Immunosuppressants Lecture Questions Flashcards
What is induction?
relatively intense use at the time of transplantation. Cannot be used long term because of toxicity
What is maintenance?
low dose, used in chronic use but hase side effects
What is rescue?
intense use applied in response to rejection episode. Chronically intolerable
What type of drugs are typically given during maintenance?
a triple-drug therapy of: calcineurin inhibitor, anti-proliferative, and steroid
What is CD3?
T cell receptor that is necessary for T cell activation
What is CD28?
combines with CD80 and CD26 to produce costimulation signal
What is calcineurin?
controls transcriptional access to NFAT. Inhibiting it prevents upregulation of IL-2
What do glucocorticoids do?
inhibit transcription of proinflammatory genes, which diminishes T cell ability to secrete IL-2
What is CD25?
The T cell surface receptor for IL-2. If blocked, diminishes T cell clonal expansion
What is mTOR?
After IL-2 receptor CD25 is activated, it activates mTOR, which initiates cell cycle critical to clonal expansion.
What is CD52 receptor?
receptor on surface of mature lymphocytes. Binding to it marks the cell for lysis by AADC and complement destruction
What is a major problem with calcineurin inhibitors?
they cause renal toxicity.
can also cause secondary malignancies and gingival hyperplasias
What are the adverse effects of corticosteroids?
protein metabolism dysfunction,
What is Sirolimus?
an mTOR inhibitor.
What does mycophenolate mofetil do?
affects primarily T and B-lymphocytes, which cannot synthesize GMP sufficientyly through salvage pathway. Inhibits activated T-cell proliferation.
