immunomodulatory and Anti-inflammatory drugs

Question 1

TH1 response

Answer 1

IFN-gamma, increases cell mediated cytotoxicity against intracellular pathogens

Question 2

TH2 respons

Answer 2

IL-4. humoral response, IgE antibodies, allergic diseases and multicellular parasites.

Question 3

TH17

Answer 3

IL-17, inflammatory responses. Extracellular bacteria.

Question 4

Immunostimulants-applications

Answer 4

enhance vaccination response, chronic infectious disease, immunodeficiency disorders and cancer.

Question 5

immunostimulant-limitations

Answer 5

do not promote specific immune reactions, cytokines have short half-lives, are expensive, and require parenteral administration.

Question 6

Alum

Answer 6

adjuvant in human vaccines.deposit with antigens and support prolonged exposure to developing immune reactions. few side effects

Question 7

BCG

Answer 7

live attenuated bacillus calmett-guerin. useful in some cancer therapies (bladder cancer). increase APC activity by interacting directly with PRR

Question 8

IL-2 (aldesleukin)

Answer 8

incrases proliferation of activated T cells, IFN gamma, and cytotoxic killer cells. Serious capillary leak, hypotension, reduced organ perfusion

Question 9

stimulates cell mediated cytotoxic immune response. produced in response to viral infection.

Answer 9

Interferons

Question 10

organ transplantation, treating inflammatory disorders, autoimmune disorders, and acts as selective immunosuppression

Answer 10

what is clinical indications for suppression of immune responses

Question 11

effective immune suppression by cross-linking DNA and killing proliferating T cells. used in auto-immune diseases, bone marrow transplancts

Answer 11

Cyclophosphamide - myelosuppression, nausea, vomiting, infertility

Question 12

metabolized to 6-MP and then to 6-thioguanine. Inhibits purine synthesis. Inactivated by xanthine oxidase

Answer 12

Azathioprine - used for renal transplants, and auto immune disease like lupus, RA. Myelosuppression, nausea, vomiting

Question 13

Inhibits inosine monophosphate dyhydrogenase and prevents purine synthesis. hydrolyzed to mycophenolic acid

Answer 13

Mycophenolate Mofetil - solid organ transplant.

Question 14

Inhibitor of DHFR. prevents thymidine as well as purine nucleotides

Answer 14

Methotrexate - drug of choice for RA. causes nausea, mucosal ulcers, hepatotoxicity, myelosuppression

Question 15

inhibits dihydroorotate dehydrogenase leading to decreased pyrimidine synthesis

Answer 15

Leflunomide - half life of 19 days, used in auto immune diseases and RA. Diarrhea, modest hepatotoxicity, myelosuppression

Question 16

Main glucocorticosteroid. Anti-inflammatory and immunosuppressive effects

Answer 16

Prednisone

Question 17

Main block of T cell receptor signaling pathway

Answer 17

Calcineurin (normally dephosphorylates NFAT to activate it)

Question 18

Tacrolimus

Answer 18

FK506 binds to FKBP12 and the complex inhibits calcineurin. used in transplants and autoimmune disorders and inflammatory diseases. causes nephrotoxicity, hypertension, hyperglycemia, liver dysfunction.

Question 19

Cyclosporin

Answer 19

binds to cyclophilin and the complex inhibits calcineurin to deactivate it. used in transplants, autoimmune, and inflammatory diseases. toxicities: nephrotoxicity, hypertension, hyperglycemia, liver dysfunciton

Question 20

Main IL2 pathway enzyme

Answer 20

mTOR

Question 21

Sirolimus (rapamycin)

Answer 21

inhibits mTOR (after binding to FKBP12) to prevent cytokine-induced growth. used in transplants. antagonizes tacrolimus effects by synergizes with cyclosporine