医学免疫学教学课件：16-免疫治疗

Immunoprophylaxis

and

ImmunotherapyImmunoprophylaxis

VariolationVaccination

Variolaminor.SomaliaApril1977October26,1979GoalofimmunizationWaysofacquiringspecificimmunityII.EssentialrequirementsofvaccineSafePracticalEffectiveVaccineTheagentusedforartificialactiveimmunizationiscalledvaccine.Vaccineisanimmunogenicpreparationofdeadorattenuated(nonpathogenic)livepathogens,orofitsantigens,togetherwithanadjuvant,thatisinjectedtoprovideimmunitytothatpathogenVaccineinactivatedvaccine(Deadvaccine)Standardstrainofamicrobeiskilledandsevervedasanimmunogen.Forexample:choleravaccineJapaneseencephalitisvaccinerabiesvaccinetyphoidvaccineVaccine2.Live-attenuatedvaccineItismoreeffectivethandeadvaccine.Asingledoseofalivevaccineoftensufficesforreliableimmunization.Livevaccinemustbeproperlystoredtoretaineffectiveness.VaccineExamplesoflivevaccinesMeaslesvirusvaccineOralPoliovirusvaccinebacillusCalmette-Guerin(BCG)vaccineTyphoidvaccine(oralliveattenuatedbacteria)VaccineLive-attenuatedVaccinesInactivatedVaccinesRouteimitatingnaturalinfectionInjectionsubcutaneouslyDosessmallLargeTimesonceTwiceormoreSideeffectsslightsevereDurationLong(3~5yearsorlifelong)Short(months~1years)MutationpossibleimpossiblePreservation4C

orlymphilizationeasytopreserveVaccineToxoid:Examples:Diphtheriatoxoid,Tetanustoxoid4,SubunitvaccineThesevaccinesareinusewhichmakeuseofantigenseitherpurifiedfrommicroorganismsorproducedbyrecombinantDNAtechnology.e.g.HBVvaccine(HBsAg)Vaccine

VaccineConjugatevaccineThesevaccinesareobtainedbyconjugatingthepurifiedpolysaccharides(bacterialcapsularpolysaccharides)tocarrierproteinssuchasdiphtheriatoxoid.Vaccine6,DNAvaccineThesearebasedonthediscoverythatwhenDNAencodingachosenmicrobialproteinisinjectedintramuscularlyorintradermally,hostcellscantakeuptheseartificialgenesandexpresstheforeignproteinforseveralweeks.Dependingontheproteinexpressed,thiscaninducespecifichumoralorcellularimmunity,orboth.VaccineVaccine7,GeneticengineeringvaccineRecombinantantigenvaccineToclonetheselectedgeneintoavector(yeast)→toculture→topurifytheAgfromtheculturesupernatant→antigenRecombinantvectorvaccineToinsertthedesiredgeneintoavector(vaccinia)whichcanthenbeinjectedintothepatient,allowedtoreplicate,expressthegeneandproducelargeamountsoftheantigen.8,SyntheticpeptidevaccineSmallantigenscanbemadesynthetically.e.g.HBsvaccine.PreventativeVaccineTherapeuticVaccineAdjuvantAsubstancethat,whenmixedwithanimmunogen,enhancestheimmuneresponseagainsttheimmunogen.AlumMF59,anoil-in-wateremulsionAS04,containsalumplusaTLR4agonist.VaccinesApplicationofVaccinesAnti-infectionandplannedimmunizationPlannedimmunizationscheduleinChina

AgeTypeofvaccine

PrimaryImmunizationBirthBCGvaccine,HBVvaccine(1st)1monthHBVvaccine(2nd)2monthsPoliovirusvaccine(1st)3monthsPoliovirusvaccine(2nd),DTP(1st)4monthsPoliovirusvaccine(3rd),DTP(2nd)5monthsDTP(3rd)6monthsHBV(3rd),Meningococcalpolysaccharidevaccine8monthsMeaslesvirusvaccine1yearJapaneseencephalitisvaccine(1stand2nd)

Booster/reimmunization1.5yearsDTP,Measlesvirusvaccine,Poliovirusvaccine,Meningococcalpolysaccharidevaccine2yearsJapaneseencephalitisvaccine3yearsJapaneseencephalitisvaccine4yearsPoliovirusvaccine5yearsDTP,Measlesvirusvaccine,BCGvaccine,MeningococcalpolysaccharidevaccineApplicationofvaccines2.Anti-tumor3.BirthcontrolVaccinesbasedonthechainofHCG,coupledtotetanusordiphtheriatoxoid,havebeenextremelysuccessfulinpreventingconceptioninhumans.4.PreventionofimmunopathologicdamageImmunotherapyConceptionofimmunotherapyImmunotherapyistheapproachtobalanceorintervenetheimmunologicfunctioninordertofightagainstthediseasebytheprincipleofimmunology.I.ConceptionandclassificationB,

ClassificationofImmunotherapyNameScopeorCharacteristicimmunoenhancingtherapyInfection,Tumor,IDDimmunosuppressivetherapyHVGR,GVHR,AID,Anaphylaxis,inflammationactiveimmunotherapyVaccine,TherapeuticVaccineoftumor,passiveimmunotherapyAb,LAKcellspecificimmunotherapyPeptide,antigen,Non-specificimmunotherapyBCG,cytokinesII.MolecularImmunotherapy1.MolecularVaccineSyntheticpeptidevaccineRecombinantvectorvaccineII.MolecularImmunotherapy2.Antibody-polyclonalAbantitoxicserumplacentalgamma-globulinantibacterialimmuneserumantiviralimmuneserumanti-lymphocytegamma-globulin,ALGVonBehring(1854~1917)II.MolecularImmunotherapy

2.Antibody-Monoclonalantibody,mAb

mAbagainstsurfacemembranemoleculesonlymphocytes：CD3mAbagainstcytokines:TNFmAb-directedtherapy

mAbcoupledtoisotopes,drugs,toxinsII.MolecularImmunotherapy

ChimericAbHumanizedAb(CDR-graftedAb)SinglechainAbBispecificAb2.Antibody-GeneticengineeringAbII.MolecularImmunotherapy

CytokinesupplementandadditiontherapyIFN,IL-2,CSFCytokineblockadeandsuppressionanti-TNFIL-1RasIL-1R3.Cytokinesandtheirantagonists

III.CellularImmunotherapyCellularVaccineTumorcellularvaccineGene-modifiedcancervaccineAPCvaccineIII.CellularImmunotherapy2.Adoptiveimmunotherapy

TILLAK（CIK）3.StemcelltransplantationBonemarrowPeripheralbloodUmbilicalblood40肿瘤浸润性淋巴细胞治疗2023/3/21浙江大学41过继免疫细胞治疗2023/3/21浙江大学VI.