Transplant drugs

Question 1

Belatacept

Answer 1

CTLA4 fused to Ig—>preferentially bind CD80/86 to stop T cell activation

Question 2

Basiliximab

Answer 2

Ab Against IL-1 receptor AKA CD 25–>block third signal

Question 3

Tac and CycA act on…

Answer 3

First signal

Question 4

mTOR inhibitors act on…

Answer 4

Third signal
Bind fkbinding protein 12
Then Rapa-FKBP complex binds to mTOR
Inhibits IL-2 costimulatory triggered cell signalling
Inhibits DNA signalling–>G1 arrest
Also inhibit protein synthesis but less so

Question 5

MMF and AZA

Answer 5

Act on cellular proliferation

• AZA active metabolite inhibits aminophosphoribyltransferase–>inhibit purine synthesis
• MMF inhibits inosine monophosphate dehydrogenase–>no denovo purine synthsis
• B and T lymphocytes depend on de novo not salvage pathway

MMF creates a second PEAK due to enterohepatic recirculation

Question 6

measure peak or trough of tac?

Answer 6

Peak with cyclosporine

Trough with Tac

Question 7

Tac binds to…

Answer 7

FK-BP- target of complex is calcineurin

Question 8

CycA binds to…

Answer 8

Cycliophilin –>whole thing binds calcineurin

Question 9

Greatest predictor of CV death on dialysis?

Answer 9

Phosphate

Question 10

Greatest predictor of CV disease after transplant?

Answer 10

Diabetes