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vaccines Flashcards

1
Q

What are the forms of antigen for a vaccine?

A 
live-attenuated
inactivated
subunit
peptides
DNA vaccines 
recombinant vaccines 
engineered virus
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2
Q

why is vaccination so effective?

A

it is successful and cost-effective compared to pharmaceuticals

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3
Q

Give examples of diseases that have been reduced significantly from vaccines

A 
diptheria
mumps 
tetanus
pertussis (whooping cough)
smallpox
poliomyelitis
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4
Q

What is Polio?

A

viral disease
causes fever, sore throat, headache, fatigue, stiffness iin the neck and meningitis
can cause paralytic polio and loss of reflexes, pt unable to breathe

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5
Q

Discuss the impact of HIV

A
  1. thousands of new infections every day
  2. economic impact
  3. impact of treatments - very costly for pt
  4. family impact - orphans and breakdown in family structures
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6
Q

Discuss the issues surrounding ebloa

A
  1. highly contagious
  2. new strains emerge
  3. high death rates
  4. spread by travel
  5. bioterrorism
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7
Q

Describe variation for smallpox

A

scratches on the arm were inoculated with pus from a pustule of someone with cowpox

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8
Q

what is the immunological theory?

A

the concept of microorganisms as a source of disease

  1. infection leads to generation of protective substances in the serum (Ab)
  2. protection persisted - memory
  3. protection could be transferred to other subjects by passive immunity
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9
Q

What did Robert Koch realise?

A

that each particular disease was caused by a specific microorganism

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10
Q

What did Louis pasteur do?

A

generated the idea that weakened pathogens could be used to artificially infect subjects

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11
Q

What did Paul Ehrlich do?

A

discovered antibodies - passive immunisation against diphtheria and B cell receptors

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12
Q

What did Mechnikov discover?

A

phagocytosis

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13
Q

What actions do antibodies do?

A
  1. neutralisation of toxins
  2. opsonisation
  3. complement activation
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14
Q

Give an example of natural passive immunisation?

A

transfer of maternal antibodies across the placenta or in breast milk

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15
Q

What is active immunisation?

A

manipulating the immune system to generate a persistent protective response against pathogens (i.e. memory)

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16
Q

What is passive immunisation?

A

transfer of performed antibodies to the circulation

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17
Q

What do antibodies that cross the placenta and in the breast milk protect against?

A 
diptheria
polio
tetanus
rubella
mumps 
streptococcus
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18
Q

What is artificial passive immunisation?

A

Treatment with human IgG or immunoserum

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19
Q

When do we use artificial passive immunisation?

A
  1. people with aggammaglobunlinaemias (B cell defect meaning that they cant produce antibodies )
  2. immune-compromised people/ where exposure could cause complications
  3. when there is no time for active immunisation - short incubation time
  4. when there is acute danger of infection (HBIG - hep B immunoglobulin)
  5. anti-toxins and anti-venins
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20
Q

Give a use for antisera

A

neutralisation of toxins after the immune system has remoeved the primary infection e.g. Clostridium tetani and botulinum

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21
Q

How does the botulinum toxin work?

A

metalloprotease acts inside the nerve terminals and blocks the neurotransmitter release into the synapse by cleavage of the proteins that are responsible for the vesicles to fuse with the pre-synaptic membrane, so neurotransmission is blocked

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22
Q

Give uses of the passive immunisation anti-toxin

A

botulism
tetanus
diphtheria

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23
Q

Give examples of diseases whether passive immunisation is used prophylactically

A

hepatitis
measles
rabies

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24
Q

Give examples of antivenins

A

snake bite
insects
jellyfish

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25
What is innoculation?
introduction of VIABLE organisms into the subject to trigger an immune response and memory
26
What is involved in innate immunity?
IgM - low affinity | germline
27
What does the secondary immune response involve?
rapid and large amounts of high affinity IgG somatic hypermutation T cell help
28
What is somatic hypermutation?
happens in the lymph nodes and is where mutations are caused in the variable region of B cell DNA to increase/ decrease affinity of Abs and increase/decrease specificity of Abs. Those B cells that have an advantageous mutation and can recognise the antigen will undergo class switching and differentiation
29
Why does flu need regular boosting annually?
as it has a rapid onset and infection can start before memory (from a previous infection/vaccine) is activated, so need to maintain high levels of circulating antibody
30
What two types of whole organism vaccines are there?
live attenuated | killed, inactivated
31
Give examples of live attenuated vaccines
TB - BCG vaccine
32
What are the advantages of live attenuated vaccines?
1. sets up transient infection 2. activation of full natural immune response 3. prolonged contact with the immune system 4. memory response in T and B cells 5. prologed and comprehensive protection 6. only single immunisation required - pt compliance
33
What are the disadvantages of live attenuated vaccines?
1. immunocompromised pts may become infected 2. complications 3. reversion to virulent form -- > can lead to serious outbreak 4. refrigeration and transport - live organisms need to be refrigerated - issue in remote areas
34
what are the advantages of killed inactive pathogens?
1. no risk of infection 2. storage less critical 3. wide range of different antigenic components present, so good immune response possible
35
What are the disadvantages of killed, inactive pathogens?
1. lack of T cell involvement, as the humour responses are just activated 2. without transient infection, the immune system can be weak 3. repeated boosters needed -- > pt compliance
36
How are the killed pathogens inactivated?
formaldehyde, not heating as this can alter the shape of the antigens
37
Give examples of subunit vaccines
1. inactivated exotoxins = toxoids 2. capsular polysaccharides 3. recombinant microbial agents 4. peptide vaccines
38
What are the advantages of subunit vaccines?
1. safe as only part of the pathogen is used 2. no risk of infection 3. easier to store and preserve
39
What are the disadvantages of subunit vaccines?
1. immune response less powerful 2. repeated vaccinations and adjuvants needed 3. there is a lot of genetic heterogeneity in the HLA/MHC due to polymorphisms, so people may vary in their response to the antigen - need to choose one where the response is very similar in everyone
40
Give examples of pathogens that produce the symptoms of disease as a result of exotoxins
diphtheria, tetanus and cholera | Corynebacterium diphtheriae/Clostridium tetanus/Vibrio cholerae
41
What is a toxoid?
A toxin that is heated or chemically modified to eliminate toxicity
42
What do capsular polysaccharides interfere with?
blocks opsonisation so interferes with phagocytosis
43
Give features of a capsular polysaccharide?
highly polar hydrophilic (as on the outside of the cell) oligosaccharide repeating units contains the main antigens for immunity against capsulated bacteria
44
Give examples of live attenuated vaccines
TB typhoid MMR Polio sabin
45
Give examples of killed inactivated vaccines
``` anthrax cholera pertussis plague hep A Rabies Influenza ```
46
What is the aim of active immunisation?
achieve long term protection produce memory B and T cells stimulate protective IgG production/ IgA
47
What is an examples of a recombinant protein?
cloning and expression of a single gene in a recombinant host
48
Give examples of a recombinant vaccine
Hep B surface proteins expressed in yeast | HPV virus coat proteins expressed in yeast
49
What is a recombinant vaccine?
The gene that encodes the antigen is inserted into the DNA of an organism and this organism expresses and produces the protein. This is then collected and purified
50
What is a purified protein vaccine?
Cultivation of the pathogen and the purifying the protein produced by the pathogen
51
What are conjugate subunit vaccines?
a polysaccharide (e.g. capsular polysaccharide - a weak antigen) linked to a carrier protein to increase its immunogenicity
52
What are synthetic peptide vaccines?
Proteins are made chemically that imitate the antigenic proteins of pathogens The proteins should bind to Abs B cells and stimulate a T cell response
53
What is an adjuvant?
Any substance added to a vaccine to stimulate the immune system
54
Give examples of adjuvants
1. whole killed organisms 2. toxoids 3. proteins - like in conjugate vaccines 4. chemicals - aluminum slats/paraffin oil
55
What methods to adjuvants use to work?
1. can extend the half life of the immunogen = depot effect 2. chemicals can cause irritation and inflammation 3. toxoids and killed organisms trigger the immune system
56
What are DNA vaccines?
A vector e.g. a plasmid containing the gene to produce an antigenic protein is transfected into muscle cells. The gene is transcribed and translated into a protein that is degraded by proteosomes and then binds MHC I. Tc CD8+ cells bind inducing cell mediated immune response
57
What are the advantages of DNA vaccines?
1. safe esp in immunocompromised people 2. no requirement for complex storage and transport 3. drug delivery simple and can be given as a widespread vaccination programme
58
What are the disadvantages of DNA vaccines?
1. likely to produce mild response and require boosting | 2. no transient infection
59
What is a recombinant vector vaccine?
imitate the effects of transient infection with pathogen but using a non-pathogenic organism - the major pathogen antigens are introduced into a non-papthogenic or attenuated microorganism and introduced into the host
60
What are the advantages of recombinant viral vaccines?
1. produce memory 2. different components can be engineered in 3. safe relative to live attenuated vaccine
61
What are the disadvantages of recombinant viral vaccines?
1. refrigeration needed 2. can cause illness immunosuppressed individuals 3. immune repose to viral carrier negates effectiveness
62
What re the properties of an ideal vaccine?
1. safe 2. induces a suitable immune response i.e. high antibody titre if Ab useful and mucosal immunity if pathogen uses this route 3. generates T cell and B cell memory 4. stable and easy to transport 5. does not require boosting

Immunology (4 decks)

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