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Medical Forum / General / General / April 2006

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Layman question about vaccination

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Squark - 17 Apr 2006 11:54 GMT
Hello everyone

The most famous success of vaccination was the eradication of smallpos
using cowpox. Supposedly after taking the cowpox vaccine your immune
system gets to "study the virus" and learn to produce suitable
antibodies which allow you to cope with smallpox viruses you might
catch later.
The question is, what prevents your immune system from doing the same
with the actual smallpox viruses, without any vaccination beforehand?
How come a non-vaccinated person who caught smallpox can actually die
from it? Does the immune system fail to start producing the antibodies,
or does it start "too late" in some sense?
I used cowpox / smallpox as an example, but the question is really
relevant to other vaccines as well.

Thx a lot for any help!

Best regards,
Squark
Rusmir G - 17 Apr 2006 14:36 GMT
As far as I know, you do not get the actual virus in the vaccine. What
vaccine contains is a "disabled" virus and on that count the human immune
system is able to train the "army" and introduce the enemy to them. It is
like bringing the molester with his hands tied in front of a victim and let
the victim learn/train how to defend itself (and revenge also) :o), without
fear of getting hurt.

> Hello everyone
>
[quoted text clipped - 15 lines]
> Best regards,
> Squark
Robert - 17 Apr 2006 18:53 GMT
> Hello everyone
>
[quoted text clipped - 5 lines]
> The question is, what prevents your immune system from doing the same
> with the actual smallpox viruses, without any vaccination beforehand?

There are two types of antibodies. One are protective blocking or
neutralizing and the others are only markers of disease. They are present
but are not protective in avoiding future disease or present disease.
Vaccines are produced in obtaining protective antibodies in some diseases
while other diseases are without vaccines.
Natural infection can produce life long immunity in some cases. In others it
does not and it all depends on the types of antibodies produced. It takes
time to produce such antibodies with the earlier ones being IgM that can
take up to several weeks to develop. The other is IgG that can take weeks to
months to develop. A person may be dead before that time.
A vaccine provides the time needed by causing mild infection with the
resulting immune antibodies produced.

> How come a non-vaccinated person who caught smallpox can actually die
> from it? Does the immune system fail to start producing the antibodies,
[quoted text clipped - 6 lines]
> Best regards,
>  Squark
Pete - 17 Apr 2006 22:59 GMT
Robert...I always enjoy your informative posts.  I was surprised that you
didn't mention the term "killed virus" vaccine (that Rusmir referred to as a
"disabled" virus in his post above yours), versus a "live virus" vaccine
(which can be risky - especially with people who have compromised immune
systems).  I believe the vast majority of vaccines for the public are
"killed" (eg influenza), with exceptions like the "live" anthrax vaccine for
our troops (please correct me if I'm wrong).

Could you elaborate a little on how they "kill" or "disable" a virus so it
can be used with a high degree of safety in a vaccine.  You don't have to
get into too many details - just a rough description, would be okay.  I have
always wondered about this.  Thanks...Pete

>> Hello everyone
>>
[quoted text clipped - 30 lines]
>> Best regards,
>>  Squark
Robert - 18 Apr 2006 03:12 GMT
> Robert...I always enjoy your informative posts.  I was surprised that you
> didn't mention the term "killed virus" vaccine (that Rusmir referred to as a
[quoted text clipped - 3 lines]
> "killed" (eg influenza), with exceptions like the "live" anthrax vaccine for
> our troops (please correct me if I'm wrong).

I am out of the loop on vaccines as I am not directly involved.
The anthrax vaccine is not live vaccine. It is parts of bacterial
components.

http://www.anthrax.osd.mil/vaccine/facts.asp

> Could you elaborate a little on how they "kill" or "disable" a virus so it
> can be used with a high degree of safety in a vaccine.  You don't have to
> get into too many details - just a rough description, would be okay.  I have
> always wondered about this.  Thanks...Pete

If I remember correctly from my college virology course they basically use
thermal, chemical or UV inactivation.
I plead guilty to answering indirectly as David states. The HIV virus can
take up to 6 months until detected and the antibodies produced do not confer
immunity so a direct answer to a general question would be misleading I feel
: )

Let me plead guilty again by saying that viral inactivation does not only
involve vaccines but blood products also. Heat inactivation is out of the
question as it would damage the biological fluid.

Here is another blood  product that involves chemical inactivation with
solvent detergent. WinRho SDF used in treating a specific type of low
platelet count. These are specific antibodies that are treated and used.

http://www.itppeople.com/winrho.htm

Plasma for general use has also been treated in such a manner and is
available for transfusion. It is more expensive but is available although
not a big hit right now.
Pete - 19 Apr 2006 02:23 GMT
>> Robert...I always enjoy your informative posts.  I was surprised
>> that you didn't mention the term "killed virus" vaccine (that Rusmir
[quoted text clipped - 8 lines]
> The anthrax vaccine is not live vaccine. It is parts of bacterial
> components.

Thanks Robert...I thought I heard something on the news about this a while
back (the news could have been wrong or I misinterpreted it).  Is it
possible that they could have two different vaccines - ie one for the public
that wasn't "live", and a 'live"one for our troops in Iraq, who are in harms
way, and more likely to get a blast of the sh.t.  Maybe I'm all wet :-)
...Pete

> http://www.anthrax.osd.mil/vaccine/facts.asp
>
[quoted text clipped - 25 lines]
> available for transfusion. It is more expensive but is available
> although not a big hit right now.
Squark - 17 Apr 2006 21:19 GMT
Thx everyone for their answers! These have been helpful.

On that account, I have two more related questions:

1) What do we know about the mechanism of "learning" which allows the
immune system to create the right antibodies for the particular kind of
virus it is up against? Is it just trial-and-error or some actual
"analysis" of the attacking virus is involved? Even if it's the first,
what is the mechanism of the feedback? How does the immune system
"know" whether the antibody it is trying (if this concept is valid at
all) is working?

2) Is it possible to create the antibodies synthetically and inject
them into patients? If no, why not? If yes, is this indeed a practiced
method of treatment?

Best regards,
Squark
Robert - 17 Apr 2006 22:01 GMT
> Thx everyone for their answers! These have been helpful.
>
[quoted text clipped - 7 lines]
> "know" whether the antibody it is trying (if this concept is valid at
> all) is working?

Single organisms have been around longer than man has. They have adapted and
have learned to evade host immune systems.
There is specific and non-specific immunity. What ever the end result is
depends on the host and the bug interactions.
They don't know the specifics of why or how the immune system produces
certain antibodies or cells or cytokines and under what circumstances those
might be. If they did we would have an AIDS vaccine by now or a malaria
vaccine etc.
With influenza we have a virus that changes and thus evades immunity. With
parasites you have the worm wraping itself with host tissue and becomes
stealth. With TB you have the bug living in a cell, macrophage, actually
living and growing in a cell intended to kill bugs. You have bacteria
secreting coagluase enzyme that walls off itself from host immune cells.
The body has sensors that detect an invader and generate a wide array of
cells that go to work. It is broad and as well as specific in the hopes of
destroying the bug.

> 2) Is it possible to create the antibodies synthetically and inject
> them into patients? If no, why not? If yes, is this indeed a practiced
> method of treatment?

Yes. It's called passive immunity. The CDC went into the field against Ebola
virus with plasma from people who survived the infection. The limiting
factor is the amount of antibodies and the quality of protection, both of
which are unknown.
Immune globulin is injected all the time with hepatitis A exposure and with
other virus exposures such as hepatitis B.
Synthetic antibodies ie monoclonal antibodies from clonal tissue cells
hybridomas are used clinically for testing and used as carriers for drug
delivery in cancer.
If they had a monoclonal antibody already then that would mean they already
had a vaccine as that is what a vaccine is or at least have a neutralizing
antibody.

> Best regards,
>  Squark
kuhnfucius - 18 Apr 2006 03:39 GMT
"Is it possible to create the antibodies synthetically and inject  them into
patients? If no, why not? If yes, is this indeed a practiced  method of
treatment?

Antibodies yes, totally human antibodies very few or currently very
expensive.  Antibodies are very large molecules.  Currently (actually this
is a few years out of date) the chimeric  (part animal and part human)
antibodies are the big thing.  I will make a very important suggestion to
you.  Your best source for the knowledge you seek is yourself.  _But_ it has
large, but enjoyable learning curve.  Get old issues of Scientific American
(the really brave, bold and experience may try The Journal Science) read on
this issue.  Get reference books to look up what you don't understand. E.g.
Dictionary of Science and Technology or the latest edition of Cellular and
Molecular Immunology, Abbas, Lichtman & Pober.   Now these are a bit heavy
(but not all that expensive) and perhaps someone can suggest others.  Web
searchs are sometimes useful, but the best source is your own learning.

>> Thx everyone for their answers! These have been helpful.
>>
[quoted text clipped - 49 lines]
>> Best regards,
>>  Squark
bae@cs.toronto.no-uce.edu - 18 Apr 2006 17:38 GMT
>Thx everyone for their answers! These have been helpful.
>
[quoted text clipped - 7 lines]
>"know" whether the antibody it is trying (if this concept is valid at
>all) is working?

To greatly oversimplify, a mammal's immune systems has a bunch of
templates that it 'tries' when it encounters (and 'recognizes') a
foreign protein.  When one matches, it begins to produce the antibody
in massive quantities.  You asked earlier why a disease like smallpox
can kill, despite the immune sytem producing antibodies against it.
The answer is that the disease organism can sometimes do a lot of
damage before the immune sytem can mount an effective response.

Again, greatly oversimplifying, the immune system 'remembers' an antigen
it has produced antibodies to in the past, so if it encounters the
same or a related antigen again, it can ramp up a defense much faster.
It also keeps a lower level of these antibodies around for varying
periods.  In the case of smallpox, this may be lifelong.  For other
diseases it may be months, years or decades.  This is the principle
behind vaccination.  Modern vaccines often contain only non-infective
material, like viral protein coats, that stimulate immunity without
any risk of disease.  Some vaccines target the protein toxin the disease
organism produces, rather than the microbe itself.  Diphteria and
tetanus vaccines work this way, preventing symptoms while other parts
of the immune system tackle the microbes by more generic methods.

There are some very intricate feedback systems that enable the immune
system to 'know' that the defense is working.

Biological systems, unlike designed or engineered ones, are ornately
complex, because, to use a programmer's metaphor, they grew by accretion,
patch on patch, kludge on kludge.  There are innumerable special cases,
unrelated redundant mechanisms, and just immense quantities of detail
and exceptions.  Note that autoimmune diseases, where the immune system
gets 'confused' and attacks normal body tissues, are very common and
include lupus, type I diabetes, rheumatoid arthritis and many others.
The immune system can also overreact and do more damage than the
invading organism, as in SARS and avian flu.

Nobody can give you a brief summary of how it works that's much more
informative than the above.  If you are interested, take the suggestion
already given to read Scientific American and similar sources.  You
can also try to find an immunology textbook or popular work that is
at a level that suits your interest.

>2) Is it possible to create the antibodies synthetically and inject
>them into patients? If no, why not? If yes, is this indeed a practiced
>method of treatment?

This method has been in use for perhaps 100 years.  Until fairly
recently, antiserums were produced by vaccinating animals and
harvesting antibody-containing serums from their blood.  As described
to you before, this provides only a passive immunity that lasts at most
weeks to months.  Immunoglobulins collected from people who have
survived some disease are sometimes used in special cases, as with
Ebola virus.  If you get a dirty wound, you may be given tetanus
antitoxin to protect you until your own immune system can mount a
defense.  This used to be a serum collected from immunized horses, but
has no doubt been superseded by a less allergenic method of
production.
Squark - 19 Apr 2006 13:28 GMT
> To greatly oversimplify, a mammal's immune systems has a bunch of
> templates that it 'tries' when it encounters (and 'recognizes') a
> foreign protein.  When one matches, it begins to produce the antibody
> in massive quantities.

This sounds as if there is a fixed set of antibodies the organism is
pre-programmed to produce and it can only produce one of them. But
surely it is not exactly so, i.e. the organism can "develop" new
antibodies
for new diseases? Probably here you are only talking about response to
previously encountered antigens?

> Again, greatly oversimplifying, the immune system 'remembers' an antigen
> it has produced antibodies to in the past, so if it encounters the
> same or a related antigen again, it can ramp up a defense much faster.

This is taking the discussion a bit sideways, but I can't resist
asking: do you
implying the immune system of other animals works in completely
different
manner? If so, in which ways?

> There are some very intricate feedback systems that enable the immune
> system to 'know' that the defense is working.

Can you elaborate on some of those?

> Nobody can give you a brief summary of how it works that's much more
> informative than the above.  If you are interested, take the suggestion
> already given to read Scientific American and similar sources.  You
> can also try to find an immunology textbook or popular work that is
> at a level that suits your interest.

I have a background in theoretical physics (quantum physics in
particular)
and basic knowledge of chemistry and a bit quantum chemistry. However,
my knowledge of biology is limitely to a purely popular level. I would
be grateful for an advice about which textbooks to read on the subject.

Best regards,
Squark
bae@cs.toronto.no-uce.edu - 19 Apr 2006 16:43 GMT
>> To greatly oversimplify, a mammal's immune systems has a bunch of
>> templates that it 'tries' when it encounters (and 'recognizes') a
[quoted text clipped - 7 lines]
>for new diseases? Probably here you are only talking about response to
>previously encountered antigens?

No.  About thirty or forty years ago it was discovered that antibody
molecules are an exception to the one-gene-one-protein model current
at the time.  There's a cut-and-splice mix-and-match process that
creates a combinatorial explosion of possible antibodies.

>> Again, greatly oversimplifying, the immune system 'remembers' an antigen
>> it has produced antibodies to in the past, so if it encounters the
[quoted text clipped - 5 lines]
>different
>manner? If so, in which ways?

All vertebrates have a generally similar basic immune system, although
it has developed differently in different lines.  Mammals are very
similar, overall, but of course not identical.

I don't know anything about the immune systems of invertebrates.  No
doubt they are wildly different in different phyla and perhaps
different classes, but I would expect to see some common factors with
vertebrates in non-vertebrate chordates, and less so in the phyla more
closely related to the chordates.  Unsurprisingly, a great deal more is
known about the immune system in mice, rats, animals of economic value,
and humans than any other taxa.

>> There are some very intricate feedback systems that enable the immune
>> system to 'know' that the defense is working.
>
>Can you elaborate on some of those?

No.  It's too complicated, and I don't have the time or the expertise.

>> Nobody can give you a brief summary of how it works that's much more
>> informative than the above.  If you are interested, take the suggestion
[quoted text clipped - 7 lines]
>my knowledge of biology is limitely to a purely popular level. I would
>be grateful for an advice about which textbooks to read on the subject.

Well, one thing about biology that's very different from physics is
that it's seldom possible to conclude anything from first principles or
mathematical methods.  The basic organizing principle is evolution by
natural selection, which is as basic as atomic theory is to chemistry,
but is more a helpful rule when investigating a system than something
manipulable to predict anything in detail.  At one time biology was a
big museum of unrelated special cases.  Now it's a much bigger museum
of special cases fairly well organized by common factors and
phylogenetic relationships.  Systems developed by evolution can be
almost fractal in their ornate complexity, kludge upon kludge, patch
upon patch, existing components warped into completely different roles,
unrelated redundant mechanisms out the wazoo.

If you have a good public library, look for books at the level you
want.  Move on to a university library if you don't find them.  Medical
school textbooks will focus on human biology, while zoology books not
aimed at pre-meds may give a wider perspective.  Textbooks for nurses
or laboratory workers will focus on practical aspects of the human
immune system in disease.  Scientific American is a good source of
material at a level for the intelligent, interested person not in a
particular field.  You've probably seen books of collected articles in
various fields.  There are probably one or more on immunology.

Immunology is a very hot field, and changes rapidly.  AIDS has funneled
a lot of research money into it, and the results have been impressive.
Immunology is important not just for the issue of coping with new
infectious diseases, but with auto-immune diseases, organ transplants,
aging and the understanding and treatment of cancer.   There's a lot of
work being done and textbooks can't be up to date.
David Rind - 17 Apr 2006 23:48 GMT
> Hello everyone
>
[quoted text clipped - 15 lines]
> Best regards,
>  Squark

Answers you are getting seem a bit indirect.

Your suggestion about "too late" is correct -- smallpox will kill many
people before their immune system is able to produce adequate antibodies.

When confronted with something "new" it generally takes the immune
system at least 10 days to make significant quantities of specific
antibodies. When confronted with something it has seen before, the
immune system can usually make large amounts of antibodies over a day or
two.

Signature

David Rind
drind@caregroup.harvard.edu

kuhnfucius - 20 Apr 2006 01:20 GMT
Also it should be noted that one can not necessarily naturally and
effectively  produce antibodies to all antigens.  It is somewhat dependent
upon the major histocompatibility complexes (MHC) gene complex that one
inherits or that is currently prevalent in the population.  Then there is
nature and oral tolerance.  Think about all that foriegn protein most of us
consumed for dinner this evening.  Thanks to the aggregates of lymphoid
patches located along the intestines (Peyer's patches) we are not all having
acute lower GI emergencies.

>> Hello everyone
>>
[quoted text clipped - 25 lines]
> When confronted with something it has seen before, the immune system can
> usually make large amounts of antibodies over a day or two.
johngohde@naturalhealthperspective.com - 18 Apr 2006 15:19 GMT
> Hello everyone
>
[quoted text clipped - 3 lines]
> antibodies which allow you to cope with smallpox viruses you might
> catch later.

http://tutorials.naturalhealthperspective.com/history.html
"{Allopathy}Edward Jenner (1749-1823) demonstrated that a method of
inoculation by vaccination with cowpox would produce protection against
smallpox. Inoculation with cowpox was actually French folk medicine
which Jenner did not discover, but rather reported upon and promoted.
Inoculation was, also, a rather dangerous practice."

But come again, the modern smallpox vaccine is also reported to be
rather dangerous.  If nothing else a smallpox vaccination can make you
sick as a dog, even if it don't out right kill you.

When I was in my early teens, my parents unknowingly put my life into
jeopardy by having me vaccinated, the second time, for smallpox just so
that I could attend Boy Scout camp for 2 weeks during summer vacation.
Boy ... times have changed.  Thanks to the Internet, people are a lot
more aware of the dangers of vaccination.

Who says so?  I do. :)
 
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