Immuno 9: Immune Modulation Therapies 1 Flashcards
Describe Clonal expansion in T cells?
If an antigen is presented to a T cell receptor which has high specificity for it, the T cell proliferates and differentiates into T helper, Cytotoxic and memory cells
List 3 vaccines given to the elderly aged over 65?
Pneumococcal vaccine (Pneum PPV)
Flu vaccine
Shingles
Describe clonal expansion in B cells ?
If the B cell receptor has high specificity for the antigen presented, the B cell will become activated and undergo proliferation and differentiation into IgM secreting plasma cells and B memory cells
Where do B cells undergo Isotype switching ?
Germinal centres
Where do plasma cells reside ?
Bone marrow
which bacteria is in the BCG vaccine ?
Bovine tuberculosis
Give 3 examples of live attenuated vaccines ?
MMR
Yellow fever
Typhoid
Give 2 examples of Toxoid vaccines (Inactive toxins) ?
Diphtheria
Tetanus
Give 3 examples of subunit vaccines ?
Hep B (HBsAG)
HPV (capsid)
Influenza (HA)
Give one advantage of a life vaccine compared to a component/inactivated vaccine ?
Longer lasting immunity (life long)
Immunity is broader (protects against more strains)
Give an advantage of a component/inactivated vaccine compared to a live vaccine ?
Can be given to immunocompromised patients
Give 3 examples of conjugate vaccines ?
HiB (haemophilus influenza B)
Meningococcus
Pneumococcus
List 2 indications for Haematopoeitic stem cell transplantation ?
SCID
Haematological malignancy
List 3 primary immunodeficiency diseases in which Antibody replacement (pool of antibodies to variety of organisms) is indicated ?
Bruton’s X-linked agammaglobulinaemia
X-linked hyper IgM syndrome
Common variable immunodeficiency
In which 2 Haematological malignancies is Antibody replacement indicated ?
CLL
Multiple myeloma
List 3 diseases in which IgG immunoglobulin therapy can be used ?
Shingles infection (varicella zoster)
Rabies (post exposure)
Hepatitis B
Give one example of an infection in which adoptive cell transfer (ACT) can be used to infuse a donor’s T cells ?
EBV infection in immunocompromised patients.
T cells from a donor are isolated and exposed to EBV antigen to stimulate Clonal expansion of specific T cells. These T cells are infused into the immunocompromised recipient to treat EBV infection.
How does Ipilimumab work in treatment of advanced melanoma ?
Ipilimumab blocks CTLA4 which is an inhibitory receptor on T cells
This causes increased T cell activation and boosts the immune response
T cells have CD28 (activator receptor) and CTLA4 (inhibitory receptor).
CD80 and CD86 on APCs can bind to either to activate/inhibit T cells
How does Pembrolizumab and nivolumab work in the treatment of advanced melanoma ?
They inhibit PD-1 receptors on T cells.
This causes increased T cell activation because PD-1 is an inhibitory pathway.
PD-1 receptors on T cells cause an inhibition of T cells when activated by PD-ligand 1 or 2 on APC or tumour cells
What side effects are more common in patients receiving monoclonal antibodies for advanced melanoma ?
Auto-immune diseases (arthritis, thyroid disease, Diabetes)
Because the T cell response is over stimulated
Match up the recombinant cytokine treatment with the disease that they are used in ?
IFN alpha Chronic granulomatous disease
IFN beta Hepatitis B
IFN gamma Behçet’s disease
IFN alpha Hepatitis B
IFN beta Behcet’s disease
IFN gamma Chronic granulomatous disease
what happens when B cells with appropriate specificity get selected
proliferate
differentiate into T cell independent IgM plasma cells
undergo germinal centre reaction and differentiate into T cell dependent IgG producing memory and plasma cells
list 3 types of APC
dendritic cells
macrophages
B lymphoctes
features of memory B and T cells
memory T - different pattern of expression of cell surface proteins involved in chemotaxis and cell adhesion, allowing rapid access to non-lymphoid tissues
memory B - circulating pre-formed high-affinity IgG antibodies present
