Immunotherapy Flashcards
What does immunotherapy do?
Persuades the immune system in some way to fight a particular disease
Types of immune suppression
Allergy and autoimmune disease suppression
Blanket immune suppression
General immunosuppression
Opportunistic infections
Pathology of acute transplant rejection
Associated with T cell responses that mediate immune cell infiltration into the graft and effect its rejection
Introduction of what in an acute transplant rejection increases the survival? And what is it?
Cyclosporine - an antirejection drug
Antirejection drugs examples
Cyclosporin
Rapamycin
What do anti rejection drugs do?
Methods for inhibiting T cell activation to treat graft rejection
Examples of active adaptive immunity
infection or exposure
Immunisation vaccines
Examples of passive adaptive immunity
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
When is human normal immunoglobulin (HNIG) used for post exposure prophylaxis?
Hepatitis A
Measles
Polio
Rubella
When are specific immunoglobulins used for post exposure prophylaxis?
Hepatitis B
Rabies
Tetanus
Varicella zoster
What is IV immunoglobulin (IvIg) used for?
A biological for replacement therapy in primary and secondary immune deficiencies and also used in some autoimmune disorders
Indications for IV immunoglobulin
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
Immunotherapy types
Direct (targeted)
Indirect
What is direct / targeted immunotherapy?
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
Types of directed / targeted immunotherapy
Monoclonal antibodies
Chimeric antigen receptors (CARs)
Bi-specific antibodies
What is indirect immunotherapy?
The immune system is activated rendering it able to seek and destroy tumour cells
What is the target in directed immunotherapy?
The tumour
What is the target in indirect immunotherapy?
The immune system
Types of indirect immunotherapy
Tumour vaccines Dendritic cell vaccines Adoptive cell transfer Cytokine therapies Checkpoint inhibitor therapies Stimulatory antibodies
What are cytokine therapies?
Immunomodulatory cytokines to active anti tumour immunity
When are cytokine therapies used?
Specific cancers
What is a polyclonal response?
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
What is a monoclonal response?
Immunisation -> fusion and immortalisation of B cells -> isolation and screening - > expansion of desired hybridoma
Examples of drugs that illicit a monoclonal response
Muine
Chimeric
Human
Fragment
