Immodulation Flashcards
what is immunomodlation
manipulating the immune system using drugs to achieve a desired immune response
what are the outcomes of immunomodulation
immunopotentiation
immunosuppression
induction of immunological tolerance
what is infliximab used for
immunosuppressant = anti-TNF antibodies used against rheumatoid arthritis
what generally is passive immunisation
what are issues
provides immediate protection - transfer of specific high titre antibody from donor to patient
causes serum sickness and still risk of transmission of viruses
what are the types and sues of passive immunisation
pooled specific human immunoglobulin
animal sera
used to treat Hep B prophylaxis, botulism, VZV in pregnancy, diphtheria and snake bites
what generally is active immunity
what types of vaccine forms are there
achieve long lasting protection
stimulate development of protective immune repose and memory
can be weakened from of pathogen , killed inactivated, purified material from pathogen such as DNA or adjuvants
what are the problems with using active immunisation
allergies
limited use in immunocompromised
delay in achieving protection (4 - 6 weeks)
which replacement techniques are used for antibody deficiency states or neutropenia
pooled human immunoglobulin
G-CSF - act on bone marrow to increase mature neutrophils
what would you use these molecules for in replacement therapy IL-2 a-interferon B-interferon y-interferon
stimulates T cell activation
treatment of Hep C
therapy of MS
intracellular infections and chromic granulomatous disease
what drugs are used in immunosuppression
corticosteroids, cytotoxic agents, anti-proliferative agnets, DMARDS
what are the effects of corticosteroids in immunsuppresion
decreased neutrophil migration
rescued production of inflammatory cytokines
inhibition of phospholipase A2
lymphotoxic
what are the side effects of immunosuppression from corticosteroids
can result in diabetes and hyperlipidaemia
poor wound healing from weakened protein synthesis
glaucoma
osteoporosis
in which medical cases would you use corticosteroid immune treatment
acute control autoimmune disease (CTD, vasculitis, RA) inflammatory disease (crohns, sarcoid) malignancies allograft rejection
describe the normal T cell pathway which is specifically targeted at different points my drugs
T cell with APC (MHC2) - release IL-2 which activates MTOR and T cell proliferation
how do antimetabolites interfere with the T cell proliferation pathway as an immunosuppressant, give examples
interfere with DNA synthesis and proliferation step of T cell activation azathioprine (AZA) mycophenolate mofetil (MMF)
how do calcineuirn inhibitors interfere with the T cell proliferation pathway as an immunosuppressant, give examples
stop activation of transcription factors and gene transcription
ciclosporin A (CyA) Tacrolimus (FK506)
how do MTOR interfere with the T cell proliferation pathway as an immunosuppressant, give examples
stop generation of M-TOR so T cells can’t proliferate further
sirolimus (rapamycin)
how do IL-2 receptor mAB’s interfere with the T cell proliferation pathway as an immunosuppressant, give examples
target IL-2 receptor and interfere with autocrine signalling
basiliximab
daclizumab
where did calcineuirn come from and what is its overall effects on T cell proliferation
fungi in south norway
reversible inhibition of T cell activation proliferation and clonal expansion
what is the converted metabolite of AZA
6 - mercaptopurine
what is the mechanism of action of MMF
prevention of production of guanosine triphosphate
what are the T and B cell effects of antimetabolites
impaired DNA production, prevents early stages of activated cells proliferation
what is the role of methotrexate and cyclophosphamide
folate antagonist
cytotoxic drug for vasiculiis and SLE
what are some examples of mAB’s (monoclonal antibodies)
extremely targeted so reduce side effects
anticytokines - TNF IL-6 IL-1
anti B cell therapies
what is the role of Tocilizumab
blocks IL-6 receptor used in the therapy of RA and AOSD
which drugs block IL-1 action
anakinra, riolacept, canakinumab
what is the action of rituximab in immunosuppression and what does it treat
chimeric mAB agains CD-20 B cell surface - binds to immature b cell receptors
used for lymphomas, leukaemia, transplant rejections
what are two examples of adoptive immune therapies and their uses
bone marrow transplant
stem cell transplant
used in SCID, lymphomas, osteoporosis, autoimmune diseases
what is omalizumab used for
mAB against IgE used in Rx of asthma
what is mepolizumab used for
mAb agains IL-5 which acts agents eosinophils
used in Rx of asthma
