Vaccines/immunization Pt. 1 Flashcards

1
Q

What is the purpose of vaccination?

A

Stimulate adaptive immune system to create MEMORY

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2
Q

Which cells function in creating adaptive memory?

A

Memory B cells
Memory helper T cells
Memory killer T cells

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3
Q

Which memory cell is associated with an antigen coming to a secondary lymph organ via lymph or blood?

A

Memory B cell

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4
Q

Which memory cell is associated with APC needing to present the antigen on MHC II?

A

Memory helper T cell

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5
Q

Which memory cell is associated with infected cells needed to present the antigen on MHC I?

A

Memory killer T cell

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6
Q

Can memory B and helper T cells be produced efficiently even when no immune system cells have been infected by the attacker?

A

Yes

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7
Q

Is the precise mechanism of vaccines well understood?

A

Currently an active area of research (so not fully)

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8
Q

What test is used to assess level of protection against attackers?

A

Antibody titers

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9
Q

Both antibody and T cell responses seem to depend on what part of the immune system?

A

Innate

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10
Q

Emerging evidence points to a key role of what cells in the immunological/vaccine mechanism?

A

T cells (examples = chicken pox and shingles)

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11
Q

What is the role of toll-like receptors in the innate immune system in immunity?

A

Regulate persistence of germinal center-memory B cell differentiation pathway

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12
Q

What is the role of basophils in the innate immune system in immunity?

A

Enhancing survival of plasma cells in bone marrow

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13
Q

What is the role of dendritic cells in lymph nodes in the innate immune system in immunity?

A

Provide instructive cues for migration of activated T and B cells to mucosal tissues

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14
Q

What is the role of macrophages in the innate immune system in immunity?

A

Regulate differentiation of antigen-specific T and B cells at mucosal sites

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15
Q

What is the definition of immunization?

A

Process of eliciting a long-lived state of protective immunity against a disease-causing pathogen

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16
Q

What is another way to achieve immunization besides vaccination?

A

Exposure to the actual pathogen followed by recovery

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17
Q

Does vaccination always ensure immunity?

A

NO

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18
Q

What needs to happen in order to have immunity against a pathogen?

A

Development of memory B and T cells against the pathogen

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19
Q

What are some examples of passive immunity?

A

Mother to fetus

Injection of antisera (produced in horse or human)

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20
Q

Is passive immunity permanent?

A

No, temporary

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21
Q

What is passive immunity?

A

Transfer of preformed antibodies conferring temporary immunity

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22
Q

Does disease always lead to immunity?

A

No

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23
Q

What are examples of diseases that do not guarantee immunity?

A

Respiratory syncytial virus, malaria

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24
Q

What is a live attenuated vaccine?

A

Weakened version of the pathogen that can mimic protective immunity

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25
Q

What are examples of some live attenuated vaccines?

A

Smallpox, yellow fever, measles, mumps, rubella (German measles), and chicken pox

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26
Q

Are live attenuated vaccines generally successful in creating long term immunity?

A

Yes

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27
Q

What is the first group of vaccines?

A

Live attenuated vaccines

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28
Q

What is the second group of vaccines?

A

Subunit, toxoid, CHO, and conjugate vaccines

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29
Q

What extra thing is included in the second group of vaccines?

A

Various adjuvants

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30
Q

What type of vaccine is the one against recombinant hepatitis B?

A

Subunit vaccine

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31
Q

What type of vaccines are those for diphtheria and tetanus?

A

Toxoid (inactivated toxins) vaccines

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32
Q

What type of vaccine is the one for pneumococcus?

A

CHO vaccine

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33
Q

What type of vaccine are the ones for Haemophilus influenzae type B or meningococccus?

A

Conjugate vaccines

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34
Q

What are the three TYPES (not groups) of vaccines?

A

Non-infectious, attenuated, carrier

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35
Q

Killed vaccines, bacterial toxins, and parts of the pathogen make up what type of vaccine?

A

Non-infectious

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36
Q

Which memory cells are UNABLE to be produced by non-infectious vaccines?

A

Memory killer T cells

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37
Q

Which memory cells ARE able to be produced by non-infectious vaccines?

A

Memory B and helper T cells (NOT MEMORY KILLER T CELLS)

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38
Q

Which type of vaccine is designed NOT to infect the host?

A

Non-infectious

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39
Q

Common flu, typhoid, and pertussis vaccines are what type?

A

Killed, non-infectious vaccines

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40
Q

What chemical is an example of one used to kill microbes for killed, non-infectious vaccines?

A

Formaldehyde

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41
Q

What are the two pathways that formaldehyde can take in the body?

A

1 attach to protein or DNA (not cool)

2 metabolize to formate, then CO2, then water (cool)

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42
Q

What is an example of a toxoid used to weakened bacterial toxins for a vaccine?

A

Aluminum

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43
Q

What is the strategy behind using parts of a pathogen for a non-infectious vaccine?

A

Removed harmful parts and keep non-harmful portions to create protection

44
Q

What kind of vaccine is the acellular pertussis vaccine?

A

Non-infectious vaccine with parts of the pathogen removed (bacterial proteins)

45
Q

What kind of vaccines are those for hepatitis B and HPV?

A

“Parts of the pathogen” technique as non-infectious vaccines (proteins used to make subunit vaccine)

46
Q

Do non-infectious vaccines infect OUR cells?

A

No

47
Q

Do non-infectious vaccines work well with poliovirus and hepatitis B vaccines?

A

Yes

48
Q

Do non-infectious vaccines work well with measles and mumps vaccines?

A

No

49
Q

Do the poliovirus and hepatitis B vaccines generate memory killer T cells?

A

No

50
Q

Whether memory CTLs are required for protections depends on what?

A

Particular microbe and its lifestyle

51
Q

Live attenuated vaccines result in the formation of which memory cells?

A

Memory B cells, helper T cells, and killer T cells

52
Q

Smallpox, yellow fever, measles, mumps, rubella, and chicken pox vaccines are what type of vaccine?

A

Live attenuated

53
Q

Why was the polio vaccine produced by Sabin weaker?

A

Polio virus was reproduced in monkey kidney cells instead of human nerve cells

54
Q

What is the function of formaldehyde with the polio vaccine?

A

Perservative

55
Q

What structure is used to inactivate the polio virus for the vaccine?

A

Formalin solution (warmed)

56
Q

Which memory cell types are a result of carrier vaccines?

A

Memory B, helper T, and killer T cells

57
Q

How do carrier vaccines work?

A

Introduction of a single gene from a pathogenic microbe into a virus that doesn’t cause disease

58
Q

Carrier vaccines infect what specific cells of the host?

A

APCs

59
Q

When infected by a carrier vaccine, what do the APCs produce?

A

Pathogenic microbe proteins

60
Q

The pathogenic microbe protein fragments produced by APCs when infected by a carrier vaccine are presented on what molecules?

A

MHC I

61
Q

What does adjuvant mean?

A

“Helper”

62
Q

What is the purpose of adjuvants in vaccines?

A

Enhance the magnitude and modulate the quality of the immune response

63
Q

What are some of the results of adjuvant in the system?

A

Mild inflammation
Attraction of phagocytes
Acceleration of phagocyte activation and antigen presentation to T cells

64
Q

What type of immune response is associated with alum as an adjuvant?

A

Th2, antibody

65
Q

What type of immune response is associated with MF59 as an adjuvant?

A

Th2, antibody

66
Q

What type of immune response is associated with AS04 as an adjuvant?

A

Th1, antibody

67
Q

What type of immune response is associated with CpG DNA aka TLR 9 or TLR 7 or TLR 8 as an adjuvant?

A

Th1, antibody

68
Q

What type of immune response is associated with flagellin-protein fusions as an adjuvant?

A

Th1 AND Th2

69
Q

Th1 helper T cells are associated with what kind of response?

A

Viral/bacterial

70
Q

What response is associated with Th1 helper T cells?

A

Classical cytokines (TNF, IFN-gamma, IL-2)

71
Q

What is the goal of Th1 helper T cells?

A

Activate macrophages and natural killer cells

72
Q

What effect does IFN-gamma have on macrophages?

A

Keeps them active

73
Q

What effect does IFN-gamma have on B cells?

A

Tells them to make IgG3

74
Q

What are the functions of IgG3 produced by B cells when stimulated by IFN-gamma?

A

Opsonization of viruses and bacteria

Fixes complement

75
Q

IL-2 regulates what cells?

A

Natural killer cells

76
Q

IL-2 stimulates the proliferation of what cells?

A

CTLs, NK cells, and Th1 cells

77
Q

What type of attack is associated with Th2 helper T cells?

A

Parasitic attack or food contaminated with pathogenic bacteria

78
Q

What response is associated with Th2 helper T cells?

A

Intestinal attack

79
Q

What cytokines are associated with a Th2 helper T cell response?

A

IL-4, IL-5, and IL-13

80
Q

What are the functions of IL-4?

A

Growth factor to proliferate T cells releasing Th2 cytokines)
Growth factor for B cells making IgE

81
Q

What is the function of IL-5?

A

Causes B cells to make IgA which is antibacterial in the GI tract

82
Q

What is the function of IL-13?

A

Stimulates mucus in the intestine

83
Q

Is mercury-containing thimerosal currently used in childhood vaccines as a preservative?

A

No (exception = some influenza vaccines)

84
Q

What is alum?

A

Aluminum salts that can be emulsified with the antigen that creates a gel-like substance

85
Q

Alum typically induces which biased response?

A

Th2

86
Q

Alum induces antibody responses independently of what other form of signaling?

A

TLR

87
Q

Alum exerts a direct effect on what substance?

A

IL-4 producing Gr-1 expression on cells

88
Q

Gr-1 is heavily expressed by what cells, and what is believed to be its function?

A

Neutrophils (but also monocytes and dendritic cells); important in fighting infection (microbial ones, too)

89
Q

What are other names for Gr-1?

A

Ly-6G/Ly-6C

90
Q

What is the main importance of the use of alum in vaccines?

A

Essential for priming and clonal expansion and optimal antibody production of B cells in vivo

91
Q

How do aluminum adjuvants work?

A

Induction of chemokines in macrophages, monocytes, and granulocytes to recruit other immune cells to the area

92
Q

Which cells are activated by sampling the area after recruitment of chemokines by aluminum adjuvants, then uptake the vaccine, and then haul the antigen to the lymph node?

A

Dendritic cells

93
Q

At least how many cytokines and chemokines are produced within 4 hours of aluminum adjuvant injection?

A

13 (examples = IL-1beta and IL-5)

94
Q

What cytokine is the main stimulus for microglial activation?

A

IL-1beta

95
Q

What is MF59 (adjuvant)?

A

Squalene-based oil-in-water emulsion

96
Q

What is the perceived mechanism of MF59?

A

Enhanced uptake by APCs

97
Q

What is the most potent inducer of genes encoding cytokines, cytokine receptors, and adhesion molecules involved in WBC migration?

A

MF59

98
Q

Because aluminum is difficult to clear from the body, where does it tend to accumulate?

A

Mitochondria and nuclei of cells

99
Q

What is the most abundant metal on Earth?

A

Aluminum

100
Q

Is there a known physiologic need for aluminum?

A

No

101
Q

About what percentage of orally administered aluminum is actually absorbed via the GI tract?

A

.3%

102
Q

What organ is the major route of elimination of absorbed aluminum from the human body?

A

Kidneys (limited ability, however)

103
Q

When intravenously infused with aluminum, who are more at risk for aluminum accumulation: adults or neonates?

A

Neonates (retention of 75% while only 40% in adults)

104
Q

Under what two situations can aluminum accumulation result?

A

When GI barrier is bypasses (IV infusion) or with advanced renal dysfunction

105
Q

What is the leading source of aluminum exposure?

A

Antacids (followed by antiperspirants)

106
Q

At 18 months of age, a child may have about how much aluminum exposure due to vaccines?

A

Over 5000 micrograms