Immunology 5: Immunotherapy

Question 1

Examples of passive immunity

Answer 1

• snake or spider bites, scorpion or fish stings > passive infusion of antibody specific for the toxin to treat
• hypogammaglobulinaemia > primary or secondary infusion of gamma-globulins to reduce infection
• rabies immunoglobulin > post-exposure prophylaxis together with vaccination

Question 2

describe the different types of immunotherapy

Answer 2

• direct (targeted): antibodies or antibody related fragments that detect an antigen on the tumour cell and destroy the target either by recruiting immune cells or by delivering a toxin or radioisotope to it. Target: the tumour.
• indirect: the immune system is activated rendering it able to seek and destroy tumour cells. Target: the immune system.

Question 3

list some examples of direct immunotherapy

Answer 3

• monoclonal antibodies
• chimeric antigen receptors (CARs)
• Bi-specific antibodies

Question 4

list some examples of indirect immunotherapies

Answer 4

• tumour vaccines
• dendritic cell vaccines
• adoptive cell transfer
• cytokine therapies
• checkpoint inhibitor therapies
• stimulatory antibodies

Question 5

give examples of cytokine therapies and their uses

Answer 5

• immunomodulatory cytokines to activate anti-tumour immunity
• pegylated IFN-alpha, IL-2, GM-CSF
• used in specific cancer
• pegylated is an effective anti-viral IFN-alpha therapy and used in melanoma

Question 6

what is Rituxan (rituximab) used for?

Answer 6

• first-line treatment for non-Hodgkin’s lymphoma
• specific for the CD20 molecule on the cell surface of a small sub-population of B cells
• now found to have highly beneficial effects in RA and SLE

Question 7

what is Infliximab (anti-TNF) used for AND HOW DOES IT WORK?

Answer 7

• First approved November 1999 for the treatment of rheumatoid arthritis
• Now used to treat several other AI diseases:
  Ankylosing spondylitis
  Crohn’s disease
  Ulcerative colitis
• Chimeric antibody that blocks the function of tumour necrosis factor alpha (TNF)
• TNF is a pro-inflammatory cytokine that stimulates an acute phase reaction

Question 8

What is Skyrizi - risankizumab used for and how does it work?

Answer 8

SKYRIZI is an interleukin-23 (IL-23) inhibitor that selectively blocks IL-23 by binding to its p19 subunit. IL-23, a cytokine involved in inflammatory processes, is thought to be linked to a number of chronic immune-mediated diseases, including psoriasis