When is passive immunity used

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Top 20 Questions about Vaccination. Vaccination for Rare Diseases. Why Vaccinate? Related Articles The Future of Immunization The impact of vaccines over the past years is evident, but challenges remain. Diphtheria Diphtheria has largely been eliminated in the United States since immunization became widespread. The amount and type of antibodies passed to the baby depends on the mother's immunity. When the baby is in its mother's womb, her blood circulates through the placenta, a cord that connects the mother and the baby.

Blood carrying nutrients and oxygen reach the developing fetus through the placenta. Breastfeeding protects against infections during and most likely after lactation.

It also protects the baby against certain immunologic diseases, including allergy. The first protein-rich version of the breast milk, also known as colostrum, is produced early, a few days after birth. This milk is high in antibodies and nutrients. This is how newborns derive immunity right after birth until they begin to develop their immune systems. Passive immunity can be derived in artificial ways too through injecting antibodies. Individuals at high risk are often treated with loaned antibodies from other people, animals, or those synthesized in a laboratory.

For example, people bitten by poisonous snakes are often treated with antivenom. Antivenom is nothing but a combination of antibodies specific to that particular snake produced when a person was exposed to such snake bites. Another typical example of immunoglobulin treatment can be seen in infants born to mothers infected with hepatitis B. To protect the newborns from becoming infected, they are administered antibodies along with vaccination.

The first vaccine given to babies includes whooping cough and Haemophilus influenzae because passive immunity for these diseases diminishes the fastest. On the other hand, passive immunity for mumps, measles, and rubella can last up to a year. The 20 patients with advanced TB showed only modest or no improvement after therapy and it was concluded that immune serum was only beneficial in early but not advanced cases of disease.

EBV is a common human pathogen that causes a chronic infection and is a leading cause of posttransplant non-Hodgkin lymphoma resulting from the uncontrolled proliferation of EBV-infected B lymphocytes in patients undergoing immunosuppressive therapies.

The most common anti-CMV immunoglobulin products were shown to contain antibodies against EBV and it is believed that this is the mechanism of action for the protection afforded during the first year posttransplantation.

However, because administration of immunoglobulin is typically only performed during the first 4 months after transplantation and antiviral antibody half-life is estimated to be approximately 25 days, it is not surprising that the protective effects of passive immunotherapy were only maintained through the first year.

Nevertheless, the inadvertent discovery of the protective role of antibodies in preventing EBV-induced non-Hodgkin lymphoma represents a potential breakthrough in clinical management of this vulnerable patient population. Despite decades of research aimed at finding a vaccine or a cure for HIV infection, this virus remains a scourge of global proportions. Early attempts at passive immunotherapy using first-generation HIV-specific monoclonal antibodies were not highly effective , , and this approach was not further pursued until a new generation of highly potent and broadly neutralizing antibodies were identified.

Although the effect of antibody therapy on viremia was mainly transient after a single administration, the viral load remained lower than their preexisting set point in 3 of 10 patients at 56 days and one subject exhibited viremia levels that remained near the limits of detection throughout the day study.

It is currently unclear if HIV viremia in these patients will eventually rebound to their original levels. Similar results were observed during antibody-based therapy of SHIV-infected rhesus macaques in which most animals showed a rebound in viral replication after the transferred monoclonal antibodies declined to undetectable levels but a subset of animals maintained virological control in the absence of further infusions.

With substantial advances in monoclonal antibody technologies and an increasing appreciation for the role of antibodies in the control of infectious disease, the development of sophisticated new passive immunotherapies is likely to continue at an accelerated pace.

One drawback to passive immunization is that antibody half-life in vivo often provides only transient protection unless repeated administrations are performed. This may change as new technologies that increase the half-life of monoclonal antibodies are employed. For example, the Fc region of an anti-RSV monoclonal antibody, motavizumab, was mutated to increase its binding to the neonatal Fc receptor FcRn , resulting in serum antibody pharmacokinetics in human subjects that increased from a typical to day half-life to up to a day half-life while still retaining virus-specific neutralizing activity.

Importantly, examples of successful passive immunization approaches may provide a useful framework for developing new and improved vaccines that elicit the most protective antibody responses. References for this chapter are available at ExpertConsult. National Center for Biotechnology Information , U.

Plotkin's Vaccines. Published online Jul Mark K. Slifka and Ian J. Guest Editor s : Stanley A. Guest Editor s : Walter A. Guest Editor s : Paul A. Professor of Pediatrics, Maurice R. Guest Editor s : Kathryn M. Edwards, MD Sarah H. Copyright and License information Disclaimer. All rights reserved. Elsevier hereby grants permission to make all its COVIDrelated research that is available on the COVID resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source.

TABLE 8. Open in a separate window. Indications have been grouped for each product type. Maternal Antibodies: The Original Passive Immunotherapy Maternal antibodies represent a natural form of passive immunotherapy in which the immunoglobulin Ig G repertoire of the mother's preexisting humoral immune response is transferred to the fetus through the placenta.

Figure 8. Age-specific prevalence of complement-fixing antibodies to sixteen viral antigens: A computer analysis of 58, patients covering a period of eight years. J Med Virol. Critical Parameters for Passive Immunotherapy Before vaccines and antibiotics revolutionized modern medicine, antibody-based therapies represented the only effective medical treatment for many life-threatening diseases including diphtheria, scarlet fever, bacterial meningitis, and bacterial pneumonia.

Polyclonal Antibodies Monoclonal Antibodies Advantages Polyvalent specificity Multiple isotypes with different effector functions High specific activity Standardized potency Unlimited availability Minimal biohazard potential Disadvantages Low specific activity Broad variation in potency Limited availability Biohazard risk of human blood products Monovalent specificity Single isotype Potential to select for escape mutants. Animal Models Clinical Studies T oxins Anthrax toxin Prophylaxis , Treatment , Prophylaxis: not available Treatment , Botulinum toxin Prophylaxis , , Treatment Prophylaxis: not available Treatment , , , Diphtheria toxin Prophylaxis , Treatment , Prophylaxis Treatment 7 , 49 , , Ricin toxin Prophylaxis , Treatment Prophylaxis: not available Treatment: not available Tetanus toxin Prophylaxis 1 , Treatment , , Prophylaxis Treatment , : not supported B acterial I nfections Bordetella pertussis whooping cough Prophylaxis , Treatment , Prophylaxis 30 b , 31 b , , Treatment , Borrelia spp.

For clinical studies, prophylaxis is defined as antibody administration prior to disease onset and treatment is defined as antibody administration after disease onset.

Efficacy of passive immunity decreases with disease progression. Passive Immunity Against Respiratory and Enteric Pathogens Although passive immunity against toxins and systemic infections such as measles 51 , 53 , 80 , 81 , 82 , 83 , 84 and smallpox 64 , 65 , 66 is well established, the impact of this approach for the prevention or amelioration of disease caused by respiratory and enteric pathogens may not be as well recognized. Future of Passive Immunization With substantial advances in monoclonal antibody technologies and an increasing appreciation for the role of antibodies in the control of infectious disease, the development of sophisticated new passive immunotherapies is likely to continue at an accelerated pace.

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Alexander HE. This article was reviewed by a member of Caltech's Faculty. Passive immunization, or passive immunotherapy, is a process in which individuals receive antibodies from another source rather than producing those antibodies on their own.

Passive immunity provides short-term protection against infection. Antibodies are proteins that bind to and help attack pathogens, such as bacteria and viruses. They are a key component of the human immune system.