| When
a Little Knowledge can be Dangerous
There is a growing trend in veterinary medicine today as pet owners
question the need for yearly vaccinations (see Parts 1
and 2 in this series).
It is a trend to check an animal’s titer to a vaccine on a
yearly basis. A titer is a blood test that measures the amount of
antibody in the blood to a given disease agent. So, for example,
a parvo titer would show the amount of antibody against parvovirus
that a dog has in her blood. Some diseases have been studied enough
that scientists know what level of antibody protects against that
disease, so this level is called a “protective titer.”
The problem with this approach is that low titers do not equate
with lack of protection, especially if measured several years after
the original vaccination.
As was mentioned in parts one and two of this series,
the practice of repeatly vaccinating an animal is neither a necessary
nor a healthy one. The evidence is strong that immunity persists
for years or for life from vaccines early in life, and the risk
of chronic illness is significantly increased with vaccine repetition.
So, if someone runs a titer test in place of vaccinating Spot, and
Spot’s titer is low, perhaps 6-8 years after his last vaccine,
the recommendation is likely to be “Spot needs another round
of vaccines to keep him safe.” I’d like to show that
this is a wrong line of thinking that will get a lot of animals
unnecessarily vaccinated, and therefore, at greater risk for developing
chronic disease.
Immunity 101
The immune system is a wonderful and complex entity, made of many
diverse parts, whose function is to decipher what is “self”
and what is foreign. It involves a number of organs, among them
the spleen, lymph nodes, tonsils, liver, thymus and bone marrow;
and a whole host of white blood cells with exotic names like “natural
killer cells,” T-Helper cells, and macrophages that do amazing
things to protect us (and our animals) against invaders. Many of
these cells elaborate toxic chemicals that kill invaders by oxidation,
or lyse them by punching holes in their membranes; other chemicals
call in various immune cells and set up the all important inflammatory
response that helps fight off the invader in general ways, like
mounting a fever.
One somewhat functional division has been made by
immunologists, whereby immunity is divided into two different components,
called
- Humoral immunity
- Cell mediated immunity
The humoral immunity is that which is mainly effected
by antibodies, large protein molecules that can engulf organisms
and make them either inactive or more susceptible to immune cell
attack. These antibodies originate from cells called B-lymphocytes,
and are carried through the blood on the surface of these same cells.
When a titer test is done, these antibodies are measured.
Cell mediated immune responses depend on a variety
of cells called T-lymphocytes, macrophages, NK cells, etc. These
are important not only in directly killing cancer cells or virally
infected cells, but in communicating to other aspects of the immune
system. This arm of the immune system can be studied, but typically
the assays of its function are expensive and relegated to research
labs. For instance, the activation of natural killer cells from
a resting base level is measurable. This is not something the average
consumer could afford to have done for an animal, however.
The immune system never uses only one of these parts
to respond to a foreign invader; there is a holistic response, with
overlap and communication between various cells, antibodies, and
chemicals. The result of the grand, organized concert of a well
balanced immune response is that the animal stays healthy, free
from foreign invaders, cancer cells, or self attack.
"You Must Remember This..."
The memory cells are worth a special mention. Originating from B-cells,
these hold a memory of a previously encountered germ, like distemper,
for instance. Whether they encountered this virus by natural exposure
or by vaccination, memory cells are long-lived and have a specific
memory about those foreigners they have encountered. If, years after
the animal has been exposed to distemper virus, there is another
exposure, these memory cells rapidly turn into plasma cells and
secrete antibodies against the recognized virus. And these antibodies
are measurable as a "rising titer." In fact, the diagnosis
of distemper is often confirmed by a titer that rises at least four-fold
from the beginning of the disease process to several weeks later.
An Incomplete Test
How is titer testing a mistake? It only measures one fraction of
the entire immune response, the antibodies produced against a particular
organism. While their presence indicates protection, there is no
reason for the immune system to keep producing antibodies against
an invader
forever, so, over time, these levels of antibody will wane. The
fight is finished, there's no more invader showing up, so there's
no need to keep a titer high. What is not measured by the titer
test is any part of the cell-mediated immunity, especially the memory
cells.
So, while antibody levels will wane over time, these
long-lived memory cells lie quietly in the recesses of the immune
system, awaiting further signals that the invader is back. It is
these cells that are responsible for the duration of immunity that
cannot be measured by a titer test.
So, if you want to measure titers, do so intelligently.
If you have vaccinated a puppy who may have been too young to respond
to the vaccine, a titer test could tell you if a response is present.
A previously vaccinated adult dog who has a gradually falling titer
over the years very likely still has immunity from the memory cells,
so don't forget that a titer test won't show this immunity. If you
equate a low titer in a vaccinated adult with a lack of immunity,
you could make a very costly mistake in your animal's health care,
by vaccinating again. See Vaccinations:Safety
for the correlation between chronic disease and repeated vaccinations.
And if protection against invaders is your ultimate
goal, then rather than vaccinating repeatedly, you would do far
better to strengthen the immune system. Transfer
Factor does this safely, simply, and surely,
in all species of animals, including Homo
sapiens. |