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Clinical Pathology (mine) > Immunotherapeutics > Flashcards

Immunotherapeutics Flashcards

1
Q

Define immunomodulation

A

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

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2
Q

What therapeutic effects may immunomodulation have? (3)

A

immunopotentiation, immunosuppression or induction of immunological tolerance

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3
Q

What are the mechanisms of immunomodulation? (7)

A
  • immunisation
  • replacement therapy
  • immune stimulants
  • immune suppressants
  • anti-inflammatory agents
  • allergen immunotherapy
  • adoptive immunotherapy
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4
Q

Define biologics

A

medical products produced using molecular biology techniques including recombinant DNA technology

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5
Q

Name three methods of immunopotentiation

A

immunisation, replacement therapies, immune stimulants

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6
Q

Define passive immunisation

A

transfer of specific, high-titre antibody from donor to recipient (provides but transient protection)

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7
Q

What are the problems with passive immunisation?

A

risk of transmission of viruses and serum sickness

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8
Q

What are the two main types of passive immunisation?

A
  • pooled specific human immunoglobulin

- animal sera

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9
Q

What are the main uses of passive immunisation?

A
  • hep B prophylaxis treatment

- botulism, VZV, diptheria, snake bites

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10
Q

Define active immunisation

A

to stimulate the development of a protective immune response and immunological memory

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11
Q

What immunological materials can be used for active immunisation?

A
  • weakened forms of pathogen
  • killed inactivated pathogens
  • purified materials (proteins, DNA)
  • adjuvants
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12
Q

What are the problems with active immunisation?

A
  • allergy to components in vaccine
  • limited usefulness in immunocompromised
  • delay in achieving protection
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13
Q

Is alpha-, beta- or gamma- interferon used in treatment of hep C?

A

alpha-interferon

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14
Q

Is alpha-, beta- or gamma- interferon used in therapy of MS?

A

beta-interferon

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15
Q

What are the 5 main groups of drugs used for immunosuppression?

A
  • corticosteroids
  • cytotoxic agents
  • anti-proliferative/activation agents
  • DMARDs
  • biologic DMARDs
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16
Q

What effect do corticosteroids have on neutrophil margination?

A

decrease it

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17
Q

What effect do corticosteroids have on inflammatory cytokines?

A

reduce production of them

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18
Q

What are the main side-effects of corticosteroids?

A
  • carbo and lipid metabolism
  • reduced protein synthesis
  • osteoporosis
  • glaucoma and cataracts
  • psychiatric complications
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19
Q

What are the main uses of corticosteroids?

A
  • autoimmune diseases
  • inflammatory
  • malignancies
  • allograft rejection
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20
Q

What do the following group of drugs all target?:

anitmetabolites, M-TOR inhibitors, calcineurin inhibitors, IL-2 receptor mABs

A

lymphocytes

21
Q

How does ciclosporin A work?

A

calcineurin inhibitor - binds to intracellular protein cycophilin

22
Q

How does tacrolimus work?

A

calcineurin inhibitor - binds to intracellular protein FKBP-12

23
Q

What drug is also known as FK506?

A

tacrolimus

24
Q

What is the mode of action of calcineurin inhibitors?

A

prevents activation of NFAT

25
Q

How do calcineurin inhibitors effect T cells?

A

reversible inhibition of T cell activation, proliferation and clonal expansion

26
Q

What is the mode of action of sirolimus?

A

inhibits response to IL-2

27
Q

What effect does sirolimus have on T cells?

A

cell cycle arrest at G1-S phase

28
Q

What are the clinical uses of calcineurin/mTOR?

A

transplantation (allograft rejection), autoimmune diseases

29
Q

How do antimetabolites work?

A

inhibit nucleotide (purine) synthesis

30
Q

What is the exact action of AZA?

A
  • guanine anti-metabolite

- rapidly converted into 6-mercaptopurine

31
Q

What is the exact action of MMF?

A
  • non-competitive inhibitor of IMPDH

- prevents production of guanosine triphosate

32
Q

What effects to antimetabolites have on T and B cells?

A
  • impaired DNA production

- prevents early stages of activated cells proliferation

33
Q

What are the clinical uses of AZA and MMF?

A
  • autoimmune diseases

- allograft rejection

34
Q

What are the clinical uses of MTX?

A
  • RA, PsA, polymyositis, vasculitis

- GvHD in BMT

35
Q

What are the clinical uses of cyclophosphamide?

A
  • vasculitis

- SLE

36
Q

Name 5 biological DMARDs

A
  • anti-cytokines
  • anti-B cells therapies
  • anti-T cell activation
  • anti-adhesion molecules
  • complement inhibitors
37
Q

What were the first biologics to be used in therapy of RA?

A

anti-TNF

38
Q

What problems may anti-IL-6 cause?

A

control of serum lipids

39
Q

What three anti-IL-1 are available?

A

anakinra, rilonacept and canalinumab

40
Q

What is the action of rituximab?

A

chimeric mAb against CD20-B cell surface

41
Q

What are the uses of adoptive immunotherapy?

A
  • immunodeficiencies
  • lymphomas and leukemias
  • inherited metabolic disorders
  • autoimmune diseases
42
Q

What are the mechanisms of allergen specific immunotherapy?

A
  • switching of immune response from Th2 (allergic0 to Th1 (allergic)
  • development of T reg cells and tolerance
43
Q

What are the routes for allergen specific immunotherapy?

A

SC or sublingual for aero-allergens

44
Q

What are the side-effects of allergen specific immunotherapy?

A

localised and systemic allergic reactions

45
Q

What are the indications for allergens specific immunotherapy?

A
  • allergic rhinoconjunctivitis not controlled on maximum medical therapy
  • anaphylaxis to insect venoms
46
Q

Omalizumab acts as a mAb against what?

A

IgE

47
Q

Mepolizumab acts as a mAb against what?

A

IL-5

48
Q

What is used in the treatment of asthma?

A

omalizumab

49
Q

How does mepolizumab work?

A

prevents eosinophil recruitment and activation

Clinical Pathology (mine) (28 decks)

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