B / 28 : Immunopharmacology III - antibodies and fusion proteins

Question 1

What is a common SE for monoclonal AB treatment?

Answer 1

injection site reaction with erythema, itching, swelling, pain and burning sensation

Question 2

How can you treat injection site reactions?

Answer 2

• Topical hydrocortisone
• Diphenhydramine
• NSAIDS

Question 3

What is an example of a polyclonal antibody?

Answer 3

ATG : antithymocyte-globulin

Question 4

ATG
- MOA
- Effect
- Indication
- SE
- ROA

Answer 4

• Polyclonal antibody : selective inhibition of cellular immunity
• ABs bind T cells involved in antigen recognition : destroys T cells
• For transplantation : prevent GVH disease
• Hypersensitivity reaction
• IV

Question 5

What are 6 monoclonal antibodies?

Answer 5

• Rituximab
• Infliximab + adalimumab
• Ustekinumab
• Dupilumab
• Tocilizumab
• Natalizumab

Question 6

Rituximab
- MOA
- Effect
- Indication
- SE

Answer 6

• Anti-CD20, chimeric monoclonal AB
• Reduced B cell count
• For B cell lymphoma, RA
• Injection site reaction, infection

Question 7

Infliximab + adalimumab
- MOA
- Effect
- Indication
- SE
- Extra

Answer 7

• Anti-TNFalpha
• Decreases formation of interleukins and adhesion molecules involved in leukocyte activation
• For RA, ankylosing spondylitis psoriasis, IBD
• Injection site reaction, infections
• Infliximab is chimeric, adalimumab is human

Question 8

Ustekinumab
- MOA
- Effect
- Indication
- SE

Answer 8

• Anti IL-12/23, human monoclonal AB
• Inhibits activation of Th1 and Th17 cells
• For Chron’s disease, psoriasis
• Injection site reaction, infections

Question 9

Dupilumab
- MOA
- Effect
- Indication
- SE

Answer 9

• Anti IL-4 receptor alpha, human monoclonal Ab
• Inhibits Th2 mediated immunoreaction
• For asthma, atopic dermatitis
• Injection site reaction, oral herpes, conjunctivitis

Question 10

Tocilizumab
- MOA
- Effect
- Indication
- SE

Answer 10

• Anti IL-6 receptor, humanIZED monoclonal AB
• Affects both T and B cell function
• For RA, juvenile idiopathic arthritis
• injection site reaction, infections, neutropenia

Question 11

Natalizumab
- MOA
- Effect
- Indication
- SE

Answer 11

• Anti integrin a4b1, humanIZED monoclonal AB
• Inhibits docking and extravasation of T cells
• For multiple sclerosis
• Injection site reaction, infections, reactivation of JC virus

Question 12

What are fusion proteins?

Answer 12

Chimeric proteins that consist of at least 2 domains that have been joined, so that they are transcribed and translated as a single unit

Question 13

What is an example of a fusion protein?

Answer 13

Abatacept

Question 14

Abatacept
- MOA
- Effect
- Indication
- SE

Answer 14

• CTLA-4 fusion protein
• T cell inhibitor
• For RA, JIA, psoriasis
• Infections, headache