chapter 18: practical applications of immunology

Transcription

1 chapter 18: practical applications of immunology Revised 4/18/2018

2 immunological memory

3 immunological memory movement via circulation memory B bone marrow secrete Ab continuously effector memory T tissue space central memory T lymphatic circulation

4 Ab & TCR affinity memory cell abundance x 1 response memory affinity 1 1/ bind tightly 2 1/1000 bind tightly B cells don t require T H cells 1 response d 2 response 1 2 d vaccine functions vaccine types

5 immunity acquired immunity natural active (infection) passive (maternal Ab) acquired immunity natural artificial active (infection) passive (maternal Ab) active (Ag inoculation) passive (Ab inoculation)

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7 childhood immunization recommendations Disease TDaP- Tetanus, Diptheria, Pertussis Vaccine tetanus & diptheria toxoid, acellular fragments of B. pertussis Pneumococcal Pneumonia Hib H. influenzae type b meningitis Hepatitis A Human Papillomavirus Influenza A Hepatitis B MMR- Measles, Mumps, Rubella Chickenpox S. pneumoniae polysaccharide conjugates polysaccharide conjugated with protein inactivated virus antigenic fragments of virus injection: inactivated virus; nasal: attenuated antigenic fragments of virus attenuated viruses attenuated Varicellavirus

8 case study: Varicellavirus March 12, yo female ER admission 3d Hx rash, 1d Hx shortness of breath, fever (101.1 O F) Dx: septic shock hospital stay Tx: acyclovir, Abx (ciprofloxacin, meropenem, STX, ticarcillin w/clavulanate, tigecycline) & mechanical ventilation pneumonia & acute respiratory distress multi-organ dysfunction pancytopenia nosocomial infections LRI: Enterobacter cloacae UTI: Pseudomonas aeruginosa sepsis: Stenotrophomonas maltophilia prognosis: dead on day 21 Click here to read and here to listen, if you have concerns about a link between autism & vaccinations.

9 immunological identification methods immunological assays Ag-Ab interaction direct detect Ag indirect detect Ab Sensitivity: probability of false negative SN-N-OUT SeNsitive when Negative rules OUT Specificity: probability of false positive SP-P-IN SPecific when Positive rules IN

10 monoclonal antibodies (mabs) hybridoma: cancerous B cell fused to Ab producing spleen cell mab

11 agglutination reactions: naked eye results ~1900: Gruber-Durham reaction agglutination Widal s serum diagnosis of Typhoid carriers Landsteiner: ABO & Rh blood typing Crypotococcus neoformans Ab: Pneumonia/Meningitis Figure 18.4

12 enhancing visibility: fluorescent Abs & FACS direct Lyssavirus rabies test

13 enhancing visibility: complement fixation Borrelia burgdorferi Abs for Lyme Disease diagnosis

14 enzyme-linked immunosorbent assay (ELISA) direct ELISA indirect ELISA

15 the rapid strep test 70 85% pharyngitis cases are viral- no Abx, bacterial cases are self-limiting S. pyogenes causes pharyngitis and long-term sequelae (rheumatic fever, kidney disease) No symptoms are specific to streptococcal pharyngitis rapid strep test 95 98% specificity; 70-95% sensitivity

16 chapter 18 learning objectives 1. How and when is immunological memory generated? 2. Where do memory B cells, effector memory T cells, and central memory T cells live? 3. Compare and contrast the affinity and speed of the primary vs. the secondary immune response. 4. Distinguish the four ways that immunity can be acquired. Be able to recognize and give an example of each. 5. Describe the serological tests discussed in lecture; include direct and indirect versions of each. Understand how to interpret positive and negative results for each. As technology has advanced, how has that made these serological tests more specific? 6. Define specificity and sensitivity. How do these terms relate to the serological tests you described above? 7. Describe the GENERAL mechanism for producing monoclonal Abs. Why are they necessary?