Immuno 9: Immune Modulation Therapies 1

Question 1

Describe Clonal expansion in T cells?

Answer 1

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

Question 2

List 3 vaccines given to the elderly aged over 65?

Answer 2

Pneumococcal vaccine (Pneum PPV)
Flu vaccine
Shingles

Question 3

Describe clonal expansion in B cells ?

Answer 3

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

Question 4

Where do B cells undergo Isotype switching ?

Answer 4

Germinal centres

Question 5

Where do plasma cells reside ?

Answer 5

Bone marrow

Question 6

which bacteria is in the BCG vaccine ?

Answer 6

Bovine tuberculosis

Question 7

Give 3 examples of live attenuated vaccines ?

Answer 7

MMR
Yellow fever
Typhoid

Question 8

Give 2 examples of Toxoid vaccines (Inactive toxins) ?

Answer 8

Diphtheria

Tetanus

Question 9

Give 3 examples of subunit vaccines ?

Answer 9

Hep B (HBsAG)
HPV (capsid)
Influenza (HA)

Question 10

Give one advantage of a life vaccine compared to a component/inactivated vaccine ?

Answer 10

Longer lasting immunity (life long)

Immunity is broader (protects against more strains)

Question 11

Give an advantage of a component/inactivated vaccine compared to a live vaccine ?

Answer 11

Can be given to immunocompromised patients

Question 12

Give 3 examples of conjugate vaccines ?

Answer 12

HiB (haemophilus influenza B)
Meningococcus
Pneumococcus

Question 13

List 2 indications for Haematopoeitic stem cell transplantation ?

Answer 13

SCID

Haematological malignancy

Question 14

List 3 primary immunodeficiency diseases in which Antibody replacement (pool of antibodies to variety of organisms) is indicated ?

Answer 14

Bruton’s X-linked agammaglobulinaemia
X-linked hyper IgM syndrome
Common variable immunodeficiency

Question 15

In which 2 Haematological malignancies is Antibody replacement indicated ?

Answer 15

CLL

Multiple myeloma

Question 16

List 3 diseases in which IgG immunoglobulin therapy can be used ?

Answer 16

Shingles infection (varicella zoster)
Rabies (post exposure)
Hepatitis B

Question 17

Give one example of an infection in which adoptive cell transfer (ACT) can be used to infuse a donor’s T cells ?

Answer 17

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.

Question 18

How does Ipilimumab work in treatment of advanced melanoma ?

Answer 18

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

Question 19

How does Pembrolizumab and nivolumab work in the treatment of advanced melanoma ?

Answer 19

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

Question 20

What side effects are more common in patients receiving monoclonal antibodies for advanced melanoma ?

Answer 20

Auto-immune diseases (arthritis, thyroid disease, Diabetes)

Because the T cell response is over stimulated

Question 21

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

Answer 21

IFN alpha Hepatitis B
IFN beta Behcet’s disease
IFN gamma Chronic granulomatous disease