Lecture 29 - Transplant Immunology Flashcards
1
Q
How to prevent allograft rejection
A
- matching donor and recipient HLA
- pre transplant HLA antibody testing
- immunosuppressive drugs
2
Q
What are the different types of immunosuppressive drugs
A
- induction therapy
- maintenance therapy
- rescue therapy
3
Q
What are the mechanisms of immunosuppression
A
- depletion of cells involved in the immune response
- inhibition of pathways required for the induction of an immune response
- blocking of receptors required for the induction of an immune response
4
Q
What are small molecule drugs
A
- mainly used for maintenance therapy
- act intracellularly
- inhibit pathways downstream of cell activation
- inhibit transcription factors required for growth factor production and expression of growth factor receptors
- inhibition of DNA synthesis
- inhibition of mTOR, limits response to growth factors
- measured by trough levels
5
Q
What are protein based/ biologic drugs
A
- mainly used for induction and rescue therapy
- act extracellularly
- receptor-ligand or antibodies
6
Q
What is prednisone
A
- commonly used for maintanance therapy
- a glucocorticosteroid
7
Q
What is methylprednisolone
A
- used for rescue therapy
- a glucocorticosteroid
8
Q
What are glucocorticosteroids
A
- broad spectrum immunosuppressive and anti-inflammatory effects
- interact with glucocorticosteroid receptors found on most body cells
- down-regulation of co-stimulatory and adhesion molecules
- down-regulation of inflammatory cytokines and up-regulation of anti-inflammatory cytokines
9
Q
How are antibodies removed
A
- plasmapheresis
- IVIg
10
Q
What is transplantation tolerance
A
- absence of a destructive immune response to an allograft in an otherwise competent immune system
11
Q
What is central tolerance
A
- immunological tolerance to self antigens that is established while lymphocytes are developing in central lymphoid organs
12
Q
What is peripheral tolerance
A
- immunological tolerance acquired by mature lymphocytes in the peripheral tissues
13
Q
What is chimerism
A
both the donors HSCs and the recipents HSCs co-exist in the recipients bone marrow
14
Q
What is peripheral tolerance
A
- immune regulatory cell therapies
- regulatory T Cells and B Cells
- tolerogenic dendritic cells and macrophages
