Medical Immunology (Exam IV Material) Lecture 11

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Medical Immunology (Exam IV Material) Lecture 11
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2015-04-28 21:19:56
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Immunology Vaccines
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PHS 109: Medical Immunology Immunological Memory and Vaccination Parham Ch. 11
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  1. Procedure by which the adaptive immune system is manipulated in an antigen-specific manner.
    Vaccination
  2. How do vaccines work?
    1. Mimic infection by a particular antigen

    2. Stimulate protective immunity (memory)
  3. True or False. Vaccines stimulate protective immunity (memory) by causing disease.
    False.

    Vaccines stimulate protective immunity (memory) WITHOUT causing disease.
  4. Immunological memory is induced by:
    a primary adaptive immune response
  5. Immunological memory is utilized during:
    a secondary adaptive immune response
  6. During a secondary immune response, a pathogen successfully infects a person for the ______.
    second time
  7. During a secondary immune response, a pathogen is NOT cleared by a combination of _______ and existing _________.
    innate immunity; pathogen-specific Ab
  8. Immunological memory is provided by which cells?
    B and T cells
  9. When is immunological memory produced?
    During a primary immune response
  10. True or False, immunological memory provided by B and T cells can provide protection for decades or even life.
    True
  11. Immunological memory provided by B and T cells are derived from...
    antigen-activated B and T cells
  12. Specific features of B cell memory:

    Low levels of pathogen-specific Ab's are maintained by what cells that are "long-lived".
    Plasma Cells
  13. Specific features of B Cell memory:

    The half life of Ab's is on the order of_____.
    months
  14. Specific features of B Cell memory:

    Continuous low level of a specific antibody for years or decades, in the absence of infection, relies on continued ______.
    Ab production
  15. Specific features of B cell memory:

    benefit from what two processes that occur during a primary immune response?
    Affinity maturation and isotype switching
  16. Specific features of B cell memory:

    Why is it a good strategy for IgG to have a bias towards the activation of memory B cells over naive B cells?
    Memory B cells are better at dealing with conserved pathogens which do not change their antigens; ex. measles
  17. Specific features of B cell memory:

    What is the drawback when the immune system has an IgG bias for memory B cells over naive B cells?
    The drawback occurs when dealing with highly mutable pathogens; ex. influenza

    Memory will not compensate for a mutated strain; will be as if body is seeing the pathogen for the first time.
  18. What are viral vaccines made from?
    1. whole viruses

    2. viral components
  19. What is variolation?
    An innoculation procedure developed in the eighteenth century where a dried pustule from a person with small pox is taken and administered to someone who has not had small pox.
  20. What are the routes of variolation?
    intranasal and intradermal (via scratch on arm)
  21. What was the rate of deaths in patients infected with small-pox?

    What was the rate after variolation?
    1. 1 out of 4 died

    2. 1 out of 100 died after variolation (they contracted small-pox)
  22. Who discovered vaccines?
    Edward Jenner (late 18th century)
  23. What was the first vaccine derived from?

    What did it provide protective immunity from?
    1. cow pox

    2. provided protective immunity from small-pox
  24. Cowpox is a ______ disease in humans than smallpox. Vaccination is _______ than variolation.
    much less severe; much safer
  25. What was a vaccination originally referred to?
    The inoculation of cowpox; now it is referred to the general process regardless of pathogen
  26. What is the latin derivative of vaccination and what does it mean?
    Vaccination comes from the latin word, "vaccus" meaning cow.
  27. Name three types of vaccines.
    1. Killed/inactivated

    2. Live/attenuated

    3. Subunit
  28. Define killed/inactivated viral vaccine.
    1. virus in a vaccine that is no longer able to replicate; ex. influenza, rabies
  29. Define live/attenuated viral vaccine.
    1. Virus that can still replicate but not as well as normal disease causing virus.

    2. Elicits a stronger immune response than killed/inactivated virus vaccine

    3. Ex measles, mumps, yellow fever
  30. Define subunit vaccine.
    1. Subunit vaccines consists of only the antigenic components of a virus and NOT the intact virus

    2. Ex. Hep B virus; HBV vaccine can made recombinantly by inserting the relevant portion of the virus into Baker's yeast protein
  31. What three viruses are on the "wish-list" for vaccines and why are they difficult to design vaccines for?
    1. HIV - it can evade the immune system

    2. Hep C - many infected hosts do not make a vigorous primary or adaptive immune response before it leads to chronic inflammation, scarring and liver failure

    3. Common cold - too many different strains
  32. What three ways are bacterial vaccines made?
    1. Whole bacteria

    2. Bacterial toxins

    3. Capsular polysaccharides
  33. What are two types of whole bacteria vaccines?
    1. Bacille Calmette-Guerin (BCG) - made from a bovine strain of Mycobacterium tuberculosis

    2. Attenuated Salmonella Typhi
  34. In regards to bacterial toxins, how do toxins elicit a response and what is the general premise behind the function of bacterial vaccines.
    Bacteria secrete bacterial proteins that have a toxinogenic effect on the host. If you block the toxin from its target, you block the disease state.

    Therefore, a toxoid (inactivated toxin) is used, which stimulates antibodies to bind to the toxin preventing the toxin from binding to its target.
  35. What are two examples of toxoids used in bacterial vaccination?

    What do these vaccines contain?
    1. DTP (Diphtheroid toxin; Tetanus toxin; killed Pertussis bacteria)

    2. DTaP (Diphtheroid toxin; Tetanus toxin; Pertussis TOXOID + antigen but NO intact bacteria) aP = acellular pertussis
  36. Many pathogenic bacteria have _______ capsules.
    polysaccharide
  37. How does the capsule affect the way the immune system responds to pathogenic bacteria?
    Capsules prevent fixation of complement via alternative complement pathway; Capsules make bacteria more pathogenic.
  38. What is the goal of capsular polysaccharide vaccines?
    The goal of capsular polysaccharide vaccines is to produce capsule-binding antibodies that can that can fix complement via the classical complement pathway.
  39. Vaccines composed purely of polysaccharides invoke what type of response?
    Vaccines composed purely of polysaccharides invoke a feeble T-cell—independent B-cell response.
  40. What is the strategy for using a vaccine composed purely of polysaccharides?
    The polysaccharide is chemically bonded (conjugated) to an immunogenic protein that can elicit a T-cell—dependent B-cell response
  41. Describe the immune response when the body is introduced to a capsular polysaccharide vaccine (conjugate).
    The conjugate vaccine gets phagocytose and processed.  Then peptide from the protein components get loaded and displayed on MHC II. This leads to a T-cell response.

    T-cells can then give help to B-cells in generating a strong humoral antibody response vs. the bacterial polysaccharide.
  42. What are examples of capsular polysaccharide vaccines (conjugate vaccines)?
    1. Haemophilus influenza (meningitis, pneumonia)

    2. Streptococcus pneumoniae (meningitis, pneumonia)

    3. Neisseria meningitidis (meningitis)
  43. Define what an adjuvant is.
    An adjuvant is a substance that induces inflammation by antigen-dependent mechanisms.

    Adjuvant translates to "helper", which induces inflammation to help the body generate an adaptive immune response vs. antigen.
  44. What are examples of adjuvants?
    1. Pertussis - DTP vaccine acts as an adjuvant for diphtheria and tetanus toxins

    2. Alum (form of aluminum hydroxide)
  45. Which adjuvant was the only adjuvant approved for human use in vaccines in 1924?
    alum (form of aluminum hydroxide)
  46. What portion of the DTP vaccine is considered an adjuvant?
    Pertussis
  47. New adjuvants have been developed in the last two decades that are agonists of what?
    Toll-like receptors (TLRs)

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