10May06KLVadheim Lecture 21 Types of Vaccines II

10May06KLVadheim Lecture 22 Types of Vaccines III

10May06KLVadheim Lecture 23 The Perfect Vaccine 100% effective Oral dosage form No adverse effects Highly immunogenic –life-long immunity from a single dose –no boosters required Cheap Stable at room temperature –no cold chain required

10May06KLVadheim Lecture 24 Combination vaccines DT DTaP DTaP-HepB-IPV HepA-HepB Hib-HepB MM MMR MMRV

10May06KLVadheim Lecture 25 The Bare Minimum Immunology MedCh 401 Spring 2006 Lecture 2

10May06KLVadheim Lecture 26 Immunology The science of differentiating self from non- self Defense against invaders –Bacterial –Viral –Fungal –Parasitic –Particulate (e.g., slivers)

10May06KLVadheim Lecture 27 Immune system characteristics Specificity Memory Tolerance

10May06KLVadheim Lecture 28 Blood cells RBCs - carry oxygen WBCs - immune cells –lymphocytes –Natural Killer cells –Polymorphonuclear leukocytes (PMNs) –macrophages

10May06KLVadheim Lecture 29 The immune system is... General and specific Innate (natural) and acquired (adaptive) Active and passive –Natural and artificial Cell-mediated and humoral Primary and secondary immune responses

10May06KLVadheim Lecture 210 Some General Immune Responses Fever Malaise Inflammation Localized erythema

10May06KLVadheim Lecture 211 Essential Concepts Active –Produced by one’s own immune system, e.g., development and recovery from disease –More permanent (years) Passive –Produced by other humans or animals and infused, injected, ingested or absorbed into recipient –Transient (weeks to months)

10May06KLVadheim Lecture 212 Active Immunity Natural –Host produces antibodies in response to infection –Host develops protective response to live viral vaccine Artificial –Host produces protective immune response to killed cells, detoxified toxins, etc.

10May06KLVadheim Lecture 213 Passive Immunity Natural –Placental transfer of maternal antibodies (IgG) –Transfer of maternal antibodies via nursing (IgA) Artificial –injection of immune serum from person who has recovered from disease –transfusion of hyperimmune serum from animal

10May06KLVadheim Lecture 214 Summary

10May06KLVadheim Lecture 215 Innate immunity Surface barriers –Skin –Ciliary action of respiratory epithelia –Mucus in respiratory and urogenital tracts –Acid pH of skin secretions –Lysozyme in tears, saliva, perspiration –Extreme acidity of stomach

10May06KLVadheim Lecture 216 Innate immunity II Normal flora –Staphylococcus aureus on skin –E. coli in gut –Candida in vaginal tract –Corynebacteria diphtheriae in laryngeal passage

10May06KLVadheim Lecture 217 Innate Immunity III Macrophages –Kupffer cells - liver –microglia - CNS –mesoangial cells - kidney –osteoclasts - bone Natural killer cells PMNs (and other WBCs)

10May06KLVadheim Lecture 218 Innate Immunity IV Complement system –Enzyme cascade –Not antigen-specific –Enhances phagocytosis –Stimulates inflammation, increasing capillary permeability to increase plasma and complement flow to injury –Can directly lyse cells

10May06KLVadheim Lecture 219 Innate Immunity V Dendritic cells –Langerhans cells –Interstitial dendritic cells –Interdigitating dendritic cells –Circulating dendritic cells

10May06KLVadheim Lecture 220 Acquired Immunity I Cell-mediated - these are lymphocytes –T cells TH2 (Helper) CD4+ - activate T and B cells TH1 (DTH) - role in allergies TC (Cytotoxic) CD8+, aka CTLs - kill cells with foreign Ag on the surface Memory –B cells Plasma cells (produce antibodies) Memory B cells

10May06KLVadheim Lecture 221 Acquired immunity II Active –Develop and recover from disease Passive –Transplacental maternal antibodies (IgG) –Maternal antibodies in human milk (IgA)

10May06KLVadheim Lecture 222 Summary

10May06KLVadheim Lecture 223 Variability of the immune response Avidity (binding affinity) –low for recent infections –high for secondary immune responses Specificity –low for primary immune responses –high for secondary immune responses

10May06KLVadheim Lecture 224 Immunoglobulins IgA - primary antibody in secretions; half- life ~5 days IgM - primary antibody response; half-life 5-10 days IgG - secondary antibody response; half-life days IgD - found on B cell surfaces IgE - bound to mast cells; amplifies immune response

10May06KLVadheim Lecture 225 Antibody functions Opsonization - coating Ag with Ab enhances phagocytosis Steric hindrance - bind to surfaces of microorganisms and prevent attachment to cells Toxin neutralization Agglutination and precipitation - bind to surface of microbes and precipitate them; reduces number of infectious units and enhances phagocytosis

10May06KLVadheim Lecture 226 Antibody functions II Complement activation –induces inflammatory response –attracts phagocytes to site of infection –opsonizes cells with foreign antigens –lyses some bacteria and viruses Antibody-dependent cell cytotoxicity - IgG enables Natural Killer cells to recognize and kill opsonized target cells

10May06KLVadheim Lecture 227 Primary v. Secondary Immune Responses

10May06KLVadheim Lecture 228 When good things go bad... Allergies –Hay fever –Delayed-type hypersensitivity –Anaphylaxis Autoimmunity –MS (CNS) –Amyotrophic Lateral Sclerosis (ALS;  -motor neurons of spinal cord) –Primary biliary cirrhosis (liver)

10May06KLVadheim Lecture 229 Terms to Know Anaphylaxis Antigen Antibodies –types –functions Antigen-presenting cells Allergen Complement WBC v. RBC T and B Memory cells Natural v. artificial responses Active v. Passive responses B, T and Plasma cells Phagocyte