IMMUNITY

• State of resistance
• ability of the body to recognize and defend
vs infectious diseases
• Types:
– Natural/Innate
– Acquired
Natural or Innate Immunity
• Inherited resistance to infections
• develops naturally without contact with
any microorganism; non-specific
• Types:
1. Species immunity - physiological and
biochemical differences between tissues
of different species
2. Racial Immunity - various races within the
same species show marked difference in
the degree of resistance to infection
- due to diet, habits, environmental
conditions, living style, economic status,
genetic basis
3. Individual immunity- different individuals
show marked difference in their immunity
- some would entirely escape from
- some develop subclinical infections
- some might develop the disease
Factors Affecting Innate
Immunity (Host Factors)
• General health of an individual
• Age
• Hormonal Influences
Mechanism of Innate Immunity
1. Prevent entry of microorganisms - 1st line
of defense
2. Interact with infectious agent through
activation of tissue factors when the
infective agent penetrates the body - 2nd
line of defense
First line of Defense (External)
• Epithelial surfaces
– Skin - keratin; inhibitory effect of fatty acids;
salts; acidic pH (5.2-5.9)
– Mucous membranes - mucus (lysozyme)
– Body secretions - sebum, sweat, tears, saliva,
gastric juice, flushing action of urine
2nd line of Defense (Internal)
• Tissue factors
1. Humoral factors - antimicrobial activity of
blood and tissue fluids
a. lysozyme - heat labile; mucolytic enzyme
b. complement - heat labile protein; serum,
bactericidal
c. Properdin - complement-like; serum; vs G-
bacteria
 d. Interferon - anti-viral agent
e. Phagocytin - heat stable protein;
bactericidal
2. Cellular factors - mediated by phagocytic
cells; blood and tissues
a. Microphages -PMNs leucocytes
(neutrophils and eosinophils)
b. Macrophages - monocytes
Inflammation
• Tissue injury or irritation initiated by entry
of microorganisms, toxins, or other factors
(heat, trauma)
• occurs as a result of: increased blood flow
and aggregation of phagocytes
• limit tissue damage; restrict infection and
initiate tissue repair
Fever
• Protective defense mechanism of the body
• Increase in temperature also increases:
– blood circulation and flushing of tissue
– destruction of pathogens
– production of interferons
Immunity : Third Line of Defense
• Definition:
- resistance to disease
• Immune response:
- antibodies are produced by lymphocytes to
recognize, bind with, inactivate, and destroy
specific microorganisms
- blood plasma, lymph, other body secretions
Acquired Immunity
• Immunity specific for a particular disease
which an individual acquires during the
course of his/her life
• Two types:
a. Active immunity
b. Passive immunity
Active Immunity
• Resistance developed by an individual in
response to the microbes or their products
• requires a considerable for development
(weeks or months), persists for long
duration and may last for years
• may be: naturally acquired
artificially acquired
• Naturally Acquired Active Immunity
– individual develops as a result of natural
contact with a microbe or its product
– individual become immune by same pathogen
for a period
– Symptoms may or may not be present when
antibodies are formed
– Resistance to reinfection may be permanent
– Ex. Mumps, measles, diptheria, poliomyelitis,
typhoid fever
• Artificially Acquired Active Immunity
– individual acquires as a result of artificial
inoculation of microbes or their products
– Person receives a vaccination; specific
antibodies are produced
– Ex. MMR, Hepatitis, Chicken Pox, Poliomyelitis
Passive Immunity
• Acquired by transfer of ready made
antibodies vs microbes or their products in
another host
– rapidly established
– immediate protection offered - diphtheria,
tetanus, snake bite etc
a. Naturally Acquired Passive Immunity
b. Artificially Acquired Passive Immunity
• Naturally Acquired Passive Immunity
- transfer of readymade antibodies from mother
to fetus (3-4months)
- before birth - placenta
- after birth- milk or colostrum
• Artificially Acquired Passive Immunity
– injecting Abs produced in some other human
or animal
– short duration immunity
– antisera and antitoxins - antibodies prepared
in animals; used only in clinical situations
where there is no other alternative available
--> risk of hypersensitivity
– Ex. Human gamma globulin, anti-venom, anti-
rabies, anti-tetanus
Antigen (Ag) and Antibodies (Ab)
• Antigen - any substance which when
introduced parenterally into the living
animal body evokes specific immune
response
• foreign substance - dead or living
microorganism, vegetable proteins, egg
albumin, plant or animal tissue, bacterial
toxins, RBCs, snake venom, milk
• Antibodies - immunoglobulins; group of
glycoproteins present in the serum and
tissue fluids of all mammals
• synthesized in response to foreign
substance
• constitute 20-25% of the total serum
proteins
Classes of Immunoglobulin
• Human sera contain 5 different types of Igs
1. Immunoglobulin G (IgG) - protects the
body fluid
2. Immunoglobulin A (IgA) - protects the
body surface
3. Immunoglobulin M (IgM) - protects the
bloodstream
4. Immunoglobulin D (IgD) - similar to IgG
5. Immunoglobulin E (IgE) - responsible for
hypersensitivity reaction and vs helminthic
parasites
Types of Antibodies
1. Opsonins - phagocytosis
2. Cytolysins - dissolve or destruct cells
3. Agglutinins - clumping of Ags and
phagocytosis
4. Hemolysins - lysis of RBCs
5. Antitoxins - in response to exotoxins
neutralizing or inactivating their effects
Immunization
• Method by which artificial immunity in an
individual is increased artificially by giving
immunizing agents
• For prophylaxis and treatment of diseases
in certain situations are most effective
• Also called vaccination
Purpose of Immunization
• Provide protection vs infectious diseases
in children
• To raise overall level of immunity in
community to control infection
• To provide protection in selected groups or
individuals having risks of particular
infection
Types of Vaccines:
• Live-attenuated vaccines
• Inactivated (killed) vaccines
• Subunit, recombinant, polysaccharide and
conjugated vaccines
• Toxoids vaccines
• Live attenuated vaccines
• Available since the 1950s, live attenuated
vaccines (LAV) are derived from disease-
causing pathogens (virus or bacteria) that
have been weakened under laboratory
conditions.
• They will grow in a vaccinated individual,
but because they are weak, they will cause
no or very mild disease.
• IMMUNE RESPONSE
• Live microorganisms provide continual
antigenic stimulation, giving sufficient
time for memory cell production.
• Attenuated pathogens are capable of
replicating within host cells. Excellent
immune response
• Attenuated pathogens can revert to
original form and cause disease
• Potential harm to individuals with
compromised immune systems (eg. HIV)
• Sustained infection (BCG - local
lymphadenitis). w Contamination of tissue
culture
• Immunization errors (Reconstitution, cold
chain). w Usually not given in pregnancy
• Less safe compared to inactivated
vaccines
Inactivated whole-cell vaccines
• made from microorganisms (viruses,
bacteria, other) that have been killed
through physical or chemical processes.
These killed organisms cannot cause
disease.
Immune response
■ Inactivated whole-cell vaccines may not
always induce an immune response and
the response may not be long lived.
■ Several doses of inactivated whole-cell
vaccines may be required to evoke a
sufficient immune response.
Safety and stability
• Inactivated whole-cell vaccines have no
risk of inducing the disease they are given
against as they do not contain live
components
■ They are considered more stable than LAV
vaccines.
Subunit vaccines
• do not contain live components of the
pathogen
• They differ from inactivated whole-cell
vaccines, by containing only the antigenic
parts of the pathogen
• These parts are necessary to elicit a
protective immune response
• Costly
• Less strong immune response
SAFETY AND STABILITY
• Do not contain live components and are
considered as very safe
• Excellent stability profile
Toxoid vaccines
• are based on the toxin produced by certain
bacteria (e.g. tetanus or diphtheria)
• toxin invades the bloodstream and is
largely responsible for the symptoms of the
disease
• protein-based toxin is rendered harmless
(toxoid) and used as the antigen in the
vaccine to elicit immunity
• the toxoid is adsorbed to aluminium or
calcium salts, which serve as adjuvants.
Safety and stability
• Toxoid vaccines are safe because they
cannot cause the disease they prevent and
there is no possibility of reversion to
virulence
• The vaccine antigens are not actively
multiplying and do not spread to
unimmunized individuals
• They are stable, as they are less
susceptible to changes in temperature,
humidity and light
Route of administration
• Intramuscular (IM) injection administers
the vaccine into the muscle mass.
Vaccines containing adjuvants should be
injected IM to reduce adverse local effects
• Subcutaneous (SC) injection administers
the vaccine into the subcutaneous layer
above the muscle and below the skin
• Intradermal (ID) injection administers the
vaccine in the topmost layer of the skin.
BCG is the only vaccine with this route of
administration. Intradermal injection of
BCG vaccine reduces the risk of
neurovascular injury.
• Oral administration of vaccine makes
immunization easier by eliminating the
need for a needle and syringe
• Intranasal spray application of a vaccine
offers a needle free approach through the
nasal mucosa of the vaccinee
Contraindications
• A contraindication to vaccination is a rare
condition in a recipient that increases the
risk for a serious adverse reaction
• Ignoring contraindications can lead to
avoidable vaccine reactions
• Most contraindications are temporary, and
the vaccination can be administered later
• The only contraindication applicable to all
vaccines is a history of a severe allergic
reaction after a prior dose of vaccine or to a
vaccine constituent
• Precautions are not contraindications, but
are events or conditions to be considered
in determining if the benefits of the vaccine
outweigh the risks