Immune therapies Flashcards
What are the aims of vaccines
Primary aim of vaccination is to stimulate adaptive immunity and generate long-term immunological memory
replicate immunity from natural infection without illness
What antibody do vaccines aim to induce production of
High affinity IgG
What is the primary response to a natural infection
Low specificity IgM produced first
High specificity IgG takes longer
-Requires T cell help
What is different in a secondary response
More rapid
More effective
High specificity IgG produced by long-lived plasma cells
What are the types of vaccines
Live attenuated
Inactivated
Subunit (purified antigens)
-Recombinant
-Toxoid
-Polysaccharide
-Conjugate
Viral Vector
What is a live attenuated vaccine and an example
Live but weakened via genetic manipulations
Capable of replication within host cells
Excellent life-long immunity
Potentially pathogenic in immune-compromised
Example - MMR, BCG, Rotavirus
What is an inactivated vaccine and an example
Killed through chemical or physical processes
Cannot replicate or cause disease
Weak immunity
Several doses required
Example - Influenza, Pertussis
What does the immune system recognise as foreign to induce an immune response
Antigens and virulence factors
What are the differences between the subunit vaccines
No live components
Recombinant – produced by genetic engineering
-Hep B
-HPV
Toxoid – inactivated bacterial toxins
-Diphtheria
-Tetanus
Polysaccharide – encapsulated bacteria – T cell-independent
Conjugate – polysaccharide antigens linked to proteins
-PCV/Hib/Men-C
What type of vaccine is the HPV vaccine
Recombinant (subunit)
What type of vaccine is used against tetanus
Toxoid (subunit)
What typeof vaccine is used against influenza
Inactivated vaccine
What type of vaccine is the MMR vaccine
Live attenuated
What vaccine only requires one dose due to the ammount of IgG it induces
Live attenuated
What are adjuvants
Enhance immune responses to vaccine antigens
Inactivated/subunit vaccines
Aluminium/calcium salts
-Maintain and prolong antigen stability
-Enhance and prolong antigen presentation
-Granuloma formation
Intramuscular delivery
What are the possible routes of administration for vaccines
Intramuscular
Subcutaneous
Intradermal
Intranasal
Oral
What factors can reduce infectious disease
Widespread implementation of vaccination strategies
Cleaner drinking water
Better nutrition
Better living standards
What class of diseases cause the most deaths globally
Non-communicable diseases
What is a side effect of successful vaccination programmes
Increasing burden of NCDs associated with aging
-Due to the induction of inflammatory pathways associated with body’s defence system
-Pathological inflammatory pathways underlie the majority of chronic diseases that dominate present day morbidity and mortality
What unwanted immune responses can vaccines induce
Chronic inflammation
Autoimmunity
Allergy
What vaccines are given subcutaneously
Measels
Yellow fever
What are the properties and trends shown with presence of mutans streptococci
Extremely efficient at accumulating and producing carious surfaces
Extremely tolerant of low pH
Colonisation coincides with tooth eruption
Colonisation stimulates specific IgA and IgG
What are examples of conventional immunosuppressive drugs
Corticosteroids
Non-steroidal anti-inflammatories (NSAIDS)
Methotrexate (DMARDs)
Biological therapies
What s methotrexate
Used at high doses as chemotherapy agent
Used at low doses to treat inflammatory arthritis
Multi-faceted anti-inflammatory effects
Slows progression of arthritis
Can be combined with biological therapies
What are biological therapies (conventional) and how can they be used to treat diseases
Genetically engineered antibodies made from human genes
Directly target specific components of immune system to inhibit activity
-B-cell inhibitor (Rituximab)
-Cytokine blockers (IL-1, IL-6, IL-17, TNFa)
Moderate to severe RA patients to slow disease progression
May be combined with DMARDs
What are the benefits of targeted biological therapies
Targeted biological therapies harness the specificity of antibodies to target and block pathological inflammatory pathways
Do anti-cytokine therapies have a role in the treatment of periodontitis
Elevated levels of cytokines in gingival tissues
Regulate immune-mediated bone destruction
What is the effect of biological therapies on periodontal tissue destruction in RA patients?
Any potential limitations?
What vaccinations are available in the UK
Pertussis (whooping cough)
Diphtheria
Tetanus
Polio
Hib
Hepatitis B
MenB and MenC
Rotavirus
Pneumococcal conjugate vaccine (PCV)
Measles, Mumps, Rubella (MMR)
Seasonal Flu
Human papilloma virus (HPV) – now offered to both boys and girls
Why do we have vaccines
Most effective strategy to prevent infectious disease
Promote human health
Primary aim to induce immunity in individuals
Successful programmes protect entire communities and populations
What ways and why do we manipulate the immune response
Promote protective immune responses
Vaccination
Fight tumours
Treat immunocompromised patients
Suppress unwanted immune responses
Chronic inflammation
Autoimmunity
Allergy
What is simmilar between periodontitis and rheumatoid arthoritis
Immune mediated inflammatory diseases affecting the bone
