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Haematology and Immunology AM > Immunotherapy > Flashcards

Immunotherapy Flashcards

1
Q

What are the established types of immunosuppression?

A

Corticosteroids
Azathioprine
Cyclophosphamide

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2
Q

How do corticosteroids cause immune suppression?

A

Alters B and T cell function

Bind to cytoplasmic receptors and are transported to nucleus, where expression of various genes is modified

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3
Q

What do corticosteroids majorly affect?

A

Cytokine networks
Inflammation
T cell and monocyte function
Transit and circulation of immunologically active cells

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4
Q

What is azathioprine?

A

Purine analogue that inhibits DNA synthesis

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5
Q

What are the functions of azathioprine?

A

Inhibit T and NK cell functions

Anti-inflammatory

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6
Q

How is azathioprine normally used?

A

In combo with steroids

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7
Q

What is cyclophosphamide?

A

Alkylating agent that interferes with DNA synthesis

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8
Q

What does cyclophosphamide interfere with?

A

Supresses B cell activity and antibody production

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9
Q

What are the newer immune suppressants?

A

Cyclosporin and tacrolimus
Sirolimus
Mycophenolic acid

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10
Q

What do cyclosporin and tacrolimus affect?

A

T cells and NK cells

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11
Q

How do cyclosporin and tacrolimus act?

A

Modulate and down regulate varoius genes, esp IL2 gene

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12
Q

How does sirolimus act?

A

Decrease IL2 production by T helper cells

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13
Q

What are the main uses of mycophenolic acid?

A

Transplant rejection

Crohn’s disease

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14
Q

How does mycophenolic acid act?

A

Prevents T cell proliferation, antibody production and leucocyte migration by inhibiting purine synthesis

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15
Q

What are the effects of cytokine therapy?

A

Affect proliferation, differentiation and growth

Activate anti-tumour immunity

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16
Q

What are the types of cytokine therapy?

A

IL-1 and TNF
IL-2
IFN alpha
IFN gamma

17
Q

What are the actions of IL-1 and TNF?

A

Decrease activity of pro-inflammatory cytokines

18
Q

What are IL-1 and TNF used in?

A

Rheumatoid arthritis

Septic shock

19
Q

What is the action of IL-2?

A

Affects activity of T cell activated cytokines

20
Q

What is IL-2 used in?

A

Autoimmune disease
Transplant rejection
Some immune deficiency disorders
Tumour therapy

21
Q

What are the actions and used of IFN alpha?

A

Anti viral- used in hep C

Anti-neoplastic- used in hairy cell leukaemia

22
Q

What is th action of IFN gamma?

A

Increase phagocyte intracellular killing activity

23
Q

What is IFN gamma used in?

A

Chronic granulomatous disease

24
Q

What is plasma exchange?

A

Patients plasma is filtered off ex vivo in centrifuge and donor plasma given back to patient

25
Q

What is plasmapheresis?

A

Albumin solutions used to replace plasma

26
Q

What is plasma exchange and plasmapheresis used in?

A

Autoimmune disorders that involve formation of autoantibodies of immune complexes ir Myasthenia gravis, Goodpastures, systemic vasculitis

27
Q

What is immunoglobulin therapy used as?

A

Replacement therapy in patients with primary or secondary antibody deficiency
Immune modulating therapy in certain inflammatory and autoimmune conditions

28
Q

What are some inflammatory/autoimmuen conditions in which Igs can be used?

A 
Kawasaki's
ITP
Allergic disorders
vasculitis
Neuropathies
SLE
Myasthenia
29
Q

What are the issues with Ig therapy?

A

Adverse reactions during infusions

Transmission of infection, esp Hep C

Haematology and Immunology AM (17 decks)

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