immunity and vaccines for exam 3
TRANSCRIPT
SO.... HOW DO YOU FIGHT
BACK?
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HOST FACTORS: WHAT YOU DO TO FIGHT INFECTIONSImmune System Overview
Factors that affects the immune status of the host
age, nutrition, hygiene, etc
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BEFORE THE IMMUNITY...
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OVERVIEW: HOW WE FIGHT INFECTIONS...
www.youtube.com/watch?v=T_4TrNRa3v8Monday, February 27, 2012
THE CELLS...
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INNATE HUMORAL : THE COMPLEMENT
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THE COMPLEMENT SYSTEM & THEIR FUNCTION
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INNATE CELLULAR
MONOCYTES
dendritic cells (antigen presenting cells)
macrophages (ingest foreign cells)
NATURAL KILLER CELLS
releases proteins to kill foreign cells
GRANULOCYTES
mast cells (releases histamines during allergic reactions)
neutrophils, eosinophil, basophils
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DENDRITIC CELLS & ANTIGEN PRESENTATION
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MACROPHAGES
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NATURAL KILLER CELLS
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MAST CELLS
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THE PHILS...
NEUTROPHILS
EOSINOPHILS
BASOPHILS
INFLAMMATION
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ADAPTIVE HUMORAL
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ADAPTIVE HUMORAL
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ADAPTIVE HUMORAL
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ADAPTIVE CELLULAR
B cells
plasma cells = differentiates to antibodies
memory cells = for secondary exposure to antigens
Th
helpers
activates humoral response (immune cells)
Tc
cytotoxic
kills and clears
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B CELLS
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T HELPER CELL
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CYTOTOXIC T CELL
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MHC CLASSES
A. Which T cell will perform
B. Which pathogen type
Intracellular ExtracellularMonday, February 27, 2012
INFECTION BY BACTERIA
Bacterial Infections Are Eliminated By Humoral Immunity
Exception: intracellular bacteria Ex. TB
Antibodies Eliminate Bacteria Or Bacterial Toxins
Opsonization Of Bacteria
Neutralization Of Toxins
Exotoxins (Ex. Diptheria)
Endotoxins (Ex. LPS)
Lysis Of Bacteria Thru Complement Pathway
Bacteria Enter Host Thru
Respiratory Tract, GI Tract, Genitourinary Tract, Skin
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EVASION BY BACTERIA
Some Bacteria Have Pili
Some Bacteria Secrete Adhesion Molecules (Bordetella pertussis)
Immune System Response To Attachment Is IgA
Prevents Attachment
Some Bacterial Evade IgA Thru Proteases That Decrease ½ Life Of IgA
Ex. Haemophilus influenzae
Some Bacteria Avoid Phagocytosis By Surrounding Themselves In A Polysaccharide Capsule. Ex. Streptococcus pneumoniae
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OVERZEALOUS IMMUNE SYSTEM NOT BENEFICIALBacterial Septic Shock
Predominant Cytokines Involved: IL-1 and TNF-α
Source: MΦ
Intracellular Bacteria Cause Granulomas
Extensive Tissue Damage
Ex. Tuberculosis
In Tuberculosis, MΦ Ingest MTB But Cannot Digest It
Eventually Burst - Releasing Bacilli
MΦ And TH1 Cells Form Granulomatous Lesion, Containment+Destruction Of Healthy Tissue
INF-γ and IL-12 Are Crucial In Eliminating Pathogen
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INFECTION BY VIRUSES
The Immune Response Against Virus Is Primarily Mediated Thru Interferons
Double stranded RNA induces production of IFN
Main producers of IFNα and IFNβ are pDCs
TLR-3 (dsRNA); TLR-7 (ssRNA)
Interferons produce an anti-viral state
A state that inhibits viral replication
A state that inhibits viral infection
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Antibody Protection Against Viruses
Antibodies Bind To Viral Surface Antigens
Protect against re-infection
Huge amounts of secretory IgA in lumen block viral attachment
Viral Entry Into Cells Is Mediated Thru Receptors
Influenza virus binds to sialic acid on glycoproteins
Rhinovirus binds to ICAMs
If Receptor Is Blocked, Infection Is Blocked
Oral Polio vaccine Relies On IgA Production
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Antibody Protection Against Viruses
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Antibodies Are Efficient In Preventing Infection
Antibody Protection Against Viruses
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Antibodies Are Efficient In Preventing Infection
Once Infection Has Occurred, Only Cell Mediated Immunity Can Eliminate Infected Cells
Antibody Protection Against Viruses
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Antibodies Are Efficient In Preventing Infection
Once Infection Has Occurred, Only Cell Mediated Immunity Can Eliminate Infected Cells
Examples Of Cell Mediated Immunity
TH1, CTL Are the major participants
Antibody Protection Against Viruses
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Antibody Protection Against Viruses
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TH1 Produce IFN-γ, IL-2, and TNF-α
IL-2 expands CTL-P
IFN-γ induces antiviral state
IL-2 and IFN-γ activate NK cells (first line of defense)
Antibody Protection Against Viruses
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TH1 Produce IFN-γ, IL-2, and TNF-α
IL-2 expands CTL-P
IFN-γ induces antiviral state
IL-2 and IFN-γ activate NK cells (first line of defense)
CTL (cytotoxic lymphocytes)
Peaks 7-10 days post infection
Eliminate virally infected cells
Antibody Protection Against Viruses
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VACCINES & VPD
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THERE ARE 2 WAYS TO PROTECT YOURSELF...A.
B.
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BACTERIAL VACCINESBacteria Disease Antigen Efficacy
Streptococcus pneumoniae
Pneumonia Capsular polysaccharide
85%
Neisseria meningitidis
meningitis Capsular polysaccharide
85%
Hemophilus influenzae
meningitis Capsular polysaccharide
85%
Corynebacterium diphtheriae
Diphtheriae Toxoid >90%
Clostridium tetani tetanus Toxoid >90%
Bordetella pertussis Whooping cough Killed organism >90%
Mycobacterium bovis (BCG)
Tuberculosis Live attenuated 0 – 70 %
Salmonella typhi Typhoid fever Killed/Live attenuated
80%
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IMMUNIZATION FOR INFANTSVaccine Reason for Immunization
BCG Given at the earliest possible age protects against the possibility of infection from
family members
DPT Early start with DPT reduces chance of severe pertussis
OPV Protection against polio increased the earlier the OPV is given
Hepatitis B Early start of HBV vaccination reduces chance of being infected and becoming a
carrier
Measles At least 80% of measles can be prevented by immunization at this age
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SCHEDULEAge Diseases to be immunized against
Birth Tuberculosis
6 weeks DPT; Polio; HBV
10 weeks DPT; Polio; HBV
14 weeks DPT; Polio; HBV
9 months Measles
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SIDE EFFECTS OF BCG30 minutes wheal disappears2 weeks: a small red tender swelling 10 cm appears
3 weeks: swelling becomes a small abscess which then ulcerates
12 weeks: course from vaccination to healing & scarification
SIDE EFFECTS:1. Koch’s phenomenon- an acute
inflammatory reaction appearing within 2-4 days of vaccination
2. Deep abscess at vaccination site – due to subcutaneous or deeper injection (I & D)
3. Indolent ulceration- an ulcer which persists after 12 weeks or > 10cm deep (Tx –INH powder)
4. Lymph node enlargementMonday, February 27, 2012
SIDE EFFECTS DPTSIDE EFFECTS:Fever: many children develop fever after injection , lasting only one day; fever that lasts more than 24 hours after a dose of DPT is not due to the vaccine but to other causes
Local Soreness: Pain or swelling at injection site
Advice/ Management
Antipyretic or tepid sponge bath
Reassure mother that swelling needs no treatment and will disappear within 3-4 days
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SIDE EFFECTS DPTSIDE EFFECTS:Abscess: If this appears a week or more after the injection, it is due to wrong technique. Either the vaccine was not injected deep enough or the needed was not sterile
Convulsions: Very rare; occurs more in >3 months; usually due to pertussis component of the vaccine
Advice/ Management
Incision and drainage is necessary
If convulsions occur, give proper management and do not continue the normal course
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SIDE EFFECTS MEASLES VACCINE
SIDE EFFECTS:Fever and rash: Children may develop fever after 5-7 days from the time of vaccination
Fever lasts only from 1-3 days.Sometimes a mild rash appears
Advice/ Management
Reassure the mother and advise antipyretic for the child
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TETANUS TOXOIDVaccine Minimum age/
intervalPercent
protectedDuration of protection
TT1 As early as possible during pregnancy
TT2 At least 4 weeks later 80% * Infants born to the mother protected from neonatal tetanus; 3 years protection to mother
TT3 At least 6 months later 95% * Infants protected; 5 years protection to mother
TT4 At least one year later 99% * Infants protected; 10 years protection to mother
TT5 At least one year later 99% Lifetime protection for mother; * all infants born to that mother will be protected
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VACCINES AND POLIO ERADICATION EFFORTS (smallpox as model)
Parungao-Balolong 2011Monday, February 27, 2012
MEASLES & HERD
IMMUNITY
thepaltrysapien.com
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EMERGING & RE-EMERGING INFECTIONS
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EMERGING & RE-EMERGING INFECTIONS
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PUBLIC HEALTH PLANNING & INTERVENTION
Disaster and Outbreak Preparedness
Accessibility to Intervention and Good Clinical Management
Environmental Sanitation and Hygiene
Research: Diagnostics, Therapy and Pathogenic Mechanisms
Surveillance and Prevention Control Programs
Health Promotion and Awareness Ads and Campaigns
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END OF BIO 120 LECTURES
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