NSG 250 Immune & Oncology PPT PDF

IMMUNE SYSTEM, IMMUNIZATIONS, AND ONCOLOGY N 376 The Immune System Barrier defenses Skin Mucous membranes Gastric acid Cell membrane histocompatibility antigens or human leukocyte antigens (recognize self vs. foreign cells) Cellular immune defense...

IMMUNE SYSTEM, IMMUNIZATIONS, AND ONCOLOGY N 376 The Immune System Barrier defenses Skin Mucous membranes Gastric acid Cell membrane histocompatibility antigens or human leukocyte antigens (recognize self vs. foreign cells) Cellular immune defenses Myelocytes produce neutrophils, basophils, eosinophils, monocytes, macrophages Lymphocytes produce lymphoid tissue and B and T cells Inflammatory response (local reaction to invasion/injury) Bradykinin, histamine, cytokine = chemotaxis = vasodilation = brings RBCs/WBCs to injured area The Immune System con’t Immune response T cells, B cells, complement proteins, formation of antibodies Interferons – chemicals secreted by cells that have been invaded by viruses and other stimuli. They prevent viral replication and suppress malignant cell replication and tumor growth Interleukins – chemicals secreted by active leukocytes to influence (activate/recruit) other leukocytes Tumor necrosis factor (TNF) – a chemical released by macrophages which inhibits tumor growth and can cause tumor regression Antigen vs. Antibody Autoimmune Disease Occurs when the body responds to specific self-antigens and produces antibodies or cell- mediated immune responses against its own cells. 3 theories: Cell is invaded by virus, body blames cell (not the virus) and attacks similar cells (Type 1 Diabetes?) Autoantibodies occur all the time but only become problematic when immunosuppression keeps T-cells from keeping them in check There is a genetic predisposition to developing aggressive autoantibodies Antibody formation B cells (“memory” cells) are released in response to antigen recognition. They cause antibodies to be formed. This is called “active immunity” Immunizations (vaccines) are administered to produce memory cells (B cells) in advance of exposure to an antigen, so the body can mount a response quickly and effectively when exposed! Vaccines have worked to eradicate and control some of the most dangerous infections in the world! Immunization VOCAB Booster: follow up doses of a vaccine that provide sustained protection (COVID-19) Titer: measurement of the amount of antibody produced; helps to verify immunity Attenuated vaccines: alive but weakened (MMR) Inactivated vaccines: killed microbes, may require boosters (Hep A) Toxoid vaccines: chemically modified so no longer toxic (Diphtheria, Tetanus) mRNA vaccines: teach our cells how to make a protein —or even just a piece of a protein—that triggers an immune response inside our bodies (COVID-19)  IMMUNIZATION VOCAB CON’T Recombinant vaccines: partial organisms of bacterial proteins (Hep B) Active immunity: caused by pathogen or vaccine; body has to produce antibodies in response to pathogen Passive immunity: preformed antibodies are transferred or donated from one person to another (placenta, breastmilk, immunoglobulin). Used when a patient is already exposed and has no time to develop active immunity or in the immunosuppressed population. (Rabies, antivenin, hepatitis exposure, botulism, tetanus, Rhogam, COVID) Immune globulins: passive immunity can be obtained (“borrowed”) to give higher AB titer quicker and in instances of immunosuppression or high risk (ie. chicken pox exposure in high-risk individuals or immigrants who have unknown status and are exposed) Serum Sickness When immunoglobulins (borrowed antibodies) are injected, the body can view them as “foreign” and mount counter-antibodies against them, leading to a massive immune reaction Fever Arthritis Flank pain Myalgia Arthralgia Use of Immunoglobulin/Immune Sera Your patient is a 10-year-old bitten by a stray dog. He is to receive rabies immunoglobulin and the first of 5 rabies vaccines. Using the terms active and passive immunity, discuss his two treatments. Immunization Side Effects Redness and discomfort Fever, aches, arthralgias Subclinical appearance of disease (what type of vaccine is this most likely associated with?) Anaphylaxis High fevers (103.5+ = do not administer next dose) Immunizations are often contraindicated in immunocompromised; current diarrhea, vomiting, fever; current high-dose steroid use. (Why?) Should delay in pregnancy if possible. Don’t give to those who had previous anaphylactic reaction to that vaccine. A slight reaction at the injection site (redness, discomfort, warmth) is expected and does not preclude administration of next dose in series Vaccine Facts MMR is made from eggs (think allergy) OPV, MMR, and varicella are live vaccines (think immunosuppression contraindications) Meningococccal vaccine is given to high-risk groups (ie. communal living) Influenza must be repeated every year - IM and nasal versions (egg allergy?) Tetanus vaccine is q 10 years unless in the presence of a wound, then q 5 years Vaccine Facts Pneumococcal vaccine is given to kids (Prevnar 13) and to adults over 65 or with risk factors (Pneumovax). HPV vaccine (Gardisil) is now indicated for boys and girls aged 11-12 (2-3 shot series) Rotavirus is only given to those