Immunotherapy Flashcards
Time course for primary and secondary lymphocytic immune responses?
Primary - 8-14 days
Secondary - 3 days
What are eosinophil roles in allergic reactions?
Detox inflammatory substances
Phagocytose Ag-Ab complexes
Basophils resemble what other cell? What are their roles?
Mast cells
Bind IgE, release Histamine, bradykinin, serotonin, heparin, SRSAs
What do immunosuppressentas work best for? When is the best time to use them?
Best for primary immune response
Best if taken before antigen exposure
What are immunosuppressants used for (3 main things)?
- Following organ transplantation
- Autoimmune disease
- Allergy
What classes of drugs are used for organ transplant - give the specific names of the drugs w/ in the class?
Gene expression regulators (prednisone, prednisolone)
Alkalyating agents (cyclophosphamide)
Purine synthesis inhibitors (azathoprine, mercaptopurine, mizoribine, mycophenolate mofetil)
Pyrimidine synthesis inhibitors (brequinar, leflunomide, malononitrilamide)
Kinase & phosphatase inhibitors (cyclosporine, tacrolimus, sirolimus/rapamycin)
Protein immunosuppressive (Antilymphocyte globulins - muromonab, daclizumab, belatacept)
How do the following immunosuppresants work? Prednisone, prednisolone Cyclophosphamide Azathioprine, 6-mercaptopurine Mizoribine, mycophenolate mofetil Brequinar, lefluonimide, malononitrilamides Cyclosporine Tacrolimus Sirolimus/rapamycin Muromonab, Daclizumab Belatacept
Prednisone, prednisolone - inhibit IL2 gene expression
Cyclophosphamide - Block DNA/RNA synthesis & function
Azathioprine, 6-mercaptopurine - Same as cyclopho
Mizoribine, mycophenolate mofetil - Same as cyclopho
Brequinar, lefluonimide, malononitrilamides - inhibit dihydroorotate DH in pyrimidine synthesis
Cyclosporine, Tacrolimus - INhibit calcineurin’s phsophatase activity = inhibits NFAT, JNK, p38 pthwys
Sirolimus/rapamycin - mTOR kinase inhibition
Muromonab, Daclizumab - Ab to T cells
Belatacept - Inhibits CD28 stimulation by binding B7 (CD80/86) on APCs
What is first line therapy for autoimmune disorders?
Corticosteroids
Why should you avoid high doses of corticosteroids?
Infections, ulcers, hyperglycemia, osteoporosis
What is important to do when giing pyrimidine synthesis inhibitors?
monitor blood levels
What immunosuppresants are nephrotoxic?
Kinase and phosphatase inhibitors:
Cyclosporine
tacrolimus
Sirolimus/rapamycin
Other than nephrotoxicity, what are toxicities of cyclosporine and tacrolimus?
gingival hyperplasia
neurotoxicity
hypertension
What immunosuppresant is contraindicated in children and can serve as an alternative therapy for kidney transplant?
Belatacept
What drugs are used for autoimmunity (5)?
Steroids Azathioprine Mercaptopurine Leflunomide Cyclosporine
What drugs are used for allergies (4 classes)?
Fatty Acids
Antihistamines
Immunotherapy (desensitization)
corticosteroids (bethamethasone, dexamethasone, methylprednisolone, triamcinolone)
