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Clinical Pathology > Immunomodulation and suppression > Flashcards

Immunomodulation and suppression Flashcards

1
Q

what is immunomodulation?

A

the act of manipulating the immune system using drugs to achieve a desired immune response

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2
Q

What are immunomodulators?

A

Medicinal products produced using molecular biology techniques, including recombinant DNA tech

Main classes include:

  • substances identical to body’s signaling proteins.
  • monoclonal antibodies
  • fusion proteins
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3
Q

What is immunopotentiation?

A

Immunopotentiation includes :

  • Immunisation (active / passive)
  • replacement therapies
  • immune stimulants
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4
Q

what is passive immunization?

A

transfer of specific antibody from donor to recipient. provides immediate but short protection.

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5
Q

what are the types of passive immunisation?

A
  • pooled specific human immunoglobin

- animal sera (used to treat antiotoxins and antivenins)

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6
Q

what are the uses of passive immunisation?

A

1) Hep B (prophylaxis and treatment)
2) Botulism
3) Varicella Zoster Virus (pregnancy)
4) Diptheria
5) snake bites

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7
Q

what is active immunization?

A

Used to stimulate the development of protective immune response ad immunological memory

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8
Q

What immunogenic material is used in active immunization?

A

1) weakened forms of pathogen
2) killed inactivated pathogen
3) purified material (proteins, DNA)

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9
Q

What are the problems encountered with active immunization?

A

1) allergy
2) limited use in immunocompromised
30 Delay in achievng protection

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10
Q

What is used for Immunosupression?

A

1) Corticosteroids
2) Cytotoxic agents
3) Anti-proliferative agents
4) DMARD’s

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11
Q

How do corticosteroids act to cause immunosupression?

A

1) Decreased neutrophil margination
2) reduced production of inflammatory cytokines
3) lymphopenia (low levels of lymphocytes)
4) Reduced immunoglobulins production

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12
Q

What are the side effects of corticosteroid therapy?

A

1) reduced carbs and lipid metabolism:
- diabetes
- hyperlipidaemia

2) Reduced protein synthesis
- poor wound healing

3) osteroporosis
4) Glaucoma and cataracts

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13
Q

What are the uses of corticosteroids

A

1) Autoimmune disaeases e.g Vasculitis and Rheumatoid arthritis

2) Inflammatory diseases
e. g. crohn’s, sarcoid,

3) Malignancies
e. g. lymphoma

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14
Q

Give an example of an antimetabolite drug which targets lymphocytes?

A

1) Azathioprine (AZA)

2) Mycophenolate mofetil (MMF)

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15
Q

M-TORs inhibit mammalian target of rapamycin. By inhibiting the response to IL-2. Which causes the T cell cycle to stop at the G1-S phase.
Give an example of an M-TOR inhibitor that targets lymphocytes?

A

1) Sirolimus (rapamycin)

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16
Q

Calcineurin causes reversible inhibition of T cell activation, proliferation and clonal expansion.Give an example of a calcineurin inhibitor that targets lymphocytes?

A

1) Ciclosporin

2) Tacrolimus

17
Q

Give an example of an Il-2 receptor mABs that targets lymphocytes?

A

1) Basiliximab

2) Daclizumab

18
Q

What are the side effects of Calcineurin/mTOR

A
  • hypertension
  • hirsutism
  • nephrotoxicity
  • hepatotoxicity
  • lymphomas
  • neurotoxicity
19
Q

how do antimetabolites work?

A

Inhibit nucleotide (purine) synthesis. Resulsts in impaired DNA in T and B cells. This prevents the early stages of activated cell proliferation.

20
Q

what is methotrexate used to treat?

A

cancer

rheumatoid arthritis

21
Q

What are some of the cytotoxic side affects of immunosuppressants?

A

1) bone marrow supression
2) Gastric upset
3) Hepatitis
4) Susceptibility to infection

22
Q

What are the clinical uses of cytotoxic drugs such as Azathioprine and Mycophenolate mofetil (MMF)

A

Autoimmune diseases e.g. SLE, vasculitis and IBD

23
Q

What are biological DMARD’s

A 
DMARD's = disease modifying anti rheumatic drugs.
Anticytokines
Anti B cell therapies
anti T cell activation
anti adhesion molecules
complement inhibitors
24
Q

In what conditions are anti-cytokines used?

A

Crohn’s
psoriasis
ankylosing spondylitis
Rheumatoid A

25
Q

rituximab is an anti b cell therapy - what can it be used for?

A
  • lymphomas and leukaemias
  • transplant rejection
  • autoimmune disorder
26
Q

What is adoptive immunotherpay and what are its uses?

A
  • bone marrow transplant (BMT)
  • Stem cell transplant (SCT)

Used for:

  • immunodeficiency
  • lymphoma / leukemias
  • inherited metabolic disorders
  • autoimmun diseases
27
Q

How does allergen specific immunotherapy act?

A

-switches of immune response from Th2 (allergic) to Th1 (non-allergic)

Also encourages the development of regulatory T cells and tolerance

Clinical Pathology (59 decks)

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