6.3 Defence Against Infectious Disease

Lupus is an autoimmune disease in which the immune system will produce autoantibodies against the body's own tissue. This results in a variety of symptoms, including inflammation of the skin and organs to more serious ones such as organ failure and strokes.

Compare and contrast an autoimmune response to the immune response against a pathogen.

The symptoms of lupus can get progressively worse over time.

Based on your knowledge of lymphocytes, suggest a reason for this.

There are a variety of ways to treat lupus. One form of treatment involves administering immunosuppressive drugs which prevents the activation of lymphocytes.

Explain the impact that this form of treatment could have on a lupus patient.

T-cells are another type of white blood cell that can help the body fight against infections. Instead of producing antibodies, T-cells will bind to the surface of infected or defective cells and destroy them directly. This ability has been harnessed in a new type of cancer treatment known as chimeric antigen receptor (CAR) T cell therapy.

During CAR T cell therapy, normal T cells from the patients blood are modified to enable them to bind to cancer cells with the help of cell surface receptors. The following diagram shows the treatment process of CAR T cell therapy.

Contrast the differences between a normal T cell (stage 1 of the diagram) and a CAR T cell (stage 3 of the diagram).

Using the information in the diagram in part a), suggest how CAR T cell therapy facilitates in the treatment of certain cancers.

Traditional forms of cancer treatment include chemotherapy during which toxic chemicals are inserted into the blood stream of a patient. These chemicals will circulate through the body and kill any fast-dividing cells, which often leads to uncomfortable side effects such as hair loss, nausea and skin rashes. The chemicals used during chemotherapy are broken down by the body and therefore have a short-lived effect, requiring patients to receive multiple treatments on a regular basis in order to be effective.

Based on the information provided and your knowledge of the immune system, suggest two advantages of CAR T cell therapy over chemotherapy.

B lymphocytes are a type of white blood cell. These lymphocytes produce antibodies in response to activation by the presence of an antigen on a pathogen.

The diagram below shows the appearance of a B lymphocyte before and after it has been activated.

Explain the changes that can be observed within the B lymphocyte when it is activated.

Rituximab is a type of antibody that is used to treat certain B lymphocyte cancers (leukaemia). It binds to the cell surface protein CD20 found on B-lymphocytes. Once the antibody binds to the protein it triggers cell death in the cancerous B-lymphocyte. Patients are given rituximab through a drip into a vein on a regular basis for the duration of their cancer treatment.

Based on your knowledge of the immune system, explain why patients would need regular infusions with rituximab.

When treating more aggressive forms of B lymphocyte cancer, rituximab is often combined with more traditional chemotherapies.

The graph below shows the results of a trial looking at the effects of several different treatments, alone and in combination, on B lymphocytes grown in the laboratory.

Rituximab on its own killed 23% of the B lymphocytes while when combined with hydroxyurea it killed 82% of B-lymphocytes in the laboratory.

Calculate the percentage effectiveness of using rituximab in combination with hydroxyurea compared to rituximab on its own. Show your working and give your answer to three significant figures.

A medical doctor concluded that drug combinations are a more effective cancer treatment for human patients than any of the drugs used alone.

Use the information from part c) to evaluate this conclusion.

One mark is available for clarity of communication throughout this question.

Phagocytes and lymphocytes play an important role in the immune system of the body.

Compare and contrast the role of phagocytes and lymphocytes in the immune system.

Certain species of bacteria may develop resistance to antibiotics over time.

Outline the development of antibiotic resistance in a bacterial population.

Outline the difference between antibodies and antigens.

The human immunodeficiency virus (HIV) can cause an immune response in its host.

Describe and explain the effect of HIV on the immune system.

Rhinoviruses that cause the common cold may be destroyed by phagocytosis when they enter a human body.

Describe how this occurs.

Vaccinations often contain antigens. Scientists investigated whether having a fourth Covid-19 vaccination booster could increase antibody production by the immune system.

•  They divided a large number of mice into five groups.
• They injected the mice in each group with a different amount of COVID-19 antigens.
• The scientists then measured mean antibody production in the mice.

 The graph below shows their results.

Use the graph to describe the effect of COVID-19 antigens on mean antibody production.

Scientists investigated the presence of bacteria resistant to the antibiotic tetracycline in poultry and in the farmers who kept them. They looked for Escherichia coli (E.coli) resistant to tetracycline. The scientists took samples of faeces from the poultry birds and the farmers. Turkey farmers often used food containing tetracycline, whereas chicken farmers did not very often.

The bacteria were grown on nutrient agar containing tetracycline. Resistant bacteria grew and were visible as colonies on the agar plates.

The results are shown in the table below.

 Suggest a hypothesis the farmers were testing in this investigation.

Describe the results of the scientists’ investigation described in part (a).

Scientists investigated treatment of a human respiratory infection caused by a species of bacterium. This species of bacterium is often resistant to the antibiotics currently used for treatment. They investigated the use of a new antibiotic to treat the respiratory infection. The new antibiotic blocks DNA replication in bacterial cells.

The scientists tested the new antibiotic on mice with the same respiratory infection.  The antibiotics were given to the mice at a dose of 25 mg kg⁻¹ per day.

Calculate how much antibiotic would be given to a 33 g mouse each day.

The antibiotic tetracycline is used to treat human bacterial infections such as pneumonia and other respiratory tract infections.  This antibiotic is safe to use in humans as it does not inhibit or block processes such as DNA replication, ribosome function, transcription or translation.

Suggest why these processes are not inhibited in humans but can be in bacteria.

The diagram shows a human immunodeficiency virus (HIV).

Suggest, with a reason, which labelled component of the virus is most likely to act as an antigen.

HIV is described as a retrovirus. 

Describe what is meant by the term retrovirus.

Antibiotics are not used to treat viral infections, such as HIV.

Explain why.

Misuse of antibiotics can cause antibiotic resistance.

 Outline two ways to prevent antibiotic resistance.

One mark is available for clarity of communication throughout this question.

Howard Florey and Ernst Chain carried out experiments on mice and humans in the 1930s to test the effectiveness of penicillin.

Describe Florey and Chain’s experimental method for testing penicillin on mice.

Florey and Chain’s experiments involved some risks.

Outline the risks involved in their experiments.

Compare and contrast current drug testing protocols with Florey and Chain’s experiments.