Lecture 7 Immunosupressants Flashcards
a hyperactive immune response is associated with ______
autoimmune disease
a hypoactive immune response is associated with _____ and _____
immunosupression, incompetence
2 reasons for use of immuno suppresants:
organ transplantation; autoimmune disorders
immunosupressants work best to prevent the ____ immune response
primary
corticosteroids are used for ____ and ____ of immunosuppression
induction, maintenance
Corticosteroids block lymphocyte activation and proliferation by inhibiting ___ transcription
IL2
azathioprine acts as a _____ ____ (precursor of 6-mercaptopurine)
purine antimetabolite
azathioprine inhibits lymphocyte proliferation by blocking _____ synthesis
nucleotide (and thus DNA)
Azathioprine affects rapidly growing cells such as those in the _____ and ____
bone marrow, GI tract
When are results seen with the use of azathioprine?
several weeks after starting treatment
Cytotoxicity of azathioprine includes ______, ____, and GI dysfunction
leukopenia, thrombocytopenia
mycophenolate mofetil (MMF) works by inhibiting _____
inosine-5-monophosphate dehydrogenase
MMF seems to lack the ____ risk and chronic _____ secondary effects
cardiovascular; nephrotoxic
MMF is used for ______ of immunosuppression
induction and maintenance
azathioprine is used for _____ of immunosuppression
maintenance
Cyclosporine inhibits _____ ____ activity, preventing translocation of NFAT transcription factors to the nucleus of activated T cells
calcineurin phosphatase
Both cyclosporine and tacrolimus are ____ inhibitors that prevent ____ transcription
calcineurin; IL2
both cyclosprine and tacrolimus are used for ______ of immunosuppression
induction and maintenance
Cyclosporine and tacrolimus are both ___toxic, but _____ also causes gingival hyperplasia
nephro;
cyclosporine
Tacrolimus inhibits calcineuring phosphatase by binding to ___, aka FK506 binding protein
FKBP12
Calcineurin is 100x ____ potent than tacrolimus
less
Tacroimus has shown potential for use of ______
myasthenia gravis
Sirolimus (rapamycin) binds FKBP12 and ____. It prevents the response to ____, not the production
mTOR; IL2
Sirolimus is less toxic to the ____ relative to cyclosporine
kidneys
_____ is another inhibitor of the mTOR pathway, derived from rapamycin
everolimus
Everolimus is used after ___ transplantation because of its limited toxicity
renal
There is a risk of _____ rejection, so everolimus must be used with calcineurin inhibitors
antibody-mediated
_____ ____ binds the T cell associated receptor CD3 complex, altering T cells
muromonab CD3
Muromonab CD3 is used for ______ of immunosuppresion and treatment of _____ rejection
induction; acute
Selective targeting of ___ instead of CD80/86 may be a newer avenue to control post transplant immune response
CD28
Belatacept acts by inhibiting ____ mediated T cell co-stimulation. it as mutant form of CTLA4Ig and interferes with ____ and _____
CD28;
CD80, CD86
Belatacept is thought to be an alternative to traditional ____ inhibitors for kidney transplants
calcineurin
_____ seems to specifically target immune reactions against transplants–>hope for long term treatment
belatacept
____ is used for treatment of rheumatoid arthritis
abatacept
_____ should be used for molecules involved in metabolization and drug transport in order to achieve target concentrations and decrease toxicity
pharmacogenomics
long term use of _____ should be avoided due to risk of infections, ulcers, hyperglycemia, and osteoporosis
corticosteroids
_____ should be watched as regards to food intake due to its large changes in blood levels
cylcosporine
3 things used for systemic treatment of allergies
fatty acids, antihistamines, biotin
reactivation of virsuses such as ____ in immunosuppresive treatment should be treated _____
HBV; prophylactically
most immunostimulants have a ____ activity towards the immune system
nonspecific
____ is a herbal product used against the common cold, influenza, and infections
echinacea
Echinacea stimulates ____ and the production of intereron and TNF
phagocytosis
_____ (aloeride) is isolated from the aloe plant and induces ____ activity and ____ production
acemannan; MQ; IL1
______ is a polysaccharide from yeast extract that activates MQs and release of ____
beta-1,3-glucan;
cytokines
QS21 is components of _____ complex purified from the bark of quillaja saponaria
saponin
QS21 stimulates _____ lymphocytes and production of cytokines, IL2, and IFN gamma
cytotoxic T
Side efects of QS21 =
vaccination site pain, myaglia, hemolytic effects
The last immunostimulants mentioned were _____ and ____
immuno globulin; cytokines
