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FoM - principles of disease > immunity > Flashcards

immunity Flashcards

1
Q

what are is innate immunity?

A

innate - non-specific and no memory

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2
Q

what are the 2 types of acquired/activated immunity?

A
  • specific and memory
  • b and t lymphocyte

active

passive

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3
Q

what is active immunity?

A

natural - infection/ exposure
artificial - immunisation/ vaccines

antigen stimulates immune response

long term immunity

immunological memory

no immediate effect, faster and better response to the next antigenic encounter

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4
Q

what is passive immunity? give advantages and disadvantages

A

Natural → Placental transfer of IgG & Colostral transfer of IgA

Artificial → Immunoglobulin therapy or Immune cells

Advantages
- immediate protection
- quick fix

Disadvantages
Short-term effect – no immunological memory

Serum sickness – incoming antibody is recognised as a foreign antigen by the recipient
->anaphylaxis

Graft Versus Host Disease (cell grafts only) – incoming immune cells reject the recipient
e.g. donated bone marrow or peripheral blood stem cells attack the recipient

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5
Q

give an example of natural passive immunity

A

Maternal immunoglobulins (IgG)

transferred to the foetus/ neonate naturally using a specialised mechanism involving the neonatal Fc receptor

Transfer of antibodies from maternal blood into the fetal circulation

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6
Q

give an example of artificial passive immunity

A

Snake or spider bites, scorpion or fish stings
- Passive infusion of antibody specific to the toxin

Hypogammaglobulinaemia – primary or secondary
- Infusion of g-globulins to reduce infection

Specific Rabies Immunoglobulin
- given “Post-exposure prophylaxis” together with vaccination

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7
Q

what is a vaccination?

A

administration of antigenic material to develop adaptive immunity to a pathogen

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8
Q

what are the 4 types of vaccines?

A

1 - inactivated killed whole organism

2- live attenuated whole organism

3- subunit

4- toxoid

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9
Q

describe the functions of killed whole vaccines, give an example:

A

target organism e.g. polio

effective and easily manufacture

booster shots

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10
Q

describe live attenuated vaccines, and give examples:

A

mainly viruses

→ An avirulent strain of the target organism is isolated

more powerful and better than killing the whole organism

simulate natural infection

problems → may revert back to a virulent form

refrigeration required

e.g. TB, measles, rotavirus, oral polio, yellow fever

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11
Q

what are subunit vaccines? give advantages and disadvantages

A

Recombinant proteins

Advantages:
safe & easy to standardise

Disadvantages:
Not very immunogenic without an effective adjuvant
Need to understand how to generate immunity

Examples:
Hepatitis B surface antigen (HBsAg)
Human papillomavirus (HPV) proteins

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12
Q

what is an adjuvant?

A

pharmacological/ immunological agent that improves the immune response of a vaccine

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13
Q

what is a toxoid vaccine (modified)?

A

A toxin is treated with formalin → Toxoid (inactivated toxin)

retains antigenicity
no toxic activity

induces immunity against the toxin, not the organism that produces it.

e.g. tetanus, diphtheria

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14
Q

What vaccines are needed to give to travellers?

A

hepatitis a

typhoid

neisseria meningitidis

cholera

yellow fever

Japanese and tick-borne encephalitis

rabies

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15
Q

describe the immunisation schedule for children

A

non-routine at birth:
TB
Hepatitis B - children with positive mum

2,3,4,12 months, 3 years, 13-18 years
- polio, strep.pneumonia, rotavirus, tetanus, diphtheria, pertussis, Haemophilus influenza b, Neisseria meningitidis c

12/13 months + >3years - measles, mumps, rubella

2/3/4 - influenza

12 years - human papillomavirus (females)

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16
Q

what are some temporary contraindications?

A

febrile illness
pregnancy (temporarily immunocompromised)

17
Q

what are some permanent contraindications?

A

allergy
immunocompromised - can’t be given live attenuated vaccines, may develop disease

18
Q

what is herd immunity?

A

resistance to the spread of an infectious disease within a population that’s based on the pre-existing immunity of a high proportion of individuals (90-95% coverage as a result of previous infection or vaccination.

The primary aim of vaccination - protect the individual who receives the vaccination

→ Vaccinated individuals are less likely to be a source of infection to others

→ Reduces the risk of unvaccinated individuals being exposed to infection

19
Q

what makes a good vaccine?

A

Potent antibody IgG response – high antibody titer

Potent CD8+ cytotoxic T-cell response

CD4+ T helper response

Memory

20
Q

Why do we need T-cell responses against infections?

A

CD4+ T cells drive B cells to produce more antibodies → to generate a potent antibody response

Diseases e.g.
Tuberculosis (BCG) vaccine generates a CD4+ T helper cell response to destroy Mycobacterium tuberculosis

21
Q

what are 5 challenges when facing vaccines?

A

Cannot elicit immunity against all infectious disease

Persistence
* Generation of memory cells → antibodies against specific pathogen

Protection of vulnerable groups (young & old & immunocompromised)

Antigenic shift and drift, and strain diversity.

The cold chain network

22
Q

what is type l hypersensitivity? what are the effects?

A

antibody-mediated

immediate phase (minutes)
- allergen introduction stimulates TH2 reactions and IgE production

IgE binds to Fc-epsilon-RI on mast cells

mast cell activation and mediator release

effects: Vasodilation, oedema and vascular congestion …etc.

late phase (hours)
Eosinophil, neutrophil and T cell infiltration

23
Q

what is the role of mast cells?

A

Mast cells release granules that contain Histamine and lipid mediators

usually released against helminth parasites.

24
Q

what is atopy?

A

genetic tendency to develop allergic diseases

e.g.
allergic rhinitis, asthma and atopic dermatitis (eczema).

associated with heightened immune responses to common inhaled or food allergens

Predisposition to allergy - the tendency to overproduce IgE to harmless environmental substances.

25
Q

what is type ll hypersensitivity?

A

Injury caused by anti-tissue antibody

Antibody (IgG) in extracellular matrix interacts with leukocytes (neutrophils & macrophages)

cause tissue injury and proinflammatory immune response.

Depends on specificity → Antibodies recognise antigens in tissue.

26
Q

what are some examples of diseases caused by type ll hypersensitivity?

A

acute rheumatic fever

graves disease - hyperthyroidism

insulin-resistant diabetes

27
Q

what is type lll hypersensitivity?

A

Immune complex-mediated tissue injury

Immune complexes of antibodies and antigens formed in circulation and deposited in blood vessels and other sites.

These immune complexes induce vascular inflammation and subsequent ischemic damage to the tissues.

28
Q

what are examples of diseases caused by type lll hypersensitivity?

A

systemic lupus erythematosus

polyarteritis nodosa

post-streptococcal glomerulonephritis

29
Q

what is type lV hypersensitivity?

A

delayed

cytokine-mediated inflammation
Cytokines → inflammation → tissue injury

OR

T cell-mediated cytotoxicity
T cells → direct cell killing and tissue injury

30
Q

give examples of autoimmune diseases associated with type IV hypersensitivity

A

type 1 diabetes

rheumatoid arthritis

multiple sclerosis

31
Q

what is systemic autoimmune disease?

A

The autoimmune process is diffused throughout the body

Affects more than one organ - not necessarily the same ones in different individuals

e.g.
- Systemic lupus erythematosus

31
Q

what is organ-specific autoimmune disease?

A

Autoimmune process directed against one organ

e.g.
- Type 1 Diabetes - pancreas
- Autoimmune Thyroiditis

31
Q

what is immune tolerance?

A

state of unresponsiveness to specific antigens
that would normally be expected to excite an immunological response.

Immune cells normally target pathogens and not self-tissues.

e.g. some B cells are specific for pathogens and others are for autoantigens.

  • Antigens can be self or foreign

Prevents adaptive responses that are damaging (immune pathology)
B cells and T cells

Can be exploited by microbes and tumours
→ Pregnancy, transplantation, autoimmune disease and cancer

32
Q

what is a hypersensitivity response?

A

damaging responses produced during normal immune responses

Chronic activation can lead to autoimmune disease – different effector mechanisms influence the disease phenotype

33
Q

what is autoimmune disease?

A

a failure or breakdown of the immune system that maintains tolerance to self-tissues.

Loss of tolerance is probably due to abnormal selection or lack of control of self-reactive lymphocytes
(B and T-cells)

34
Q

describe how type 1 diabetes works:

A

The Islet of Langerhans damage in type 1 diabetes is mediated by CD4+ Th1 T-cells that are reactive with islet autoantigens.

They drive the influx of CD8+ T cells to destroy
insulin-producing b-cells

FoM - principles of disease (17 decks)

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