Immune therapies & Transplantation Flashcards Preview

Path (AJC) > Immune therapies & Transplantation > Flashcards

Flashcards in Immune therapies & Transplantation Deck (24):
1

Which cells to anti T cell monoclonal antibodies act on?

Resting T cells

2

Muromonab-CD3

Anti T cell
Blocks CD3
Used in active rejection

3

Basiliximab

Anti T cell
Blocks CD25 (in IL-2 Receptor)
Prevents rejection

4

Tocilizumab

Anti T cell
Blocks IL-6 Receptor
Used in Rheumatoid arthritis if anti-TNF drugs have failed (like Abatacept)

5

Abatacept

Anti T cell
Anti CTLA-4. Prevents costimulation of T cells.
Used in Rheumatoid arthritis if anti-TNF drugs have failed (like Tocilizumab)

6

Cyclophosphamide

Anti-proliferative
Alkylating agent
Affects B > T cells.
Used in multi-system connective tissues diseases (SLE)
and cancer.
SFX: Hair loss, sterility.

7

Azathioprine

Anti-proliferative:
Liver metablises to 6-mercaptopurine,
Blocks de novo purine synthesis.
Used in: inflam & AI disease, transplantation.

8

Mycophenelate mofetil

Anti-proliferative:
Blocks de novo nucleotide synthesis
Affects T > B cells.
Used in: AI disease, vasculitis, transplantation.

9

Tacrolimus and Ciclosporin

Inhibit calcineurin (cell signalling), lowering IL-2 transcription.
Used for rejection prophylaxis in transplantation, with sirolimus.

10

Sirolimus

Blocks clonal proliferation (by stopping cell signalling).
Used for rejection prophylaxis in transplantation, with tacrolimus and ciclosporin.

11

Prednisolone

Corticosteroid: inhibits Phospholipase A2:
- lowers Platelet Activating Factor
- lowers Arachidonic Acid
- less trafficking of phagocytes
- lymphopaenia (apoptosis of T and B cells)
Used as anti-inflam and in AI disease.

12

Plasmapheresis

Replace 50% of plasma.
Used in Goodpasture's, inflam and AI disease.
(Rebound Ab production limits efficacy.)

13

Infliximab

anti-TNF-alpha
Used for psoriasis, Crohns, RA ...

14

Ustekinumab

anti-IL-12/23
Binds to p40 subunit of IL-12 and IL-23.
Used in psoriasis.

15

Riuximab

anti-CD20
Decreases B cells (expressed until maturity, so doesn't affect plasma cells).
Used for lymphoma and AI disease.

16

Methotrexate

Inhibits DHFR, so stops DNA synthesis.
Uses:
- AI disease: RA, psoriasis, Crohns ...
- Cancer
- Termination of pregnancy
Teratogenic and hepatotoxic.

17

Alemtuzumab

anti-CD52,
depletes lymphocytes
Used in CLL.
Susceptibility to CMV.

18

Hyperacute transplant rejection

Minutes - hours.
Preformed Abs activate complement, causing
thrombosis and necrosis.
Prevent by HLA matching.

19

"Acute" cellular transplant rejection

Weeks - months.
CD4, so type IV hypersensitivity,
cellular infiltrate.
Tx: T cell immunosuppression

20

"Acute" antibody mediated transplant rejection

Weeks - months.
B cell activation;
Abs attack vessels: Vasculitis, C4d.
Tx: Ab removal and B cell suppression.

21

Chronic transplant rejection

Months - years.
Immune and non-immune mechanisms.
Leads to fibrosis.
Tx: minimise organ damage.

22

Graft versus Host Disease

Days - weeks.
Donor immune cells attack host body cells.
Rash, bloody diarrhoea, vomiting, jaundice.

23

CDC, FACS, Luminex

- Complement Dependent Cytotoxicity,
- Flow Assisted Cell Sorting Cytometry,
- Luminex is a sort of solid phase FACS.
All to check presence of Ab against ABO.

24

Pre-transplant induction

Suppress T cells
eg. Alemtuzumab (a-CD52) or Basiliximab (a-CD25)