Applied Immunology Aftab Jasir: European Centre for Disease Prevention and Control (ECDC) European Public Health Microbiology training program (EUPHEM) Introductory course, Menorca,2012 Objectives • Define basic components of immunology • Describe important terms in immunology • Explain major applications of immunology What is immunology? Immunology is a broad branch of biomedical science that covers the study of all aspects of the immune system in all living organisms. It deals with the physiological functioning of the immune system in states of both health and disease What is the immune system? The immune system is the ministry of defence of the human/animal body Immunodeficiency and Immunosuppression Immunodeficiencyis a state in which the immune system's ability to fight infectious disease is low or entirely absent. Immunosuppression involves an act that reduces the activation or efficacy of the immune system. immunosuppression may occur as an adverse reaction to treatment of other conditions. Major defence components of the human immune system Cells Immunoglobulins Overview of the immune system Immune system Innate (nonspecific) 1st line of defense Cellular components Humoral components Adaptive (specific) 2nd line of defense Cellular components Humoral components Definitions/terminology Antigens (Ag) Large molecules, is anything that obtain the formation of a specific immune response (Anomy) Ag determinants (epitopes) are the particular chemical groups on a molecule that are antigenic Antibody(Ab)/immunoglobulin (Ig). A special group of soluble proteins that are produced in response to foreign antigens (substances) Antigen and antibody 5 classes of IGs 1. IgM (first exposure, large, not passing placenta, huge amont) 2. IgG (secondary exposure, small, passing placenta) 1. IgD (proteins in the plasma membranes of mature Blymphocytes, same time as IgM) 1. IgA (mucosal immunity, respiratory tract) 1. IgE (Allergy and parasites) Haptens Vaccine conjugate Ministry of defence of the human body Antibody Protection of the Host Primary and secondary antibodies P: antibodies raised against an antigenic target of interest and are typically unconjugated. S: antibody that binds to primary antibodies or antibody fragments. They are typically labeled with probes that make them useful for detection, Immune Precipitation Antigen Antibody Agglutination RBC IgM Antibody RBC RBC RBC RBC RBC RBC RBC IgG Antibody RBC RBC RBC Factors influencing immunogenicity Factors Contribution of immunogen Contribution of biological system Method of administration Class Switching Biological mechanism that changes a B cell's production of antibody from one class to another, for example, from IgM to IgG. antibody titer IgM IgG time Four phases of the primary response • lag phase where no antibody is detected • log phase in which the antibody titer rises logarithmically • plateau phase during which the antibody titer stabilizes • phase (decline) during which the antibody is cleared or catabilized Kinetics of the Ab Response T-dependent Ag; 1o Response LOG PLATEAU DECLINE Ab Titer • Lag • Log LAG • Plateau • Decline Ag Days After Immunization Kinetics of the Ab Response • Lag • Log • Plateau • Decline Ab Titer T-dependent Ag; 2o Response 1o Ag 2o Ag Days After Immunization Major practical applications of immunology – Use of antiserum and vaccination to provide protection against disease. – Diagnostic tool to detect disease. – Epidemiological investigation of vaccine preventable diseases My face is my fortune Where are you going, my pretty maid? I’m going a-milking, sir, she said May I go with you, my pretty maid? You’re kindly welcome, sir, she said What is your father, my pretty maid? My father is a farmer, sir, she said What is your fortune, my pretty maid? My face is my fortune, sir, she said Variolation The word ‘variolation’ comes from the Latin word ‘variola’ for human smallpox. Discovery of small pox vaccine Edward Jenner 1780AD Blossom Types of acquired immunity Passive – receive Abs made by another 1. natural 2. artificial - γ globulin, hyperimmune serum Natural Artificial Mode of delivery Advantages and Disadvantages of Active Immunization Advantages Disadvantages Not immediate Long term immunity Herd immunity Immune suppressed/deficiency Risk of infection Risk of contamination Animal ??? Attenuated can revert to their pathogenic form Advantages and Disadvantages of Passive Immunization Advantages Disadvantages no long term protection immediate protection serum sickness risk of hepatitis and HIV graft vs. host disease Serology A science that attempts to detect signs of infection in a patient’s serum such as Ab for a specific microbe Serological tests based on Abs specifically binding to Ag – Ag of known identity will react with Ab in an unknown serum sample. – Known Ab can be used to detect Ag in serum Ag-Ab reactions are visible by clumps, precipitates, color changes or release of radioactivity. The most effective tests have high specificity and sensitivity. Enzyme (ELISA) Immunoassay Enzyme conjugated to anti-Ig antibody (“second antibody”) anti-antigen antibody Antigen Add substrate for enzyme a) The presence of a specific Ab b) Identification of microbes Specificity, sensitivity, and cross reactivity a) Specificity – Ab attaches with great exact-ness to only one type of Ag. b) Sensitivity – Ab can locate Ag, even when it is greatly diluted. c) Cross reactivity – the ability of an individual antibody combining site to react with more than one antigenic determinant or the ability of a population of antibody molecules to react with more than one antigen. Examples of serological tests 1. 2. 3. 4. 5. 6. 7. Agglutination tests Precipitation tests Immunoelectrophoresis Western blot tests Complement fixation tests Immunofluorescence testing Immunoassays Acute infection Onset of symptoms Incubation Primary infection Days Weeks Months Years Acute infection Onset of symptoms IgM Incubation Primary infection Days Weeks Months Years Acute virus infection Onset of symptoms IgG IgM Incubati on Primary infection Days Weeks Months Years Acute virus infection Avidity = the sum of affinities between: antibody Onset of symptom s and antigen IgG avidity IgG IgM Incubation Primary infection Days Weeks Months Years Onset of symptom s IgG avidity IgM IgG Incubation Persistence Primary infection Days Weeks Months Secondary infection or Years reactivation Onset of symptoms IgG avidity IgM IgG Viremia Primary infection Days Weeks Months Secondary infection or Years reactivation Q fever IgM2 IgM1 IgG2 1/800 IgG1 IG titter 1/64 1/40 1 2 1 1 2 Time What should you have in mind!!! Tack home massage Some times Ag x Ab based tests can results in wrong alarm of outbreak ( Salmonella) Antigen variation is always a problem (Chlamydia, grouping of streptococci) Cross-reactivity can give wrong information of an outbreak Any unusual or unexpected results should be confirmed by genetic test If possible use other methods than serology in an outbreak situation or combine with other methods