Passive Immunotherapy Flashcards
_____ results from transfer of pre-formed immune components from one person to another
Passive Immunotherapy
Passive Immunotherapy is easy to accomplish with ___ but hard to accomplish with ___
antibodies; immune cells
True or False: In passive immunotherapy, the recipient must undergo synthesis/metabolism to acquire protection
False
Three examples of passive immunotherapy?
1) Toxin neutralization (TIG)
2) Prevent disease following exposure to a carrier (Rabies IgG)
3) Suppress or augment immune response
True or False: Immune globulin can be used to treat autoimmune diseases
True
Within immune globulins, there is a _____ fraction which contains all antibody reactivity. Due to this, it is termed the immune globulin.
Gamma globulin
_____ antibody results from immunization or recovery from infection
Polyclonal
aka: polyclonal activation of B cells (plasma cells)
What type of Ig is derived from MULTIPLE B cells and, therefore, represents an antibody against multiple epitopes?
Polyclonal Ig
Sources of polyclonal antibody preps?
Sera, placentae
True or False: Monoclonal antibody preps are usually lypophilized and reconstituted. Therefore, they are quite stable.
False - this is the case with polyclonal antibodies
How can you increase IgG concentrates 25 fold in polyclonal antibody preps?
Ethanol precipitation or concentrated ammonium sulfate
______ is a type of of immune globulin that is taken from more than 1,000 donors
Human Immune Globulin
What Ig is mostly found in Human Immune Globulin?
IgG
True or False: Human Immune Globulin is largely unstable but provides high level of Ab
False - it is stable and has high level of Ab
Three different preparations for Human Immune Globulin?
IMIG
SCIG
IVIG
True or False: A patient with Guillian-Barre, M. gravis, or Kawasaki —inflammatory/autoimmune processes— will benefit from monoclonal antibodies
False - they will benefit from human immune globulin
What are the two primary uses for human immune globulin?
1) Protect from infection
2) Suppressed inflammatory or autoimmune function
A person who is immunocompromised develops measles. What post-exposure prophylactic can be used?
Human Immune Globulin
Patient presents to clinic with hypogammaglobulinemia. What type of immune globulin can be given?
Human Immune Globulin
- note: this can also be used as prophylaxis
In contract to Human Immune Globulin, ______(SHIG) is an antibody preparation in which donors are screened for higher titer of antibody against certain antigen/pathogen
Specific human immune globulin (SHIG)
Both specific human immune globulin and human immune globulin, antibody preparations, are screened.
In the prior, however, they are screened for _____ while the latter are screened for _____
human immune globulin = bloodborne pathogens or antibodies
specific human immune globulin = high titer of Ab against antigen/pathogen
Examples of specific human immune globulin?
1) HBIG
2) HTIG
3) HRIG
4) DIG
5) VariZIG
6) RhoGAM
7) COVID-19 convalescent plasma
For polyclonal antibodies, anti-sera usually comes from _____, such as a horse
heterologous species
True or False: Scorpian, spider, and snake anti-venom are examples of MAB
False - they are a type of polyclonal antibody preparation
Contraindication for polyclonal antibody preps?
IgA deficiency
- risk of anaphylaxis
Monoclonal preparations are derived from a ______ population and has binding specificity for a ____ epitope
clonal (arising from single parental B cell); single
If an antibody binds a single epitope and multiple copies are found on virus surface, what type of preparation do you have: polyclonal or monoclonal?
Monoclonal
True or False: Polyclonal antibodies are derived from many B cells, work against many epitopes, and have different binding specificity
True
Side effect of anti-venoms (an example of polyclonal antibody preparation)?
Serum sickness
Which type of polyclonal antibody preparation provides the broadest immunity
Human Immune Globulin
For monoclonal antibodies ___ and ____ cells were combined to make hybridoma
myeloma and rat splenic cells
What two features do hybridomas exhibit?
1) Immortal
2) Makes a single, specific, antibody
Why did myeloma cells need to be fused to rat splenic cells to develop MAB?
Myleoma cells lack HGPRT - therefore: cannot grow in HAT medium unless fused
Making MAB involves identifying fused cells and clones that make __________
specific antibody to antigen
Two disadvantages of MAB?
1) Pricey
2) Usually from heterologous host
How can MAB that come from heterologous host (mouse or other rodent) overcome foreignness?
-Recombinant DNA technology
-Mouse:human chimeras
-Antibody libraries
-Transgenic mice
Three types of mouse hybridomas?
1) Mouse
2) Chimeric
3) Humanize
Advantages of MAB?
1) no lot to lot variation in concentration
2) 100% of injected/infused protein is antibody SPECIFIC for target antigen
New bispecific MAB can bind ___ different antigens
two
Functions of MAB?
1) Prophylaxis - ID/disease in general
2) Targets tumors
3) Detects and treats cancers
4) Prevents allograft rejection
5) Treat auto-imm disease and hypersensitivty
6) Inhibit leukocyte migration
7) Neutralize cytokines
Palivizumab is a MAB used for ____ prophylaxis.
Target?
RSV
- Target: anti-RSF F protein
- MOA: prevents virus from fusing into the target
True or False: REGEN-COV is a MAB that binds to spike protein in order to block it
False - neutralizes it
Trastuzumab is a MAB used to _______
Target?
target tumors
anti-ErbB-2 (epidermal growth factor receptor)
What two unique mechanisms does trastuzumab use to target tumors?
1) Targets immune system and depletes targeted cells via:
- ADCC
- opsonization
-complement activation
2) Uses non-depleting MoAb (receptor blocker)
- blocks target cell from proliferating by blocking the GF-R
Ibritumomab tiuxetan is a MAB used for ______
Target?
cancer detection and treatment
target = CD20 (B cell marker)
How does Ibritumomab tiuxetan target small tumors and metastases?
1) MoAb-toxin
2) MoAb-radioisotope conjugates
____ is a chimeric MAB that targets ____ on B cells for ADCC and classical pathway of complement cascade
Rituximab; CD20
Which MAB is best for depleting B cells, which cause lymphoproliferative disorders and auto-immune diseases like RA?
Rituximab
True or False: Muromonab-CD3 is a MAB that can be used to prevent allograft rejection and treat T1DM (autoimmune disease)
True
Target for Muromonab-CD3?
Anti-CD3
Compare and contrast the way that Muromonab-CD3 prevents allograft rejection and treats T1DM
In both cases, muromonab-CD3 targets Anti-CD3
To treat allograft rejection, uses a RECEPTOR BLOCKADE only!!!
To treat T1DM, uses both a RECEPTOR BLOCKADE + REDUCES T CELL NUMBER
True or False: Muromonab-CD3 and Ibritumomab tiuxetan are murine antibodies
True
Omalizumab is good for hypersensitivity treatments, such as ____ and ____
Target?
allergies and allergic asthma
Target: Anti IgE
Omalizumab binds to the ___ portion of human IgE and prevents it from binding to Fc-R
Fc portion
_____ is a humanized monoclonal antibody against the cell adhesion molecule alpha4-integrin
Natalizumab
True or False: Omalizumab can be used to inhibit leukocyte migration
False - Natalizumab can be used to inhibit leukocyte migration
Natalizumab is used to treat what two conditions?
1) MS
2) Crohn’s
Which MAB neutralizes cytokines?
Target?
Daclizumab
- IL-2R
True or False: Daclizumab can be used to prevent RENAL allograft rejection
True
How does Daclizumab work?
Blocks access of IL-2 to its receptor, preventing activation
Two general mechanisms by which MAB work?
1) Deplete target cells via:
- complement
- opsonization
- ADCCC
2) non-depleting MoAB (receptor blocker without effects on cells)