Active and passive immunization



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

In 1798, Jenner introduced 1^st vaccination (vacca: cow) following his experimentation with
isolates of cow pox virus from ‘Blossom’.

Primary and secondary immune response
Secondary antibody response
Primary antibody response
IgM
IgG
Weeks

S0241X-007-f002a
Downloaded from: StudentConsult (on 18 July 2006 11:29 AM)
© 2005 Elsevier
top_logo
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 promoter into the
bacterial plasmid.     Intramuscular applications,                intraepidermal - "gene gun"
          mucosal     The antigen is produced in vivo and induces both an antibody and a cellular
immune response

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 b-amyloid or t-protein
•Contraception – most frequently anti-HCG
•Treatment of high blood pressure – enzymes of angiotensin-renin-aldosterone system •Vaccination
against autoimmune diseases – e.g. against autoimmune TCR.
•Vaccination against drugs (cocaine, possibly nicotine)
•
•