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Semester Three > IIH L22-L27 Clinical Immunology Block > Flashcards

IIH L22-L27 Clinical Immunology Block Flashcards

1
Q

What are polyclonal antibodies? L22

A

ABs secreted by different B cell lineages

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2
Q

What are monoclonal antibodies? L22

A

ABs secreted by a single cell lineage

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3
Q

Example of monoclonal antibody? L22

A

Muromomab (anti-CD3)

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4
Q

Advantages of clonal antibodies over natural antibodies? L22

A

High specificity

Relatively long half-life

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5
Q

What are Antibody Drug Conjugates (ADCs)? L22

A

Highly potent chemotherapy agents are attached to an antibody and given to a pt. This increases the dose of drug that can be given while reducing toxicity.

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6
Q

What is Adoptive Cell Therapy (ACT)? L22

A

T cells are taken from a pt’s blood or tumour, and expanded in the lab to large numbers using cytokines. The T cells are then infused back into the pts and the tumour may be destroyed.

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7
Q

Three types of transplants? L23

A

Autologous- from the same pt
Allogeneic- from a different person
Xenogeneic- from an animal

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8
Q

3 class-I HLA antigens? L23

A

HLA-A
HLA-B
HLA-C

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9
Q

3 class-II HLA antigens? L23

A

HLA-DR
HLA-DP
HLA-DQ

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10
Q

How many sets of HLA antigen do we have? L23

A

Two; one from mother and one from father

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11
Q

What is the chance two siblings will be ‘HLA-identical’? L23

A

25%

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12
Q

HLA antigens are important in transplantation because…

L23

A

They mediate T cell rejection of the organ

They are major targets for AB mediated rejection of a graft

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13
Q

Define minor histocompatibility molecules. L23

A

Any other polymorphic molecule which can be recognised by T cells
E.g. H-Y antigens can mediate rejection of organs derived form men transplanted into women

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14
Q

What is Graft vs Host Disease (GvHD)? L23

A

The transferred T cell immunity attacks the host

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15
Q

Do SCT pts have to take immunosuppressants permanently? L23

A

No as tolerance usually develops and they can permanently stop all immunosuppressants

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16
Q

HLA matching is more important for SOT or SCT? L23

A

SCT

17
Q

What is screened for SOT? L23

A

Antibodies in pt against the HLA molecules on the donor

Blood group antigen of the donor

18
Q

What is hyper-acute rejection? L23

A

Where antibodies bind to the graft and activate complement and destroy the graft within a few hours. Recipients are ABO blood group typed to prevent this happening.

19
Q

What is alloimmunisation? L23

A

Patients develop antibodies against HLA proteins which are non-self

20
Q

What is Acute allograft rejection? L23

A

Occurs within 7 days post transplant and is mediated by T cell rejection of the graft. Treated with high dose immunosuppressants.

21
Q

What is Chronic allograft rejection? L23

A

The adaptive immune system gradually rejects the kidney tissue or the vascular tissue supplying the kidney. T cells and macrophages are seen at the sit of organ injury.

22
Q

5 main types of HSCT? L23

A 
Autograft
HLA-identical sibling allograft
Matched Unrelated Donor (MUD) allograft
Haploidentical allograft
Cord blood allograft
23
Q

What is ‘conditioning’ and what is myeloablative?

A

Treating a pt with high dose chemotherapy before HSCT transplant. Myeloablative is when the conditioning completely destroys the haemopoeitic system.

24
Q

What is ‘engrafting? L23

A

Allowing space for the donor HSC to grow, achieved by conditioning

25
Q

How are grafts manipulated before transplant? L23

A

T cells removed to reduce the risk of GvHD

26
Q

Why is mild GvHD seen as a good sign? L23

A

It is also targeting the underlying cancerous cells (GvL)

27
Q

How do immunosuppressants work? L23

A

Inhibit T cell activation or block lymphocyte proliferation

28
Q

Examples of immunosuppressants? L23

A

Azathioprine
Cyclosporine A
Steroids (side effects at long term use)

29
Q

How are the alleles for MHC and HLA-antigens inherited and what are they called? L23

A

“en bloc”

The MHC haplotype/ HLA haplotype of that chromosome

Semester Three (12 decks)

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