Transplant Immunology Flashcards
what type of sensitization generates the broadest and longest HLA antibody response
Sensitization following the rejection of a transplanted allograft generates the broadest and longest lasting HLA antibody responses
To what epitope does blood transfusions typically generate ?
Patients sensitized through blood transfusion generate antibodies primarily toward HLA class I proteins (HLA-A, -B, and to a lesser degree HLA-C).
What type of immune response is generated after pregnancy or transplant ?
Exposure via pregnancy and transplant, on the other hand, elicit HLA antibody responses to HLA class I and class II with a greater propensity for class II sensitization following transplant
SPI
lid phase immunoassays (SPI)
MFI
mean fluorescence intensity (MFI)
What does a 50% PRA mean?
A PRA of 50% reflected a positive reaction with 50% of the cells on the panel. These results would be conveyed to the clinician as 50% of all potential deceased donors would be incompatible.
what is CPRA
Calculated PRA
What induces MHC Class II expression on vascular endothelium >?
Class II antigens may be induced by:
ischemia/reperfusion injury of the allograft,
making the endothelial barrier a prime target for the allo-immune response.
canonical
- according to or ordered by canon law.
- included in the list of sacred books officially accepted as genuine.
ar·ri·viste
an ambitious or ruthlessly self-seeking person, especially one who has recently acquired wealth or social status.
accismus,
a form of irony in which a person feigns indifference to or pretends to refuse something he or she desires.
Occhiolism
Occhiolism (noun): The awareness of the smallness of your perspective, by which you couldn’t possibly draw any meaningful conclusions at all, about the wor
gauche
|gōSH| adjective lacking ease or grace; unsophisticated and socially awkward
“Et in Arcadia Ego”
“Et in Arcadia Ego” is “Even in Arcadia, there am I”. —- death is always there
op·pro·bri·um
harsh criticism or censure.
MFI
MFI: Mean Fluorescence Intensity
genetically engineered CD20-directed cytolytic monoclonal antibodies .
Rituximab and obinutuzumab are genetically engineered CD20-directed cytolytic monoclonal antibodies targeted at B-cells.
rituximab: chimeric murine human,
obinutuzumab: fully humanized
Rituximab
Rituximab and obinutuzumab are genetically engineered CD20-directed cytolytic monoclonal antibodies targeted at B-cells. (rituximab: chimeric murine human, obinutuzumab: fully humanized).
CTOT-11 randomized trial
However, the CTOT-11 randomized trial raised concerns about the use of Rituximab as an induction therapy in:
- non-sensitized patients
was associated with a marked and unexpected increase in cardiac allograft vasculopathy progression as assessed by intravascular ultrasound compared to placebo
oleaginous
o·le·ag·i·nous
/ˌōlēˈajənəs/
adjective
1.
rich in, covered with, or producing oil; oily or greasy.
“fabrics would quickly become filthy in this oleaginous kingdom”
2.
exaggeratedly and distastefully complimentary; obsequious
Proteasome inhibitors
Proteasome inhibitors:
- bortezomib
- carfilzomib
Bortezomib
class / protein
MOA
Bortezomib,
a modified dipeptidyl boronic acid, is a reversible inhibitor of the 26S proteasome
that promotes apoptosis of plasma cells triggered by the accumulation of unfolded proteins and endoplasmic reticulum stress in addition to exhibiting other pleiotropic immunomodulatory effects.
CD38
CD 38:
- Surface glycoprotein on many immune cells including:
- plasma cells and plasmablasts.
- Function:
- cell adhesion
- signal transduction
- calcium signaling.
Targeting plasma cells, a major source of antibodies, might be beneficial in the field of allosensitization.
Daratumumab
Anti CD-38 antibody
