Immune therapy Flashcards
Corticosteroids
Prednisolone
Anti proliferative agents
Inhibit DNA synthesis, cells with rapid turnover most sensitive
Cyclophosphamide
Mycophenolate mofetil
Azathioprine
Methotrexate
Inhibitors of cell signalling
Tacrolimus Ciclosporin Sirolimus Tofacitinib Apremilast
Agents directed at cell surface antigens
Block signalling, cell depletion
Basilixmab Abatacept Rituximab Natalizumab Tocilizumab Muromonab-CD3 Anti-thymocyte Daclizumab Efalizumab Alemtuzumab (campath)
Agents directed at cytokines
Infliximab Adalimumab (fully human) Certolizumab Golimumab Etanercept Ustekinemab Secukinumab Denosumab
Prednisolone
Inhibits PL A2 –> blocks AA, reduces PG synthesis, inhibits phagocyte trafficking, phagocytosis and release of proteolytic enzymes, lymphopenia, promotes apoptosis, blocks cytokine gene expression, decreased ab production
AI disease, autoinflammatory disease, prevention and treatment of transplant rejection
Cyclophosphamide
Alkylates guanine base of DNA, damages DNA and prevents cell replication
Affects B>T cells
Connective tissue disease, vasculitis, anti-cancer agent
Mycophenolate mofetil
Inhibits IM PDH, prevents guanine synthesis, prevents replication of DNA
prevents T>B cell proliferation
Transplantation, AI diseases, vasculitis
Azathioprine
Antimetabolite agent
Metabolised by liver to 6MP
blocks de novo purine synthesis
Prevents replication of DNA and peripherally inhibits T cell activation and proliferation
Transplantation, AI disease, auto-inflammatory diseases
Methotrexate
Inhibits dihydrofolate reductase therefore decreases DNA synthesis
RA, psoriasis, Crohn’s, used in chemo and as an abortifacient
Plasmapheresis
Removal of pathogenic Ab
Plasma treated to remove immunoglobulins and then reinfused
Severe antibody mediated disease (Goodpasture’s, MG, vascular rejection), antibody mediated rejection
Tacrolimus
inhibits calcineurin which normally activates transcription of IL-2
Reduces T cell proliferation
Rejection prophylaxis in transplantation
Cyclosporin
inhibits calcineurin which normally activates transcription of IL-2
Reduces T cell proliferation
Rejection prophylaxis in transplantation
Sirolimus
Blocks clonal proliferation of T cells
Rejection prophylaxis in transplantation
Tofacitinib
JAK inhibitor
Rheumatoid arthritis
Apremilast
PDE4 inhibitor
Psoriasis, psoriatic arthritis
Basiliximab
anti CD25 (alpha chain of IL-2 receptor)
Inhibits T cell proliferation
allograft rejection
Abatacept
Anti CTLA4-Ig
Reduces T cell activation
Rheumatoid arthritis
Rituximab
Anti CD20, depletes mature B cells (not plasma cells)
Lymphoma, RA, SLE
Natalizumab
anti alpha4 intern (binds to VCAM1 and MadCAM1 to mediate rolling/arrest of leucocytes)
Inhibits T cell migration
RR-MS, Crohn’s
Tocilizumab
anti IL6 receptor
Reduces macrophage, T/B cell and neutrophil activation
Castleman’s disease, RA
Muromonab-CD3
Blocks CD3 on T cells
Mouse monoclonal ab (OKT3)
Active allograft rejection
Anti thymocyte globulin (ATG)
Lymphocyte depletion
Modulation of T cell activation and migration
Allograft reaction (renal, heart)
Daclizumab
IL2 receptor antibody
Targets CD25
Organ transplant rejection prophylaxis
