Vaccines

ASSIGNED READING CHAPTER 18: pp 443-458 OUTLINE/SUMMARY

  1. Active vs Passive Immunization
  2. Vaccines for Active Immunization
  3. Whole Organism Vaccines
  4. Attentuated viral or bactrial vaccines
  5. Inactivated viral or bactrial vaccines
  6. Purified macromolecules as vaccines
  7. Recombinant Vector Vaccines
  8. DNA Vaccines
  9. Synthethetic Peptide Vaccines
  10. Multivalent Subunit Vaccines
  11. Anti-Idiotype Vaccines
  12. Vaccines for Passive Immunization

PERFORMANCE OBJECTIVES

DEFINE THE FOLLOWING KEY TERMS:

passive immunization [444] active immunization [445] vaccine[445]
boosters[445] herd immunity [446] attenuated vaccines [448]
inactivated vaccines[448] reversion [449] toxoid[451]
vector [451] vector vaccines [451] antiidiotype vaccine [455]
Immunostimulating Complexes (ISCOMS) [454    
solid matric antibody antigens (SMAA) [454    

ON COMPLETION OF THIS SECTION THE STUDENT SHOULD BE ABLE TO:

  1. Compare the acquisition passive and active immunization and give specific examples of each [444]
  2. Discuss the recommended program for Childhood immunizations.[445]
  3. Construct a table to compare the advantages and disadvantages of attentuated vs inactivated vaccines.
  4. compare the risks associated with attenturated or inactivated vaccines vs specific purified macromolecular vaccines.
  5. Compare the three general forms of purified macromolecular vaccines; polysaccharide, toxoid, and recombinant antigens
  6. Draw a diagram to show the steps in the production of a vaccina virus vector vaccine[452]
  7. Draw a diagram to show the uses of an anti-idiotypeantibody as a vaccine.
  8. Discuss the advantages of anti-idiotype vaccines[455]
  9. Compare solid matrix antibody-antigen complexes with immunostimulating complexes in the development of multivalent subunit vaccines. [455]

SHORT ANSWER QUESTIONS

  1. Differentiate between variolation and vaccination.
  2. Define vaccine. Name fouR types of vaccines and give examples of each.

Infection & Immunity

CHAPTER 19: Immune Response to Infectious Disease

THIS CHAPTER WILL NOT BE DEALT WITH IN THIS COURSE AS IT IS THE FOCUS OF THE INFECTIOUS DISEASE COURSE AND THE MEDICAL MICROBIOLOGY COURSE

Autoimmunity

ASSIGNED READING

CHAPTER 20: pp 485-505

OUTLINE/SUMMARY

  1. Organ Specific Autoimmune Diseases
  2. Direct cellular damage
  3. Antibody effects
  4. Systemic Autoimmune Diseases
  5. Animal Models
  6. TCR & MHC in Autoimmunity
  7. Induction of Autoimmunity
  8. Experimental Treatment

PERFORMANCE OBJECTIVES

DEFINE THE FOLLOWING KEY TERMS:

autoantigens autoimmunity autoimmune hemolytic diseases
cold antibody Graves disease autoimmune hemolytic anemia
Warm antibody Hasimoto's thyroiditis thrombocytopenic purpura
glomerulonephritis myasthenia gravis autoimmune hemolytic anemia
rheumatic fever Horror Autoxicus Insulin dependent diabetes millitus ( Type I)
rheumatoid arrthritis allergic encephalomyeltis Organ specific autoimmune diseases
  systemic lupus erythematosis systemic autoimmune diseases

ON COMPLETION OF THIS SECTION THE STUDENT SHOULD BE ABLE TO:

  1. Show how the origins of autoimmune disease may lie in the immune process, the self antigens or both.
  2. Describe two major events that may lead to autoimmune disease
  3. Distinguish between cell mediated and antibody mediated autoimmune diseases, give two specific examples of each and discuss these examples.
  4. Discuss the treatment of autoimmune diseases

SHORT ANSWER QUESTIONS

  1. The idea of clonal deletion suggests that self reactive cells are eliminated (no cells to react to self antigens; therefore, we tolerant self antigens), yet autoimmune diseases occur (react to self antigens). Explain.
  2. The idea of "Horror autotoxicus" was proposed in 1901 to suggest that reactions against self could not occur.
  3. Current evidence suggests otherwise. Explain.
  4. Other than the characteristic of foreigness, self antigens and exogenous antigens are not inherently different. Explain?
  5. What are Witebsky's postulates?
  6. Why are they important in describing autoimmune disease?
  7. The origin of an autoimmune disorder may lie in the immune process, the self antigens, or both. Explain.
  8. What are the two major events that could lead to an autoimmune disease?
  9. List some other possibilities.
  10. The description of SLE includes three mechanistic elemtns; What are they?
  11. In Hashimoto's disease, high levels of antibodies against thyroglobulin are found. Yet these antibodies do not seem to cause the disease. Explain.
  12. Compare and contrast the three lines of treatment for RA.
  13. Briefly discuss some autoimmune disease that can follow bacterial infections.
  14. Why would the induction of tolerance to an autoantigen, which is causing disease, be one of the most effective treatment approaches for autoimmunity?

Immunodeficiency Diseases ASSIGNED READING Chapter 21: pp 507-521 OUTLINE/SUMMARY

  1. Phagocytic Deficiencies
  2. Humoral Deficiencies
  3. Cell mediated Deficiences
  4. Combined Immunodeficiences
  5. Complement Deficiences

PERFORMANCE OBJECTIVES

DEFINE THE FOLLOWING KEY TERMS:

immunodeficiency [507] Wiskott-Aldrich syndrome (WAS)[519]
neutropenia[508] congenital agranulocytosis [508]
granulocytopenia[508] leukocyte-adhesion deficiency [508]
agranulocytosis[508] lazy leukocyte syndrome [510]
selective Iga Deficiency [ 514] chronic granulomatous disease (CGD)[510],
nude mice [515] X linked agammaglobulinemia [511],
reticular dysgenesis [516 X-linked hyper IgM (XHM) syndrome [512]
bare lymphocyte syndrome [516] common variable hypogammaglobulinemia(CVH) [513
X linked SCID [518] DiGeorge Syndrome (Congential thymic aplasia) [515]
  severe combined immunodeficiency disease (SCID)[517]

ON COMPLETION OF THIS SECTION THE STUDENT SHOULD BE ABLE TO:

  1. construct a table comparing four different
  2. phagocytic deficiency diseases [510]
  3. Construct a table comparing 4 different humoral deficiences;
  4. Draw a diagram of hematopoiesis and indicate congential defects that impair the immune response for
  5. Discuss the impact of T cell deficiencies
  6. Construct a table of the combined immunodeficiences that shows the disease, the immune system deficiency and the possible mechanism [517]
  7. Discuss the use of CB-17 SCID mice as a model system

SHORT ANSWER QUESTIONS

  1. How does immunodificiency differ from immunotolerance?

AIDS

ASSIGNED READING Chapter 22: pp 523-554 OUTLINE/SUMMARY

  1. Discovery
  2. Human Immunodeficiency Virus (HIV)
  3. Diagnosis of HIV
  4. Diagnosis of AIDS
  5. Destruction of CD4+ T cells
  6. CD4+ T cells infected with HIV
  7. Destruction of CD4+ T cells uninfected with HIV
  8. Immunologic Abnormalities in Aids
  9. Development of AIDS Vaccine

PERFORMANCE OBJECTIVES

DEFINE THE FOLLOWING KEY TERMS:

long terminal repeats[531 Acquired immunodificiency syndrome(AIDS) [524] fusin[529]
HIV-1 Human immunodeficiency virus (HIV)[524] integrase[530]
HIV-2 simian immunodificiency virus (SIV) [526] budding[530]
HIV-0 cytopathic retroviruses[524] syncytium[]542]
retroviruses [524] transforming retroviruses [524] Karposi's sacrcoma
V3 loop[536] reverse transcriptase [526] fusogenic domain[528]
seroconversion[536] opportunistic infections [524] crown region[536]

D ON COMPLETION OF THIS SECTION THE STUDENT SHOULD BE ABLE TO:

  1. Draw and label cross sectional diagram of an HIV virion
  2. Draw and label a diagram of the genome of HIV-1
  3. Discuss the factors that contribute to the genetic variation of HIV
  4. Construct a table of the cell types that can be infected by HIV[530].
  5. Draw and label a diagram show the steps in the infection of a target cell by HIV[528]
  6. Draw and label a diagram that shows activation of HIV provirus [528]
  7. Discuss the origins of HIV-1, HIV-2 and HIV-0.
  8. Draw a diagram to show the early and late stages in the expression of HIV-1 proviral DNA [534]
  9. Label a diagram of HIV-1 envelope glycoproteins.
  10. Describe the screening tests for HIV infection [537].
  11. Describe the clinical symptoms of AIDS[537]
  12. Describe the various mechanisms for the depletion of CD4+ cells in AIDS patients[538-543]
  13. Construct a Table summarizing the immunologic abnormalities associated with HIV infection.
  14. Construct a table showing the estimated incidence of AIDS around the world[525]

SHORT ANSWER QUESTIONS

Transplantation Immunology ASSIGNED READING CHAPTER 23: pp 555-572 OUTLINE/SUMMARY

  1. Immunological Basis of Graft Rejection
  2. Clinical Manifestions of Graft Rejection
  3. Tissue Typing
  4. General Immunosupressive Therapy
  5. Specific Immunosupressive Therapy
  6. Clinical Transplantation

PERFORMANCE OBJECTIVES

DEFINE THE FOLLOWING KEY TERMS:

allogtraft alloreactivity autograft
chronic rejection Class I MHC Class II MHC
first set rejection graft grafting
Graft vs host reaction privileged sites privileged tissues
mixed lymphocyte reaction syngraft transplant
second set rejection transplantation xenograft
transplantation immunity    

ON COMPLETION OF THIS SECTION THE STUDENT SHOULD BE ABLE TO:

  1. Show that the cell mediated response to transplants in the same as the immune response to any other foreign antigen
  2. Describe four types of grafts
  3. Describe the five transplantation laws
  4. Distinguish among first set rejection, second set rejection and chronic rejection;
  5. Differentiate between host versus graft reaction and graft versus host reaction.
  6. Compare the contribution of Class I and Class II MHC to graft rejection.
  7. Comment on which T cells are responsible for graft rejection
  8. Describe serologic tissue typing.
  9. Describe the mixed lymphocyte reactions and why you would want to use the MLR in tissue typing
  10. Rank the success rate for transplants of different tissues and organs

SHORT ANSWER QUESTIONS

  1. What do we mean when we say that the immune system is the greatest obstacle to most transplants?
  2. What is the difference between autograft and syngraft? Give examples of both.
  3. How do we know that the immune system is involved in allograft rejection?
  4. Are antibodies or T cells the main mediators of rejection?
  5. ompare and contrast first set rejection and second set rejection.
  6. What does second set rejection suggest about the similiarity of transplantation antigens?
  7. What conditions could lead to a graft vs host response (GvHR)?
  8. Even though class II antigens are found mainly on immune cells, they can still contribute to graft rejection. How?
  9. What may be the biologic significance of alloreactivity?
  10. Describe serologic tissue typeing.
  11. Describe the MLR. Why is this test done in addition to serologic tissue typing?
  12. Differentiate between privileged sites and privileged tissues.

Cancer & Immunity ASSIGNED READING Chapter 24: pp 573-596 OUTLINE/SUMMARY

  1. Origins & Terms
  2. Malignant Transformation
  3. Oncogenes
  4. Tumours of the Immune System
  5. Tumour Antigens
  6. Tumour associated antigens
  7. Immune Response to Tumours
  8. Tumour Evasion of Immune Response
  9. Cancer Immunotherapy

PERFORMANCE OBJECTIVES

DEFINE THE FOLLOWING KEY TERMS:

Antibody dependent cell mediated cytotoxicity (ADCC) benign tumour carcinogens
tumour specific transplantation antigens natural killer cells (NK) immunotoxins
immalignancymune surveillance Specific immunotherapy neoplasm
non specific immunotherapy tumour specific antigens oncogens
Lymphokine activated killer cell(LAK) malignant tumour tumour
tmour associated transplantation antigens oncofetal antigens cancer
tumour associated antigens proto oncogens metastasis

ON COMPLETION OF THIS SECTION THE STUDENT SHOULD BE ABLE TO:

  1. Differentiate between a benign tumour and a malignant tumour.
  2. Describe the concept of immunosurveillance
  3. Describe the different ways that tumours can camouflage themselves to evade immune defenses,
  4. Discuss the advantages of immunotherapy over other forms of cancer therapy.
  5. Distinguish between specific and nonspecific immunotheraphy with the use of specific examples.
  6. Describe immunotoxins.
  7. Describe the development of humanized antibodies to tumour antigens
  8. Evalulate the contribution of T cells, NK cells, Macrophages, and B cells to tumour immunity.
  9. Distinguish between tumour specific transplantation antigens and tumour assoicated transplantation antigens.
  10. Describe oncofetal antigens.

SHORT ANSWER QUESTIONS

  1. Explain how some cancer cells that can make TGF-beta are immunosuppressive.
  2. Tumours and transplants are similar to one another,yet very different. Explain this observation in the context of what the immune system recognizes and the result of this recognition.
  3. The qualities of proliferation and differentiation are essentially all that distinguishes a normal cell from a cancer cell. Explain.
  4. Design an experiment using mice that proves that the immune system provides immunity against tumours.
  5. Distinguish between tumour-specific transplantation antigens (TSTA) and tumour associated transplantation antigens (TATA).
  6. Design an experiment to show Tumour associated Transplantation Antigens (TATA).
  7. What is the main difference separating cell surface antigens from chemically induced and virually induced cancers? Speculate on why this difference leads to difficulty in designing anticancer vaccines.
  8. What are oncofetal antigens? Are they important in tumour immunity? Why?
  9. What is immune surveillance? All evidence for immune surveillance is indirect. Speculate on how you could get direct evidence.
  10. What immune cells play a role in tumour rejection? Briefly describe how each accomplishes this task. Include such things as cytokines, perforins, ADCC etc.
  11. Cancers camouflage themselves to evade antitumour defenses. Pick three possible forms of camouflage that you think are most important, describe them and state why you think they are most important.
  12. What are immunotoxins?
  13. Surgery, radiation and chemotherapy are the methods most widely used to treat cancer patients. What are the problems with this regimen, and how could immunotherapy overcome these problems. Distinguish between specific and nonspecific immunotherapy.