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Immunology > Immunotherapy > Flashcards

Immunotherapy Flashcards

1
Q

What does immunotherapy do?

A

Persuades the immune system in some way to fight a particular disease

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2
Q

Types of immune suppression

A

Allergy and autoimmune disease suppression
Blanket immune suppression
General immunosuppression
Opportunistic infections

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3
Q

Pathology of acute transplant rejection

A

Associated with T cell responses that mediate immune cell infiltration into the graft and effect its rejection

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4
Q

Introduction of what in an acute transplant rejection increases the survival? And what is it?

A

Cyclosporine - an antirejection drug

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5
Q

Antirejection drugs examples

A

Cyclosporin

Rapamycin

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6
Q

What do anti rejection drugs do?

A

Methods for inhibiting T cell activation to treat graft rejection

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7
Q

Examples of active adaptive immunity

A

infection or exposure

Immunisation vaccines

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8
Q

Examples of passive adaptive immunity

A

Placental transfer of IgG
Colostral transfer of IgA - mother to foetus
Immunoglobulin therapy or immune cells
Snake or spider bites, scorpians or fish stings
- passive infusion of antibody specific for that toxin
Hypogammaglobulinaemia - primary or secondary
- infusion of y - globulins to reduce infection
Rabies immunoglobulin
- post exposure prophylaxis together with prevention

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9
Q

When is human normal immunoglobulin (HNIG) used for post exposure prophylaxis?

A

Hepatitis A
Measles
Polio
Rubella

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10
Q

When are specific immunoglobulins used for post exposure prophylaxis?

A

Hepatitis B
Rabies
Tetanus
Varicella zoster

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11
Q

What is IV immunoglobulin (IvIg) used for?

A

A biological for replacement therapy in primary and secondary immune deficiencies and also used in some autoimmune disorders

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12
Q

Indications for IV immunoglobulin

A 
Primary immunodeficiency 
Wiskott Aldrich syndrome
IgG subclass deficiencies with recurrent infections
Idiopathic thrombocytopenic purpura 
Kawasaki disease 
common variable immunodeficiency 
Multiple myeloma / CLL
Children with HIV
GB syndrome
allogenic bone marrow transplantation
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13
Q

Immunotherapy types

A

Direct (targeted)

Indirect

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14
Q

What is direct / targeted immunotherapy?

A

Antibodies or antibody related fragments that detect an antigen on the tumour cell and destroy the target by recruiting immune cells or by delivering a toxin or radiosotope to it

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15
Q

Types of directed / targeted immunotherapy

A

Monoclonal antibodies
Chimeric antigen receptors (CARs)
Bi-specific antibodies

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16
Q

What is indirect immunotherapy?

A

The immune system is activated rendering it able to seek and destroy tumour cells

17
Q

What is the target in directed immunotherapy?

A

The tumour

18
Q

What is the target in indirect immunotherapy?

A

The immune system

19
Q

Types of indirect immunotherapy

A 
Tumour vaccines
Dendritic cell vaccines
Adoptive cell transfer
Cytokine therapies
Checkpoint inhibitor therapies 
Stimulatory antibodies
20
Q

What are cytokine therapies?

A

Immunomodulatory cytokines to active anti tumour immunity

21
Q

When are cytokine therapies used?

A

Specific cancers

22
Q

What is a polyclonal response?

A

Immunisation with antigen will typically lead to a polyclonal response
Recognise different epitopes of the reagent and so antibodies bind to the different epitopes - so a number of epitope will be bound by antibody
Many different B cell clones will generate antibodies specific for the antigen

23
Q

What is a monoclonal response?

A

Immunisation -> fusion and immortalisation of B cells -> isolation and screening - > expansion of desired hybridoma

24
Q

Examples of drugs that illicit a monoclonal response

A

Muine
Chimeric
Human
Fragment

25
Q

What is Rituxan (rituximab) first line for?

A

Non-Hodgkin’s lymphoma

26
Q

What is Rituxan?

A

Specific for the CD20 molecule on the cell surface of a small sub population of B cells

27
Q

What kind of therapy is infliximab?

A

Anti-TNF therapy

28
Q

What does infliximab treat?

A

RA
Ankylosing spondylitis
Crohn’s disease
Ulcerative colitis

29
Q

What does infliximab do?

A

Chimeric antibody that blocks the function of tumour necrosis factor alpha (TNF)

30
Q

What is TNF?

A

A pro inflammatory cytokine that stimulates an acute phase reaction

31
Q

What does Herceptin treat?

A

HER2 positive metastatic breast cancer

32
Q

How does Herceptin work?

A

The antibody binds HER2 on cancer cells and marks them out for destruction by the immune system

33
Q

What % of breast cancers are HER?

A

15-20%

34
Q

What do checkpoint inhibitor antibodies do?

A

Unlock the gateway to the adaptive immune system

Powerful anti tumour responses

35
Q

How to DC vaccines work?

A

Take blood sample from patient and culture the cells in vitro with cytokines that promote APC function
Transfuse patients with APC after uptake of the tumour antigen

36
Q

How does CAR T cell therapy work?

A

CAR T cell are engineered to express antigen targeted receptors specific for tumour antigens

37
Q

How to chimeric antigen receptors work?

A

Combined antibody and T cell response

38
Q

What can immune therapies be used to do?

A

Modulate the immune response

Can be immunosuppressive or immune boosting

39
Q

Examples of cellular immunotherapies

A

T cells
Dendritic cells
CAR-T cells

Immunology (10 decks)

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