Immunology 7 - Immune-modulating therapies 1 & 2 Flashcards Preview

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Flashcards in Immunology 7 - Immune-modulating therapies 1 & 2 Deck (44)
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1

By what mechanism can B cells provide immunological memory?

High affinity IgG remains circulating in blood

2

What is the best predictor of immunity to influenza following a vaccine?

IgG against haemaglutinnin (moreso than CD8 T cells)

3

Why is adjuvant used in some vaccines?

It stimulates an innate immune response

4

Describe the process of antibody replacement in patients with a B cell immunodeficiency

1. Prepare from a pool of donors
2. Infusion will contain IgG to a wide range of unspecified organisms
3. Administer either IV or subcutaneously

5

What does PEP for HIV contain?

Specific immunoglobulin for HIV

6

Give 2 examples of where adaptive cell transfer can be used as a therapy

1. In EBV-related B cell lymphoma, can use virus-specific T cells
2. In other haematological malignancies, can use T cell replacement and CAR T cell therapy

7

What monoclonal antibody can be used in melanoma treatment?

Ipilimumab (anti-CDL4)
This blocks an immune checkpoint --> enhanced T cell response

8

In what disease can IFN gamma be given therapeutically?

Chronic granulomatous disease

9

In what disease can IL2 be given therapeutically?

Renal cell carcinoma
IL-2 expands NK and T cell responses via the IL-2 surface receptor

10

In what diseases can INF alpha be given therapeutically?

CML
Multiple myeloma

11

How do steroids inhibit the immune response?

Inhibit PLA2 which is a key enzyme in prostaglandin formation
Also decrease phagocyte trafficking (hence there is a transient increase in neutrophil count)

12

Recall 3 examples of anti-proliferative agents

Cyclophosphamide
Azothioprine
Mycophenalate

13

What is the mechanism of action of cyclophosphamide?

Alkylation of guanine --> inhibition of DNA synthesis

14

What is the mechanism of action of azothioprine?

Anti-metabolite to purine

15

What must always be checked before prescribing azothioprine?

TPMT activity

16

How can plasma exchange be used to treat autoimmune diseases?

Removes problematic antibody
Need to give alongside an antiproliferative agent
Only for severe disease

17

How do calcineurin inhibitors work?

Calcineurin causes an upregulation of IL2 - inhibition of this allows cell proliferation

18

Give an example of a calcineurin inhibitor?

Ciclosporin

19

Give 2 diseases in which JAK2 inhibitors can be useful?

Rheumatoid and psoriatic arthritis

20

By what mechanism do PDE4 inhibitors work, and in what disease are they useful?

Inhibition of PDE4 --> inceased cAMP
cAMP modulates cytokine production
--> fewer cytokines
Useful in psoriasis

21

Recall 2 immune-modulating therapies that are useful in the prophylaxis of allograft rejection

Anti-thymocyte globulin
Anti-CD25

22

Wha type of antibody is rituximab?

Anti-CD20

23

What monoclonal antibody can be used in IBD treatment?

Vedolizumab
Anti - alpha4beta7 integrin

24

What is infliximab?

Anti-TNF alpha

25

What monoclonal therapy can be used in osteoporosis?

anti-RANK/RANK-ligand
Denosumab

26

What is the mechanism of action of tofacitinib

JAK inhibition

27

What is the mechanism of action of apremilast?

Anti-PDE4

28

What is the mechanism of action of basilixumab?

Anti-CD25 (alpha chain of interleukin 2)

29

What is the mechanism of action of Abatacept?

Anti-CTLA4

30

What is the mechanism of action of rituximab?

Anti-CD20

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