed in class?

A

1) Exposure to pathogen followed by recovery
2) Vaccination
3) Transfer of preformed antibodies (passive)- mother to fetus and injection of antisera

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10
Q

Common agent used for a black widow spider bite

A

Horse antivenin

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11
Q

Common agent used for botulism

A

Horse antitoxin

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12
Q

Common agent used for cytomegalovirus

A

Human polyclonal Ab

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13
Q

Common agent used for diphtheria

A

Horse antitoxin

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14
Q

Common agent used for hepatitis A and B

A

Pooled human immunoglobulin

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15
Q

Common agent used for measles

A

Pooled human immunoglobulin

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16
Q

Common agent used for rabies

A

Human or horse polyclonal Ab

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17
Q

Common agent used for respiratory disease

A

Monoclonal anti-RSV

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18
Q

Common agent used for snake bite

A

Horse antivenin

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19
Q

Common agent used for tetanus

A

Polled human Ig or horse antitoxin

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20
Q

Common agent used for varicella zoster virus

A

Human polyclonal Ab

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21
Q

Does disease always lead to immunity?

A

No.

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22
Q

Give examples of diseases/infections where the body does not acquire immunity.

A

1) Respiratory syncytial virus
2) Malaria
3) Pathogens that mutate rapidly- HIV
4) Pathogens with multiple stereotypes- Dengue virus
5) Pathogens that cause persistent or latent infection- HIV or Hep C

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23
Q

What 3 groups are vaccines classified into?

A

1) Non- infectious
2) Attenuated
3) Carrier

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24
Q

What are live attenuated vaccines?

A

They are weakened versions of the pathogens that mimic the kind of protective immunity induced in people who survive live infection, where long term immunity is usually conferred

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25
Q

What are some examples of live attenuated vaccines?

A

1) Smallpox
2) Yellow fever
3) Measles
4) Mumps
5) Rubella
6) Chicken pox

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26
Q

What is another broad group of vaccines?

A

1) Subunit vaccines
2) Toxoid Vaccines
3) CHO vaccines
4) Conjugate vaccines

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27
Q

What do subunit, toxoid, CHO and conjugate vaccines typically contain?

A

Adjuvants

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28
Q

What is an example of a subunit vaccine?

A

Hepatits B and HPV vaccines- these are non-infectious subunit

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29
Q

What are examples of toxoid vaccines?

A

Inactivated toxins against diphtheria and tetanus

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30
Q

What is an example of a CHO vaccine?

A

Vaccine against pneumococcus

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31
Q

What are examples of conjugate vaccines?

A

Vaccines against Haemophilus infulenzae type B or meningococcus

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32
Q

What are the 3 categories of non-infectious vaccines?

A

1) Killed vaccines
2) Bacterial toxins
3) Parts of a pathogen

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33
Q

What types of cells do non-infectious vaccines tell the body to make?

A

Memory B cells and Memory T helper cells

34
Q

What type of cell does non-infectious vaccines tell the body NOT to make?

A

Memory killer T cells

35
Q

What is the main purpose of non-infectious vaccines?

A

Designed NOT to infect the host

36
Q

What are examples of non- infectious vaccines made with killed components?

A

1) Common flu vaccine (killed virus)
2) Typhoid vaccine (killed bacteria)
3) Pertussis Vaccine (killed bacteria)

37
Q

What is a common chemical that is used to kill microbes to make killed non-infectious vaccines?

A

Formaldehyde

38
Q

Explain how bacterial toxins are used to make non-infectious vaccines.

A

The toxin is purified and then weakened with aluminum, so it is then called a toxoid.

39
Q

What do non- infectious vaccines made with bacterial toxins do in the body?

A

B cells make antibodies that bind to the toxin and weaken the real attack

40
Q

What are examples of non- infectious vaccines make with bacterial toxins?

A

1) Diphtheria

2) Tetanus

41
Q

Explain how they make non-infectious vaccines using parts of the pathogen.

A

They get rid of the harmful portions that cause dangerous effects and keep the non-harmful portions that the immune system needs to see for protection

42
Q

What are some examples of on-infectious vaccines that are made with parts of the pathogen?

A

1) Acellular pertussis vaccine

2) Hepatitis B or HPV- one or a few synthetic viral proteins are used to make a subunit vaccine

43
Q

Why aren’t our cells infected by non-infectious vaccines?

A

Some extracellular bacteria will never infect out cells and the non-infectious vaccines cause B cells to make antibodies sufficient to protect against many pathogens.

44
Q

Non- infectious vaccines can work well with some other vaccines that do infect cells. Give 2 examples of these types of vaccines and state why.

A

1) Poliovirus
2) Hepatitis B virus

Neither vaccine generates memory killer T cells

45
Q

Give 2 examples of vaccines that infect cell that non-infectious vaccines do not work well with.

A

1) Measles

2) Mumps

46
Q

What types of cells does live attenuated vaccines result in?

A

1) Memory B cells
2) Memory helper T cells
3) Memory killer T cells

47
Q

Explain how carrier vaccines are prepared.

A

They introduce a single gene from a pathogenic microbe into a virus that doesn’t cause disease. The carrier then infects the host’s antigen presenting cells. The APCs produce the pathogenic microbes proteins and then the pathogenic microbes protein fragments are presented on MHC I molecules.

48
Q

What types of cells do carrier vaccines result in?

A

1) Memory B cells
2) Memory helper T cells
3) Memory killer T cells

49
Q

What are carrier vaccines referred to as?

A

The Trojan Horse because it carries the gene of the pathogenic microbe into human cells.

50
Q

What does the yellow fever vaccine activate?

A

TLR2, TLR3, TLR7, TLR8, and TLR9 on dendritic cells

51
Q

What is an adjuvant?

A

It helps stimulate the immune system, increasing the immune response to the vaccine.

52
Q

What is the purpose of an adjuvant?

A

It should enhance the magnitude and modulate the quality of the immune response. It does this by causing mild inflammation.

53
Q

How does an adjuvant cause mild inflammation?

A

It attracts phagocytes
Accelerates phagocyte activation
Accelerates antigen presentation to T cells

54
Q

What are examples of adjuvants?

A
Alum
MF59 
AS04
CpG DNA (TLR ligand) 
TLR7 and TLR8 ligands 
Flagellin-protein fusions
55
Q

What kind of attacks do Th1 helper T cells respond to?

A

Viral or bacterial attacks

56
Q

What kind of response does Th1 helper T cells elicit?

A

Classical cytokines: TNF, IFN-y, IL-2

57
Q

What is the goal of Th1 helper T cells?

A

To activate macrophages and natural killer cells.

58
Q

What does IFN-y do when Th1 helper T cells activate it?

A

IFN-y keeps the macrophages active and tells the B cells to make IgG3 which opsonizes viruses and bacteria and fixes the complement.

59
Q

What does IL-2 do when Th1 helper T cells activate it?

A

IL-2 recharges the natural killer cells and stimulates proliferation of CTLs, NK cells and Th1 cells

60
Q

What kind of attacks does Th2 helper T cells respond to?

A

Parasitic attack or food contaminated with pathogenic bacteria

61
Q

What kind of response does the Th2 helper T cells elicit?

A

It responds to the intestines under attack by releasing interleukins (IL-4, IL-5, IL-13)

62
Q

What is the purpose of IL-4 when stimulated by Th2 helper T cells?

A

IL-4 growth factor to proliferate T cells which releases Th2 cytokines. It is also a growth factor for B cells that are making IgE.

63
Q

What is the purpose of IL-5 when stimulated by Th2 helper T cells?

A

IL-5 causes the B cells to make IgA which is an antibacterial in the GI

64
Q

What is the purpose of IL-13 when stimulated by Th2 helper T cells?

A

IL-13 stimulates mucus in the intestine

65
Q

Explain how aluminum adjuvants work?

A

Aluminum adjuvants induce chemokines in macrophages, monocytes, and granulocytes. This causes many events to occur:

  • Recruits other immune cells to the area
  • Monocytes enter and turn into dendritic cells
  • Dendritic cells are activate by sampling the area (aka uptake contents of the vaccine)
  • B cells and T cells are activated
66
Q

Do aluminum salts or alum induce a Th1 or Th2 biased response?

A

Th2 biased response

67
Q

What cytokine does alum have a direct effect on?

A

IL-4 which produces Gr-1 expression on cells

68
Q

What is the purpose of Gr-1?

A

It is heavily expressed by neutrophils and though to be important in fighting infection (also expressed by monocytes and DCs)

69
Q

How many cytokines and chemokines are produces within 4 hours of aluminum adjuvant injection?

A

at least 13 (IL-1B and IL-5… IL-1B is main stimulus for microglial activation)

70
Q

Is aluminum toxic? How?

A

I say yes because aluminum displaces iron in metalloenzymes. It decreases the Kreb’s cycle, decreases Beta Oxidation, and decreases the Electron Transport Chain. These all affect iron homeostasis and cause free iron release. Free iron release leads to increased ROS which causes inflammation and increased Hepcidin which causes decreases GI iron intake and decreased GI iron release from cells which causes anemia!

71
Q

How are humans exposed to aluminum?

A

Foods, industrial exposures, drinking water, pharmaceuticals, and vaccines

72
Q

Is aluminum easy to get rid of once it’s in your body?

A

No, its tough to get rid of aluminum. It accumulates in the mitochondria and nucleus of cells.

73
Q

Are there physiologic needs for aluminum?

A

No

74
Q

What organ is a major route for elimination of aluminum?

A

Kidneys, however, the normal kidney has limited ability to excrete aluminum and when large parenteral loads are administered, varying amounts are retained.

75
Q

What percentage of aluminum is retained in adults when it is administered intravenously? Neonates?

A

40%

75%!!!!

76
Q

What are the 3 main sources of aluminum exposure?

A

1) Antacids
2) Environmental air inhalation
3) Industrial air inhalation

77
Q

What are other sources of aluminum exposure?

A

Antiperspirants, cigarettes, vaccines, and allergy immunotherapy

78
Q

Is aluminum in food the same as aluminum found in vaccines, deodorants, antacids, etc?

A

No, in food the aluminum doesn’t exist as a metal and it is harmless.

79
Q

What antacids contain aluminum? What is the common ingredient that they share?

A

Equate, Maalox, and Mylanta

Aluminum hydroxide

80
Q

Approximately how much aluminum is exposed to an 18 month old child who is receiving vaccines?

A

The child may have over 5000 micrograms.