Lasers as vaccine adjuvants
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- Lasers as vaccine adjuvants
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Lasers as vaccine adjuvants
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[post_date] => 2024-12-23 18:45:44
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[post_content] => Practice Passage (Question 1-6)
*This passage is the property of Khan Academy and has been reformatted into an AAMC-style interface in their entirety by MedLife Mastery. MedLife Mastery does not endorse and is not an affiliate of Khan Academy.
Influenza A (H1N1), a negative-sense RNA virus colloquially referred to as the “swine flu,” commonly causes fever, inflammation, and cough but can lead to more dangerous symptoms, such as respiratory compromise. To combat H1N1, scientists often look for adjuvant therapies that could increase the efficacy of vaccines that are already stockpiled, as opposed to creating new ones.
One potential adjuvant treatment is a technique used in cosmetic dermatology referred to as nonablative fractional laser (NAFL) treatment. Laser light is used to lightly damage skin, creating a microthermal zone (MTZ) of 200 by 300 micrometers. In dermatology practices, limiting the area of damage allows epithelial cells to quickly grow over the MTZ but provides the skin with a healthier appearance. Using NAFL at the site of injection could also potentially make vaccines more effective.
Figure 1 A diagram of NAFL treatment; prior to inoculation, the injection site is exposed to laser light for a short time.
To assess NAFL as an adjuvent, laboratory mice were divided into three groups: a control group, a group receiving a combination of the vaccine and NAFL, and a group receiving a combination of the vaccine and AddaVax, an oil-based adjuvant currently on the market. After a brief inoculation period, serum immunoglobulin G levels were measured for each group. This was followed by testing levels of interleukin 6, a cytokine involved in the mediation of fever and inflammation, as well as body temperature recordings made over a 10-hour time frame. Results are shown in Figures 2-4.
Figure 2 Immunoglobulin G levels of each group after inoculation.
Figure 3 Interleukin 6 levels of each group over a two-day period.
Figure 4 Average relative body temperature over 10 hours; all temperatures were normalized to mice receiving no treatment or intervention
Sources: Wang et al. A micro-sterile inflammation array as an adjuvant for influenza vaccines. Nature Communications, 5. Nonablative (2014). Nonablative Laser Light Increases Influenza Vaccine Response 4 to 7-fold. Neomatica.
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[question] => Upregulation of which substance most significantly contributes to the cough observed in H1N1 patients?
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[description] => Reason for Correct Answer:
Cough is generally caused by inflammation, irritation, or fluid buildup in the lungs.
Adrenaline (epinephrine) is typically associated with the “fight or flight” response in the body. It can increase heart rate and blood pressure and is not directly related to the cough observed in H1N1 patients. In fact, adrenaline might suppress the immune response, which is not conducive to combating infections like H1N1.
Albumin is a protein found in blood plasma and is not directly related to the cough observed in H1N1 patients. Its primary functions are maintaining oncotic pressure and transporting various substances in the blood.
Histamine is a well-known compound involved in the inflammatory response of the body. Histamine is released by immune cells, such as mast cells and basophils, in response to various stimuli, including viral infections like the flu. It can increase inflammation, cause vasodilation (and increased fluid in the lungs), increase mucus production, and cause itchiness. All of these could exacerbate cough.
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[each_answer] => A. Albumin
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[each_answer] => B. Histamine
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[each_answer] => C. Vasopressin
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[each_answer] => D. Adrenaline
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[1] => Array
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[quiz_unique_key] => 1403770772
[question] => What is the likely control group for the experiment described in the passage?
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[answer] => 3
[description] => Reason for Correct Answer:
The purpose of the study was to compare how two adjuvant treatments (NAFL and Addavax) improved the efficacy of the H1N1 response in stimulating an immune response.
The delta you’re looking for, therefore, is the difference between the adjuvant + vaccine therapy and the vaccine alone, in the NAFL and Addavax groups.
The best control group therefore is mice give the vaccine only, because comparison with this group will show how much each adjuvant improved immune response to the vaccine.
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[each_answer] => A. Mice treated with a combination of NAFL and Addavax
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[each_answer] => B. Healthy mice given no intervention
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[each_answer] => C. Mice given the vaccine only
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[each_answer] => D. Mice inoculated with H1N1
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[quiz_unique_key] => 1403770772
[question] => Why might physicians refrain from using AddaVax as an adjuvant?
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[answer] => 1
[description] => Reason for Correct Answer:
Look at Figures 2 and 3 to see what makes AddaVax unique.
AddaVax does increase immune response, but that is not a reason to refrain from using it, as that is the intention of it.
Addavax does stimulate an increase in IL-6 levels, but NAFL also stimulates an increase in IL-6 levels, and so does the control (vaccine only) to a lesser extent. So, this is not a reason to refrain from using it.
The figures do show that AddaVax causes a much larger increase in IL-6 as well as a larger increase in temperature than control or NAFL. These increases are consistent with the exacerbation of H1N1 symptoms.
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[0] => Array
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[each_answer] => A. It exacerbates H1N1 symptoms.
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[each_answer] => B. It increases immune response.
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[each_answer] => C. It stimulates the increase of IL-6 levels.
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[each_answer] => D. It is oil-based, resulting in delivery difficulties.
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[question] => Which finding would help explain why NAFL is useful as an adjuvant in vaccine treatment?
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[answer] => 2
[description] => Reason for Correct Answer:
The purpose of an adjuvant is to increase the ability of the vaccine to mount an immune response.
Vaccines contain antigens, which are molecules from the pathogen that your immune system recognizes as foreign and potentially harmful. These antigens can be in the form of weakened or inactivated pathogens, pieces of the pathogen (like proteins or sugars), or genetic material from the pathogen.
Antigen-presenting cells (APCs), such as dendritic cells, macrophages, and some B cells, are equipped with receptors that can recognize and bind to antigens present in the vaccine. When a vaccine is administered, APCs capture the antigens from the vaccine components. They then present these antigens in order to activate T cells and B cells.
Cellular damage sending out damage-associated molecular signals that attract and activate antigen-presenting cells would explain why NAFL makes vaccines more effective. More activated APCs in the area will mount more of an immune response/immune activation from the vaccine.
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[0] => Array
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[each_answer] => A. AFL can promote epidermal remodeling and activate fibroblasts, which involves the formation of a new and healthier epidermal layer.
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[1] => Array
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[each_answer] => B. In response to injury, cells release damage-associated molecular signals that attract and activate antigen-presenting cells.
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[2] => Array
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[each_answer] => C. Thermal injury can stimulate angiogenesis, which is the growth of new blood vessels.
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[each_answer] => D. Controlled thermal injury caused by a laser prompts the body to produce new collagen.
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[quiz_unique_key] => 1403770772
[question] => What is found in the deepest layer penetrated by the microthermal zone of NAFL?
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[answer] => 1
[description] => Reason for Correct Answer:
Figure 1 shows that the dermis is the deepest layer penetrated by the thermal zone during NAFL.
The dermis is not composed of non-living keratinocytes. Instead, keratinocytes are the predominant cells found in the epidermis, where they produce the protein keratin, contributing to the skin’s waterproof barrier function.
The dermis is not responsible for the production of melanin. Melanin is primarily produced by melanocytes, which are located in the basal layer of the epidermis. Melanin is responsible for skin pigmentation and UV protection.
The dermis is not primarily composed of adipose (fat) tissue. Adipose tissue is found in the hypodermis (subcutaneous layer) beneath the dermis. The hypodermis primarily serves as an energy store and provides insulation.
The dermis is characterized by its dense network of blood vessels, lymphatic vessels, and nerve endings, contributing to various functions such as thermoregulation, sensation, and nourishing the skin and its appendages.
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[each_answer] => A. A dense network of blood vessels, lymphatic vessels, and nerve endings that contribute to thermoregulation, sensation, and nourishing of the skin and its appendages
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[each_answer] => B. The primary site of melanin production, which gives the skin its pigmentation and protects against harmful UV radiation
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[each_answer] => C. A thick layer of non-living keratinocytes, providing a waterproof barrier to prevent the loss of bodily fluids
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[each_answer] => D. A large protective cushion of adipose tissue, storing excess energy and providing insulation against temperature fluctuations
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[quiz_unique_key] => 1997864699
[question] => To study viral genome replication, scientists treated infected cells with a labeled nucleoside analog; the nucleoside analog is incorporated into newly synthesized viral nucleic acids, thereby allowing for their visualization. Which nucleoside analog would be most suitable?
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[answer] => 3
[description] => Reason for Correct Answer:
There are several ways to label newly synthesized nucleic acids.
The passage mentions that H1N1 is an RNA virus.
RNA does not use the same nucleosides as DNA. Specifically, RNA uses uridine (along with adenosine, guanosine and cytidine); not deoxyadenosine, deoxyguanosine, thymidine or deoxycytidine.
Out of the options, only uridine is an RNA nucleoside; therefore Choice C is the only possible option (note that all other options could be used to label DNA).
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[0] => Array
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[each_answer] => A. Deoxyadenosine labeled with a radioisotope
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[each_answer] => B. A thymidine analog that becomes fluorescent upon reaction with a probe
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[each_answer] => C. Uridine labeled with a functional group that selectively reacts with a fluorescent dye
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[each_answer] => D. Deoxyguanosine labeled with a bromine atom
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Figure 1
Figure 2 Immunoglobulin G levels of each group after inoculation.
Figure 3 Interleukin 6 levels of each group over a two-day period.
Figure 4 Average relative body temperature over 10 hours; all temperatures were normalized to mice receiving no treatment or intervention
Sources: Wang et al. A micro-sterile inflammation array as an adjuvant for influenza vaccines. Nature Communications, 5. Nonablative (2014). Nonablative Laser Light Increases Influenza Vaccine Response 4 to 7-fold. Neomatica.
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