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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
Q

What does T helper cell stimulate?

A

Stimulate B cells to produce antibodies Activate phagocytes to destroy pathogens

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26
Q

What do cytotoxic T cell do?

A

Recognise and destroy infected cells

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27
Q

Memory T cells

A

Increases frequency of cells (100-1000 fold higher) Increased survival characteristics e.g. increase in BCL2 Can be re-stimulated much more easily

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28
Q

What is principle of costimulation?

A

Provokes longer lasting immunity

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29
Q

What do CD4 produce?

A

Interferons

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30
Q

429BC

A

Thucydides recognise that people who survive “small pox” do not get re-infected

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31
Q

900AD

A

Chinese discover variolation

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32
Q

Variolation

A

Expose healthy people to tissue from scab from patients with small pox by putting dabs under skin or up nose

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33
Q

Varius

A

Spotted

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34
Q

Varus

A

Pimple

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35
Q

1721

A

Variolation arrives in England

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36
Q

1796

A

Edward Jenner discovers vaccination

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37
Q

Edward Jenner

A

Used pus from blisters of patients with cowpox

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38
Q

result

A

If those ‘vaccinated’ contracted cowpox, it was a less severe disease than small pox

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39
Q

1880

A

A vaccine against Rabies (Louis Pasteur)

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40
Q

1920

A

Vaccine becomes widely available

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41
Q

1980

A

Smallpox eradicated from world

42
Q

Vacca

A

Cow

43
Q

What are viruses that cause cowpox called?

A

Vaccinia

44
Q

Define vaccination

A

The administration of vaccinia virus to humans

45
Q

What is vaccination?

A

Take vaccine and inject individual

46
Q

What is immunisation?

A

Process of developing immunological memory through vaccination or by natural infection

47
Q

Why small pox?

A

Major killer Highly infectious High mortality

48
Q

What is R0?

A

Number of cases one case generates on average over the course of its infectious period

49
Q

What are features of effective vaccine?

A

safety Protection Longevity Neutralising antibodies Practicality

50
Q

Safety

A

The vaccine itself must not cause illness or death

51
Q

Protection

A

The vaccine must protect against exposure to antigen

52
Q

Longevity

A

The vaccine should give long lasting protection

53
Q

What are the two types of longevity?

A

Neutralising antibodies - must be induced to protect against pathogens Protective T cells - must be insect to protect against pathogens such as TB

54
Q

Practicality

A

The vaccine must be cheap to produce and easy to administer

55
Q

Who does hers immunity give protection to?

A

New-born babies Elderly people Too sick to be vaccinated

56
Q

What are 3 types of vaccine?

A

Active immunisation Passive immunisation Modern vaccine

57
Q

Active immunisation

A

Inactivated vaccine (heat-treated) Attenuated vaccine (weaker strain)

58
Q

Passive immunisation

A

Receiving antibodies Transfer of maternal antibodies from mother to baby

59
Q

Modern Vaccine

A

Recombinant peptide vaccine DNA vaccine Therapeutic vaccines

60
Q

Receiving antibodies

A

Counteract insect/animal

Venom (e.g. spider or snake venom) Horse serum is used

61
Q

What are problems associated with passive immunity ?

A

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
Q

Active immunisation

A

Endogenous generation of protective immune response following exposure to antigen (e.g. vaccination or infection)

63
Q

Passive immunisation

A

Transfer of antibody from one individual to another The antibodies are not made by the recipients

64
Q

Types of vaccine

A

Whole organism: live but attenuated, killed/ inactivated Subunit: peptide, polysaccharide, conjugate

65
Q

Issues with live vaccine

A

although attenuated - potential to cause disease The risk of disease is small but increased in immunocomprised individual

66
Q

Jonas Salk

A

Inactivated vaccine Virus marinated in formalin Virus unable to replicate Generates good humoral immunity No chance of disease

67
Q

Albert Sabin

A

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
Q

Examples of inactivated vaccines

A

Diphtheria Whooping cough (pertussis) Tetanus Polio Cholera Influenza
Plague

69
Q

What does inactivated vaccine require ?

A

Neutralising antibodies

70
Q

Examples of Attenuated vaccines

A

Measles, mumps, rubella [MMR] Polio Chicken pox Tuberculosis (BCG) Influenza (FluMist) Yellow fever Rabies

71
Q

What does Attenuated vaccine need ?

A

Neutralising antibodies Cell mediated response

72
Q

What are two routes to producing an antibody response?

A

T-cell dependent T- cell independent

73
Q

T cell dependent response

A

Most common Generates robust, long lasting response

74
Q

T cell independent response

A

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
Q

If neighbouring cells produce cytokines what can B cells class switch to?

A

IgG

76
Q

What kind of infection are patients with dysfunctional or absent spleen predisposed to?

A

Pneumococcus Meningococcus Haemophilus

77
Q

What are pneumococcal used for?

A

Immunise adults at risk

78
Q

What are prevnar used for?

A

Conjugate vaccine that is being introduced routinely childhood immunisation

79
Q

What is conjugation?

A

Process of combining a carbohydrate/polysaccharide to a protein

80
Q

Examples of commonly used peptide conjugates

A

Diphtheria toxin (non toxic e.g. CRM197) Tetanus toxoid

81
Q

Monitorix

A

MenC polysaccharide + Heamophilus type b polysaccharide - each combined to Tetanus toxoid

82
Q

What do polysaccharide vaccine involve and generate

A

B cells and IgM memory

83
Q

Recombinant peptide vaccine e.g. Hepatitis B

A

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
Q

Why are adjuvants used?

A

Proteins on it’s own are poor stimulants of the immune system

85
Q

What do adjuvants do?

A

Trick the immune system into thinking there is an infection

86
Q

What do purified proteins used to generate an immune response?

A

MHC molecules

87
Q

Tetanus toxoid

A

Not immunogenic

88
Q

Tetanus toxoid + aluminium salt

A

Immunogenic

89
Q

Adjuvant I’m presence of cytokines

A

More robust stimulation (costimulatory molecules)

90
Q

Adjuvants

A

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
Q

Which vaccines to use?

A

Depends on risk of exposure/ risk of disease

92
Q

Universal vaccination

A

Routine childhood vaccine schedule

93
Q

Vaccinating at risk group

A

Determined by exposure

94
Q

Employment

A

Healthcare workers - HBV, bat handlers - Rabies

95
Q

Travel

A

Yellow fever, Japanese encephalitis

96
Q

Social

A

MSM - HBV, university students - menACWY

97
Q

What is risk determined by?

A

Consequence of infection

98
Q

What is recommended for immunocomprised individual/ above age of 65?

A

Chicken pox vaccine

99
Q

Immune suppressed

A

Individuals most at risk of developing infection

100
Q

Chronic diseases

A

Cardiac, respiratory, neurological, hepatic

101
Q

Specific immune deficiencies

A

HIV Asplenia Complement dysfunction Solid- organ transplant Post bone marrow transplant

102
Q

Mantoux

A

Delayed type hypersensitivity response

Immunology (20 decks)

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