Serum Sickness

Question 1

What is rituximab?

Answer 1

A chimeric monoclonal antibody to human CD20 (found on pre/mature B cells)

Question 2

How does C1q meaure Immune complexes?

Answer 2

Radiolabelled C1q is used to bind to circulaing immune complexes

-remember C1q combines with r2s2 to cleave C4 and C2

Question 3

What does a reduced CH50 indicate?

Answer 3

Reduced levels of classical and or/MAC components

an AH50 measures the alternate pathway

Question 4

In a person with an active immune response, why would C3 and C4 levels be reduced?

Answer 4

The production of immune complexes may reduce serum C3 and C4 levels, which would be expected if there is an immune response

Question 5

What are the components of a chimeric ab?

Answer 5

A chimeric antibody is fusion of a moutse antigen-binding Fab region (variable domains of the heavy and light chains, VH and BL) from one species like a mouse, with a the Fc constant domain

Question 6

After using ritizumab what CD should you look for to monitor therapy?

Answer 6

CD19 becuase rituximab is killing the CD20

Question 7

What is used to isolate the variable mouse region for a monoclonal antibody?

Answer 7

Pepsin

Question 8

What type of Hypersensitivity is Serum sickness?

Answer 8

Type III immune complex

Question 9

How do you treat serum sickness to ritxuimab?

Answer 9

Take them off the medication, and maybe give steroids

Question 10

In serum sickness to Rituximab what is patinet producing antibodis against?

Answer 10

The mouse Fab grament, patient is having an IgG response

Question 11

What happens to the deposited immune complexes in serum sickness?

Answer 11

They are removed by phagocytes

-this is because they are large complexes, smaller complexes are carried to the liver by CR1 erythrocytes and removed

Question 12

What is serum sickness?

Answer 12

It is a type III hypersensitivity reaction, in which the person has developed an immune response against some type of therapy (Drugs, Mab, etc.)

Question 13

What is being used to overcome and diminish the possibility of serum sickness?

Answer 13

Using chimeric antibody.

-The less foreign the antibodies are the less chance of producing antibodies should be.

Question 14

What is an arthus reaction?

Answer 14

Localized Type III hypersensitivty reaction, like in a local immune complex deposition due to immunization

Question 15

What are the examples of Type I hypersen?

Answer 15

Allergy, asthma, eczema, anaphylactic shock

Question 16

What are the type II hypersen examples?

Answer 16

True autoimmune disease like Myastania Gravis and Graves disease

Question 17

What are the type III hypersen examples?

Answer 17

Lupus, serum sickness, arthus reaction, also RA

Question 18

What are type IV examples?

Answer 18

Chron’s disase, sarcoidosis, poison ivy, MS, Hasimotos

Question 19

What is the cause of capillaritis?

Answer 19

Capillaritis can be due to a number of causes, but a reaction to a drug is the most common, although the actual mechanism is disputed. It is due to blood leaking from the capillaries.

Question 20

Suggest a mechanism for the a raised ESR?

Answer 20

Activated phagocytes will induce an acute phase response, with resultant production of liver proteins which bind to RBC

Question 21

Why were the BUN and serum creatinine raised?

Answer 21

Immune complexes were depositied in the kidneys resulting in redued renal function