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Sumy State University . The D epartment of I nfectious D iseases and E pidemiology with C ourse of M icrobiology, V irology and I mmunology . Immunotherapy and Prevention . T a t y ana Ivakhnyuk 2011. Active Immunization.

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immunotherapy and prevention

Sumy State University

The Department of Infectious Diseases andEpidemiology with Course of Microbiology, Virology and Immunology

Immunotherapy and Prevention

Tatyana Ivakhnyuk

2011

active immunization
Active Immunization

Stimulates the host’s immune system to produce specific antibodies or cellular immune responses or both which would protect against or eliminate a disease.

slide3

Passive Immunization

A preparation of antibodies that neutralizes a pathogen and is administered before or around the time of known or potential exposure.

vaccines
Vaccines

Provide an antigenic stimulus that does not cause disease but can produce long lasting, protective immunity

principles and effects of vaccination

Sterile protection

Non sterile protection

Specific

Specific

Quick

amplification

Pathogen

neutralization

Specific

Clearance of the pathogen

before spreading

Clearance of the pathogen

after infection

Extra cellular pathogens or free intracellular pathogens

Antibody mediated

Intracellular pathogen with cell to cell transmission

Cell mediated

Principles and Effects of Vaccination
slide7

Vaccine technologies

          • Examples
  • Live vaccines polio, yellow fever
  • Recombinant vaccines RSV
  • Killed vaccines influenza, pertussis
  • Plasma derived vaccines Hepatitis B
  • Polysaccharide conjugates Hib, Pneumo
  • Peptide vaccines Malaria
  • Subunit vaccines HIV candidates
  • DNA vaccines Influenza
  • Combination vaccines DPT
  • Passive (antibodies) e.g. HBIG, VZIG
types of vaccines and their characteristics1
Types of Vaccines and Their Characteristics
  • Attenuated whole-agent vaccines use living but attenuated (weakened) microbes. Live vaccines more closely mimic an actual infection. Lifelong immunity, especially with viruses, is often achieved without booster immunizations, and an effectiveness rate of95% is not unusual. This long-term effectiveness probably occurs because the attenuated viruses replicate in the body, increasing the original dose and acting as a series of secondary (booster) immunizations.
slide10

Ideal properties of a live vaccine

Attenuated microorganism which replicates

in the host thus eliciting immune responses

similar to natural infection

Able to elicit lifelong protection using only

one or two doses

Disease causing capacity is virtually eliminated.

Elicits both humoral and cellular immunity

slide11

Examples of Attenuated or live vaccines

Live attenuated vaccines oral polio, yellow fever

mumps, measles, VZV

tuberculosis (BCG)

types of vaccines and their characteristics2
Types of Vaccines and Their Characteristics

Inactivated whole-agent vaccines use microbes that have been killed, usually by formalin or phenol. Inactivated virus vaccines used in humans include those against rabies (animals sometimes receive a live vaccine considered too hazardous for humans), influenza, and polio (the Salk poliovaccine). Inactivated bacterial vaccines include those for pneumococcal pneumonia and cholera. Several long-used inactivated vaccines that are being replaced for most uses by newer, more effective types are those for pertussis (whooping cough) and typhoid.

types of vaccines and their characteristics3
Types of Vaccines and Their Characteristics
  • Toxoids, which are inactivated toxins, are vaccines directed at the toxins produced by a pathogen. The tetanus and diphtheria toxoids have long been part of the standard childhood immunization series. They require a series of injections for full immunity, followed by boosters every 10 years. Many older adults have not received boosters; they are likely to have low levels of protection.
modification of toxin to toxoid example

Tetanus Toxoid

chemical and temperature

modification

toxin moiety

antigenic determinants

Modification of Toxin to Toxoid (example)

Extracellular Toxin

of Clostridiun tetani

Toxin

types of vaccines and their characteristics4
Types of Vaccines and Their Characteristics

Subunit vaccines use only those antigenic fragments of a microorganism that best stimulate an immune response. Subunit vaccines that are produced by genetic modification techniques, meaning that other microbes are programmed to produce the desired antigenic fraction, are called recombinant vaccines.

For example, the vaccine against the hepatitis B virus consists of a portion of the viral protein coat that is produced by a genetically modified yeast.

types of vaccines and their characteristics5
Types of Vaccines and Their Characteristics

Conjugated vaccines have been developed in recent years to deal with the poor immune response of children to vaccines based on capsular polysaccharides.

slide19

Polysaccharide vaccines

Unique type of inactivated subunit vaccine

composed of long chains of sugar molecules

that make up the surface capsule of

certain bacteria.

Available for Pneumococcal disease,

meningococcal disease and

Haemophilus influenzae type b

slide20

Combination vaccines

Examples influenza

trivalent OPV, inactivated IPV

DPT, DPT/Hib, etc.

MMR, MMRV

PnC/MnC

Advantages: only one needle at a visit

may reduce number of visits

reduces costs of administration

geographic tailoring

Disadvantages: loss of immunogenicity due to competition

technically more difficult to produce

higher production costs

higher evaluation costs

correlates
Humoral component

Tetanus

Dyphteria

H. influenzae

Influenza

Measles

Varicella (herpes zoster)

Dengue

S. pneumoniae

Cellular components

BCG

HIV

Herpes type 1&2

Shingles (herpes zoster)

Influenza in elderly

Varicella (herpes zoster)

Measles

Correlates ?
description of immunity
Description of immunity

Postinfection

Postvaccine

Active

Passive

Humoral

Cellular

Antibacterial

Antiviruses

Antitoxins

Antifungal

Specific

Nonspecific

Group specific, species specific,

Type-specific

bcg bacillus calmette guerin
BCG (bacillus Calmette-Guerin)
  • Content:– living or attenuated, liophilic dried up culture unpathogenic strain of M. tuberculosis, was found by the French scientists Calmette and Guerin. Used for the active specific prophylaxis of tuberculosis. Plugged in the calendar of inoculations. Contra-indicated people with violation of cellular link of immunity.

Whattypeofimmunity (originally) iscreatedinanorganismafterintroduction?

Postvaccine

Active

Cellular

Antibacterial

General

Specific

killed brucellosis vaccine
Killed brucellosis vaccine
  • Content:– It contains the killed by heat the cow-type and sheep-type species of the brucella. It is using for immunotherapy by chronic brucellosis. It has high sensibillization and allergic ability and it is using only for patients with normegric reaction of the organism on the intra-skin injection of the brucellin. For the patients with hyperergia and allergic reaction and for person with generalized infection the vaccination is dangerous. The intra-skin therapy is making often then intravenous. The injection of the brucellin is useful for same patients.

Whattypeofimmunity (originally) iscreatedinanorganismafterintroduction?

Postvaccine

Active

Cellular

Antibacterial

General

Specific

meningococcal chemical vaccine
Meningococcal chemical vaccine

Content:This vaccine contains cleared polysaccharide of Neisseriameningitidis group A and C.

Appointment: Prophylaxis of cerebrospinal meningitis, caused meningococcus of serogroupp A and C. Vaccination is recommended in endemic regions, and also in the case of epidemic, caused meningococcus of serogorupp A or C.

Whattypeofimmunity (originally) iscreatedinanorganismafterintroduction?

Postvaccine

Active

Humoral

Antibacterial

General

Specific

staphylococcal toxoid
Staphylococcal toxoid

Content: this vaccine, in which contains inactivated, which help formalin (0,4%) and temperature (56°C) exotoxinS.aureus. It is used for specific preventive and treatment of staphylococcal infections

Whattypeofimmunity (originally) iscreatedinanorganismafterintroduction?

Postvaccine

Active

Humoral

Antitoxic

General

Specific

slide27
APDT

Content:- аdsorbed on the hydrate of oxide of aluminium mixed vaccine, consisting of the killed microorganisms – the whooping-cough bacteria’s and toxoids – diphtherial and tetanic. Used for plannad prophylaxis.

Whattypeofimmunity (originally) iscreatedinanorganismafterintroduction?

Postvaccine

Active

Humoral

Antitoxic

Antibacterial

General

Specific

slide28

Adjuvant activity

  • Formation of a depot of antigen primarily at the
  • site of application from which the antigen is
  • released during a variable period
  • Increased uptake of antigen into APCs
  • Induction of synthesis and secretion of
  • enhancing factors, such as cytokines.
slide29

Adjuvant activity

  • Facilitation of antigen transport, uptake and presentation by antigen-capturing and processing cells
  • Repeated or prolonged release of antigen (depot effect)
  • Signaling of receptors activating innate immune cells to release cytokines which upregulate co-stimulatory molecules
  • ‘Danger signals’ from stressed or damaged tissues activate APCs
  • Signaling by recombinant cytokines or co-stimulatory molecules mimics classical adjuvant activity
immunotherapy preformed ab
Immunotherapy – preformed Ab

Immune serum globulin– (gamma- globulin) contains immunoglobulin extracted from the pooled blood of at least 1,000 human donors

  • Treatment of choice for preventing measles, hepatitis A and replacing Ab in the immune deficient
  • Lasts 2-3 months
immunotherapy preformed ab1
Immunotherapy – preformed Ab

Specific immune globulin- prepared from convalescent patients in a hyperimmune state

  • Contains high titer of specific Ab
  • pertussis, tetanus, chickenpox, hepatitis B
  • sera produced in horses are available for diphtheria, botulism, spider and snake bites
  • act immediately and can protect patients for whom no other useful medication exists
effectors functions of antibodies

Cell

Effectors functions of antibodies

prevent contacts with host cell

  • Neutralization
  • Complement mediated lyses

reduce the pathogen load

Inhibit bacterial toxins

inhibits the pathogen

penetration of the host cell

  • Complement binding è pathogen destruction
antianthracis gamma globulin
Antianthracis gamma-globulin
  • Content:preparation contains antitoxins. It is gamma-globulins fraction of serum of the hyperimmunized animals. There is the diminished amount of ballast matters in such preparation, that diminishes probability of development of by-reactions, above all things allergic substantially

Whattypeofimmunity (originally) iscreatedinanorganismafterintroduction?

Passive

Humoral

Antibacterial

General

Specific

antidiphtherial antitoxic serum
Antidiphtherial antitoxic serum
  • Content:preparation is got by hyperimmunization of horse a diphtherialtoxoid. Effective mean of specific therapy of diphtheria. At the use it should be remembered rules of introduction of heterogenic serum, to eliminate development of anaphylactic shock and serum illness.

Whattypeofimmunity (originally) iscreatedinanorganismafterintroduction?

Passive

Humoral

Antibacterial

General

Specific

sources of passive immunity
Sources of Passive Immunity
  • Almost all blood or blood products
  • Homologous pooled human antibody (immune globulin)
  • Homologous human hyperimmune globulin
  • Heterologous hyperimmune serum (antitoxin)
classification the serum preparations
Classification the serum preparations
  • homogeneous serum: serum obtained from blood donor volunteers, have been immunized.
  • heterogeneous serum: serum obtained from blood of animals hyperimmunized.
hypersensitivity reactions by injection of the heterogeneous serum
Hypersensitivity reactionsby injection of the heterogeneous serum
  • Anaphylactic shock

Type I, or anaphylactic, react ions often occur within 2 to 30 minutes after a person sensitized to an antigen is reexposed to that antigen. Anaphylaxis means opposite of protected," from the prefix ana-, meaning against, and the Greek phylaxis, meaning protection. Anaphylaxis is an inclusive term for the reactions caused when certain antigens combine with IgE antibodies.

Anaphylactic responses can be systemic reactions, which produce shock and breathing difficulties and are sometimes fatal, or localized reactions, which include common allergic conditions such as hay fever, asthma, and hives (slightly raised, often itchy and reddened areas of the skin).

  • Serum Sickness

This is a systemic form of hypersensitivity of immediate reaction. It appears 7 to 12 days following single injection of high concentration of foreign serum

the mechanism of anaphylaxis
The mechanism of anaphylaxis

IgE antibodies, produced in response to an antigen (heterogenic antibody), coat mast cells and basophils. When an antigen bridges the gap between two adjacent antibody molecules of the same specificity, the cell under goes degranulation and releases histamine and other mediators.

bezredka method
Bezredka method
  • Bezredka method (A.M. Bezredka, a microbiologist, was born in Russia, worked in France, 1870-1940) - a specific method of desensitization of the body that is used to prevent complications after the administration of heterogeneous serums.
bezredka method1
Bezredka method

Heterologous hyperimmune sera (eg, antibotulinum, antitetanus, etc.) are highly concentrated; for desensitization recommended minimum dose. While under the influence of serum antigen occurs, neutralizing antibodies, fixed on the cell surface, and a decline in blood concentrations of physiologically active substances (histamine, etc.) that prevents the development of complications after re-introduction of the antigen.

slide41

Thank you for

your attention!

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