Immunology and Neonatal Medicine

Baculovirus vectors in moth cell lines produce large amounts of glycosylated recombinant protein. The baculovirus is a natural infectious agent of insect cells.

Herd immunity can only be achieved in those diseases which depend on human transmission, such as diphtheria. Thus, in the case of tetanus, active immunization is of benefit to the individual, but not to the community, since it will not eliminate the organism which is found in the feces of domestic animals and persists in soil as highly resistant spores.

The eradication of smallpox was due to an enormous World Health Organization (WHO)-sponsored effort combining extensive vaccination and selective epidemiologic control methods. The WHO also hopes to eradicate poliomyelitis in the near future.

Prematurity is the most important risk factor, with IVH being very rare in term infants.

A major concern about subunit vaccines, especially when just short peptides are used, is the variation in ability to associate with the different polymorphic forms of MHC molecules present in an outbred population.

The change that best predicts a bad outcome is abnormality in signal intensity in the posterior limb of the internal capsule (PLIC) and basal ganglia with 90% sensitivity and 100% specificity, and positive predictive value of 100%.

Inherited causes now account for 50% of all cases of severe sensorineural hearing impairment; 80% are due to single-gene autosomal recessive disorders and 15% to autosomal dominant disorders.

In preterm infants, Iron stores are low and exhausted quickly because of the infant's rapid growth rate. However routine administration of iron is controversial and not given in all units

Classic β-thalassaemia major does not affect neonates because most of the haemoglobin is in the fetal (HbF) form.

Horse globulins containing anti-tetanus and anti-diphtheria toxins have been extensively employed prophylactically, but have the drawback that serum sickness develops in response to foreign proteins, producing vasculitic skin rashes, swollen joints and transient albuminuria due to immune complex-mediated inflammatory reactions.

The peptide bonds hold the amino acids together and if these are not maintained, then the vaccine will simply consist of a mixture of amino acids; not much use as a specific vaccine.

Live attenuated organisms can be safely administered to children under 8 years of age, so long as they are not immunodeficient. Attenuated vaccines for poliomyelitis (Sabin), measles and rubella have gained general acceptance and are routinely given to babies and infants.

Idiotype defines the surface and properties of the variable region and of antigen receptors of T cells. Thus, determining the antigen specificity and therefore the idiotope of the molecule.

Bacterial exotoxins can be detoxified by formaldehyde treatment which does not destroy the major immunogenic determinants. The toxoid is generally given after adsorption to aluminum hydroxide which acts as an adjuvant and produces higher antibody titers.

Salmonella infects cells of the mononuclear phagocyte system throughout the body and thereby stimulates the production of cell-mediated immunity, in addition to both secretory and systemic antibody production. It can be made to express proteins from shigella, cholera, malarial sporozoites, etc and has potential as an orally administered vaccine.