Immunotherapy

Question 1

What is direct immunotherapy

Answer 1

Ab or Ab fragments that detect an antigen on tumour cell and destory by delivering toxin or recruiting immune cells

Question 2

What are examples of direct immunotherapy

Answer 2

Monoclonal Ab
CAR T cells
Bispecific Ab

Question 3

What is indirect immunotherapy

Answer 3

Immune system is activated so able to seek and destroy tumour cell

Question 4

What are examples of indirect immunotherapy

Answer 4

Tumour vaccine 
Dendritic cell vaccine
Adoptive cell transfer
Cytokine therapies 
Checkpoint inhibitor therapies 
Mediator antagonista - block mediates of inflammation e.g. H1 blocker (anti-histamine) 
Stimulatory antibodies

Question 5

What are cytokines

Answer 5

IL
Interferon
TNF

Question 6

What is cytokine therapy

Answer 6

Immunomodulatory cytokines used to activate anti-tumour

or inhibit harmful cytokines e.g. in RA or septic shcok

Question 7

Examples of cytokine therapy

Answer 7

Pegylated IFN-a - antitumour and antiviral

IFNy in chronic granulomatous to increase killing

Question 8

What is adaptive immunity

Answer 8

Vaccine

Specific and provoke memory

Question 9

What is passive immunity

Answer 9

Human Ig extracted from range of donor
Only IgG
No memory but immediate protection
My get serum sickness / anaphylaxis if Ig recognised as foreign

Question 10

What do you give HNIG for prophylaxis

Answer 10

Hep A
Measles
Polio
Rubella

Question 11

What do you give specific Ig for prophylaxis

Answer 11

Hep B
Rabies
Tetanus
VZV

Question 12

What is intravenous Ig key in treating

Answer 12

Immunodefinceiy disorders
PID
IgG deficiency 
MM / CLL
Children with HIV
GBS
Allogenic bone marrow transplant
Autoimmune - Kawasaki / ITP / GVHD / vasculitis / myasthenia gravis / SLE

Question 13

What are the complications of Ig

Answer 13

Adverse reaction

Transmission of infection

Question 14

What is rituximab and what is it used in

Answer 14

Monoclonal Ab against CD20 on B cell
1st line in NHL
Used to treat RA + SLE

Question 15

What in infliximab

Answer 15

Anti TNF-a (pro-inflammatory cytokines)
RA
AS
IBD

Question 16

What is tratuzumab / Petruzumab

Answer 16

Binds HER2 on cancer cell and marks for destruction

Rx metastatic breast cancer

Question 17

When is plasma exchange used

Answer 17

Autoimmune diseases which involve formation of autoantibodies or immune complexes
Myasthenia graves
Anti-GBM
Vasculitis
Use in combination with immunosuppression

Question 18

What are CAR T cells

Answer 18

T cells expressing CAR directed at same antigen which increases trafficking of immune system to the tumour site
Need to identify tumour antigen

Question 19

What do dendritic cell vaccines do

Answer 19

Take blood sample of patient
Culture cells with cytokines that promote APC function
Transfusion of APC after uptake of tumour antigen

Question 20

What are examples of immunsoupresion

Answer 20

Corticoisteroid
Azathioprine
Cyclophosphamide 
Cyclosporin
Tacrolimus
Sirolimus
MMF

Question 21

What do corticosteroids do

Answer 21

Affect T and B cell function

Anti-inflammatory as stops cytokines etc

Question 22

What does azathioprine / cyclophosphamide do

Answer 22

Inhibit DNA synthesis + suppress B cell activity
Little anti-inflammation
Use in combination with steroid

Question 23

What does cyclosporin, sirolimus and tacrolimus do

Answer 23

Calcineurin inhibitor
Down regulation of IL-2 which is released in inflammation
Suppression Th and NK cells

Question 24

What does MMF do

Answer 24

INhiibts purine synthesis
Prevent T cell and Ab production
Used in transplant rejection / Systemic diseases

Question 25

What are SE of cyclosporin

Answer 25

Everything increased 
Nephrotoxicty
Hepatotoxity 
Fluid retention
High BP
Hyperkalaemia
Hypertrichosis 
Gingival hyperplasia 
Tremor
Impaired glucose - high 
Hyperlipid
Increased infection