I - Immune Modulation Flashcards
Describe how Ag exposure leads to immune memory
Ag exposure —> APC —> clonal expansion following exposure to Ag —> IgM T cells or IgG/A —> immunological memory
Where does IgM act on to produce plasma cells
Germinal centre
Which AB has higher affinity, IgG or IgM
IgG > IgM
Which type of memory cells have higher affinity / longevity
B cell memory cells
How do AB prevent influenza infection
Influenza and RBC reaction is inhibited by ABs to haemaglutanin
What type of reaction is Mantoux test for TB
Type 4 mediated reaction
Examples of live attenuated vaccines (7)
MMR
BCG
Yellow fever
Zostavax
Typhoid (oral)
Polio (Sabin oral)
Influenza nasal spray
Who can’t have live attenuated vaccines
Imm supp
4 benefits of live attenuated
Establishes infection
Broad imm response against multiple Ag
T&B cell response
1 dose for life
3 cons of live attenuated vaccines
Rare - can revert to virulence
Spread to contacts potentially
Storage issues
5 examples of inactivated vaccines
Influenza
Cholera
Hep a
Pertussis
Raboies
3 examples of subunit vaccines
Hep B s Ag
HPV capsid
Flu (not used much)
2 examples of toxoid vaccines
Diphtheria
Tetanus
4 benefits of inactivated / component vaccines
No reversion to virulence
Cheap
Easy to store
Imm supp
3 cons of inactivated / component vaccines
Multi dose
Narrower immune response
Poor immunogenicity
Who gets conjugate vaccines mainly
Kids
Example of conjugate vaccine
HiB
What is the conjugate vaccine made of
Polysaccaride and protein
How do adjuvant vaccines work
Mimic PAMPs on TLR to activate adaptive imm resp
What adjuvants are added to adjuvant vaccines
Aluminium salts or lipids
2 benefits of mRNA vaccines
Non infectious
Non integrating
Wha type of vaccine is Covid AZ
Adenoviral vector
On whom are dendritic cell vaccines used
Oncology pts
Give an example of dendritic cell vaccine
Provenge for prostate cancer
How does cytokine therapy help immunity
Stimulate T cells
Enhance macrophage function
Antiviral
How can replacing missing components help the immune response (give eg)
Bone marrow transplant / haematopoeitic stem cell transplant
Indications for AB replacement
Primary AB def - x linked gamma globulinaemia
Secondary AB def - CLL / MM
Why would you replace specific Ig
Post exposure prophylaxis
When would Ig be given for hep B
Needle stick injury
When would rabies Ig be given
Post bite
When would VZV Ig be given
Women <20 weeks pregnant
Imm supp
Give 3 types of adoptive cell transfer (ACT)
Virus specific T cells
Tumour infiltrating T cells
Manipulated T cells - CART cells
When would virus specific ACT be done
Anti EBV in post transplant pt
When would tumour infiltrating T cell ACT be used
Melanoma
How does targeting PD1 allow tumour lysis
PD1 = programmed death 1 (its a checkpoint inhibitor)
Present on APC / tumour cells - AB to PD1 = blocks neg reg of tumour cells
Which cancers can anti PD1 be used on
Melanoma
Renal cell carcinoma
Now loads of cancers
Complications of checkpoint inhibitors
Autoimmunity eg thyroid disease
