Immune Therapies Flashcards

1
Q

what sort of things promote protective immune response

A

vaccination, fight tumours, treat immunocompromised patients

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2
Q

what are some unwanted immune responses

A

chronic inflammation, autoimmunity and allergy

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3
Q

why would you want to manipulate the immune system?

A

to promote protective immune responses and to suppress unwanted immune responses

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4
Q

why do we vaccinate?

A

most effective strategy to prevent infectious disease, promote human health, to induce immunity in individuals, protect entire communities and populations

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5
Q

what is the evolution of the immunisation programme

A

1 - pre-vaccine so disease rates high
2 - vaccine coverage and disease rates decrease
3 - public loss of confidence so outbreak of disease
4 - resume confidence with vaccine
5 - eradication of disease

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6
Q

how do vaccines work?

A

stimulate adaptive immunity and generate long-term immunological memory

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7
Q

simplify the steps of induction of long term immunity once vaccinated

A

1 - innate immune system recognises antigens and activates inflammation
2 - cytokines released to recruit more innate immune
3 - dendritic and APC travel to lymph nodes to display pathogen to T and B cells
4 - T and B cells activated once pathogenic antigen receptor found, T cells turn to effector T cells, B cells make antibodies
5 - T cells help B cells to turn into plasma cells by somatic hypermutation and isotype switching
6 - highly specific antibodies produced
7 - B and T cells travel to infection and work with innate cells to eradicate infection
8 - small portion of adaptive cells remain as memory cells

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8
Q

how are antibodies made to be highly specific?

A

initially are IgM antibodies but once B cells work with T cells they learn more about the pathogen and change to plasma cells to produce high affinity antibodies - IgG

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9
Q

what is the aim of vaccination?

A

produce high affinity IgG

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10
Q

what is the primary response to a vaccine

A

low specificity IgM produced then high specificity IgG takes longer and requires T cell help

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11
Q

what is the secondary response to a pathogen

A

more rapid, more effective, high specificity IgG produced by long-lived plasma cells

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12
Q

what are virulence factors called and what are they recognised as

A

molecules expressed by bacteria to attach, invade and replicate in tissue, recognised as antigens

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13
Q

what are the types of vaccine?

A

live attenuated, inactivated, subunit, viral vector

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14
Q

what is a live attenuated vaccine

A

live whole pathogens but weakened via genetic manipulations, can replicate within host cells, have excellent life-long immunity, one dose required

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15
Q

what is an inactivated vaccine?

A

killed through chemical or physical processes, cannot replicate, weak immunity, several doses required

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16
Q

what are subunit vaccines

A

no live components just take proteins from pathogen which attach to receptors in our cells

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17
Q

what are the types of subunit vaccine?

A

recombinant, toxoid, polysaccharide, conjugate

18
Q

what is a subunit recombinant vaccine

A

produced by genetic engineering

19
Q

what is a subunit toxoid vaccine?

A

inactivated bacterial toxins

20
Q

what is a subunit polysaccharide vaccine?

A

encapsulated bacteria - T cell independent so immune responses are weak as only B cells activated

21
Q

what is a subunit conjugate vaccine

A

polysaccharide antigens linked to proteins

22
Q

what is a viral vector vaccine

A

non-replicating type of live virus, use chimpanzee adenovirus which is used as a delivery system to carry COVID material

23
Q

which types of vaccines require a second/third dose?

A

inactivated/subunit

24
Q

what is an adjuvant?

A

they enhance immune response to vaccine antigens by holding antigens at the site and making sure they are not washed away in the bloodstream

25
Q

what routes of administration are used for vaccines?

A

intramuscular, subcutaneous, intradermal, intranasal, oral

26
Q

name some non-communicable diseases

A

cardiovascular diseases, cancer, metabolic diseases etc. (anything that cannot be passed on in the community)

27
Q

what have successful vaccination programmes contributed to?

A

decreasing burden of infectious diseases and increasing burden of NCDs associated with aging

28
Q

what are the conventional immunosuppressive drugs

A

corticosteroids, NSAIDs, methotrexate, biological therapies

29
Q

what are corticosteroids

A

synthetic versions of cortisol which have a non-specific anti-inflammatory function

30
Q

what are the side effects of corticosteroids

A

weight gain, risk of infection, risk of diabetes and hypertension

31
Q

what are corticosteroids used to treat

A

wide range of inflammatory/allergic conditions

32
Q

what do corticosteroids actually do?

A

target and decrease expression of cytokines and chemokines

33
Q

what are NSAIDs used for

A

reducing pain, inflammation and fever

34
Q

what do NSAIDs actually do?

A

inhibit COX2

35
Q

what is methotrexate used for?

A

high doses as chemotherapy, low doses to treat inflammatory arthritis and slow progression of it

36
Q

what are biological therapies and what do they do?

A

genetically engineered antibodies made from human genes which directly target specific components of immune system to inhibit activity

37
Q

what are the 2 types of biological therapies?

A

B cell inhibitor which binds to B cells and makes them self destruct (monoclonal antibody)
cytokine blockers

38
Q

what is the function of TNF?

A

coordinates pathological immune reactions in the joint that lead to destruction of bone and surrounding connective tissues (arthritis)

39
Q

what do anti-TNF therapies do?

A

either stops cytokine message (infliximab) by binding to soluble TNFa
or
stops TNF binding and delivering message (etanercept) by binding and blocking TNF receptor

40
Q

what are conventional immunosuppressants used for?

A

treat wide-range of conditions

41
Q

what are targeted biological therapies used for?

A

harness the specificity of antibodies to target and block pathological inflammatory pathways