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Immunology > Lecture 11: Immunological Memory > Flashcards

Lecture 11: Immunological Memory Flashcards

1
Q

Why do we vaccinate people?

A

To prevent disease

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2
Q

What was vaccine-preventable infections associated with?

A

Significant morbidity + mortality

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3
Q

Tetanus

A

81% mortality

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4
Q

Diphtheria

A

10% mortality

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5
Q

Measles

A

550,000 cases per year in USA

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6
Q

Small Pox

A

30,000 cases per year in USA

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7
Q

What was the Spanish Flu?

A

Influenza pandemic of 1918-1919 killed more people than the WW1 Killed more than 25 million people around world Killed more people in US

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8
Q

How does vaccination work?

A

Induce an immune response without causing an infection Expose the immune system to less virulent or inactivated pathogen

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9
Q

What is immunological memory?

A

The ability of the immune system to respond quicker and better to pathogens that have been encountered previously e.g. bacteria and virus

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10
Q

What are the key features of immunological memory?

A

Long lived Maintained in absence of antigen Antigen specific

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11
Q

What is immunological memory a privilege of?

A

Adaptive immune system

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12
Q

Which key components play a role in development of vaccination?

A

Innate immune response Neurrophils Passing antibodies Adaptive immunity

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13
Q

What do natural B cells produce?

A

IgM

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14
Q

What happens if you do not have a good robust immune response?

A

Toxic shock syndrome (overstimulation of T cells through MHC class molecules)

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15
Q

What does bacteria staphylococcus need to produce antibodies?

A

B cell immunity

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16
Q

What is achieved by generating B cell memory?

A

The frequency of antigen specific B cell

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17
Q

Where does class switch occur?

A

Germinal centre

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18
Q

In the germinal centre in which sequence does the antibody class go?

A

IgM —> IgG —> IgA

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19
Q

What is T cell help?

A

Interaction between MHC class II on T cell and CD80/86 on the B cell

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20
Q

What is Antibody-mediated (humoral) immunity?

A

Antibodies produced by B cells/plasma cells

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21
Q

What are the categories of antibody mediated immunity?

A

Neutralisation Antibody dependent cytotoxicity Activation of the classical complement cascade?

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22
Q

What is neutralisation?

A

Preventing vital entry and action of bacterial toxins

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23
Q

What is antibody dependent cytotoxicity?

A

Phagocytes recognise antibodies bound to extracellular pathogens Antibodies have Fc receptors With one side of FAB they attach to pathogen and FC triggers cells like NK cells and cytotoxic cells Cells phagocyte the target bacteria or produce cytokines that can facilitate the process

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24
Q

What is the classical complement cascade?

A

Bind to c1q proteins to antibody-antigen complexes Some of the antibodies have complement receptors and activate the complement cascade Function as a general inflammatory response - perpetuate the response by anaphylatoxins C3A and C5A

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25
What does T helper cell stimulate?
Stimulate B cells to produce antibodies Activate phagocytes to destroy pathogens
26
What do cytotoxic T cell do?
Recognise and destroy infected cells
27
Memory T cells
Increases frequency of cells (100-1000 fold higher) Increased survival characteristics e.g. increase in BCL2 Can be re-stimulated much more easily
28
What is principle of costimulation?
Provokes longer lasting immunity
29
What do CD4 produce?
Interferons
30
429BC
Thucydides recognise that people who survive “small pox” do not get re-infected
31
900AD
Chinese discover variolation
32
Variolation
Expose healthy people to tissue from scab from patients with small pox by putting dabs under skin or up nose
33
Varius
Spotted
34
Varus
Pimple
35
1721
Variolation arrives in England
36
1796
Edward Jenner discovers vaccination
37
Edward Jenner
Used pus from blisters of patients with cowpox
38
result
If those ‘vaccinated’ contracted cowpox, it was a less severe disease than small pox
39
1880
A vaccine against Rabies (Louis Pasteur)
40
1920
Vaccine becomes widely available
41
1980
Smallpox eradicated from world
42
Vacca
Cow
43
What are viruses that cause cowpox called?
Vaccinia
44
Define vaccination
The administration of vaccinia virus to humans
45
What is vaccination?
Take vaccine and inject individual
46
What is immunisation?
Process of developing immunological memory through vaccination or by natural infection
47
Why small pox?
Major killer Highly infectious High mortality
48
What is R0?
Number of cases one case generates on average over the course of its infectious period
49
What are features of effective vaccine?
safety Protection Longevity Neutralising antibodies Practicality
50
Safety
The vaccine itself must not cause illness or death
51
Protection
The vaccine must protect against exposure to antigen
52
Longevity
The vaccine should give long lasting protection
53
What are the two types of longevity?
Neutralising antibodies - must be induced to protect against pathogens Protective T cells - must be insect to protect against pathogens such as TB
54
Practicality
The vaccine must be cheap to produce and easy to administer
55
Who does hers immunity give protection to?
New-born babies Elderly people Too sick to be vaccinated
56
What are 3 types of vaccine?
Active immunisation Passive immunisation Modern vaccine
57
Active immunisation
Inactivated vaccine (heat-treated) Attenuated vaccine (weaker strain)
58
Passive immunisation
Receiving antibodies Transfer of maternal antibodies from mother to baby
59
Modern Vaccine
Recombinant peptide vaccine DNA vaccine Therapeutic vaccines
60
Receiving antibodies
Counteract insect/animal | Venom (e.g. spider or snake venom) Horse serum is used
61
What are problems associated with passive immunity ?
Immunisation effects lasts for as long as antibody remains active The patient makes an immune response against serum (cause serum sickness) Does not give long-lasting protection
62
Active immunisation
Endogenous generation of protective immune response following exposure to antigen (e.g. vaccination or infection)
63
Passive immunisation
Transfer of antibody from one individual to another The antibodies are not made by the recipients
64
Types of vaccine
Whole organism: live but attenuated, killed/ inactivated Subunit: peptide, polysaccharide, conjugate
65
Issues with live vaccine
although attenuated - potential to cause disease The risk of disease is small but increased in immunocomprised individual
66
Jonas Salk
Inactivated vaccine Virus marinated in formalin Virus unable to replicate Generates good humoral immunity No chance of disease
67
Albert Sabin
Attenuated vaccine A live weakened polio virus Virus can replicate - doesn’t cause disease Humoral and cell-mediated immunity Occasional polio in vaccinated patients
68
Examples of inactivated vaccines
Diphtheria Whooping cough (pertussis) Tetanus Polio Cholera Influenza Plague
69
What does inactivated vaccine require ?
Neutralising antibodies
70
Examples of Attenuated vaccines
Measles, mumps, rubella [MMR] Polio Chicken pox Tuberculosis (BCG) Influenza (FluMist) Yellow fever Rabies
71
What does Attenuated vaccine need ?
Neutralising antibodies Cell mediated response
72
What are two routes to producing an antibody response?
T-cell dependent T- cell independent
73
T cell dependent response
Most common Generates robust, long lasting response
74
T cell independent response
Some pathogens evade the immune system by surrounding themselves in carbohydrate coat - invisible to T cells Repeating polysaccharide antigens cause simultaneous ligation of multiple B cell receptors
75
If neighbouring cells produce cytokines what can B cells class switch to?
IgG
76
What kind of infection are patients with dysfunctional or absent spleen predisposed to?
Pneumococcus Meningococcus Haemophilus
77
What are pneumococcal used for?
Immunise adults at risk
78
What are prevnar used for?
Conjugate vaccine that is being introduced routinely childhood immunisation
79
What is conjugation?
Process of combining a carbohydrate/polysaccharide to a protein
80
Examples of commonly used peptide conjugates
Diphtheria toxin (non toxic e.g. CRM197) Tetanus toxoid
81
Monitorix
MenC polysaccharide + Heamophilus type b polysaccharide - each combined to Tetanus toxoid
82
What do polysaccharide vaccine involve and generate
B cells and IgM memory
83
Recombinant peptide vaccine e.g. Hepatitis B
Does not use whole pathogen - reducing risk of side effects Specific gene is removed from the pathogen Gene is added to a culture of yeast A single purified protein is used for the vaccine Mixed with adjuvant
84
Why are adjuvants used?
Proteins on it’s own are poor stimulants of the immune system
85
What do adjuvants do?
Trick the immune system into thinking there is an infection
86
What do purified proteins used to generate an immune response?
MHC molecules
87
Tetanus toxoid
Not immunogenic
88
Tetanus toxoid + aluminium salt
Immunogenic
89
Adjuvant I’m presence of cytokines
More robust stimulation (costimulatory molecules)
90
Adjuvants
Bias towards TH2 antibody response stimulate mucosal immunity (e.g. pertussis toxin or cholera toxin) Bias towards TH1 cell-mediated response (e.g. IL-12) activate dendritic cells and other APC
91
Which vaccines to use?
Depends on risk of exposure/ risk of disease
92
Universal vaccination
Routine childhood vaccine schedule
93
Vaccinating at risk group
Determined by exposure
94
Employment
Healthcare workers - HBV, bat handlers - Rabies
95
Travel
Yellow fever, Japanese encephalitis
96
Social
MSM - HBV, university students - menACWY
97
What is risk determined by?
Consequence of infection
98
What is recommended for immunocomprised individual/ above age of 65?
Chicken pox vaccine
99
Immune suppressed
Individuals most at risk of developing infection
100
Chronic diseases
Cardiac, respiratory, neurological, hepatic
101
Specific immune deficiencies
HIV Asplenia Complement dysfunction Solid- organ transplant Post bone marrow transplant
102
Mantoux
Delayed type hypersensitivity response

Immunology (20 decks)

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