Immunomodulation Flashcards

1
Q

When is immune modulation indicated?

A
  • Suppression of inappropriate immune responses
  • Enhance immune response against neoplasia
  • Limit the immune response in degenerative disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which hypersensitivity reaction is IgG mediated?

A

Type II

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the action of anti-inflammatory medications?

A

Act to block some effector mechanisms of the innate immune system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the action of immunosuppressive medications?

A

Mainly act to reduce the function of the adaptive immune system
Reduce lymphocyte proliferation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the 3 main groups of immunosuppressive drugs used in a veterinary practice?

A

Drugs which inhibit:

  • Cytokine gene expression
  • IL-2 production
  • DNA synthesis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is used as the first line immunosuppressive treatment for many immune mediated diseases?

A

Glucocorticoids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Where are glucocorticoids metabolised and excreted?

A

Metabolised in the liver

Excreted by the kidneys

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Describe the MOA of glucocorticoids?

A
  • Bind to receptors in the cytoplasm
  • Transit to nucleus and bind to DNA influencing transcription of a huge number of genes in many tissues
  • Reduce degranulation
  • Reduce pro-inflammatory cytokine production
  • Reduce antigen presentation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

The effect of glucocorticoids depends on..?

A

Dose and formulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

List some adverse effects of glucocorticoids

A
  • Skin thinning
  • Weight gain
  • Muscle loss
  • Polyphagia
  • PU/PD
  • GI bleeding
  • Lethargy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What systemic effects are expected of glucocorticoids?

A
  • Stimulate gluconeogenesis
  • Suppress inflammation
  • Alter fat, protein and carbohydrate metabolism
  • Suppress HPA axis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which cells produce IL-2?

A

CD4+ cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

IL-2 leads to stimulation of…?

A
  • Activation of T-cells
  • B-cell proliferation
  • Activity of innate immune cells (macrophages, NK cells)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What occurs when IL-2 is inhibited?

A
  • Reduced activity of all functions requiring helper T-cells (adaptive immunity)
  • Cytokine suppression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Which 2 drugs are most commonly used to inhibit IL-2 production/action?

A

Ciclosporin

Tacrolimus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Which molecule is blocked by the drugs which inhibit IL-2 production?

A

Calcineurin

17
Q

Name 2 drugs which inhibit DNA synthesis

A
Azathioprine
Mycophenolate mofetil (MMF)
18
Q

Which enzyme is targeted by drugs which inhibit DNA synthesis?

A

Purine

19
Q

What are second line immunosuppressives used in conjunction with?

A

Steroids

20
Q

What are immunosuppressives and steroids used in conjunction for?

A
  • To increase the immunosuppressive effect
  • To increase the rate at which steroids can be withdrawn
  • To reduce dose and adverse effects of steroids
21
Q

What is the action of imiquimod?

A

Applied to the skin and it stimulates the immune system

22
Q

What is the action of a vaccine dependant on?

A
  • Route of vaccine
  • Type of vaccine
  • Presence or absence of co-stimulatory molecule