7- Therapeutics for managing the over-active immune response Flashcards
What is an immunomodulatory drug
Drug that stimulates/ supress the immune system
What does a ‘specific’ immunomodulatory drug do
Drugs targeted against a specific component of the immune system
Name 2 factors that the specificty of a specific immunomodulatory drug is determined by
Ability to bind to an immune protein to prevent interaction with a receptor
Ability to bind to a receptor without activating it effectively blocking it
Ability to inhibit inflammatory cytokines
Traditional we use high dose what as a 1st line treatment for immune suppression in dogs/cats with IMDs
Glucocorticoids (steroid treatment)
Name the most common glucocorticoids used in IMDs
Prednisolone
List 2 the effects of low dose (anti-inflammatory dose) glucocorticoids in IMDs
Inhibits release of pro inflammatory cytokines
Stabilises granulocyte cell membranes
In a high dose of glucocorticoids used for IMDs what is targeted?
Macrophage function - reduces phagocytosis of opsonised RBC & platelets
List an adverse effects of glucocorticoids use in IMDs
Iatrogenic hyperadrenocorticism (cushings)
Increased risk of thrombosis & thromboembolic disease
Immune suppression contributes to increased risk of bacterial infection
Needs to be withdrawn slowly or iatrogenic hypoadrenocorticism
Explain the steroid-sparing concept
additional immune suppressive agents are often used to enable reduction in ‘glucocorticoid’ dose
azathioprine, chlorambucil, mycophenolate
How is vitamin D linked to the immune response
Enhances the immune response
Modulation of the adaptive immune system via effects on T cell activation and function of APC
T/F Omega 3 fatty acids reduces production of inflammatory mediators
True
What can be used with glucocorticoids as an immune suppressive drug
generally glucocorticoids often used in combination with other non-specific immunomodulatory drugs (steriod sparing drugs)- to reduce the side effects of steroid treatment by enabling a reduction in steroid use
Why is prednisolone generally the first line of treatment for most IMD
rapid onset of action
cheap and avalible
licensed for use in both dogs and cats
most vets are familiar with it
What immune suppressive drug should never be used in cats
azathioprine
