Immunology Flashcards
Cyclosporin
Cyclosporin
Binds to cyclophilins, inhibits calcineurin
Blocks T cell activation by preventing IL-2 Transcription.
USE: Transplant rejection prophylaxis, psoriasis, RA
TOX: Nephrotoxicity and HTN ( causes vasoconstriction of efferent and afferent renal arteries)
Tacrolimus (FK506)
Tacrolimus
Binds FK506BP, inhibits calcineurin. Blocks T cell activation by preventing IL-2 transcription.
USE: Transplant rejection prophylaxis.
TOX: Neurotoxicity (HA, paraesthesias), nephrotoxicity and HTN
Sirolimus
Sirolimus
mTOR inhibitor that binds FKBP. Blocks T-cell activation and B cell differentiation by preventing response at IL-2.
USE: Kidney transplant and rejection prophylaxis.
TOX: NOT NEPHROTOXIC. (causes anemia, etc)
Used in drug-eluting stents, synergistic w cyclosporine.
Daclizumab, basiliximab
Daclizumab
Monoclonal Abs that block IL-2R (CD25)
USE: Kidney transplant rejection prophylaxis.
TOX: Edema, HTN, tremor
Azothioprine
Azothioprine
Antimetabolite precursor of 6MP, inhibits lymphocyte proliferation by blocking nucleotide synthesis (dec proliferation of cells)
USE: Transplant rejection prophylaxis, RA, crohn, glomerulonephritis, autoimmune conditions
TOX: Leukopenia, anemia, thrombocytopenia.
6MP degraded by XO (6MP is a metabolite of Azothioprine) Therefore increased toxicity by allopurinol.
Glucocorticoids
Inhibit NFKB, suppress B and T cell function by decreasing transcription of cytokines.
Transplant prophylaxis, autoimmune DO, inflammation
Can cause many SE including iatrogenic Cushing syndrome.
Mycophenylate
Blocks IMP-Dehydrogenase, preventing synthesis of guanine nucleotide.
Decreases cell proliferation of T cells and B cells
USed in transplant PTS, SLE Nephritis
Muromunab (OKT3)
Muromunab
monoclonal Ab that binds CD3 on surface of T cells, interferes with T cell signal transduction. USed for transplants
Thalidamide
Thalidamide
USed for immunosuppresion, antiangiogenic
MECH: affects TNFalpha
TOX: Phocomelia (prior use as sedative in pregnancy)
Alemtuzumab
Alemtuzumab
Targets CD52, Used for CLL
(Alymtuzumab, for chronic lymphocytic leukemia
Bevacizumab
Bevacizumab
Target VEGF, used in colorectal cancer and renal cell carcinoma
Cetuximab
Cetuximab
Blocks EGFR, used in stage IV colorectal cancer, head and neck cancer
Rituximab
Rituximab blocks CD20, used in B-cell non hodgkin lymphoma, CLL, rhuematoid arthritis, ITP
Adalimumab, infliximab
Adalimumab blocks soluble TNF-alpha
Used in IBD, RA, ankylosing spondylitis, psoriasis
Entercept is a decoy TNF alpha receptor (not a monoclonal Ab)
Eculizumab
Eculizumab blocks complement protein C5
USE: paroxysmal nocturnal hemoglobinuria
Natalizumab
Natalizumab blocks alpha4-integrin, used in MS, crohns
alpha 4 integrin is involved in WBC adhesion. Risk of PML in patients with JC virus
Denosumab
Denosumab blocks RANKL
USE- osteoporosis, inhibits osteoclast maturation (mimics osteoprotegerin)
Denosumab affects osteoclasts
Abciximab
Abciximab blocks platelet glycoproteins IIB/IIIa.
USE: Antiplatelet agent for prevention of ischemic complications in patients undergoing coronary intervention (unstable angina)
IIb times IIIa = ab”six”umab
Digoxin immune Fab
Targets Digoxin, antidote for digoxin toxicity
Omalizumab
Omalizumab blocks IgE,
USE: allergic asthma, prevents IGE from binding FCERI. Very expensive, rarely used
Palivizumab
Palivizumab blocks RSV F protein
USE: RSV prophylaxis for high risk infants
PaliVIzumab - virus
Ranibizumab, bevacizumab
Ranibizumab and bevacizumab target VEGF
Used in neovascular age-related macular degeneration
