mAb inflammation Flashcards

(28 cards)

1
Q

what does tumor necrosis factor do

A

inflammatory mediator
increases tissue damage(apoptosis) and cellular proliferation and aggregation
regulation of immune cells and cytokine release

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

high concentration of TNK in synovial fluids in which conditions

A

rheumatoid arthritis
psoriatic arthritis
ankylosing spondylitis
psoriasis plaques

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

TNF are

A

a family of cytokines involved in regulatin gthe immune response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

role of TNF alpha in RA

A

proinflammatory cytokine cascade
triggers production of other proinflammatory cytokines
facilitates activation of T lymphocytes by foreign antigens
causes t cell accumulation in tissues and neutrophil accumulation in synovial fluid
stimulates fibroblasts and macrophages to release destructive enzymes
stimulates osteoclastogenesis through enhanced expression of RANKL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

3 TNF alpha antagonists

A

adalimumab
infliximab
etanercept

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

adalimumab approved for

A

RA
crohns
psoriatic arthritis
ankylosing spondylitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

humira MOA

A

recombinant monoclonal antibody that binds to human TNF alpha to prevent binding to receptor
doesnt block TNFbeta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

drug interactions with humira

A

kineret
methotrexate
live vaccines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

infliximib MOA

A

neutralizes biological activity of both soluble and transmembrane forms of TNFalpha by preventing binding to its receptor but doesnt neutralize TNF beta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

which is the only antiTNF given IV

A

infliximab

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

as a chimeric antibody infliximab is expected to have higher rates of

A

immunogenicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

patients with antidrug to antibodies to infliximab are more likely to

A

have higher rates of drug clearance
reduce efficacy
2x increased incidence of infusion reactions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

black box warning for infliximab

A

infection and malignancy risks

contraindication for high dose in heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

etanercept is a

A

dimeric soluble dusion protein composed of parts of the ligad binding regions of the p75 high affinity type 2 TNF receptor which binds TNF alpha and TNFbeta linked to parts of the IgG1 Fc regions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

entanercept MOA

A

fuses with TNKalpha and beta???? idk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

abatacept use

A

RA with inadequate response to DMARDS

17
Q

abatacept is a fusion protein consisting of…

A

the extracellular domain of CTLA4 and a modified Fc portion of IgG1
doesnt fix complement due to the modification of Fc portion

18
Q

abatacepy MOA

A

costimulation modulator that binds CD80 and CD86 and blocks their interaction with CD28 inhibiting T cell activation

19
Q

omalizumab is used for

A

allergic asthma

20
Q

omalizumab binds to

A

free IgE in the blood and interstitial fluid, membrane bound IgEon the surface ofB lymphocytes
doesnt bind to IgE that is already bound by the high affinity IgE receptor on mast cells and basophils

21
Q

main adverse effect of omalizumab

22
Q

natalizumab is a

A

recombinant humanized IgGK monoclonal antibody

first selective adhesion molcule inhibitor

23
Q

natalizumab is used for

24
Q

what are integrins

A

heterodimers of noncovalently associated glycoprotiens composed of alpha and beta
cell adhesion receptors involved in interactions between cell extracellular matrix and cell-cell interactions
main way cells bind to and respond to the extracellular matrix

25
expression of what 2 things are increased in MS
VCAM1 immunoglobulin | VLA3 transmembrane alpha4 integrin receptor
26
natalizumab MOA
binds to alpha 4 subunit of alpha4beta1 and alpha4beta7 integrins expressed on the surface of all leukocytes and competitively inhibits alha 4 subunit mediated adhesion of leukocytes to the adhesion molecules
27
how is natalizumab beneficial in MS
inhibits the migration of immune cells into the CNS | inhibits interactions between beta 4 integrins and its ligands
28
what is PML (reported in treatemtns with natalizumab)
opportunistic infection of the brain which leads to death or severe disability thus why natalizumab is only availble through a restricted distribution program