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CP > Immunomodulation > Flashcards

Immunomodulation Flashcards

1
Q

Definition of immunomodulation

A

Act of manipulation the immune system using immunomodulatory drug to achieve a desired immune response

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2
Q

Effects of immunomodulation

A

Immunopotentiation
Immunosuppression
Induction of immunological tolerance

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3
Q

Definition of immunomodulators

A

Medicinal products produced using molecular biology techniques including recombinant DNA technology

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4
Q

Main classes of immunomodulators

A

Substances (nearly) identical to the body’s own key signalling proteins
Monoclonal antibodies
Fusion proteins

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5
Q

Forms of immunopotentiation

A

Immunisation (both active and passive)
Replacement therapies
Immune stimulants

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6
Q

Passive immunisation

A

Transfer of antibodies e.g. naturally in breastmilk, or artificially from donor. Immediate but transient protection

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7
Q

Problems with passive immunisation

A 
Risk of virus transmission
Serum sickness (type III immune response)
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8
Q

Types of passive immunisation

A 
Pooled specific human immunoglobulin
Animal sera (antitoxins and antivenoms)
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9
Q

Uses of passive immunisation

A

Hep B prophylaxis and treatment

Botulism, VZV (pregnancy), diphtheria, snake bites

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10
Q

Active immunisation

A

Stimulation of the development of a protective immune reponse and immunological memory

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11
Q

Immunogenic material for active immunisation

A

Weakened pathogens
Killed inactivated pathogens
Purified materials (e.g protein, DNA)
Adjuvants

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12
Q

Problems with active immunisation

A

Allergy to any vaccine component
Limited usefulness in immunocompromised
Delay in achieving protection

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13
Q

Replacement therapies and immune stimulation

A

Pooled human immunoglobulin
G-SCF/GM-SCF
alpha-interferon
gamma-interferon

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14
Q

Pooled human immunoglobulin

A

Delivered IV or SC

Used in Rx of antibody deficiency states

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15
Q

G-CSF/GM-SCF

A

Act on bone marrow to increase production of mature neutrophils

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16
Q

alpha-interferon

A

Main use in treatment of Hep C, now superseded by new treatments

17
Q

gamma-interferon

A

Can be useful in treatment of certain intracellular infection (atypical mycobacteria), also used in chronic granulomatous disease and IL-12 deficiency

18
Q

Forms of immunosuppression

A 
Corticosteroids
Cytotoxic agents
Anti-proliferative/activation agents
DMARDSs
Biological DMARDs
19
Q

Action of corticosteroids

A

Decreased neutrophil margination
Reduced protection of inflammatory cytokines
Inhibition phospholipase A2 (reduced arachidionic acid metabolites production)
Lymphopenia
Decreased T cell proliferation
Reduced immunoglobulin production

20
Q

Corticosteroid side effects

A

Carbohydrate and lipid metabolism (diabetes and hyperlipidaemia)
Reduced protein synthesis (poor wound healing)
Osteoporosis
Glaucoma and cataracts
Psychiatric complications

21
Q

Uses of corticosteroids

A

Autoimmune diseases (CTD, vasculitis, RA)
Inflammatory diseases (Crohn’s, sarcoid, GCA/polymyalgia rheumatica)
Malignancies (lymphoma)
Allograft rejection

22
Q

Drugs targeting lymphocytes

A

Antimetabolites (Azathioprine, Mycophenolate mofetil)
Calcineurin inhibitors (Cyclosporin A, Tacrolimus)
M-TOR inhibitors (Sirolimus)
IL-2 receptor mABs (Basiliximab, Daclizumab)

23
Q

Calcineurin inhibitors

A

Prevents activation of NFAT (factors which stimulate cytokine gene transcription)
Reversibly inhibits T-cell activation, proliferation and clonal expansion

24
Q

Clinical use of calcineurin inhibitors and mTORs

A

Allograft rejection after transplant

Autoimmune

25
Q

Cytotoxic drugs

A

Methotrexate (folate antagonist)

Cyclophosphamide (cross-link DNA)

26
Q

Allergy immmunomodulators

A

Immune suppressors such are steroids
Allergen specific immunotherapy
Anti-IgE monoclonal therapy
Anti-IL-5 monoclonal treatment

27
Q

Allergen specific immunotherapy

A

SC or sublingual administration of allergen
Over time, development of T reg cells and tolerance
Side effects: localised and systemic allergic reactions

CP (19 decks)

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