Immodulation

Question 1

what is immunomodlation

Answer 1

manipulating the immune system using drugs to achieve a desired immune response

Question 2

what are the outcomes of immunomodulation

Answer 2

immunopotentiation
immunosuppression
induction of immunological tolerance

Question 3

what is infliximab used for

Answer 3

immunosuppressant = anti-TNF antibodies used against rheumatoid arthritis

Question 4

what generally is passive immunisation

what are issues

Answer 4

provides immediate protection - transfer of specific high titre antibody from donor to patient

causes serum sickness and still risk of transmission of viruses

Question 5

what are the types and sues of passive immunisation

Answer 5

pooled specific human immunoglobulin
animal sera

used to treat Hep B prophylaxis, botulism, VZV in pregnancy, diphtheria and snake bites

Question 6

what generally is active immunity

what types of vaccine forms are there

Answer 6

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

Question 7

what are the problems with using active immunisation

Answer 7

allergies
limited use in immunocompromised
delay in achieving protection (4 - 6 weeks)

Question 8

which replacement techniques are used for antibody deficiency states or neutropenia

Answer 8

pooled human immunoglobulin

G-CSF - act on bone marrow to increase mature neutrophils

Question 9

what would you use these molecules for in replacement therapy 
IL-2
a-interferon
B-interferon
y-interferon

Answer 9

stimulates T cell activation

treatment of Hep C

therapy of MS

intracellular infections and chromic granulomatous disease

Question 10

what drugs are used in immunosuppression

Answer 10

corticosteroids, cytotoxic agents, anti-proliferative agnets, DMARDS

Question 11

what are the effects of corticosteroids in immunsuppresion

Answer 11

decreased neutrophil migration
rescued production of inflammatory cytokines
inhibition of phospholipase A2
lymphotoxic

Question 12

what are the side effects of immunosuppression from corticosteroids

Answer 12

can result in diabetes and hyperlipidaemia
poor wound healing from weakened protein synthesis
glaucoma
osteoporosis

Question 13

in which medical cases would you use corticosteroid immune treatment

Answer 13

acute control 
autoimmune disease (CTD, vasculitis, RA) 
inflammatory disease (crohns, sarcoid) 
malignancies 
allograft rejection

Question 14

describe the normal T cell pathway which is specifically targeted at different points my drugs

Answer 14

T cell with APC (MHC2) - release IL-2 which activates MTOR and T cell proliferation

Question 15

how do antimetabolites interfere with the T cell proliferation pathway as an immunosuppressant, give examples

Answer 15

interfere with DNA synthesis and proliferation step of T cell activation 
azathioprine (AZA) 
mycophenolate mofetil (MMF)

Question 16

how do calcineuirn inhibitors interfere with the T cell proliferation pathway as an immunosuppressant, give examples

Answer 16

stop activation of transcription factors and gene transcription

ciclosporin A (CyA)
Tacrolimus (FK506)

Question 17

how do MTOR interfere with the T cell proliferation pathway as an immunosuppressant, give examples

Answer 17

stop generation of M-TOR so T cells can’t proliferate further

sirolimus (rapamycin)

Question 18

how do IL-2 receptor mAB’s interfere with the T cell proliferation pathway as an immunosuppressant, give examples

Answer 18

target IL-2 receptor and interfere with autocrine signalling

basiliximab
daclizumab

Question 19

where did calcineuirn come from and what is its overall effects on T cell proliferation

Answer 19

fungi in south norway

reversible inhibition of T cell activation proliferation and clonal expansion

Question 20

what is the converted metabolite of AZA

Answer 20

6 - mercaptopurine

Question 21

what is the mechanism of action of MMF

Answer 21

prevention of production of guanosine triphosphate

Question 22

what are the T and B cell effects of antimetabolites

Answer 22

impaired DNA production, prevents early stages of activated cells proliferation

Question 23

what is the role of methotrexate and cyclophosphamide

Answer 23

folate antagonist

cytotoxic drug for vasiculiis and SLE

Question 24

what are some examples of mAB’s (monoclonal antibodies)

Answer 24

extremely targeted so reduce side effects
anticytokines - TNF IL-6 IL-1
anti B cell therapies

Question 25

what is the role of Tocilizumab

Answer 25

blocks IL-6 receptor used in the therapy of RA and AOSD

Question 26

which drugs block IL-1 action

Answer 26

anakinra, riolacept, canakinumab

Question 27

what is the action of rituximab in immunosuppression and what does it treat

Answer 27

chimeric mAB agains CD-20 B cell surface - binds to immature b cell receptors
used for lymphomas, leukaemia, transplant rejections

Question 28

what are two examples of adoptive immune therapies and their uses

Answer 28

bone marrow transplant
stem cell transplant

used in SCID, lymphomas, osteoporosis, autoimmune diseases

Question 29

what is omalizumab used for

Answer 29

mAB against IgE used in Rx of asthma

Question 30

what is mepolizumab used for

Answer 30

mAb agains IL-5 which acts agents eosinophils

used in Rx of asthma