Immune modulation Flashcards
When might you want to modulate the immune system?
In immunosuppression
Enhance host immune response e.g. to neoplasia
What are the 4 types of hypersensitivity reactions that mediate immune disease?
Type I - IgE and MCT mediated
Type II - IgG mediated
Type III - immune complex disease
Type IV - cytotoxic T cell mediated
Immunosuppressive medications reduce function of which immune system: adaptive or innate? How do they do this?
Adaptive
Reduce lymphocyte proliferation or limit their effect
What are the 3 main groups of immunosuppressive drugs?
Drugs inhibit cytokine gene expression
Drugs that inhibit IL-2 production/action
Drugs that inhibit DNA synthesis
Give an example of a first line immunosuppressive drug
Gluococorticoids
How do gluocorticoids work as immunosuppressants?
Down regulate Fc receptor expression on macrophages
Reduces antigen presentation
Give an example of a glucorticoid
Prednisolone
What are the adverse effects of glucocorticoids?
Hypercoaguability GI bleeding PUPD Polyphagia and weight gain Skin thinning Increased infections - especially UTI
When are glucocorticoids contraindicated?
Diabetes
Heart disease
Pregnancy
What are second line immunosuppressives used in conjunction with? Why?
Steroids
Increase immunosuppressive effect, reduce dose and side effects of immunosuppressants
Give an example of a drug that inhibits IL-2 action
Tacrolimus
What does interleukin 2 do? Where is it produced?
Produced by T helper cells
Simulates B cell proliferation, clonal proliferation and activation of T cells and innate immune cells (NK cells, macrophages)
What are the disadvantages of immunosuppressant drugs?
Opportunistic infections
Vomiting
Human immunoglobulin can be given as an immunosuppressant. How does it work? Is it long or short lasting?
Bind to T and B cells to inhibit proliferation and activtation
Rapid acting, short lived - useful to block immune function whilst other drugs start to act
What are the disadvantages of human immunoglobulin?
Cost
Hypercoaguability
