L11

Question 1

What cells secrete IFN gamma?

Answer 1

CTL (cytotoxic t lymophocytes?) and other cells

Question 2

What does IFN gamma do?

Answer 2

Enhance expression of MHCI (endogenous derived peptides ) (IFN gamma R on cell and then transcription
effects on MHC I locus)

Question 3

Why is having more MHCI more likely to get a better immune response?

Answer 3

More Ag presentation by increased no. of MHCI molecules

Question 4

What happens to cells that lack MHCI?

Answer 4

More likely to be killed by NK cells

Question 5

What is the other role of IFN gamma?

Answer 5

Activate NK cells

Question 6

What are the two types of immunity?

Answer 6

Active and passive

Question 7

Give an example of the two types of active immunity and how it’s acquired?

Answer 7

Being exposed to a pathogen naturally, or getting a vaccine

Question 8

Give an example of the two types of passive immunity and how it’s acquired?

Answer 8

Naturally acquired (breastfeeding) or artificially acquired (acquiring Ab from another person)

Question 9

How do we achieve immunisation

Answer 9

Through vaccination

Question 10

What is the half life for passive immunity?

Answer 10

Short (half-life of IgG about 3 weeks)

Question 11

Give some examples of medical uses of passive immunity

Answer 11

Hypogammaglobulinaemia in infants as maternal IgG
declines
IVIgG every 2-4 weeks for immunodeficiency to maintain
protective levels
Tetanus antitoxin

Question 13

What is hypogammaglobulinaemia

Answer 13

When maternal IgG is degraded

Question 14

What is a characteristic of active immunity?

Answer 14

Memory

Question 15

What is the most dominant Ig class in our circulation?

Answer 15

IgG

Question 16

Compare secondary vs primary active immunity

Answer 16

faster, greater in magnitude, may be qualitatively better (higher affinity Ab)

Question 17

Who can immunisation protect?

Answer 17

The individual and the population - the disease declines if the majority of the population is immune

Question 18

How many people died from Measles in 2022?

Answer 18

136,000 people

Question 19

What are some of the serious complications that can be caused by measles?

Answer 19

ear infection, pneumonia (esp in young children), sub-accute scloriding panencephalitis (SSPE) (rare but fatal complication involving the CNS)

Question 20

When was the first vaccine introduced for measles?

Answer 20

1963

Question 21

When was MMR introduced?

Answer 21

1988

Question 22

What percentage of the population had to be immunised to prevent outbreaks?

Answer 22

83-94%

Question 23

What impacted the uptake of vaccination of MMR?

Answer 23

A paper in 1998 linking MMR to autism

Question 24

What are the requirements of an effective vaccine?

Answer 24

Safe
High level of protection
Long-lasting protection
Right type of response (local or systemic; antibody or cell-mediated immunity)
Low cost
Stable
Easy to administer
Minimal side-effects

Question 25

What do vaccines contain?

Answer 25

Induce protective response to pathogen without causing disease

Question 26

List the different types of vaccines

Answer 26

Inactivated, attenuated, subunit, toxoid, conjugate

Question 27

What do inactivated vaccines contain?

Answer 27

dead organisms

Question 28

Give an example of an inactivated vaccine

Answer 28

Salk polio vaccine

Question 29

What are the points that need to be taken in consideration when making an inactivated organism

Answer 29

Important antigens must survive killing May have side-effects

Question 30

What do attenuated vaccines contain?

Answer 30

live but virulence disabled - contains live vaccine but is altered?

Question 31

Give examples of live/attenuated vaccines

Answer 31

Vaccinia (smallpox), sabin (polio - drop on tongue w sugar), MMR or BCG

Question 32

What are the pros of live vaccines?

Answer 32

Single dose effective May be given by natural route May induce local and systemic immunity May induce right type of response

Question 33

What are the cons of live vaccines?

Answer 33

Reversion to virulence Possibility of contamination Susceptible to inactivation Causes disease in immunocompromised host

Question 34

What is polio caused by?

Answer 34

enterovirus

Question 35

What is the route through which polio is spread?

Answer 35

faeco-oral route

Question 36

What is the main age group that contract polio

Answer 36

children under 5

Question 37

What is the rate of patients that end up with paralysis

Answer 37

1/200 (0.05%)

Question 38

What is polio a member of?

Answer 38

picornaviridae

Question 39

What sort of RNA does polio have?

Answer 39

positive sense RNA

Question 40

What happens to the RNA in polio?

Answer 40

translated into a large polypeptide which is cleaved post-translation

Question 41

How many strains of polio are there?

Answer 41

3

Question 42

Where is polio more common

Answer 42

Regions like Afghanistan and Pakistan

Question 43

What do subunit vaccines contain?

Answer 43

Isolated antigens

Question 44

Give examples of diseases that use subunit vaccines

Answer 44

Hep B, pneumococcal polysaccharide

Question 45

What is tetanus toixoid

Answer 45

inactivated form of a protein exotoxin secreted by the bacteria

Question 46

What do conjugate vaccines contain?

Answer 46

Capsular polysaccharide conjugated to a protein

Question 47

Give examples of diseases that have conjugate vaccines

Answer 47

Hib, MenC, pneumococcal conjugate vaccines (prevnar 13),

Question 48

How do conjugate vaccines alter the immune response?

Answer 48

TI-2 polysachharide antigen to a thymus dependent TD

Question 49

What is reverse vaccinology

Answer 49

Screening of the whole genome to identify proteins that could be used as vaccines

Question 50

Give an example of a disease that uses reverse vaccinology

Answer 50

Neisseria meningitidis group B

Question 51

How many novel surface proteins were identified in Neisseria meningitidis group B

Answer 51

91

Question 52

How many induced bacterial Ab in Neisseria meningitidis group B

Answer 52

28

Question 53

How many components in the Neisseria meningitidis group B vaccine

Answer 53

4

Question 54

What are some additional conditions that should be considered when developing a vaccine

Answer 54

Inducing the right type of immunity as the wrong type of immune response can do more harm than good

Question 55

Give an example for vaccines causing more harm than good due to the wrong immune response type

Answer 55

1960 vaccine for resp. syncitial virus - vaccinated children suffered more serious infections with RSV

Question 56

What are adjuvants?

Answer 56

A substance administered with an antigen to promote the immune response

Question 57

Why do we no longer use oil adjuvants anymore in humans?

Answer 57

very stimulatory and can lead to necrotic regions

Question 58

Why do we use adjuvants?

Answer 58

Pure antigens often elicit only weak immune responses

Question 59

How do adjuvants enhance immune responses?

Answer 59

Providing a depot and by providing immunostimulatory properties

Question 60

What are the ways adjuvants can act in?

Answer 60

Activate dendritic cells via TLRs or NLRs Cause release of endogenous danger signals Promote antigen uptake by dendritic cells Stimulate release of chemokines/cytokines Promote ‘cross-presentation’ of exogenous antigens by class I

Question 61

What type of adjuvants are used in animals?

Answer 61

Freunds adjuvant: oil in water emulsion Freunds complete adjuvant: also contains mycobacteria

Question 62

What type of adjuvants are used in humans?

Answer 62

alum most commonly used aluminium hydroxide or aluminium phosphate Licensed in 1920s Better for Ab responses than cell mediated immunity

Question 63

What are the more recent clinical uses of newer adjuvants?

Answer 63

MF95 (novaritis_ ASO3 (GSK) ASO4 (GSK) MenB Men ACWY Influenza Shingles RSV

Question 64

What vaccine has had the fastest rate of vaccine development globally

Answer 64

SARS-CoV-19

Question 65

How many vaccines were ready at the clinical trial stage?

Answer 65

183