Immunotherapy

Question 1

What does calcineurin do?

Answer 1

Dephosphorylates and hence activates a T-cell transcription factor
Part of immune resposne

Question 2

What does FKBP12-FK506 do?

Answer 2

Inhibits calcineurin

Question 3

What is passive immunity?

Answer 3

Protection from a disease provided by antibodies created outside of the body
I.e. artificial or placental transfer

Question 4

What is active immunity?

Answer 4

Immunity to a pathogen that occurs following exposure to said pathogen
I.e. vaccination or natural

Question 5

What is Human Normal Immunoglobulin (HGIN) used for?

Answer 5

Post-exposure prophylaxis to:
Hep A
Measles
Polio
Rubella

Question 6

What are some infections which require specific immunoglobulins for post-exposure prophylaxis?

Answer 6

Hep B
Rabies
Tetanus
Varicella-Zoster

Question 7

What is IVIg?

Answer 7

IV immunoglobulin
Polyclonal IgG pooled from thousands of donors
Key biologic for replacement therapy in primary and secondary immunodeficiency disorders

Question 8

What are some disorders which can benefit from IVIg?

Answer 8

Primary immunodeficiency
Wiskott Aldrich syndrome
Kawasaki disease
Multiple myeloma
Guillain-Barre syndrome

Question 9

What is direct immunotherapy?

Answer 9

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

Question 10

What is indirect immunotherapy?

Answer 10

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

Question 11

What are some examples of direct immunotherapy?

Answer 11

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

Question 12

What are some examples of indirect immunotherapy?

Answer 12

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

Question 13

How is cytokine therapy used?

Answer 13

Immunomodulatory cytokines to activate anti-tumour immunity

Pegasys is effective anti-viral for melanoma

Question 14

What is rituximab?

Answer 14

Monoclonal antibody which targets CD20 surface protein

Question 15

What conditions are treated with rituximab?

Answer 15

First line treatment for non-hodgkins lymphoma
RA
SLE

Question 16

What is infliximab?

Answer 16

Chimeric antibody

Blocks function of TNF-alpha

Question 17

What is trastuzumab (herceptin)?

Answer 17

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

Question 18

How does pertuzumab work?

Answer 18

Anti-HER2 antibody

Disrupts dimer formation

Question 19

How do checkpoint inhibitor antibodies work?

Answer 19

Unlock gateway to adaptive immune system

Powerful anti-tumour responses

Question 20

How do anti-PD1/PD-L1 antibodies work?

Answer 20

Blockade of PD-1 or ligand to depress TCR signalling thereby permitting T cell activation
PD-1 inhibitor receptor is expressed by T cells in tumours

Question 21

Give some examples of anti-PD1/PD-L1 antibodies and their uses.

Answer 21

Pembrolizumab
Nivolumab

Anti-tumour
Greater overall survival than chemo

Question 22

What is the main benefit of CAR use?

Answer 22

A T cell modified with a CAR is endowed with a new antigen specificity, and binding its antigen supports T-cell activation and killing of the target cell