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A Welcome Upgrade to a Childhood Vaccine – PCV 13

Children aren’t supposed to die.  That so many of us accept this statement without a blink is remarkable and wonderful, but it is also a very recent development in human history.  Modern sanitation, adequate nutrition, and vaccination have largely banished most of the leading killers of children to the history books.  Just look at the current leading causes of childhood death in developing countries to see how far these relatively simple interventions have taken us.

As we have systematically removed the leading infectious killers of children from prominence, other organisms have naturally risen to the top of the list.  This has lead some to the fatalistic (and mistaken) conclusion that we are simply opening up niches to be inevitably filled by other virulent organisms.  This assumes that there is some mandated quota of say, meningitis, that children must suffer every year, and if one organism doesn’t meet this quota then another will fill it.  Were this the case, after vaccination we’d expect to see a shift in the causes of meningitis, but at best a transient drop in the total number of cases per year as other bugs step in to pick up the slack of their fallen, virulent, meningitis-inducing brethren.  Such is not the case.

Though new organisms are now the leading causes of invasive bacterial infections in children, and we have indeed seen some increases in non-vaccine targeted strains, as I’ll discuss below, the total number of such infections has dropped precipitously.  It’s fair to say that the vaccination program has done a remarkable job improving a child’s chance of surviving to adulthood in good health.  However, no one in their right mind would argue that the current state of affairs, as good as it is, is good enough, and so we have shifted our sights to the current leading cause of invasive bacterial infections in children, Streptococcus pneumoniae (S. pneumo, or pneumococcus).

The Need for a Pneumococcal Vaccine

S. pneumo is a challenging bug to prevent and treat.  Its 90 different serotypes together cause a variety of infections, from the relatively mild such as otitis media (ear infection) and sinusitis, to the far more serious including pneumonia, sepsis, meningitis, and osteomyelitis. Much of this versatility and the primary factor determining each strain’s virulence comes from the polysaccharide capsule surrounding S. pneumo.  This gel-like substance hides many of its antigens from exposure, and is itself a poor target for the immune system.

Increasing antibiotic resistance in some strains of S. pneumo certainly doesn’t help the matter, but neither is it the primary cause of S. pneumo’s current position of infamy.  The majority of strains are susceptible to good old penicillin, and even resistant strains are susceptible to other classes of drugs.  The problem is that in a small minority of cases the infection spreads so aggressively that children die or suffer complications in spite of rapid medical care and appropriate antibiotics.

This is why in children prior to 2000, and in spite of modern medical care, S. pneumo caused around 13,000 cases of bacteremia, 2500 cases of pneumonia, 700 cases of meningitis, and 200 deaths (not to mention 5,000,000 cases of otitis media).  As always, prevention would be better than treatment, and in 2000 the first vaccine against S. pneumo for children under the age of 2 was licensed in the US (an earlier vaccine, PCV-23, existed for adults but was incapable of generating a good response in children).  PCV-7 (Prevnar) targeted only 7 of the more than 80 known serotypes, but the seven were well selected, accounting for 80-85% of the cases of invasive disease and a majority of penicillin resistant strains.

Coverage Gaps and Moving Targets

The subsequent 10 years have been almost exactly what you would hope for from the vaccine.  Invasive pneumococcal disease in children has dropped by 76% (including non-targeted serotypes), and disease from targeted serotypes, which recall made up 80% of all invasive disease before the vaccine, dropped 99%.   We’ve even seen a modest but significant decrease in the incidence of S. pneumo disease in the elderly, which is most consistent with the effect of herd immunity.  This is an outstanding success.

Though PCV-7 is effective, it’s also far from perfect.  Predictably, the strains not targeted by PCV-7 have persisted in the population and become more common.  Some of these strains are less pathogenic, but a few have shown themselves capable of virulence, and so in the last decade we’ve seen a shift in the behavior of infections caused by S. pneumo.  One such example of this may be seen in the increased rate of empyema.

Occasionally during a pneumonia bacteria can also infect the space between the lung and the wall of the chest, causing an accumulation of pus that is difficult to treat with antibiotics alone, and usually requires some form of drainage. Typically this is done with a tube inserted between the ribs or thorascopic surgery, and usually includes a prolonged hospital stay.  Needless to say, an empyema is undesirable, and the rate of this complication from pneumonia seems to be increasing.

This concerning trend has been most recently demonstrated by an article appearing in Pediatrics.  Between 1997 (3 years pre-PCV-7 licensure) 2006, the authors found an approximate 50% drop in invasive pneumococcal disease in general, pneumonia, meningitis, and bacteremia, consistent with the existing literature confirming the general efficacy of PCV-7.  However, they also were able to demonstrate a subtle increase in the rates if empyema during the same amount of time.  This means that with a near halving in the total number of pneumonias, but an increase in a complication of pneumonia, the risk of developing an empyema during a pneumococcal pneumonia has roughly doubled in the last decade.

Now comes the hard part: Why?  Well, frankly, we don’t yet know.  This study doesn’t establish the causative mechanism behind the increased incidence of empyema; it simply establishes that it has increased in spite of pneumococcal vaccination. The increase could be part of a previously occurring trend, after all, the incidence of empyema was already increasing before the vaccination was implemented.  It could be from a shift toward serotypes that are more prone to cause empyema, but aren’t targeted by the vaccine.  Unfortunately this particular study isn’t designed to look at involved serotypes, and the other literature to support this hypothesis is currently mixed.  I find it compelling to note that this very study also demonstrates a nearly identical increase in the rate of empyema associated with Staphylococcal pneumonia, suggesting an unidentified common factor between the two.

We Can Do Better

We know that PCV-7 is effective at controlling most infections from targeted serotypes, that non-targeted serotypes are beginning to thrive, and the increased rate of empyema has not been curtailed by the current vaccine.  The next logical step is to broaden our coverage to include the non-targeted pathologic strains within the vaccine.

This is precisely what has been done.  Several vaccines with a broader scope have been in development, and on February 24th the FDA licensed the first of this next generation of pneumococcal vaccines. PCV-13 targets all seven prior serotypes and includes an additional six that together comprise the most common and pathological serotypes currently in circulation (serotypes 1, 3, 4, 5, 6A and B, 7F, 9V, 14, 18C, 19A, 19F, and 23F).  It is slated to replace the current PCV-7, will follow the same 4-shot 2, 4, 6, and 12-15 month schedule, and can be used to complete a series of PCV-7 vaccinations.

This vaccine, like every other one, has undergone extensive testing for both safety and efficacy.  It is built on the identical technology as PCV-7 that has a decade’s worth of excellent safety, and will, as with all other vaccines, undergo even more rigorous post-release surveillance.

Based on PCV-7’s success, we have every reason to expect an even greater reduction in the burden of serious infections suffered by our children. If we’re lucky, we’ll soon have to declare a new bug the leading cause of invasive bacterial infections in children, not because of its success, but because of S. pneumo’s fall.

Posted in: Public Health, Science and Medicine, Vaccines

Leave a Comment (126) ↓

126 thoughts on “A Welcome Upgrade to a Childhood Vaccine – PCV 13

  1. KathyO says:

    I recently read a book about the development of the polio vaccine. As someone who grew up after that vaccine, I never gave polio much thought. Reading that book made me want to hug my child and weep for the generations of parents before me who must have stayed up nights summer after summer worrying about whether their children would succumb. And now we have another weapon against the awful fear of childhood disease. Bravo Science.

  2. gr8blessings says:

    I’ve seen rejection of these vaccines based on serotype replacement and the reported increase of empyema. Given that anti-vaxers don’t have the grasp of the science they think they do, I suspected that this information was twisted to support their conclusions. Furthermore, on a pure emotional level, I could reject their argument. Sure the vaccine doesn’t cover ALL the causes of meningitis, but why not protect children from some if the causes? I could only conclude that anti-vax is indeed pro-disease.

    Thank you for explaining why they are wrong in a more scientific way.

  3. fetner says:

    So, should children who have been vaccinated in the last few years get another vaccination when the new form is available?

  4. cervantes says:

    “Modern sanitation, adequate nutrition, and vaccination have largely banished most of the leading killers of children to the history books.” Err, no, they haven’t. All you have to do is follow your own link to find out that your assertion is false. Diarrheal diseases kill more than 1 and a half million children every year. Malaria kills more than a million and measles still gets half a million. 138,000 kids just flat starve to death.

    Progress, yes, but banished to the history books? Not hardly.

  5. mikerattlesnake says:

    @cervantes

    Are you citing worldwide stats? If so, I think that Dr. Albietz specifically pointed to the dichotmoy betweeen developed and developing nations in regards to preventative healthcare and its effects elsewhere in the article. I believe in the quoted passage it’s implied that he’s refering to developed countries with widespread access to proper healthcare.

  6. cervantes says:

    No he isn’t. He specifically says “developing countries.” I can read.

  7. watso359 says:

    @cervantes

    I think mikerattlesnake is correct. Joe is pointing out how sanitation, nutrition, and vaccination have banished many childhood diseases to the U.S. history books. He is using the W.H.O. stats to point out the discrepancy between the Americas and developing countries (which is inferred to have less sanitation, nutrition, and vaccination).

    You can read, but maybe you did not comprehend what you read.

  8. Chewbuddy13 says:

    @ cervantes

    “Children aren’t supposed to die. That so many of us accept this statement without a blink is remarkable and wonderful, but it is also a very recent development in human history. Modern sanitation, adequate nutrition, and vaccination have largely banished most of the leading killers of children to the history books. Just look at the current leading causes of childhood death in developing countries to see how far these relatively simple interventions have taken us.”

    Developing countries do not usually have good sanitiation, nutrition or vaccine programs, but modern countries do. This is the point that Dr. Albietz is making, hence the link to statistics of “developing countries”.

  9. desiree says:

    KathyO, was the book splendid solution? i also loved it. the part where the book told about how they decided to test the polio vaccine against a placebo made me think of the anti-vax claim that vaccines are never tested against a placebo.

    great post! the initial media reports on the pediatrics study you talked about were terriblo imo, citing percentage increases for empyema and %age decreases for pnemonia that made it sound like the situation was a wash. definitely provided some fodder for the anti-vax crowd and probably just confused average parents.

    (typing w/ 1 hand while nursing, sorry !)

  10. querty says:

    @cervantes

    Yes, he presents data from “developing countries” in an attempt to contrast that with developed countries. The article shows a marked decrease in childhood death in developed countries when compared to developing countries (who have not benefited as much from “Modern sanitation, adequate nutrition, and vaccination”).

    These measures /have/ “largely banished most of the leading killers of children to the history books” in the Americas. Childhood mortality is still very high in the developing world.

  11. crazyred says:

    @ cervantes:

    Some forms of diarrheal illness are prevented by vaccination – the rotavirus vaccine. Also, adequate sanitation prevents outbreaks of diarrhea by helping to prevent contamination of drinking water by feces. Measles is prevented by…the measles vaccine.

    Unfortunately, malaria has evaded vaccination developers for so many reasons, the life cycle of the bug being one of the most significant problems.

    And, isn’t starvation prevented by adequate nutrition?

    Did I miss something here? I think the statement ‘just look at the current leading causes of childhood death in developing countries to see how far these relatively simple interventions have taken us’ means to compare developed versus developing countries.

  12. sanjiva86 says:

    Cervantes, you seem to be misunderstanding his point. The fact that these diseases are rampant in developing countries (where adequate nutrition, sanitation, and vaccination is lacking), suggests that these interventions are responsible for the low prevalence of these diseases in developed countries. It’s an ecological assessment, but a fair one.

  13. edgar says:

    Social justice is also a powerful player that is often left out.

  14. cervantes says:

    So if it isn’t happening in the rich countries, it’s been “banished to the history books?” Sorry, that may not be what he meant to say but he said it.

  15. KathyO says:

    @Desiree

    Yes it was. Great book. I’m listening to ‘The Demon under the Microscope’ right now, which is about antibiotics.

  16. Th1Th2 says:

    I just couldn’t imagine how many more healthy children will be devastated let alone suffer from this newly invented vaccine.

  17. Th1Th2 says:

    gr8blessings,

    “I could only conclude that anti-vax is indeed pro-disease.”

    Wrong conclusion. You and the vaccinators are the ones responsible for deliberately infecting naive immune cells of healthy newborns with hideous antigens. Get your facts straight.

  18. Chris says:

    Troll1Troll2:

    I just couldn’t imagine how many more healthy children will be devastated let alone suffer from this newly invented vaccine.

    What evidence do you have that the vaccine causes harm? Since you say we need to get our facts straight, provide some of those “facts” with real evidence. Until you show some real evidence to support your opinion you should be ignored.

  19. Th1Th2 says:

    The evidence of harm a.k.a. adverse reactions if you know what that means or where to find it. (Hint: package inserts). You can begin reading them before we can go to court judgments, understand?

    Does the word NAIVE sound familiar? Maybe you can explain what vaccine antigens do to a naive cell?

  20. gr8blessings says:

    Oh my friend Th1Th2. We have had this discussion before regarding the difference between antigen, infection and disease. I see that you are still grasping to understand these concepts.

    The pneumococcal vaccines are conjugate vaccines. As such, these vaccines do not cause an infection since the vaccine does not contain any live bacterial cells. Furthermore, they are not given to newborns. The schedule is 2, 4, 6 and 12-15 months.

    Once again, Th1Th2, it seems that you are the one with your facts out of order.

  21. Th1Th2 says:

    gr8blessings,

    “As such, these vaccines do not cause an infection since the vaccine does not contain any live bacterial cells. ”

    The initial stage of pathogenesis begins with the introduction of antigens to naive immune cells regardless whether the antigen is live or inactivated. This is called infection. And infection can occur naturally (natural infection) or artificially (vaccination). Replication then follows infection (except for inactivated antigens).

    “Inactivated vaccines are not alive and cannot replicate.
    The entire dose of antigen is administered in the injection.
    These vaccines cannot cause disease from INFECTION, even in
    an immunodeficient person.” (Emphasis added)
    http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/prinvac.pdf

    Since these healthy newborns are NAIVE to these antigens then why are you promoting contamination of their immune system in the first place? Antigens do not protect. Even my 3 year old niece knows that.

  22. weing says:

    “The initial stage of pathogenesis begins with the introduction of antigens to naive immune cells regardless whether the antigen is live or inactivated. This is called infection.”

    Now we know that you don’t know what an infection is.

  23. BillyJoe says:

    th1th2
    (thick and thicker)

    I will make this really simple:

    Prevnar is made up using only parts of the pneumococcal bacteria.
    It is an inactivated vaccine.
    It cannot cause disease.
    It protects against disease.
    It stimulates the body to produce an immune response that protects against infection with the live bacteria.

  24. Chris says:

    No real evidence presented that the vaccine is harmful by the troll. Ignore it.

  25. Th1Th2 says:

    BillyJoe,

    1. “Prevnar is made up using only parts of the pneumococcal bacteria.”

    So? It is still an antigen.

    2.”It is an inactivated vaccine.”

    It limits spread of infection.

    3.”It cannot cause disease.”

    It can cause infection that can cause the disease.

    4. “It protects against disease.”

    Dream on. Antigens do not protect. On the contrary antigens can provoke infection, allergy and disease. It is the job of the body to eliminate antigens.

    5. “It stimulates the body to produce an immune response that protects against infection with the live bacteria.”

    Read number 4.

  26. Th1Th2 says:

    Chris,

    Understandably, you have never vaccinated before that’s why you are nescient that every vaccine comes with package insert.

  27. BillyJoe says:

    thick and thicker,

    “It is the job of the body to eliminate antigens.”

    You win one!
    Amazing!
    Yes, correct, the body’s immune system eliminates the injected antigens by producing antibodies so that, when the antigens of the live virus arrive, it is primed and ready to eliminate them as well.

    Give the doggie a bone.

  28. micheleinmichigan says:

    “This is why in children prior to 2000, and in spite of modern medical care, S. pneumo caused around 13,000 cases of bacteremia, 2500 cases of pneumonia, 700 cases of meningitis, and 200 deaths (not to mention 5,000,000 cases of otitis media”

    Thanks for an informative post. I would like to add that aside from the risks of death from the above diseases there is a risk of long term consequences.

    One of my son’s classmates (school for children with hearing/speech impairments) has profound hearing loss, and delays in gross and fine motor control all due to a meningitis infection. He’s a sweet and inquisitive kid who is going to have a really tough road for a long time to come.

    I do not know if this new vaccine would have prevented his particular case of meningitis, but it is good to know that it will prevent some cases like his.

    My question would be, like the above commenter. Is it recommended that children already vaccinated receive the new one. Would it be a booster or a new set of shots?

  29. Draal says:

    @T-helper cell 1 T-helper cell 2

    A quick introduction to how an infants immune system works can be found here: http://www.immune.org.nz/site_resources/Professionals/Vaccinology/The_infant_immune_system_and_immunisation.pdf
    from http://www.immune.org.nz/?t=904.

    If and when you read some background on how the infant immune system responds to antigens and vaccines, we can continue having a discussion. Until then, adieu adieu adieu.

  30. watso359 says:

    @ TH1/TH2

    I am confused by your statements. Is activation of the immune system by vaccines bad?

    If so, what is your opinion of the thousands of antigens that our bodies encounter “naturally”? Are those antigens dangerous too, or is it just vaccine antigens?

  31. Th1Th2 says:

    BillyJoe,

    “Yes, correct, the body’s immune system eliminates the injected antigens by producing antibodies so that, when the antigens of the live virus arrive, it is primed and ready to eliminate them as well.”

    Wrong. The immune system does NOT eliminate antigens through the production of antibodies. In fact, antibodies do NOT kill and dispose of antigens. So who does the job? Come back here if you know the answer.

  32. Th1Th2 says:

    Draal,

    So what’s your point with the Sesame Street-like handout?

  33. Th1Th2 says:

    watso359,

    @ TH1/TH2

    “I am confused by your statements. Is activation of the immune system by vaccines bad?

    Terribly bad and abnormal.

    “If so, what is your opinion of the thousands of antigens that our bodies encounter “naturally”? Are those antigens dangerous too, or is it just vaccine antigens?”

    Extraneous antigens occurring naturally are mediated through non-specific immunity (skin barrier, mucosal, enzymatic destruction, pH balance, nutrition, etc.) provided these antigens do not take another route or port of entry which infringes and corrupts that innate physiologic defense in contrast to vaccination which is the intentional and intrusive way of inoculating the body with disease particles.

    Antigenic exposure and reaction varies and depends on several factors: age, health status, nutritional level, allergy, intact skin barrier, etc. Susceptibility occurs in malnourished and immunocompromised people which can predispose them to infection, allergy, diseases and even death.

  34. weing says:

    watso359,

    You realize you were just answered by a person who doesn’t even know what an infection is.

  35. Th1Th2 says:

    weing,

    At your level of understanding (or the lack of it), here’s might suit you:
    http://diseases-viruses.suite101.com/article.cfm/how_does_my_immune_system_work

    How does Infection get into your body?

    Your body has many defence shields to prevent infection:

    * Tears protect the eyes
    * Your skin
    * Cell layers that cover the mouth, vagina, nose and alimentary canal
    * Acid in your stomach
    * Clotting mechanism in the blood

    If the infection gets past any of these and ANTIGENS INFECT and reproduce within your bloodstream then there are two further processes that can destroy the pathogen – your immune response and phagocytosis. (Emphasis added)

    Now go on and enjoy the weekend.

  36. weing says:

    So, you read that and still haven’t learned what an infection is. Amazing. Simply amazing. Deliberate ignorance.

  37. Th1Th2 says:

    weing,

    There’s no hope for you.

  38. weing says:

    “The initial stage of pathogenesis begins with the introduction of antigens to naive immune cells regardless whether the antigen is live or inactivated. This is called infection.”

    No. This is called ignorance.

  39. watso359 says:

    Th1/Th2

    Again I’m a little confused….

    If most healthy immunocompetent people are protected by innate defenses and rarely see internal antigens, why is it that almost all people have so many antibodies and memory B cells in their blood and lymphatic circulation?

    This fact seems contradictory to how you explained the natural immune system functions. How does one reconcile this?

    Thanks

  40. watso359 says:

    Weing
    Do you know Socrates?

  41. Th1Th2 says:

    watso359,

    I do not see any conflict. Before I proceed, are you inferring that the only chance antibodies and memory cells are produced is through encounter with antigens?

  42. watso359 says:

    I wasn’t inferring anything, only asking questions based on the conversation between you and other posters.

  43. watso359 says:

    Th1/Th2
    Please continue

  44. Chris says:

    Troll1/Troll2: I have been vaccinated many times, starting with smallpox, typhus, polio, yellow fever and other vaccines as an infant (born overseas) to recently getting the H1N1 vaccine. I have read the inserts.

    The big difference between us is that I actually understand them. I know the difference between an antigen and the full bacteria.

    Now provide real evidence that getting the new PCV 13 vaccine is worse than getting the diseases. Explain clearly (with actual documentation and not your misinterpretation of lawyer written inserts) why we should go back what it was like before the PCV-7 was available as described above by Dr. Albietz:

    This is why in children prior to 2000, and in spite of modern medical care, S. pneumo caused around 13,000 cases of bacteremia, 2500 cases of pneumonia, 700 cases of meningitis, and 200 deaths (not to mention 5,000,000 cases of otitis media).

    Package inserts are not acceptable as evidence. Actually cite real literature.

    Otherwise, go back under your bridge.

    watso359, you will not get any real data or information from Troll1/Troll2. He has done the “read package inserts” bit before when asked for real evidence, and has demonstrated multiple times that s/he/it does not understand anything beyond a University of Google education. See previous encounters here:
    http://www.sciencebasedmedicine.org/?p=1296 .

  45. Th1Th2 says:

    watso359,

    First of all, as you know antibodies are produced through plasma B cells and plasma B cells originate in the bone marrow. Even at birth, neonates have self-derived immunoglobulins. But this ability to produce antibodies occurs in a stepwise fashion. This is an inherent physiologic process—we are born with it.

    In addition, memory B cells are formed after primary exposure to infection such as in vaccination. However, memory B cells does not ‘protect’ like plasma B cells.

    The humoral-mediated response is not the primary and ultimate function of the immune system.

  46. Th1Th2 says:

    Chris,

    “I have been vaccinated many times,”

    I don’t care if you were vaccinated, my point was if you have ever vaccinated a living creature with your own hands.

  47. Chris says:

    I read too fast, so sue me. I only spend the minimum time required to read your idiocy. You are not worth the time.

    You have also never vaccinated anyone. Now answer the question, or go back under your bridge.

  48. Th1Th2 says:

    Chris,

    You are wrong. I work in the medical field and have administered vaccines on all ages. And at the same time, I have taken care of vaccine-damaged patients.

    GTG for awhile.

  49. BillyJoe says:

    Everyone,

    Please look at this exchange:

    Troll1Troll2: “It is the job of the body to eliminate antigens.”

    BillyJoe: “Yes, correct, the body’s immune system eliminates the injected antigens by producing antibodies so that, when the antigens of the live virus arrive, it is primed and ready to eliminate them as well.”

    Troll1Troll2: “Wrong. The immune system does NOT eliminate antigens through the production of antibodies. In fact, antibodies do NOT kill and dispose of antigens. So who does the job? Come back here if you know the answer.”

    I produce a statement which is correct but incomplete. The troll says it’s wrong, implying that I was saying that it is the antibody – and only the antibody – that is responsible for eliminating the antigen!

    I’m afraid that in our exchanges with this troll, we are going to find that, unless we write book length responses – and even then – the troll is going to find fault. On the other hand he himself will be allowed to write incomplete responses and pose questions and expect us to scurry off and find the full text somewhere else.

    Troll, you have been exposed!

  50. watso359 says:

    @Th1/Th2

    Sorry for asking so many questions, but this material is complicated…

    So you are saying that plasma cells are always producing antibodies, regardless of whether or not they have ever actually been “activated” by an antigen? That is not the way it is explained on internet sites, could you help elaborate on that for me?

    Same thing with the memory cells…internet websites say that they are the reason why you don’t usually get the chickenpox twice. You are saying that there is a different defense system responsible for that? How does it work and where can I learn about it?

    Thanks again

  51. Chris says:

    BillyJoe:

    Troll, you have been exposed!

    Again. Which is why s/he/it should be ignored.

  52. BillyJoe says:

    Regarding the Troll:

    Why does the troll think that antigens infect?
    Because, when he googled the internet, the troll found this quote:

    “If the infection gets past any of these and ANTIGENS INFECT and reproduce within your bloodstream”

    (The CAPITALISATION is his of course)

    Yep, “expertise” via the internet!
    All we have in that quote is loose langauge, nothing more.
    Antigens don’t infect – and they don’t reproduce either.
    The micro-organisms that contain these antigens infect and reproduce.

    Unless of course you are humpty dumpty – then you can make word mean exactly what you want them to mean! :D

    Troll, you have been exposed!

  53. BillyJoe says:

    There is another exchange between the troll and watso that I could expose but I’m laughing so hard I can’t get my fingers on the right keys.

    It’s coming out something like this:

    MAS kygtq TURB dbzjs ATION :D

  54. Chris says:

    So he is attending the University of Google, and plagiarizing a blog written by a fiction (and sometime health) writer, who occasionally teaches English as a foreign language. Her health books are listed on Amazon, but they range from 100 to 160 pages long, not exactly deep books.

  55. Chris says:

    Share, BillyJoe, share!

  56. Draal says:

    Th1Th2, define what an antigen is and what an infectious agent is for the rest of the class. Come on, go ahead.

    I’ll give you a hand. The definition of an attenuated vaccine is a live pathogens that has lost their virulence but are still capable of inducing a protective immune response to the virulent forms of the pathogen.

    Do you know what virulence means? The letter of the day is V, V for virulence. Virulence is the ability to cause disease. Lost virulence means the opposite. Do you know what an antonym?

    The bonus round is brought to us by the letter I, I for infection. An Infection is defined as an invasion by and multiplication of pathogenic microorganisms in a bodily part or tissue, which may produce subsequent tissue injury and progress to overt disease through a variety of cellular or toxic mechanisms.

    Can an attenuated virus multiply? No, because it is not virulent. So can an attenuated vaccine cause an infection? No, because it’s made up of attenuated virus.

    Does Th1Th2 care to be spoon fed some more? Open wide!

  57. Th1Th2 says:

    BillyJoke,

    “I produce a statement which is correct but incomplete. The troll says it’s wrong, implying that I was saying that it is the antibody – and only the antibody – that is responsible for eliminating the antigen!”

    You appear so dyslexic. Read your statement again. Are antibodies (circulating or induced) capable of eliminating injected antigens? Just answer yes or no.

    “Antigens don’t infect – and they don’t reproduce either.
    The micro-organisms that contain these antigens infect and reproduce.”

    Naturally, exogenous antigens do not cause infection if they don’t bypass the body’s physiologic and physical barriers. The inoculum (pathogen or pathogen parts) in the vaccine is introduced directly to the bloodstream and enters the cell (antigen-receiving and presenting cells), hence, the term infection. The infection of the host cell must occur to trigger effector immune cells, otherwise, the vaccine would be considered ineffective. The inability to replicate (inactivated vaccines) only limits the spread of infection.

  58. BillyJoe says:

    Th1Th2, it is really sad that you haven’t realised it yet but…the game is up.

  59. Th1Th2 says:

    watso359,

    “So you are saying that plasma cells are always producing antibodies, regardless of whether or not they have ever actually been “activated” by an antigen? That is not the way it is explained on internet sites, could you help elaborate on that for me? ”

    Hence the question I raised earlier. All naive B cells (B cells that have not been exposed to antigen) are capable of expressing immunoglobulins in their cell surface. Antigenic stimulation will later enhance B cell maturity and thereby differentiation into plasma or memory cells along the way.

    Plasma B cells can be activated either by antigen alone or with the help of T cells.

    “Same thing with the memory cells…internet websites say that they are the reason why you don’t usually get the chickenpox twice. You are saying that there is a different defense system responsible for that? How does it work and where can I learn about it? ‘

    Well, a memory cell can either be a T- or B-memory cell, so it depends. Which one are you referring to?

  60. Th1Th2 says:

    BillyJoe,

    You don’t have to flinch, just answer the question. It’s so simple that my 3 year old niece knows the answer.

  61. Th1Th2 says:

    Draal,

    Even though your argument sounds so rudimentary to me, it does not invoke critical thinking and logical relevance to someone who actually works in the medical field. You’re way better off explaining that to non-medical people and I guarantee you will not receive any rebuttal.

  62. Chris says:

    Troll1/Troll2 continues to post without any evidence. Still to be ignored.

    BillyJoe, please share the link if you can stop laughing long enough!

  63. Draal says:

    Th1Th2 said, “The inoculum (pathogen or pathogen parts) in the vaccine is introduced directly to the bloodstream and enters the cell (antigen-receiving and presenting cells), hence, the term infection.”

    That is not the consensus for the definition of infection. You’ve redefined the term to suit your needs.

    Have you heard of an autoimmune disease? The same process you described of how an antibody response is triggered by a pathogen is the same process that results in an autoimmune disease. One’s own body is not an infectious agent. Therefore, the antibody response does not equal an infection.

    Bacteria can cause an infection. The bacteria do not rely on the immune system to infect. An infection does not require white blood cells or an antibody response.

    Th1Th2, are you employed as a RN, LPN, PA, NP or a custodian that happens to work in a hospital aka medical field? You should throw that argument from authority around a little more. I’m so close to realizing I should just believe everything you say is true.

  64. watso359 says:

    Th1/Th2

    Thats interesting.

    So what would be the outcome if a person didn’t have the humoral branch of the immune system? (Antibody production)

  65. watso359 says:

    @ Th1/Th2

    Th1/Th2
    “All naive B cells (B cells that have not been exposed to antigen) are capable of expressing immunoglobulins in their cell surface.”

    Would that result in free secreted gamma immunoglobulins in the blood plasma?

    “Well, a memory cell can either be a T- or B-memory cell, so it depends. Which one are you referring to?”

    Is one more important for an overall immune response than the other?

  66. Th1Th2 says:

    Draal,

    “An infection does not require white blood cells or an antibody response.”

    According to the dogma of the Church of Modern Medicine that is considered a heresy.

    “The same process you described of how an antibody response is triggered by a pathogen is the same process that results in an autoimmune disease. One’s own body is not an infectious agent.”

    Yes I do concur that an autoimmune reaction can happen but this physiologic event is tightly controlled and regulated. However, the introduction of vaccine appears to disturb this homeostatic balance with destructive consequences.

  67. Th1Th2 says:

    watso359,

    “So what would be the outcome if a person didn’t have the humoral branch of the immune system?”

    The same thing that would happen for a person without a bone marrow.

  68. Th1Th2 says:

    watso359,

    “Would that result in free secreted gamma immunoglobulins in the blood plasma?”

    Yes, hence the name plasma B cells, as it matures.

    “Is one more important for an overall immune response than the other?”

    Yes.

  69. Watcher says:

    Did anyone see the latest episode of the Office where every time Erin ask’s Kevin a question he answers with a one-word answer without furthering the conversation? I’m reminded of that here …

  70. micheleinmichigan says:

    Yes, it is one of the more bizarre exchanges I’ve seen on SBM.

  71. watso359 says:

    Th1/Th2

    This has been fun, but it’s getting old.

    “In addition, memory B cells are formed after primary exposure to infection such as in vaccination. However, memory B cells does not ‘protect’ like plasma B cells.
    The humoral-mediated response is not the primary and ultimate function of the immune system.”

    No one is claiming that antibodies are the ultimate or even primary action of the immune system, but rather an integral part, much like innate, cytotoxic components, and etc of the whole immune system working together.

    You are claiming that antibodies play a decreased role in healthy individuals, yet you admit “The same thing that would happen for a person without a bone marrow.” in patients with agammaglobulinemia; indeed this is what is seen, and with intravenous antibodies derived from donors, they can live relatively healthy lives.

    Even YOU do not believe your own crap.
    A bored trolling undergrad biology student is all you are.

  72. Th1Th2 says:

    watso359,

    “No one is claiming that antibodies are the ultimate or even primary action of the immune system, but rather an integral part, much like innate, cytotoxic components, and etc of the whole immune system working together.”

    That’s precisely the reason why vaccines are CRAP, in and on itself. Well, does that hurt your ego?

    “indeed this is what is seen, and with intravenous antibodies derived from donors, they can live relatively healthy lives. ”

    Because eating an apple a day to keep doctors away is quite boring nowadays, isn’t it? We need a little excitement like Ig therapy and even bone marrow transplantation and still live a “healthy” life. Well, good luck with that.

    “A bored trolling undergrad biology student is all you are.”

    Sign of defeat.

  73. watso359 says:

    Th1/Th2

    “Sign of defeat”

    You’re funny : ), I think we are gonna be good friends.

    Excellent, I will recommend to the next agammaglobulinemia patient that they should eat apples instead of getting that exotic plasma transfusion.

    Could you please show me the double blinded clinical trial showing apples prevent the hereditary agammaglobulinemia/ ablated bone marrow systemic infections? I can’t seem to locate it on PubMed….

    Cheers my new pal!

  74. weing says:

    The troll is clearly an incompetent sadist or psychopathic killer. He said he gives vaccines to kids. He knows they are bad for them, giving them deadly diseases, and he does it anyway.

  75. squirrelelite says:

    Cute cartoon, Draal!

    I like xkcd.

  76. Th1Th2 says:

    watso359,

    ‘Could you please show me the double blinded clinical trial showing apples prevent the hereditary agammaglobulinemia/ ablated bone marrow systemic infections? I can’t seem to locate it on PubMed….’

    If you can’t find it, try oranges. Gee whiz. SBM is really amazing.

  77. Th1Th2 says:

    weing,

    “The troll is clearly an incompetent sadist or psychopathic killer. He said he gives vaccines to kids. He knows they are bad for them, giving them deadly diseases, and he does it anyway.”

    Pathognomonic sign of a loser. There’s nothing else I can do.

  78. weing says:

    Or he’s just full of stool and doesn’t believe his own crap. I mean, nobody could be that stupid, could they?

  79. weing says:

    “Pathognomonic sign of a loser. There’s nothing else I can do.”

    You could always quit.

  80. Chris says:

    Troll1/Troll2:

    You are wrong. I work in the medical field and have administered vaccines on all ages. And at the same time, I have taken care of vaccine-damaged patients.

    I submit that this clueless troll is also a liar. A very bad liar who plagiarizes blogs by using the University of Google.

    Ignore the troll.

  81. BillyJoe says:

    “BillyJoe on 06 Mar 2010 at 6:05 pm:

    MAS kygtq TURB dbzjs ATION :D

    I trust everyone can decipher the message now.
    The poor guy obviously needs a helping had but….

  82. Archangl508 says:

    Th1Th2,

    Your B cell biology is god-awful.

    “B cells and plasma B cells originate in the bone marrow”

    There are two types of B cells. B1 and B2 cells. B1 cells reside mostly in the peritoneal cavity and are not bone marrow derived. B2 cells are derived from B cell-precursors originate in the bone marrow (or fetal liver) and go through several maturation stages in the bone marrow. It is during these initial steps that VDJ/VJ recombination occurs (pro/pre Bcell stages) and the cells are on their way to becoming a B cell. Following these steps you have an immature B cell, one still not yet prepared for antigenic stimulation. That Bcell then leaves the bone marrow and migrates to the periphery (i.e. spleen) and finishes its maturation process.

    Plasma cells are not derived from the bone marrow. They are derived from splenic or lymph node residing B cells that are stimulated with antigen. After antigenic stimulation the B cell becomes activated and proliferates rapidly. During this process there are other events that can occur (i.e. germinal center formation, class switching, affinity maturation) but the end result then is differentiation into either a memory B cell or an antibody producing cell (i.e. plasma cell). Plasma cells do not originate in the bone marrow, but rather in the site of activation. Plasma cells will return to the bone marrow, however, following their creation where they will continue to produce antibody.

    “Plasma B cells can be activated either by antigen alone or with the help of T cells. ”

    Plasma cells are terminally differentiated cells. They do not get activated by antigen at all, as they are the result of B cells (either naive or memory) being previously activated. Plasma cell function is to produce antibody. No further activation is needed.

    “All naive B cells (B cells that have not been exposed to antigen) are capable of expressing immunoglobulins in their cell surface.”

    That is a correct statement, but the antibodies produced that reside on the cell surface and very different from antibodies that are produced for secretion. The similarity is that they contain the same heavy and light chain sequences that confer antibody specificity, but the FC region of the antibody is quite different. For example, cell surface immunologlobulins are built to associate with signaling molecules in order to provide the requisite cell signaling to induce cell activation. Secreted immunoglobulins have difference FC types dependent on their function (IgM, IgG, IgA, IgE).

    “The inoculum (pathogen or pathogen parts) in the vaccine is introduced directly to the bloodstream and enters the cell (antigen-receiving and presenting cells), hence, the term infection.”

    No vaccines are delivered directly into the bloodstream. Vaccines are given subcutaneously, intra-muscularly, intranasally, or orally, but not intraveneously.

  83. Chris says:

    Troll1/Troll2:

    The inoculum (pathogen or pathogen parts) in the vaccine is introduced directly to the bloodstream and enters the cell (antigen-receiving and presenting cells), hence, the term infection.

    Troll/Troll2:

    You are wrong. I work in the medical field and have administered vaccines on all ages. And at the same time, I have taken care of vaccine-damaged patients.

    Sorry I missed s/he/it saying the vaccine goes directly into the bloodstream. It is obvious the troll is a liar. If not, then s/he/it is a med-tech who has damaged those that have had their vaccines given to them wrong!

  84. Calli Arcale says:

    Th1Th2:

    Since these healthy newborns are NAIVE to these antigens then why are you promoting contamination of their immune system in the first place? Antigens do not protect. Even my 3 year old niece knows that.

    Correct, antigens do not protect. They educate. I realize this concept may be unfamiliar to you.

  85. Th1Th2 says:

    Archangl508,

    1. “B1 cells reside mostly in the peritoneal cavity and are not bone marrow derived.”

    This is why SBM is full of crappy so-called experts in medical science but in reality, just a load of Scientific Wild Ass Guess.

    Now, I know this is just a ruse of your persistent ego-tripping on this board as I am giving you a chance to revise your ego-derived STUPID statement before you get mortified.

    2. “Plasma cells are not derived from the bone marrow. They are derived from splenic or lymph node residing B cells that are stimulated with antigen….Plasma cells do not originate in the bone marrow, but rather in the site of activation.”

    So you are saying these plasma cells did not originate from the B2 cells which were derived from B cell-precursors that originated in the bone marrow ? You know B cells do migrate, right?

    3. ‘Plasma cells are terminally differentiated cells. They do not get activated by antigen at all, as they are the result of B cells (either naive or memory) being previously activated. Plasma cell function is to produce antibody. No further activation is needed.”

    Correct. I was referring to naive B cells being activated directly by antigens or with the help of T-cell based from my previous paragraph. Thanks for bringing that up.

    4 “That is a correct statement, but the antibodies produced that reside on the cell surface and very different from antibodies that are produced for secretion… Secreted immunoglobulins have difference FC types dependent on their function (IgM, IgG, IgA, IgE).”

    So what?

    5. “No vaccines are delivered directly into the bloodstream. Vaccines are given subcutaneously, intra-muscularly, intranasally, or orally, but not intraveneously.”

    Yes, not INTRAVENOUSLY per se, otherwise it will be a QUICK KILL, kwim?

    That is the reason there are other ‘humane’ routes of administration for a slower process of directing the inoculum to the blood stream. Physiologically, blood vessels consist of the veins, arteries and capillaries and the bloodstream is the blood which flows through the circulatory system of an organism, meaning you. The circulatory system or the cardiovascular system consist of the heart and the blood vessels (arteries, arterioles, capillaries, venules, veins and SINUSES) and the lymphatic system (lymph capillaries, lacteals, LYMPH NODES, lymph vessels and main lymph duets (thoracic and right lymphatic duct).

    Therefore, the inoculum in the vaccine, whether injected intramuscularly or subcutaneously, administered intranasally or orally, are picked up by the capillaries which carry the material into the larger vessels of the circulatory system and even to the lymphatic system. So, the vaccine contents are introduced into the blood stream and the lymphatic system. Do you think humoral mediated immunity can occur elsewhere?

    Anyone who’s going to disagree with this physiologic process should go back to basic anatomy and physiology class.

  86. Th1Th2 says:

    Calli Arcale,

    “Correct, antigens do not protect. They educate. I realize this concept may be unfamiliar to you.”

    I am more familiar of vaccine-induced infections as part of your so-called ‘education’. At least you knew that vaccines, which are antigenic preparation, do not protect at all.

    Vaccine apologists will call your statement a heresy. They do not like to hear such blasphemy. Just reminding you.

  87. Prometheus says:

    Th1Th2 has dropped a significant load of misinformation on this thread, much of which has already been addressed. I thought it might be helpful to give a summary of the ignorance to date:

    “You and the vaccinators are the ones responsible for deliberately infecting naive immune cells of healthy newborns with hideous antigens.”

    The “naive immune cells” of newborns are exposed to millions of antigens (hideous and non-hideous) with the first breath (and often even before the first breath). I’ll deal with Th1Th2′s eccentric definition of “infection” later, but not even all live virus vaccines infect immune cells.

    “The initial stage of pathogenesis begins with the introduction of antigens to naive immune cells regardless whether the antigen is live or inactivated. This is called infection.” [emphasis added]

    “Infection” – in the real world – involves replication of bacteria, viruses or eukaryotic parasites within the body of an organism (not necessarily within the cells, although all viruses and some bacteria do replicate within cells). By definition, inactivated (i.e. “dead”) viruses, bacteria, etc. cannot cause “infection” because they cannot replicate.

    Th1Th2′s perseveration on this error is pathognomonic of someone who is incapable of accepting correction. Clearly, he/she is not as educated in biology/medicine as he/she thinks.

    “Extraneous antigens occurring naturally are mediated through non-specific immunity (skin barrier, mucosal, enzymatic destruction, pH balance, nutrition, etc.) provided these antigens do not take another route or port of entry which infringes and corrupts that innate physiologic defense in contrast to vaccination which is the intentional and intrusive way of inoculating the body with disease particles.”

    Th1Th2 is again showing his/her ignorance. Non-specific immunity (innate immunity) is a combination of phsyical barriers, humoral factors (e.g. complement, coagulation factors, lactoferrin/transferrin, interferons, interluekins, lysozyme, etc.), and cellular components (e.g. macrophages, neutrophils, NK/LAK cells, eosinophils). Many components of the innate immune system interact with the adaptive immune system (which includes, but is not limited to, antibodies) in a synergistic fashion.

    The innate immune system is also involved in the production of a long-lasting (anamnestic) immune response to vaccination (e.g. macrophages presenting antigens).

    It is worth noting that vaccination is no more “intrusive” than getting a splinter or an insect bite. If our immune systems weren’t up the that challenge, we would have perished as a species long ago.

    “The inoculum (pathogen or pathogen parts) in the vaccine is introduced directly to the bloodstream and enters the cell (antigen-receiving and presenting cells), hence, the term infection.”

    For starters, if Th1Th2 is telling the truth when he/she said “I work in the medical field and have administered vaccines on all ages.”, then we must assume that he/she is grossly incompetent. Vaccines are not injected into the bloodstream.

    Notice – again – the eccentric definition of “infection”.

    I’m sure I’ve missed some of Th1Th2′s misinformation, but I think those are the highlights.

    I don’t do this with any hope of educating Th1Th2 – he/she clearly is suffering from the end stages of the arrogance of ignorance. However, I thought it important to reinforce – along with everyone above who has bravely tried to stem the tide of ignorance that is Th1Th2 – that most of what Th1Th2 has said about vaccines, infection and the immune system is wrong.

    Prometheus

  88. Th1Th2 says:

    Moderator,

    I am missing a post. What gives?

  89. Th1Th2 says:

    (this is a repost, about an hour ago)

    Archangl508,

    1. “B1 cells reside mostly in the peritoneal cavity and are not bone marrow derived.”

    This is why SBM is full of crappy so-called experts in medical science but in reality, just a load of Scientific Wild Ass Guess.

    Now, I know this is just a ruse of your persistent ego-tripping on this board as I am giving you a chance to revise your ego-derived STUPID statement before you get mortified.

    2. “Plasma cells are not derived from the bone marrow. They are derived from splenic or lymph node residing B cells that are stimulated with antigen….Plasma cells do not originate in the bone marrow, but rather in the site of activation.”

    So you are saying these plasma cells did not originate from the B2 cells which were derived from B cell-precursors that originated in the bone marrow ? You know B cells do migrate, right?

    3. ‘Plasma cells are terminally differentiated cells. They do not get activated by antigen at all, as they are the result of B cells (either naive or memory) being previously activated. Plasma cell function is to produce antibody. No further activation is needed.”

    Correct. I was referring to naive B cells being activated directly by antigens or with the help of T-cell based from my previous paragraph. Thanks for bringing that up.

    4 “That is a correct statement, but the antibodies produced that reside on the cell surface and very different from antibodies that are produced for secretion… Secreted immunoglobulins have difference FC types dependent on their function (IgM, IgG, IgA, IgE).”

    So what?

    5. “No vaccines are delivered directly into the bloodstream. Vaccines are given subcutaneously, intra-muscularly, intranasally, or orally, but not intraveneously.”

    Yes, not INTRAVENOUSLY per se, otherwise it will be a QUICK KILL, kwim?

    That is the reason there are other ‘humane’ routes of administration for a slower process of directing the inoculum to the blood stream. Physiologically, blood vessels consist of the veins, arteries and capillaries and the bloodstream is the blood which flows through the circulatory system of an organism, meaning you. The circulatory system or the cardiovascular system consist of the heart and the blood vessels (arteries, arterioles, capillaries, venules, veins and SINUSES) and the lymphatic system (lymph capillaries, lacteals, LYMPH NODES, lymph vessels and main lymph duets (thoracic and right lymphatic duct).

    Therefore, the inoculum in the vaccine, whether injected intramuscularly or subcutaneously, administered intranasally or orally, are picked up by the capillaries which carry the material into the larger vessels of the circulatory system and even to the lymphatic system. So, the vaccine contents are introduced into the blood stream and the lymphatic system. Do you think humoral mediated immunity can occur elsewhere?

    Anyone who’s going to disagree with this physiologic process should go back to basic anatomy and physiology class.

  90. Kausik Datta says:

    I see that Th1Th2 has been leaving droppings all over this thread. Again. And again. Not the first time, won’t be the last time. Some people just never learn.

    Prometheus, Archangl508 and all others who have bravely taken on this troll, kudos to you. You are a better person than I am. The egregious misinformation spread by Th1Th2 needs to be corrected so that anyone stumbling across this page gets to be acquainted with accurate information.

    I don’t do this with any hope of educating Th1Th2 – he/she clearly is suffering from the end stages of the arrogance of ignorance.

    Well put. If you search for Th1Th2′s username for prior threads, you’d notice that his/her posts are conspicuous by the total absence of any substance.

  91. EricG says:

    is there a specific logical fallacy that is oriented to labeling any random set of ideas as a religion? T1000 has evoked the crap out of that one.

    argumentum ad religio?

  92. Th1Th2 says:

    Archangl508,

    “No vaccines are delivered directly into the bloodstream. Vaccines are given subcutaneously, intra-muscularly, intranasally, or orally, but not intraveneously.”

    Prometheus,

    “Vaccines are not injected into the bloodstream.”

    My answer: Both of you should take remedial class in basic anatomy and physiology.

    Yes, not INTRAVENOUSLY per se, otherwise it will be a QUICK KILL, kwim? That is the reason there are other ‘humane’ routes of administration for a slower process of directing the inoculum to the blood stream.

    Physiologically, blood vessels consist of the veins, arteries and capillaries and the bloodstream is the blood which flows through the circulatory system of an organism, meaning you. The circulatory system or the cardiovascular system consist of the heart and the blood vessels (arteries, arterioles, capillaries, venules, veins and SINUSES) and the lymphatic system (lymph capillaries, lacteals, LYMPH NODES, lymph vessels and main lymph duets (thoracic and right lymphatic duct).

    Therefore, the inoculum in the vaccine, whether injected intramuscularly or subcutaneously, administered intranasally or orally, are picked up by the capillaries which carry the material into the larger vessels of the circulatory system and even to the lymphatic system. So, the vaccine contents are introduced into the blood stream and the lymphatic system. Do you think humoral mediated immunity can occur elsewhere?

    Anyone who’s going to disagree with this physiologic process should go back to basic anatomy and physiology class.

  93. Th1Th2 says:

    Moderator,

    So my missing comments are still awaiting moderation for the past 4 hours? Good job SBM.

  94. Draal says:

    “argumentum ad religio?”

    Contrarian?

    http://www.skepdic.com/contrarian.html

    Jackass?

    8 year-old?

  95. Draal says:

    Th1Th2,
    The crux of your argument is based on that vaccines cause infections. You’ve incorrectly defined what an infection is. Thus, the rest of your argument is worthless . Address this issue and stop your diarrhea of the mouth. Else your higher education degree isn’t worth the paper it’s written on and you should use it for toilet paper.

    Here’s a couple sources that contradict your idea that an infection does not require replication.
    1. infection The invasion of any living organism by disease-causing microorganisms (see pathogen), which proceed to establish themselves, multiply, and produce various symptoms in their host.

    “infection” A Dictionary of Biology. Elizabeth Martin and Robert Hine. Oxford University Press, 2008. Oxford Reference Online.

    2. infection The invasion of a susceptible host by a disease agent (a pathogenic organism) that can develop and proliferate and usually, but not necessarily, causes overt disease.

    “infection” A Dictionary of Public Health. Ed. John M. Last, Oxford University Press, 2007. Oxford Reference Online. Oxford University Press.

  96. I wanted to comment on the whole childhood-deaths-being-reduced topic, but watching Troll1/Troll2 play semantics is too entertaining. I think y’all should keep stringing along Troll1/Troll2 because as he she it gets more involved, the responses start to sound more strange.

    “I will give you one last chance, Earthling,” etc.

    Mods: please don’t hold back on Troll1/Troll2, unless the name-calling crosses the line. The old saying is: give them enough rope…

    PS: Troll1/Troll2: the Janeway text seems to come out with a new edition each year. It would not be that difficult for you to quickly jump in and update a widely read immune system text. Many otherwise well-educated, intelligent people are obviously suffering for lack of your wisdom. -MVT

  97. Archangl508 says:

    Th1Th2,

    I am well aware of anatomy and physiology, however you stated:

    ““The inoculum (pathogen or pathogen parts) in the vaccine is introduced directly to the bloodstream and enters the cell (antigen-receiving and presenting cells), hence, the term infection.””

    Directly into the bloodstream means just that. DIRECTLY…also known as intraveneously. I know you have difficulty with word definitions (as infection seems to have thrown you for a loop), but injecting into another tissue is not the same as injecting directly into the bloodstream. If one takes an oral vaccine and the vaccine is adsorbed through the gastrointestinal tract and eventually enters the bloodstream, it is entering the bloodstream or lymphatic system indirectly, not directly. I would suggest reading up on the definition of directly:

    http://www.thefreedictionary.com/directly

    The two most relevant definitions are:

    “1. In a direct line or manner; straight: The road runs directly north.
    2. Without anyone or anything intervening: directly responsible.
    3. Without delay or hesitation; with no time intervening”

    Nowhere did I suggest that vaccine contents do not, at least to some degree, get into the blood stream. But “directly” implies that all of the contents of the vaccine will end up in the blood stream with no intervening action. That is not true, especially given that many antigens are picked up directly in the tissues by antigen presenting cells like dendritic cells. In fact, immunizing directly in the bloodstream does not always produce a good immune response and the response is dependent on the structure of the antigen:

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1578848/pdf/clinexpimmunol00355-0074.pdf

    “I was referring to naive B cells being activated directly by antigens or with the help of T-cell based from my previous paragraph.”

    But that is not what you said. What you said was:

    ““Plasma B cells can be activated either by antigen alone or with the help of T cells. ””

    Therefore you are incorrect as plasma cells are not activated by antigen. The B cells are activated and then become plasma cells. The correct statement would be “Plasma cells can be produced by activation of B cells either by antigen alone or with T cell help”. It is a subtle difference and it is quite obvious that you often miss the subtleties of immunology.

    You were right about one thing though, I will amend my above statement to be as I intially intended, “B1 cells reside mostly in the peritoneal cavity and are mostly not bone marrow derived.” I left out the word mostly as there is a very small percentage of B1 cells derived from adult bone marrow, although the main method for B1 cell homeostasis is self-renewal and not the production of new cells as is seen with B2 cells. Somehow I doubt you will admit your mistakes anywhere near as readily.

    “So what?”

    You made the original statement

    “All naive B cells (B cells that have not been exposed to antigen) are capable of expressing immunoglobulins in their cell surface”

    in response to Watso’s question about plasma cells producing antibodies without antigenic stimulation. I was simply pointing out that the immunoglobulins produced that reside in the cell surface are different in function from those produced for secretion, providing clarification for Watso. In fact, I did state that your statement was correct as you will notice. Don’t blame me if you are unable to take a compliment.

  98. Prometheus says:

    My, my, my! Th1Th2 is just so precious!

    After saying:

    “The inoculum (pathogen or pathogen parts) in the vaccine is introduced directly to the bloodstream and enters the cell (antigen-receiving and presenting cells), hence, the term infection.”

    and being called on his/her misunderstanding of basic vaccination practices (despite claiming to be a medical professional), he/she tries to cover the mistake:

    “Therefore, the inoculum in the vaccine, whether injected intramuscularly or subcutaneously, administered intranasally or orally, are picked up by the capillaries which carry the material into the larger vessels of the circulatory system and even to the lymphatic system. So, the vaccine contents are introduced into the blood stream and the lymphatic system. Do you think humoral mediated immunity can occur elsewhere?”

    Now, I could say that humoral immunity actually happens in the lymph nodes and spleen, but I’m sure that Th1Th2 would subsequently say that since the spleen has a blood supply and since lymph nodes “filter” lymph which is derived from blood, it’s all happening “in the blood”.

    Here’s a tip for Th1Th2 – when you’ve decided that the hole you’re in is deep enough, the best thing to do is stop digging.

    The funny thing is that I’m not an immunologist, and yet I know more about the immune system than Th1Th2, who arrogantly proposes to teach us about the immune system.

    Thus we come to the first lesson of the day: don’t take instruction from people who don’t know the subject.

    Google (and Yahoo) is a wonderful thing, but it is not a substitute for education. One of the paradoxes of education – shown most eloquently in a study by Kruger and Dunning (1998) – is that the less people actually know about a subject, the more they think they know about it. (see also: http://photoninthedarkness.com/?p=140)

    I’ve taken undergraduate and graduate level courses in immunology and my research touches on immunology, but I know that there is much that I don’t know about the immune system that the real experts do. Th1Th2, in contrast, knows little about immunology and yet thinks that he/she can lecture us all on the subject.

    I can’t think of a better confirmation of Kruger and Dunning than that.

    Prometheus

Comments are closed.