Vaccinations
Vincenzo Berghella in Maternal-Fetal Evidence Based Guidelines, 2022
Pregnancy is an important part of the life cycle when certain infections can play a particularly destructive role. Pregnancy creates a relative immune suppression, which places a woman at greater risk of complications from illnesses such as influenza and varicella. Likewise, maternal infections with such viruses as varicella and rubella can cause a spectrum of fetal effects including congenital anomalies, fetal morbidities, and even fetal death. Finally, neonates are highly susceptible to complications from vaccine preventable diseases at a time when they do not receive full protection from vaccination themselves. Vaccination of an individual induces immunity, a process known as active immunization.Maternal vaccination also provides protection of the neonate through passive immunization, in which maternal antibodies (IgG) are transmitted transplacentally, particularly in the last 4–6 weeks of gestation [3]. An additional benefit may occur with the passage of antibodies (IgA) via breast milk. In addition, by immunizing close contacts of a newborn, the risk of exposure to disease is reduced, a strategy known as cocooning.
Immunization
Julius P. Kreier in Infection, Resistance, and Immunity, 2022
Any disease to which a human or other animal may develop an immunity which protects against subsequent infection is a candidate for control by vaccination. Attainment of the immune state can be by active or passive means. Active immunization is based on the premise that administration of an appropriate immunogen will stimulate the afferent arm of the immune system to provide immune effector agents (cells or molecules capable of immune attack) which will protect the recipient against disease if exposure to the virulent agent occurs. Useful vaccines will do this without themselves causing significant disease. Passive immunization involves the administration of specific neutralizing or opsonizing antibodies or other immune effector molecules to protect against known or probable exposure. (Passive immunization with cells is not currently practical because of transplantation immunity against cells derived from a donor of a different histocompatibility haplotype [see chapter 11].) For the most part, this process depends on the availability of protective antibodies which must have initially been generated by an active immune response, but recent studies have demonstrated the protective effect of passively administered recombinant cytokines.
General Principles
E. George Elias in CRC Handbook of Surgical Oncology, 2020
Cancer immunotherapy can be classified to active and passive immunizations. Each of those can be reclassified into tumor specific or tumor nonspecific types. While active immunization requires, in general, a relatively intact immune system to stimulate, passive immunization does not. In addition, active immunization lasts much longer than the passive one. Tumor nonspecific active immunotherapy includes: (1) immune stimulators such as bacillus Calmette-Guerin (BCG), methanol extract residue of BCG (MER), Corynebacterium parvum, interferon, and others and (2) immuno-reconstitutors such as levamisole and thymosin. Passive tumor nonspecific immunotherapy consists of the transfer of cellular immunity by the transfer of immunocompetent cells or the immunological component of the cells, such as Lawrence transfer factor. Similarly, and theoretically, humoral transfer can also be established via plasma (containing the antibodies) transfusion. On the other hand, tumor specific active immunotherapy can be achieved by utilizing live autologous tumor cells that have been attenuated by irradiation or treated by mitomycin-C, or by utilizing TAA. These should be mixed with BCG or complete Freund adjuvant, at least initially, and administered repeatedly intradermally. Tumor-specific passive immunotherapy consists of the transfer of immune competent materials (cellular or humoral) to a recipient with low tumor load, if a sensitized donor is found. Monoclonal antibodies are very tumor specific, but have no ability to kill, and several methods are being investigated to enable them to destroy the tumor cells on contact.
Vaccines for healthcare-associated infections: present, future, and expectations
Published in Expert Review of Vaccines, 2018
Amandine Gagneux-Brunon, Frédéric Lucht, Odile Launay, Philippe Berthelot, Elisabeth Botelho-Nevers
Immunization of at-risk patients represents an ‘ecological’ strategy to fight antimicrobial resistance and to reduce the burden of HAIs. It is not surprising that the development and the use of vaccines form part of government plans to address the concern of antimicrobial resistance [167,168]. Here, we reported that active immunization among at-risk patients with licensed vaccines reduces significantly vaccine-preventable HAIs and complications for example for influenza and rotavirus. However, the data concerning immunization records of hospitalized patients are frequently missing as observed in a cohort of hospitalized patients [169]. We can put forward several hypotheses to explain this lack of data. First, physicians in charge of a patient hospitalized for an acute disease may not consider that it is in their mission to immunize the patient. Second, obtaining reliable proofs of immunization is challenging as immunization booklets are rarely available (lost, not with the patient…). Generalization of electronical immunization records will probably help this latter issue. Thus, it seems crucial to keep better records of data on vaccination in patients hospitalized or sheltered in long-term care facilities [170,171]. In fact, a hospitalization or a hospital discharge can represent good opportunities to immunize vulnerable patients that are frequently hospitalized [169]. Immunization during hospitalization may be more easily accepted based on data published in 2007. However, in current period of global vaccine hesitancy, actualization of these results seems necessary.
Emerging drugs for progressive supranuclear palsy
Published in Expert Opinion on Emerging Drugs, 2019
Nikolaos Giagkou, Maria Stamelou
An important aspect to be considered is that all biologics, monoclonal antibodies included, have the ability to induce an undesired immune reaction against them. Immune reactions can be severe and life-threatening as it has been seen in animal models of tauopathies, or, more commonly, they can alter the pharmacokinetics or counter the efficacy of a compound (anti-drug antibodies) [78,79]. Passive immunization approaches are considered safer than active immunization but are not free from the theoretical potential of severe immunogenicity [78]. Anti-amyloid beta immunization in the past has been associated, in a subset of patients, with the development of symptoms of meningoencephalitis, white matter lesions, vasogenic edema, and microhemorrhages, together termed Amyloid-related imaging abnormalities [78]. Regarding the two monoclonal antibodies in Phase 2 trials in PSP, so far, there are no reports of central nervous system toxicity or of the development of anti-drug antibodies or other immune reactions.
Surgical management of severe facial trauma after dog bite: A case report
Published in Acta Oto-Laryngologica Case Reports, 2020
Bernhard Prem, David Tianxiang Liu, Bernhard Parschalk, Boban M. Erovic, Christian A. Mueller
In our presently reported case, direct closure of the subtotally amputated nose was possible. To avoid post-operative nasal obstruction, we aimed to reconstruct the nasal airway without applying tension. At half a year after the attack, we and the patient deemed the aesthetic outcome to be satisfactory. Furthermore, the woman reported proper nasal ventilation. Regarding anti-infective therapy against bacteria, our patient received intravenous amoxicillin–clavulanate twice daily for 10 days, with no need to adapt this therapy. Due to the patient’s unknown vaccination status, we implemented active immunization against tetanus, diphtheria, polio and pertussis. Due to the decreasing attendance to vaccinations and the problems that arise when only tetanus is boosted, it should be considered that emergency departments administer tetravalent vaccines (diphtheria, tetanus, polio and pertussis). Since the dog in this case had received all recommended vaccinations against rabies and showed no signs of the disease, there was no reason to vaccinate the patient against rabies.