Flashcards in 12 Immunotherapeutics Deck (24):
Manipulating the immune system using immunomodulatory drugs to achieve the desired response.
What are the three types of immunopotentiation?
What are the types, and risks of passive immunisation?
Pooled specific human immunoglobulin.vAnimal sera (antitoxins as antivenins).
Risk of viral transmission and serum sickness.
Why are adjuvants needed in active immunisation?
Stimulates the desired immune response type e.g. predominantly antibody vs cytokine response.
Name 5 therapies using immune stimulation
G-CSF/GM-CSF - neutrophil production
IL-2: stimulates T cell activation.
α-interferon: Hep C
β-interferon: MS therapy.
γ-interferon: CGD, atypical mycobacteria infection.
How do corticosteroids work? (6)
Less neutrophil margination.
Less cytokines produced.
Inhibition of phospholipase A2 (less arachidonic acid derivatives.
Decreased T cell proliferation.
Reduced immunoglobulin production.
Side effects of corticosteroids. (6)
Diabetes and hyperlipidaemia.
Poor wound healing.
Glaucoma and cataracts.
What are the 4 types of lymphocyte targeting drugs?
IL-2 receptor mABs.
Name two calcineurin inhibitors. How do they work?
Ciclosporin A (CyA) - binds to cyclophilin.
Tacrolimus (FK506) - binds to FKBP-12.
Prevents NFAT activation (cytokine gene transcription). Inhibit T cell activation, proliferation and expansion.
Name an M-TOR inhibitor.
How does it work?
When is it used?
Binds to FKBP12, inhibits IL-2 response. Arrests T cell cycle at G1-S phase.
Transplantation and AI diseases.
Name 4 cytotoxics/ antimetabolites. How do they work?
Azathioprine (AZA) - guanine anti-metabolite.
Mycophenolate mofetil (MMF) - inhibits IMPDH.
Methotrexate (MTX) - folate.
Cyclophosphamide - cross links DNA.
Impact DNA production, prevents proliferation of B and T cells
What are the side effects of cytotoxics/antimetabolites? (4).
Bone marrow suppression, gastric upset, hepatitis, infection susceptibility.
Cyclophosphamide - cystitis.
MTC - pneumonitis.
What are the uses of AZA/MMF (cytotoxics)? (2).
What are the uses of methotrexate (cytotoxic)? (5).
Graft vs host disease in bone marrow transplant.
What are the uses of cyclophosphamide (cytotoxic)? (2).
Name two examples of IL-2 receptor monoclonal antibodies.
What are DMARDs used for?
Disease-modifying anti rheumatic drugs.
Which anti-cytokines are used as DMARDs? Risks?
Anti TNF. TB risk.
Anti-IL-6 (tocilizumab). Serum lipid control risk.
Anti-IL-1 (anakinra, rilonacept, canakinumab).
How does Rituximab function?
What is it used for? (4).
Chimeric mAb against CD20 on the B cell surface. This kills all cells with autoantibody and allows repopulation.
Lymphomas, leukaemias, transplant population, autoimmune disorders.
Name two types of adoptive immunotherapy.
Bone marrow transplant.
Stem cell transplant.
What types of immunomodulators are used in allergy? (4).
Allergen specific immunotherapy.
Anti-IgE monoclonal therapy.
Ant-IL-5 monoclonal treatment.
When is allergen specific immunotherapy indicated?
How does it work? (2).
Uncontrollable allergic rhinoconjuctivis.
Anaphylaxis to insect venoms.
Switches response from Th2 to Th1. Development of Treg cells and tolerance.
What is omalizumab?
Rx for? (3)
Possible side effect?
mAb against IgE.
Rx for asthma, chronic urticaria and angiodema.
Severe systemic anaphylaxis.