W03_11 Immunosuppression Flashcards
what do corticosteroids bind to?
glucocorticoid receptor and other transcription factors, like NF-kB
what is dexamethasone?
corticosteroid.
0.75 mg po or IV
what is methylprednisolone?
corticosteroid.
4 mg IV
what is prednisone?
corticosteroid.
5 mg po
what is hydrocortisone?
corticosteroid.
20 mg IV
what is cyclophosphamide?
antiproliferative agent.
used in cancers and autoimmune disease.
forms cross links in DNA that causes cell death
what’s a general common side effect of antiproliferative agents for immunosuppression?
bone marrow suppression. e.g. neutropenia
what’s azathioprine?
antiproliferative agent.
purine analogue that interrupts DNA synthesis
what’s mycophenolic acid?
antiproliferative agent.
inhibits purine synthesis
what’s leflunomide?
antiproliferative agent.
inhibits pyrimidine synthesis
what’s methotrexate?
antiproliferative agent
blocks folic acid action. (DNA issues)
side effects of antiproliferative agents?
hepatotoxicity, pancreatitis, GI upset. (also neutropenia)
what’s sirolimus?
antiproliferative agent.
list three diseases that antiproliferative agents treat
rheumatoid arthritis, inflammatory bowel disease, transplantation
what’s calcineurin?
blocks T-cell activation;
prevent IL-2 production;
prevents transcription factors from entering nucleus.
indications for calcineurin inhibitors?
transplantation; some types of glomerulonephritis; psoriasis; rheumatoid arthritis; opthalmic diseases
what’s basiliximab?
anti-IL-2;
given before transplantation for acute prevention
what’s infliximab?
anti-TNFa; also kills TNFa-producing T cells;
used for IBD, ankylosing spondylitis, psoriasis, others
what’s alemtuzumab?
treats lymphoma + transplantation;
depletes T and B cells
what’s rituximab?
treats lymphoma, type II HS rejection, glomerulonephritis, vasculitis, others;
depletes B cells
what’s eculizumab?
treats antibody-mediated rejection;
mAb against C5 complement
what’s thymoglobulin?
polyclonal antibody used to prevent and treat transplant rejection;
depletes T, B, dendritic cells
what’s IVIg?
used for autoimmune diseases, like ITP, kawasaki disease, myasthenia gravis, etc.
what’s etanercept?
TNFa blocker;
fused protein with TNFa receptor and Fc IgG
what’s abatacept/belatacept?
fused protein with Fc IgG and CTLA-4. binds to B7 and prevents CD28 co-stimulation to prevent T cell activation.
used in kidney transplantation and rheumatoid arth.
what’s sulfasalazine/5-aminosalicylic acid?
used in IBD; mechanism unknown
what’s hydroxychloroquine?
first-line agent in lupus;
also in rheumatoid arthritis and sjogren’s syndrome; may cause macular toxicity
