ACADEMY OF MEDICAL SCIENCE Biology by SUMESH MONGA

Vaccination – It is the inoculation of weak or attenuated antigens, or a toxin, or a proteins, into the body. The introduction of antigens
stimulates the production of antibodies and memory cells, which protect the body against that antigen/disease.

Vaccines are of 3-types:-

1) 1st generation vaccines  These vaccines are developed by introducing attenuated antigens, toxins or proteins. Most of the available
vaccines are of this type. Eg. DPT vaccine , BCG vaccine.

2) 2nd generation vaccines  Such vaccines are developed by genetic engineering, with the help of transgenic organisms. Eg. Vaccine of
Hepatitis-B and Herpes virus. (The hepatitis-B vaccine has been produced from transgenic yeast).

3) 3rd generation vaccines They are synthetic vaccines

Vaccines Disease/ Disorder

Salk & Sabin Polio(Salk vaccine contains ‘dead viruses’, inactivated by chemicals, and is injected
vaccine in the arm; whereas Sabin vaccine contains ‘live viruses’, weakened through
multiple culturing processes, and is given orally in drops).
BCG (Bacillus of Calmette and Guerin) – T.B.
DPT Diphtheria, Pertusis and Tetanus
MMR Measles, Mumps and Rubella (German measles)

Attenuated viruses – These are weakened viruses which replicate very slowly and hence cause no disease, but are active enough to
stimulate an immune response.

1) Auto-immune disorders(Auto immunity) - such disorders develop when the immune system goes off track. The antibodies are
produced against the organs of one’s own body. The KT-cells do not differentiate the self from non-self and start destroying the affected
organ.

a. Rheumatoidal arthritis – In this disorder the antibodies Ig M, rheumatoidal factor, produce thickening and inflammation of synovial
membrane. Cause of the disease is unknown but it is believed to involve a combination of genetic and environmental factors.
Inflammation of synovial membrane causes increased secretion of synovial fluid  Joints become swollen, tender and warm. Most
commonly hands and wrist joint get involved.

b. Chronic hepatitis – The immune system damages the liver.

c. Chronic anaemia – The immune system destroys RBCs.

d. Hashimoto disease – In this disorder the cells of the thyroid glands are destroyed. This is also known as ‘Suicide of thyroid’. Over the
time, thyroid may enlarge forming a painful goitre. Some patients may develop HYPOTHYROIDISM with its accompanying wight gain,
constipation, feeling tired. After many years, the thyroid shrinks in size.

GRAVE’s disease – It is also an auto immune disorder that affects the thyroid, most common cause of HYPERTHYROIDISM. It often
results in an enlarged thyroid. Sign and Symptoms of HyperThyroidism may include muscle weakness, poor tolerance of heat and
unintentional weight loss.

e. Multiple sclerosis – The antibodies destroy myelin sheath and cause damage directly to the nerves and indirectly to the muscles.

f. Myasthenia Gravis – The antibodies produced in this case bind with the acetylcholine receptors of post synaptic membrane and causes
muscle degeneration. This prevents neve impulses of triggering muscle contraction. It causes skeletal muscle weakness.

2) Immuno deficiency disorders – Such disorders may develop by infection, genetic causes or due to malnutrition. Eg. SCID & AIDS.

In SCID(Severe combined immune deficiency) the B-cells and T-cells(lymphocytes) are either not produced, or are produced in
insufficient number. In AIDS, HIV ,multiples inside HT-cells and destroys them to paralyze the immune system.

3. Allergy – the pollen grains, mites, dust particles, fibres or chemicals, which cause allergy are called allergens. The exaggerated response
of the immune system to allergens is called allergy. ‘Anything can cause allergy to anyone, anywhere at anytime’. The allergies
are not genetically transmitted but the tendency to develop the allergy can be inherited. The antibodies (Ig E type) formed
against the allergens are called regains. Through allergy response differs from organ to organ but, the common symptoms
to allergic reactions are more or less same. They include sneezing, difficulty in breathing, running of nose, watery eyes and
rashes or hives on skin.
The symptoms of allergy become apparent due to the release of Histamine and Serotonin from the Mast cells of connective
tissues, or the Basophils of blood. The use of drugs like Antihistamine, Adrenalin and Steroids quickly reduce the symptoms
of allergy. The modern day life style and the over protected environment, given to the children in their early life are mainly
responsible for their hypersensitivity to the environment. This has resulted in lowering of immunity and an increase in the
cases of allergy, like Asthma and Hay fever, at least in metro cities of India. On the basis of the site affected the allergies can
be of 4-types :-

(i) Urticaria – it is the allergy of skin and can be caused by various chemicals. In this type of allergy histamine and serotonin
is released by rupturing of the mast cells. There is local swelling and reddening of skin. The rashes or blisters may develop
over the entire skin.

(ii) Asthma – it is the allergyof respiratory passage. The smooth muscles of bronchioles constrict during the attack and the
exhalation becomes difficult

(iii) Hay fever – it is the allergy of nasal lining and develops due to pollen grains or volatile chemicals. In this case a large
amount of mucus is secreted , and due to irritation , the episode of sneezing starts.

(iv) Anphyllaxis – it is the allergy of blood and may develop due to the injection of penicillin, or other drugs. In this type of
allergy also, the histamine is released by rupturing of basophils of the blood. In severe anaphylactic shock the capillaries may
dilate and blood pressure may drop drastically . This can be fatal.

Tissue/Organ transplantation -Before grafting the HLA(Human Leucocyte associated antigens or proteins) are matched,
called tissue typing, between the tissues of donor and the recipient . the HLA is a group of 6-antigens(out of 150 types).
These antigens are different in different individuals. Only the identical twins can have similar HLA. The grafts can be of the
following types:

1) Autograft – When grafting is done in the same individual at different place. There is no rejection of the graft in such a
case.eg. Grafting of skin from thigh to the burnt face. 2) Isograft – When grafting is done between two individuals of the
same genotypes(identical twins). There are also the least chances of graft rejection. 3) Allograft – When grafting is done in
between two individuals of different genotypes but, of the same species. The chances of tissue rejection are many. 4)
Xenograft – When grafting is done in between two individuals/organisms of different species. The chances of rejection in such
a case are maximum. In above cases the chances of graft rejection, from minimum to the maximum, are in the following
order ,and is, therefore, the preferred order of transplantation. Same individuals < Identical twins< Different individuals<
Different species. Immune response involves primary immune response and secondary immune response.

(a) Primary immune response – After an initial contact with an antigen, no antibodies are present for a period of several days. Then, a
slow rise in antibody filter(units) occurs. First IgM and then IgG followed by a gradual decline in antibody titer. This is called the primary
response.

(b) Secondary immune response – Memory cells may remain in the body for decades. Every new encounter with same antigen results in
a rapid proliferation of memory cells. This is called booster response. The antibody titer after subsequent encounter is far greater than
during a primary response and consists mainly of IgG antibody. This accelerated more intense response is called the secondary immune
response. Antibodies produced during a secondary response have an even higher affinity for an antigen. A person who had undergone
exposure to measles, small pox or chicken pox becomes immune to subsequent attack of there disease.

Antigens – Antigens are substances which are introduced into the body, stimulate the production of Antibodies. Antigens consist of
proteins, polysaccharides or nucleic acids. Structure epitopes – Epi : Upon and Topos : Place. Epitopes are components of antigens. Each
antigen carries many epitopes. Each Y shaped antimolecule has atleast two binding sites that can attach to a specific epitope on an
antigen. An antibody can bind to two identical epitopes of two different antigens at the same time which can cause neighbouring cells
to aggregate.

Types – Antigens are of two types : Complete and Incomplete. A complete antigen is able to induce antibody formation and produce a
specific and observable response with the antibody whereas incomplete antigen cant induce the formation of antibody by themselves,
but can be capable of inducing antibodies formation on combining with larger molecules.( Self Antigen / Alon Self Antigen ) Antigen
presenting cells – The cells that can engulf antigens and present the fragments to T cells are called antigens presenting cells (APC). There
are three types of antigen presenting cells in the body –

(i) Macrophages (ii) Dendritic cells (iii) B cells. Usually found in resting state. They are stimulated to become macrophages.
(ii) Dendritic cells – Characterised by long cytoplasmic processes. Found in lymph nodes, spleen, thymus and are highly effective APC.
(iii) B cells – B cells possess on their surface B cells antigen receptors( Immunoglobulins), all the receptors on B cells are identical so each B
cell binds to a single Antigen. This makes them more efficient APC.