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IMMUNITY AND
IMMUNOLOGICAL
PRODUCTS
HIMANSHU
ASSISTANT PROFESSOR
GGSCOP,YNR
INTRODUCTION
• Immunity: protection against infections. OR Depends on the ability of
the immune system to distinguish between self and non-self molecules
(foreign molecules)
• Immune system: molecules, cells and tissues that mediate responses to
foreign substances
• Immunology: the branch of biomedical science concerned with the
response of the organism to antigenic challenge, the recognition of self
from non-self, and all of the biological (in vivo), serological (in vitro), and
physical chemical aspects of immune phenomena
• As it protects us from disease it is also called disease resistance.
• Lack of immunity is known as susceptibility.
• Pathogen: A pathogen or infectious agent is a biological agent that
causes disease or illness to its host
• Antigens: substances recognized by the cells and molecules of the
immune system and to which the system responds
• Antibodies: are proteins produced and secreted by B cells. They bind
to foreign substances that invade the body, such as pathogens. The
term "antibody" refers to its function, which is to bind to an antigen.
• Toxins: these are the poisonous substances produced by pathogenic
microorganisms and lead to infection or disease in man or animals.
• Exotoxins: these are the toxins which can diffuse freely through the
bacterial cell wall into the blood or the medium in which the
microorganisms are growing.
• Endotoxins: these arc the toxins which cannot diffuse through the
bacterial cell wall and arc retained within the bacteria. They are
released only when the cells die and start disintegrating.
• Antitoxins: these are the substances containing antibodies produced by the
blood, which specifically neutralise the toxins produced by particular
microorganisms.
• Sera or immune sera: a clear fluid which separates from blood when it clots is
known as serum. When a serum contains antitoxic antibodies it is known as
antitoxic serum. They are usually obtained from animals but sometimes from
human serum also.
• Toxoids: these are the toxins whose toxicity has been removed by gentle heat
or by chemical treatment but their antigenic properties are retained e.g.
tetanus toxoid and staphylococcus toxoid.
• Vaccines: these are the substances which are administered in the body to
produce resistance against infectious diseases. They are mainly used as
prophylactic treatment. Vaccines may contain living, attenuated or killed
bacteria, viruses or rickettsia.
• B cell: A type of white blood cell that gives rise to antibodies. Also known as
a B lymphocyte
Simple vaccines contain only one species of microorganisms
Mixed vaccines contain two or more two species of microorganisms
Univalent vaccines contain only one strain
Polyvalent vaccines contain two or more strains of the same species of
microorganisms.
Types of vaccine
Types of immunity
Innate
immunity
Anatomical
barrier
Blood
proteins
cytokines
Phagocytic
barriers
Acquired
immunity
Passive
immunity
Naturally
acquired
Artificially
acquired
Active
immunity
Naturally
acquired
Artificially
acquired
Innate Immunity: It is also called natural or native immunity, consist of
mechanisms that exist before infection and are capable of rapid responses to
microbes. OR Adaptive to a potential pathogen or foreign substance.
• It is the first line of defense present in healthy individuals.
• There is no memory on subsequent exposures.
It is comprises four types of defense barriers
• Anatomical/Physical barriers
Skin: Mechanical barriers retards entry of microbes. Acidic environment (pH 3-
5) retards growth of microbes.
Mucous membrane: Mucous entraps foreign microorganism.
• Phagocytic barriers
Temperature: Body temperature and fever response inhibits growth of some
pathogens.
Low pH: Acidic pH of stomach, skin and vaginal pH kills most ingested
microorganism.
• Mechanical removal:
Mucus: In the respiratory tract: microorganism trapping and attachment prevention by the mucus
Cilia: Cilia propels the mucus and trapped microbes towards the sites of removal
Cough and sneeze reflex: Respiratory tract: removal of microorganisms from the body
Vomiting and diarrhea: GI tract: removal of toxins and pathogens from the GI tract
Flushing of body fluids Systemic: fluids such as tears, urine, saliva and sweat also flush microbes
from the body
• Chemical barriers
Lysozymes: Bactericidal enzyme secreted by the cells, found in tears & at the mucosal surfaces
Lactoperoxidase: Mucosal secretion that stimulates cells to produce toxic radicals
Surfactant proteins A and D: Present in lungs: function as opsonins, enhancing the phagocytic
activity of cells
• Blood proteins: Ingest and destroys microbes by endocytosis and phagocytosis)
• Cytokines: Tissue damage and infection induce leakage of vascular fluid, containing serum
protein with antibacterial activity
Types of innate immunity
It is of three types
Species Immunity: Species immunity is the total immunity shown by all
members of a species against pathogen; e.g. birds immune to tetanus.
Racial Immunity: Racial immunity is that in which various races show marked
difference in their resistance to certain infectious disease.
For example: Races Negroes have high resistance to yellow fever where. white men are susceptible to it.
Individual Immunity: Individual immunity is very specific for each and every
individual despite having same racial background and opportunity for
exposure. It is well known that some persons are more resistant to cold and
skin infections than others.
Age: Most of the children between 2-5 years of age group are susceptible to
diphtheria whereas most adults are immune to it.
Acquired immunity:
Acquired or adaptive immunity is the immunity that is developed by the host
in its body after exposure to suitable antigen or after transfer of antibodies
lymphocyte from an immune donor.
• Is the second line of defense.
• It can store the information about the invader as memory to show an
enhanced response to subsequent challenge (it has memory).
• It develops more slowly and mediates, more effective, defense against
infection.
 Characteristics of Acquired Immunity
• Antigenic Specificity
• Diversity
• Immunologic memory
• Self/non-self recognition
Types of Acquired Immunity
Acquired Immunity is of two types- active and passive immunity.
Active immunity It is induced by natural exposure to a pathogen or by
vaccination. It can be categorized into two types
Naturally acquired active immunity: Active immunity is acquired through conti-
nuing, subclinical infections, caused by bacteria and viruses, which largely remain
unnoticed and which is more advantageous than passive immunity.
Artificially acquired active immunity: This type of immunity is usually obtained
through vaccination or through administration of toxoids. Vaccines are killed or
live attenuated microorganisms, whereas the toxoids are preparations of toxins,
which have been inactivated by certain clinical treatments or modifications so as
make them non-toxic in nature.
Passive immunity Passive immunity is achieve by transfer of immune products,
such as antibody or sensitized T-cells, from an immune individual to non immune
one.
It is of two types-
Naturally acquired passive immunity: This can be acquired through trans-placental
transfer of immunoglobulins (IgG) from mother to the foetus. This immunity lasts
for about six months after birth. Antibodies for chickenpox,diphtheria, measles
scarlet fever are transmit in this way, that is why the infant shows high resistance
against these diseases only for about six months after which this resistance is lost.
Artificially acquired passive immunity: This type of immunity is produced by
injecting antibody-containing preparations known as antisera, sera or immune
The antibody are first produced in an animal usually a horse or occasionally some
other person and then injected into the concerned person.
Routine passive immunization is done against different diseases like tetanus,
botulinum, diptheria, hepatitis, measles and rabies.
CLASSIFICATION OF IMMUNOLOGICAL PREPARATIONS
The immunological preparations may be classified as follows:
1. Preparations producing active immunity
 Vaccines containing living bacteria e.g. B.C.G. vaccine.
 Vaccines containing dead bacteria e.g. cholera. pertussis, plague and typhoid vaccine.
 Vaccines containing killed rickettsia e.g. typhus vaccine.
 Vaccines containing living viruses e.g. measles, small-pox. poliomyelitis and yellow fever.
 Vaccines containing toxoids e.g. diphtheria, tetanus and staphylococcus.
2. Diagnostic preparations containing bacterial toxins used for schick test and tuberculin test.
3. Preparations containing antibodies (antiserum, and antitoxins)used to produce passive immunity.
BACTERIAL VACCINES
Vaccines
Vaccines are preparations of antigenic materials which are administered with the object of inducing in the
recipient active immunity to specific bacteria or viruses. They may contain living or killed microorganisms,
bacterial toxoids, or antigenic material from particular parts of the bacterium, ricketssia or virus.
The term vaccination and immunization are often used synonymously and interchangeably. Vaccination is
strictly only the administration of a vaccine whereas immunization results in the demonstrable presence of
protective levels of antibodies confirmed usually by serological testing.
VACCINES CONTAINING LIVING BACTERIA E.G. BCG
(BACILLUS CALMETTE GUERIN)
• BCG vaccine, vaccine against tuberculosis.
• The BCG vaccine is prepared from a weakened strain of Mycobacterium bovis, a bacteria closely related to M. tuberculosis,
which causes the disease.
• The vaccine was developed over a period of 13 years, from 1908 to 1921, by French bacteriologists Albert Calmette and
Camille Guérin, who named the product Bacillus Calmette-Guérin, or BCG.
• The vaccine is administered shortly after birth only in infants at high risk of tuberculosis. BCG vaccine produces an immune
response that partly protects infants and young children from serious forms of tuberculosis
• B.C.G. vaccine is available both in a liquid and a freeze dried form.
• It is freeze-dried and need to be mixed with the correct diluent from the same manufacture before administration. But vaccine
must be discarded 6 hrs after mixing which is stored at 2˚-8˚C
• Dose: for new born – 0.05ml (a vial with 20 doses and dark colored ampules) upper arm
• BCG can give upto one year old baby.
• BCG contains 0.1 -0.4 million live viable bacilli per dose
• Injection strictly intradermal, with tuberculin syringe & 26G/27G needle on convex part of deltoid after cleaning with
sterile saline
• 5mm wheal=successful I/D administration
• At birth or at 6 weeks with other vaccines
• Catch up vaccines till 5 years
VACCINES CONTAINING DEAD BACTERIA E, G. CHOLERA,
PERTUSSIS, PLAGUE AND TYPHOID VACCINE
1. Cholera vaccine It is a sterile suspension of killed strains of Cholera vibrio (vibrio cholerae) in a
sodium chloride injection or other suitable diluent.
• It is prepared from equal portions of suspensions of Inaba and Ogawa strains of Cholera vibrio, which
are grown separately.
• The bacteria are killed either by heating the suspension at 56˚C for one hour or by treating it with a
bactericide.
• The number of killed bacteria which should not be less then 8000 million bacteria in I nil.
• The suspension is sterilized by suitable method and then distributed in sterile ampoules or vials which
are sealed immediately.
• Uses: It is used for prophylactic immunization against cholera. Its effect remains for 3-6 months. it is
given by subcutaneous or intramuscular injection.
2. Pertussis vaccine
• It is a sterile suspension of killed strains of Pertussis bacilli (bordetella pertussis) in a sodium
chloride injection or other suitable diluent.
• It is prepared by growing one or more strains of B.pertussis on a suitable liquid medium for 24
to 72 hours.
• The bacteria are killed by heating the suspension at 56˚C or by adding a suitable bactericide.
• The suspension is centrifuged, the supernatant liquid is discarded and the deposited bacteria are
suspended in a sodium chloride injection or other suitable diluent isotonic with blood.
• The suspension at this stage is very concentrated which is kept in the cold for about three
months to eliminate abnormal toxicity.
• his concentrated suspension is then diluted with sodium chloride injection or other suitable
diluent to get final dilution of the preparation. The number of killed bacteria are counted in the
suspension which should not be less than 20000 million bacteria in I ml.
• Uses: It is used for active immunization of children against whooping cough. It is given by
subcutaneous injection.
3. Plague vaccine
• It is a sterile suspension of killed strains of Plague bacilli(Pasteurella pans) in isotonic sodium chloride
solution or other suitable diluent.
• It is prepared similar to pertussis vaccine by growing a strain of P
. pestis on a suitable media. Plague
vaccine contains 3000 million bacteria in I ml.
• Uses This vaccine is used for immunization against plague. It is given by. intramuscular Or
injection.
4. Typhoid. (paratyphoid A and B vaccine)
• It is a sterile suspension of killed strains of Salmonella typhi, S. paratyphi A. and S. paratyphi B.
• It is prepared similar to pertussis vaccine, from strains of S. typhi. S. paratyphi A, and S. paratyphi B
grown on suitable culture media.
• This vaccine is also known as TAB vaccine.
• TABC contains S. paratyphi C in addilion to TAB.
• Uses: TAB vaccine is used for immunization against typhoid fever.
• It is given by subcutaneous injection.
VACCINES CONTAINING KILLED RICKETTSIA E.G.
TYPHUS VACCINE
• It is a suitable suspension of the killed typhus rickettsia.
• It may be prepared by injecting small doses of living organisms into the yolk sacs of fertile
eggs which have been incubated for seven days.
• They are again incubated for 4 to 7 days or until the yolk sac is heavily infected.
• The yolk sacs arc ground to liberate maximum number of rickettsia and the material is
suspended in a saline or other suitable diluent isotonic with blood.
• The product so obtained is purified by extraction with solvent ether. to remove fatty matter
from the yolk. The resultant suspension is distributed under aseptic conditions in sterile
containers and sealed immediately.
• Uses: TINS vaccine is used for immunization against diseases and infections caused by
rickettsia. It Is given by subcutaneous injection.
VACCINES. CONTAINING LIVING VIRUSES E.G.
SMALLPOX, MEASLES, POLIOMYELITIS VACCINE ETC
1. Smallpox vaccine
• It is a liquid or dried preparation of Vaccinia virus grown on the skin of living healthy
sheep or calves; or in the membranes of the chick embryo.
• Method of Preparation by using Animals
• A brief account of different stages involved for the preparation of smallpox vaccine is given
below:
1. Selection of animals
2. Preparation for scarification
3. Scarification and inoculation
4. Incubation
5. Withdrawal of contents of Pustules
6. Purification
1. Selection of Animals Generally living mammals e.g. calves or sheep art selected for the production of smallpox vaccine.
Before selection of the animals they are kept in quarantine for 10-14 days under observation. Those proved quite
healthy and free from a, disease are selected for the purpose.
2. Preparation for Scarification The selected animal is thoroughly scrubbed. washed and disinfected. Then the
animals is taken to a special room where the flanks and abdomen are shaved, rescrubbed and thoroughly Redis
infected.
3. Scarification and Inoculation 'The prepared animal is shifted to an aseptic room where longitudinal light
scratches are made on the sacrificed area of the abdomen and flanks with the help of a comb like device the
scarified. without drawing blood. This process of making light scratches on the skim of the animal is known as
scarification. The scarified area is then rubbed with a seed virus of known potency, obtained from the animal
previously suffering from cowpox.
4. Incubation The inoculated area is allowed to incubate. During the next 4 to 5 days, pustules or vesicles
containing the virus develop along the lines of scarification. During all this period every precaution must be
taken to keep the animal and inoculated area as clean and aseptic as possible.
5. Withdrawal of Contents of Pustules The animal is brought to the operation table and killed. A postmortem
is done to confirm the absence of infectious diseases which are not detected otherwise. The abdomen and flanks
are washed with sterile water and contents of pustules are withdrawn with the help of a special sharp edged
instrument. with aseptic precautions.
6. Purification The contents withdrawn arc treated with glycerine, with or without some other bactericide, to
kill the pathogenic microorganisms and to reduce the number of other bacterial to a very low level. The
glycerine treated contents are stored for a long time at -10˚. Now a days the purification is done by extracting
the contents with trichloro trifluoroethane or other suitable protein solvent by means of centrifugation, The
supernal.: liquid is treated with phenol 0.4% W/V. Sufficient glycerine and peptone are added and a suitable
colouring agent may also be incorporated. After purification it is stored at a temperature - I0°C.
7. Filling The purified contents are distributed in sterilized single dose capillary tubes holding 0.06 nil which are
then sealed. The scaled containers must be stored at a temperature below 0°C because it loses its potency at
room temperature.
Alternative Method of Preparation using Eggs
Hen's eggs which have been incubated for twelve days are selected. A small cut of the shape of a mangle is
made in the shell which is lifted up gently to expose the chorioallantoic membrane. This membrane is
inoculated with seed viruses, the opened cut is sealed by replacing the flap in position and the eggs are
incubated for 72 hours. After this time the shells are separated and contents added to sterile saline solution at
0°C . The material is ground to obtain a homogeneous product which is then transferred to sterile capillary
tubes.
Uses This vaccine is used for active immunization against small pox. This is applied on forearm or shoulder of
individual to be vaccinated. or vaccine
2. Measles vaccine
• It is of two types;
• (a) Measles vaccine containing attenuated living viruses
• (b) Measles vaccine containing killed viruses (inactivated vaccine).
(a) Generally attenuated measles vaccines has high properties than the inactive measles vaccines.
The former causes severe reactions whereas the latter is almost reaction free and is a poor
immunizing agent therefore it is used alone. This vaccine contains attenuated living viruses is an
aqueous suspension of a suitable attenuated living strain of measles virus grown in chick embryo
tissue only
(b) Measles vaccine containing killed viruses is aqueous suspension of a suitable measles viruses
grown in chick embryo or in monkey kidney cells. The virus are inactivated by a suitable method
and may be adsorbed on aluminium hydroxide or aluminium phosphate. The resulting product
will be more effective antigen.
Uses: injection for prophylaxsis of measles
VACCINES CONTAINING TOXOID E.G. DIPHTHERIA,
TETANUS AND STAPHYLOCOCCUS
• Diphtheria Toxoid
• Diphtheria is an infection caused by the bacterium Corynebacterium diphtheriae.
• A toxin is first prepared by growing a suitable strain of Corynebacterium diphtheriae
on a liquid medium medium which must not be made with horse flesh or serum to
prevent sensitizing reaction.
• After incubation at optimum temperature until sufficient concentration of toxin is
obtained, the microorganisms are collected on paper pulp and passed through
bacteria proof filter.
• The filtrate constitute the desired toxin.
To the toxin so obtained, formaldehyde solution (formalin) is added and the
mixture is incubated at 37°C for 2-3 weeks so as to remove toxicity. This
detoxicated toxin is known as Formol Toxoid (FT) which is unpurified form of
vaccine. Now a days a number of purified products are available which are
discussed as under.
(a) Alum Precipitated Toxoid (A.P.T.) The Formol toxoid is treated with charcoal to
remove colouring matter and some of the non-specific impurities. After washing
and filtration to remove Ilse charcoal, a suitable concentration of alum is added
which precipitates the toxoid. The precipitates so obtained are repeatedly washed
with and suspended in normal saline solution.
(b) Purified Toxoid Aluminium Phosphate(P.T.A.P.) It is prepared by adding purified
formal toxoid to a suspension of hydrated aluminum phosphate in a saline or
other suitable solution isotonic with blood.
Uses
This vaccine is used for active immunization against diphtheria
TETANUS TOXOID
• .This is also known as tetanus vaccine and is prepared from tetanus toxin
produced by the growth of Clostridium tetani on a suitable culture medium.
• It is of two types
• Tetanus Formol toxoid and
• Fill tetanus alum precipitated toxoid.
• The method of preparation of these toxoids is similar to that of diphtheria Formol
toxoid and diphtheria alum precipitated toxoid
• Uses It is used for active immunization against tetanus.
STAPHYLOCOCCUS TOXOID
• . It is a sterile filtrate prepared from a suitable strain of Staphylococcus and the
alpha toxin produced is modified by treating it with formaldehyde solution and
heat until the toxicity has been completely removed or reduced to a low level.
• Uses It is used for the prophylaxis of staphylococcal infections.
PREPARATION CONTAINING ANTIBODIES
(ANTITOXIN AND ANTISERUM)
• Antibodies are the substances which are produced in response to stimulation by
antigens.
• When a person or animal has been actively immunized either by natural or artificial
means the blood contains a large number of antibodies
• . When the blood is withdrawn and allowed to clot. the blood cells and a clear liquid
!mown as serum is separated which contains the antibodies.
• These serum containing antibodies are known as antitoxins.
• A scrum may contain antitoxin, antibacterial or antiviral antibodies and are known as
antitoxin. antibacterial or antiviral sell. respectively.
• Antitoxin serums are commonly known as antitoxins.
DIPHTHERIA ANTITOXIN
• It is a sterile, nonpyrogenic solution containing the specific antitoxic antibodies
obtained from the serum of healthy horses and have the power of neutralizing
the toxin formed by Corynebacterium diphtheriae.
ANTIBACTERIAL SERA
• Antibacterial sera are used to provide passive immunity for diseases caused by
endotoxin producing bacteria.
• They were used against a number of diseases e.g. typhoid. pneumonia and
meningitis but now these sera have been replaced by chemotherapeutic agents.
• No antibacterial sera is official now a days but Leptospira antiserum is included in
B.P.C.
• This preparation is occasionally used with chemotherapeutic agents in the early
treatment of spirochaetal jaundice which is also known a Weil's disease.
ANTIVIRAL SERA
• Antiviral sera are used to produce passive immunity and the main source of antiviral antibodies
is human scrum e.g. measles, German measles. etc. but rabies antiserum is prepared in horses.
• Rubies antiserum
• It is prepared from horses by giving a course of dead rabies virus to horses followed by a course
of living virus.
• Then the blood is collected and the gamma-globulin fraction containing the antiviral antibodies
separated
• highly effective if administered within 24 hours of bitten by the animal.
• It is given along with rabies vaccine for preventing rabies if the person is bitten in a sensitive
area like head and neck specially if the animal is suspected to be rabid
THANK YOU

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Immunity and Immunological Products HImanshu

  • 2. INTRODUCTION • Immunity: protection against infections. OR Depends on the ability of the immune system to distinguish between self and non-self molecules (foreign molecules) • Immune system: molecules, cells and tissues that mediate responses to foreign substances • Immunology: the branch of biomedical science concerned with the response of the organism to antigenic challenge, the recognition of self from non-self, and all of the biological (in vivo), serological (in vitro), and physical chemical aspects of immune phenomena
  • 3. • As it protects us from disease it is also called disease resistance. • Lack of immunity is known as susceptibility. • Pathogen: A pathogen or infectious agent is a biological agent that causes disease or illness to its host • Antigens: substances recognized by the cells and molecules of the immune system and to which the system responds • Antibodies: are proteins produced and secreted by B cells. They bind to foreign substances that invade the body, such as pathogens. The term "antibody" refers to its function, which is to bind to an antigen. • Toxins: these are the poisonous substances produced by pathogenic microorganisms and lead to infection or disease in man or animals. • Exotoxins: these are the toxins which can diffuse freely through the bacterial cell wall into the blood or the medium in which the microorganisms are growing. • Endotoxins: these arc the toxins which cannot diffuse through the bacterial cell wall and arc retained within the bacteria. They are released only when the cells die and start disintegrating.
  • 4. • Antitoxins: these are the substances containing antibodies produced by the blood, which specifically neutralise the toxins produced by particular microorganisms. • Sera or immune sera: a clear fluid which separates from blood when it clots is known as serum. When a serum contains antitoxic antibodies it is known as antitoxic serum. They are usually obtained from animals but sometimes from human serum also. • Toxoids: these are the toxins whose toxicity has been removed by gentle heat or by chemical treatment but their antigenic properties are retained e.g. tetanus toxoid and staphylococcus toxoid. • Vaccines: these are the substances which are administered in the body to produce resistance against infectious diseases. They are mainly used as prophylactic treatment. Vaccines may contain living, attenuated or killed bacteria, viruses or rickettsia. • B cell: A type of white blood cell that gives rise to antibodies. Also known as a B lymphocyte
  • 5. Simple vaccines contain only one species of microorganisms Mixed vaccines contain two or more two species of microorganisms Univalent vaccines contain only one strain Polyvalent vaccines contain two or more strains of the same species of microorganisms. Types of vaccine
  • 7. Innate Immunity: It is also called natural or native immunity, consist of mechanisms that exist before infection and are capable of rapid responses to microbes. OR Adaptive to a potential pathogen or foreign substance. • It is the first line of defense present in healthy individuals. • There is no memory on subsequent exposures. It is comprises four types of defense barriers • Anatomical/Physical barriers Skin: Mechanical barriers retards entry of microbes. Acidic environment (pH 3- 5) retards growth of microbes. Mucous membrane: Mucous entraps foreign microorganism. • Phagocytic barriers Temperature: Body temperature and fever response inhibits growth of some pathogens. Low pH: Acidic pH of stomach, skin and vaginal pH kills most ingested microorganism.
  • 8. • Mechanical removal: Mucus: In the respiratory tract: microorganism trapping and attachment prevention by the mucus Cilia: Cilia propels the mucus and trapped microbes towards the sites of removal Cough and sneeze reflex: Respiratory tract: removal of microorganisms from the body Vomiting and diarrhea: GI tract: removal of toxins and pathogens from the GI tract Flushing of body fluids Systemic: fluids such as tears, urine, saliva and sweat also flush microbes from the body • Chemical barriers Lysozymes: Bactericidal enzyme secreted by the cells, found in tears & at the mucosal surfaces Lactoperoxidase: Mucosal secretion that stimulates cells to produce toxic radicals Surfactant proteins A and D: Present in lungs: function as opsonins, enhancing the phagocytic activity of cells • Blood proteins: Ingest and destroys microbes by endocytosis and phagocytosis) • Cytokines: Tissue damage and infection induce leakage of vascular fluid, containing serum protein with antibacterial activity
  • 9. Types of innate immunity It is of three types Species Immunity: Species immunity is the total immunity shown by all members of a species against pathogen; e.g. birds immune to tetanus. Racial Immunity: Racial immunity is that in which various races show marked difference in their resistance to certain infectious disease. For example: Races Negroes have high resistance to yellow fever where. white men are susceptible to it. Individual Immunity: Individual immunity is very specific for each and every individual despite having same racial background and opportunity for exposure. It is well known that some persons are more resistant to cold and skin infections than others. Age: Most of the children between 2-5 years of age group are susceptible to diphtheria whereas most adults are immune to it.
  • 10. Acquired immunity: Acquired or adaptive immunity is the immunity that is developed by the host in its body after exposure to suitable antigen or after transfer of antibodies lymphocyte from an immune donor. • Is the second line of defense. • It can store the information about the invader as memory to show an enhanced response to subsequent challenge (it has memory). • It develops more slowly and mediates, more effective, defense against infection.  Characteristics of Acquired Immunity • Antigenic Specificity • Diversity • Immunologic memory • Self/non-self recognition
  • 11. Types of Acquired Immunity Acquired Immunity is of two types- active and passive immunity. Active immunity It is induced by natural exposure to a pathogen or by vaccination. It can be categorized into two types Naturally acquired active immunity: Active immunity is acquired through conti- nuing, subclinical infections, caused by bacteria and viruses, which largely remain unnoticed and which is more advantageous than passive immunity. Artificially acquired active immunity: This type of immunity is usually obtained through vaccination or through administration of toxoids. Vaccines are killed or live attenuated microorganisms, whereas the toxoids are preparations of toxins, which have been inactivated by certain clinical treatments or modifications so as make them non-toxic in nature.
  • 12. Passive immunity Passive immunity is achieve by transfer of immune products, such as antibody or sensitized T-cells, from an immune individual to non immune one. It is of two types- Naturally acquired passive immunity: This can be acquired through trans-placental transfer of immunoglobulins (IgG) from mother to the foetus. This immunity lasts for about six months after birth. Antibodies for chickenpox,diphtheria, measles scarlet fever are transmit in this way, that is why the infant shows high resistance against these diseases only for about six months after which this resistance is lost. Artificially acquired passive immunity: This type of immunity is produced by injecting antibody-containing preparations known as antisera, sera or immune The antibody are first produced in an animal usually a horse or occasionally some other person and then injected into the concerned person. Routine passive immunization is done against different diseases like tetanus, botulinum, diptheria, hepatitis, measles and rabies.
  • 13. CLASSIFICATION OF IMMUNOLOGICAL PREPARATIONS The immunological preparations may be classified as follows: 1. Preparations producing active immunity  Vaccines containing living bacteria e.g. B.C.G. vaccine.  Vaccines containing dead bacteria e.g. cholera. pertussis, plague and typhoid vaccine.  Vaccines containing killed rickettsia e.g. typhus vaccine.  Vaccines containing living viruses e.g. measles, small-pox. poliomyelitis and yellow fever.  Vaccines containing toxoids e.g. diphtheria, tetanus and staphylococcus. 2. Diagnostic preparations containing bacterial toxins used for schick test and tuberculin test. 3. Preparations containing antibodies (antiserum, and antitoxins)used to produce passive immunity.
  • 15. Vaccines Vaccines are preparations of antigenic materials which are administered with the object of inducing in the recipient active immunity to specific bacteria or viruses. They may contain living or killed microorganisms, bacterial toxoids, or antigenic material from particular parts of the bacterium, ricketssia or virus. The term vaccination and immunization are often used synonymously and interchangeably. Vaccination is strictly only the administration of a vaccine whereas immunization results in the demonstrable presence of protective levels of antibodies confirmed usually by serological testing.
  • 16. VACCINES CONTAINING LIVING BACTERIA E.G. BCG (BACILLUS CALMETTE GUERIN) • BCG vaccine, vaccine against tuberculosis. • The BCG vaccine is prepared from a weakened strain of Mycobacterium bovis, a bacteria closely related to M. tuberculosis, which causes the disease. • The vaccine was developed over a period of 13 years, from 1908 to 1921, by French bacteriologists Albert Calmette and Camille Guérin, who named the product Bacillus Calmette-Guérin, or BCG. • The vaccine is administered shortly after birth only in infants at high risk of tuberculosis. BCG vaccine produces an immune response that partly protects infants and young children from serious forms of tuberculosis • B.C.G. vaccine is available both in a liquid and a freeze dried form. • It is freeze-dried and need to be mixed with the correct diluent from the same manufacture before administration. But vaccine must be discarded 6 hrs after mixing which is stored at 2˚-8˚C • Dose: for new born – 0.05ml (a vial with 20 doses and dark colored ampules) upper arm • BCG can give upto one year old baby.
  • 17. • BCG contains 0.1 -0.4 million live viable bacilli per dose • Injection strictly intradermal, with tuberculin syringe & 26G/27G needle on convex part of deltoid after cleaning with sterile saline • 5mm wheal=successful I/D administration • At birth or at 6 weeks with other vaccines • Catch up vaccines till 5 years
  • 18. VACCINES CONTAINING DEAD BACTERIA E, G. CHOLERA, PERTUSSIS, PLAGUE AND TYPHOID VACCINE 1. Cholera vaccine It is a sterile suspension of killed strains of Cholera vibrio (vibrio cholerae) in a sodium chloride injection or other suitable diluent. • It is prepared from equal portions of suspensions of Inaba and Ogawa strains of Cholera vibrio, which are grown separately. • The bacteria are killed either by heating the suspension at 56˚C for one hour or by treating it with a bactericide. • The number of killed bacteria which should not be less then 8000 million bacteria in I nil. • The suspension is sterilized by suitable method and then distributed in sterile ampoules or vials which are sealed immediately. • Uses: It is used for prophylactic immunization against cholera. Its effect remains for 3-6 months. it is given by subcutaneous or intramuscular injection.
  • 19. 2. Pertussis vaccine • It is a sterile suspension of killed strains of Pertussis bacilli (bordetella pertussis) in a sodium chloride injection or other suitable diluent. • It is prepared by growing one or more strains of B.pertussis on a suitable liquid medium for 24 to 72 hours. • The bacteria are killed by heating the suspension at 56˚C or by adding a suitable bactericide. • The suspension is centrifuged, the supernatant liquid is discarded and the deposited bacteria are suspended in a sodium chloride injection or other suitable diluent isotonic with blood. • The suspension at this stage is very concentrated which is kept in the cold for about three months to eliminate abnormal toxicity. • his concentrated suspension is then diluted with sodium chloride injection or other suitable diluent to get final dilution of the preparation. The number of killed bacteria are counted in the suspension which should not be less than 20000 million bacteria in I ml. • Uses: It is used for active immunization of children against whooping cough. It is given by subcutaneous injection.
  • 20. 3. Plague vaccine • It is a sterile suspension of killed strains of Plague bacilli(Pasteurella pans) in isotonic sodium chloride solution or other suitable diluent. • It is prepared similar to pertussis vaccine by growing a strain of P . pestis on a suitable media. Plague vaccine contains 3000 million bacteria in I ml. • Uses This vaccine is used for immunization against plague. It is given by. intramuscular Or injection. 4. Typhoid. (paratyphoid A and B vaccine) • It is a sterile suspension of killed strains of Salmonella typhi, S. paratyphi A. and S. paratyphi B. • It is prepared similar to pertussis vaccine, from strains of S. typhi. S. paratyphi A, and S. paratyphi B grown on suitable culture media. • This vaccine is also known as TAB vaccine. • TABC contains S. paratyphi C in addilion to TAB. • Uses: TAB vaccine is used for immunization against typhoid fever. • It is given by subcutaneous injection.
  • 21. VACCINES CONTAINING KILLED RICKETTSIA E.G. TYPHUS VACCINE • It is a suitable suspension of the killed typhus rickettsia. • It may be prepared by injecting small doses of living organisms into the yolk sacs of fertile eggs which have been incubated for seven days. • They are again incubated for 4 to 7 days or until the yolk sac is heavily infected. • The yolk sacs arc ground to liberate maximum number of rickettsia and the material is suspended in a saline or other suitable diluent isotonic with blood. • The product so obtained is purified by extraction with solvent ether. to remove fatty matter from the yolk. The resultant suspension is distributed under aseptic conditions in sterile containers and sealed immediately. • Uses: TINS vaccine is used for immunization against diseases and infections caused by rickettsia. It Is given by subcutaneous injection.
  • 22. VACCINES. CONTAINING LIVING VIRUSES E.G. SMALLPOX, MEASLES, POLIOMYELITIS VACCINE ETC 1. Smallpox vaccine • It is a liquid or dried preparation of Vaccinia virus grown on the skin of living healthy sheep or calves; or in the membranes of the chick embryo. • Method of Preparation by using Animals • A brief account of different stages involved for the preparation of smallpox vaccine is given below: 1. Selection of animals 2. Preparation for scarification 3. Scarification and inoculation 4. Incubation 5. Withdrawal of contents of Pustules 6. Purification
  • 23. 1. Selection of Animals Generally living mammals e.g. calves or sheep art selected for the production of smallpox vaccine. Before selection of the animals they are kept in quarantine for 10-14 days under observation. Those proved quite healthy and free from a, disease are selected for the purpose. 2. Preparation for Scarification The selected animal is thoroughly scrubbed. washed and disinfected. Then the animals is taken to a special room where the flanks and abdomen are shaved, rescrubbed and thoroughly Redis infected. 3. Scarification and Inoculation 'The prepared animal is shifted to an aseptic room where longitudinal light scratches are made on the sacrificed area of the abdomen and flanks with the help of a comb like device the scarified. without drawing blood. This process of making light scratches on the skim of the animal is known as scarification. The scarified area is then rubbed with a seed virus of known potency, obtained from the animal previously suffering from cowpox. 4. Incubation The inoculated area is allowed to incubate. During the next 4 to 5 days, pustules or vesicles containing the virus develop along the lines of scarification. During all this period every precaution must be taken to keep the animal and inoculated area as clean and aseptic as possible. 5. Withdrawal of Contents of Pustules The animal is brought to the operation table and killed. A postmortem is done to confirm the absence of infectious diseases which are not detected otherwise. The abdomen and flanks are washed with sterile water and contents of pustules are withdrawn with the help of a special sharp edged instrument. with aseptic precautions.
  • 24. 6. Purification The contents withdrawn arc treated with glycerine, with or without some other bactericide, to kill the pathogenic microorganisms and to reduce the number of other bacterial to a very low level. The glycerine treated contents are stored for a long time at -10˚. Now a days the purification is done by extracting the contents with trichloro trifluoroethane or other suitable protein solvent by means of centrifugation, The supernal.: liquid is treated with phenol 0.4% W/V. Sufficient glycerine and peptone are added and a suitable colouring agent may also be incorporated. After purification it is stored at a temperature - I0°C. 7. Filling The purified contents are distributed in sterilized single dose capillary tubes holding 0.06 nil which are then sealed. The scaled containers must be stored at a temperature below 0°C because it loses its potency at room temperature. Alternative Method of Preparation using Eggs Hen's eggs which have been incubated for twelve days are selected. A small cut of the shape of a mangle is made in the shell which is lifted up gently to expose the chorioallantoic membrane. This membrane is inoculated with seed viruses, the opened cut is sealed by replacing the flap in position and the eggs are incubated for 72 hours. After this time the shells are separated and contents added to sterile saline solution at 0°C . The material is ground to obtain a homogeneous product which is then transferred to sterile capillary tubes. Uses This vaccine is used for active immunization against small pox. This is applied on forearm or shoulder of individual to be vaccinated. or vaccine
  • 25. 2. Measles vaccine • It is of two types; • (a) Measles vaccine containing attenuated living viruses • (b) Measles vaccine containing killed viruses (inactivated vaccine). (a) Generally attenuated measles vaccines has high properties than the inactive measles vaccines. The former causes severe reactions whereas the latter is almost reaction free and is a poor immunizing agent therefore it is used alone. This vaccine contains attenuated living viruses is an aqueous suspension of a suitable attenuated living strain of measles virus grown in chick embryo tissue only (b) Measles vaccine containing killed viruses is aqueous suspension of a suitable measles viruses grown in chick embryo or in monkey kidney cells. The virus are inactivated by a suitable method and may be adsorbed on aluminium hydroxide or aluminium phosphate. The resulting product will be more effective antigen. Uses: injection for prophylaxsis of measles
  • 26. VACCINES CONTAINING TOXOID E.G. DIPHTHERIA, TETANUS AND STAPHYLOCOCCUS • Diphtheria Toxoid • Diphtheria is an infection caused by the bacterium Corynebacterium diphtheriae. • A toxin is first prepared by growing a suitable strain of Corynebacterium diphtheriae on a liquid medium medium which must not be made with horse flesh or serum to prevent sensitizing reaction. • After incubation at optimum temperature until sufficient concentration of toxin is obtained, the microorganisms are collected on paper pulp and passed through bacteria proof filter. • The filtrate constitute the desired toxin.
  • 27. To the toxin so obtained, formaldehyde solution (formalin) is added and the mixture is incubated at 37°C for 2-3 weeks so as to remove toxicity. This detoxicated toxin is known as Formol Toxoid (FT) which is unpurified form of vaccine. Now a days a number of purified products are available which are discussed as under. (a) Alum Precipitated Toxoid (A.P.T.) The Formol toxoid is treated with charcoal to remove colouring matter and some of the non-specific impurities. After washing and filtration to remove Ilse charcoal, a suitable concentration of alum is added which precipitates the toxoid. The precipitates so obtained are repeatedly washed with and suspended in normal saline solution. (b) Purified Toxoid Aluminium Phosphate(P.T.A.P.) It is prepared by adding purified formal toxoid to a suspension of hydrated aluminum phosphate in a saline or other suitable solution isotonic with blood. Uses This vaccine is used for active immunization against diphtheria
  • 28. TETANUS TOXOID • .This is also known as tetanus vaccine and is prepared from tetanus toxin produced by the growth of Clostridium tetani on a suitable culture medium. • It is of two types • Tetanus Formol toxoid and • Fill tetanus alum precipitated toxoid. • The method of preparation of these toxoids is similar to that of diphtheria Formol toxoid and diphtheria alum precipitated toxoid • Uses It is used for active immunization against tetanus.
  • 29. STAPHYLOCOCCUS TOXOID • . It is a sterile filtrate prepared from a suitable strain of Staphylococcus and the alpha toxin produced is modified by treating it with formaldehyde solution and heat until the toxicity has been completely removed or reduced to a low level. • Uses It is used for the prophylaxis of staphylococcal infections.
  • 30. PREPARATION CONTAINING ANTIBODIES (ANTITOXIN AND ANTISERUM) • Antibodies are the substances which are produced in response to stimulation by antigens. • When a person or animal has been actively immunized either by natural or artificial means the blood contains a large number of antibodies • . When the blood is withdrawn and allowed to clot. the blood cells and a clear liquid !mown as serum is separated which contains the antibodies. • These serum containing antibodies are known as antitoxins. • A scrum may contain antitoxin, antibacterial or antiviral antibodies and are known as antitoxin. antibacterial or antiviral sell. respectively. • Antitoxin serums are commonly known as antitoxins.
  • 31. DIPHTHERIA ANTITOXIN • It is a sterile, nonpyrogenic solution containing the specific antitoxic antibodies obtained from the serum of healthy horses and have the power of neutralizing the toxin formed by Corynebacterium diphtheriae.
  • 32. ANTIBACTERIAL SERA • Antibacterial sera are used to provide passive immunity for diseases caused by endotoxin producing bacteria. • They were used against a number of diseases e.g. typhoid. pneumonia and meningitis but now these sera have been replaced by chemotherapeutic agents. • No antibacterial sera is official now a days but Leptospira antiserum is included in B.P.C. • This preparation is occasionally used with chemotherapeutic agents in the early treatment of spirochaetal jaundice which is also known a Weil's disease.
  • 33. ANTIVIRAL SERA • Antiviral sera are used to produce passive immunity and the main source of antiviral antibodies is human scrum e.g. measles, German measles. etc. but rabies antiserum is prepared in horses. • Rubies antiserum • It is prepared from horses by giving a course of dead rabies virus to horses followed by a course of living virus. • Then the blood is collected and the gamma-globulin fraction containing the antiviral antibodies separated • highly effective if administered within 24 hours of bitten by the animal. • It is given along with rabies vaccine for preventing rabies if the person is bitten in a sensitive area like head and neck specially if the animal is suspected to be rabid