Flashcards in mAb inflammation Deck (28)
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1
what does tumor necrosis factor do
inflammatory mediator
increases tissue damage(apoptosis) and cellular proliferation and aggregation
regulation of immune cells and cytokine release
2
high concentration of TNK in synovial fluids in which conditions
rheumatoid arthritis
psoriatic arthritis
ankylosing spondylitis
psoriasis plaques
3
TNF are
a family of cytokines involved in regulatin gthe immune response
4
role of TNF alpha in RA
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
5
3 TNF alpha antagonists
adalimumab
infliximab
etanercept
6
adalimumab approved for
RA
crohns
psoriatic arthritis
ankylosing spondylitis
7
humira MOA
recombinant monoclonal antibody that binds to human TNF alpha to prevent binding to receptor
doesnt block TNFbeta
8
drug interactions with humira
kineret
methotrexate
live vaccines
9
infliximib MOA
neutralizes biological activity of both soluble and transmembrane forms of TNFalpha by preventing binding to its receptor but doesnt neutralize TNF beta
10
which is the only antiTNF given IV
infliximab
11
as a chimeric antibody infliximab is expected to have higher rates of
immunogenicity
12
patients with antidrug to antibodies to infliximab are more likely to
have higher rates of drug clearance
reduce efficacy
2x increased incidence of infusion reactions
13
black box warning for infliximab
infection and malignancy risks
contraindication for high dose in heart failure
14
etanercept is 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
15
entanercept MOA
fuses with TNKalpha and beta???? idk
16
abatacept use
RA with inadequate response to DMARDS
17
abatacept is a fusion protein consisting of...
the extracellular domain of CTLA4 and a modified Fc portion of IgG1
doesnt fix complement due to the modification of Fc portion
18
abatacepy MOA
costimulation modulator that binds CD80 and CD86 and blocks their interaction with CD28 inhibiting T cell activation
19
omalizumab is used for
allergic asthma
20
omalizumab binds to
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
main adverse effect of omalizumab
anaphylaxis
22
natalizumab is a
recombinant humanized IgGK monoclonal antibody
first selective adhesion molcule inhibitor
23
natalizumab is used for
MS
24
what are integrins
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