Immune prophylaxis and Immunotherapy

Immune prophylaxis

I. Introduction

•The last known person in the world to have a natural case of smallpox. Variola minor in 23-year-old Ali Maow Maalin, Merka, Somalia CDC •In 1980, WHO announced that smallpox has been eradicated in the world.

II. Essential requirements of vaccine

III. Artificial active immunization

Antigen:Vaccine or Toxoid inactivated vaccine (Dead vaccine ) Live-attenuated vaccine Toxoid Recombinant Vaccine:HBsAg

Agents used in active immunization

The agent used for artificial active immunization is called vaccine.

1. inactivated vaccine (Dead vaccine ) Standard strain of a microbe is killed

and severed as an immunogen. For example: cholera vaccine Japanese encephalitis

vaccine rabies vaccine typhoid vaccine

Agents used in active immunization

2. Live-attenuated vaccine It is more effective than dead

vaccine I.E:Bacillus Calmette-Guerin (BCG)

vaccine;Measles virus vaccine;Polio virus vaccine (oral);Typhoid vaccine (oral live attenuated bacteria)

Live attenuated vs inactivated Vaccines

Live-attenuated Vaccines Inactivated Vaccines

Route imitating natural infection Injectionsubcutaneously

Doses small LargeTimes once Twice or more

Side effects slight severeDuration Long

(3~5years or life long)Short

(months~1 years)Mutation possible impossible

Preservation 4C or lymphilization easy to preserve

Jonas Salk Albert Sabin

Live attenuated vs inactivated Vaccines

3. Toxoid

Exotoxin can be converted into nontoxic but

still immunogenic preparations called toxoid.

Examples:Diphtheria toxoid, Tetanus toxoid

IV. Artificial passive immunization

Abs:Antitoxin,Human Ig(IMIG,IVIG,Specific Ig,McAb)

Cytokines(IL-2, IFN, CSF)

Cells(LAK,TIL).

Active immunization Passive immunization

Administration Ag (vaccines, toxoid) Ab (antitoxin, -

globulin) Production of slowly immediately immunity Duration of long (from several short (2 weeks to immunity months to years) months)

Usage immunoprophylaxis emergency prophylaxis and therapy

Comparison between active and passive immunization

V. Adjuvant

A substance that, when mixed with an immunogen, enhances the immune response against the immunogen.

Alum

VI. Planned immunization• A rational program of immunization

against infectious diseases has been committed in children worldwide when many of the most damaging and preventable infections normally appear.

• The program of childhood immunization is called planned immunization.

Planned immunization schedule in China  Age Type of vaccine

   PrimaryImmunization

Birth BCG vaccine, HBV vaccine (1st)

1 month HBV vaccine (2nd)

2 months Poliovirus vaccine (1st)

3 months Poliovirus vaccine (2nd), DTP (1st)

4 months Poliovirus vaccine (3rd), DTP (2nd)

5 months DTP (3rd)

6 months HBV (3rd), Meningococcal polysaccharide vaccine

8 months Measles virus vaccine

1 year Japanese encephalitis vaccine (1st and 2nd)

  Booster/reimmunization

1.5 years DTP, Measles virus vaccine, Poliovirus vaccine, Meningococcal polysaccharide vaccine

2 years Japanese encephalitis vaccine

3 years Japanese encephalitis vaccine

4 years Poliovirus vaccine

5 years DTP, Measles virus vaccine, BCG vaccine, Meningococcal polysaccharide vaccine

VII. Development of novel vaccines

• Subunit vaccine• These vaccines are in use which

make use of antigens either purified from microorganisms or produced by recombinant DNA technology.

• e.g. HBV vaccine (HBsAg)

• Conjugate vaccine

• Synthetic peptide vaccine

• Genetic engineering vaccine

Recombinant antigen vaccine

Recombinant vector vaccine

DNA vaccine Transgenic plant vaccine

Reverse vaccinology for identification novel vaccine antigen

Preventative Vaccine

Therapeutic Vaccine

VIII. Challenge of vaccines

HIV HCV TB Malaria

Immunotherapy

I. Conception and classificationName Scope or Characteristic

immunoenhancing therapy Infection, Tumor, IDD

immunosuppressive therapy

HVGR, GVHR, AID,Anaphylaxis, Inflammation

active immunotherapy Vaccine,Therapeutic Vaccine of tumor,

passive immunotherapy Ab, LAK cell

specific immunotherapy Peptide,antigen,

Non-specific immunotherapy

BCG, cytokines

II. Molecular Immunotherapy

1. Molecular Vaccine Synthetic peptide vaccine Recombinant vector vaccine DNA vaccine used as treatment of tumor

and infection

II. Molecular Immunotherapy2. Antibody-polyclonal Ab antitoxic serum placental gamma-globulin antibacterial immune serum antiviral immune serum anti-lymphocyte gamma-globulin,

ALG

II. Molecular Immunotherapy

2. Antibody-Monoclonal antibody, mAb

mAb against surface membrane molecules on lymphocytes ：CD3 ， CD20,

mAb against cytokines:TNF mAb-directed therapy mAb coupled to isotopes, drugs, toxins

Application of Ab in vitro: elimination of cancer cells in bone marrow or T cells to prevention GVHD

Examples of tumor antigens that have been targeted by monoclonal antibodies in therapeutic trials.

II. Molecular Immunotherapy

Chimeric Ab Humanized Ab (CDR-grafted

Ab) Single chain Ab Bispecific Ab

2. Antibody-Genetic engineering Ab

II. Molecular Immunotherapy

Cytokine supplement and addition therapy

IFN, IL-2, CSF Cytokine blockade and

suppression anti-TNF IL-1Ra sIL-1R

3. Cytokines and their antagonists

III. Cellular Immunotherapy

1. Cellular Vaccine Tumor cellular vaccine Gene-modified cancer vaccine APC vaccine

III. Cellular Immunotherapy

2. Adoptive immunotherapy TIL LAK （ CIK）3. Stem cell transplantation Bone marrow Peripheral blood Umbilical blood

VI. Biological response modifier and immunosuppressive agent

1. Biological response modifier(BRM) A variety of agents that stimulate the

immune response non-specifically are called biological response modifier.

Microorganism products: BCG, corynebacterium parvum (CP), polysaccharide

Synthetic molecules:polyI:C CK Hormones:Thymosin, Thymopoietin

• Immunosuppressive agents

1. Chemicals Glucocorticoids, cyclophosphamide,

azothioprine, etc.

2. Microorganism products Cyclosporin, FK506, rapamycin

Summary

Classification of immunoprophylaxis and their biological materials

Classification of immunotherapy and their biological materials

Thank you for your attention!

chenjianzhong@zju.edu.cn