Passive immunity

Source: Wikipedia, the free encyclopedia.

In

immunity can occur naturally, when maternal antibodies are transferred to the fetus through the placenta, and it can also be induced artificially, when high levels of antibodies specific to a pathogen or toxin (obtained from humans, horses, or other animals) are transferred to non-immune persons through blood products that contain antibodies, such as in immunoglobulin therapy or antiserum therapy.[1] 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.[2] Passive immunization can be provided when people cannot synthesize antibodies, and when they have been exposed to a disease that they do not have immunity against.[3]

Naturally acquired

Maternal passive immunity

Maternal passive immunity is a type of naturally acquired passive immunity, and refers to

pertussis, however, maternal IgG 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.[5] Maternal antibodies protect against some diseases, such as measles, rubella, and tetanus, more effectively than against others, such as polio and pertussis.[6] Maternal passive immunity offers immediate protection, though protection mediated by maternal IgG typically only lasts up to a year.[6]

Passive immunity is also provided through

IgA antibodies that are transferred to the gut of the infant, providing local protection against disease causing bacteria and viruses until the newborn can synthesize its own antibodies.[7] Protection mediated by IgA is dependent on the length of time that an infant is breastfed, which is one of the reasons the World Health Organization recommends breastfeeding for at least the first two years of life.[8]

Other species besides humans transfer maternal antibodies before birth, including primates and lagomorphs (which includes rabbits and hares).[9] In some of these species IgM can be transferred across the placenta as well as IgG. All other mammalian species predominantly or solely transfer maternal antibodies after birth through milk. In these species, the neonatal gut is able to absorb IgG for hours to days after birth. However, after a period of time the neonate can no longer absorb maternal IgG through their gut, an event that is referred to as "gut closure". If a neonatal animal does not receive adequate amounts of colostrum prior to gut closure, it does not have a sufficient amount of maternal IgG in its blood to fight off common diseases. This condition is referred to as failure of passive transfer. It can be diagnosed by measuring the amount of IgG in a newborn's blood, and is treated with intravenous administration of immunoglobulins. If not treated, it can be fatal.[citation needed]

Other

A

better source needed
]

Antibodies from vaccination can be present in saliva and thereby may have utility in preventing infection.

better source needed
]

Artificially acquired

See also: Temporarily induced immunity

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

prophylactically in the case of immunodeficiency diseases, such as hypogammaglobulinemia.[12][13] It is also used in the treatment of several types of acute infection, and to treat poisoning.[2] Immunity derived from passive immunization lasts for a few weeks to three to four months.[14][15] There is also a potential risk for hypersensitivity reactions, and serum sickness, especially from gamma globulin of non-human origin.[7] 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 unless they acquire active immunity or vaccination.[7]

History and applications of artificial passive immunity

A vial of diphtheria antitoxin, dated 1895

In 1888

Emil Adolf von Behring and Kitasato Shibasaburō, antitoxin became the first major success of modern therapeutic immunology.[16][17] Shibasaburo and von Behring immunized guinea pigs with the blood products from animals that had recovered from diphtheria and realized that the same process of heat treating blood products of other animals could treat humans with diphtheria.[18] By 1896, the introduction of diphtheria antitoxin was hailed as "the most important advance of the [19th] Century in the medical treatment of acute infective disease".[19]

Prior to the advent of vaccines and

antibiotics, specific antitoxin was often the only treatment available for infections such as diphtheria and tetanus. Immunoglobulin therapy continued to be a first line therapy in the treatment of severe respiratory diseases until the 1930s, even after sulfonamides were introduced.[13]

This image is from the Historical Medical Library of The College of Physicians of Philadelphia. This displays the administration of diphtheria antitoxin from horse serum to young child, dated 1895.

In 1890 antibody therapy was used to treat

tampon scare.[citation needed
]

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 to areas of endemic infection.[21]

In 1953, human

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.[13]

During a 1995

Epstein-Barr virus (EBV), and cytomegalovirus (CMV).[13]

FDA licensed immunoglobulins

The following immunoglobulins are the immunoglobulins currently approved for use for

prophylaxis and immunotherapy, in the United States.[23]

FDA approved products for passive immunization and immunotherapy
Disease Product[a] Source Use
Botulism Specific equine IgG horse Treatment of wound and food borne forms of botulism.
Despeciated equine IgG[24]
Human specific IgG[24] human Treatment of infant botulism types A and B; brand name "BabyBIG".
Cytomegalovirus (CMV) hyperimmune IVIG human Prophylaxis, used most often in
transplant
patients.
Diphtheria Specific equine IgG horse Treatment of diphtheria infection.
Hepatitis B Hepatitis B Ig human Post-exposure prophylaxis, prevention in high-risk infants
(administered with Hepatitis B vaccine).
Hepatitis A, measles Pooled human Ig human serum Prevention of Hepatitis A and measles infection,
treatment of
congenital or acquired immunodeficiency
.
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 ocular forms (usually resulting from
immunocompromised
individuals).
Varicella
(chicken-pox)		 Varicella-zoster Ig human Post-exposure prophylaxis in high risk individuals.
Rh disease Rho(D) immune globulin human Prevention of
RhD isoimmunization in Rh(D)-negative mothers[25]
  1. normal human immunoglobulin
    .

Passive transfer of cell-mediated immunity

The one exception to passive humoral immunity is the passive transfer of

deliberately inbred mouse strains which are histocompatible.[citation needed
]

Advantages and disadvantages

Passive immunity starts working faster than vaccines do, as the patient's immune system does not need to make its own antibodies: B cells take time to activate and multiply after a vaccine is given. Passive immunity works even if an individual has a immune system disorder that prevents them from making antibodies in response to a vaccine.[18] In addition to conferring passive immunities, breastfeeding has other lasting beneficial effects on the baby's health, such as decreased risk of allergies and obesity.[26]

A disadvantage to passive immunity is that producing antibodies in a laboratory is expensive and difficult to do. In order to produce antibodies for infectious diseases, there is a need for possibly thousands of human donors to donate blood or immune animals' blood would be obtained for the antibodies. Patients who are immunized with the antibodies from animals may develop serum sickness due to the proteins from the immune animal and develop serious allergic reactions.[6] Antibody treatments can be time-consuming and are given through an intravenous injection or IV, while a vaccine shot or jab is less time-consuming and has less risk of complication than an antibody treatment. Passive immunity is effective, but only lasts a short amount of time.[18]

See also

References

  1. ^ "Vaccines: Vac-Gen/Immunity Types". www.cdc.gov. Archived from the original on 2011-12-22. Retrieved 2015-11-20.
  2. ^ a b c "Microbiology/Virology/Immunology/Bacteriology/Parasitology Text Book On-line". www.microbiologybook.org. Archived from the original on 2021-05-30. Retrieved 2023-09-28.
  3. ^ "Passive Immunization - Infectious Diseases". Merck Manuals Professional Edition. Archived from the original on 2020-04-08. Retrieved 2015-11-12.
  4. PMID 25210721
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  5. ISSN 1546-170X. Archived
    from the original on 2017-05-09. Retrieved 2023-09-28.
  6. ^ a b c d "Centers for Disease Control and Prevention" (PDF). Archived (PDF) from the original on 2020-04-08. Retrieved 2017-09-07.
  7. ^
    ISBN 0-8153-4101-6. Archived
    from the original on 2009-06-28. Retrieved 2017-09-07..
  8. ^ "WHO | Exclusive breastfeeding". www.who.int. Archived from the original on 2019-10-30. Retrieved 2016-06-06.
  9. ISBN 9780124158474
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  10. medRxiv 10.1101/2022.04.28.22274443
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  11. S2CID 248389239
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  12. ^ "prophylactically". Archived from the original on 2020-04-08. Retrieved 2015-11-20. {{cite journal}}: Cite journal requires |journal= (help)
  13. ^
    PMC 88952. Archived
    from the original on 28 September 2023. Retrieved 28 September 2023.
  14. ^ "Types of Immunity to a Disease | CDC". www.cdc.gov. 2022-04-06. Archived from the original on 2011-12-22. Retrieved 2023-09-28.
  15. PMID 18045976
    .
  16. PMID 4581249
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  17. ^ 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 Archived 2020-04-08 at the Wayback Machine)
  18. ^ a b c "Passive Immunization — History of Vaccines". www.historyofvaccines.org. Archived from the original on 2020-04-08. Retrieved 2015-11-20.
  19. PMC 5050965
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  20. PMID 9696731. Archived
    from the original on 2022-10-09. Retrieved 2023-09-29.
  21. ^ 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
  22. ^ 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
  23. ^ Robbins, John B.; Schneerson, Rachel; Szu, Shousun C. (1996). "Table 8-2, U.S. Licensed Immunoglobulin For Passive Immunization". www.ncbi.nlm.nih.gov. Archived from the original on 2013-12-05. Retrieved 2023-09-29.
  24. ^
    ISBN 978-0-16-095526-6
    .
  25. ^ "Rho(D) Immune Globulin". Drugs.com. The American Society of Health-System Pharmacists. Archived from the original on 9 January 2017. Retrieved 8 January 2017.
  26. ^ "Breastfeeding Overview". WebMD. Archived from the original on 2020-04-08. Retrieved 2015-11-20.
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