Acquired Immunity

Disha S. Kataria B.D.S. IInd Roll no. 33

ACQUIRED IMMUNITY
The resistance that an individual acquires during his lifetime is known as ACQUIRED IMMUNITY. Acquired Immunity is Antigen Specific.

ACTIVE IMMUNITY
It is the resistance developed by an individual as a result of antigenic stimulus. It is also called adaptive immunity.

This involves the active functioning of the hosts immune apparatus leading to the synthesis of antibodies and/or the production of IMMUNOCOMPETENT CELLS (ICC) Active immunity appears after a LATENT PERIOD/ LAG PERIOD i.e.,the time required for generation of the immunological machinery.

During development of active immunity there is often a NEGATIVE PHASE during which the level of measurable immunity may actually be lower than it was before the antigenic stimulus. If an individual who has been actively immunised against an antigen experiences the same antigen subsequently, the immune response occurs more quickly and abundantly than during the first encounter. This is known as SECONDARY RESPONSE.

This is done by memory cells. IMMUNOLOGICAL MEMORY This implies that the immune system is able to retain for long periods the memory of a prior antigenic exposure and to produce a secondary type of response when it encounters the same antigen again. Once developed active immunity is long lasting and more effective than passive immunity.

NATURAL ACTIVE IMMUNITY

This results from either a clinical or subclinical infection. This immunity is usually long lasting but the duration varies with the type of pathogen.

Chicken Pox Life long Measles Life long Influenza Short Lived Common Cold Short Lived

The immunity following bacterial infection is generally less permanent than that following viral infections.

Syphillis CONCOMITANT Immunity The immunity to reinfection lasts only as long as the original infection is active. Once the disease is cured, the patient becomes susceptible to the spirocheate again. Chancroid by Haemophilus Ducreyi No effective immunity. There are chances of reinfection even while the original infection is active.

ARTIFICIAL ACTIVE IMMUNITY

It is the resistance induced by vaccines. Vaccines are preparations of live or killed micro-organisms or their products used for immunisation. o BACTERIAL VACCINES (a) Live: B.C.G. for Tuberculosis (b) Killed: Cholera Vaccine

BACTERIAL PRODUCTS Tetanus Toxoid Diptheria Toxoid VIRAL VACCINES (a) Live: Sabin Vaccine for poliomyelitis (b) Killed: Salk Vaccines for poliomyelitis
Influenza Vaccine Hepatitis A Hepatitis B

LIVE VACCINES
These initiate an infection without causing any injury or disease. The immunity following live vaccine administration parallels that following natural infection though it may be of a low order. They may be administrated orally or parenterally. Strict conditions of storage are required.

KILLED VACCINES
These are generally less immunogenic than live vaccines and protection lasts only for a short period. Therefore they have to be administered repeatedly. The first dose is known as the PRIMARY DOSE and the subsequent doses are known as BOOSTER DOSES.

Strict conditions of storage are not required. Oral route for killed vaccines is generally not effective. Antibody response to killed vaccines is improved by addition of adjuvants, for example Aluminium Phosphate adjuvant vaccine for cholera.

Passive Immunity
The resistance that is transmitted to recipient in a readymade form is known as PASSIVE IMMUNITY. The protection is effective immediately after immunisation. It confers only transient immunity lasting usually for days or weeks till the antibodies are metabolized and eliminated.

Here subsequent administration of antibodies is less effective due to IMMUNE ELIMINATION. Following the first injection of an antibody such as immune horse serum, the elimination is only by metabolic breakdown but during subsequent injections of horse serum, elimination is much quicker as it combines with antibodies to horse serum that would have been produced following its initial injection.

The main advantage of passive immunisation is that it acts immediately and therefore can be employed when instant immunity is desired like in case of protection against tetanus, gas gangrene and diptheria following exposure.

NATURAL PASSIVE IMMUNITY

This is the resistance transferred to foetus through placenta. After birth the immunoglobulins are passed to the newborn through breastmilk. Immunoglobulins like IgA & IgG. It is only by the age of 3 months that the infant acquires a satisfactory level of immunological independence, till then maternal antibodies give passive protection to the infant.

Transport of antibodies across placenta is an active process, therefore, the concentration of antibodies in foetal blood may sometimes be higher than that seen in the mother. These antibodies are generally against all common infectious diseases in the locality. By active immunisation of mother during pregnancy, the immune status of the neonate can be improved.

ARTIFICIAL PASSIVE IMMUNITY

It is the resistance transferred to a recipient by the administration of antibodies. This is done by hyper immune sera of man or animals. For example; tetanus antitoxin is prepared in horse by active immunisation of horse with tetanus toxoid, bleeding them and separating the serum.

They give temporary protection but carry the disadvantages of hypersensitivity and immune elimination. Sera collected from patients covalescing from infectious diseases contain high level of specific antibodies. Hence they can be employed for passive immunisation against viral infection such as measles and rubella. Placenta also provides a convenient source of human immunoglobulins.

However with human serum, there is a grave risk of transmission of human immunodeficiency virus and hepatitis B, C and D viruses.

Indications of passive Immunisation

When instant immunity is desired. Administration of Anti Rh (D) IgG to Rhnegative mother bearing Rh- positive baby at the time of delivery to prevent Rh isoimmunisation. For suppression of autoimmunity.

COMBINED IMMUNISATION
Combination of active and passive immunisation is employed. For eg; a person exposed to tetanus may be injected tetanus antitoxin on one arm and tetanus toxoid on the other arm with separate syringes followed by full course of tetanus toxoid. Diptheria antitoxin and diptheria toxoid can also practiced similarly.