Information about Passive Immunity
Passive immunity is the transfer of active humoral immunity in the form of readymade antibodies, from one individual to another. Passive immunity can occur naturally, when maternal antibodies are transferred to the fetus through the placenta, and can also be induced artificially, when high levels of human (or horse) antibodies specific for a pathogen or toxin are transferred to non-immune individuals. Passive immunization is used when there is a high risk of infection and insufficient time for the body to develop its own immune response, or to reduce the symptoms of ongoing or immunosuppressive diseases.[1]
Passive immunity is also provided through the transfer of IgA antibodies found in breast milk that are transferred to the gut of the infant, protecting against bacterial infections, until the newborn can synthesize its own antibodies.[4]
Artificially acquired passive immunity is a short-term immunization achieved by the transfer of antibodies, which can be administered in several forms; as human or animal blood plasma or serum, as pooled human immunoglobulin for intravenous (IVIG) or intramuscular (IG) use, as high-titer human IVIG or IG from immunized or from donors recovering from the disease, and as monoclonal antibodies (MAb). Passive transfer is used prophylactically in the case of immunodeficiency diseases, such as hypogammaglobulinemia.[5] It is also used in the treatment of several types of acute infection, and to treat poisoning [1] Immunity derived from passive immunization lasts for only a short period of time, and there is also a potential risk for hypersensitivity reactions, and serum sickness, especially from gamma globulin of non-human origin.[4] Passive immunity provides immediate protection, but the body does not develop memory, therefore the patient is at risk of being infected by the same pathogen later.[4]
In 1888 Emile Roux and Alexandre Yersin isolated diphtheria toxin, and following the 1890 discovery of an antitoxin based immunity to diphtheria and tetanus, by Emil Adolf von Behring and Shibasaburo Kitasato, and antitoxin became the first major success of modern therapeutic Immunology.[6]
The artificial induction of passive immunity has been used for over a century to treat infectious disease, and prior to the advent of antibiotics, was often the only specific agents available to treat certain infections. Immunoglobulin therapy was continued to be a first line therapy in the treatment of severe respiratory diseases until the 1930’s, even after sulfonamides were introduced.[5]
In 1890 antibody therapy was used treat tetanus, when serum from immunized horses was injected into patients with severe tetanus in an attempt to neutralize the tetanus toxin, and prevent the dissemination of the disease. Since the 1960’s, human tetanus immune globulin (TIG) has been used in the United States in un-immunized or incompletely immunized patients who have sustained wounds consistent with the development of tetanus.[5] The administration of horse antitoxin remains the only specific pharmacologic treatment available for botulism.[8] Antitoxin is often also given prophylactically to individuals known to have ingested contaminated food. IVIG treatment was also used successfully to treat several victims of toxic shock syndrome, during the 1970’s tampon scare.
Antibody therapy is also used to treat viral infections. In 1945, hepatitis A infections, epidemic in summer camps, were successfully prevented by immunoglobulin treatment. Similarly, hepatitis B immune globulin (HBIG) effectively prevents Hepatitis B infection. Antibody prophylaxis of both Hepatitis A and B has largely been supplanted by the introduction of vaccines however it is still indicated following exposure and prior to travel areas of endemic infection.[9]
In 1953, human vaccinia immunoglobulin (VIG) was used to prevent the spread of smallpox during an outbreak in Madras, India, and continues to be used to treat complications arising from smallpox vaccination. Although the prevention of measles is typically induced through vaccination, it is often treated immuno-prophylactically upon exposure. Prevention of rabies infection still requires the use of both vaccine and immunoglobulin treatments.[5]
During a 1995 Ebola virus outbreak in the Congo, whole blood from recovering patients, and containing anti-Ebola antibodies, was used to treat eight patients, as no effective means of prevention or treatment currently exists. Only one of the eight infected patients died, compared to a typical 80% Ebola mortality, which suggested that antibody treatment may contribute to survival.[10] Immunoglobulin has been used to both prevent and treat reactivation of the herpes simplex virus (HSV), varicella zoster virus,Epstein-Barr virus (EBV), and cytomegalovirus (CMV).[5]
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Naturally acquired passive immunity
Maternal passive immunity is a type of naturally acquired passive immunity, and refers to antibody-mediated immunity conveyed to a fetus by its mother during pregnancy. Maternal antibodies (MatAb) are passed through the placenta to the fetus by an FcRn receptor on placental cells. This occurs around the third month of gestation.[2] Immunoglobulin G is the only antibody isotype that can pass through the placenta.[2] Immunization is often required shortly following birth to prevent diseases such as tuberculosis, hepatitis B, polio, and pertussis, however, MatAb can inhibit the induction of protective vaccine responses throughout the first year of life. This effect is usually overcome by secondary responses to booster immunization.[3]Passive immunity is also provided through the transfer of IgA antibodies found in breast milk that are transferred to the gut of the infant, protecting against bacterial infections, until the newborn can synthesize its own antibodies.[4]
Artificially acquired passive immunity
see also: Temporarily-induced immunityArtificially acquired passive immunity is a short-term immunization achieved by the transfer of antibodies, which can be administered in several forms; as human or animal blood plasma or serum, as pooled human immunoglobulin for intravenous (IVIG) or intramuscular (IG) use, as high-titer human IVIG or IG from immunized or from donors recovering from the disease, and as monoclonal antibodies (MAb). Passive transfer is used prophylactically in the case of immunodeficiency diseases, such as hypogammaglobulinemia.[5] It is also used in the treatment of several types of acute infection, and to treat poisoning [1] Immunity derived from passive immunization lasts for only a short period of time, and there is also a potential risk for hypersensitivity reactions, and serum sickness, especially from gamma globulin of non-human origin.[4] Passive immunity provides immediate protection, but the body does not develop memory, therefore the patient is at risk of being infected by the same pathogen later.[4]
History and applications of artificial passive immunity
The birth of passive immunotherapy may have begun with Mithridates VI of Pontus, who sought to harden himself against poison, and took daily sub-lethal doses of poison to build tolerance. Mithridates is also said to have fashioned a 'universal antidote' to protect him from all earthly poisons.[6] For nearly 2000 years, poisons were thought to be the proximal cause of disease, and a complicated mixture of ingredients, called Mithridate, was used to cure poisoning during the Renaissance.[6] An updated version, Theriacum Andromachi, was used well into the 19th century.[7])
A vial of diphtheria antitoxin, dated 1895
The artificial induction of passive immunity has been used for over a century to treat infectious disease, and prior to the advent of antibiotics, was often the only specific agents available to treat certain infections. Immunoglobulin therapy was continued to be a first line therapy in the treatment of severe respiratory diseases until the 1930’s, even after sulfonamides were introduced.[5]
In 1890 antibody therapy was used treat tetanus, when serum from immunized horses was injected into patients with severe tetanus in an attempt to neutralize the tetanus toxin, and prevent the dissemination of the disease. Since the 1960’s, human tetanus immune globulin (TIG) has been used in the United States in un-immunized or incompletely immunized patients who have sustained wounds consistent with the development of tetanus.[5] The administration of horse antitoxin remains the only specific pharmacologic treatment available for botulism.[8] Antitoxin is often also given prophylactically to individuals known to have ingested contaminated food. IVIG treatment was also used successfully to treat several victims of toxic shock syndrome, during the 1970’s tampon scare.
Antibody therapy is also used to treat viral infections. In 1945, hepatitis A infections, epidemic in summer camps, were successfully prevented by immunoglobulin treatment. Similarly, hepatitis B immune globulin (HBIG) effectively prevents Hepatitis B infection. Antibody prophylaxis of both Hepatitis A and B has largely been supplanted by the introduction of vaccines however it is still indicated following exposure and prior to travel areas of endemic infection.[9]
In 1953, human vaccinia immunoglobulin (VIG) was used to prevent the spread of smallpox during an outbreak in Madras, India, and continues to be used to treat complications arising from smallpox vaccination. Although the prevention of measles is typically induced through vaccination, it is often treated immuno-prophylactically upon exposure. Prevention of rabies infection still requires the use of both vaccine and immunoglobulin treatments.[5]
During a 1995 Ebola virus outbreak in the Congo, whole blood from recovering patients, and containing anti-Ebola antibodies, was used to treat eight patients, as no effective means of prevention or treatment currently exists. Only one of the eight infected patients died, compared to a typical 80% Ebola mortality, which suggested that antibody treatment may contribute to survival.[10] Immunoglobulin has been used to both prevent and treat reactivation of the herpes simplex virus (HSV), varicella zoster virus,Epstein-Barr virus (EBV), and cytomegalovirus (CMV).[5]
FDA licensed immunoglobulins
The following immunoglobulins are some of the immunoglubulins currently used for infectious disease prophylaxis and immunotherapy, in the United States.[11]| Disease | Product | Source | Use |
|---|---|---|---|
| Botulism | Specific equine IgG | horse | Treatment of wound and food borne forms of botulism, infant botulism is treated with human botulism immune globulin (BabyBIG). |
| Cytomegalovirus (CMV) | hyper-immune IVIG | human | Prophylaxis, used most often in kidney transplant patients. |
| Diphtheria | Specific equine IgG | horse | Treatment of diphtheria infection. |
| Hepatitis A, measles | Pooled human Ig | human serum | Prevention of Hepatitis A and measles infection, treatment of congenital or acquired immunodeficiency. |
| Hepatitis B | Hepatitis B Ig | human | Post-exposure prophylaxis, prevention in high-risk infants (administered with Hepatitis B vaccine). |
| ITP, Kawasaki disease, IgG deficiency | Pooled human IgG | human serum | Treatment of ITP and Kawasaki disease, prevention/treatment of opportunistic infection with IgG deficiency. |
| Rabies | Rabies Ig | human | Post-exposure prophylaxis (administered with rabies vaccine). |
| Tetanus | Tetanus Ig | human | Treatment of tetanus infection. |
| Vaccinia | Vaccinia Ig | human | Treatment of progressive vaccinia infection including eczema and occular forms (usually resulting from smallpox vaccination in immunocompromised individuals). |
| Varicella (chicken-pox) | Varicella-zoster Ig | human | Post-exposure prophylaxis in high risk individuals. |
Passive transfer of cell-mediated immunity
The one exception to passive-humoral immunity is the passive transfer of cell mediated immunity, also called adoptive immunization which involves the transfer of mature circulating lymphocytes. It is rarely used in humans, and requires histocompatible (matched) donors, which are often difficult to find, and carries severe risks of graft versus host disease.[1] This technique has been used in humans to treat certain diseases including some types of cancer and immunodeficiency. However, this specialized form of passive immunity is most often used in a laboratory setting in the field of Immunology, to transfer immunity between "congenic", or deliberately inbred mouse strains which are histocompatible.See also
References
1. ^ Microbiology and Immunology On-Line Textbook: USC School of Medicine
2. ^ Coico, R., Sunshine, G., and Benjamin, E. (2003). “Immunology: A Short Course.” Pg. 48.
3. ^ Lambert, Paul-Henri, Margaret Liu and Claire-Anne SiegristCan successful vaccines teach us how to induce efficient protective immune responses? (Full text-html) Nature Medicine 11, S54 - S62 (2005).
4. ^ Janeway, Charles; Paul Travers, Mark Walport, and Mark Shlomchik (2001). Immunobiology; Fifth Edition. New York and London: Garland Science. ISBN 0-8153-4101-6. .
5. ^ Keller, Margaret A. and E. Richard Stiehm Passive Immunity in Prevention and Treatment of Infectious Diseases Clinical Microbiology Reviews, October 2000, p. 602-614, Vol. 13, No. 4
6. ^ Silverstein, Arthur M. (1989) History of Immunology (Hardcover) Academic Press. Note: The first six pages of this text are available online at: (Amazon.com easy reader)
7. ^ ^ This article incorporates content from the 1728 Cyclopaedia, a publication in the public domain. "Mithridate".
8. ^ Shapiro, Roger L. MD; Charles Hatheway, PhD; and David L. Swerdlow, MD Botulism in the United States: A Clinical and Epidemiologic Review Annals of Internal Medicine. 1 August 1998 Volume 129 Issue 3 Pages 221-228
9. ^ Casadevall, A., and M. D. Scharff. 1995. Return to the past: the case for antibody-based therapies in infectious diseases. Clin. Infect. Dis. 21:150-161
10. ^ Mupapa, K., M. Massamba, K. Kibadi, K. Kivula, A. Bwaka, M. Kipasa, R. Colebunders, and J. J. Muyembe-Tamfum on behalf of the International Scientific and Technical Committee. 1999. Treatment of Ebola hemorrhagic fever with blood transfusions from convalescent patients. J. Infect. Dis. 179(Suppl.):S18-S23
11. ^ Samuel Baron MD (1996) Table 8-2. U.S. Licensed Immunoglobulin For Passive Immunization Medical Microbiology Fourth Edition The University of Texas Medical Branch at Galveston
2. ^ Coico, R., Sunshine, G., and Benjamin, E. (2003). “Immunology: A Short Course.” Pg. 48.
3. ^ Lambert, Paul-Henri, Margaret Liu and Claire-Anne SiegristCan successful vaccines teach us how to induce efficient protective immune responses? (Full text-html) Nature Medicine 11, S54 - S62 (2005).
4. ^ Janeway, Charles; Paul Travers, Mark Walport, and Mark Shlomchik (2001). Immunobiology; Fifth Edition. New York and London: Garland Science. ISBN 0-8153-4101-6. .
5. ^ Keller, Margaret A. and E. Richard Stiehm Passive Immunity in Prevention and Treatment of Infectious Diseases Clinical Microbiology Reviews, October 2000, p. 602-614, Vol. 13, No. 4
6. ^ Silverstein, Arthur M. (1989) History of Immunology (Hardcover) Academic Press. Note: The first six pages of this text are available online at: (Amazon.com easy reader)
7. ^ ^ This article incorporates content from the 1728 Cyclopaedia, a publication in the public domain. "Mithridate".
8. ^ Shapiro, Roger L. MD; Charles Hatheway, PhD; and David L. Swerdlow, MD Botulism in the United States: A Clinical and Epidemiologic Review Annals of Internal Medicine. 1 August 1998 Volume 129 Issue 3 Pages 221-228
9. ^ Casadevall, A., and M. D. Scharff. 1995. Return to the past: the case for antibody-based therapies in infectious diseases. Clin. Infect. Dis. 21:150-161
10. ^ Mupapa, K., M. Massamba, K. Kibadi, K. Kivula, A. Bwaka, M. Kipasa, R. Colebunders, and J. J. Muyembe-Tamfum on behalf of the International Scientific and Technical Committee. 1999. Treatment of Ebola hemorrhagic fever with blood transfusions from convalescent patients. J. Infect. Dis. 179(Suppl.):S18-S23
11. ^ Samuel Baron MD (1996) Table 8-2. U.S. Licensed Immunoglobulin For Passive Immunization Medical Microbiology Fourth Edition The University of Texas Medical Branch at Galveston
Immune system / Immunology | |
|---|---|
| Systems | Adaptive immune system vs. Innate immune system • Humoral immune system vs. Cellular immune system • Complement system (Anaphylatoxins) |
| Antibodies and antigens | Antibody (Monoclonal antibodies, Polyclonal antibodies, Autoantibody) • Allotype • Isotype • Idiotype • Antigen (Superantigen) |
| Immune cells | White blood cells (T cell, B cell, NK cell, Mast cell, Basophil, Eosinophil) • Phagocyte (Neutrophil, Macrophage, Dendritic cell) • Antigen-presenting cell • Reticuloendothelial system |
| Immunity vs. tolerance | Immunity • Autoimmunity • Allergy • Tolerance (Central) • Immunodeficiency |
| Immunogenetics | Somatic hypermutation • V(D)J recombination • Immunoglobulin class switching • MHC / HLA |
| Other | Cytokines • Inflammation • Opsonin |
The Humoral Immune Response (HIR) is the aspect of immunity that is mediated by secreted antibodies, produced in the cells of the B lymphocyte lineage (B cell). Secreted antibodies bind to antigens on the surfaces of invading microbes (such as viruses or bacteria), which flags them
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Immunity is a medical term that describes a state of having sufficient biological defenses to avoid infection, disease, or other unwanted biological invasion. Immunity involves both specific and non-specific components.
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H.O.R.S.E. is a form of poker commonly played at the high stakes tables of casinos. It consists of rounds of play cycling among:
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- Texas Hold 'em,
- Omaha eight or better,
- Razz,
- Seven card Stud, and
- Seven card stud E
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Antibodies (also known as immunoglobulins) are proteins that are found in blood or other bodily fluids of vertebrates, and are used by the immune system to identify and neutralize foreign objects, such as bacteria and viruses.
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A pathogen or infectious agent is a biological agent that causes disease or illness to its host.[1] The term is most often used for agents that disrupt the normal physiology of a multicellular animal or plant.
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toxin (Greek: τοξικόν, toxikon, lit. (poison) for use on arrows) is a poisonous substance produced by living cells or organisms.
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immune system is a collection of mechanisms within an organism that protects against disease by identifying and killing pathogens and tumor cells. It detects a wide variety of agents, from viruses to parasitic worms, and needs to distinguish them from the organism's own healthy
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Immunosuppression involves an act that reduces the activation or efficacy of the immune system. Some portions of the immune system itself have immuno-suppressive effects on other parts of the immune system, and immunosuppression may occur as an adverse reaction to treatment of
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Antibodies (also known as immunoglobulins) are proteins that are found in blood or other bodily fluids of vertebrates, and are used by the immune system to identify and neutralize foreign objects, such as bacteria and viruses.
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fetus (or foetus, or fœtus) is a developing mammal or other viviparous vertebrate, after the embryonic stage and before birth. The plural is fetuses (foetuses, fœtuses) or, very rarely, foeti.
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The placenta is an ephemeral (temporary) organ present in placental vertebrates, such as some mammals and sharks during gestation (pregnancy).
The placenta develops from the same sperm and egg cells that form the fetus, and functions as a fetomaternal organ with two
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The placenta develops from the same sperm and egg cells that form the fetus, and functions as a fetomaternal organ with two
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Gestation is the carrying of an embryo or fetus inside a female viviparous animal. Mammals during pregnancy can have one or more gestations at the same time (multiple gestations).
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Immunoglobulin G (IgG) is a multimeric immunoglobulin, built of two heavy chains γ and two light chains. Each complex has two antigen binding sites. This is the most abundant immunoglobulin and is approximately equally distributed in blood and in tissue liquids,
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Isotype can refer to:
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- In crystallography, an "Isotype" is a synonym for isomorph
- In biology, per the International Code of Botanical Nomenclature, the "Isotype" is a duplicate of the holotype.
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Hepatitis B
Classification & external resources
ICD-10 B 16. ,
B 18.0 -B 18.1
ICD-9 070.2 - 070.3
OMIM 610424
DiseasesDB 5765
MedlinePlus 000279
eMedicine med/992 ped/978
MeSH D006509
Hepatitis B virus
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Classification & external resources
ICD-10 B 16. ,
B 18.0 -B 18.1
ICD-9 070.2 - 070.3
OMIM 610424
DiseasesDB 5765
MedlinePlus 000279
eMedicine med/992 ped/978
MeSH D006509
Hepatitis B virus
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Poliomyelitis
Classification & external resources
ICD-10 A 80. , B 91.
ICD-9 045 , 138
DiseasesDB 10209
MedlinePlus 001402
eMedicine ped/1843 pmr/6
MeSH C02.182.600.
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Classification & external resources
ICD-10 A 80. , B 91.
ICD-9 045 , 138
DiseasesDB 10209
MedlinePlus 001402
eMedicine ped/1843 pmr/6
MeSH C02.182.600.
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Pertussis
Classification & external resources
ICD-10 A 37.
ICD-9 033
DiseasesDB 1523
MedlinePlus 001561
eMedicine emerg/394 ped/1778
Pertussis, also known as whooping cough
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Classification & external resources
ICD-10 A 37.
ICD-9 033
DiseasesDB 1523
MedlinePlus 001561
eMedicine emerg/394 ped/1778
Pertussis, also known as whooping cough
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IGA may stand for:
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- The Iowa General Assembly (state legislature)
- Iga Province, Japan
- IgA or immunoglobulin A - see also IgA nephritis which is a renal disease
- IGA (supermarkets) Independent Grocers Association or Independent Grocers Alliance
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Breast milk usually refers to the milk produced by a human female which is usually fed to infants by breastfeeding. It provides the primary source of nutrition for newborns before they are able to eat solid food and digest a wider variety of food.
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Blood plasma is the liquid component of blood, in which the blood cells are suspended. It makes up about 55% of total blood volume. Blood plasma is prepared simply by spinning a tube of fresh blood in a centrifuge until the blood cells fall to the bottom of the tube.
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Serum (Latin for "whey") may refer to:
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- Blood plasma, with clotting factors removed
- Serous fluid, any clear bodily fluid
- Truth serum, a general term for sedative drug or unspecified drug that is likely to make people tell truth or divulge information
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Monoclonal antibodies (mAb or moAb) are antibodies that are identical because they are produced by one type of immune cell that are all clones of a single parent cell.
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Prophylaxis (Greek "προφύλαξις" to guard or prevent beforehand) is any medical or public health procedure whose purpose is to prevent, rather than treat or cure, disease.
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Immunodeficiency
Classification & external resources
ICD-10 D 84.9
ICD-9 279.3
DiseasesDB 21506
MeSH D007153 In medicine, immunodeficiency (or immune deficiency
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Classification & external resources
ICD-10 D 84.9
ICD-9 279.3
DiseasesDB 21506
MeSH D007153 In medicine, immunodeficiency (or immune deficiency
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MeSH D017074 Common variable immunodeficiency (CVID) is a group of 20-30 primary immunodeficiencies (PIDs) which have a common set of symptoms but with different underlying causes.
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- For biological toxicity, see toxin and poison.
- For use of the term in reference to catalysis, see catalyst poisoning.
- For use of the term in reference to fissionable material, see Nuclear poison.
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MeSH D006967 Hypersensitivity refers to undesirable (damaging, discomfort-producing and sometimes fatal) reactions produced by the normal immune system. Hypersensitivity reactions require a pre-sensitized (immune) state of the host.
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Serum sickness is a reaction to an antiserum derived from an animal source. It is a type of hypersensitivity, specifically immune complex (type 3) hypersensitivity.
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