Lecture 7 Immunosupressants

Question 1

a hyperactive immune response is associated with ______

Answer 1

autoimmune disease

Question 2

a hypoactive immune response is associated with _____ and _____

Answer 2

immunosupression, incompetence

Question 3

2 reasons for use of immuno suppresants:

Answer 3

organ transplantation; autoimmune disorders

Question 4

immunosupressants work best to prevent the ____ immune response

Answer 4

primary

Question 5

corticosteroids are used for ____ and ____ of immunosuppression

Answer 5

induction, maintenance

Question 6

Corticosteroids block lymphocyte activation and proliferation by inhibiting ___ transcription

Answer 6

IL2

Question 7

azathioprine acts as a _____ ____ (precursor of 6-mercaptopurine)

Answer 7

purine antimetabolite

Question 8

azathioprine inhibits lymphocyte proliferation by blocking _____ synthesis

Answer 8

nucleotide (and thus DNA)

Question 9

Azathioprine affects rapidly growing cells such as those in the _____ and ____

Answer 9

bone marrow, GI tract

Question 10

When are results seen with the use of azathioprine?

Answer 10

several weeks after starting treatment

Question 11

Cytotoxicity of azathioprine includes ______, ____, and GI dysfunction

Answer 11

leukopenia, thrombocytopenia

Question 12

mycophenolate mofetil (MMF) works by inhibiting _____

Answer 12

inosine-5-monophosphate dehydrogenase

Question 13

MMF seems to lack the ____ risk and chronic _____ secondary effects

Answer 13

cardiovascular; nephrotoxic

Question 14

MMF is used for ______ of immunosuppression

Answer 14

induction and maintenance

Question 15

azathioprine is used for _____ of immunosuppression

Answer 15

maintenance

Question 16

Cyclosporine inhibits _____ ____ activity, preventing translocation of NFAT transcription factors to the nucleus of activated T cells

Answer 16

calcineurin phosphatase

Question 17

Both cyclosporine and tacrolimus are ____ inhibitors that prevent ____ transcription

Answer 17

calcineurin; IL2

Question 18

both cyclosprine and tacrolimus are used for ______ of immunosuppression

Answer 18

induction and maintenance

Question 19

Cyclosporine and tacrolimus are both ___toxic, but _____ also causes gingival hyperplasia

Answer 19

nephro;

cyclosporine

Question 20

Tacrolimus inhibits calcineuring phosphatase by binding to ___, aka FK506 binding protein

Answer 20

FKBP12

Question 21

Calcineurin is 100x ____ potent than tacrolimus

Answer 21

less

Question 22

Tacroimus has shown potential for use of ______

Answer 22

myasthenia gravis

Question 23

Sirolimus (rapamycin) binds FKBP12 and ____. It prevents the response to ____, not the production

Answer 23

mTOR; IL2

Question 24

Sirolimus is less toxic to the ____ relative to cyclosporine

Answer 24

kidneys

Question 25

_____ is another inhibitor of the mTOR pathway, derived from rapamycin

Answer 25

everolimus

Question 26

Everolimus is used after ___ transplantation because of its limited toxicity

Answer 26

renal

Question 27

There is a risk of _____ rejection, so everolimus must be used with calcineurin inhibitors

Answer 27

antibody-mediated

Question 28

_____ ____ binds the T cell associated receptor CD3 complex, altering T cells

Answer 28

muromonab CD3

Question 29

Muromonab CD3 is used for ______ of immunosuppresion and treatment of _____ rejection

Answer 29

induction; acute

Question 30

Selective targeting of ___ instead of CD80/86 may be a newer avenue to control post transplant immune response

Answer 30

CD28

Question 31

Belatacept acts by inhibiting ____ mediated T cell co-stimulation. it as mutant form of CTLA4Ig and interferes with ____ and _____

Answer 31

CD28;

CD80, CD86

Question 32

Belatacept is thought to be an alternative to traditional ____ inhibitors for kidney transplants

Answer 32

calcineurin

Question 33

_____ seems to specifically target immune reactions against transplants–>hope for long term treatment

Answer 33

belatacept

Question 34

____ is used for treatment of rheumatoid arthritis

Answer 34

abatacept

Question 35

_____ should be used for molecules involved in metabolization and drug transport in order to achieve target concentrations and decrease toxicity

Answer 35

pharmacogenomics

Question 36

long term use of _____ should be avoided due to risk of infections, ulcers, hyperglycemia, and osteoporosis

Answer 36

corticosteroids

Question 37

_____ should be watched as regards to food intake due to its large changes in blood levels

Answer 37

cylcosporine

Question 38

3 things used for systemic treatment of allergies

Answer 38

fatty acids, antihistamines, biotin

Question 39

reactivation of virsuses such as ____ in immunosuppresive treatment should be treated _____

Answer 39

HBV; prophylactically

Question 40

most immunostimulants have a ____ activity towards the immune system

Answer 40

nonspecific

Question 41

____ is a herbal product used against the common cold, influenza, and infections

Answer 41

echinacea

Question 42

Echinacea stimulates ____ and the production of intereron and TNF

Answer 42

phagocytosis

Question 43

_____ (aloeride) is isolated from the aloe plant and induces ____ activity and ____ production

Answer 43

acemannan; MQ; IL1

Question 44

______ is a polysaccharide from yeast extract that activates MQs and release of ____

Answer 44

beta-1,3-glucan;

cytokines

Question 45

QS21 is components of _____ complex purified from the bark of quillaja saponaria

Answer 45

saponin

Question 46

QS21 stimulates _____ lymphocytes and production of cytokines, IL2, and IFN gamma

Answer 46

cytotoxic T

Question 47

Side efects of QS21 =

Answer 47

vaccination site pain, myaglia, hemolytic effects

Question 48

The last immunostimulants mentioned were _____ and ____

Answer 48

immuno globulin; cytokines