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Transcript
Immune prophylaxis and Immunotherapy Immune prophylaxis I. Introduction •The last known person in the world to have a natural case of smallpox. Variola minor in 23year-old Ali Maow Maalin, Merka, Somalia CDC •In 1980, WHO announced that smallpox has been eradicated in the world. II. Essential requirements of vaccine III. Artificial active immunization Antigen:Vaccine or Toxoid inactivated vaccine (Dead vaccine ) Live-attenuated vaccine Toxoid Recombinant Vaccine:HBsAg Agents used in active immunization 1. The agent used for artificial active immunization is called vaccine. inactivated vaccine (Dead vaccine ) Standard strain of a microbe is killed and severed as an immunogen. For example: cholera vaccine Japanese encephalitis vaccine rabies vaccine typhoid vaccine Agents used in active immunization 2. Live-attenuated vaccine It is more effective than dead vaccine I.E:Bacillus Calmette-Guerin (BCG) vaccine;Measles virus vaccine;Polio virus vaccine (oral);Typhoid vaccine (oral live attenuated bacteria) Tuberculin Skin Test A tuberculin skin test is done to see if you have ever had tuberculosis (TB). Normal (negative results): No TB infection, No BCG vaccinantion positive Post TB infection; BCG vaccinantion Strong Positive Active TB infection Comparison between live and dead vaccines Live vaccine vaccine Route of administration dead imitating natural injecting infection subcutaneously Doses of administration small large Times of administration once twice or more Side effect slight severe Duration of immunity long short 3~5 years several months~1 year Mutation possible impossible Preservation of vaccine at 4C easy to preserve or lyophilization 3. Toxoid Exotoxin can be converted into nontoxic but still immunogenic preparations called toxoid. Examples:Diphtheria toxoid, Tetanus toxoid IV. Artificial passive immunization Abs:Antitoxin,Human Ig(IMIG,IVIG,Specific Ig,McAb) Cytokines(IL-2, IFN, CSF) Cells(LAK,TIL). Comparison between active and passive immunization Active immunization Administration globulin) Production of immunity Duration of immunity Usage Passive immunization Ag (vaccines, toxoid) Ab (antitoxin, - slowly immediately long (from several months to years) short (2 weeks to months) immunoprophylaxis emergency prophylaxis and therapy V. Adjuvant A substance that, when mixed with an immunogen, enhances the immune response against the immunogen. VI. Planned immunization • A rational program of immunization against infectious diseases has been committed in children worldwide when many of the most damaging and preventable infections normally appear. • The program of childhood immunization is called planned immunization. Planned immunization schedule in China Primary Immunization Booster/ reimmunization Age Type of vaccine Birth BCG vaccine, HBV vaccine (1st) 1 month HBV vaccine (2nd) 2 months Poliovirus vaccine (1st) 3 months Poliovirus vaccine (2nd), DTP (1st) 4 months Poliovirus vaccine (3rd), DTP (2nd) 5 months DTP (3rd) 6 months HBV (3rd), Meningococcal polysaccharide vaccine 8 months Measles virus vaccine 1 year Japanese encephalitis vaccine (1st and 2nd) 1.5 years DTP, Measles virus vaccine, Poliovirus Meningococcal polysaccharide vaccine 2 years Japanese encephalitis vaccine 3 years Japanese encephalitis vaccine 4 years Poliovirus vaccine 5 years DTP, Measles virus vaccine, BCG vaccine, Meningococcal polysaccharide vaccine vaccine, VII. Development of novel vaccines • Subunit vaccine • These vaccines are in use which make use of antigens either purified from microorganisms or produced by recombinant DNA technology. • e.g. HBV vaccine (HBsAg) • Conjugate vaccine These vaccines are obtained by conjugating the purified polysaccharides (bacterial capsular polysaccharides) to carrier proteins such as diphtheria toxoid. • Synthetic peptide vaccine Small antigens can be made synthetically. e.g. HBs vaccine Synthetic B-and T-cell epitopes can be combined in various ways to optimize the resulting immune response. • Genetic engineering vaccine Recombinant antigen vaccine Recombinant vector vaccine DNA vaccine Transgenic plant vaccine Reverse vaccinology for identification novel vaccine antigen Preventative Vaccine Therapeutic Vaccine VIII. Challenge of vaccines HIV HCV TB Malaria Immunotherapy I. Conception and classification Name Scope or Characteristic immunoenhancing therapy Infection, Tumor, IDD immunosuppressive therapy HVGR, GVHR, AID, Anaphylaxis, Inflammation Vaccine,Therapeutic Vaccine of tumor, active immunotherapy passive immunotherapy Ab, LAK cell specific immunotherapy Peptide,antigen, Non-specific immunotherapy BCG, cytokines II. Molecular Immunotherapy 1. Molecular Vaccine Synthetic peptide vaccine Recombinant vector vaccine DNA vaccine used as treatment of tumor and infection II. Molecular Immunotherapy 2. Antibody-polyclonal Ab antitoxic serum placental gamma-globulin antibacterial immune serum antiviral immune serum anti-lymphocyte gamma-globulin, ALG II. Molecular Immunotherapy 2. Antibody-Monoclonal antibody, mAb mAb against surface membrane molecules on lymphocytes：CD3 mAb against cytokines:TNF mAb-directed therapy mAb coupled to isotopes, drugs, toxins Application of Ab in vitro: elimination of cancer cells in bone marrow or T cells to prevention GVHD Examples of tumor antigens that have been targeted by monoclonal antibodies in therapeutic trials. II. Molecular Immunotherapy 2. Antibody-Genetic engineering Ab Chimeric Ab Humanized Ab (CDR-grafted Ab) Single chain Ab Bispecific Ab II. Molecular Immunotherapy 3. Cytokines and their antagonists Cytokine supplement and addition therapy IFN, IL-2, CSF Cytokine blockade and suppression anti-TNF IL-1Ra sIL-1R III. Cellular Immunotherapy 1. Cellular Vaccine Tumor cellular vaccine Gene-modified cancer vaccine APC vaccine III. Cellular Immunotherapy 2. Adoptive immunotherapy TIL LAK（CIK） 3. Stem cell transplantation Bone marrow Peripheral blood Umbilical blood VI. Biological response modifier and immunosuppressive agent 1. Biological response modifier(BRM) A variety of agents that stimulate the immune response non-specifically are called biological response modifier. Microorganism products: BCG, corynebacterium parvum (CP), polysaccharide Synthetic molecules:polyI:C CK Hormones:Thymosin, Thymopoietin • Immunosuppressive agents 1. Chemicals Glucocorticoids, cyclophosphamide, azothioprine, etc. • Immunosuppressive agents 2. Microorganism products Cyclosporin, FK506, rapamycin Summary Classification of immunoprophylaxis and their biological materials Classification of immunotherapy and their biological materials Thank you for your attention! [email protected]
