12 Immunotherapeutics Flashcards Preview

Clinical Pathology > 12 Immunotherapeutics > Flashcards

Flashcards in 12 Immunotherapeutics Deck (24)
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1
Q

Define immunomodulation.

A

Manipulating the immune system using immunomodulatory drugs to achieve the desired response.

2
Q

What are the three types of immunopotentiation?

A

Immunisation.
Replacement therapies.
Immune stimulants.

3
Q

What are the types, and risks of passive immunisation?

A

Pooled specific human immunoglobulin.vAnimal sera (antitoxins as antivenins).
Risk of viral transmission and serum sickness.

4
Q

Why are adjuvants needed in active immunisation?

A

Stimulates the desired immune response type e.g. predominantly antibody vs cytokine response.

5
Q

Name 5 therapies using immune stimulation

A
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.
6
Q

How do corticosteroids work? (6)

A
Less neutrophil margination.
Less cytokines produced.
Inhibition of phospholipase A2 (less arachidonic acid derivatives.
Lymphopenia.
Decreased T cell proliferation.
Reduced immunoglobulin production.
7
Q

Side effects of corticosteroids. (6)

A
Diabetes and hyperlipidaemia.
Poor wound healing.
Osteoporosis.
Glaucoma and cataracts.
Psychiatric complications.
8
Q

What are the 4 types of lymphocyte targeting drugs?

A

Antimetabolites/ cytotoxics.
Calcineurin inhibitors.
M-TOR inhibitors.
IL-2 receptor mABs.

9
Q

Name two calcineurin inhibitors. How do they work?

A

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.

10
Q

Name an M-TOR inhibitor.
How does it work?
When is it used?

A

Sirolimus (rapamycin).
Binds to FKBP12, inhibits IL-2 response. Arrests T cell cycle at G1-S phase.
Transplantation and AI diseases.

11
Q

Name 4 cytotoxics/ antimetabolites. How do they work?

A

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

12
Q

What are the side effects of cytotoxics/antimetabolites? (4).
Cyclophosphamide specifically?
MTC?

A

Bone marrow suppression, gastric upset, hepatitis, infection susceptibility.
Cyclophosphamide - cystitis.
MTC - pneumonitis.

13
Q

What are the uses of AZA/MMF (cytotoxics)? (2).

A

Autoimmune diseases.

Allograft rejection.

14
Q

What are the uses of methotrexate (cytotoxic)? (5).

A
Rheumatoid arthritis.
Psoriatic Arthritis.
Polymyositis.
Vasculitis.
Graft vs host disease in bone marrow transplant.
15
Q

What are the uses of cyclophosphamide (cytotoxic)? (2).

A

Vasculitis.

SLE.

16
Q

Name two examples of IL-2 receptor monoclonal antibodies.

A

Basiliximab.

Daclizumab.

17
Q

What are DMARDs used for?

A

Disease-modifying anti rheumatic drugs.

Rheumatoid Arthritis.

18
Q

Which anti-cytokines are used as DMARDs? Risks?

A

Anti TNF. TB risk.
Anti-IL-6 (tocilizumab). Serum lipid control risk.
Anti-IL-1 (anakinra, rilonacept, canakinumab).

19
Q

How does Rituximab function?

What is it used for? (4).

A

Chimeric mAb against CD20 on the B cell surface. This kills all cells with autoantibody and allows repopulation.
Lymphomas, leukaemias, transplant population, autoimmune disorders.

20
Q

Name two types of adoptive immunotherapy.

A

Bone marrow transplant.

Stem cell transplant.

21
Q

What types of immunomodulators are used in allergy? (4).

A

Immune suppressants.
Allergen specific immunotherapy.
Anti-IgE monoclonal therapy.
Ant-IL-5 monoclonal treatment.

22
Q

When is allergen specific immunotherapy indicated?

How does it work? (2).

A

Uncontrollable allergic rhinoconjuctivis.
Anaphylaxis to insect venoms.

Switches response from Th2 to Th1. Development of Treg cells and tolerance.

23
Q

What is omalizumab?
Rx for? (3)
Possible side effect?

A

mAb against IgE.
Rx for asthma, chronic urticaria and angiodema.
Severe systemic anaphylaxis.

24
Q

What is mepolizumab
What does it do?
When is it used?

A

mAb against IL-5.
Prevents eosinophil recruitment and activation.
Asthma (limited effect).

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