Immune Therapies

Question 1

what is the most effective strategy to prevent infectious disease?

Answer 1

vaccination

Question 2

how do vaccines work?

Answer 2

replicate immunity from natural infection without illness

- primary aim is to stimulate adaptive immunity and generate long-term immunological memory

Question 3

what immune response occurs 0-12 hours after infection?

Answer 3

innate immunity

- inflammatory response

Question 4

what occurs 1-7 days after infection?

Answer 4

adaptive immune response

• dendritic antigen presenting cells stimulate T cells
• effector T cell (clones) activate B cells
• B cells become plasma cells which produce highly specific antibodies

Question 5

explain the induction of highly specific antibodies (to natural infection) via the primary response:

Answer 5

• low specificity IgM produced first

- high specificity IgG takes longer (requires T cell help causing lag)

Question 6

explain the induction of highly specific antibodies (to natural infection) via the secondary response:

Answer 6

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

Question 7

how do vaccines initiate the immune response?

Answer 7

by exposing our immune system to disease-causes microbial antigens (but without disease!)
- pathogen is modified making it unable to cause disease

Question 8

what are the different types of vaccines?

Answer 8

• live attenuated
• inactivated
• subunit
• viral vector

Question 9

what is a live attenuated vaccine? an example of this?

Answer 9

• live pathogen but weakened via genetic manipulations

- MMR, BCG

Question 10

are live attenuated vaccines successful? when may they not be suitable?

Answer 10

• excellent life long immunity

- potentially pathogenic in immunocomprimised

Question 11

what is an inactivated vaccine? an example of this?

Answer 11

• pathogen is killed through chemical or physical processes
• cannot replicate or cause disease
• Polio

Question 12

are inactivated vaccines effective?

Answer 12

• safer than live vaccines but less effective
• weak immunity
• therefor several doses required

Question 13

what are the different kinds of subunit vaccines?

Answer 13

• recombinant
• toxoid
• polysaccharide
• conjugate

Question 14

what are subunit vaccines?

Answer 14

purified antigens (no live components or whole organism)

Question 15

what are recombinant subunit vaccines? an example of this?

Answer 15

• contains the protein receptor that the virus uses to attach to our cells (to stimulate immunity)
• Hep B, HPV

Question 16

what are toxoid subunit vaccines? an example of this?

Answer 16

• inactivated bacterial toxins

- Diphtheria and Tetanus

Question 17

what are polysaccharide vaccines?

Answer 17

• contain subunit found on outside of encapsulated bacteria that helps it hide from our immune response
• T cell independent response

Question 18

what are conjugate vaccines? an example of these?

Answer 18

• contains polysaccharide antigens linked to proteins (T cells & B cells involved)
• PCV/Men-C

Question 19

alongside the pathogen source, what else is also found within vaccines?

Answer 19

Adjuvants

Question 20

what is the function of Adjuvants?

Answer 20

specific molecules that enhance the immune response to vaccine antigens

Question 21

in what type of vaccines are adjuvants most important?

Answer 21

• inactivated vaccines

- subunit vaccines

Question 22

what are adjuvants composed of? how do these enhance immune response?

Answer 22

Aluminium/calcium salts

• maintain and prolong antigen stability
• enhance and prolong antigen presentation
• granuloma formation**

Question 23

what are different routes of administrations for vaccines?

Answer 23

• intramuscular
• subcutaneous
• intradermal
• intranasal

Question 24

what is the most common route of administration for vaccines?

Answer 24

intramuscular

Question 25

by what rout of administration is the BCG vaccine given?

Answer 25

intradermal

Question 26

what are corticosteroids? an example?

Answer 26

synthetic version of cortisol (stress hormone) | - prednisolone

Question 27

what effect does cortisol have on the immune response?

Answer 27

dampens immune response

Question 28

what is the function of corticosteroids?

Answer 28

non-specific anti-inflammatory function | - used to treat a wide range of inflammatory/allergic conditions

Question 29

how are corticosteroids applied?

Answer 29

systemic or topical application

Question 30

what are some of the side effects of corticosteroids?

Answer 30

- weight gain - risk of infection - risk of diabetes - risk of hypertension

Question 31

what type of drugs are NSAIDs?

Answer 31

COX-2 inhibitors

Question 32

what is the function of NSAIDs? examples of these?

Answer 32

- reduce pain, inflammation and fever | - ibuprofen and aspirin

Question 33

what are some limitations of NSAIDs?

Answer 33

- overuse can lead to gastro-intestinal bleeding, liver and kidney problems - interactions with other medications (warfarin, methotrexate, diuretics)

Question 34

what is an example of a DMARD? (disease-modifying anti-rheumatic drug)

Answer 34

Methotrexate

Question 35

what are some uses of methotrexate?

Answer 35

- used at high doses as a chemotherapy agent | - used at low doses to treat inflammatory arthritis

Question 36

what are biological therapies?

Answer 36

genetically engineered antibodies made from human genes (monoclonal antibodies)

Question 37

how do biological therapies work?

Answer 37

directly target specific components of the immune system to inhibit activity - B cell inhibitor - Cytokine blockers

Question 38

what are examples of anti-TNF drugs?

Answer 38

- infliximab | - etanercept

Question 39

how does Infliximab work?

Answer 39

by binding soluble TNFa and prevents it from interacting with receptor

Question 40

how does Etanercept work?

Answer 40

binds and blocks TNF receptor (prevents cytokine binding)