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Immunology Flashcards

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1
Q

List functions of the innate immune system.

A 
Inflammation 
Recruitment of immune cells 
Activate complement 
Natural killer cytotoxicity 
Phagocytosis
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2
Q

List cells of the innate immune system.

A 
Erythrocyte
Eosinophil
Monocytes - dendritic cells, macrophages
Basophil
Neutrophil
Megakaryocyte
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3
Q

What innate cells are found in the tissue?

A

Mast cell
Macrophage
Dendritic cells

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4
Q

What is the difference between MHC 1 and MHC 2 presentation?

A

MHC1 = all nucleated cells and platelets have it, present to CD8

MHC 2 = antigen presenting cells, present to CD4+

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5
Q

Where do T cells encounter antigens?

A

Lymph nodes

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6
Q

How do dendritic cells present antigens?

A

Via MHCII

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7
Q

What cells are the key players of the adaptive immune response?

A

B (differentiate to plasma cells) and T lymphocytes

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8
Q

What cytokines are released from Th1 cells?

A

IFN gamma

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9
Q

What cytokines are released from Th2 cells?

A

IL-4, 5, 13

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10
Q

What cytokines are released from Th17 cells?

A

IL-7A, 17F, 22

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11
Q

What helper cells are particularly good at triggering activation of mast cells and eosinophils?

A

Th2

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12
Q

What helper cells are particularly good at triggering activation of macrophages?

A

Th1

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13
Q

What helper cells are particularly good at triggering activation of netrophils?

A

Th17

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14
Q

What is the function of cytokines?

A

Regulate and co-ordinate cells of innate and adaptive immune responses

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15
Q

How to cytotoxic T cells kills cells by inducing apoptosis?

A

IFN and TNFa
FasL
Perforin and granzymes

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16
Q

What kind of cell is a natural killer cell?

A

Innate

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17
Q

What is the function of NK cells?

A

Kill infected cells

Produce cytokines to stimulate macrophages, Th1 and CD8+ cytotoxic

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18
Q

What is the function of B lymphocytes?

A

Neutralization of microbe, phagocytosis, complement activation
Opsonisation
Antibody-dependent cellular toxicity

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19
Q

What antibody is a pentamer?

A

IgM

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20
Q

What antibody is a dimer?

A

IgA

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21
Q

What antibody is for parasitic infections and allergy?

A

IgE

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22
Q

Where is IgA contained?

A

In secretions?

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23
Q

What antibody is best at activating complement?

A

IgM

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24
Q

What antibody is responsible fro memory in a secondary antigen exposure?

A

IgG

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25
List physical and chemical barriers of the immune system.
``` Intact mucosal membranes Lysozymes in tears Normal flora Fluhsing in urinary tract Mucociliary escalator Acidic pH of stomach Intact skin with sebum maintaining pH ```
26
What lymphatic tissues are found in membranes?
Mucosa-associated (MALT) Bronchus associated Gut associated
27
List cells formed in the myeloid lineage.
Megakaryocyte, mast cells, myeloblasts, erythrocytes
28
What are formed from megakaryocytes?
Platelets
29
What are formed from myeloblasts?
Basophil Eosinophil Neutrophil Monocyte
30
What are the two types of B lymphocytes?
Plasma cells and memory B cells
31
What system removes erythrocytes?
Reticuloendothelial system
32
What are the main targets of mast cells?
Parasites and allergens
33
What cells contain histamine and target parasites?
Basophils
34
What are the first cells that migrate to the site of infection, targeting bacteria and fungi specifically?
Neutrophil
35
What immune cells target parasites to big for phagocytosis?
Eosinophils
36
What 2 types off cells do monocytes become?
Macrophages | Dendritic cells
37
A dendritic cell is a professional APC. How does it present antigens?
Present to CD4+ via MHC II, releasing cytokines
38
How do natural killer cells work?
Granules contain proteins such as perforin and proteases | Activated by IFN and macrophage derived cytokines
39
List three types of T lymphocytes.
CD4+ CD8+ CD4+CD25+ (regulatory)
40
List cells involved in the innate immune system.
Phagocytes Dendritic cells NK cells Complement
41
List cells that work by phagocytosis.
Basophil Neutrophil Monocytes (macrophages and dendritic cells)
42
List the classic professional antigen presenting cells.
``` Dendritic cells Macrophages Dendritic cells Langerhans cells B cells ```
43
What cells are involved in the adaptive immune system?
B cells T cells APCs
44
All nucleated cells display set markers via what protein?
MHC I aka HLA
45
What does MHC I present?
Self antigens and intracellular foreign antigens
46
What is the function of MHC II?
Present exogenous or extracellular antigens from pathogenic invaders
47
What cells contain MHCII?
Dendritic, macrophages, B lymphocytes
48
What does MHCI and II complexes bind to?
MHC I = CD8+ | MHC II = CD4+
49
Discuss the cause of autoimmunity.
CD8+ cells destroy MHCI presenting self antigen i.e destroys healthy cell
50
How does the body prevent CD8+ cells binding and destroying self antigenic?
Immunological tolerance: 1. Central = in primary lymph nodes 2. Peripheral = in secondary lymphoid organs
51
Where do T and B cells develop central tolerance?
T - in thymus | B - in bone marrow
52
What cells are responsible fro peripheral tolerance?
Regulatory T lymphocytes
53
List conditions which would block chemical/physical barriers of immunity.
``` Mucositis Sjogren's syndrome Cystic fibrosis Toxic megacolon due to C difficile Burns ```
54
What are the primary lymphoid organs?
Bone marrow and thymus
55
What are secondary lymphoid organs?
MALT, Spleen, Peters patches, tonsils, lymph nodes
56
Name an immune cell responsible for recognising a viral infected host cell.
NK cell
57
List cells capable of phagocytosis.
Macrophage Basophil Neutrophil Monocyte
58
Can eosinophils phagocytose?
No
59
What cell types are responsible for targeting large parasites that are too large for phagocytosis?
Mast cells Basophils Eosinophils
60
How are T cells developed in thymus?
Alpha and beta chains on T cell receptor (TCR), contains complimentary determining regions (CDR)
61
What is V(D)J recombination?
Occurs in developing T cells - process of genetic changes which create a diverse selection of Ag binding sites
62
List the steps of T lymphocyte development.
Double -ve --> double +ve --> positive selection --> interaction with MHC --> negative selection --> reacts appropriately
63
What are the 3 mechanisms used by CD8+ T cells?
FasL IFN and TNFa Perforin and granzymes
64
What is the function of helper T cells?
Activates other immune cells by releasing T cytokines B lymphocyte antibody class switching Activation and growth of cytotoxic T cells Maximise activity of phagocytes
65
What cytokines are released by Th1 cells?
IFN gamma
66
What cytokines are released by Th2 cells?
IL -4, 5 and 13
67
What cytokines are released by Th17 cells?
IL-17,21,22
68
What Th cells have roles in allergy?
Th2
69
What occurs with increased Th1?
Type 4 hypersensitivity e.g MS
70
What occurs with increased Th2?
Type 1 hypersensitivity e.g Asthma
71
What occurs with increased Th17?
Chronic pro-inflammatory state (RA)
72
What is the function of Treg?
Suppress activation. proliferation and cytokine production of CD4 and CD8 lymphocytes Monitor self tolerance
73
What cytokines are released by Treg?
IL-10 and TGF-beta
74
What produces antibodies?
Plasma
75
What is the function of the Fc region on the antibody?
Communicate with other components of the immune system
76
What is the only isotope that can cross the placenta?
IgG
77
What antibody is involved in the primary response?
IgM
78
List functions of antibodies.
Bind to Ags - immune complexes Act as opsonins for phagocytosis Activate complement cascade Antibody Dependent Cellular Cytotoxicity (ADCC)
79
During ADCC, what does the Fc region bind to?
CD16
80
If Fc region binds to CD16, what happens?
Perforin and granzymes released --> apoptosis | Activates macrophages, eosinophils and neutrophils --> release granules and toxic enzymes
81
What are the 3 mechanisms of B cell activation?
Th dependent Th independent (B cells activated by antigens) Memory B cells
82
What is class switching?
Change in Ab heavy chain - same antigen specificity but acts with different effector cells
83
What antibody is found in the highest concentration in secondary infection
IgG
84
What occurs from a change in Ab heavy chain?
Change in isotype
85
Describe the innate immune system.
Fast, non-specific initial response
86
List cells involved in the innate immune system.
NK cells Mast cells Myeloblast cells
87
List functions of the innate immune system.
``` Antigen recognition Inflammation Recruitment of immune cells NK cytotoxicity Phagocytosis Opsonisation Activation of complement cascade ```
88
Give 2 examples of pattern recognition receptors.
Toll-like | C-type lectin
89
What do pattern recognition receptor recognise?
Pathogen associated molecular patterns (PAMPs) e.g lipopolysaccharide on gram -ve bacteria OR damage associated molecular patterns (DAMPs)
90
Discuss the pathophysiology of inflammation.
Macrophages recognise PAMPs and DAMPs --> release IL-1 and TNFa --> increase vascular permeability and neighbouring vessels express CAMS Chemokine released to recruit/attract immune cells to point of inflammation
91
What is leukocyte extravasation?
Leukocytes move through endothelium to site of infection/inflammation
92
What loosens junctions between endothelial cells until neutrophils can squeeze through the gap into inflamed tissue?
Histamine and bradykinin
93
What are the cardinal signs of inflammation?
Dolar - pain (from histamine and bradykinin) | Calor - heat Rubor - redness Tumour - swelling by vasodilation and increased vascular permeability
94
List atypical APCs.
Mast cells Basophils Eosinophils
95
List professional APCs.
Dendritic cells Macrophages B lymphocytes
96
What nucleated cell does not contain MHCI?
Platelets
97
How do NK cells differ from cytotoxic T cells?
Rapid response, no memory, don't require primary antigen
98
What cells do NK cells target?
Pathogens/cells with reduced or absent MHC I signal
99
What can NK cells release if activated by MHC I expression?
IFN gamma Perforin and granzyme TNFa
100
What cells are activated by IFN gamma?
Macrophages, NK cells
101
What can activate NK cells?
IFN gamma IL-2 Ab-opsonised Ag binding to Fc receptor
102
What is opsonisation?
Binding of an opsin (tag) to an invading cell - 'prepare for eating' Increase efficiency of phagocytosis Increase no of binding sites
103
What is the complement cascade?
Biochemical cascade of plasma proteins Trigger recruitment of immune cells Opsonise pathogens Aggregate forming membrane attack complex (through C3, C5 converts)
104
What are the 3 complement cascades?
Classical (Ag-Ab immune complex) Lectin (mannose (bacterial polysaccharides)-binding to lectin) Alternative (direct binding to microbe)
105
What is the difference between C3a and C3b?
``` C3b = large fragment, opsonin C3a = small fragment, pro-inflammatory ```
106
What forms the membrane attack complex?
C5b + C6 + C7 + C8 + C9
107
What is the function of the membrane attack complex?
Forms cytolytic pores which punches holes in cell membrane of target pathogens
108
List types of opsonins.
Plasma proteins Ab Complement
109
What do cytokines released in response to inflammation induce endothelial cells to produce for leukocyte adhesion?
Selectin
110
What is mast cell degranulation dependent on?
Cross linking of IgE Abs bound to Fc receptors on mast cell
111
What antibodies protect newborns in the first 6 months of life?
Maternally transferred IgG
112
How are immunodeficiencies classified?
Primary/congenital, secondary/acquired
113
What are patients with immunodeficiencies susceptible?
Infection Cancer Autoimmunity
114
What can be affected by primary immunodeficiencies?
Components of innate immune system Stages of lymphocyte development Response of mature lymphocytes to antigenic stimulation
115
List examples of congenital disorders that affect innate immune system.
Chronic granulomatous disease, leukocytes adhesion deficiency
116
What causes SCID?
Defects in T and B cells
117
If Serum Ig levels reduced, what type of deficiency does this suggest?
B cell deficiency
118
What changes are seen in follicles and germinal centres?
B cell deficiency - absent T cell deficiency - normal
119
What does repeated infection with encapsulated bacteria a sign of?
Defective antibody production
120
If deficiency in IgG and IgA, what can this lead to?
Recurrent respiratory infection by pneumococcal or haemophilus spp.
121
What are infections with staph, gram -ve bacteria and fungi a sign of?
Reduced number of phagocytes
122
What defects can predispose to meningitis?
Complement defects
123
What do T cell/macrophage defects result in?
Predisposition to infection with protozoa, viruses, intracellular bacteria
124
What is reactivation of latent herpes virus?
T cell immunodeficiency
125
What does recurrent attacks of cold sores or shingles suggest?
Mild immunodeficiency (specifically T cell)
126
Give examples of herpes virus- induced tumours caused by T cell dysfunction.
Kaposi's sarcoma | NHL
127
What pathway is likely to be defected with recurrent candida infections?
TH17
128
List causes of primary immunodeficiency.
``` Mutations Polymorphisms (two or more variants of a particular DNA sequence) Polygenic disorders (more than one gene involved) ```
129
List genetic causes of SCID?
Autosmal inherited | X-linked
130
What is a curative treatment for SCID?
Stem cell transplant (soon after birth)
131
What are common variable immunodeficiency (CVID) caused by?
Polygenic disorders - IgA deficiency
132
What does CVID cause?
Recurrent respiratory tract infections
133
What antibody fights fungal infections?
IgE
134
What do patients with APECED have a defect in?
Central tolerance | Produce antibodies against IL17
135
What do patients with APECED have an increased risk of?
Recurrent candida infections
136
How do you diagnose primary immune deficiency?
- Recurrent infections - Unusual infections - Family history of neonatal death - Lymphocyte count (low) - Flow cytometry for antibody count (IgG, IgE, IgM)
137
How do you treat primary immunodeficiency?
``` Prevent infection by... Prophylactic antibiotics If severe --> Immunoglobulin replacement therapy Stem cell transplant e.g for SCID Gene therapy ```
138
What are secondary causes of low antibodies?
Kidney or gut disease
139
When can you give gene therapy for primary immunodeficiency?
Gene mutation identified Evidence correcting mutation will improve condition Transfected gene must confer a d proliferative survival advantage Must not cause malignancy
140
List 3 types of antigens that can cause hypersensitivity?
Infection Harmless environmental substances Self-antigen
141
Name a virus that can cause hypersensitivity reactions.
Influenza | damage endothelium --> exaggerated immune response --> trigger cytokine storm --> hypotension and coagulation
142
How does IgE get produced in hypersensitivity reactions?
Th2 --> IL-4 --> B cells --> IgE
143
List environmental factors that can trigger hypersensitivity.
Pollen Dust Food Nickel (contact dermatitis)
144
What is the difference between IgE and IgG mediated hypersensitivities?
IgE --> immediate, allergy symptoms IgG --> farmer's lung
145
What are haptens?
Small molecules that bind to proteins and elicit and immune response. Can't bind to antibodies but bind to other small proteins,
146
What is a type 1 hypersensitivity reaction?
Allergy Immediate reaction IgE mediated Mast cells and eosinophil degranulation
147
What is a type 2 hypersensitivity reaction?
Antibody mediated, on second exposure allergic reaction
148
What is a type 3 hypersensitivity reaction?
Immune complexes formed between antibodies and antigens
149
What is a type 4 hypersensitivity reaction?
Delayed hypersensitivity
150
What do Th2 cells induce?
Production of IgE from B cells via IL-4
151
Define atopy.
Immediate hypersensitivity rection to environmental antigens mediated by IgE Develops within minutes of exposure
152
List signs of atopy.
``` Anaphylaxis Angioedema Urticaria Rhinitis Asthma Dermatitis ```
153
What is angioedema?
Non-specific, non-itchy swelling
154
What is the allergic march?
Development of allergic reactions over time
155
Define allergens.
Antigens that cause allergic reactions.
156
What is the allergen in penicillin allergies?
B-lactam
157
When do B cells produce IgE?
Co-stimulation with IL-4 secreted by Th2
158
What causes allergic symptoms?
Release of mediators that cause allergic symptoms
159
What cells degranulate causing allergic symptoms?
Mast cells Eosinophils (migrate to tissues) Basophils (stay in circulation)
160
What receptors are found on mast cells?
``` For IgE (regular and high affinity types) ```
161
What is a genetic cause of allergies?
Polymorphisms in gene encoding filaggrin which is expressed in keratocytes
162
What is the role of fillagrin?
Maintains epithelial barriers and moisturising surfaces and controlling pH
163
What are polymorphisms?
Slightly different alleles for same gene, present in 1% or more of population
164
List two polymorphism variants that can cause induction of Th2.
Filaggrin variant | LPS receptor variant
165
Why is the incidence of allergies increasing globally?
Urbanisation | Hygiene hypothesis
166
Discuss the pathophysiology of anaphylaxis.
Mast cells produce prostaglandins and leukotrienes through the cyclo-ocygenase and lipoxygenase pathways --> vasodilation and increased vascular permeability --> shift of fluids from vascular to extra-vascular space --> drop in BP Histamine in skin --> further increase shift of fluid (oedema)
167
Discuss the pathophysiology of rhinitis.
Inhaled allergens stimulates mast cells in nasal mucosa Leukotrienes increase mucous secretion
168
How do you treat type 1 hypersensitivity reactions?
Desensitisation (allergy immunotherapy) Drugs: B2-adrenergic agonists, adrenaline, antihistamines, leukotriene agionists, corticosteroids
169
What test can be carried out to identify cause of allergies?
Skin prick test
170
How does type 2 hypersensitivity reactions occur?
Antibody mediated - IgG (through complement) or IgM (through pathogen)
171
What is the most common type of type 2 hypersensitivity?
Haemolytic anaemia
172
List examples of immune mediated haemolysis.
Alloimmune haemolysis e.g incompatibility with ABO Autoimmune haemolysis e.g induced by infection or drugs, autoantibodies produced by malignant B cells Type 2 reactions against solid tissue e.g Goodpastures syndrome
173
Give an example of a condition which release antibodies that affect cell function.
Graves disease - Thyroid stimulated with autoantibody that binds into the TSH receptor
174
List examples of hypersensitivity type 2 diseases.
``` Autoimmune haemolytic anaemia Autoimmune thrombocytopenia purpura Pemphigus vulgaris Vasculitis caused by ANCA Myaesthenia gravis Penicious anaemia ```
175
What antibody is responsible for type 3 hypersensitivity reaction?
IgG --> form antigen-antibody complex (large complexes when antibody= antigen, when antibody>antigen = small complex)
176
In type 3 hypersensitivity reactions, what breaks down large complexes?
Complement
177
What causes immune complex disease in type 3 hypersensitive reactions?
Failure of clearance of complexes by complement | --> activation of innate immune system
178
Give an example of a type 3 hypersensitivity reaction with immune complex disease.
Glomerulonephritis Farmer's lung SLE
179
What is the slowest type of hypersensitivity?
Type 4 (2-3 days)
180
What initiates type 4 hypersensitivity reactions?
Macrophages recognise ANTIGEN --> dendritic cells migrate to lymph nodes and present antigen to T cells --> exaggerated response against self antigen
181
What stimulates most of the damage in type 4 hypersensitivity?
TNF secreted by macrophages and T cells
182
Give examples of type 4 hypersensitivity reactions.
``` Rheumatoid arthritis Multiple sclerosis T1DM IBD Psoriasis ```
183
What helper T cells are associated with type 4 hypersensitivity reactions?
Th1 and 17
184
How do you treat delayed hypersensitivity?
Prevent through avoidance of antigens Anti-inflammatories: NSAIDs, corticosteroids, drugs that block TNF and IL-6, Abs against B cells Immunosuppressive drugs
185
Define immunological tolerance.
Unresponsiveness to an antigen that is induced by previous exposure to that antigen
186
What are tolerogens?
antigens that induce tolerance
187
What occurs from failure of self tolerance?
Autoimmunity
188
What are the two types of immunological tolerance?
Central - thymus, eliminate T cells with high affinity to self. Bone marrow for B cell tolerance Peripheral - mature lymphocytes that recognise self in peripheral tissues become incapable of activation or die by apoptosis
189
List mechanisms of peripheral tolerance.
``` Anergy Antigen recognition with co-stimulation Treg suppression Deletion Some self antigens sequestered from immune system by anatomic barriers ```
190
Define autoimmunity.
Adaptive immune response to self antigens
191
Define autoantigens.
Antibodies directed at normal cellular components
192
autoimmune disease occurs when auto reactive T cells or autoantibodies cause tissue damage through what types of hypersensitivity?
2, 3, 4
193
What is the major source of autoantibodies?
B1 cells | --> cross-react with inherited A and B antigens of red cells, make IgM anti-A and anti-B even if not exposed
194
What causes breakdown of T cell tolerance?
Genetic predisposition (familial clustering, MHC alleles, polymorphisms, rare genetic diseases, AIRE gene) Environmental factors (infections, drugs, UV radiation )
195
What gene can be mutated to prevent central tolerance from not taking place?
AIRE gene (transcription factor expressed by medullary epithelial cells in thymus)
196
What is molecular mimicry?
Structural similarity between self-proteins and microbial antigens may trigger an autoimmune response --> caused by infection, drugs
197
Most autoimmune diseases present age 15-65. Give an exception to this.
T1DM
198
What are the two different types of autoimmune disease.
Non-organ specific Organ specific (endocrine gland)
199
Give examples of autoimmune diseases.
SLE T1DM Coeliac disease
200
How is autoimmune diseases treated?
suppress damage of immune response (immunosuppressives) Replace function of organ damaged e.g Treg cell therapies
201
What gender is autoimmune diseases most common in?
Females mostly
202
Define autograft.
Transfer of tissue between different sites within same organism.
203
Define isograft.
Transfer between genetically identical individuals
204
Define allograft.
Transfer between genetically non-identical individuals of same species
205
Define xenograft.
Transfer between species
206
What is the most common type of transplant?
Allograph
207
List two things to do to prevent transplant rejection.
``` Tissue match (ABO, HLA-A, B, DR) Prophylactic immunosuppressive therapy ```
208
Describe an instance when no tissue matching or immunosuppressive therapy is required.
Corneal transplant
209
Define privileged sites.
When no tissue typing or immunosuppression required | Can tolerate new antigens without inducing an immune response
210
List 7 complications of transplantation.
``` Graft rejection GVHD Infection Neoplasm Recurrence of original disease Drug side effects Ethical, surgical problems ```
211
List two mechanisms of graft rejection.
Direct alloantigen recognition or indirect presentation *Mostly due to incomplete HLA matching
212
Define hyperacute rejection.
Minutes, from pre-formed Abs
213
Define accelerated rejection.
2-5 days, from T cells pre-sensitised
214
Define acute rejection.
7-21 days, from T cells newly sensitised
215
Define chronic rejection.
months-years, multifactorial
216
List 4 types of graft rejection.
Hyperacute, accelerated, acute, chronic
217
What is the most common cause of GVHD?
Bone marrow transplant
218
What circumstance need to be present to cause GVHD?
Presence of functioning immunocompetent donor T cells in graft Defective immunity in recipient HLA differences
219
Where is GVHD most commonly seen?
Skin, gut, liver and immune cells
220
How can GVHD by prevented?
Careful/v close tissue matching | Deplete donor marrow of T cells in vitro prior to grafting
221
Before bone marrow transplant, what should be done?
Conditioning - High dose chemo and radiotherapy (to destroy recipients SCs and allow engraftment of donor cells)
222
Give an example of an xenograft.
Porcine tisse
223
What is a problem with the use of porcine tissue?
Humans have naturally acquired IgM against pig Ags and galactose residues
224
Give examples of immunosuppressive drugs.
``` Cyclosporin Tacrolimus Basiliximab Rapamycin Azathioprine Methotrexate ```
225
List side effects of cyclosporin.
Nephrotoxic Infections DM HTN
226
List side effects of the monoclonal antibody treatment Rapamycin.
Hyperlipidaemia/cholesterolaemia, HTN, Anaemia, Thrombocytopenia, acne
227
What is acute graft rejection associated with?
T cell responses that mediate immune cell infiltration into graft
228
What is IV immunoglobulin used for?
1. Replacement therapy - primary and secondary immunodeficiencies 2. Modulatory therapy - inflammatory and autoimmune disorders
229
What are potential problems with IVIg?
ADRs during infusions | Infection transmission e.g Hep C
230
List the two types of immunotherapy and give examples.
Direct (targeted) - Monoclonal Abs, CARs, Bi-specific Ab Indirect - Tumour vaccines, dendritic cell therapies, cytokine therapies, checkpoint inhibitor therapies, stimulatory Abs
231
List established immunosuppressive/modulatory drugs.
Corticosteroids Azathioprine Cyclophosphamide
232
How do corticosteroids work?
affect B and T cells, cytokine network, inflammation, monocytes, transit and circulation of immunologically active cells
233
How does azathipoprine work?
inhibits DNA synthesis, T cells and NK cells, anti-inflammatory
234
How does cyclophosphamide
Suppress B cells and Ab production
235
List newer immunosuppressives.
Cyclosporin, Tacrolimus Rapamycin Mycophenolic acid
236
How do monoclonal antibody therapies work?
Target specific antigens e.g T cell receptors (CD3, 4 and 52, HLA, Cytokines) Use mouse/rat derived AB, cleave Fc and replace with human Fc
237
Give 3 examples of monoclonal antibody therapies.
1. Rituximab - NHL 2. Inflixumab - RA, AS, IBD 3. Trastuzumab/Herceptin - Breast cancer
238
How do cytokine therapies work?
Exert autocrine effects on cells or paracrine effects on cells around them Involves production of factors that will interfere with cytokines or produce/administer recombinant cytokines
239
What is the purpose of cytokine therapy.
Inhibit harmful cytokines or enhance beneficial cytokines
240
Give examples of cytokine therapies.
IL-1/TNF - decrease activity in RA IL-2 - Decrease activity in transplant rejection or increase in tumour therapy
241
What is the purpose of checkpoint inhibitors?
Unlock gateway to adoptive immune system - powerful anti-tumour response
242
What is a potential side effect of checkpoint inhibitors?
Immune related ADRs
243
Give an example of a checkpoint inhibitor for metastatic melanoma.
Ipilimumab
244
Discuss PD1/PDL-1 as targets for inhibitors.
In a cancer state, PD1 on T cell binds with PD-L1 on tumour cell causing reduced T cell function and therefore preventing immune system from attacking tumour. If inhibit these checkpoints, then immune system can attack.
245
Give an example of an adoptive cell therapy.
CAR-T

Haematology and Immunology (2 decks)

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