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Chronic Disease > Immunotherapy > Flashcards

Immunotherapy Flashcards

1
Q

What 4 therapy types are used

A

Vaccines
Immunomodulatory drugs
Biologics
Cell therapies

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2
Q

What’s the difference between prophylactic and therapeutic vaccines

A

Therapeutic given after eg after cancer developed

Prophylactic is preventative

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3
Q

Give a therapeutic vaccine for advanced melanoma

A

T-VEC (manipulated hsv)

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4
Q

Who would need immunosuppressant therapy

A

Autoimmune / allergy syndromes
Or transplant patients

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5
Q

Which responses do vaccines induce

A

Both t and b cells

T cells don’t prevent the disease but prevent progression

B cells can neutralise before infection

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6
Q

What is given often with vaccines

A

Adjuvants

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7
Q

Why would therapeutic be less effective

A

Underlying inflammation/ evasion which stops natural and vaccine induced immunity still present

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8
Q

What vaccine is there for prostate cancer which is effectively a cell therapy and what does it do

A

Provenge
Draw blood from patient
Stimulate apc like dc with pap antigen from tumour cells
Injected back
T cell stimulation

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9
Q

Why is this effective possibly in cancers sometimes

A

Downreg of MHC is common

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10
Q

What is the MHC restriction

A

The fact T cells only recognise ag on MHC

And MHC are highly specific and polymorphic / individuals

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11
Q

What is done to counteract this

A

Multiepitope vaccines

Pre clinical screening for effective MHC presentation of candidate peptides

Conjugate vaccines to stimulate T cells aswell as b cells

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12
Q

Which vaccine type is more common for chronic infections

A

Prophylactic

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13
Q

Why

A

Because it reduces chance of Comorbidites like immunodeficiency and cancer

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14
Q

Why is vaccination limited

A

Still not for many serious viruses like hiv which develops cancer later and immunodeficiency

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15
Q

What sort of things can be immunostimulant drugs (ikmunomodulators)

A

Cytokines
Prr activators
Chemokines

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16
Q

Which type of immuno mod are still in clinical trials

A

Ido inhibitors

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17
Q

What is imiquimod immunostimulant

A

Artificial dsrna

Stimulates tlr 7/8

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18
Q

Which cytokine often used for anti cancer as it’s stimulant

A

Ifna

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19
Q

What does lenalidomide (immuno mod)work best with for non Hodgkin lymphoma (

A

Rituximab (anti cd20)

20
Q

What is tacrolimus

A

An immunosuppressant cdrug

21
Q

How does it stop T cell proliferation

A

Through calcineurin blocking

22
Q

Why cytokines is used to be suppressant for MS maybe because it induces ido

A

Ifnb

23
Q

Why would jak inhibitors be immunosuppressant

A

Cytokines signal through jak-stat pathway for effects

24
Q

What’s the diff between chimeric and humanised mab

A

Chimeric is half and half eg where whole variable region is mouse but constant is human

Humanised is all human except the CDR from immunised mice

25
Q

Explain how they are made

A

Form hybridomas where immunised b cells and myeloma cells come together
Myeloma cells make the b cells immortalised so keep divining and producing mab clones

Hybridomas are cultured and purified mab

26
Q

What 3 types of ma. are there

A

Cytoloyric

Blocking

Agonist

27
Q

What are fusion proteins-fc

A

They are proteins fused to the fc region of antibodies so are delivered specifically eg to arthritic joints

28
Q

Give 2 examples of fusion proteins

A

Ctla4-igg1 : Ctla4 suppresses T cell activity in arthritis

Tnfrecetor- igg1 : blocks TNFa signalling

29
Q

What is an agonist example

A

Cd40 for T cell activation

30
Q

Which cytolytic mab for ra are suggested to cause long term suppression after treatment = remission?

A

Cd20 and cd52 since they directly impact the haemotpietic lineage

31
Q

How are they cytolytic eg cd20 to b non Hodgkin cells

A

They have a igg1 human fc portion which triggers complement activation by c1q, and also binds fcyR on NK cells

= mac and NK fell killing

32
Q

Give a cancer specific mab treatment

A

Herceptin for Her2 overexpression

33
Q

What is immunoradiotherapy

A

Mab conjugated with radioactive product

Targets cancer cells specifically

34
Q

What can reg T cell therapy be used for

A

T1d or gvHD after a bm transplant eg if someone has leukemia

35
Q

What are the 2 dc therapies

A

Regulatory dc therapy eg for arthritis

Provenge

36
Q

Give some immune checkpoint blockers for cancer

A

Ctla4, anti pd 1/l1 , IDO (still clinical trial)

37
Q

Which adjuvant can be used for cancer

A

PI:C

38
Q

Which vaccine found increased stimulation of CTL recruitment via chemokines with pi:c

A

Bcg used for bladder cancer

39
Q

What is pi:c

A

Artificial Dsrna stimulating tlr3

40
Q

What do IDO do

A

Catabolise tryptophan which blocks innate and adaptive responses

41
Q

What toxic metabolite does this form

A

Kyn

42
Q

What could inducers be used for in future

A

Transplant or other things

43
Q

What things do kyn toxic metabolites do to suppress immunity by t cells

A

Suppress effector T cells eg via anergy, autophagy, cell cycle arrest

44
Q

How do they impact NK and cd8

A

Cytotoxic to them

45
Q

What Innate receptor does ido downreg

A

NK recetor

46
Q

What is the main issues with immunotherapy

A

Need long term

Remission rates are quite low

Adverse side effects eg neurotoxicity

Expensive eg mabs

47
Q

What sort of side effects can pd1 for example have

A

Cardio toxicity and neurotoxicity

Chronic Disease (16 decks)

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