New Final Material: Fancher +Larson stars and pulse checks

cancer= abnormal growth and cell division + apoptosis (cell death) does __ occur

not

There are __ tumors like breast, lung, prostate, colon, pancreas, ovaries. There are ____ tumors like leukemia, lymphoma, and multiple myeloma

solid, liquid

___ cancer= confined to a single area or organ

localized

___ cancer=- migration of same cancer to different site away from primary tumor

metastatic

is metastatic or localized cancer more likely to be cured?

localized

3 treatment modalities for cancer

radiation, surgery, chemotherapy

in cancer, a programmed death (PD-1) receptor on tumor will __ T cells from killing the tumor

block

Immune checkpoint inhibitors (ICI) ___ the PD-1 receptor so that T cells can recognize tumor as foreign and kill it

inhibit

___ (keytruda) is a drug in the ICI class

pembrolizumab

when using ICIs, you will __ experience the traditional chemotherapy effects like hair loss and nausea/vomiting

not

when using ICIs, you are at risk for more ___ like adverse effects (irAEs)

autoimmune

vaccines generate an immune response in the __ of pathogen

absence

The ___ period is the time between when a person is infected and when symptoms appear

incubation

immune memory is generally sufficient when the incubation period of a disease is ___ (like in hepatitis B!)

long

immune memory may NOT be sufficient against ___ invasive pathogens (ie they have short incubation periods)

rapidly

immune memory may NOT be sufficient against rapidly invasive pathogens and therefore __ vaccinations are often required (like in influenza)

booster

1. live attenuated vaccines: attenuated means it reduces ___ (ability to cause disease) while maintaining ___ (still triggers an immune response)

virulence, immunogenicity

___ attenuation: inactivates or removes virulence genes by targeting mutations or gene deletion

rational

2. killed whole organism vaccines: the vaccine has ___ organisms, but they have been __ by physical or chemical means

whole, killed

3. toxoid vaccines are made from inactivated bacterial exotoxins. When you get vaccine, your immune system makes antibodies against the toxoid. Later, if you’re exposed to the real toxin, these antibodies will ___ exotoxins before they can reach target cell

neutralize

Antibodies (produced bc patient is given toxoid vaccine) are effective at neutralizing exotoxins because they recognize ___ epitopes AND ___ epitopes

linear, conformational

4. subunit vaccines only contain pieces of pathogen, which are the ___ molecules or critical ____ necessary for patient to be protected against infection after being given vaccine

antigenic, epitopes

5. virus-like particle vaccines: these vaccines have viral proteins that mimic the native virus but lack the viral __ (so can't cause disease)

genome

6. outer membrane vesicle vaccines contain fragments of the outer membrane from gram-___ bacteria, along with antigens that are important for immune recognition.

negative

7. Polysaccharide and protein-polysaccharide conjugate vaccines MUST be conjugated to a ____ to elicit T cell-dependent responses and generate immune memory (ie to develop long-lasting immunity)

protein

8. Viral vectored vaccines are a ___ virus (virus with genome altered) that express the target pathogen __ (the protein that triggers immunity).

recombinant, antigen

8. Nucleic acid vaccines consist of either __ or __ encoding the target antigen

DNA, RNA

Subcutaneous or Intramuscular Injections stimulate __ immunity in spleen, lymph nodes, and peripheral blood

systemic

Subcutaneous or Intramuscular Injections

-interrupt person-to-person ___

-prevent pathogen from spreading to crucial ___

transmission, organs

In Mucosal administration, the antigen stimulated lymphocytes from the initial site ____ to other mucosal surfaces, therefore conferring immunity at multiple sites

travel

__ protection: use of specific neutralizing antibodies purified from immune donors to prevent transmission of various viruses

passive

if there is no vaccination for a disease, there will be no __ immunity of the population

herd

what type of vaccine is MMR?

live attenuated

what 3 types of influenza affect humans?

a, b, c

type A influenza subtypes are determined by ___ and __

hemagglutinin, neuraminidase

type B influenza subtypes are classified into __ lineages, which are B/Yamagata and B/Victoria

2

type C influenza subtypes are __ reported as cause of human illness

rarely

influenza virus is transmitted through respiratory drops/fomites, and attaches and penetrates the __ ___ cells in the trachea and bronchi

respiratory epithelial

replication of influenza virus results in destruction of __ cells

host

innate immune response against influenza A involves engagement of receptors (PRRs), which leads to activation of what 3 transcription factors?

IRF3, IRF7, NF-kB

adaptive immune response against influenza A involves antigen specific ___ T cells using cytotoxic granules and FasL mediated apoptosis to eliminate infected cells

CD8

adaptive immune response against influenza A involves ___ T cells triggering B cell activation and promoting antibody activation to neutralize virus

CD4

Rapid and prominent ___+ T cell recall are important for early recovery from severe influenza (ie immune memory)

CD8+

____ transmission- refers to how influenza is transferred to humans via mainly wild aquatic birds

zoonotic

within these reservoirs (for the virus-so the birds), influenza A virus is capable of ___, which means it can swap gene segments to generate a new virus

reassortment

antigenic ____: 2+ different strains of a virus combine to form a new subtype

shift

antigenic ___: virus changes because of accumulaton of mutations over time

drift

flu vaccines cannot give you the flu because IIVs (inactivated influenza vaccines) are _____, so the virus is dead

inactivated

strains are chosen for the flu vaccine based on the WHO/CDC trying to __ the strains that will dominate the next year

predict

how does CDC calculate vaccine effectiveness for influenza?

influenza vaccine effectiveness network

You should get vaccinated bc antibodies against one strain of influenza may also offer __-__ against related strains

cross-protection

SARS-cov 2 is ___ pathogenic

highly

SARS-CoV-2

-highly pathogenic

-___ sense

-___ stranded, nonsegmented RNA virus

positive, single

positive sense RNA virus: RNA can can act as mrna and translate into a protein with ___ conversion

no

negative sense RNA virus: RNA must be ___ to positive sense before translation

converted

SARS-CoV-2 enters cells by binding to what?

angiotensin converting enzyme 2 receptor

SARS-CoV-2 enters cells by binding to ACE2 receptor through a ___ protein

spike

clinical features of COVID-19 may include __ __ __ __ (ARDS), which can be fatal

acute respiratory distress syndrome

ARDS involves __ and __ being attracted to damage and promoting inflammation and coagulation

monocytes, neutrophils

in ARDS, neutrophils will release __ and promote formation of microthrombi

NETs

in ARDS, there is a focal pattern of highly inflamed and flooded lung tissue, impairing ___ exchange and leading to hypoxia

oxygen

coronavirus STUDY: the overall goal of the study was to understand immunological ___

memory

coronavirus STUDY: the 4 types of immune memory examined were __ cell, antibody, CD4+ __ cell, CD8+ ___ cell

B, T, T

coronavirus STUDY:

durability=length of time immune cell memory is __ after infection

studied

coronavirus STUDY: IgA is important to study in the context of SARS-CoV-2 infection so we can study humoral immunity at ____ surfaces like airways and lungs

mucosal

coronavirus STUDY: ___ T cells will help B cells produce antibodies, and help with long-lived humoral immunity

helper

coronavirus STUDY: Helper T cells containing CCR6+ in SARS-COV-2 increase over time. The function of CCR6 is to help cells ___ from one place to another

move

coronavirus STUDY: Helper T cells that express CCR6 move to __

tissues

how do mRNA vaccines elicit an immune response?:

1) after IM injection, the mRNA is took up by __

APCs

how do mRNA vaccines elicit an immune response?:

1) after IM injection, the mRNA is took up by APCs

2) there is trafficking to __ __

lymph nodes

how do mRNA vaccines elicit an immune response?:

1) after IM injection, the mRNA is took up by APCs

2) trafficking to lymph nodes

3) __ of T lymphocytes

priming

how do mRNA vaccines elicit an immune response?:

1) after IM injection, the mRNA is took up by APCs

2) trafficking to lymph nodes

3) priming of T lymphocytes

4) CD4+/CD8 T cell ___ and germinal center reaction

activation

Janssen is a replication ___ adenovirus that carries the gene for the SARS-CoV2 spike protein

defective

COVID boosters are still effective even though they do not __ the new variants

match

COVID boosting works even though it doesn't match the new variants by greater levels of ___-__ from neutralizing antibodies

cross-reactivity

___ cells are holding up really well against new variants of COVID

T

boosting will lead to __ ___ - which is broader and more efficient antibodies forming over time

affinity maturation

COVID vaccine was developed so fast because of the ____ ___ approach to vaccine development

prototype pathogen

prototype pathogen approach: a vaccine development strategy where scientists prepare in advance for potential emerging infectious diseases, so the mRNA platform for the COVID vaccine was developed and tested ___ the infectious disease emerged

before

mRNA vaccines are "plug and play" which means they are ___ and easy to reproduce

fast

also, the COVID vaccine was developed fast because there was ___ in early clinical trial phases and manufacturing that allowed expedited process

overlap

VZV = __ __ __

varicella zoster virus

what are the 2 diseases that VZV causes?

chicken pox, shingles

shingles (zoster) is reactivation of the __ virus (means it is present in cell but not replicating)

latent

VZV pathogenesis involves a widely distributed vesicular __

rash

VZV pathogenesis involves a widely distributed vesicular rash due to viral spread to __ __ + transport of virus from blood to skin through infected __ cells

lymph nodes, T

skin rash from VZV is different than than from measles and rubella infections bc it begins in torso and spreads ___

outwards

VZV infection of T cells ___ homing to skin

enhances

VZV infected CD4+ T cells express skin homing proteins, like cutaneous leukocyte antigen (___) and ___

CLA, CCR4

once in the skin, viral infection triggers __ immune response

innate

once in the skin, viral infection triggers innate immune response with release of __ ___ ___ and ___

type 1 interferons, PML

PML= promyelocytic leukemia protein, which can form intranuclear __ to __ new virions

cages, trap

VZV establishes latency by infecting sensory nerve bodies in the __ __ __ (spine) and __ __ (face)

dorsal root ganglia, trigeminal ganglia

zoster manifests in the ___ that is innervated by the affected ganglion

dermatome

both __ ___ __ (CMI) and ___ are required to resolve VZV infection

cell mediated immunity, antibodies

___ T cells are critical for prevention reactivation of VZV

memory

if you have shingles once, can you get it again?

yes

VZV is spread to skin by VZV infected __ cells migrating to skin

T

the varicella vaccine is given to to newborns older than 12 months because before that they will have high __ ___ to clear out virus

maternal antibodies

gE is a surface protein on VZV. antibodies against gE are ____, so they will block the infection

neutralizing