Immune therapies Flashcards
Why would you want to manipulate the immune response?
- Promote protective immune responses
- Suppress unwanted immune responses
Why do we vaccinate? (4 points)
- 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 is included in the 6 in 1 vaccine?
- Pertussis (whooping cough)
- Diphtheria
- Tetanus
- Polio
- Hib
- Hep B
What are the 5 stages of evolution of immunisation programme?
Stage 1 - Pre-vaccine
Stage 2 - Increasing coverage
Stage 3 - Loss of confidence
Stage 4 - Resumption of confidence
Stage 5 - Eradication
What is the aim of a vaccine?
Replicate immunity from a natural infection without illness
- It is to stimulate adaptive immunity and generate long-term immunological memory without the stage of getting sick first
What is the most important goal of vaccination in terms of levels of IgG?
- Production of high affinity IgG represents the most important goal of vaccination
What is the primary response of the body to natural infection?
- Low specificity IgM produced first
- High specificity IgG takes longer because it requires T cell help
What is the secondary response of the body to natural infection?
- More rapid than primary
- More effective than primary
- High specificity IgG produced by long-lived plasma cells
What are the different types of vaccines? (3 points)
- Live attenuated
- Inactivated
- Subunit (purified antigens) 4 types:
- Recombinant, Toxoid, Polysaccharide, conjugate
What are live attenuated vaccines?
- Live but weakened via genetic manipulations
- Capable of replication within host cells
Do you get good long-term immunity with live attenuated vaccines?
- Yes, excellent life-long immunity
What is a possible problem with live attenuated vaccines?
- Potentially pathogenic to people who are immunocompromised
Give 3 examples of live attenuated vaccines?
- MMR
- BCG
- Rotavirus
How many doses of live attenuated vaccines are usually given?
- One dose is very effective but typically get 2 doses
- Shows that one dose of live vaccine can generate a high specificity IgG response
What are inactivated vaccines?
- Killed through chemical or physical processes
- Cannot replicate or cause disease
Do inactivated vaccines give you good immunity?
- No, weak immunity
How many doses of inactivated vaccines are required?
- Several doses required
Give 2 examples of inactivated vaccines?
- Polio
- Pertussis
What are subunit vaccines?
- No live components
- Proteins or peptides from the pathogen and immunise with those
How are recombinant subunit vaccines produced?
- Produced by genetic engineering
How are Toxoid subunit vaccines produced?
- Inactivated bacterial toxins
How are rpolysaccharide subunit vaccines produced?
- Encapsulated bacteria - T cell independent
How are conjugate subunit vaccines produced?
- Polysaccharide antigens linked to proteins (a way to get around evading T cells by just polysaccharide)
What do adjuvants do?
- Enhance immune responses to vaccinate antigens
- Inactivated/subunit vaccines
What kind of administration are adjuvants given by?
- IM delivery
What are the possible routes of administration of vaccines? (5 points)
- Intramuscular
- Subcutaneous
- Intradermal
- Intranasal
- Oral
What are 4 examples of conventional immunosuppressive drugs?
- Corticosteroids
- NSAID’s
- Methotrexate (DMARD’s)
- Biological therapies
What are corticosteroids a synthetic version of?
- cortisol
- e.g. prednisolone
What is the function of corticosteroids?
- Non-specific anti-inflammatory function
- Treat wide range of inflammatory/allergic conditions
How would you apply corticosteroids?
- Systemic or topical application
What are possible side effects of corticosteroids? (4 points)
- Weight gain
- Risk of infection
- Risk of diabetes
- Risk of hypertension
Give 2 examples of NSAID’s?
- Ibuprofen and aspirin
What do NSAID’s do?
- Reduce pain, inflammation and fever
What can constant use of NSAID’s lead to?
- Can lead to GI bleeding, liver and kidney problems
NSAID’s interact with other medications. Give 3 examples of these?
- Warfarin, Diuretics, Methotrexate
What is Methotrexate?
- A disease-modifying anti-rheumatic drug
- Used at high doses as chemotherapy agent
- Used at low doses to treat inflammatory arthritis
What are biological therapies?
- Genetically engineered antibodies made from human genes
What do biologic therapies directly target?
- Directly target specific components of immune system to inhibit activity
- B-cell inhibitor (Rituximab)
- Cytokine blockers (IL-1, IL-6, IL-7, TNFa)
What are 2 ways in which Anti-TNF therapies work?
- Infliximab binds soluble TNFa
- Etanercept binds and blocks TNF receptor
Do anti-cytokine therapies have a role in the treatment of periodontitis?
- Elevated levels of cytokines in gingival tissue
- Regulate immune-mediated bone destruction
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What are the biological considerations in relation to barriers to dental caries vaccine? (3 points)
- Mutans streptococci dominate environments frequently exposure to dietary carbohydrates
- Mutans streptococci are not the only cariogenic bacteria in the oral biofilm
- Other cariogenic species likly to fill niche
What are the ethical considerations in relation to barriers to dental caries vaccine? (3 points)
- Non-life threatening condition
- Expensive
- Other initiatives more cost effective:
- Childsmile, water fluoridation, dietary advice
