tumour immunology

Question 1

what is immunotherapy

Answer 1

a treatment that uses the immune system to treat disease eg cancer
sometimes also called biologics

Question 2

9 factors affecting immune health

Answer 2

chronic stress
physical inacitivity
poor personal hygiene
impaired micro blasts
environmental toxins
lack of sleep
substance use
nutrient deficiencies
poor diet

Question 3

examples of auto immune diseases

Answer 3

multiple sclerosis
systemic lupus
celiac disease
eczema and psoriasis
hashimotos thyroiditis
asthma
rheumatoid arthritis

Question 4

describe etiology of cancer

Answer 4

1. transformation of germ line cells - inheritable cancers
2. transformation of somatic cells - non inheritable cancers
3. environmental factors - UV, chemicals, pathogens

Question 5

hallmarks of cancer (features)

Answer 5

• growth self suffienciy
• evade apoptosis
• ignore anti proliferative signals
• limitless replication potential
• sustained angiogenesis
• invade tissues
• escape immune surveillance

Question 6

how has the immune system evolved

Answer 6

to discriminate self from non self based on the principle that anything recognised as non self may be dangerous (eg external pathogens)

Question 7

what is the ultimate goal of tumour imunology

Answer 7

to induce clinically effective anti tumour immune responses that would discriminate between tumour cells and normal cells in cancer patients

Question 8

what cells mediate

Answer 8

T cells
NKT cells
NK cells

Question 9

what is cancer immunosurveillance

Answer 9

immune system can recognise and destroy nascent transformed cells
, normal control

Question 10

what is cancer immunoediting

Answer 10

tumours tend to be genetically unstable, so immune system can kill and also induce changes in the tumour - resulting in tumour escape and recurrence

Question 11

what are Tumour Specific Antigens (TSA)

Answer 11

only found on tumours

as a result of point mutations or gene rearrangement

derive from viral antigens

Question 12

what are tumour Associated Antigens (TAA)

Answer 12

found on both normal and tumour cells, but are overexpressed on cancer cells

developed antigens which become depressed

differentiation antigens are tissue specific

altered modification of a protein could be an antigen

Question 13

difference between TSA and TAA

Answer 13

1. tsa only on tumours
2. tsa from viral antigens
3. taa found on normal and tumour cells but overexpressed on cancer cells

Question 14

evidence of human tumour immunity

Answer 14

1. spontaneous regression - in melanoma & lymphoma
2. regression of metastases after removal of primary tumour - pulmonary metastases from renal carcinoma
3. infiltration of tumours by lymphocytes and macrophages - melanoma and breast cancer
4. lymphocyte proliferation in draining lymph nodes
5. higher incidence of cancer after immunosuppressive, immunodeficiency (aids, neonates), aging etc

Question 15

evidence for escape 9detectbale tumours)

Answer 15

1. immune responses change tumours such that tumours will no longer be seen by the immune system - tumour escape
2. tumours change the immune responses by protecting immune suppressor cells - immune evasion

Question 16

what is the dual function of immune responses

Answer 16

immunosurveillance and immunoediting of tumour

elimination, equilibrium and escaper

Question 17

what is immunoediting

Answer 17

immune responses can change tumours to be hidden from recognition by the immune system and tumours can promote immune suppression

Question 18

what is adaptive immunity

Answer 18

to induce an immune response against the tumour that would discriminate against between the tumour and normal cells

Question 19

what kind of immune are vaccines

Answer 19

active immunotherapy

Question 20

give 6 types of vaccination

Answer 20

1. killed tumour vaccine
2. purified tumour vaccine
3. professional APC based vaccines
4. cytokine and costimulator enhanced vaccines
5. dna vaccines
6. viral vectors

Question 21

2 types of passive immunotherapy

Answer 21

1. adoptive cellular therapy — t cells
2. anti tumour antibodies

Question 22

what are cellular therapies used for

Answer 22

to activate a patients immune system to attack cancer

and used as a delivery vehicle to target therapeutic genes to attack the tumour

they don’t act directly on cancer cells - they work systemically to activate the body’s immune system

Question 23

examples of dendritic cells

Answer 23

interstitial cells - liver heart.
langerhan cells of the epidermis

Question 24

what do dendritic cells do

Answer 24

detect and chew up foreign invader proteins and then present piece of the invaders on their surfaces

Question 25

how to make a DC vaccine

Answer 25

the blood of the cancer patient is collected and enriched to increase the population of DC

Question 26

where can macrophages sit

Answer 26

they don’t just sit on top of tumour, they penetrate and accumulate in hypoxia areas
hypoxic cells survive radiotherapy and chemotherapy and regrow

Question 27

what is a tumour hypoxia

Answer 27

low oxygen

so less blood supply further from outside of tumour so tumour cells adapt to low blood supply and oxygen

Question 28

problems with tumour hypoxia

Answer 28

1. stimulates new vessel growth
2. suppresses immune system
3. resistant to radio and chemotherapy
4. increased tumour hypoxia after therapy

Question 29

3 general features of tumours

Answer 29

Tumours express antigens that are recognised as foreign by the immune system of the tumour-bearing host

Immune responses frequently fail to prevent growth of tumours

The immune system can be activated by external stimuli to effectively kill tumour cells and eradicate tumours

Question 30

what are the immune responses to tumours

Answer 30

T lymphocytes
Antibodies
NK cells
Macrophages

Question 31

define tumour escape

Answer 31

immune responses change tumours such that tumours will no longer be seen by the immune system.

Question 32

define immune evasion

Answer 32

tumours change the immune responses by promoting immune suppressor cells.