Active and passive
immunization
Active
immunisation
Passive immunisation
Speed of response Delayed Prompt
Length of response Long-term Short-term
Clinical use Long-term
prophylaxis
Treatment, short-term
prophylaxis
Active and passive arteficial immunisation
Passive immunization
• Substitution of missing specific antibodies
protecting against infectious disease or
treating the infectious disease.
• Used mainly in infectious diseases or
diseases caused by toxins.
• Prompt but short-term effect.
• No immunological memory is induced.
Antisera used in human
medicine
• Against bacterial infections: Tetanus (human),
Diphteria (equine), Botulism (equine)
• Against viral infetions: Hepatitis B (human),
Rabies (equine), Varicella-zoster (human), CMV
(human), tick-born encephalitis (human), hepatitis
A, measles and other viral infections (pooled
human immunoglobulin)
• Against snake or black widow spider toxins
• Anti Rh
Non-specific immunoglobulin
derivates
• Obtained from donors´ plasma by ethanol
extraction.
• Contains almost exclusively IgG, other isotypes
are present only in traces.
• Currently only derivates for intravenous or
subcutaneous application are used.
Therapeutic use of immunoglobulin
derivates - I
• Replacement treatment in patients with
hypogammaglobulinemia .
• It is only IgG substitution, other isotypes are not
present.
• In patients with primary hypogammglobulinemia it
is usually a life-long treament.
Therapeutic use of immunoglobulin
derivates - II
• High-dose intravenouss immunoglobulin
treatment can be used in severe inflammatory or
autoimmune diseases.
• The mechanism is complex (inhibition of
phagocytosis, suppression of B-cells function,
effete on T-cell functions) .
• The efficacy is variable and in situation difficult to
predict.
• Most effective in Kawasaki disease and immune
thrombocytopenic purpura (ITP).
Active immunization
(vaccination)
• Induction of immune memory by a harmless
antigen.
• In the case of infection by a pathogen
prompt secondary immune response
protects the immunized person from the
disease.
• Has protective, but no therapeutic effect.
Edward Jenner
Discovery of small pox vaccine
Primary and secondary immune
response
Secondary antibody
response
Primary
antibody
response
IgM
IgG
Firstexporsure
Serumantibodytiters
Weeks
Secondexposureto
antigen
Downloaded from: StudentConsult (on 18 July 2006 11:29 AM)
© 2005 Elsevier
Primary and secondary immune response
The effect of vaccination on infectious
diseases occurrence in USA
„Classical“ vaccines
• Atenuated microbes: mumps, measles
rubella (MMR vaccine), rotavirus
varicella, BCG (against TBC),cholera,
yellow fever, poliomyelitis,
• Inactivated microorganisms: rabies,
hepatitis A, tick-born encephalitis,
poliomyelitis, cholera, plague. Formerly
pertussis.
• Toxoids: tetanus, diphteria
„Modern“ vaccines
• Subunit: influenza, pertussis
• Polysaccharide: Heamophilus influenzae B
(conjugated), Meningococcus (conjugated group
B, nonconjugated the remaining serotypes),
Pneumococcus (conjugated)
• Recombinant: hepatitis B
• Virus-like particles : papillomavirus
„Future (?)“ vaccines
• Synthetic polypeptides
• Antiidiotype antibodies
• DNA vaccines
• RNA vaccines
• Vector vaccines
• Antigens inserted into food
(bananas, potatoes)
DNA-vaccines
The DNA segment encoding the protective
antigen is inserted with a suitable
promoter into the bacterial plasmid.
Intramuscular, mucosal applications,
intraepidermal - "gene gun„
The antigen is produced in vivo and induces
both an antibody and a cellular immune
response.
he DNA segment encoding the respective antigen is inserted with a suitable pr
BCG (Bacille Calmette Guérin)
vaccine
• Prepared in 1921 - after 13 years of passage of Mycobacterim bovis, on potatoes
with glycerin and beef bile.
• It has been and is used in protection against M. tuberculosis and partly also other
mycobacteria.
• It protects mainly against severe disseminated forms of TB.
• It is a live vaccine that stimulates T-lymphocytes, it was given on the 4th day after
birth. However, administration was often accompanied by BCG infection, most often
BCG lymphadenitis, so most European countries gradually withdrew from routine
administration of BCG vaccine in general population.
• Efforts have been made to use BCG in the treatment of tumors (non-specific
immunostimulator); currently, local BCG is a treatment of choice in bladder cancer.
• However, current statistics suggest that people who have been given the BCG
vaccine may be more resistant to some infections (including COVID 19) - perhaps by
a "trained immunity" mechanism.
Other (possible) uses of
vaccination approach
• Anti-tumour vaccination – both preventive to therapeutic
approaches are used
• Prevention ant treatment of Alzheimer disease – anti bamyloid
or t-protein
• Contraception – most frequently anti-HCG
• Treatment of high blood pressure – enzymes of angiotensinrenin-aldosterone
system
• Vaccination against autoimmune diseases – e.g. against
autoimmune TCR.
• Vaccination against drugs (cocaine, possibly nicotine)