Biological therapies to treat chronic inflammatory disorders Flashcards
What are the advantages of using biological therapies to treat chronic inflammatory diseases?
Fewer side effects since the therapies only affect the target
Low mass doses are highly effective
Very effective
What are the disadvantages of using biological therapies to treat chronic inflammatory diseases?
Agents are large biological molecules (usually proteins)
Expensive
Usually need to be injected in hospital
Agents need to be biosynthesised so there’s a risk of them becoming contaminated with viruses during this
Proteins may be allergens and could provoke anaphylaxis
Name 2 classes of biological agent.
Cytokine blockers: TNF blockers, IL-6 blockers
Anti-B lymphocyte: CD20 blockers
What does TNF stand for, in the case of TNF-blockers?
Tumour necrosis factor blockers
What is TNF?
Tumour necrosis factor
It is a pro-inflammatory cytokine
What does TNF do?
Causes the death of tumour cells by apoptosis
Mediates inflammation by stimulating release of more TNF, IL-6, IL-1
Maturation of dendritic cells
Activation of Th1 response
Causes cachexia
How do TNF blockers work?
They bind to the naturally secreted TNF and neutralise its ability to interact with its receptors
Blocking TNF blocks all of the things that TNF triggers, so blocks inflammation
Name some TNF blockers.
Infliximab
Adalimumab
What drug would you give alongside TNF blockers?
Methotrexate
What are the side effects of TNF blockers?
Increased susceptibility to TB & activation of dormant TB
Susceptibility to other infections
Increased incidence of cancers
Why do TNF blockers cause increased susceptibility to TB?
Because of the blunting of Th1 action
What type of drug is infliximab?
TNF blocker
What type of drug is adalimumab?
TNF blocker
What type of drug is rituximab?
Anti-CD20
What type of drug is tocilizumab?
IL-6 blocker
