Inflammation 2

Question 1

What is rheumatoid arthritis

Answer 1

Autoimmune disorder - joint swelling, pain, stiffness, porr sleep

Question 2

What is the action of rheumatoid arthritis

Answer 2

Th1 cell activation - activation of macrophages through the release of cytokines - synthesis and release of proinflammatory mediators IL-1 and TNF - alpha - these activate fibroblasts and osteoclasts to produce proteases which will destroy the tissue surrounding the joint

Question 3

What are DMARDs

Answer 3

Disease modifying anti-rheumatic drugs - Methotrexate - folic acid antagonist - cytotoxic and immunosuppressant activity - inhibits Tcell production
Glucocorticoids - Inhibits transcription of proinflammatory cytokines

Question 4

What is a cytokine

Answer 4

A secreted protein that causes the activation of immune cells around it

Question 5

What is a chemokine

Answer 5

A signalling molecule that attracts immune cells

Question 6

What is the action of cyclosporin

Answer 6

Binds to a molecule in T cells called cyclophilin - the drug-receptor complex binds to calcineurin - calcineurin is a phosphatase - when T cells are activated, calcium increase, calcineurin activity increase
normally acts to remove phosphate from secondary messengers which activates NF kB which would move from the cytosol to the nucleus to increase transcription of IL-2 (a cytokine)

Question 7

What is the action of adelimumab

Answer 7

A humanized monoclonal antibody that binds to TNF -alpha with a high affinity
This neutralizes the action of either soluble or membrane bound pro inflammatory cytokines
The soluble TNF - alpha receptor is mimicked, so binds TNF reducing its activity

Question 8

What is an unwanted side effect of adalimumab

Answer 8

Too effective - Cytokines key to normal immune response - Dampening of this response makes the patient more susceptible to infection

Question 9

What is the action of Hypersensitivity due to IgE

Answer 9

First exposure - B cells stimulated to produce IgE antibodies specific to an antigen - Mass production for second detection - bind to specific receptors on mast cells and basophils. Second exposure detected by IgE on sensitized cells - Degranulation and exocytosis of histamine, prostaglandins for vasodilation, activation of NFkB - increased transcription of cytokines and chemokines

Question 10

What is asthma associated with

Answer 10

Overactivity of Th2 cells - activates cytokines - B cells - ThR leads to Bcells creating IgE ….