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Immunology > Cytokines, Complement, and Immune Drugs > Flashcards

Cytokines, Complement, and Immune Drugs Flashcards

1
Q

What do Th1 cells secrete?

A

IFN-gamma (macrophage activator), Il-2 (T cell growth factor and CD8 T cell activator), Lymphotoxin B

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2
Q

What do Th2 cells secrete?

A

Il-4, Il-5, Il-10, Il-13

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3
Q

What do classically activated macrophages secrete?

A

Il-1, TNF-alpha

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4
Q

CD markers for Tregs

A

CD3, CD4, CD25

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5
Q

What do Tregs secrete?

A

Anti-inflammatory - Il-1/TGF-B

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6
Q

Fever (major)

A

Il-1, TNF

PGE2 mediates fever in hypothalamus

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7
Q

T cell “growth factor”

A

Il-2 (especially T-regs)

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8
Q

Stimulates bone marrow, acts like GM-CSF

A

Il-3 (secreted by T cells)

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9
Q

Stimulates IgE/IgG production

A

Il-4

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10
Q

Stimulates IgA class switching

A

Il-5

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11
Q

Associated with acute phase proteins

A

Il-1, Il-6

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12
Q

Major chemotactic factors for neutrophils

A

Il-8
LTB4
C5A
Bacterial products

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13
Q

CD on macrophages that recognizes LPS

A

CD14 (marker of monocyte-macrophage lineage)

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14
Q

What cleaves pre-kallikrein to kallikrein?

A

Hageman’s factor (12a)

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15
Q

What cleaves HMWK to bradykinin?

A

Kallikrein

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16
Q

Bradykinin

A

Histamine (vasodilation, increased permeability) + pain

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17
Q

What inhibits bradykinin?

A

ACE (ACEi cause increase in bradykinin –> cough, edema)

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18
Q

Prostacyclin (PGI2)

A

Endothelial cells
Vasodilator
Inhibits platelet aggregation

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19
Q

LTC4, D4, E4

A 
Slow-reacting substances of anaphylaxis
All contract SM:
1) Vasoconstriction (arteriole)
2) Bronchoconstriction (SM)
3) Increased vascular permeability (pericytes)
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20
Q

How are mast cells activated?

A

1) Trauma
2) C3a, C5a “anaphylotoxins”
3) Cross-linking of surface antigen

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21
Q

Histamine

A

Vasodilation of arterioles
Increased permeability at post-capillary venule
Mediates anaphylaxis

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22
Q

Pain

A

Bradykinin and PGE2 sensitize nerve endings

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23
Q

What mediates P selection release from W-P bodies in endothelium?

A

Histamine

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24
Q

What mediates E-selection on endothelium?

A

TNF-alpha, Il-1

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25
Q

What molecule do selectins bind on leukocytes?

A

Sialyl Lewis X

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26
Q

What upregulates cellular adhesion molecules ICAM and VCAM on endothelium?

A

TNF, Il-1

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27
Q

What upregulates integrins on leukocytes?

A

C5a, LTB4

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28
Q

TCR Complex

A

TCR, CD3, associated ITAMs on Zeta

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29
Q

Endogenous pyrogen

A

Il-6, also secreted by TH2

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30
Q

Induces differentiation of T cells into TH1 cells

A

IL-12 (INF-gamma)

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31
Q

Activates NK Cells

A

IL-12 (IL-2, IFN-beta, IFN-alpha)

Decreased MHC I expression

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32
Q

Mediates septic shock

A

TNF-alpha

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33
Q

Has antiviral and antitumor properties

A

IFN-gamma

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34
Q

Stimulates growth and differentiation of eos

A

Il-5

35
Q

Promotes B cell growth

A

Il-4

36
Q

Il-10

A

Anti-inflammatory
Inhibits TH1
Similar to TGF-B

37
Q

Interferons alpha and beta

A

Inhibit viral protein synthesis in neighboring cells - the neighboring cells will translate proteins when there is the presence of viral RNA (dsDNA)

38
Q

Suppresses TH2 cells

A

IFN-gamma

39
Q

Increases MHC I and II expression and antigen expression in all cells

A

IFN-gamma

40
Q

Binds B7 on APCs, B cells, or Macrophages

A

CD28 on T cell

41
Q

Cell surface proteins of helper T cell

A

CD4, CD40 ligand

42
Q

C3b

A

opsonization (macrophages have C3b receptor)

43
Q

C5b-9

A

cytolysis by MAC - without it, susceptible to neisseria

44
Q

Inhibitors of complement activation

A

Decay accelerating factor (DAF), inhibits c3 convertase
C1 esterase inhibitor

Prevent complement activation on self-cells (RBCs)

45
Q

C1 esterase inhibitor deficiency

A

Hereditary angioedema, ACEi contraindicated

46
Q

C3 deficiency

A

Recurrent pyogenic sinus and respiratory tract infections

Increased susceptibility to type III hypersensitivity rxns

47
Q

DAF (GPI anchored enzyme) deficiency

A

PNH, RBC lysis

48
Q

Receptor for EBV on B Cells

A

CD21

49
Q

B Cell CD markers

A

CD19, CD20, CD21, CD40

50
Q

Macrophage CD markers

A

CD14, CD40

Fc and C3b receptors

51
Q

NK Cells CD marker

A

CD16 (binds Fc of IgG)
CD56 (unique marker for NK)
Does NOT expression CD4, 8, 3

52
Q

Il-12

A

Important in granuloma formation
Macrophages present antigen to CD4 T cells that secrete Il-12 and promote conversion to TH1 phenotype that, in turn, secrete IFN-gamma to activate macrophages

53
Q

Cyclosporine - Mechanism

A
  • Binds to cyclophilins inside the cells
  • Complex blocks differentiation and activation of T cells by inhibition of calcineurin, thus preventing production of Il-2 and its receptor
54
Q

Cyclosporine - Clinical Use

A

Supresses organ rejection after transplant

Selected autoimmune disorders

55
Q

Cyclosporine - Toxicity

A

7H’s

1=Hirsutism

2=Hyperplasia of gums

3=Harm to kidneys

4=Hypertension

5=Hyperglycemia

6=Hyperlipidemia

7=Hyper hand (tremor)

56
Q

Tacrolimus (FK-506) - Mechanism

A

Similar to cyclosporine, binds to FK-binding protein, inhbiting calcinuerin and IL-2

57
Q

Tacrolimus (FK-506) - Clinical Use

A

Potent immunosuppression used in organ transplant recipients

58
Q

Tacrolimus (FK-506) - Toxicity

A

Similar to cyclosporine - no gum hyperplasia or hirsutism

59
Q

Sirolimus (rapamycin) - Mechanism

A

Inhibits mTOR, thereby inhibiting T cell proliferation in response to Il-2

60
Q

Sirolimus (rapamycin) - Clinical Use

A

Immunosupression after kidney transplantation in combo with cyclosporine and corticosteroids; also used with drug-eluting stents

61
Q

Sirolimus (rapamycin) - Toxicity

A

Hyperlipidemia
Thrombocytopenia
Leukopenia

62
Q

Azathioprine - mechanism

A

Antimetabolite precursor of 6-MP that interferes with metabolism and synthesis of nucleic acids - toxic to proliferating lymphocytes

63
Q

Azathioprine - clinical use

A

Kidney transplant, autoimmune disorders (including glomerulonephritis and hemolytic anemia)

64
Q

Azathioprine - toxicity

A

Bone marrow suppression

Toxic effects may be increased by allopurinol since metabolite mercaptopurine is metabolized by xanthine oxidase

65
Q

Muromonab-CD3 (OKT3) - mechanism

A

Monoclonal Ab that binds to CD3 (epsilon chain) on the surface of T cells
Blocks cellular interaction with CD3 protein responsible for TCR signal transducion

66
Q

Muromonab-CD3 (OKT3) - clinical use

A

Immunosuppression for kidney transplantation

67
Q

Muromonab-CD3 (OKT3) - toxicity

A

cytokine release syndrome, hypersensitivity rxn

68
Q

Aldesleukin (IL-2) - Recombinant cytokine

A

Renal cell carcinoma, metastatic melanoma

69
Q

Epoetin alka (EPO) - Recombinant cytokine

A

Anemias (especially renal failure)

70
Q

Filgrastim (G-CSF) - Recombinant cytokine

A

Recovery of bone marrow

71
Q

Sagramostim (GM-CSF) - Recombinant cytokine

A

Recovery of bone marrow

72
Q

Alpha-interferon - Recombinant cytokine

A

Hep B and C, Kaposi’s sarcoma, leukemias, malignant melanoma

73
Q

Beta-interferon - Recombinant cytokine

A

MS

74
Q

Gamma-interferon - Recombinant cytokine

A

CGD

75
Q

Oprelvekin (IL-11) - Recombinant cytokine

A

Thrombocytopenia

76
Q

Thrombopoetin - Recombinant cytokine

A

Thrombocytopenia

77
Q

Digoxin Immune Fab

A

Target - Target is Digoxin

Clinical use - Antidote for digoxin intoxication

78
Q

Infliximab

A

Target - TNF-alpha

Clinical use - Crohn’s, RA, Psoriatic arthritis, Ankylosing spondylitis

79
Q

Adalimumab

A

Target - TNF-alpha

Clinical use - Crohn’s, RA, Psoriatic arthritis

80
Q

Abciximab

A

Target - GPIIb/IIIa
clinical use - prevent cardiac ischemia in unstable angina and in patients treated with percutaneous coronary intervention

81
Q

Trastuzumab (Herceptin)

A

Target - HER2

Clinical use - HER2 overexpressed BC

82
Q

Rituximab

A

Target - CD20

Use - B cell non-Hodskin’s lymphomas

83
Q

Omalizumab

A

Target - IgE

Use - Last resort treatment of nonsteroid responsive asthma

84
Q

Induces MHC II expression

A

IFN-gamma

Immunology (4 decks)

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