immune therapies Flashcards
why do we need to vaccinate?
prevent infectious diseases
induce immunity in individuals
protect entire communities and populations
functions of immune therapies
vaccination
chronic inflammation (suppress)
autoimmunity (suppress)
vaccines are not complately risk free. there are sometimes side effcets like
nausea
mild fever
public trust is very important
vaccines only really work at population levels
what % of the population must be vaccinated for the virus to stop circulating in population?
about 95%
how do vaccines work?
stimulate adaptive immunity and generate long term immunological memory
replicate immune response from natural response without causing illness
EFFECTOR t cells do what?
help innate immune cells to clear infection +
communicate with b cells and activate b cells that differentiate into plasma cells that produce antibodies
what antibodies do b cells produce
b cells produce IgM, broad specificity
what antibodies do plasma cells produce
plasma cells produce IgG, more high affinity and specific antibodies
IgG or IgM antibodies are better?
IgG more specific and higher affinity which is better
think G for good!
primary vs secondary response?
primary => low specficity IgM first, high specificity IgG slightly longer
secondary response => more rapid and effective, more IgG produced by long lived plasma cells
live attenuated vaccines
live pathogens but are weakened by genetic manipulations
why is live attenuated vaccine so effective?
first dose produces large amounts of IgG
excellent life long immunity
inactivated vaccine type
take a pathogen and kill it through chemical or physical processing
cannot replicate or cause disease so its safer
but weak immune response generated so more doses of vaccine are needed
subunit vaccine type
take components of the pathogen you want to immunise against
no live components
just proteins or peptides
viral vector vaccine type
modify a unrelated harmless virus, use it to deliver genetic material of the actual virus
live attenuated vs subunit/inactivated
live attenuated
- stronger
- one dose enough
- but may be less safe for people with weaker immune system
subunit/inactivated
- multiple doses needed
- weaker
what are adjuvants
enhances the immune response to vaccine antigens
what are the uses of aluminum and calcium salts in vaccine?
they act as adjuvants
maintain and prolong antigen stability
enhances and prolongs antigen presentation
granuloma formation
found in subunit type
how are many vaccines administered?
intramuscular or subcutaenous
colonisation of the oral cavity by s.mutans stimulate production of which 2 antibodies?
IgA and IgG
polio vaccine is what type
inactivated
MMR vaccine is what type of vaccine
live attenuated
hep b and hpv vaccine is what type of vaccine?
subunit
so is tetanus, diphtheria
examples of conventional immunosuppressive drugs
corticosteroids
NSAIDs (ibuprofen and aspirin)
methotrexate
examples of targeted immunosuppressive drugs
biological therapies
prednisolone is a what drug
corticosteroid
synthetic version of cortisol
what do corticosteroids do?
decreases inflamamtion
reduce pro inflammatory mediators
decrease in cell adhesion molecules
thromboxane A2 vs leukotrienes vs prostaglandins
Thromboxanes promote platelet aggregation and vasoconstriction.
Leukotrienes are involved in the inflammatory response, promote the recruitment of immune cells and enhance vascular permeability, contributing to inflammation.
Prostaglandins - modulation of inflammation, can have both pro-inflammatory and anti-inflammatory effects
another name for NSAIDs
cox II inhibitors
what do cox II inhibitors do?
they inhibit arachidonic acid -> prostaglandins
prostaglandins makes us feel pain. switch it off so less pain.
how are biological therapies ie biologics more effective?
they are more SPECIFIC antibodies made from human genes
is tnf alpha pro or anti inflammatory
pro
rheumatoid arthritis is treated using what drug
methotrexate, or biologics
can biologics be used to treat periodontitis since rheumatoid arthritis is quite similar? in that they are both chronic inflammatory diseases..?
Name the type of vaccine that needs to be administered with an adjuvant
Subunit/inactivated type
rationale for dental caries vaccine?
bacteria streptococci causes tooth decay
they adhere to the tooth surface
could vaccination be used to block colonization?
if you can stimulate igg and iga antibody production using vaccine, it could delay or prevent colonization of streptococci on tooth surfaces and thus can prevent caries
what are some biological and ethical considerations of producing a dental vaccine?
biologically - can cause resistance? vaccine boosters needed? disrupt commensal microbiome? difficult to target all bacteria involved in caries development? may cultivate more harmful bacteria?
ethical - may cause vaccinated patients to end up consuming more sugar if they think that their risk of caries are low now, clinical trials might cause harm to the test group if their commensal oral microbiome is disrupted, may cause perio or caries, having to test on people with no decay is not ethical as they may end up getting decays from the testing and trials
