Immunotoxicity Flashcards

1
Q

What is immunotoxicity?

A

Immunotoxicity is an adverse or inappropriate change in the structure and function of the immune system after exposure to a foreign substance.

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2
Q

ADAs?

A

Antibody drug antibodies

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3
Q

What route of adminstration is best for multiple dose?

A

IV not SC because of more immune cells present in the skin to fight foreign species

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4
Q

What types of immunogenicities are there?

A

Immunosuppressive
Autoimmunity
Hypersensitivity (1-4)
Infusion reaction

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5
Q

Type I hypersensitivity is related to?

A

Anaphylaxis

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6
Q

Type II hypersensitivity is related to?

A

Trombocytopenia

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7
Q

Type III hypersensitivity is related to?

A

Serum sickness

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8
Q

Type IV hypersensitivity is related to?

A

Allergy, DRESS, SJS, TEN and AGEP

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9
Q

Infusion reactions can manifest as?

A

Anaplylaxis, anaphylactoid reactions, cytokine release syndrom

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10
Q

How can immunosuppression be induced?

A

IFN-a treatment → blocking hemtological bone marrow colony-forming units leading to myelosuppression

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11
Q

What is autoimmunity associated with?

A

drug-induced lupus DIL

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12
Q

How is Type I hypersensitivity mediated

A

IgE immediate reaction 2-30 min

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13
Q

How is Type II hypersensitivity mediated

A

IgG and IgM cytotoxic reactions 5-8h

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14
Q

How is Type III hypersensitivity mediated

A

(IgG and IgM) Immune complex-mediated reaction 2-8h

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15
Q

How is Type IV hypersensitivity mediated

A

(T) cell-mediated 24-72h

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16
Q

Which hypersensitivities are Ab-mediated and which are Cell mediated?

A

1-3: Ab-mediated: 1:IgE, 2-3: IgG and IgM
4: T cell-mediated

17
Q

Which hypersensitivity is transient and disappears after treatment?

A

Type III, serum sickness and Type I DI-lupus

18
Q

Why is Type III hypersensitivity called serum sickness

A

Ig production against soluble Ag unlike type II hypersensitivity → formation of circulating immune complexes

19
Q

Type III hypersensitivity aka complex-mediated hypersensitivity. What is the mechanism?

A

Antigens in excess:
Ab-Ag complexes deposited in tissue → classic pathway: release of C3a and C5a → recruiting macrophages and neutrophils → inflammatory damage to tissue

20
Q

Anti-venom drugs can induce what hypersensitivity?

A

Type III
bcs of foreign protein moiety from another species.
Snake venom is made from horse polyclonal antibodies. Snake venom has many active groups making it less cost-efficient to produce mAbs

21
Q

What hypersensitivity has an induction phase and elicitation phase

A

Type IV

22
Q

Characterize Drug-induced lupus DIL

A

Autoimmune manifestation: Abs against self Ag, butterfly rash in face and affect many tissues

23
Q

Core cytokine in CRS?

A

IL-6, IL-10, TNF-a and IFN-gamma are elevated in patients with CRS

24
Q

IL-6 role in CRS?

A

Induces positive feed back loop for T cell activation

25
Q

Minimum anticipated biological effect lvl required for biopharmaceuticals MABEL as opposed to No observed adverse effect lvl NOAEL for SOMs. Why is MABEL not used for all drugt?

A

It requires more time and data (experiments) to determine MABEL

26
Q

Any adverse effects experiences by patients during the infusion (bio)pharmalogic agents or any event occuring on the firsts fay of drug adminstration…?

A

Infusion-related reactions (IRRs)

27
Q

Examples of IRRs

A

IgE mediated (Type I/Anaphylaxis)
Non-IgE mediated (Anaphylactoid)
CRS

28
Q

Low immunogenicity risk?

A

Native human protein
Single dose

29
Q

High immunogenicity risk?

A

Autoimmune disease
The presence of host cell proteins or DNA
Aggregates
Foreign sequences
Duration of treatment
Multiple dose