Fundamentals of

immunoprophylaxis and
immunotherapy of WHO's
immunization program.
Prospects for elimination
of infectious diseases.
 Immunization - the
creation of active and
passive immunity
 
Immunotherapy -
treatment of developing
the disease.
 Immunoprophylaxis and
immunotherapy are used when
necessary:

Form, to create a specific immunity or

activate the immune system:
Suppress the activity of certain parts of
the immune system:
Normalize the immune system, if there
are deviations of its function in one way
or another
 All preparations for the IP and IT
named immunobiological preparations
(IBP).
 Currently, there are 5 groups of the
IBP:
1.Derived from living or dead
microbes, microbial products and used
for specific prevention and therapy.
(Live and inactivated vaccines,
subcellular vaccine. Toxoids, phage,
probiotics, prebiotics and synbiotics)
2. On the basis of specific
antibodies - immunoglobulins,
immune serum. Immunotoxins,
antibodies, enzymes (abzymes)
receptor antibody, a mini-
antibody;
3. Immunomodulators
(immunosu-compressor and
immunostimulants)
4. Diagnostic preparations

5. Adaptogens-complex
him.veschestva different
origin.
 Vaccine (from Lat.
Vacca - cow) - a
medicine for creating
immunity to infectious
diseases.
Classification of
Vaccines
Vaccines:
-Living
-Inactivated
-Subcellular
-Microbial metabolites
-Chemically or biologically
-Synthesized drugs
(subedinichnye, conjugate, the
vector and recombinant DNA)
 Live vaccines are produced by
artificial attenuition (an attenuated
strain (BCG - 200 - 300 passages on
bile broth ZHVS - passage to the green
monkey kidney tissue), or by selecting
a natural avirulent strains. At the
present time possible way to create live
vaccines by genetic engineering at the
level of chromosomes using restriction
enzymes.
 Positive aspects: mechanism of
action on the body similar to the
"wild" strain, may live in the body
and long-lasting immunity. Used
small doses of vaccination (usually
single) and therefore vaccination is
easy to carry out organizational.
The latter allows us to recommend
this type of vaccines for future use.
 Negative aspects: a live
vaccine Corpuscular - contains
99% of the ballast and,
therefore, is usually sufficient
reactogenicity, in addition, it can
cause mutation of cells
(chromosome aberrations),
which is especially dangerous for
germ cells.
 Inactivated (killed) vaccine
Inactivated vaccines are produced
by exposure to microorganisms by
chemical or heat. Such vaccines
are relatively stable and safe.
virulency.But these vaccines have
some drawbacks, in particular, they
induce a weaker immune response
and require multiple doses.
Chemical vaccine
Contain components of cell walls or other
parts of the pathogen.
Chemical vaccine - created from the
antigenic components extracted from the
microbial cells. Distinguish those antigens
that define the immunogenic characteristics
of the microorganism. These vaccines
include: polysaccharide vaccine (meningitis
A C Act - HIB, Pneumo 23, Tifim Bu),
acellular pertussis vaccine
 Biosynthetic vaccine
In the 1980's was born a new direction,
which is now successfully developed - is the
development of biosynthetic vaccines -
vaccines of the future.
Biosynthetic vaccine - a vaccine obtained
by genetic engineering methods, and are
artificially created by the antigenic
determinants of micro-organisms
(recombinant vaccine against hepatitis B, a
vaccine against rotavirus).
Biosynthetic vaccines are synthesized from
amino acid peptide fragments that
correspond to the sequence of amino acid
the structures of viral (bacterial Nogo)
protein that are recognized by immune-
dimensional system and cause an immune
response. An important advantage of
synthetic vaccines in comparison with the
traditional is that they do not contain
bacteria and viruses, their metabolic
products and cause the immune response
of narrow specificity.
 Vector (recombinant) vaccine
Vaccines obtained by genetic
engineering. The essence of the
method: the genes of a virulent
microorganism responsible for the
synthesis of protective antigens,
inserted into the genome of a harmless
microorganism, which is under
cultivation produces and accumulates the
appropriate antigen (recombinant vaccine
against hepatitis B, a vaccine against
rotavirus).
 Ribosomal vaccine
To obtain this type of vaccine used
ribosomes present in every cell.
Ribosome - it organelles that
produce protein from the matrix -
and RNA. Dedicated ribosomes
with matrix in the pure form and
submit the vaccine (dysentery
vaccine IRS - 19, Broncho-moon,
Ribomunyl).
 Subunit vaccines
Subunit vaccines consist of fragments
of antigen that can ensure an adequate
immune response. These vaccines can
be represented as particles of micro-
CWA, and obtained in the laboratory
using genetic engineering technology
(vaccine against Streptococcus
pneumoniae vaccine against
meningococcus type A)
Criteria for effective vaccines:
- Security.
- Vaccines should not cause illness or
death.
- Protective.
- Vaccines to protect against disease
caused by "wild" strain of pathogen.
- Maintenance of protective immunity.
- Protective effect must persist for several
years.
- Induction of neutralizing antibodies.
- Neutralizing antibodies are necessary
to prevent infection of these cells.
- Induction of protective T cells.
- Pathogens that multiply intracellularly
more efficiently controlled by the T-cell-
mediated immunity. Practical
considerations:
- Relatively low price of the vaccine;
- Ease of use;
- A broad effect.
Vaccination can rightly be called
one of the greatest
achievements of mankind.
Creation of an effective method
of prevention could substantially
reduce the morbidity infections
such as tuberculosis, diphtheria,
pertussis, tetanus, polio,
measles, and mortality.
 To combat infectious diseases, the
World Health Organization declared
in 1974 extended-ing the
immunization program, providing
improved coverage in the
susceptible population and quantity
of antigens. Success of the program
are obvious - in 1977 on Earth
eradicated such a dangerous
disease like smallpox.
 In 1994, WHO launched a new
Global Programme for Vaccines
and Immunization, which includes:
the Expanded Programme of
Immunization (intro, of,
maintenance and monitoring of
vaccination), support research to
develop new improved vaccines,
vaccine supply and quality control.
Kazakhstan, like other countries of the
WHO, committed to a policy of this
organization in the field of
immunization. As part of the Expanded
Programme on Immunization, WHO
recommends a transition to a safe and
economical combination vaccines -
complex drugs that cause the
appearance of antibodies to multiple
antigens simultaneously
 One of these vaccines - a
modern combined tetravaktsina
Tritanriks ™-HB production of
pharmaceutical company
GlaxoSmithKline - contains
diphtheria, tetanus toxoids,
inactivated pertussis (whole-)
bacteria and the main surface
antigen of hepatitis B virus HBV.
 It is designed to
immunize children aged
between 6 weeks and
older.
 The use of combination vaccines can
reduce the number of injections, reduce
the dose of thimerosal and the
likelihood of vaccine reactions, and
increases the compliance of
vaccination coverage of the population,
facilitates storage, application and
administration of vaccines and
monitoring of the child in the post-
immunization period.
2. On the basis of specific antibodies -
immunoglobulins, immune serum.
Immunotoxins, antibodies, enzymes
(abzymes) receptor antibody, a mini-
antibody;
Immune serum: serum containing
antibodies obtained from immunized
animals or immune human volunteers.
Applied to specific therapy or
prevention of infectious diseases
Abzymes - antibodies against the
enzymes involved in metabolic
processes
Monoclonal antibodies - antibodies, a
class derived in the laboratory from
hybridoma cells (tumor cells coupled
with the plasma cell)
Immuno-toxins, or immune-adhesins -
antibodies obtained for any structures
of the microbial cells.
3. Immunomodulators (immunosu-compressor
and immunostimulants) - biological drugs used for
the stimulation or inhibition (suppression) of
immune response

4. Diagnostic preparations - diagnosticums

(suspension of killed bacteria), diagnostic serum
(agglutinated, precipitating, neutralizing
komplemenfiksiruyuschie).

5. Adaptogens-complex him.veschestva different

origin, stimulating the body as a whole
(eleutetrakok, ginseng, Pantocrinum).
Immune status
1. The concept of immune status
2. Primary immunodeficiency
states
3. Secondary immunodeficiency
4. Methods of assessing the
immune status
1. The state of functional activity of the
human immune system as a whole is
vital for the body and is denoted by the
term "immune status".
   Immune status - a qualitative and
quantitative characterization of the
state of functional activity of the
immune system and some non-specific
mechanisms pro-tivomikrobnoy
protection.
Violations of the immune status and
the ability of the normal immune
response to different antigens are
called immunodeficiency tsitnymi
states (immunodeficiencies), which
are divided.
• the primary (congenital,
hereditary);
• secondary (acquired).
Correction of immunity

1. The concept of
immunotherapy

2. Characteristics of
immunomodulators
 1.Immuno-deficiency
(especially the secondary
immuno-deficiency) is now quite
common, which gave impetus to
the development of new areas of
medicine - immunotherapy
based on the latest
achievements in theoretical
immunology.
Such therapy is aimed at
normalizing the violations
of the functional activity
of immune system (the
correction of violations of
human immune status)
On the effect of the immune system
immunotropic drugs are divided
into:
• on immunosuppressive drugs
(immunosuppressive);
• adjuvants (agents that stimulate
the immune system);
• immunomodulators, which turns
out to yvayut multidirectional effect
depending on the source of the immune
By origin
immunocorrectors divided into 3
groups:
• preparations of exogenous
(microbial) origin;
• preparations of endogenous
origin;
• synthetic and chemically pure
drugs.
The group of agents of exogenous
(microbial) origin of the substances mainly
of bacterial and fungal origin (pirogenal,
prodigiozan, Ribomunyl and nukleinat
sodium). The indications for the use of
these immunostimulants are:
• chronic infections of bacterial, fungal or
viral;
• long-term healing wounds;
• leukopenia;
• psoriasis.
The group of drugs are endogenous
immunoregulatory peptides in the central immune
organs (thymus, bone marrow), and received
from the extracts. Among them are drugs produce
thymic origin:
• timalin;
• T-activin;
• Timoptin;
• timaktid (polypeptides from the thymus gland of
cattle);
• timostimulin;
• vilozen (extracts of the thymus gland of cattle).
They have shown patients with lesions of the T-system
immunity or allergic diseases of upper respiratory tract
The second group of preparations of
endogenous origin are bone marrow-
derived drugs, which in our country is
presented in such a way as Myelopid
(peptides synthesized by bone marrow
cells), which is widely used in diseases
with involvement of the B-system
immunity.
  To drugs of endogenous origin are also
cytokines - biologically active proteins
produced by lymphocytes and
macrophages (interleukins)
As a result of the directed synthesis of a
number of new active immunomodulators
(synthetic drugs):
• Poludan-for treatment of viral diseases of
the eye;
• leakalin - for the treatment of leukopenia,
• kemantan - for the treatment of many
secondary immunodeficiencies.
As an immunomodulator can also be used
antilymphocytic serum and
immunoglobulins (Pentaglobin, intraglobin).
Immune status
1. The concept of immune status
2. Primary immunodeficiency
states
3. Secondary immunodeficiency
4. Methods of assessing the
immune status
1. The state of functional activity of
the human immune system as a whole
is vital for the body and is denoted by
the term "immune status".
   Immune status - a qualitative and
quantitative characterization of the
state of functional activity of the
immune system and some non-specific
mechanisms pro-tivomikrobnoy
protection.
Violations of the immune status
and the ability of the normal
immune response to different
antigens are called
immunodeficiency tsitnymi states
(immunodeficiencies), which are
divided.
• the primary (congenital,
hereditary);
• secondary (acquired).
2. Primary immunodeficiency person - genetically
determined inability to implement thior that
immunity. Manifest soon after birth, inherited, as
a rule, recessive manner.
Primary immunodeficiency states may be
expressed in lesions of B-and T-immunity system
and supporting cells (antibody and cell shape)
immune response and may be combined-
governmental, but they are called specific, in
contrast to the inherited defect of nonspecific
factors of protection - phagocytosis, complement
system, etc.
3. Secondary immunodeficiency states
arise as a consequence of immune
disorders and other pathological
processes are accompanied by
limfopenieyi hypogammaglobulinemia.
Secondary immunodeficiencies are
related:
• past infectious diseases (measles,
influenza, leprosy, candidiasis);
• Somatic (with nephrotic syndrome);
• cancer (tumor lymphoreticular origin) diseases;
• burns;
• serious injury;
• major surgery;
• some treatments (X-ray irradiation,
radiation therapy of tumors, therapy
with corticosteroids, cytotoxic drugs
and immunosuppressants in
transplantation of tissues and
organs, thymectomy, splenectomy,
etc.).
In chronic lymphocytic leukemia,
myeloma, macroglobulinemia, and
diseases involving the loss of
protein, mostly suffering from a B-
system immunity.
When chlamydia, Hodgkin's
disease, leprosy, viral infections -
the T-system.
Old age is an expression of T-
immunodeficiencies.
4. For identifying
immunodeficient states of arises
the need for performance
assessment of the functional
activity of the immune system,
ie, the immune status.
Evaluation of immune status
resign, found from several
stages:
• clinical laboratory, which includes:
• collection and evaluation of immunological
history (frequency of infectious diseases,
the nature of their flow, the severity of the
reaction temperature, presence of chronic
infection foci, the reaction to vaccination or
introduction of medicines);
• assessing the general results of clinical
blood (the content of granulocytes,
monocytes, lymphocytes);
• Identification by bacteriological, virological
and / or serologic studies of bacteria and
virus infection;
• laboratory immunology. At this stage in the
immunological laboratory studies are aimed,
in fact, is the qualitative and quantitative
evaluation of the functional
activity of the immune system
(immunocompetent cells). To this end,
developed a number of (set) tests, which
are divided into test 1 (tentative) and 2-
second (analytical) levels.
Tests Level 1
 are tentative and can detect serious
violations of the immune system.
They include the definition:
• general and relative numbers of
lymphocytes;
• major subpopulations (T and B cells);
• phagocytic activity of leukocytes;
• concentration of immunoglobulins of
different classes in the serum.
Total (absolute) and relative number of
lymphocytes determined by the results
of clinical blood. The content of T-and
B-lymphocyte counts in the reaction
immunoflyuores-cence, using
fluorescent-labeled monoclonal serum
to specific surface antigen markers,
denoted by CD (clasterdifferentiation).
Such antigenic markers known to a few
dozen, but some of them are
characteristic of a particular cell type:
• receptor CD3 - all T-
lymphocytes;
• receptor CD19, 20, 21, 72 - B-
lymphocytes;
• receptors in CD4 - T-helper
cells;
• receptor CD8 - T-suppressor;
• receptor CD16 - NK-cells
(natural killer).
More accessible and easier, but less
accurate method is outdated and rosette. It
is based on the fact that B cells can adsorb
red blood cells in mice, and T-lymphocytes -
sheep erythrocytes (they can also form a
NK-cells). Lymphocytes from red blood cells
sticking to it - this is the socket, they are
counted in the stained according to
Romanovsky-Giemsa smears from a
mixture of lymphocytes and the
corresponding red blood cells.
To assess the phagocytic
activity of blood neutrophils
determines the percentage of
phagocytic cells and
phagocytic index (average
number of germ-dimensional
cells, absorbed by one
leukocyte).
Concentration (level) of different
classes of immunoglobulins G,
M, A and E in blood serum in the
reaction in the gel pretsipitaschi
{radial immunodiffusion by
Mancini) and antiglobulin sera
for IgG, IgM, IgA, IgE, but this
method gives a fairly large error
in determining : ± 15%.
Tests Level 2 allows a deeper
analysis of the immune system
and clarify the nature of the
defects identified by the test
level 1. These include, for
example, the definition of
individual subclasses bowline
immunoglobulins (especially IgG,
secretory-Nogo IgA) and B-
 Immunoprophylaxis and
immunotherapy are the sections of
immunology, which are exploring and
developing ways and methods of
specific prevention, treatment and
diagnosis of infectious and
noncommunicable diseases through
immunobilogicheskih drugs that affect
immune system function, or action is
based on immunological
principles.
 Dang shen
Codonopsis
pilosula
Eleutherococcus senticosus
Ganoderma lucidum Reishi mushroom
Lepidium Maca
meyenii
Gynostemma Jiaogulan
pentaphyllum
Ocimum Holy basil
sanctum
Schisandra Schisandra
chinensis
Cordyceps Cordyceps
sinensis