Immune Modulators Flashcards
What are the different ways of immune supression?
Reducing inflammatory response, reducing allergic response, suppression of inappropriate immune response
How can the immune response be enhanced?
Vaccination
Against neoplasia
What are the three types of immunosuppressive drugs ?
Inhibits cytokine gene expression
inhibits IL-2 production/action
Inhibits DNA synthesis
How do drugs that inhibit IL-2 production work?
IL-2 produced by CD4 cells, stimulates clonal proliferation and activation of T cells- stimulates stimulates B cell proliferation which causes activity of innate immune cells- macrophages and NK cella’s
Therefore removes this response
What is the outcome of glucocorticoids on the immune system?
Stabilise mast cell membranes reducing de-granulation
Reduce pro-inflammatory cytokine production
Down regulate Fc receptor expression on macrophages- reduce antigen presentation
What are the adverse effects of glucocorticoids?
Skin thinning, weight gain, muscle loss, polyphasic, laminitis, GI bleeding, hyper-coagulability, HPA axis
What are examples of glucocorticoids used for the immune system?
Prednisolone
Methylprednisolone
Dexamethasone
What is the mode of action of ciclosporin and tacrolimus?
Both block calcineurin activation giving reduced IL-2 production
How are cyclosporin and tacrolimus administered?
Ciclosporin- Topical, oral or parenteral
Tacrolimus- most commonly topical
Where are cyclosporin and tacrolimus metabolised and excreted
What are their adverse effects?
Liver, excreted by bile
Adverse effects- Transient vomiting, increase the risk of neoplasia, opportunistic infections
What are azathioprine, myophenolate mofentil and leflunomide all examples of?
Drugs which inhibit DNA synthesis
What is the MOA of azathioprine and mycopenolate mofetil?
Azathioprine- inhibits purine synthesis, inhibits DNA synthesis and therefore alters metabolism- reduces TH1 mediated immunity
Mycopenolate mofentil- inhibits enzymes for purine synthesis
How is azathioprine administered, metabolised and excreted?
What are its adverse effects?
Admin- oral
Metabolised- hepatic
Found in all excreta
Adverse effects- hepatopathy, myelosupression, pancreatitis, GI signs
How is mycopenolate mofentil administered, metabolised, excreted?
What are its adverse effects?
Admin- oral
Heptatic metabolism
Renal excretion
Adverse- diarrhoea, weight loss
What drug is commonly administered with mycopenolate mofentil?
Ciclosporin
