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81 Cards in this Set
- Front
- Back
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what is it called whn you treat disease my modulating the immune system.
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immunotherapy
**tx based on modulating the immune system prophylactically or theraputically |
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what is an example of prophylactic AB tx
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if your exposed to hep A and then you take AB against it to neurtalize the hep A
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what are 3 things that can be used for immunotherapies (in general)
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1. Cytokines
2. TIL, LAK 3. AB |
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what are 3 cytokines that can be used to tx CA. how do they work
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1. IL2: activate T cells adn NK (CMI immunity).
2. IFNa: inhibit viral replication 3. G-CSF: makes lots of mast, baso, eosinophiles, PMN (tx neutropenia) |
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what does IL 2 do? how can be be used theraputically
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differentiation of T cells adn NK cells
IndiceCMI Renal Cell Carcinoma, melanoma, leukemia, lymphoma, HIV |
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what cytokine can be used to treat neutropenia caused by chemo
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G_CSF
**induce hematopoiesis |
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what does IFNa do> how is it sued in immunotherapies
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inhibits viral replication
tx multiple mylemoa, AIDS sarcoma, Hep B and C |
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so the 3 cytokines to tx cancer are IL2, IFNa, and G-CSF. What ar ethe 3 used to tx inflammatory disorders
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1. IFNb: antiviral. MS
2. IFNg: macrphage activation, CMI response. chronic granulomatous disease 3.TNFa BLOCKER: TNFa is a inflammatory promotor so we block this. RA, psoriasis, anlakyosing spondylitis |
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waht does IFNb do?
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its an antiviral
**MS tx its a cytokine that prevents inflammatory disease (IFNg and TNFa blockers also prevent inflammatory disorders) |
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what does IFNg do and how is it used as an immunotherapy
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promotes macrophage activation and enhance CMI
((tx for chronic granulatomous disease) **its a cytokine immunotherapy for inflammatory disease |
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what does TNFa do? what is an immunotherapy>
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promotes inflammation
TNFa BLOCKER used to tx RA, psoraiss, ankylosing spomdylithis |
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what is adOptive immunotherapy
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t cells are removed from either tumor (TIL) or peripheral blood (LAK) and treated with IL2 (this promotes CMI of T and NK). Then these T cells are super charged ready to kill and will be injected back into the person to kill the cancer
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what is it called when you remove immune cells from the..
peripheral blood tumor and then tx them with IL2 and then put back in the body |
adOptive immunity
TIL: from tomor LAK: from blood |
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what about AB make them so good for tx (not jsut dx)
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SPECIFICITY!
**specify where you want to deliver toxin |
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what kinds of things can AB be used for theraputically
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neutralize
prophylactic prevention of infections disease/immunodeficiencies (IVIG) Cancer therapy |
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so AB can be used to neutralize, phyphylatic, immunodeficiencies, cancer therapy. what are the 2 types of AB used
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1. Monoclonal: homogenous prep of AB made from a SINGLE B cells, all have SAME AG specificity
2. Polyclonal: mic og AB, made from a variety of B cells, recognize SAME AG but dif EPITOPES |
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what distinguished mono from polyclonal AB
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poly are made from multiple B cells. they recognize the SAME AG but a different EPITOPE
**monoclonal homogenous production of AB, all made from a SINGLE B cells and have SAME AG specificity |
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if you have an antisera with several AG epitopes what kind do you have
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polyclonal
**made form several B cells. If a single B made a sing Epitope it would be monoclonal |
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if AB are made from a mouse what are they called? whats there letter
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murine
**O |
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whats it called when you get a bad IR when you inject an "O" AB
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O means mouse, murine
**HAMA: Human Against Mouse AB. we recognize the FC constant region as foerign and attack the murine AB |
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what is HAMA
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human against mouse AB
**its whn you use murine (O) AB as therapy but teh body knows their Fc constant region is foerign and so will attack **we can make them more human to reduce hama |
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so with totaly murine AB we were having problems with HAMA how can we avoid some of this
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made them mroe human like
Murine: O (total mouse, NO human) Chimeric: IX, variable binding side is mouse, rest is human Humanized (ZU) : jsut the AB binding area is mouse Human (U) Bispecific: can be a mixture of the above |
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where did the AB come from
O A E I U XI ZU |
O: mouse (total mouse, NO human)
A: rat E: hamster I: primate U: human XI: chimeric ZU: humanized |
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what is the nomenclature of monoclonal AB generic names
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suffix "MAB"
this is preceeded by a letter to ID the course of AB a: rat o: mouse e: hamsyer i: primate u: human, total uz: humanized, AB binding is muse xi: chimeric, entire variable is mouse |
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based on nomenclature what is
muromonab CD3 |
MURINE (O)
Monoclonal (MAB) binds CD3 for T cells and depletes them so that transplants wont be rejected |
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what is the drug that depletes CD 3 t cells to prevent transplant rejection (reduce rejection)
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muromonab
O mouse mAB monoclonal AB |
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hat is a chimeric AB
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murine FAB (where AG binds, the variable region)
Human: human constant regions (the constant region is viewed as foerign in murina HAMA responses. chimeric is less foerign) **XI |
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what is the name of a specific TNFa blocker, what animal? what does it tx
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TNFa is proinflammatory so blockers dampen the inflammation. used to treat inflammatory diseases like RA, psorissi etc
**Infliximab: Chimeric (mouse FAB, human constant) |
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what is influiximab
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its a TNFa bloker to treat inflammatory disease like RA, psorissi
**Chimeric: (XI), |
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other than human AB what are hte most silmilar to human and least likely to have HAMA
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humanized, its where the JSUT the binding area is mouse (binding area, same as CDR, complimentary determining area)
ZU |
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wht type of AB has ONLY murine CDT
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complimentary determing area
humanized Trastuzumab: breast cancer |
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what is teh name of the AB that treats breast cancer
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trastuzumab
ZU: humanized, has just the CDR murine, the rest is human. closes to human we can get besides human |
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what is adalimumab? how is it made
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HUMAN AB, made with transgenic mice and phage technology
FULLY human AB, TNFa blocker to decrease inflammatory resoinse. RA, prorisis |
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what allows several cell types to come together
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bispecific AB
can even have 3 fx when we consider the Tc effector region |
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waht are hte 2 bispecific AB
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1. catumaxomab: CD3 and EpCAM
2. Blinatumomab: CD3 and CD19 |
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what is catumaxomab
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bispecific AB
**CD3 (tcell) and EpCAM(epitheliel adhesion). Fc then binds to FcR adn can be used for cancer |
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wat is blinatumomab:
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bispecific AB, Bispecific T cell Engager (BiTEs)
* binds CD19 and CD3 (B and T). tx for ALL and NHL *2 fused FAB NO Fc region |
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how are the bispecoific AB catumaxomab and Blinatumomab silmilar and different
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Cat: does CD3 and EpCAM to bring the cells together and act with FcR
Blitna (BiTEs- bispecific t cell ingager). 2 fused FAB, with NO Fc |
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what is the bispecific AB that uses Fc? what is the one that is just 2 fised FAb with NO Fc
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Catumaxomab: CD3 and EpCAM
Blinatumomab: CD3 and CD19 |
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what do naked AB do
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neutralize
ADCC Activate Compliment ACT AS DRUNG |
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what are 3 things that happens with AB acts as a drug
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1. Neutralizatin
2. ADCC 3. Activate Compliment NAKED AB |
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so naked AB act as drugs, what are conjugated monoclonal AB (immunoconjugates)
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Ab couvalently bound to radioactive toxin
nuclide toxin chemo drug **deliver drug DIRECLTY to the cancerous cell, SPECIFIC AB as a carrier |
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whats another word for immunoconjugates, what do they do
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conjugated monoclonal AB
**they bind to drugs/toxins and deliver them specifically **AB as a carrier |
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name a new AB used as neutralizing agents
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1. Horse/rabbit antisera for snake bites
2. antidiptheria toxin antisera 3. digibind: polyclonal anti digitoxin. FAB fragments |
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what can you do if exposed to diptheria
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administer AB prophylactically to neutralize the toxin
**snake antisera acts the same way |
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whats the best way to make AB so they just neutralize
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use FAB only, NO Fc region that can make effector fx
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what is digiband
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its an FAB fragment that binds to the drug/toxin digoxin
**its an example of an AB workign as a drug to neurtralize AG **FAB so no effector fx. Just hte neutralization |
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waht can you do for ppl with immunodeficiency syndromes
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give them AB as a prevention thing
gammaguard sandroglubulin gamimune HUMAN AB |
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wht drugs are used for ppl with hep B
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hyper HepB
HepBHammagee HUMAN AB |
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waht do gamma guard, sandoglobin, and gamminune do?>
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give AB to ppl with immunodeficiencies
**These are ALL Human AB |
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what is ATGAM>? what does it help, what is the source of AB
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animal Ig
management of allograft rejection in renal transplant patients |
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OKT3 is what
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a MONOclonal AB that is used as a drug to prevent renal, ,hepatic, cardiac transplants
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what isthe AB that prevents renal, hepatic and cardiac transplants
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OKT3
**MONOclonal AB (AB as a drug) |
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how does RhoGam work
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its an AB that acts as a drug to clear things via phagocytosis
**clears fetal RH + from maternal system. clears the RH before the mom can see that its foerign and mount an IR against it |
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what is the drug given to RH - moms when they are pregnant with RH + babies
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RhoGam
**its AB as a drug, the drug effect is to clear RH + via phago |
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how can you prevent fetal erythroblastosis
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RhoGam, AB that acts as a drug to clear RH from maternal circulation of RH
**clears before mom can mount an IR against. if mom had memory to RH and then had another baby she might kill the baby |
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why would an AB against growth factors be beneficial as an AB drug
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AB against GF to prevent proliforation
**Cetuximab (chimeric) MONOclonal against EGF receptor, EGF is required for cancer growth, the cetuximab blocks the EGF |
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what is cetuximab?
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its a chimeric monoclonal AB that prevents the growth of cancer by blocking GF
**the GF ifs EGF. Cetuximab binds to the EGFR and blocks EGF so the canver cant grow |
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name 5 monoclonal AB that act as drugs
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1. cetuximab (prevent GF to stop cancer proliforation)
2. Rituxin: against CD20, tx for B cell non hodgkin lymphoma 3. Zenepax: humanized anti IL2, inhibits T cell proliforation. given to reduce organ rejection 4. Xolair: Humanized IgE AB, binds to IgE adn blocks it from binding its receptor. NO degranulation. Releave asthma and allergic rhinitis 5. Yervoy: Human AB against CTLA4. NEW!!! (CTLA4 inhibits T cells) |
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what is rituxin
source mono or poly what deos it act on whts the effect |
chimeric
monoclonal CD20 Tx of B cell NHL (non hodgkin lymphoma) **this is used to target B cells that are infected |
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waht is zenepax
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humanized
monoclonal **AB against IL2 **this means it inhibits T cell differentiation, used to prevent organ rejection |
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what is used to prevent organ rejection?
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ATGAM: animal AB, prevent allograph rejection: renal, hepatic, cardiac
Zenepax: prevents IL2, no T cell differntiation |
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what stim IL2, what inhibits it?
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Stim: proleukin (kill cancer)
Inhibit: zenepax (prevent rejection) |
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what is xolair
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humanized IgE AB
monoclonal Blocks IgE from binding to its receptor, NO histamine degranulation (ect) tx allergic rinitis and asthma |
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what is an AB drug that tx asthma and allergic rhinitis? what is the mech
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xolair
**AB that binds to IgE, IgE can no longer to its thing to release mast cell histamnie rlease. this releives asthma and allergic rhinitis |
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what is yervoy
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human
monoclonal AB against CTLA4 (recall CTLA4 is an inhibitory signal for T cells, T cells arent turned ok kand so will kill longer) SUPER NEW!!! |
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what types of things benefit from having an AB carrier mediated mechanism of action
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things that are SUPER lethal
things that arent readily abs by its tissue |
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what are the 2 major categories of immunoconjugates?> how are they classified
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based on the label
1. immunotoxins: SUPER toxic material is targeted to a certain cell 2. radioimmunotherapy |
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what is an axample of an immunotoxin that delivers toxin directly to a target tissue
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gemtuzumab ozogamicin (mylotarg)
calicheamicin is the toxin and it is linked to an ANTI CD33 AB. so it brings toxin to CD33 cells. TX for acute mylegouous leukemia |
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what is gemtuzumab
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tx for acute myelogenous leukemia
**calicheamicin is the toxin and it is sent to monocytes with Cd33. The AB is ANTI CD33 adn is linked to this toxin. This delivers toxin to the cells it needs to be around |
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what are 2 radioimmunotherapy AB
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1. ibritumomab
2. tositumomab **radiation cant usually be abs really well so this linking to an AB really helps. **it will also kill cells in proxemity so cancerous cells that have lost immunogenicity can still be killed |
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what are 2 drugs that kill targeted cells as well as 2-3 around it? is thsi beneficial or harmfubn
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the radioactve ibritumomab and tositumomab
**this is good, can kill cancerous cells that have lost immunogenicity **radioactive, radioactive isnt abs really well by tissues |
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waht are the radiolabeled drugs that detect colorectal/ovarian cancer adn prostate cancer
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oncoscint
prostascint |
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what is ibritumomab
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deliveries radioactivity directly to cancerous B cells
**tx of non hodgekins Lymphoma that doest respond to other tx **kills several surrounding cells |
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what is tositumomab
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deliver radioactivity to non dodgkin lymphomas
**last resprt type med (if no response to rituxan or chemo) **targets several surrounding cells |
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the cytokines, for each one list the fx and its clinical use
IL2 IFNa IFNb IFNg G-CSF/GM-CSF TNF R |
IL2: enhance CMI. Cancer, HIV
IFNa: inhibit viral replication. HIV, Hep, MM IFNb: dampen inflammation. Viral infection, MS IFNg: enhance macrophage activity adn activate CMI. CGD G-CSF/GM-CSF: growth factor for hematopoeiss. BMT, tx neutropenia TNF R: block TNF. Autoimmune inflammation conditions |
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what does
IFNa IFNb IFNg do |
IFNa: inhibit viral replication (HIV, Hep, MM)
IFNb: dampen inflammtion. Viral infections, MS IFNg: enhance macrophage nad CMI. BMT, TX for neutropenia |
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what are TIL/LAK. what makes them
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take T cells from..
TIL: tumor LAK: peripheral blood tx with IL2 to increase T cell activity and then put them back in the body to tx cancer |
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what is the FAB? what is the FC? what is the source
O XI ZU U |
O: mouse. Murin FAB and Fc
XI: chimeric, FAB is Murine, Fc is human zu: humanized, FAB is most human with some murine, Fc is human U: human. all is human |
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what is teh mechanism adn clinical use for the following naked AB
1. FAB fragment 2. Human IgG 3. AntiHepB 4. Animal AntiT cell AB 5. AntiD (AntiRh) 6. Antigrowth factor AB 7. AntiB |
Fab: neutralize toxin/drug. antitoxin, drug clearance
IgG: replacement for deficiency. Humoral deciciencies, XLA AntiHepB" neutralization, complimanet, ADCC. Hep B Animan AntiT cells: decrease T cell response. prevent HDNB (prevent renal, hepatic, cardiac rejections) AntiGF: block GF. Tx cancer AntiB cells: bind B cell markers. Activate ADCC. Tx B cell cancers |
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the 2 conjugated AB we learned to deliver toxine/nuclide to specific cells targeted what CD
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CD33: calicheamicin is delivedd to CD33 cells (monocytes) to TX AML (acute mylegenous lymphoma)
CD20: radtioactive Y90, I 131. tx B cell NHL |
