B6 Preventing and Treating Disease

Vaccination

for serious diseases, the immune system has no time to produce the right antibodies

vaccination (or immunisation) can protect you from serious diseases

Immunisation

a dead or inactive (safe) forms of pathogen make a vaccine

stimulates immune response to make specific antibodies and destroys antigens

specific antibody is remembered which makes you immune

if the same live pathogen invades, correct antibody can be produced rapidly

no disease symptoms occur

vaccines protect against bacterial and viral diseases

MMR vaccine protects against measles, mumps and rubella

Herd Immunity

if most of the population are vaccinated, the spread of the pathogen is much reduced and may disappear

introduced into the body (often injected)

smallpox has been completely wiped out by vaccination

if not enough people are vaccinated, herd immunity is lost

risk of outbreaks

people may fear the safety of the vaccine

takes money and effect to reach global herd immunity

disease can reappear

protects the entire society and those not vaccinated

pathogen will not spread to them

epidemics within a country

pandemics across many countries

Antibiotics and Painkillers

Painkillers

WHO (world health organisation) wants 95% of children to have 2 doses of measles vaccine

relieve and treat the disease symptoms

do not kill the pathogen

do not cure you any faster

usually for viral diseases

waits for immune response

Aspirin

thins blood/ pain relief

Paracetamol

interferes with receptors to brain

Ibuprofen

anti-inflammatory (reduces swelling and pressure)

Antibiotics

antibiotics kill pathogenic bacteria inside the body

antiseptics and disinfectants are too poisonous to use inside the body

antibiotics don't damage body cells

cures bacterial diseases

cannot treat viral diseases

taken as a pill or syrup

can be put straight into bloodstream for faster effect

specific bacteria treated with specific antibiotic effective against them

some antibiotics kill a wide range of bacteria

some antibiotics are specific to a particular bacteria

virus reproduce inside body cells

treatment for viral infections also damages body cells

strains of antibiotic-resistant bacteria have evolved

some bacteria are resistant to all known antibiotics

the antibiotic no longer kills the bacteria

more people could die from incurable bacterial diseases

scientist need to find new drugs to kill antibiotic-resistant bacteria

antibiotics shouldn't be overused and overprescribed

the full course of the medicine should be taken

should only be used for diseases you can't naturally overcome

prevents more multi-resistant bacteria evolving

Drug Discovery & Development

Discovery

modern new drugs are synthesised in the lab using computer models

starts from chemicals extracted from plants, animals or microorganisms

Plants

digitalis and digoxin are extracted from the foxglove plant

drugs used to strengthen heart alongside modern drugs

aspirin painkiller extracted from willow tree bark

Felix Hoffman synthesised aspirin

drug works better

has fewer side effects

anti-inflammatory

Microorganisms

Discovering Penicillin

in 1928, Alex Flemming was growing bacteria and he left the lid off his culture dishes

he notices some of the culture plates had mould growing on them

the mould spots had rings of clear jelly around it

a substance had killed the bacteria

he called it 'penicillin' after the Penicillium mould that produced it

Alex Fleming tried to extract the active juice from the mould but failed

10 years after discovery, Ernest Chain and Howard Florey successfully extracted penicillin

they tested penicillin on a infected patient and cured him

showed penicillin could cure bacterial diseases in humans

working with Pfizer company, penicillin was produced on an industrial scale

used in WW2 to save lives and is still used today

first discovered antibiotic

Future Medicines

promising compounds can be modified to be more effective

Noni Fruit

used in traditional medicine in Costa Rica

treats infections and non-communicable diseases

used for food and drink with no health issues

research shows it has antibiotic properties

Soil Microorganisms

global soil samples taken to find antibiotic microorganisms

only 1% soil microorganisms can be cultured in lab

in 2015, a new antibiotic discovered from some soil bacteria

has destroyed all antibiotic resistant bacteria so far (Inc. MRSA)

special technology needed

Development

new medical drugs are tested extensively for efficacy(effectiveness), toxicity and dosage

drugs should be effective at curing the disease or relieving symptoms

safe(non-toxic) for patients and with no unacceptable side effects

stable drugs to be taken in normal conditions and stored for some time

can be taken in to reach its target, and removed easily out of the body

developing a new drug can take 12 years and cost $1700B including £failures

Preclinical Testing

many possible drugs are tested on cells, tissues and organs in the lab

tests for toxicity and efficacy

5000 -10000 compounds

10-20 drugs are then tested on small animals and then larger animals

see how they work in living organisms

information on possible side effects

preclinical testing is used as models to predict drug behaviour in humans

Clinical Trials

low dosages are given to healthy human volunteers

checks for safety and side effects

if drug is safe, it is trialled on a small no. of patients

to find out its efficacy (if it treats the disease)

if safe and effective, bigger trials with higher dosages on patients take place

to find the optimum drug dosage

Licensing

if a drug pasts all the legal tests, it is licensed

drug safety is still monitored throughout its use

Double Blind Trials

in patient trials, double blind trials are used to verify the genuine efficacy

some patients are given the drug and some a placebo

a placebo doesn't contain the new tested drug

placebo may contain an existing drug which treats the disease

so patient is not deprived of treatment

patients are randomly allocated to different groups

neither doctor nor patient knows who is given drug or placebo

rules out any biased judgement

patients health is monitored carfully

drug testing results are published like scientific research

results scrutinised by peer review

other scientist can check results for fake claims

national bodies (National Institute for health and Care Excellence NICE) look at published results

decide on good value drugs to invest into NHS

doctors can prescribe the drug

Monoclonal Antibodies

many chemicals fail at this stage

takes 4.5 years

takes 1.5 years

tests 5-10 compounds

takes 1.5 years

tests 2-5 compounds

takes 2.5 years

tests 1-2 compounds

takes 1.5 years

takes 1.5 years

monoclonal antibodies are a form of medical treatment using the immune system

Production

mouse lymphocytes are stimulated to make a particular antibody

proteins made to target particular cells or chemicals in the body

antibodies produced from a single clone of cells

hybridoma cells

combines antibody-specific lymphocytes and tumour cells

B lymphocytes naturally produce antibodies but cannot divide

so can't be used to produce antibodies for medicines

tumour cells divide rapidly but don't make antibodies

makes a clone of cells

mouse lymphocyte combined with a tumour cell to make a hybridoma

single hybridoma cells divide to make clones of the cell

large no. of identical cells that all produce the same antibodies

monoclonal antibodies are collected and purified to be used

recently, mice cells are also combined with human cells

produces monoclonal antibodies less likely to be rejected by humans

antibodies are specific to one binding site of a specific antigen

cell surface protein molecules or free protein molecules act as antigens

antibody may only be found on specific body cell or specific chemical

Uses

Pregnancy Tests

antibodies bind to the HCG hormone (human chorionic gonadotrophin)

hormone is produced in early pregnancy

small amount of the hormone are passed out in the urine

produces a colour change indicating HCG presence

Disease Diagnosis

antibodies bind to specific antibodies on a pathogen, blood clot or cancer cell

monoclonal antibodies may carry markers for easy build up detection

allows for early disease detection

used in blood test for prostate cancer

monoclonal antibodies used to detect plant, animal and human diseases

Measuring and Monitoring

monitors the levels of hormones and other chemicals in the blood for diagnosis

used in screening donated blood for HIV infection

detecting illegal drugs taken by athletes

detecting syphilis infections

Research

scientists can locate specific molecules in a cell or tissue

markers of fluorescent dye are added to antibody

build of fluorescence observed where desired molecule is

Disease Treatment

monoclonal antibodies may be the 'magic bullet' drug targeted at specific pathogens and disease

some are developed to target specific antigens on certain cancer cells

some trigger the immune system to recognise, attack and destroy cancer cells directly

some block receptors on cancer cells, removing stimulus to grow and divide

monoclonal antibody binds to the receptor site

growth-stimulating molecule can no longer bind to cancer cell

some carry toxic drugs, radioactive substances or growth inhibiting chemicals directly to cancer cell

attached chemicals or radioactivity kills the cancer cell

monoclonal antibody binds to antigen on cancer cell

monoclonal antibody bind to specific antigen on cancer cell

signals to the immune system by making the cancer cell more noticeable

other healthy body cells not harmed

Advantages

only binds to specific diseased cells that need treatment

healthy cells are not affected

very specific so could treat a wide range of condtions

conventional cancer treatment carries drugs around the body, damaging other body cells

radiotherapy cancer treatment is area targeted but still affects healthy cells nearby

Disadvantages

not as widely used yet as originally hoped

expensive to develop and produce

side effects due to human immune response to mouse antibodies

using mouse-human hybridomas could reduce side effects

only using fractions of antibodies to carry drugs

doctors are now prepared and ready to treat the side effect symptoms

producing the right monoclonal antibody and attaching them to drugs and chemicals is very difficult

but has potential to be cheaper to develop than conventional drugs