FA Immunology Flashcards
Immunosuppressants
Cyclosporine, Tacrolimus, Sirolimus (Rapamycin), Basaliximab, Azathioprine, Glucocorticoids
Cyclosporine Mechanism
Calcineurin inhibitor; binds cyclophilin. Blocks T cell activation by preventing IL-2 transcription.
Cyclosporine Use
Transplant rejection prophylaxis, psoriasis, rheumatoid arthritis.
Cyclosporine Toxicity
Nephrotoxicity, hypertension, hyperlipidemia, hyperglycemia, tremor, hirsutism, gingival hyperplasia.
Tacrolimus Mechanism
Calcineurin inhibitor; binds FK506 binding protein (FKBP).
Blocks T cell activation by preventing IL-2 transcription.
Tacrolimus Use
Transplant rejection prophylaxis.
Tacrolimus Toxicity
Similar to cyclosporine, ↑ risk of diabetes and nephrotoxicity; no gingival hyperplasia or hirsutism.
Sirolimus (Rapamycin) Mechanism
mTOR inhibitor; binds FKBP. Blocks T cell activation and B cell differentiation by preventing IL-2 signal transduction.
Sirolimus (Rapamycin) Use
Kidney transplant rejection prophylaxis. Synergistic with cyclosporine. Also used in drug-eluting stents.
Sirolimus (Rapamycin) Toxicity
Anemia, thrombocytopenia, leukopenia, insulin resistance, hyperlipidemia; non-nephrotoxic.
Basiliximab Mechanism
Monoclonal antibody; blocks IL-2R.
Basiliximab Use
Kidney transplant rejection prophylaxis.
Basiliximab Toxicity
Edema, hypertension, tremor.
Azathioprine Mechanism
Antimetabolite precursor of 6-mercaptopurine.
Inhibits lymphocyte proliferation by blocking nucleotide synthesis.
Azathioprine Use
Transplant rejection prophylaxis, rheumatoid arthritis, Crohn disease, glomerulonephritis, other autoimmune conditions.
Azathioprine Toxicity
Leukopenia, anemia, thrombocytopenia. 6-MP degraded by xanthine oxidase; toxicity ↑ by allopurinol.
Glucocorticoid Mechanism [Immunology]
Inhibit NF-κB.
Suppress both B and T cell function by ↓ transcription of many cytokines.
Glucocorticoid Use [Immunology]
Transplant rejection prophylaxis (immune suppression), many autoimmune disorders, inflammation.
Glucocorticoid Toxicity [Immunology]
Hyperglycemia, osteoporosis, central obesity, muscle breakdown, psychosis, acne, hypertension, cataracts, peptic ulcers. Can cause iatrogenic Cushing syndrome.
Epoetin Alfa (erythropoietin) Use
Anemias (especially in renal failure)
Thrombopoietin Use
Thrombocytopenia
Oprelvekin (interleukin-11) Use
Thrombocytopenia
Filgrastim (granulocyte colony-stimulating factor) Use
Recovery of bone marrow
Sargramostim (granulocyte-macrophage colonystimulating factor) Use
Recovery of bone marrow
Aldesleukin (interleukin-2)
Renal cell carcinoma, metastatic melanoma
IFN-α Use [Immunology]
Chronic hepatitis B and C, Kaposi sarcoma,
hairy cell leukemia, condyloma acuminatum,
renal cell carcinoma, malignant melanoma
IFN-β Use [Immunology]
Multiple sclerosis
IFN-γ Use [Immunology]
Chronic granulomatous disease
Alemtuzumab Target
CD52
Alemtuzumab Use
CLL
Bevacizumab Target
VEGF
Bevacizumab Use
Colorectal cancer, renal cell carcinoma
Cetuximab Target
EGFR
Cetuximab Use
Stage IV colorectal cancer, head and neck cancer
Rituximab Target
CD20
Rituximab Use
B-cell non-Hodgkin lymphoma, rheumatoid arthritis (with MTX), ITP
Trastuzumab Target
HER2/neu
Trastuzumab Use
Breast cancer, gastric cancer
Infliximab, Adalimumab Target
TNF-α
Infliximab, Adalimumab Use
IBD, rheumatoid arthritis, ankylosing spondylitis, psoriasis
Natalizumab Target
α4-integrin: leukocyte adhesion
Natalizumab Use
Multiple sclerosis, Crohn disease
Natalizumab Toxicity
Risk of PML in patients with JC virus
Abciximab Target
Glycoprotein IIb/IIIa
Abciximab Use
Anti-platelet agent for prevention of ischemic complications in patients undergoing percutaneous coronary intervention
Denosumab Target
RANKL
Denosumab Use
Osteoporosis; inhibits osteoclast maturation (mimics osteoprotegrin)
Digoxin Immune Fab Target
Digoxin
Digoxin Immune Fab Use
Antidote for digoxin toxicity
Omalizumab Target
IgE
Omalizumab Use
Allergic asthma; prevents IgE binding to FceRI
Palivizumab Target
RSV F protein
Palivizumab Use
RSV prophylaxis for high-risk infants