Biological Sciences M121. Immunology with Hematology. Lecture 06. Antibody Structure & B-Cells.
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- Опубликовано: 11 сен 2024
- UCI BioSci M121: Immunology with Hematology (Fall 2013)
Lec 06. Immunology with Hematology -- Antibody Structure & B-Cells --
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Instructor: David A. Fruman, Ph.D.
License: Creative Commons CC-BY-SA
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Description: UCI BioSci M121 covers the following topics: Antibodies, antigens, antigen-antibody reactions, cells and tissues of lymphoreticular and hematopoietic systems, and individual and collective components of cell-mediated and humoral immune response.
Recorded on October 9, 2013
Required attribution: Fruman, David. Immunology with Hematology M121 (UCI OpenCourseWare: University of California, Irvine), ocw.uci.edu/cou.... [Access date]. License: Creative Commons Attribution-ShareAlike 4.0 United States License. (creativecommons....
Studying immunology during pandemic.. who else here in 2020 🙌
I take Stelera to manage my Crohn's disease which is a monoclonal antibody which neutralizes proinflammatory TNF-alpha. It's produced in the way you describe. It works relatively well for me
I'm enjoying your lecture as a older student and I have a question on TB resistant stains I heard where found in the Philippines. What is causing this problem. I know in some parts of the world TB is still a problem do to no vaccines available but, not in the USA. Also, my first wife is a physician and she was taught in medical school to be careful in using antibiotics do to the resistance to built up by bacteria. I met this other doctor how seems to thinks this isn't a problem. Is there a problem and how much of a problem? Thanks for the educated lecture series it's very much needed an appreciated especially by poor older students and please thank University of California Irvine etc... Is there a large Japanese community in the area? They've helped me so much.
TB resistance is a big problem. Especially in some countries like the Philippines. It is caused due to the selection of resistant bacterias during the misuse of the anti TB drugs. This problem is higher in patients with AIDS or malnutrition because of their immunosuppression. People with a healthy immune system generally can overcome this infection even if they have a resistant TB bacteria, but if they do not have a robust immune system, they become very ill and disperse this resistnt TB bacteria quickly to other people.
Thanks for the reply. I'm enjoying the lectures and as a result found a few errors in a diagram in Warren Levensens 11th edition book on Microbiology and Immunology, that's used in Medical Schools which is a excellent book for medical school students. A further question in the selection of resistant bacteria during the misuse is this do to the length of treatment of the drug?
Short answer, yes. What happens is 1). If you kill all the TB-bacteria (Mycobacteria) as quickly as you can the chances of a mutation, which gets resistance to the bacteria, is low. 2). If you have a mix of TB-bacteria, an a few ones are resistant, killing the susceptible ones helps the immune system to deal with the resistant ones early. 3). If you get a significant amount of resistant TB-bacteria and you can not deal with them with your immune system, you need a special antiresistant-TB-drug. For all these reasons there are special treatments with no only one drug, clinicians use combinations of drugs and depending on the ecology of the TB-bacterias, if there are resistant TB-bacterias in the area (like in the Philipines), they use a cocktail of medications that can surpass this resistance. For the same reasons, the length and the compliment of the treatment are critical. The duration of the treatment is months or years because the mycobacteria have a slow reproduction.
You might possibly have interest in the following. I put the following together for a person battling a bacterial infection similar to the treatment that you described. I'm new to studying immunology but find the field fascinating.
This sounds similar to treatment for Mycobacterium avium-intracellulare infection (MAI) which is an atypical mycobacterial infection, i.e. one with "nontuberculous mycobacteria" or NTM, caused by Mycobacterium avium complex ("MAC"), which is made of three mycobacteria species, M. avium, M. intracellulare, and M. chimaera.
A person I know contracted MAC after open heart surgery, which I think was do to the field of surgery being contaminated. I understand this particular bacteria is very rare to obtain in tis way. The patient was treated at Saint Josephs Medical Center in Paterson, New Jersey.
Two types of MAC lung disease
- nodular disease: multiple nodules in the lungs
- upper lobe cavitary disease: cavities in the upper parts of the lung that mimic tuberculosis
Treatment:
MAC lung patients are initially treated for 15-18 months. Monthly follow up visits are recommended that include blood work and sputum samples. Less frequent testing is done via CT scans, chest films, and pulmonary function studies about every 6 months. Bronchoscopy may be required for those patients unable to produce sputum samples for culture (a common problem among the women with nodular disease and bronchiectasis).
Baseline tests are performed upon initiation of medication therapy. Diagnostic checkups are then recommended on a regular basis every 4-6 weeks while on medications. The monthly safety tests include blood counts, liver and kidney function tests, and sputum cultures. Physician follow up visits consist of questions about the potential development of side effects such as blurry vision (caused by ethambutol), nausea and vomiting, or diarrhea (Biaxin or Zithromax), or fever and chills (rifabutin). The questioning about blurry vision while on ethambutol is especially important because the drug must be promptly discontinued if the vision change appears to relate to the medicine. Additional testing for eyes are use of the “eye chart” with letters read at 20 feet, and a red-green color book to distinguish changes in the ability to visualize colors. HRCT (high resolution computerized tomography) scans, and pulmonary function tests are completed at the start of therapy and continued on an as needed basis.
Patients whose sputum remains culture positive for MAC after 12 months of drug treatment are considered treatment failures. Patients whose sputum cultures become negative for MAC almost always do so within 6 months of starting their drugs. If the condition worsens with symptoms or if the tests appear to change, then the physician would need to reevaluate the treatment plan and possibly consider another regimen of antibiotic therapy.
The current treatment of choice for new patients with either of the two types of lung disease due to MAC is a three-drug regimen of pills.
- clarithromycin (Biaxin, made by Abbott Pharmaceuticals) or
- azithromax (Zithromax, made by Pfizer), (both belong to a chemical class of drugs called macrolides)
- ethambutol (Myambutol, Barr Pharmaceuticals); and
- rifabutin (Mycobutin, Pfizer); or rifampin (Rifadin, produced by Aventis Pharmaceuticals).
If advanced or severe disease a fourth drug is given as an intramuscular shot or intravenous infusion.
This drug is either:
- amikacin (Amikin, by Sicor Pharmaceuticals) or
- Streptomycin (X-Gen Pharmaceuticals)
The usual length of treatment lasts for at least 15 to 18 months. keep taking the medications for the prescribed length of time in order for the germs to be eliminated.
If “super-bugs” (drug resistant germs) develop:
- cultures would be taken and medications adjusted for efficacy and susceptibility of the ‘bugs’ to other antibiotic treatments.
Current recommendations are to take the oral medicines until the sputum cultures do not grow the MAC for 12 months based on monthly sputum tests. The shots or infusions are generally given only for the first 2-4 months.
Other medicines may be used in patients who have failed therapy with these drugs or who cannot tolerate them are:
- inhaled amikacin (via a nebulizer)
- ciprofloxacin (Cipro)
- rifabutin (for patients who were on rifampin)
- mefloquin (Larium, a malaria drug)
- clofazimine (Lamprene, a leprosy drug)
- ethionamide: rarely used because of their toxicity and the need for the latter to be closing monitored via blood levels.
- cycloserine: rarely used because of their toxicity and the need for the latter to be closing monitored via blood levels.
Alternate Treatments:
There are antibiotics introduced by intramuscular injection or infusion therapy via use of peripherally inserted central catheters (also called PICC lines). These medicines include amikacin and streptomycin.
Inhaled antibiotics such as amikacin are available but there are no published clinical studies of the effectiveness of these drugs. These forms of antibiotics aren’t usually given unless the oral medications fail.
Surgery to remove portions of the damaged lung is occasionally recommended. This is especially true for patients with disease in just one part of the lung who have failed therapy or whose MAC has become resistant to clarithromycin and azithromycin.
The cure rate is greater than 90% if sputum cultures are negative for 12 months while on the medications. The problem is the infection caused both left and right sides of the heart to back up causing complications of ascites from liver and pulmonary fluid buildup. Pulmonary system and heart treated with appropriate medication. Peritoneal fluid drained periodically and patients infection finally brought under control. Long battle and patient doing better.
Nice Job!
anyone know what the flow cytometry question was at the end of the lecture?
Is there any way to also get the notes that accompany the lectures?
ocw.uci.edu/courses/biosci_m121_immunology_with_hematology.html
@38:00 If human himself proteins own these structures, should be the antibody kill them too?