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Medical Immunology Acquired Immunity Medical Immunology Harvesting Antibody Medical Immunology: : Manufacturing Antibody Monoclonal Antibodies Medical Immunology: Manufacturing Antibody Vaccines Vaccination- The deliberate induction of adaptive immunity to a pathogen by injecting a vaccine, a dead or attenuated (nonpathogenic) form of the pathogen. “Killed” vaccines * Bacterial Dead * Viral Replication Ability Removed “Live” attenuated vaccines * Bacterial Nonpathogenic types or disabled mutants * Viral Reduced ability to replicate in human cells More potent and risky for immunosuppressed individual Medical Immunology: Vaccines Requirements of Vaccines * Safe * Induce effective protection in a high proportion of the vaccinated population * Long-lived immunological memory must be conferred * There should be little or no requirement for “boosters” * Cheap Medical Immunology: Vaccines An Effective Vaccination Program.... Provides “herd immunity” By lowering the number of susceptible individuals in a population the natural reservoir of infected individuals also falls. Thus the probability of transmission is reduced; even non-vaccinated individuals enjoy the benefits of a large scale vaccination program. #*@%! Medical Immunology: Vaccines Allergies (Type 1 Hypersensitivity) Allergy- Disease following a response by the immune system to an otherwise harmless antigen Common allergens * Drugs * Foods (eg. Tree nuts, shellfish) * Venoms * Insect bites * Pollens * Dust mites faeces The antibody produced to respond to these antigens is IgE. Medical Immunology: Allergies Allergies The constant region of the IgE antibody may bind to surfaces of mast cells. When allergens cross-link preformed IgE that is bound to mast cells histamine is released. Histamine causes smooth muscle contraction and blood vessel dilation. Medical Immunology: Allergies Allergy Mast cells line the body surfaces (inc. blood vessels, connective tissue, lining of the gut and lungs) as an alert system to local infection. As a result, an allergic reaction will create different symptoms depending on the tissue affected. Medical Immunology: Allergies Blood Types: ABO Blood Transfusions: ABO Units of packed red cells are made by removing as much of the plasma as possible from whole blood units. Thence, type O individuals are considered a universal donor- antibodies have been removed and no antigen is present to excite immune responses in the recipients. Having both A and B antigen means that type AB individuals have no anti-A or anti-B antibodies. They are universal recipients. Blood Transfusions: ABO and Rhesus +/The presence/absence of rhesus factor is marked by +/- respectively. Transfusions should approach rhess in the same manner as ABO. Blood Typing: Rhesus Factor Medical Immunology: Blood Typing Immunodeficiency: HIV/AIDS First reported cases 1981 Over 25% of adults infected in Zimbabwe and Botswana There are actually 2 types; HIV1 and HIV2 Spread to humans from primates Pssst....wanna try some HIV1? ...how about some HIV2? Medical Immunology: HIV/AIDS Human Immunodeficiency Virus Infection occurs after transfer of body fluids via * infected T helper cells * as a free virus in blood, semen, vaginal fluid, milk This includes: * Sexual intercourse * Sharing of contaminated needles * Use of infected blood or blood products * Pregnancy (25% foetal infection rate) Medical Immunology: HIV/AIDS Human Immunodeficiency Virus HIV is understood to primarily infect and replicate in T helper cells can also infect macrophages and dendritic cells. T helper cell concentrations are significantly reduced after initial infection. T helper cell populations are partially restored after an initial adaptive response. Afterwards T helper cell populations will gradually and persistently decrease. The destruction of T helper cells leads to immunodeficiency. Medical Immunology: HIV/AIDS Acquired Immunodeficiency Syndrome (AIDS) The adaptive immune response controls but does not eradicate HIV. HIV does not immediately cause AIDS Most infected individuals progress towards AIDS over time and die following opportunistic infections and tumours. Medical Immunology: HIV/AIDS Tissue & Organ Grafting Graft rejection involves the destruction of transplanted tissue I prefer your head to mine..... This occurs as an immune response to antigens on the grafted tissue. The tissues of donors and recipients must closely matched in order to minimise likelihood of rejection. Hmmmm.... ...let's swap!!! (no-one will find out anyway!) The likelihood of achieving a close tissue match therefore increases with greater genetic similiarity between donor and recipient. Medical Immunology: Graft Rejection Donors and Recipients There are several major categories of tissue grafting Autografts: Donor and recipient are the same individual (often occurs for skin grafts) Syngeneic grafts: Donor and recipient are identical (eg. identical twins) Allografts: Donor and recipient are individuals of the same species Xenografts: Donor and recipient are of different species For recipients of allografts and xenografts a strict regimen of powerful immunosuppressant drugs is required. Medical Immunology: Graft Rejection MHC Matching MHC markers are constantly presenting both self and non-self peptides on the membranes of nucleated cells. Individuals with similar MHC types are likely to present a similar variety of peptides. Thence matching MHC types is an important part of minimising the rejection of allografts. Medical Immunology: Graft Rejection Autoimmunity Autoimmune diseases occur when an adaptive immune response is mounted against self antigens. Because the antigen is part of the host's own tissues an immune response does not eradicate the antigen completely; resulting in a sustained immune response. This can lead to chronic inflammatory injury to tissues. Autoimmune disorders usually arise spontaneously and can be triggered by * infectious agents * internal immune dysregulation Medical Immunology: Autoimmunity Autoimmune Diseases Common autoimmune diseases include Rheumatoid arthritis Insulin dependent diabetes Multiple Sclerosis Lupus Erythematosus Pemphigus vulgaris Medical Immunology: Autoimmunity