Vaksin dan sera

Active
Vaksin: Substansi yg bersifat antigen: immunity
-mikro-organisme:
-bakteri
- virus
- adjuvan

Sera: Substansi yang bersifat sebagai antibodi:

-protein:
Passive
immunity
-Imunoglobulin (serum imun)
- monoklonal antibodi
 Dihasilkan dari
perlawanan tubuh
thd antigen (vaksin
atau agen infeksius)
shg tubuh
menghasilkan
antibodi sebagai
respon
Dihasilkan dari
pemberian antibodi
yang berasal dari
organisme lain dapat
Specific defenses alamiah atau
Immunity artifisial

Active immunity Passive immunity

Infeksi klinis ikutan alami Transfer antibodi ibu hamil

melalui plasenta

Infeksi subklinis ikutan Transfer antibodi ibu hamil

melalui susu
dapatan
Vaksinasi ikutan Pemberian imunoglobulin
atau antiserum
Immunological Memory vs. Serum
Antibody Levels
Kapan vaksin pasif (sera diberikan)?

1. Kekurangan dalam sintesis Ab sebagai hasil

Deficiency in synthesis of Ab as a result of
congenital or acquired B-cell defects

2. Susceptible person is exposed to a disease that

will cause immediate complications (time is the
biggest issue)

3. Telah timbul penyakit

Common Agents For Passive
Immunization
 Passive Immunization

Infection Source of Antiserum Indications

Tetanus Immune human; horse Post exposure (plus vaccine)

Diptheria Horse Post-exposure

Gas gangrene Horse Post-exposure

Botulism Horse Post-exposure

Varicella-Zoster Immune human Post-exposure in immunodeficiency

Rabies Immune human Post exposure (plus vaccine)

Hepatitis B Immune human Post-exposure prophylaxis

Hepatitis A Pooled human Ig Prophylaxis

Measles Immune human Prophylaxis

Snakebite Horse Post-bite

Some autoimmune disease Pooled human ig Acute thrombocytopenia and

neutropenia
 The Immune System and Passive
Immunization

 Passive immunization is the administration of preformed antibodies

either intravenously or intramuscularly.

 The transfer of antibodies will not trigger the immune system

 There is NO presence of memory cells

 Risks are included

 Recognition of the immunoglobulin epitope by self immunoglobluin paratopes
 Some individuals produce IgE molecules specific for passive antibody, leading to
mast cell degranulation
 Some individuals produce IgG or IgM molecules specific for passive antibody,
leading to hypersensitive reactions
 Active Immunization

 Natural Infection with microorganism or artificial acquisition (vaccine)

 Both stimulate the proliferation of T and B cells, resulting in the formation of

effector and memory cells

 The formation of memory cells is the basis for the relatively permanent effects
of vaccinations
 Active immunization is the administration of vaccines containing microbial
products with or without adjuvants in order to obtain long term immunological
protection against the offending microbe.
 At present the normal route of vaccination in most instances is either
intramuscularly or subcutaneously.
 Types of Vaccines

Whole-Organism
 Attenuated Viral/Bacterial
 Inactivated Viral/Bacterial
Purified Macromolecules
 Polysaccharide
 Toxoid
 Recombinant Antigen
 Recombinant-Vector
DNA

Synthetic Peptide

Multivalent Subunit
 Bahan untuk pembuatan vaksin

LPS POLYSACCHARIDE

capsular INTRACELLULAR
PROTEINS
Entire organism SURFACE
• live
PROTEINS
(attenuated)
• killed TOXINS
 Whole-Organism
Vaccines

 Many common vaccines

used consist of
inactivated or
attenuated bacterial
cells or viral particles
 Includes attenuated and
inactivated vaccines
 Antigen Preparations Used in Vaccines
Type of antigen Examples
Viruses Bacteria

Normal heterologous organism Vaccinia (Cowpox)

Living attenuated organism Measles BCG
Mumps Typhoid (New)
Rubella
Polio (Sabin)
Yellow fever
Varicella-Zoster
Whole killed oranism Rabies Pertussis
Poli (Salk) Typhoid
Influenza Cholera
Subcellular fragment
Inactivated toxin (toxoid) Diphtheria
Tetanus
Cholera (New)
Capsular polysaccharide Meningococcus
Pneumococcus
Haemophilus
Typhoid (New)
Surface antigen Hepatitis B
 Attenuated Viral or Bacterial
Vaccines
Attenuation – to reduce in force, value, amount,
or degree; weaken

 Achieved by growth under abnormal culture conditions

 Bacillus Calmette-Guerin (BCG)

 Act as a double edged sword, as they have distinct

advantages and disadvantages…
Attenuation vs. Inactivation
 Mekanisme
terbentuknya
imunitas dengan
imunisasi aktif

A. Vaccines contain antigens (weakened or dead viruses, bacteria, and fungi that cause disease and infection)
B. B cells to produce antibodies, with assistance from T-cells
D. macrophages engulf them, process the information contained in the antigens,
C. and send it to the T-cells so that an immune system response can be mobilized
 Bandingkanlah

Vaksin dari Vaksin dari

mikroorganisma yang mikroorganisma yang
dilemahkan diinaktivasi
/dimatikan
Metode produksinya
Dosis vaksin
stabilitas
Jenis imunitas yang
diinduksi
Toksisitas
 Fungsi vaksin

Sebagai profilaktik
 Mencegah serangan infeksi mikroba
patogen
Sebagai therapeutik
 Untuk pengobatan penyakit kanker
 Syarat vaksin yang baik
1. Mampu meningkatkan respon imun terhadap penyakit
tertentu (TB-CMI; bakteriIg)

2. Mempunyai daya proteksi yg lama

 Idealnya masa hidupnya lama
3. Aman
 Tdk menimbulkan penyakit
4. Stabil
 Tdk berubah dlm penyimpanan seblm diberikan
5. Relative murah
 Mekanisme

A. Vaccines contain antigens (weakened or dead viruses, bacteria, and fungi that cause disease and infection)
B. B cells to produce antibodies, with assistance from T-cells
D. macrophages engulf them, process the information contained in the antigens,
C. and send it to the T-cells so that an immune system response can be mobilized
 Jenis vaksin yg telah diproduksi

 Hepatitis B virus
 Hepatitis A virus
 Influenza
 Measles
 Mumps
 Polio
 Rubella
 Rabies
Develop vaccines against infectious diseases
 Yellow Fever such as tuberculosis, malaria, AIDS and rotavirus.
 Varicella Zoster
 Vaksin hidup

Attenuated organisms
 Organisme dilemahkan (kurang virulen) dengan cara invitro
mis.dg. perlakuan pemanasan (mutans), dengan bahan kimia
 Org. Selektif mutans dlm tubuh bereplikasi lambat dan tidak
virulen, tdk menimbulkan gejala klinis
 Menimbulkan respons imun

Live attenuated vaccines should not be administered to

persons with suppressed immune response due to:
Leukemia and lymphoma
Other malignancies
Receiving corticosteroids and anti-metabolic agents
Radiation
pregnancy
 Vaksin hidup
 Heterologous vaccines
◦ Organisme yang mirip dengan target vaksin tetapi kurang
virulen, yg dpt berbagi antigen dengan organisme virulen
◦ Strain vaksin tersebut bereplikasi dalam tubuh penerima
dan menstumir terbentuknya respon Ab, bereaksi silang
dengan organisme virulen (target)
◦ Misalnya: virus cowpox dan vaccinia- mirip virus variola

Agen penyakit smallpox

 Vaksin rekombinan
- Menggunakan rekayasa genetika:

- Gen yg telah terkode sebg imunogenik protein dari

suatu organisme disisipkan kedalam genome
organisme lain (mis virus vaccinia)

- Organime tersebut mengekspresikan gen yg baru

gen baru tersebut dinamakan rekombinan

- Bila diinjeksikan pada individu akan bereplikasi dan

mengekspresikan sejumlah protein asing yg cukup utk
menginduse respon imun spesifik dr protein tersebut
Plasmid rekombinan di insersikan ke bakteri,
shg bakteri memproduksi protein baru yang
sesuai dengan gen yang diinsersikan tadi
Vaksin rekombinan
 Vaksin mati/killed vaccine

Organisme patogen di inaktivkan

dengan cara:

- Pemanasan
- bahan kimia:
beta-propiolactone or formaldehyde

These vaccines are not infectious and are therefore relatively safe.
 Subcellular fractions:
- Protektive imun biasanya terjadi langsung dari
satu atau dua jenis protein dari organisme patogen

- Memungkinkan utk menggunakan protein murni

dari org yg dimurnikan utk digunakan sebagai vaksin

prosedur:
MO dibiakkan dan kemudian di inaktivkan
Protein yg diinginkan dimurnikan dan dikonsetratkan
dr suspensi kultur.
 Prosedur (vaksin virus polio)

Step 2 Step 3
Step 1 Use
Use the tissue culture Use the purifier to
isolate the polio formaldehyde to
to grow new viruses. kill the viruses.
viruses.

Done Step 4
The polio Fill the syringe with the
vaccine is killed
complete.
 Prosedur (vaksin tetanus toxin)

Step 1 Step 3
Use the growth Step 2 Add aluminum
medium to grow new Isolate the salts to the purified
copies of the toxins with the toxins.
Clostridium tetani purifier.
bacteria

Done
Step 4
The tetanus
Fill the
vaccine is
syringe with
complete.
the treated
toxins.
 Vaksin protein rekombinan (killed vaksin)
-Immunogenic proteins of virulent organisms may be
synthesized artificially by introducing the gene coding
for the protein into an expression vector, such as E-
coli or yeasts.

The protein of interest can be extracted from lysates

of the expression vector, then concentrated and
purified for use as a vaccine.

The only example of such a vaccine, in current use,

is the hepatitis B vaccine.
 Prosedure protein rekombinan (vaksin HiB)

Step 2
Step 1 Add the
Use the segment of Step 3
tweezers to pull DNA to the DNA Use the purifier to
out a segment of a yeast cell isolate the hepatitis
of DNA from the (which is in the B antigen
hepatitis B yeast culture produced by the
virus. yeast cells.

Done Step 4
The hepatitis B Fill the syringe with the
vaccine is complete. purified hepatitis B
antigen.
 Adjuvants
Certain substances, when administered simultaneously with a specific
antigen, will enhance the immune response to that antigen. Such
compounds are routinely included in inactivated or purified antigen
vaccines.

Adjuvants in common use:

1. Aluminium salts
-First safe and effective compound to be used in human vaccines.
-It promotes a good antibody response, but poor cell mediated
immunity.
2. Liposomes and Immunostimulating complexes (ISCOMS)
3. Complete Freunds adjuvant is an emulsion of Mycobacteria, oil and
water ; -Too toxic for man
-Induces a good cell mediated  immune response.
4. Incomplete Freund's adjuvant as above, but without Mycobacteria.
5. Muramyl di-peptide
Derived from Mycobacterial cell wall.
6. Cytokines
IL-2, IL-12 and Interferon-gamma.
 Types of vaccines
Live Live Killed Toxoids Cellular fraction Recombinant
vaccines Attenuated Inactivated vaccines vaccines
vaccines vaccines

•Small pox •BCG •Typhoid •Diphtheria •Meningococcal •Hepatitis B

variola •Typhoid •Cholera •Tetanus polysaccharide vaccine
vaccine oral •Pertussis vaccine
•Plague •Plague •Pneumococcal
•Oral polio •Rabies polysaccharide
•Yellow vaccine
•Salk polio
•Hepatitis B
fever •Intra-
•Measles polypeptide
muscular vaccine
•Mumps influenza
•Rubella •Japanise
•Intranasal encephalitis
Influenza
•Typhus
 DNA Vaccines

DNA vaccines are at present experimental, but hold promise for

future therapy since they will evoke both humoral and cell-
mediated immunity, without the dangers associated with live
virus vaccines.

The gene for an antigenic determinant of a pathogenic organism

is inserted into a plasmid.  

This genetically engineered plasmid comprises the DNA vaccine

which is then injected into the host.  

Within the host cells, the foreign gene can be expressed

(transcribed and translated) from the plasmid DNA, and if
sufficient amounts of the foreign protein are produced, they will
elicit an immune response.
 Vaksin DNA sebenarnya
sama dengan vaksin
rekombinan

Perbedaannya adalah kalau vaksin rekombinan

mengandung protein-protein yang diperoleh dari hasil
rekayasa genetik, sedangkan vaksin DNA mengandung
rekombinan DNA yang terdiri vektor dan gen penyandi
protein. Jika vaksin rekombinan yang dimasukkan ke
tubuh resipien adalah protein maka pada vaksin DNA yang
dimasukkan adalah DNA nya yang diharapkan di dalam
tubuh akan mengekspresikan protein-protein yang bersifat
imunogenik.
 Anak mendapat imunisasi

Untuk 7 jenis penyakit

 TBC
 Difteria
 Tetanus
 Batuk rejan
 Polio
 Campak dan hepatitis B
 Vaksin BCG

BCG menimbulkan kekebalan aktif terhadap

penyakit tuberkulosis (TBC ).
Mengandung kuman BCG ( Bacillus calmette-Guerin ),
masih hidup, tetapi telah dilemahkan.
Cara pemberian : sejak bayi lahir sampai berumur 12
bulan. ( 0-2 bulan) yang baik 2 bulan, cukup diberikan
1 kali, dan dilakukan uji mantoux, bila positif ,
tidak diberikan


 Vaksin tetanus

Imunisasi aktif atau pasif

 Aktif toksoid tetanus( toksin kuman yg telah dilemahkan
dan dimurnikan
 Ada 3 macam :
 vaksin tunggal
 Vaksin DT
 Vaksin DPT

 ATS ( Anti Tetanus Serum ) pasif

Sekian