Lecture 28 Flashcards
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briefly describe the hierarchy that makes up the types of immunity
immunity divided into innate and acquired with acquired further divided to passive and active immunity with each having natural and artificial immunity
this type of immunity is geared toward inborn and genetic factors
innate immunity
this type of immunity is a response made by the host. Composed of T cells and antibody
active immunity
this type of immunity is one in which responses are “pre-made”. Composed of antibodies
passive immunity
this is a type of acquired immunity that has its own antibodies
active immunity
this is a type of acquired immunity that has ready made antibodies from other sources
artificial immunity
this type of active immunity takes effect when there is exposure to an infectious agent
natural active immunity
this type of active immunity is used for immunization and when Ags introduced into the body equals vaccination
artificial active immunity
this is a type of passive immunization in which maternal antibodies are used in an immune response like Abs being passed from mother to child
natural passive immunity
this is a type of passive immunization in which antibodies are from other sources and Abs is introduced into the body
artificial passive immunity
infection is what type of immunity mounted response
natural active
vaccination is what type of mounted response
artificial active
transplacental breast milk is what type of mounted response
natural passive
injection of immune system is what type of mounted response
artificial passive
why do we need passive immunity?
protection for immunocompromised
infants have no prior exposure to antigens or mature immune systems
Name the three types of natural passive immunity?
transplacental (IgG)
colostrum (IgG, IgA, IgM)
FcRn (neonatal receptor in placenta and intestine that transfers Ab into circulation)
the level of immunity for a baby is at its lowest point around this time its development?
6 months
artificial passive immunity types?
virus neutralization environmental venom bacterial toxin autoimmune disease terms used also: immunoprophylaxis and antidote
immunity from infection is what type of immune response? this provides what two functions?
natural active immunity
protection from reinfection
boosted immunity from subsequent exposure
vaccine induced immunity is what type of immunity?
artificial active immunity
vaccine induced immunity goal?
induction of sustained immune responses that protect against infection
vaccine induced immunity mechanism?
induction of Ab with enough CD4(strong humoral)/CD8 T(cleans up infection) cell response
vaccine induced immunity factors to consider, 3 types?
timing- infant, adult, senior
immunocompetence of recipient- pregnancy, illness, meds
route- parenteral (intramuscular, intradermal), mucosal
what is important in terms of pediatric timing and why the timing is important for immunization of pediatric patients?
delay until > 2 months
time to develop an immune response required between doses
the immunology of pediatric immunization has these two points to consider
immaturity of the immune system
maternal Ab protects but limits ability of pediatric patient to develop immunogenicity
what is the Prime boost strategy?
repeated exposure by infection or immunization increases the magnitude of protective immunity
what does prime mean in the prime boost strategy?
one’s primary or first exposure to an antigen whether by natural infection or by vaccination
what does boost mean in the prime boost strategy?
second infection; it increases the effectiveness of the immune response due to memory from the adaptive immunity
what factors do we consider for immunocompetence and immunization?
age, pregnancy, immunosuppressed and allergies
how are most immunizations given? what does this induce?
parenterally
IgG and cell mediated immunity and little IgA
Salk and Sabin are what type of vaccines?
Polio
this polio vaccine consists of IM injection of killed virus, induces good serum IgG, IgM, and IgA but no mucosal IgA
The Salk Vaccine (IPV)
this polio vaccine is consists of oral administration of live-attenuated virus. Induced good serum IgG, IgM, and IgA, but also induced good mucosal IgA (nasal and duodenal).
The Sabin vaccine (OPV)
OPV, Rotavirus route of administration
oral immunization
DTaP, DT, Hep B, IPV, Hib, PCV-7
intramuscular immunization
Measles and Yellow Fever
subcutaneous immunization
BCG
intradermal immunization
what factors should we be mindful about when it comes to precautions and failures in vaccination?
target audience
immunocompetence (Age, Immune status, Type of immunity)
what are the four components of vaccines?
antigens
platforms
evaluation technologies
adjuvants/formulations
this enhances the immune response generated to an antigen but not immunogenic by itself but helps the vaccine to become immunogenic?
adjuvant
what are the mechanism of actions for adjuvants?
enhanced delivery of antigen
potentiation of immunity
TLR4, TLR7, and TLR9 agonists; cytokines (IL-2, IL-12 GM-CSF) is what type of adjuvant?
immunologic adjuvant
pathogen has been weakened to make less virulent, but can still actively infect target cells
live attenuated vaccine
pathogen has been made non-infectious by heat or chemical inactivation
killed or inactivated vaccine
what are the two types of vaccine strategies for whole organisms?
live attenuated
killed or inactivated vaccine
BCG
cholera
antibody response
type of vaccine?
live attenuated
polio rabies bacterial rotavirus antibody and cell mediated immune response type of vaccine?
killed or inactivated
this type of vaccine is a modification of toxin to toxoid
subunit vaccine
this type of vaccine treats tetanus, diphtheria, pertussis, DTaP and mounts antibody response
subunit vaccine
this is a type of vaccine in which an antigen with low immunogenicity (bacterial polysaccharide, drug) is linked (i.e. conjugated) to a more immunogenic protein (carrier or from same bacteria).
conjugate vaccine
this type of vaccine treats Haemophilus
influenzae
pneumococcus
meningococcus
mounts a Helper T cell dependent antibody response
conjugate vaccines
this type of vaccine utilizes a pathogen molecule that is chemically synthesized or expressed then administered. Requires an adjuvant or special process
synthetic or recombinant vaccine
this is a vaccine that treats hepatitis and HPV
antibody response
synthetic or recombinant vaccine
this vaccine utilizes a pathogen that is of low pathogenicity without causing the disease of its own, the gene of interest is inserted into the vector then administerd
vector vaccine
this vaccine can be viral or vector based and treats HIV antigen and canary pox
cell mediated and humoral immune response
vector vaccine
this vaccine utilizes a DNA segment encoding the antigen of interest and then constructed in a plasmid and under control of a promoter that generates high production of the vaccine antigen
DNA vaccine
this vaccine is under clinical trials
cell mediated and humoral immune response
DNA vaccine
what makes a good bacterial vaccine?
conjugate the weak Ag (capsule polysaccharide – CPS) to a strong Ag (tetanus or diphtheria toxoid – TT or DT, flagellin, Pseudomonas exotoxin A, LPS)
Toxins and attachment/motility factors (flagella, pili, fimbriae) are good antigens, but polysaccharide capsules are not very immunogenic.
A major challenge – induction of protective immunity against the poorly immunogenic capsule found on many bacteria
name the vaccine based on the following:
mass drug administration (MDA) programs
New vaccine technologies are being applied
parasitic vaccines
name the vaccine off the following:
Obligate intracellular organism
Induction of humoral immunity (antibody) is generally not sufficient.
viral vaccine
what is the purpose of immunopharmacology?
to understand how the mechanism of the drug effects the immune response and the effect of the modulated immune response on the disease
increase the magnitude or duration of an immune response or alter the composition to enhance protection against disease
immunopotentiation
– stimulate host immunity to identify, reject, and destroy tumors. Examples:
Ipilimumab – first in class drug (checkpoint inhibitor); anti-CTLA4 MAb; reverses immunosuppression induced by metastatic melanoma cells
IFN-α – approved for treatment of melanoma, Kaposi’s sarcoma, chronic HBV/HCV infection, and several hematologic cancers
Cancer immunotherapy
use DCs to activate a cytotoxic response against an antigen. For example:
DCs are removed from patient and pulsed with an antigen; Ag presentation and DC maturation is triggered; activated DCs are re-infused into patient
DC-based immunotherapy
amplify existing Ag-specific T cells or generate new ones. For example:
Lymphocytes are removed from patient, T cells are isolated and treated with Ag and IL-2, then given back to patient
T cell-based immunotherapy
reduce the activation or efficacy of immune responses
immunosuppression
what is important to note about pediatric immunization schedule?
Most are delayed until >2 months so maternal immunity can begin to wane
Repeated dosing is needed due to immaturity of the infant immune system
Time is needed between doses to allow development of an immune response
points to note on adult immunization?
1-2 doses 40+ years
tetanus every 10 years; flu vaccine annually
serology check, Hep B titers
Live attenuated vaccines are contraindicated
this vaccine was recalled in 1999 due to cases of intussusception in children
Rotashield
too many vaccines, too much antigen → weakened immune system or misdirected immune responses
vaccine overload
the increased rates of asthma and allergies are because our immune systems are “trying to find something to do” and react to environmental substances in the absence of pathogenic exposures.
hygiene hypothesis
