Microbio Test 4 [Part 4+5]

B-Cell Action in the Adaptive Response: Humoral immunity - B cells usually receive chemical messages from TH2 cells and then undergo clonal expansion - some Bs turn into activated B cells which are called ____________ cells - plasma cells grow rapidly and release ________________ that _________________________________ - response made to ____________________ pathogens

- plasma - antibodies - circulate in the blood - extracellular [Extracellular pathogens are parasitic worms, protozoans and fungi]

how specific antigens are destroyed or inactivated= _____________________________________________

Adaptive immune response

in the usual case, limited life to a B cell culture creating hybridomas provides an "______________" _________________ capable of producing pure antibodies [Antibody "factory"] Plasma cells are short-lived. Fusing them with a cancer cell line makes them live longer.

- "immortal" cell line

Primary response vs. secondary response [pic] First exposure to antigen: latent period before IgM and IgG are produced Second exposure to antigen: rapid response, no latent period. - Long-lasting IgG produced robustly right away by memory B cells - _____________________ response = renewed rapid production of antibodies on the 2nd [or subsequent] encounter with the same antigen

- Anamnestic response

Adaptive immune response is divided into 4 categories:

- Cell-mediated immunity - Humoral immunity - Complement proteins - Antibody dependent cell-mediated cytotoxicity

Immature T cells mature in the thymus where they produce T cell receptors. Immature B cells mature in the stroma of the bone marrow where they produce B cell receptors. ____________________________________________ produce a diverse population of __________________ T cells and B cells (>10^11) with distinct T cell and B cell receptors, respectively. Lymphocytes that react to self will undergo anergy (inactivation) or apoptosis (cell suicide or programmed cell death). Mature but naïve T cells and B cells survive after immune tolerance. They migrate to lymphatic organs. Lymphatic organs = lymph nodes and spleen: locations where lymphocytes encounter antigens which results in clonal selection and clonal expansion of T and B cells.

- Random gene rearrangements - immature [orange notes: - Immature T cells mature in the thymus where they would produce T cell receptors. Immature B cells mature in the stroma of the bone marrow, where they would produce B cell receptors. During maturation of B cells and T cells, random gene rearrangements produce a diverse population of immature T cells and immature B cells with distinct B cell receptors and T cell receptors. Also during maturation, the B cells and the T cells will undergo what's called immune tolerance or negative selection. If they react with the self molecule or a self-antigen, they will be eliminated from your immune system. This protects you from future autoimmunity or reaction to self antigens. At the end of maturation, you will have a diverse populations of B cells and T cells with unique receptor display at the power of about 10^11 diverse B cells and 10^11 T cells. After maturation, the mature B cells and T cells will now migrate to the lymph nodes and the spleen where they will encounter an antigen. Upon encountering an antigen, the B cells and the T cells that are specific to the antigen will undergo clonal selection and they will replicate, make more of themselves, in a process called clonal expansion]

types of T cells: 2. ________________________ [T-killer] lymphocytes: release chemicals that _________ tumor cells or virus-infected cells via apoptosis [programmed cell death]; have CD8 receptor on surface. - Also, stimulate macrophages to increase phagocytosis

- T-cytotoxic - lyse

types of T cells: 1. ________________ lymphocytes [or T4 or CD4]: bind to antigen presented by dendritic cells, macrophages, sometimes B cells [antigen presenting cells or APCs]; T-helpers then fully activate B cells, macrophages and other types of T cells such as CD8 T cells

- T-helper

What is the composition of the receptor complex?

- The antigen presenting cell is presenting an antigen by an MHC class 2. - The antigen is recognized by the T cell receptor of the CD4 T cell. - The T cell has a CD4 coreceptor that binds to the MHC molecule of the antigen presenting cell.

Adaptive/Acquired defenses - Responses in the future can be modified based on "experience" with pathogens today [ ______________ ]!!!! - Stronger and faster future immune responses to the same pathogen because of memory B and T cells.

- [memory]

Three Classes of MHC Genes Class I MHC Genes: - Markers appear on ___________________________ - Display unique characteristics of self - Allow for ___________________________ and the regulation of immune reactions - Each human inherits a particular combination of class I MHC genes Class II MHC Genes: - Code for immune regulatory markers found on ____________________, ________________________, and ____________ [APCs] - Involved in presenting _____________ antigens to T cells during cooperative immune reactions Class III MHC Genes: - Encode proteins involved with the ____________________________

- all nucleated cells - recognition of self - macrophages, dendritic cells, and B cells [APCs] - foreign - complement system

Five classes of antibodies 3. IgE: involved in quick _____________ responses _______________: histamine-containing cells found throughout the body; - IgE causes degranulation of mast cells upon _________________ allergen encounter, - ________________ histamine and causing the typical symptoms associated with allergies [inflamed tissues, teary eyes, excess mucous production, etc.]

- allergic - mast cell - secondary - releasing

Diagnostic testing based on immunology some basic ideas: 2. to test for an _______________ in a person, work with either a known antigen that the antibody reacts with OR, use an antibody _________________________________________________ [use the antibody you want to test for as the "antigen" to produce monoclonal antibodies against the antibody; ______________________________; see mouse diagram] You can generate an anti-human IgG from a mouse, horse, rabbit, donkey, sheep, pig, goat, etc. This requires prior isolation and identification of the unknown antibody using a known antigen.

- antibody - generated against that unknown antibody - mouse anti-human IgG

Diagnostic tests [Immunology] how can we make an antibody[MAb] against an antibody? - Antigen is injected into mouse, but what if antigen actually consists of one specific antibody type? - An antibody can also be an antigen. A mouse can produce monoclonal antibodies against a human antibody. The human antibody is an ____________ in the mouse. The mouse will develop antibodies against the human antibody.

- antigen

T-Cell Action in the Adaptive Response: Cell-Mediated Immunity - produced when T cells are activated by an ______________ the target of CMI is usually a cell [bacteria-infected cell, virus-infected cell, cancerous cell]; response made to ______________________________ Examples of intracellular antigens are viruses and bacteria. Cancer cells are targeted by activated CD8 T cells [cytotoxic T cells] because they fail to display sufficient MHC class I markers on their cell surface.

- antigen - intracellular antigens

4 polypeptide chains make up an antibody molecule: 2 heavy chains and 2 light chains. The variable region [V] of the heavy chain and the variable region [V] of the light chain make up the ____________________________. Both antigen binding sites recognize the same antigen. The antibody molecule is divided into 2 fragments. Fc = fragment, crystallizable; Fab = fragment, antigen binding The FC region of an antibody can bind to mast cells, eosinophils, natural killer cells, and other phagocytes. When an antibody is bound to eosinophil and natural killer cells and phagocytes, they are involved in antibody dependent cell-mediated cytotoxicity. When the antibody, such as IgB is bond to mast cells, the mast cells is involved in allergic reactions.

- antigen binding site

specific antibody functions: 4. neutralization of pathogens and toxins: when antibodies ________ to these, they are ___________________________________________________ and exerting their effects Antibodies surround virus which prevents it from binding the host cell [inactivation of pathogen or toxin] Antitoxins are antibodies directed against exotoxins.

- bind - prevented from attaching to host cells

5. fluorescence tests [direct, indirect, FACS] concept: fluorescent marker dye is __________________________________; these are added to clinical specimen and observed under a special microscope FACS = fluorescence activated cell sorter; provides an accurate count of # of fluorescently-labeled bacteria or virus. - positive test: fluorescent yellow-green glow concentrated in areas where antigen is present - examples: rabies, syphillis

- bound to antibodies

HERD IMMUNITY: 8 out of 10 protected Population is protected because _________________________________________________________________________________________________________________________________________. The disease does not spread beyond the immunized person.

- chain of transmission ends when the pathogen infects an immunized person

specific antibody functions: 1. precipitation [soluble Antigen] and agglutination [whole Antigen (such as whole bacterium)]: when antibodies bind to antigen to precipitate or ___________ them together Precipitation and agglutination are indications of a positive result in a diagnostic kit, when you are testing for blood samples and you are testing for serological samples.

- clump

6. enzyme-linked immunosorbent assay, ELISA [direct, indirect] concept: to detect antibody, first, known antigen is bound to plastic microtiter plate and serum is added; then, enzyme-linked antibodies and substrate are added positive test: enzyme and substrate reaction causes a ______________________ [if antibodies are present in the sample] examples: HIV tests, home pregnancy tests Home pregnancy tests detect the presence of hCG or human chorionic gonadotropin secreted by the placenta or uterus when the embryo attaches to the uterine lining.

- color change [the direct is when you're trying to determine for the presence of the antigen. and indirect is when you're trying to determine whether or not the patient has the antibody to the disease.]

Five classes of antibodies 4. IgG: most abundant, longest-lived Antibody; active against all types of pathogens; the only antibody that _____________ the _______________ 5. IgM: _________ Antibody formed to a new antigen; excellent at agglutination IgG can cross the placenta because it is the ______________ of all the antibody types. IgM is excellent in agglutination because it is _________________. Memory B cells mostly secrete IgG [not IgM]

- crosses - placenta - first - smallest - pentameric [ Pentameric meaning there are 5 different antibodies that are hooked together. ]

Autism and the MMR vaccine - The Institute of Medicine in 2011 published the results of a comprehensive examination of childhood vaccinations - Stated unequivocally that the MMR vaccine ________________ cause autism

- does not

HERD IMMUNITY: 2 out of 10 protected 2 out of 10 ______________________________ the spread of outbreaks of the disease. Population is not protected.

- does not minimize

specific antibody functions: 2. opsonization: ________________ phagocytosis accomplished through _______________________________________________ 3. complement fixation: antibodies bind to antigen, forming complexes that start the complement cascade reaction Classical Complement pathway = C1 complement protein binds to antibody already bound to the antigen and recruits other complement proteins to form membrane attack complex [MAC] which lyses the bacteria.

- enhanced - antibody-coating of antigen

DNA Vaccines - Microbial DNA is inserted into a plasmid vector and inoculated into a recipient - Human cells take up the plasmid and express the microbial DNA in the _____________________ - These foreign proteins will be recognized by the immune system and sensitize B and T cells

- form of proteins

antibody half-life [half-life is the time for ______ of a substance to break down]: IgG is longest: 23 days others are 2-6 days

- half

[pic] a) Antigen-Independent Period 1. During development of early lymphocytes from stem cells, a given stem cell undergoes rapid cell division to form numerous progeny. During this period of cell differentiation, random rearrangements of the genes that code for cell surface receptors occur. The result is a large array of genetically distinct cells, each bearing a different receptor that is specific to react with only a single type of foreign molecule or antigen. 2. At this same time, any lymphocytes that develop a specificity for self molecules and could be harmful are eliminated from the pool of diversity. This is called _____________________________. 3. The specificity for a single antigen molecule is programmed into the lymphocyte and is set for the life of a given cell. The end result is an enormous pool of _______________________________ lymphocytes that are ready to further differentiate under the influence of certain organs and immune stimuli. b) Antigen-Dependent Period 4. Mature lymphocytes come to populate the lymphatic organs, where they will finally encounter antigens. These antigens will become the stimulus for the lymphocytes' final activation and immune function. Entry of a specific antigen selects only the lymphocyte that carries matching surface receptors. This will trigger proliferation, which results in large numbers of cells bearing identical antigen-specific receptors.

- immune tolerance - mature but naive

Diagnostic testing based on immunology: GOAL is to look for a certain antibody or antigen that _________________ the presence of disease [either current or past] some basic ideas: 1. to test for an ______________ antigen in a person, use a ______________ antibody against the antigen which you are looking for Past infections - check for presence of _______________ in the patient [e.g. HIV infection or after Hep B vaccination] Recent infections - check for presence of ______________ [pathogen] in the patient since patient has not produced the antibody to the pathogen yet.

- indicates - unknown - known - antibody - antigen

Passive immunity b. artificial passive immunity: - results from ______________________ of antibodies [by injection or IV] - appropriate when __________________________________________ - usually blood-derived; contains high concentration of antibodies to a certain disease - products called immune globulins, gamma globulins, antiserums, antivenoms, antitoxins

- introduction - instant immunity is required

General types of tests 2. precipitation [precipitin ring test, immunodiffusion and immunoelectrophoresis] - concept: _____________ antibodies used to detect the presence of soluble antigen in test tube or agar gel - positive test: cloudy precipitate or color indicating a reaction - examples: pneumococcus, 2° AIDS test Immunoelectrophoresis test is used as secondary AIDS test. HIV proteins are detected with antibody on a Western Blot.

- known

3. agglutination [direct, indirect, hemagglutination] concept: fixed amount of _________________________________________ is added to ______________________ sample and __________________________________________ against that known antigen are detected - positive test: visible aggregates [agglutination] - examples: brucellosis, Salmonella, rapid strep tests, mononucleosis

- known particulate antigen - patient serum - presence of antibodies

types of vaccines: - whole _______ modified [__________________] pathogen; weakened pathogen; ex., Sabin oral polio vaccine - toxoids: inactivated exotoxins; ex., diphtheria and tetanus toxoids

- live - [attenuated] Attenuated = weakened but alive ; maybe genetically modified to remove or delete virulence factors

- memory is stored in "trained" B and T cells [B and T memory cells] that form clones in _________________ and other lymphatic tissues; may remain for life - these memory cells _________________________ upon secondary exposure to Ag[antigen] and produce a ____________ immune response primary vs. secondary exposure to antigen

- lymph nodes - rapidly activate - strong

herd immunity: presence of immunity in ________ of the population that _______________________________________________________; at least 80% population must have immunity for protection to be conferred to all > or equal to 80% of population must be immune to the disease for the population to have herd immunity. A new born baby relies on herd immunity for the first couple of months.

- most - minimizes the spread of outbreaks

Five classes of antibodies Plasma cells secrete all types of antibody but all types of antibody have the same specificity to one epitope of an antigen. 1. IgA: secreted onto _____________ membranes; present in _________________ [____________________] 2. IgD: acts as a receptor on the surface of __________ ; not abundant

- mucous - colostrum [breast milk] - B cells

Active immunity a. natural active acquired immunity: from a _____________ exposure to an antigen - could be the result of having the disease or from an asymptomatic [subclinical] infection by the pathogen

- natural

*slight differences in T helpers: TH1 works with dendritics, macrophages and other Ts; TH2 works with B cells another T-helper is the T-regulatory lymphocytes [TR or TREG]: turn _____ the immune response when antigen is ____ longer present [anti-inflammatory] TH17 secretes IL-17 which is inflammatory

- off - NO

Acquired immunity types-- active vs. passive 1. active immunity: produced by _____ immune mechanism upon ______________ to the antigen - the host ________________________________________________ - takes time to develop [not instant] (about a week and a half) - long term, maybe lifetime because immune _____________ results

- own - exposure - produces own immune response - memory

types of vaccines: - __________ of pathogens [subunit vaccines, __________________________________, recombinant vaccines, nucleic acid vaccines]; ex. of contents= viral proteins, viral spikes , bacterial capsules, bacterial flagellum, "naked" DNA

- parts - acellular vaccines

4. complement fixation concept: to test ____________________________________________________________, first add antigen and complement to serum; then, add sheep RBCs and complement fixing anti-RBC antibodies - positive test: if serum contains antibodies, the complement will be used up and is not available to lyse the sheep RBCs [if serum does not contain antibodies, the complement will not have been used up and is available to lyse the sheep RBCs] - Examples: __________________________________________

- patient serum for certain antibodies - viral and fungal diseases

[pic w/mouse] Cancerous plasma cells [long-lived] Antibodies to different epitopes of antigen. Myeloma cells are cancerous plasma cells. Plasma cells are B cells that produce disease- and infection-fighting antibodies in your body. Spleen cells and myeloma cells are fused using ______________________________________ [_______]. [orange notes] This diagram shows how monoclonal antibodies are made. The antigen is injected into a mouse and after injection, we collect the spleen cells, the B cells that are found in the spleen. We then fuse those B cells with the myeloma cells that are long-lived, creating what's called the hybridoma. The hybridoma are then cultured and we then select the specific hybridoma that we are interested in, and then we maintain those by injecting them into mouse, and also we can culture them to purify the monoclonal antibodies that we're interested in.

- polyethylene glycol [PEG]

Acquired immunity types-- active vs. passive 2. passive immunity: - receiving ______________________________ from _____________ of the body - provides _____________ immunity - ___________________________ because _____ immune memory develops

- pre-formed antibodies - outside - instant - short-term only - no

Antibodies [Ab], aka immunoglobulins [Ig] - Y-shaped structures made mostly of ___________ that bind to specific sites on antigens [epitopes] in order to target them for inactivation and destruction - antigen-antibody complex

- protein

Monoclonal antibodies [MAb]: preparations of _______________ antibodies against ____ antigen only - made in the _____ ; used for diagnosis and treatment (such as cancer patients) - usually made by ________________ cells [ ________________ cells = "trained" B cells fused with cancerous plasma B cells--myelomas]

- purified - one - lab - hybridoma - hybridoma

7. radioimmunoassay (RIA) - concept: like ELISA, but uses _________________"_____" instead of an enzyme - 1000X more sensitive than ELISA but not as portable. - positive test: measurable radioactivity - examples: hepatitis

- radioactive "tag"

upon subsequent exposure to the same antigen, the immune response is ______________________ and will prevent infection humoral: minutes to hours CMI: 1-2 days

- rapid and strong [The memory B cells can be activated in minutes to hours. And the memory T cells can be activated within a day or two.]

types of T cells: 3. T-memory cells: retain a _________ of the specific immune response; settle in lymphatic tissues

- record

types of vaccines: - living _____________ of a pathogen; ex., cowpox [vaccinia] virus as a vaccine for smallpox [the first vaccine] [A person injected with the cowpox virus will develop immunity against both the cowpox and the smallpox virus.] - whole ___________ [inactivated] pathogen; ex., Salk polio vaccine

- relative - killed

Immune memory - upon the first exposure to an antigen, the immune response is ________ and ________ [too little, too late] and _________________________________ [WHY?] several days to weeks Immune system does not recognize the new pathogen [e.g. measles, mumps, rubella virus]. No memory cells recognize the pathogen because it is a new pathogen. APCs have to process antigen for presentation to T cells. It takes a week or 2 to start making antibodies against the pathogen [latent period].

- slow and weak - does not prevent infection

Adaptive/Acquired defenses - highly ______________ against ________ pathogen [species OR strain within a species] - ______ inherent, not innate or inborn, but only develops _________ exposure to the pathogen [_______________]; for certain elements, like antibodies and TCR (T cell receptor), recombination or splicing of genetic elements leads to ________________________________ not existing immediately at birth will give rise to about 10^11 different types of B cell receptors and 10^11 different types of T cell receptors VDJ recombination [non-homologous end joining mechanism]

- specific - one - not - upon - [acquired] - novel combinations

General types of tests 1. cutaneous skin testing concept: inject antigen just ______________________ - positive test: _________________ or ____________ [raised, red, firm area at injection site= induration; or diffuse, puffy whitish area on reddish background=wheal=welt=hive] examples: allergen testing, tuberculin [Mantoux] testing

- under the skin - induration or wheal

Active immunity b. artificial active acquired immunity: from antigen in a _________________ the goal is to develop protection from disease _________________ having to develop the full-blown disease

- vaccine - without [ Vaccination = ACTIVE artificial (or active immunization) ]

As anyone who has had wheals knows, they can be intensely, infuriatingly itchy. Wheals reflect circumscribed dermal edema [fluid collection in the layer of skin below the surface]. A wheal is also sometimes called a ________ and often a ________. Induration: Localized hardening of soft tissue of the body. The area becomes firm, but not as hard as bone.

- welt - hive

Development of New Vaccines Dozens of bacterial, viral, protozoan, and fungal diseases still remain ______________ a functional vaccine: - Malaria - HIV/AIDS - Various diarrheal diseases - Respiratory disease - Parasitic Worm infestations Most existing vaccines are out of reach for much of the world's population

- without

Five classes of antibodies

1. IgA 2. IgD 3. IgE 4. IgG 5. IgM Ig = immunoglobulin

Sequence of T-cytotoxic activity

1. After being activated by TH, the TC binds Antigen-MHC class I complex of infected cell 2. TC releases pore-forming proteins [perforins] that punch holes into infected cell 3. TC then secrete granzymes that induce apoptosis [programmed cell death aka cell suicide]

sequence of T-helper activation

1. Antigen presenting cell, APC, engulfs pathogen 2. Antigen is processed by APC and moved to its surface as an antigen-MHC II complex 3. APC presents antigen [as antigen-MHC II complex] to "naïve" TH 4. The TH that recognizes the foreign antigen becomes fully activated and copies itself [clonal expansion] and goes on to activate other immune cells [macrophages, T and B cells] through cytokine secretion

specific antibody functions:

1. precipitation and agglutination 2. opsonization 3. complement fixation 4. neutralization of pathogens and toxins

[READ only] [pic] Events in T-Cell Activation [1] When T helper [CD4] cells are stimulated by antigen/MHC complex, they differentiate into either T helper 1 [TH1] cells, T helper 2 [TH2] cells, T helper 17 [TH17] cells, or T regulatory cells [TREG] depending on what type of cytokines the antigen-presenting cells secrete. A TH1 cell will activate phagocytic cells to be better at inducing inflammation. The job of TH2 cells is to secrete substances that influence B-cell differentiation and enhance the antibody response. One of their important roles is to respond to extracellular microbes, helminths, and allergens. TH17 cells are so-named because they secrete interleukin-17, which leads to the production of other cytokines that promote inflammation. Inflammation, is useful, of course, but when excessive or inappropriate may lead to inflammatory diseases such as Crohn's disease or psoriasis. TH17 may be critical to these conditions. TREG cells are also broadly in the TH class, in that they also carry CD4 markers. But they are usually put in their own category. They act to control the inflammatory process (TREG is anti-inflammatory), to prevent autoimmunity, and to make sure the immune response doesn't inappropriately target normal biota.

CMI and humoral immunity are dependent on CD4 activation and differentiation into TH1 and TH2 cells.

[READ only] [pic] In the lymph nodes and spleen - This slide gives you a big picture of what happens in adaptive immunity. We start with the hematopoietic stem cells that will migrate to the thymus and differentiate and mature into T cells. You also have hematopoietic stem cells that will mature in the bone marrow and develop into B cells. Upon maturation and development of the B cell receptors and T cell receptors, the B cells and the T cells will now migrate to the lymph nodes and the spleen where they will encounter an antigen. In the lymph node/spleen, the antigen is presented by an antigen presenting cell. Antigen presenting cells are composed of dendritic cells, macrophages, B cells, and endothelial cells. The antigen presenting cell will phagocytose the antigen, and it's gonna process it, degrade it into smaller peptides and is now going to present it on its surface via an MHC class 2. So the antigen is complexed or fused to an MHC class 2 molecule on the surface of the antigen presenting cell. It's going to present the antigen to a CD4 T cell or a T helper cell. CD4/ T helper are the same thing. Upon presentation of the antigen to the CD4 T cell, the CD4 T cell will become activated and it's going to differentiate into either a memory CD4 T cell or it can differentiate into a helper T cell type 1 or a helper T cell type 2. The activated CD4 T cell will also activate B cells. B cells require activation from CD4 T cells. Upon activation, the B cells will differentiate into memory B cells or plasma cells. Plasma cells are responsible for synthesizing antibodies that will circulate in the circulatory system.

Dendrites of dendritic cells provide more surface area to display antigen compared to macrophages and B cells. Dendritic cells are more effective APCs than macrophages or B cells. Because of this DCs are called professional APCs. Activated CD4 T cells turn into TH1 or TH2 helper T cells [and memory CD4 cells] CD8 T cells require activation from TH1 helper T cells. Activated CD8 T cells turn into cytotoxic T cells [and memory CD8 cells].

[READ only] [pic] Steps required for B cell activation and B cell differentiation. 1. Clonal Selection and Antigen Binding. B cells can independently recognize microbes [example here is a virus] and their foreign antigens and can bind them with their Ig receptors. This is how the initial selection of the antigen-specific B-cell clone occurs. 2. Antigen Processing and Presentation. Once the microbe is attached, the B cell endocytoses it, processes it into smaller protein units, and displays these on the MHC-II complex [similar to other APCs). This event readies the antigen for presentation to a specific TH cell. 3. B-Cell/ TH Cell Recognition and Cooperation. For most B cells to become functional, they must interact with a T helper cell that bears receptors for antigens from the same microbe. The two cells engage in linked recognition, in which the MHC-II receptor bearing antigen on the B cell binds to both the T-cell antigen receptor and the CD4 molecule on the T cell [inset]. 4. B-Cell Activation. The T cell gives off additional signals in the form of interleukins and B-cell growth factors. The linked receptors and the chemical stimuli serve to activate the B cell. Such activation signals an increase in cell metabolism, leading to cell enlargement, proliferation, and differentiation. 5-6. Clonal Expansion/Memory cells. The activated B cell undergoes numerous mitotic divisions, which expand the clone of cells bearing this specificity and produce memory cells and plasma cells. The memory cells are persistent, long-term cells that can react with the same antigen on future exposures. 7. Plasma cells/Antibody Synthesis. The plasma cells are short-lived, active secretory cells that synthesize and release antibodies. These antibodies [here IgM] have the same specificity as the Ig receptor and circulate in the fluid compartments of the body, where they react with the same antigens shown in panel 1.

The B cell APC only gets activated by a TH2 cell that can recognize the same antigen that is being presented by the B cell. The TH2 cell may have been previously activated by a dendritic cell which presented the same antigen to the naïve T helper cell or the T helper cell is being activated by the B cell.

Why Abs are used for diagnostic and treatment: Abs will only bind their cognate antigen [specificity]. Abs can recognize their antigen even when the antigen is highly diluted [sensitivity].

[orange notes] - Antibodies are very useful and powerful for diagnosing disease and also for curing disease. The two reasons why we use antibodies for diagnostic and for therapeutic purposes is because they are highly specific to their cognate antigen. So they're very specific to their cognate antigen and they're also extremely sensitive. What does that mean? Sensitivity refers to the ability of the antibody to recognize the antigen even though the antigen is extremely diluted. So antibody sensitivity is as high as 1 in a million so they will detect the antigen even though there's only 1 antigen in a million other antigens.

[READ only] Recommended Adult Immunization Schedule

[orange notes] - The last schedule of immunization is from 19 years of age to about 65 and above. So again, you have the flu vaccine, you have to have the flu vaccine every year. Then the TDaP, you get a booster shot every 10 years. The shingles the recommended is at age 60 but you can get the shingles vaccine as early as 50-55 years. And then you have the pneumococcal vaccine, the pneumococcal vaccine is recommended for people at the age of 65 and above, but if you are at risk, you can get the pneumococcal vaccine earlier. The same thing for the meningococcal vaccine, you can get those if you believe you are at risk of getting the meningococcal infection. And then you have the MMR, the HPV, chickenpox Hep A, Hep B, and Haemophilus influenza type B, those are all recommended for kids. But if you haven't had those vaccinations, you can catch up and get those vaccinations later in life.

Immunoelectrophoresis test: Western Blot to detect HIV Antigen [secondary HIV test] The numbers signify the size of the protein in kilo Daltons [kDa].

[orange notes] - The other type of precipitation test is called Immunoelectrophoresis test or western blot. In a western blot, the blood samples from a patient are loaded into a gel and a current electricity is passed on to the samples. The viral proteins will migrate in the gel depending on their molecular size. After the electrophoresis has been run, the viral proteins are transferred into a nitrocellulose membrane and they are blotted with specific antibodies to the different types of viral proteins. The bands, the dark blue bands, indicate the presence of the specific viral proteins.

[READ only] 2016 Recommended Immunizations for Children from Birth Through 6 Years Old routine childhood immunization: different diseases for different nations. U. S. schedule comes out every year. RV=rotavirus vaccine; PCV=pneumococcal vaccine; IPV=inactivated polio vaccine Herd immunity is very important especially against influenza, mumps, measles, rubella, and varicella because the baby does not get immunized until he/she is 6 months old or 12 months old. Most vaccines come in 2 to 3 doses or shots spread several months apart. And some require a booster shot after a few years.

[orange notes] - There is a vaccination schedule published by the CDC that recommends immunizations from the day of birth up to 65 years of age. The schedule of vaccination is different from countries to countries because different countries will have different types of diseases. Tropical countries like in Asia and South America, and also countries in Africa they have different diseases that are not common in the United States so what I'm showing you right now is just the schedule that is published here in the U.S. just bear in mind that different countries will have a different type of schedule The first schedule is from birth to 6 years of age. So as soon as you're born, the first vaccine that is given is Hepatitis B. And then after that, you will have the rotavirus, and then you have the DTaP so this is the diphtheria, acellular pertussis, and tetanus vaccine. And then you have the Hib [Haemophilus Influenza type B]. And then you have the PCV that's pneumococcal vaccine. And then you have the IPV and that stands for inactivated polio vaccine. But you will notice that for the first four months of the baby, they are susceptible to influenza, they are susceptible to measles, mumps, and rubella, and they're also susceptible to chicken pox. So for the first 4-6 months of the baby, they rely mostly on herd immunity.

Events in T-Cell Activation [2] Antigen enters with APC and activates CD8 cell. For a CD8 killer T cell [TC] to become activated, it must recognize a foreign peptide complexed with self MHC-I and mount a direct attack upon the target cell. After activation, the TC cell severely injures the target cell. This process involves the secretion of perforins and granzymes. Infected self cell = tumor cell or virally-infected cell

[orange notes] This slide shows the activity of the CD8 T cells. So you will see that the CD8 T cells are activated by the type 1 helper T cell and it also binds to an antigen presenting cell that is presenting the MHC class 1 complex to the antigen. Upon activation of the CD8 T cells, it will differentiate into a cytotoxic T lymphocyte that will secrete the perforin that will punch holes into the infected host cell and then it will also secrete some granzymes that will induce cell suicide in the infected host cell.

[ READ only ] 2016 Recommended Immunizations for Children and Youth 7 Through 18 Years Old

[orange notes] The 2nd part of the schedule is a recommended immunization schedule for 7 years of age to 18 years of age. There are different colors on this graph but mainly the green one is the recommendation. So for the flu vaccine, you have to have the vaccine every year, that is the recommended dose of the flu vaccine. The orange ones are mostly in reference to vaccinations for people who have not had the vaccination yet and are trying to catch up. For the TDaP and the Hepatitis B, Hep A, inactivated polio, MMR, and chicken pox, so those are the orange ones refers to kids who have not been vaccinated, so this is their first time catching to the vaccine. The violet one refers to people who are at risk of having that disease and so they can get that vaccine early. For instance, when we're talking about the human papillovirus, Normally, human papillovirus are given boys and girls at around 11 years of age. But some kids are more susceptible to the disease and so they can get the HPV vaccine at around 9 years of age if they belong in the risk group. The same thing with the meningococcal. So there are some people who are at risk of getting meningococcal infection so they can get the vaccine as early as 7 years of age but normally, it's given to kids around 11 years of age. And then you also have the meningococcal B. So the meningococcal ACWY, that is normally given to kids and then the meningococcal B is given to kids who are at risk of getting the meningococcal type B.