1.17 - Immunization, Types of Vaccines, and Immune Deficiency & iRAT

Name 3 different uses for monoclonal antibody products.

- Diagnosis of certain types of cancer (colorectal, prostate, ovarian, breast) - Treatment of cancer (B-cell chronic lymphocytic leukemia, non-Hodgkin lymphoma) - Prevention of transplant rejection - Treatment of autoimmune diseases (Crohn's disease, rheumatoid arthritis) and infectious diseases

What are 2 ways to produce active immunity?

- Survive infection with the disease-causing form of the organism - vaccination

In what cell lineages might defects causing primary immune deficiencies occur?

- combined lymphoid cell lineage - T- or B-cell lineages separately - lineages producing phagocytic cells and NK cells - cells producing complement components

What are 3 nonimmunologic characteristics that occur in specific immune deficiency diseases?

- platelet deficiency (thrombocytopenia) (Wiskott-Aldrich syndrome) - loss of balance (ataxia) and widened blood capillaries (telangietasia) (immunodeficiency with ataxia telangiectasia) - partial or complete albinism (Chediak-Higashi syndrome)

What are 3 characteristics commonly seen in many immune deficiency diseases?

- recurrent or chronic infections - inability to clear infectious agents after standard antibiotic therapy - unusual infectious agents

During pregnancy, antibodies are transported across the placenta during the last 1-2 months of pregnancy. As a result, a full-term infant will have the same antibodies as its mother and will be protected from certain diseases for up to?

1 year

Name 4 sources of passive immunity.

1. Many types of blood or blood products 2. Homologous pooled human antibody (immune globulin) 3. Homologous human hyperimmune globulin 4. Heterologous hyperimmune serum (antitoxin)

In what 3 populations should live attenuated vaccines be avoided?

1. Those with weakened immune systems 2. Long-term health problems 3. People who've had an organ transplant

Severe problems with recurrent infection and with immune complex-mediated disease can result from a deficiency of what complement protein and why?

C3 because it is in a central position in all 3 of the complement activation pathways

What immune cells are destroyed by HIV?

CD4+ T cells

How is immune globulin (homologous pooled human antibody) produced?

Combining (pooling) the IgG antibody fraction from thousands of adult donors in the U.S., meaning that it contains antibodies to many different antigens

What type of vaccine contains a polysaccharide that is chemically linked to a protein?

Conjuage polysaccharide

Which type of polysaccharide vaccine (conjugated or not conjugated) provides a booster effect?

Conjugate polysaccharide

Which type of polysaccharide vaccine (conjugated or not) produces immunologic memory?

Conjugated

What does it mean when immune globulin is "polyclonal"?

Contains many different kinds of antibodies

Pathology in autoimmune disease may be caused by a number of mechanisms, including: (select all that apply) a. Direct lysis of cells b. Autoantibodies binding to a cell membrane receptor c. Activation of mast cells by IgG antibodies d. Type X hypersensitivity

a. Direct lysis of cells b. Autoantibodies binding to a cell membrane receptor

Which is (are) true regarding secondary immunodeficiency? (select all that apply) a. May occur at any time of life b. Affected individuals are less susceptible to infection c. Caused by congenital defects d. Always involve hypersensitivity

a. May occur at any time of life

Hepatitis A, rabies, and flu and polio shots are all examples of what type of vaccine? a. inactivated b. conjugate polysaccharide c. toxoid d. live attenuated

a. inactivated

Who, in 1796, first introduced the procedure we know as vaccination and is generally credited with its invention?

Edward Jenner

True or False: Autoimmune disease is never systemic and always restricted to one organ.

False

True or False: Inactivated vaccines do NOT require booster shots to maintain immunity.

False

True or False: Like live attenuated vaccines, inactivated vaccines also replicate.

False

True or False: Stress does not affect immune function.

False

True or False: All antibody products can interfere with live-virus vaccines.

False While immune globulins do, monoclonal antibody products specific to one, non-vaccine microbe will not interfere with live vaccines.

True or False: Side effects are very common with subunit-type vaccines.

False, they are less common with these types of vaccines.

True or False: Defects in the alternative pathway and mannan-binding lectin (MBL) pathways lead to increased antibody production.

False, they lead to increased susceptibility to infection.

True or False: Because the live attenuated version is similar to the natural infection, but still a weakened version, it does NOT provide a strong, or long-lasting immune response.

False. Because it is similar to the natural infection it DOES provide a strong, long-lasting response.

True or False: Like immune globulin and homologous human hyperimmune globulin, heterologous hyperimmune serum may contain antibodies to several different antigens.

False. Heterologous hyperimmune serum, aka antitoxin, contains antibodies against only one antigen.

True or False: Various reports indicated that increased levels of iron, zinc, selenium, and vitamins A, B6, C, and E are associated with impaired immune function.

False. REDUCED levels would be correct

True or False: Inactivated vaccines provide stronger immunity than live attenuated vaccines.

False. They do not provide as strong an immune response as live attenuated.

True or False: Polysaccharide-based vaccines include toxoids and subunit or subvirion products.

False. This describes protein-based vaccines.

Which of the following are antibody products that contain high titers of specific antibody? a. homologous pooled human antibody (immune globulin) b. homologous human hyperimmune globulin c. heterologous hyperimmune serum (antitoxin)

b. homologous human hyperimmune globulin

Diphtheria and tetanus shots are both examples of what type of vaccine? a. inactivated b. conjugate polysaccharide c. toxoid d. live attenuated

c. toxoid

Which of the following types of vaccines use toxin made by the pathogen that causes a disease, providing immunity to the part of the pathogen that causes disease rather than the pathogen itself? a. inactivated b. conjugate polysaccharide c. toxoid d. live attenuated

c. toxoid

Primary immunodeficiency may be caused by defects in: a. Lymphocytes b. Phagocytes c. Complement system d. All of the above

d. All of the above

Which of the below is NOT a possible cause of immunodeficiency? a. Malignancy b. Malnutrition c. Infection d. All of the above are possible causes of immunodeficiency

d. All of the above are possible causes of immunodeficiency

The MMR, rotavirus, smallpox, chicken pox, yellow fever, and shingles vaccines are all examples of what type? a. recombinant b. conjugate polysaccharide c. toxoid d. live attenuated

d. live attenuated

Which of the following types of vaccines provides the longest-lasting and strongest immune response? a. inactivated b. conjugate polysaccharide c. toxoid d. live attenuated

d. live attenuated

Which of the following vaccines contains a weakened form of the pathogen that must replicate to work? a. inactivated b. subunit c. toxoid d. live attenuated

d. live attenuated

Which of the following is described as a procedure whereby severe disease is prevented by prior exposure to the infectious agent in a form that does not cause disease? a. inoculation b. paralysis c. infection d. vaccination/immunization

d. vaccination/immunization

Immune globulin is used primarily for post exposure prophylaxis for what 3 diseases/conditions?

Hepatitis A, measles, and tx of certain congenital immunoglobulin deficiencies

Name at least 3 examples of subunit, recombinant, polysaccharide, or conjugate vaccines?

Hib, Hepatitis B, HPV, Whooping Cough, Pneumococcal disease, Meningococcal disease

Serum sickness, common with use of antitoxin for botulism and diphtheria, is an immune reaction to what?

Horse protein (antitoxin is produced in animals, usually horses)

What is the predominant antibody produced in response to most polysaccharide vaccines and what is the consequence?

IgM; Less functional activity than antibodies induced by protein antigens

What is the more common term for homologous pooled human antibody?

Immune globulin

What is described as the ability of the human body to tolerate the presence of material indigenous to the body ("self") and to eliminate foreign ("nonself") material?

Immunity

Some bacteria secrete enzymes that are capable of destroying what 2 kinds of molecules involved in the immune system?

Immunoglobulins and complement components

What term is described by persistence of protection for many years after the infection?

Immunologic memory

Passive immunity is most important source of immunity during what phase of an individual's life?

Infancy; occurs transplacentally

Why does the polysaccharide vaccine only produce short-lived immunity without a booster effect?

It stimulates T-cell INDEPENDENT immunity (stimulates B cells without assistance of T-helper cells)

Antigens, such as viruses and bacteria, can be in what 2 forms?

Live or inactivated

What 2 processes are involved in the direct lysis of cells in the pathology of autoimmune diseases?

Membrane attack complex (MAC) and ADCC

Monoclonal antibodies are produced from a single clone of B cells, so these products contain antibody to how many antigens?

Only one antigen or closely related group of antigens

Because of how HIV destroys CD4+ T cells, the immune system undergoes a gradual decline in humoral and cellular responses, leading to an individual's increased susceptibility to what kinds of infections?

Opportunistic

What 3 events are impaired by defective complement components?

Opsonization, lytic killing of microbes (via MAC) and the ability to induce inflammation

What is the MOA of how cancerous lymphocytes reduce the immune system's ability to respond to different antigens?

Overgrows the rest of the lymphocyte population

Which mechanism for acquiring immunity includes protection provided by products produced by an animal or human and transferred to another human, usually by injection?

Passive

What is an example of a subunit vaccine?

Pertussis component of DTaP

What is the difference in the kind of T-cell immunity stimulated by polysaccharide versus conjugate polysaccharide vaccines?

Polysaccharide vaccines stimulate T-cell independent immunity, whereas conjugate polysaccharide vaccines stimulate T-cell dependent immunity.

Hyperimmune globulins are used for what?

Post-exposure prophylaxis for several diseases, including hepatitis B, rabies, tetanus, and varicella

Fractional vaccines can be based on what two kinds of macromolecules?

Protein or polysaccharide

What kind of immune deficiencies are caused by environmental factors such as infection, therapeutic treatments, cancer, and malnutrition?

Secondary

Vaccination was first used against what infectious disease?

Smallpox

What is a "wild" virus or bacterium?

The original disease-producing organism/pathogen

Defects in phagocytic cells such are significant because?

They have key roles in BOTH innate and adaptive immune responses.

What 2 kinds of therapeutic treatment might result in a suppressed immune system?

Transplant recipients often undergo treatment to inhibit immune responsiveness to prevent rejection of the grafted tissue. Cancer therapy injures the immune system as it targets cells undergoing rapid division.

True or False: A general rule with vaccination is that the more similar a vaccine is to the disease-causing form of the organism, the better the immune response to the vaccine is.

True

True or False: Although repeated doses of most inactivated protein vaccines cause the antibody titer to go progressively higher, or "boost" the immune system, this does NOT occur with polysaccharide antigens.

True

True or False: Certain infections can cause secondary (acquired) immune deficiencies.

True

True or False: Defects in the classical pathway (except for C3) are not associated with significantly increased susceptibility to infection except for those caused by encapsulated bacteria.

True

True or False: Inactivated vaccines contain a killed version of the pathogen and may contain adjuvants to enhance the immune response.

True

True or False: Some bacteria and viruses have mechanisms to protect themselves after ingestion by phagocytes by inhibiting several key phagocyte activities.

True

True or False: Some infectious organisms can influence the entry of naive T cells into either the Th1 or Th2 pathways, whichever is least effective for the clearance of those particular microbes.

True

True or False: Subunit, recombinant, polysaccharide, and conjugate vaccines can be used on almost anyone who needs them, including those with weakened immune systems and long-term health problems.

True

True or False: Subunit, recombinant, polysaccharide, and conjugate vaccines may require booster shots.

True

True or False: T-cell independent antigens, including polysaccharide vaccines are NOT consistently immunogenic in children younger than 2 years of age.

True

True or False: While defects in T-cells may cause abnormalities in B-cell numbers and immunoglobulin production, defects in B-cells typically do not affect T-cell numbers and functions.

True

Defects in regulatory components of the complement system can lead to what?

Uncontrolled episodes of inflammation

A poor response or no response to a vaccine is also known as what?

Vaccine failure

What is the booster effect?

A strong secondary immune response generated by subsequent exposure to an antigen.

Defects in phagocytes and natural killer cells affect what 2 major functions?

Ability to kill microbes and their interactions with other cell types

Which mechanism for acquiring immunity involves production of protection by a person's own immune system?

Active

Which mechanism for acquiring immunity usually lasts for many years and often a lifetime?

Active

What are the 2 basic mechanisms for acquiring immunity?

Active and passive

Immunity to a microbe is usually indicated by the presence of what to that organism?

Antibodies

What are the 2 mechanisms by which autoantibodies binding to a cell membrane receptor contribute to the pathology in autoimmune disease?

Antibody can agonize or antagonize receptors.