MODULE 3 - JO'S LECTURES Flashcards

1
Q

where do B cells develop?

A

in the bone marrow

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2
Q

where do B cells get activated?

A

in the spleen or lymph nodes by naked antigen via BCR

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3
Q

what are some of the things B cells can do?

A

secrete antibody

present antigen on MHCII to CD4 T cells to activate them

can class switch (first isotype IgM)

can undergo somatic hypermutation (increasing ab affinity)

undergo clonal expansion

can differentiate in antibody producing plasma cells

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4
Q

how does BCR signal activate B cells with no signalling component?

A

has closely associated signalling components which are the invariant molecules Ig-alpha and Ig-beta

these closely associate with membrane bound Ig (BCR) to transduce signal into B cell

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5
Q

what are the clinical reasons it is important to understand B cell activation?

A

in order to:

develop new cures for cancer (B cell malignancies like lymphoma and leukaemia)

develop new treatments for AI diseases

make new vaccines

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6
Q

what are kinases?

A

enzymes that phosphorylate themselves and other proteins

phosphorylation can generate binding sites for other proteins to allow signal to transmit along chain

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7
Q

what are phosphotases?

A

take phosphate off things stopping signal transduction

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8
Q

what is the first messenger in BCR signalling?

A

naked antigen

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9
Q

what does the BCR consist of?

A

cell surface Ig (with two light and two heavy chains) + invariant signalling proteins Igalpha and Igbeta

Igalpha and Igbeta are connected by a disulphide-link to make them a heterodimer

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10
Q

what does the BCR co-receptor do and what does it consist of?

A

CD21 - complement receptor 2; binds complement-coupled antigen

CD19 - augments signalling through BCR and also recruits PI3 kinase

B cell equivalent of CD4/CD8; decreases BCR signalling threshold by amplifying BCR signals allowing B cells to respond to low levels of antigen

also includes CD81 which trafficks CD19 to cell surface

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11
Q

how and why can BCRs move around on the cell surface?

A

on lipid rafts

clustering together all the molecules is necessary to send a good signal down (I think this is called receptor clustering)

this clustering/aggregation is usually caused by highly repetitive structures e.g. flagellin

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12
Q

what is an example of T cell independent antigen?

A

highly repetitive structures like polysaccharide

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13
Q

how can antigen which is typically T-cell-dependent activate a BCR without T cell help?

A

monovalent soluble antigen can cause the Src family kinase Lyn to ‘disturb’ the actin cytoskeleton which obscures phosphorylation sites and open the BCR allowing signal transduction

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14
Q

how can antigen-bound complement fragments trigger the BCR?

A

antigen-bound complement fragments like C3d or C3b can bind to CD21; the antigen binds to the antibody (membrane bound?) resulting in cross-linking

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15
Q

outline the main intracellular signalling pathway for the BCR?

A

tyrosine phosphorylation is main mechanism by which transmembrane receptors transduce signals

phosphotyrosine residues are recognised by proteins containing the phospho-dependent binding domain SH2

SH2 domain proteins can act to recruit other molecules as enzymes or as transcription factors

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16
Q

what are the main tyrosines responsible for BCR signal transduction?

A

ITIMs (immunoreceptor tyrosine-based inhibitory motifs)

ITAMs (immunoreceptor tyrosine-based activation motifs)

these are found on Igalpha and Igbeta

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17
Q

how do ITAMs get phosphorylated BCR?

A

Src family kinases Fyn, Blk and Lyn associate with Igalpha and Igbeta

when ligand binds BCR and receptor clustering occurs the kinases phosphorylate tyrosines in the ITAMs on Igalpha and Igbeta

this allows Syk (another Src family kinase) to come in and bind the ITAMs on Igbeta too thus activating Syk

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18
Q

what does the Src family kinase Syk do?

A

Syk has two SH2 domains and binds ITAMs on Igbeta

by binding to phosphorylated site Syk becomes activated

Syk then phosphorylates the scaffold protein BLNK which induces formation of a membrane-associated signalling complex called the signalsome

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19
Q

what does BLNK do?

A

has multiple sites for tyrosine phosphorylation

it recruits other SH2 domain proteins to form the multi-protein signalling complex called the signalsome

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20
Q

what are the three pathways that can be activated by BCR signal transduction?

A

PLCgamma2 pathway (main pathway)

PI3K pathway

ERK pathway

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21
Q

outline the PLCgamma2 pathway of BCR signalling?

A

activated by Bruton’s tyrosine kinase (Btk) which gets recruited to the signalsome

this activates PLCgamma2 which then hydrolyses PIP2 into IP3 and DAG

this leads to increased intracellular calcium which cause PKC to get activated

PKC has multiple functions but the main one is activate MAPkinases which leads to TF activation

PKC also activates IKK which turns of inhibitory signal to NFkappB thus activating? it/turning it on

calcium flux also leads to activation of calcineurin which activates the TF NFAT

activation of these TFs leads to increased B cell activation and maturation

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22
Q

outline the PI3K pathway of BCR signalling?

A

phosphorylation of CD19 co-receptor by LYN activates PI3K

this leads to PIP3 production which recruits BCR signalling components to the plasma membrane and activates them

AKT is the main mediator of PI3K pathway and it leads to activation of genes which regulate cell cycle and apoptosis (leads to inactivation genes involved in apoptosis)

AKT activation induces pro-survival genes through IKK and mTOR (controls cell growth and proliferation)

overall the PI3K pathway promotes B cell growth and survival

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23
Q

outline the ERK pathway of BCR signalling?

A

RAS activation leads to ERK phosphorylation and dimer formation which allows it to translocate across nucleus to induce proliferation, survival and differentiation promoting genes

ERK can also be activated by PLCgamma2 pathway

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24
Q

how is BCR signalling negatively regulated?

A

ITIM phosphorylation turns shit off

it recruits phosphotases that dephosphorylate adaptor proteins like BLNK and also activates cellular calcium releases impairing calcium mediated signalling

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25
Q

how is BCR signalling negatively regulated?

A

ITIM phosphorylation turns shit off

it recruits phosphotases that dephosphorylate adaptor proteins like BLNK and also activates cellular calcium releases impairing calcium mediated signalling

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26
Q

what are two key defects of B cell development and differentiation?

A

Bruton’s tyrosine kinase (Btk) deficiency

Igalpha deficiency (agammaglobulinaemia)

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27
Q

what is Bruton’s tyrosine kinase deficiency?

A

Bruton’s disease or X-linked agammaglobulinemia means there is low or no Igs in blood (all isotypes)

Btk gene on X chromosome so only males get it

Btk is a crucial component of the signalsome as it phosphorylates and activates PLCgamma2. If no Btk this means no B cell proliferation, activation or maturation

symptoms include frequent infections and delayed growth

treatment involves regular intravenous gamma globulin and prompt treatment of any cuts/infections

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28
Q

what is Igalpha deficiency?

A

Igalpha crucial signalling component of the BCR

agammaglobulinaemia

symptoms include frequent infections and delayed growth and treatment involves regular intravenous gamma globulin and prompt treatment of any cuts/infections

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29
Q

what are the four key phases of B cell development?

A

BCRs form in bone marrow and B cell precursors rearrange Ig genes

negative selection occurs in bone marrow, immature B cell bound to self Ag is removed

B cells migrate to periphery, mature B cells bound to foreign antigen get activated

activated B cells give rise to plasma and memory cells leading to antibody secretion and memory cells in bone marrow and lymphoid tissue

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30
Q

how do autoreactive B cells get a second chance?

A

light chain encoded by kappa and lambda so if you are autoreactive you get a second chance to express other genes

but if those are still self-reactive you die

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31
Q

what occurs during antigen independent B cell development?

A

this is the first part of B cell development in the bone marrow where you get generation of lymphocyte diversity through Ig gene rearrangement

the B cell precursors here are stem cell, then pro B cell and then pre B cell

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32
Q

what occurs during antigen dependent B cell development?

A

the second half of B cell development which involves immature B cell, mature B cell, germinal centre B cell, memory and plasma B cells

important things which happen here include somatic hypermutation and antibody class switching (these occur once mature B cell binds foreign antigen)

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33
Q

what the fuck is the germinal centre?

A

mostly composed of proliferating B cells and 10% antigen-specific T cells

is very dynamic - grows as immune response increases and shrinks and disappears once infection is cleared

germinal centres generally found in lymph node or spleen

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34
Q

why is it beneficial that IgM gets secreted in pentameric form?

A

IgM gets secreted very early on in infection so tends to have very low binding affinity for antigen as hasn’t undergone somatic hypermutation

so instead its avidity gets increased by having lots of antigen binding points

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35
Q

what is antibody class switching?

A

genes for different isotypes ordered from IgM, IgD, IgG, IgE and then IgA

cytokines can induce RNA transcript production in “switch regions” near the heavy chain segment they preferentially induce (switch regions located just ahead of isotope genes)

so basically excises DNA for that isotope allowing the next to be expressed

once this DNA excised B cell cannot go back to making that isotype

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36
Q

how do switch regions allow class switching?

A

switch region sequences cause formation of secondary DNA structures that promote pausing of RNA polymerase II and binding of activation-induced deaminase (AID) which then introduces DNA breaks

AID can only bind ssDNA (like where gene transcription is occurring and RNA poly II has been paused)

AID also only expressed in activated B cells (it gets upregulated on activation)

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37
Q

how does AID drive somatic hypermutation?

A

AID works by deamination of cytosine to uridine which causes the mismatch repair system to try repair this resulting in point mutations (somatic hypermutation) and the good ones which increase affinity are selected for (affinity maturation)

this occurs in the IgV (variable) regions which encode protein that binds antigen

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38
Q

how does AID drive class switching and how is this different to the way it drives somatic hypermutation?

A

AID deaminates switch region instead of IgV region which results in double stranded breaks

repair mechanism for ds breaks just excises out the affected area and any genes (for any isotope) within that get lost

this means that once this DNA is looped out you can’t get those genes back and express that class of Ig and the next class on will be expressed

so the excising of these ds breaks allows for class switch recombination and the expression of new classes of antibody

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39
Q

how do cytokines regulate class switching?

A

cytokines regulate the gene transcription of switch regions

e.g. IL-4 enhances gene expression of switch region ahead of IgE so AID will deaminase this one

prob coming from an antigen-specific T cell in the germinal centre

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40
Q

what genes are expressed in a naive B cell and what happens when you add LPS and IL-4 to it?

A

recombined VDJ region encoding variable genes and also constant genes encoded by Cmew and Cdelta (making IgM and IgD)

if you add LPS these genes get upregulated but if you add IL-4 too you start to see gene expression in switch regions preceding IgG1 and IgE

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41
Q

outline somatic hypermutation?

A

occurs after antigen-driven B cell activation as part of germinal centre response and after receiving T cell signals

involves the introduction of point mutations to rearranged V region genes, ones that increase antigen affinity outcompete the others

50% chance that B cell will acquire a mutation in antibody it encodes at each division

requires activation of AID which deaminated DNA leading to base pair mismatches, lesion repair induces mutations

doesn’t have the same sequences that pause RNA polymerase II as switch regions do, no-one knows how it occurs in IgV gene for somatic hypermutation

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42
Q

how do 3’ enhancers ensure AID recruitment is specific to the discussed regions?

A

3’ enhancers after C regions enable chromosomal looping and this forms transcriptional domains that control transcriptional levels enabling AID to bind

without the 3’ enhancers there is no somatic hypermutation or class switching

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43
Q

what antibody isotype is best at opsonisation?

A

IgG1

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44
Q

what antibody isotype is best at sensitisation of mast cells?

A

IgE

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45
Q

what antibody isotype is best at complement activation?

A

IgM

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46
Q

what are the key functions of antibody isotypes?

A

neutralisation

opsonisation

sensitisation of mast cells

complement activation

each isotype is good at some of these to varying extents i.e. they all have different roles

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47
Q

how are antibody isotypes distributed?

A

distribution varied as they go different places to exert function

only ones that get through to placenta are IgG isotypes

all are found in serum

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48
Q

what are the two cells which exhibit B cell memory?

A

plasma cells

memory B cells

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49
Q

what are the differences between short-lived and long-lived plasma cells?

A

short-lived plasma cells reside in the lymph node or spleen

long-lived plasma cells reside in the bone marrow where they receive survival signals from stromal cells so that they can last months. These are a source of long lasting high affinity class switched antibody

both are antibody factories

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50
Q

what are memory B cells?

A

arise from germinal centre reaction (occurs in lymph node or spleen) and have inherited the genetic changes from this meaning they express high-affinity antibody and have undergone antibody class switching

they express higher levels of MHCII and co-stimulatory molecules than naive B cells so that they are ready to interact with T cells

thye populate the spleen and lymph nodes and circulate through the blood and divide slowly if at all and express surface Ig but do not secrete antibody and quickly generate antibody producing plasma cells if they re-encounter antigen

most current vaccines rely on B cell memory

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51
Q

what are memory T cells?

A

long-lived cells which survive after the contraction of effector phase resulting in a higher precursor frequency

have different activation requirements making them much easier to activate and respond upon reinfection and this also means different cell surface proteins from naive and effector cells

cytokines IL-7 and IL-15 important for memory T cell survival as well as periodic contact with MHC-peptide

divide more frequently than naive T cells

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52
Q

why are memory T cells better than naive?

A

proliferate more than naive T cells and in response to lower amounts of antigen

require less co-stimulation for activation than naive cells

produce cytokine faster and retain their polarised phenotype

may be strategically positioned in the tissue where the pathogen is most likely to be re-encountered

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53
Q

compare and contrast central and effector memory T cells?

A

central memory - express lymph-node homing molecules, slower than effector memory cells to produce cytokine, generally found in secondary lymphoid tissues e.g. spleen, lymph-node

effector memory - lack lymph-node homing molecule expression, rapidly produce cytokine upon antigenic stimulation, generally found circulating blood and tissues (might pass through lymph-node briefly)

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54
Q

what were key discoveries made regarding memory T cells?

A

discovery that lymph node homing molecules CCR7 and CD62L are co-expressed on a subset of CD4 and CD8 memory T cells

discovery that Tem persist in tissue and are functionally superior to Tcm

discovery of Trm subset as after infection memory CD8+ cells remain in tissues after infection clears without recirculating

55
Q

what are tissue resident memory T cells?

A

lack lymph-node homing molecule expression, express the integrin CD103 and CD69 (help them locate and stay in tissue)

do not recirculate in blood

rapidly produce cytokine upon antigenic stimulation

could provide a problem for vaccination efficacy

56
Q

what T cells will you find in blood?

A

naive T cells

central memory cells (Tcm)

effector memory cells (Tem)

WON’T FIND RESIDENT MEMORY CELLS (Trm)

57
Q

what T cells will you find in a secondary lymphoid organ such as a lymph-node?

A

naive T cells

central memory T cells (Tcm)

resident memory T cells (Trm)

effector memory T cells (Tem) BUT they will leave quickly as they don’t have the signals to be retained there

58
Q

what T cells will you find in the tissues?

A

mostly resident memory T cells (Trm)

also some effector memory T cells (Tem)

won’t really find any Tcm

59
Q

what can resident memory T cells do upon reinfection?

A

Trm when restimulated can release cytokines that:

  • tell APCs to upregulate con stimulatory molecules and lymph node homing molecules (for quicker presentation)
  • tell NK cells to upregulate granzyme expression

can also possibly proliferate and create new Trm cells

can also possibly directly lyse infected cells

60
Q

what are the three models of memory T cell development and which one is correct?

A

linear model

progressive model

divergent model

there is good evidence that all of them exist

61
Q

what is the linear model of memory T cell development?

A

memory cells develop directly from differentiated effector cells

evidence: adoptive transfer studies show CD4 and CD8 T cells develop into memory populations that retain similar functional polarisations to the effector cells

(adoptive transfer meaning the cells were taken from one mouse and put in another)

62
Q

what is the progressive model of memory T cell development?

A

degree of activation dictates the fate of a cell ( i.e. effector or memory)

evidence: transcriptional profile analysis of naive, memory and effector CD8 T cells generated after vaccination suggest cumulative antigen stimulation drives naive T cells to differentiate into memory T cells, then into terminally differentiated effector T cells

basically low activation = memory cell which can later on become effector, high activation = effector cell and effectors are always terminally differentiated

63
Q

what is the divergent model of memory T cell development?

A

T cells are destined to an effector or memory lineage due to asymmetric cell division

evidence: clustering of receptors and molecules at the immunological synapse causes uneven distribution of cell contents in daughter cells

so all the molecules move around on lipid rafts and so upon activation one end of cell has them all and the other has fuck all and the one with fuck all becomes memory cell

64
Q

how do resident memory cells develop?

A

BAFT3+ expressing DCs drive development of precursors to resident memory cells

reactivated Tcm can also possibly be driven to become Trm (and Tem)

Trm get recruited into the tissue by IFN-gamma producing CD4 T cells and here they get signals to upregulate CD69 and CD103 which are the molecules that tell them to stay the fuck in their place

65
Q

how do we know there is plasticity among memory T cells?

A

Tcm can be driven to become Tem or Trm

66
Q

how do different subsets of memory T cell differ at the transcription factor level?

A

Tcm express TFs TC1 and KLF2 which drive expression of homing molecules CD62L and CCR7 and S1PR1 (allows it to leave lymph node) and also cytokine receptors

Tem express BLIMP-1 which downregulates the Tcm TFs and allows it to express S1PR1 so it too can leave the lymph node

Trm express the TFs HOBIT and NUR77 which downregulates expression of Tcm molecules and upregulates CD69 and CD103 which tells it to stay in the tissue

67
Q

what is trained innate immunity?

A

monocyte recognises pathogen through PRR

this induces epigenetic heritable changes in monocytes which results in broadly specific (cause they don’t have antigen receptors) enhanced protection

innate cells not long-lived but you can get innate immune training occurring in precursors in bone marrow which are sustained and so their daughter cells inherit these changes making them better suited to fight pathogens

evidence: many vaccines have effects extending beyond targeted disease e.g. BCG vaccine significantly reduces infuse mortality

67
Q

what is trained innate immunity?

A

monocyte recognises pathogen through PRR

this induces epigenetic heritable changes in monocytes which results in broadly specific (cause they don’t have antigen receptors) enhanced protection

innate cells not long-lived but you can get innate immune training occurring in precursors in bone marrow which are sustained and so their daughter cells inherit these changes making them better suited to fight pathogens

evidence: many vaccines have effects extending beyond targeted disease e.g. BCG vaccine significantly reduces infuse mortality

68
Q

what is cowpox?

A

causes pustular lesions on skin

first thing someone vaccinated for on some random 8 year old using variolation (giving a small bit of infected matter to healthy individual to give small but controlled infection)

69
Q

what does a vaccine do?

A

induces memory without causing disease

70
Q

what are the five types of vaccine?

A

protein (subunit) + adjuvant

DNA (not used in humans) or RNA vaccines

virus vectors (adenovirus, modified vaccinia)

virus-like particles (VLP)

inactivated pathogens (killed or live but weakend)

71
Q

what are the two routes of vaccination?

A

oral

by injection (intradermal or intramuscular)

72
Q

what are the features of an effective vaccine?

A

safe

induces protection from pathogen

gives sustained protection

induces neutralising antibody (essential to prevent infection of irreplaceable cells like neurons)

induces protective T cells

practical considerations e.g. low cost, stability for transport etc.

73
Q

what things need to be considered when designing a new vaccine?

A

the desired immune response

route of vaccination (think of Trm cells)

mode of delivery

type of vaccine (desired antigen and antigen form)

type of adjuvant

74
Q

what are some improvements on the usual vaccine delivery method (shove a needle into you) and why are they improvements?

A

needle-free delivery (e.g. oral vaccination which can be good at inducing mucosal immune response)

dermal delivery (micro needles)

these are potentially safer, cheaper, more effective and more palatable to the public than intramuscular delivery

75
Q

why is dermal delivery so effective?

A

there’s a shit load of APCs in our skin

76
Q

what are the four types of dermal delivery?

A

transcutaneous (patch + pretreatment w microneedles or abrasion)

epidermal (microneedles, jet injectors)

intradermal (fine syringes, microinjection)

percutaneous (multiple-puncture with short needles)

77
Q

what are the two forms of microneedles?

A

hollow

solid

78
Q

outline the benefits of intradermal delivery?

A

easier administration

reduced risk of sharps injuries

easier disposal

potentially improves immunogenicity

finding better methods of vaccination is important as:

reduced dose and cost per course

increased availability of limited antigens

avoidance of adjuvants

79
Q

what do mucosal delivery vaccines use?

A

virus-like particles

liposomes

synthetic polymers

lipids

attenuated organisms

79
Q

what do mucosal delivery vaccines use?

A

virus-like particles

liposomes

synthetic polymers

lipids

attenuated organisms

80
Q

why might mucosal delivery be better for vaccinating for respiratory disease?

A

resident memory cells

81
Q

what are adjuvants?

A

TLR and NLR agonists including:

  • alum (triggers inflammasome)
  • MPL (TLR4 agonist)

or can be toxins like pertussis toxin (downregulates Treg activity)

some are better at inducing different type of responses than others - important to find right one

82
Q

why is it important to induce the correct immune response through vaccination?

A

to prevent disasters like the FI-RSV vaccine disaster from occurring

83
Q

what is bronchiolitis?

A

infants bronchiole walls swell and obstruct the airway

caused by RSV (respiratory syncytial virus) which is ssRNA and -ve sense genome

epidemics occur in winter and kill 1/1000 infected infants

84
Q

what are the best recognised antigens on RSV?

A

fusion protein (F)

attachment protein (G)

85
Q

what was the RSV vaccine disaster?

A

despite the inactivated RSV vaccine inducing high antibody titres, many vaccinees required hospitalisation upon viral exposure and 2 infants died

so basically the FI-RSV vaccine exacerbated disease

post mortem findings: extensive bronchopneumonia and moncytic and eosinophilic infiltration

86
Q

why did the FI-RSV vaccine exacerbate disease?

A

virus was strong TLR4 activator

formalin inactivated virus in vaccine didn’t activate TLR4 so there wasn’t much antibody affinity maturation - vaccine produced low avidity antibody response

this was in conjunction with a strong CD4+ T cell response and no cytotoxic CD8+ T cell response which led to formation of antibody complexes which activated complement

complement and the CD4+ T cell response drove a huge but unsuccessful inflammatory response in the lungs

87
Q

what are considered to be the big three disease requiring vaccines (prior to COVID)?

A

HIV

TB

Malaria

88
Q

why is it difficult to create vaccines for the big three?

A

HIV - high glycosylation, low rate of natural immunity, prob requires CD8 T cell and neutralising antibody response which is difficult

TB - low rate of natural immunity, increasing IFN production does nothing

Malaria - natural immunity is short-lived

it is also difficult to find adequate animal models which mimic the infection in humans

89
Q

overall to design a new vaccine what do you need to consider?

A

the desired immune response (safety)

route of infection

mode of delivery

type of vaccine (desired antigen and antigen form)

type of adjuvant

90
Q

what is SARS-CoV-2?

A

causes COVID-19

mostly spread through respiratory aerosols

important features are:

spike protein (virus derived, needed to infect host cell by binding ACE2 receptor)

virus envelope (derived from host cell it buds out of)

nucleic acid (RNA) coated with protein

91
Q

how does SARS-CoV-2 infect cells?

A

it must bind to the human cell surface protein ACE2 receptor using its spike protein

the virus then enters the cell and hijacks the cells machinery to reproduce making thousands of new viruses

92
Q

how do antibodies stop SAR-CoV-2 from infecting cells?

A

antibodies that stop this are anti-spike antibody

they bind spike proteins on virus so it can no longer bind ACE2 receptor

93
Q

how do T cells help fight SARS-CoV-2?

A

cytoxic T cells can lyse infected cells (virus inside uncoated so non-infectious)

94
Q

how do T cells help B cells make antibody?

A

CD40-CD40L interaction between T and B cells important for augmenting B cell response where class switching and somatic hypermutation happens

cytokines produced by T cells direct B cells to correct antibody isotype they need to be producing

95
Q

how do RNA vaccines prevent COVID-19?

A

contain lipid nanoparticles with mRNA inside encoding SARS-CoV-2 full length spike protein with two proline mutations that lock the spike trimer into a pre-fusion conformation

upon binding ACE2 (can also happen spontaneously) the normal spike trimer is cleaved and folds irreversibly into post-fusion conformation - no use making antibody for this conformation

these lipid nanoparticles move into the cell and the mRNA gets translated

cells begin making spike protein which gets presented to B cells which start making anti-spike antibody

when virus actually infects we ready with the right antibody

96
Q

what is the adjuvant in the SARS-CoV-2 vaccine?

A

the antigen itself

97
Q

what is immune-complex-based disease enhancement?

A

phenomenon when using inactivated virus vaccines where it induces inappropriate immune response making non-neutralising antibody which results in shit loads of inflammation

observed in vaccines against RSV, SARS, MERS, feline coronavirus

one way to prevent this can include using an adjuvant

98
Q

what is antibody-mediated disease enhancement (ADE)?

A

occurs through non-neutralising antibody binding virus and being taken up by Fc receptors of phagocytic cells

so rather than preventing infection you end up inducing infection in phagocytic cells

99
Q

what are the two incorrect immune responses that the covid vaccine had to be careful not to induce?

A

immune-complex-based disease enhancement

antibody-mediated disease enhancement (ADE)

100
Q

what is the correct antibody response you want the covid vaccine to induce?

A

when you get neutralising antibody which prevents spike protein interacting with ACE2

101
Q

what was the paper that looked into mucosal neutralising antibody for the SARS-CoV-2 vaccine?

A

wanted to determine if the intramuscular mRNA vaccine induced respiratory immunity as this is the first site of infection

wanted to find out if vaccination and/or natural infection induced mucosal neutralising antibodies and if these are protective

took blood and bronchoalveolar lavage (BAL) samples from unvaccinated, vaccinated and convalescents

measured antibodies and antibody efficacy

found that vaccination induced as much IgG in blood and BAL as infection, but not as much IgA in BAL as infection (so mucosal IgA response not great after vaccination)

also found that mucosal B and T cell responses not great after vaccination as showed less specificity for virus

also found that a heterologous prime-boost (using two vaccines) more effective than homologous price-boost, especially if different routes of administration for prime and boost

102
Q

what vaccines did they look at in the paper and what ones did they find worked best at inducing mucosal response?

A

protein subunit vax

viral vector vax

mRNA vax

they found that best mucosal response induced by using mRNA prime (administered intramuscularly) with viral vector (Ad5-S vaccine encoding spike) boost (administered intranasally) and it induces mucosal neutralising antibody

103
Q

what were some limitations of the study?

A

small sample size

people of same demographic

they detected mucosal response but no evidence that it actually helps

104
Q

outline how the immune system changes as we age?

A

early on we only have maternal antibody (IgG can move across placenta or IgA in breastmilk) as immune system developing

as you get older the strength of your immune response increase

then drops off once you get very old well Th2 response strength tends to linger

105
Q

what is immunosensescence and what are the. ain things it manifests in?

A

the gradual deterioration of immune system function as you age

this manifests in reduced ability to fight infection, reduced vaccine efficacy and reduced tumour clearance

106
Q

what barriers get weaker as you age and what does this mean?

A

physical and chemical barriers (skin gets weaker and also dryer so less AM properties, mucosal barriers less effective)

this leads to increased incidence and severity of disease

this is also very clear in NZ with demographics around influenza and is why flu vax free for over 65

107
Q

how do shingles and immunosenescence link?

A

shingles is the reactivation of varicella zoster virus presenting as a painful rash

can lead to postherpetic neuralgia, vision loss and hearing loss as well as secondary infections

reactivates in old age as immune system weakens so some old people get vaccinated for this, however vaccine less effective as person older

108
Q

what drives immunosenescence?

A

NOT due to lack of immune cells but due to reduced diversity of adaptive immune cells

  • reduced T and B cell diversity
  • reduced proportion of naive cells
  • oligo-clonal expansion of memory cells

oligo-clonal means restricted clonality (so less clones expanding with memory so less diverse TCRs and BCRs)

109
Q

why is there a decreased T cell function in old people?

A

decreased number of naive T cells in older age

accumulation of CD8 T cells with limited TCR repertoire leading to memory inflation (associated with CMV)

increased proportion of memory T cells

110
Q

why is there a decreased number of naive T cells in older age?

A

progressive decrease in thymic output (called thymic involution)

111
Q

what is the memory inflation associated with CMV seropositivity?

A

because of CMV constantly reactivating your T cells keep getting restimulated so you end up with shitloads of T cells specific for CMV which takes away from your T cell response to other things

112
Q

why do we end up with an increased proportion of memory T cells as we age?

A

virtual memory CD8 cells accumulate which are cells with a memory phenotype but are antigen-naive so not actually that functional

same happens with conventional T cells subsets

113
Q

broadly, why are the immune systems of old people shit and what does this result in?

A

shit cause:

  • decreased thymic output due to thymic involution
  • more inflammatory cytokines produced
  • stem cells biased to myeloid lineage over lymphoid
  • decreased self-renewal and increased DNA damage
  • decrease in naive cells and increase in virtual cells
  • decrease DC maturation so decreased antigen presentation

results in:

  • decreased immune protection
  • decreased poly-function
  • decreased proliferation
  • decreased effector molecule expression and TF expression
114
Q

why do we see decreased B cell function in old people?

A

inefficient memory B cell generation

impaired B cell development due to decrease in numbers of early B cell progenitors (cause of stem cell bias to myeloid) and decreased expression of B cell development genes

alterations in size and composition of BCR expression

115
Q

what does decreased B cell function result in?

A

increased susceptibility to infection

decreased antibody response to vaccination

increased incidence of AI disease

116
Q

how is there a decreased expression of B cell development genes in old cunts?

A

surrogate light chain (SLC) is important for expression of a full functional BCR

less pre B cells expressing SLC in old people leading to immature B cells

this is called decreased B cell genesis

117
Q

how are age associated B cells shit in regard to TLR signalling?

A

they rely on TLR7 or TLR9 signals for formation and activation and don’t respond to BCR signalling alone

because they rely mostly on TLR signalling for formation they often are enriched for autoantibody specificities leading to increased incidence of AI disease

(think about how old cunts get rheumatoid arthritis)

118
Q

what is inflammaging?

A

heterogenous exogenous and endogenous danger stimuli (PAMPs and DAMPs) interact with a limited repertoire of sensors (e.g. TLRs, NLRs)

this results in worse inflammatory responses such as inflammasome activation and type I IFN responses

119
Q

what is the structure/components of mucosal barriers?

A

outer mucus layer (traps microorganisms)

inner mucus layer (lots of cells making AM peptides and IgA)

these layers protect the epithelial cells and also have their own commensal microbiota

120
Q

outline immunity in the respiratory tract?

A

constant exposure to inhaled antigens and allergens and so a common site of infection

so it needs to be able to response to the bad bacteria and not the good and needs to avoid damage as its so important

trachea and bronchi are tolerogenic cause they don’t want to be responding to stuff

in the bronchioles however there are lots of immune cells

in the alveoli there are alveolar macrophages

121
Q

how does ageing effect respiratory immunity?

A

in healthy individual there are type I and II pneumocytes which are important for gas exchange and ALF secretion

there is also lots of alveolar lining fluid (ALF) which protects with pH and AMPs and also preserves cells so they maintain function

however in an ageing individual the ALF is oxidised so less protective

122
Q

what immune cells do we have in the lungs?

A

lots of innate immune cells in lungs and adaptive in draining lymph node - so APCs in the lung can present antigen to adaptive cells in lymph node upon infection and then they come into lung to exert their functions

also have Trms and Tems in lung

have Tcms and Tems in lymph node

123
Q

what are innate lymphoid cells (ILCs)?

A

have no antigen receptors but respond to cytokines the same way CD4 T cell subsets do

ILC1 (th1) makes IFN-gamma and TNF for intracellular infections

ILC2 (th2) makes IL-4, 5, 9 and 13 for worm infections and can cause allergy

ILC3 (th17) makes IFN-gamma, TNF, IL-22, 17 for extracellular bacteria and is associated with chronic inflammation

cytotoxic ILCs are called NK cells! and they produce p/g, IFN gamma and TNF for viruses and cancers

124
Q

outline immunity in the GI tract?

A

often exposed to food antigens and is a common site of infection as a result

needs to be able to respond to bad bacteria and not good

to do this it has a specialised structure to allow antigen sampling and local immune responses

125
Q

outline the specialised structure of the GI tract?

A

gut has villi to increase surface area - these have crypts

crypts have paneth cells making AMPs and goblet cells making mucus which protects epithelia

also has peyers patches (secondary lymphoid tissue) which are packed with adaptive immune cells and sit under M cells

M cells allow adaptive immune cells to translocated through them for antigen sampling

there are also a lot of Tregs in the gut to control inflammation

this makes crypts the most sterile part of the gut

126
Q

how is homeostasis between the good and bad bacteria maintained in the gut?

A

the good bacteria help with digestion and don’t need virulence factors cause don’t need to infect us to survive

so these have no DAMPs resulting in Treg activation through TGF-beta production leading to tolerance in the gut

the bad pathogenic bacteria need to infect us to survive so have DAMPs which PRRs recognise and activate DC’s which make pro-inflammatory cytokines (IL-6, 12 and 23) which cause an inflammatory response from T cells

127
Q

paneth cells constitutively express AMPs, when would they upregulate this?

A

if bacteria not being killed by AMPs this will lead to more TLR and NLR signalling which causes paneth cells to upregulate AMP production

this helps keep things in check without too much inflammation occurring

128
Q

what happens during antigen sampling?

A

M cells translocate antigen to adaptive immune cells sitting underneath them

if this activates APC, it travels to mesenteric lymph node (the draining lymph node for the gut) or activates B cells in peyers patches

B cells can then make IgA (following class switching) and move to the lumen of the gut to fuck shit up

129
Q

what antibody is found in mucosal surfaces?

A

IgA

130
Q

outline memory immunity in the gut?

A

Trm (especially CD8) are found in the gut non-lymphoid tissue

Tem can also move into the non-lymphoid tissue, blood and lymphoid organs

Tcm are in the lymphoid organs

there is plasticity among these memory T cells; BATF3+ expressing DC’s can reactivate Tcm and IFN-gamma producing CD4 T cells recruit them into the tissue where the Tcms upregulate CD69 and CD103

131
Q

what is the effect of ageing on gut immunity?

A

old people get changes in gut microbial communities and decline in intestinal tissue function

this fuels inflammaging which further fucks up the host microbiome (vicious inflammatory cycle)

132
Q

what is a good way of researching gut immunity and intestinal disease?

A

using intestinal organoids which are an in vitro model of the gut