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191 Cards in this Set

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Define Immunogenicity
Ability of a substance (immunogen) to induce a humoral or cell-mediated immune response
At what mass do immunogenic properties decline?
10,000 Daltons or less
True or False.
Macromolecules incapable of degradation & MHC presentations are poor immunogens
True
Describe the type of molecule that is more easily phagocytosed by the immune system
Large, more soluble molecules are more easily phagocytosed by immune system cells than small soluble ones
The ability of a substance (antigen) to react specifically with an antibody or T-cell receptor is _______.
Antigenicity
All _________ are antigens.
Not all antigens are ________.
Immunogens
Immunogens
What is the site on an antigen that is recognized by an antibody or antigen receptor?
Epitope
__________ _________ are also called Epitopes.
Antigenic determinates are also called Epitopes
Do antigens have more than one determinant?
Yes, most antigens have one or more determinants.
- they are multivalent. In general determinant is above 5 amino acids or sugars in size
Any substance that enhances the effects of a drug or increases the immungenicity of an antigen is called a ________.
Adjuvants
-latin origin "adjuvans" means to help
__________ promote prolonged persistence of antigen and/or enhanced immune cell activation in response to antigen.
Adjuvants
Cytokines and other substances that activate immune cells when given in conjunction with vaccines are also referred to as ___________.
Adjuvants
Define Haptens.
Small organic molecules with antigenic binding properties but are not immunogenic.
-NOT CAPABLE of independently initiating response.
Complexing with carrier is required for _______ to become immunogenic and the __________ component is immunodominant.
hapten
hapten
What is an example of a hapten?
The small molecule urushiol found in poison ivy and poison oak. It covalently couples to proteins in the skin and causes an inflammatory response.
Describe the antibody structure.
Two heavy chains and two light chains held together by disulfide bonds to form one antibody (immunoglobin)
True or False.
Secreted antibodies have a transmembrane domain.
False.
Secreted antibodies lack a transmembrane domain
The _________ domains of an antibody differ in amino acid sequence between antibodies of different antigen binding specificities and are depicted as light chains and heavy chains.
Variable domains (V-light & V-heavy)
Describe the constant domain of an antibody.
Determine the class and overall function of the antibody and are depicted as constant heavy chains and constant light chains.
What region of the antibody allows for flexibility for binding simultaneously to two identical antigens?
hinge region
-this is a very important region on the antibody
What is the Fc region on an antibody for?
The Fc region binds to Fc receptors on B cells and other antigen presenting cells and activates intracellular signaling cascades
The _________ region is produced by papain cleavage that contains one antigen-binding arm.
Fab region is produced by papain
________ cleaves immunoglobulins at the hinge region leaving an Fc containing portion and an F(ab)s antigen binding portion that has both antigen binding arms.
Pepsin cleaves immunoglobins
Describe the difference between an Isotype, Idiotype, and Allotype.
Isotype: determine by heavy chain constant region (antibody class and function)
Idiotype: determined by heavy chain and light chain variable regions (antibody binding specificity)
Allotype: determined by allelic polymorphisms
________ is determined by heavy chain constant region (antibody class and function)
Isotype
________ determined by heavy chain and light chain variable regions (antigen binding specificity)
Idiotype
________ determined by allelic polymorphisms.
Allotype
Antigens bind to specific antigenic sites called __________
Epitopes
Is the binding between antigens and its epitope noncovalent and reversible.
Yes
What do antibodies recognize on antigens?
Three-dimensional structure and primary amino acid sequences
What influences the binding affinity of an antibody?
the binding affinity is influenced by complimentary determining regions (CDRs) in the variable domain of the antibody.
What region of the antibody are the CDRs located?
Complimentary determining regions are located in the variable domain of the antibody
What makes an antibody bivalent in its binding capacity?
Antibodies have two antigen binding arms
What types of antigens are bound by antibodies?
Proteins, polysaccharides, nucleic acids, lipids, small chemicals
Define the difference between affinity and avidity.
Affinity: is the binding strength between one antigenic epitope and one immunoglobulin antigen binding site.
Avidity: is the overall combined binding strength between an antibody and antigen.
What determines avidity?
Avidity is determined by both affinity and valency.
For the same antigen in which IgG and IgM have binding sites for, do they have the same affinity and avidity?
IgM has higher avidity than IgG because it has 5 binding sites for the epitope whereas IgG has only two binding site.
IgM and IgG have the same affinity for the epitope though.
What determines the isotype of the antibody?
The heavy chain constant region determines the isotype.
How many different heavy chain constant regions are present in humans? What are they?
5 different types of heavy chain constant regions.
IgA
IgD
IgE
IgG
IgM
The functions of _____ antibody are mucosal immunity, neonatal passive immunity.
IgA
IgA is a dimer
Opsonization, complement activation, antibody dependent cell mediated cytotoxicity, neonatal immunity, & feedback inhibition of B cells are the functions of this type of antibody.
IgG
IgG is a monomer
What antibody isotype is responsible for the function of naive B-cell antigen receptors?
IgD
There is not a secreted form of IgD
This isotype of antibody functions in immediate hypersensitivity.
IgE
IgE is a monomer
The antibody isotype is a pentamer. What is it? What are its functions?
IgM
Naive B-cell antigen receptor
complement activation
What are dimeric IgA held together by?
Dimeric IgA are held together by a linker called the J chain.
_______ and ________ help protect the IgA from degradation in mucosal secretions.
"J Chain" and heavy glycosylation
Secreted IgM is held together as a pentamer by the ________.
"J chain"
What is unique about IgE?
IgE contains an extra heavy chain constant region which gives it a unique Fc region which binds to Fc receptors on mast cells and causes activation and release of histamines.
What are the effector functions of antibodies?
1. Neutralization of microbe and toxins
2. Opsonization and phagocytosis of microbes
3. Antibody dependent cellular cytotoxicity
4. Lysis of microbes
5. Phagocytosis of microbes opsonized with complement fragments
6. Inflammation
7. Complement activation
______ is the process of attaching opsonins, such as IgG or complement fragments to microbial surfaces to target the microbes for phagocytosis
Opsonization
What is an important difference between IgA1 and IgA2?
IgA1, which is most abundant in serum, is susceptible to bacterial proteases, and binds mostly to peptide antigens
IgA2: predominated in secretions, is resistant to bacterial proteases, and binds to polysaccharids and lipopolysaccharides.
What immunoglobin is the only one transmitted across the placent?
IgG is the only Ig transmitted across the placenta
What is the most prominent serum Immunoglobin?
IgG
What is the only immunoglobin that binds macrophages and neutrophil Fc receptors, and has the longest half life?
IgG
What are three ways that microbes & toxins are neutralized by antibodies?
1. antibody blocks binding of microbe and infection of cell
2. Antibody blocks infection of adjacent cell
3. Antibody blocks binding of toxin to cellular receptors
List the steps involved in antibody-mediated opsonization & phagocytosis of microbes.
1. Opsonization of microbe by IgG
2. binding of opsonized microbes to phagocyte Fc receptors
3. Fc receptor signals activate phagocyte
4. Phagocytosis of microbe
5. Killing of ingested microbe
What must occur on the antibody after opsonization for the phagocyte to engulf the microbe?
The constant portion/Fc receptors must crosslink and then the phagocyte will engulf the microbe and lyse it
What occurs in the immune system if a microbe is to large to be engulfed by a phagocyte?
1. antibodies of certain IgG subclasses bid to cells
2. The Fc regions of the bound antibodies are recognized by Fc-gamma receptors of NK cells
3. NK cells are activated
4. NK cells kill the antibody coated cell
_____ and ______ are expressed by fully mature naive B-cells. These function in antigen receptors for B-cell activation
IgM and IgD
If a B lymphocyte reaches the pro-B cell and/or pre-B cell stages and fails to express functional antigen receptors, Ig heavy chain and Ig light chain, respectively, what will this result in?
Failure to express functional antigen receptors results in death of the cells by a default pathway of apoptosis
What activated B-cells?
B-cells are activated by antigen cross-linking of membrane bound Ig which triggers an intracellular signaling cascade that causes B-cells to clonally expand.
T/F
Each B cell clone produces antibodies that have a single "clonal" antigen specificity.
true
T/F
B cell clones can further differentiate into memory B cells or plasma cells that secrete antibodies of different classes.
True
Describe the features of antibody responses that are T-cell dependent.
1. Chemical nature: proteins
Features of Antibody responses:
2. Isotype switching: IgM -- IgG, IgE, or IgA
3. Affinity maturation: yes
4. Secondary response: yes memory B-cells are produced
Describe the features of antibody responses that are T-cell independent.
Chemical nature: Polymeric antigens, especially polysaccharides, also glycolipids, nucleic acids
Features of antibody responses:
1. Isotype switching: Little or no/may be some to IgG
2. Affinity maturation: little or no
3. Secondary response: only seen with some antigens/hardly any memory B-cells produced
how can a single individual generate antibodies with more than 100 million different specificities when humans only carry approximately 30,000 different functional genes?
1. Gene rearrangement
2. Somatic hypermutation
how are heavy and light chain loci arranged in the genome?
geners for numerous variable domains (V), are distant from enes that encode different joining regions (J) different diversity regions (D/which is absent in light chain loci) and multiple constant regions (C). This allows for a large number of different antibodies to form by a process of recombination where a given V gene can combine with numerous D and J regions
Describe allelic exclusion
When an Ig gene on one allele is successfully recombined the B cell stops rearrangement and does not recombine the genes on the other allele.
This ensures that each B cell produces antibodies with a single antigen
What ensures that B cells produce antibodies with a single antigen specificity?
allelic exclusion
how does the recombination of an Ig light chain and a TCR-alpha differ from a heavy chain?
-the expression of an Ig heaby chain involves 2 gene recombination events:
1. D-J joining
2. joining of a V region to the DJ complex with deletion and loss of intervening gene segments
--the VDJ segment is spliced n the 1st heavy chain RNA
-light chains and TCR follow this same pattern EXCEPT they are lacking D segments and the alpha-V gene recombines directly with a J gene segment
What 2 mechanisms contribute to diversity generated by gene rearrangement?
1. combinational diversity
2. junctional diversity
Why is there more diversity with junctional diversity?
although the combinational diversity generates many different combinations. an additional mechanism JUNCTIONAL DIVERSITY occurs durring gene rearrangement that generates even greater diversity. This is a process in which there are nucleotides removed and added at the V,D, and J junctions. This random process generates a tremendous potential for diversity when combined with the combinational diversity
what is an important effector function of IgA antibodies?
IgA antibodies neutralize toxins and microbes in secretions on immune surfaces
How does an antibody (IgA) get through the epithelium barrier?
-this is called mucosal immunity
-IgA is produces by plasma cels in the lamina propria and is actively transported through epithelial cells by an IgA-specific Fc receptor
-On the luminal surface the IgA with a portion of the bound receptor will be released
what is the hallmark of the adaptive immune system?
A hallmark of he adaptive immune system is that it remembers previous encounters with antigens and adapts so that upon subsequent encounter with the same antigen the response is altered for quicker and more efficient eradication if antigen represented danger to the host
in the primary antibody response how long does it take for the immune response to peak?
10-14 days
IgM
Memory B-cells will be produced
described the secondary antibody response to an antigen?
memory B cell is present
antibodies are secreted faster and produce a much larger immune response, reaching its peak at ~5 days
(faster response, and larger antibody titers)
what is class switching
changing to other isotypes other than IgM
describe the lag time after immunization, peak response, antibody isotype, and antibody affinity in the primary immune response
lag after immunization: usually 5-10 days
peak response: smaller
antibody isotype: usually IgM > IgG
antibody affinity: lower average affinity, more variable
describe the lag after immunization, peak response, antibody isotype, and antibody affinity of the secondary immune response?
lag after immunization: usually 1-3 days
peak response: larger
antibody isotype: relative increase in IgG and under certain situations IgA, IgE (heavy chains class switching)
antibody affinity: higher average affinity (affinity maturation)
describe antibody isotype switching
mostly during secondary B cell responses the immunoglobulin locus will undergo further recombination to produce antibodies of the same specificity but different isotypes
-This occurs in the presence of T-cell secreted cytokines and T-cell cross signaling with B cells
what determines which isotype the B-cell will differentiate into?
The cytokines that are secreted by the T-cells determines how the B-cell differentiates
Is a T-cell activated when it meets a B-cell for isotype switching?
NO!
First the B-cell must activate the T-cell and then the T-cell in turn activates the B-cell to proliferate and differentiates
what is the principle effector function of IgM
complement activation
-IgM is the default pathway of immunoglobulins
what is the principle effector function of IgG
Fc receptor-dependent phagocyte responses
complement activation
neonatal immunity (placenta transfer)
-macrophages
What is the principle effector functions of IgE
immunity against helminths
-mast cell degranulation (immediate hypersensitivity)
what is the principle effector function of IgA?
mucosal immunity
-transport of IgA through epithelia)
-is often associated with TGF-beta
If there is no signal from helper T-cells what is the route of an immunoglobulin gene transcription and translation?
IgM
If signals from helper T-cells (CD40 ligand, cytokines) what will the fate of the immunoglobulin transcription and translation be?
IgG or IgE
possibly IgA
during the life of a mature B cell, the rearranged immunoglobulin genes accumulate mutations in the variable regions of the heavy and light chain genes resulting in yet another mechanism for generation of diversity in binding specificity and affinity. What is this called?
somatic hyper-mutations
What gives a B-cell survival advantages?
B cells producing higher affinity antibodies are provided survival advantages.
Define affinity maturation.
B cell producing higher affinity antibodies are provided survival advantages and thus secondary and subsequent B cell immune response generate higher and higher affinity antibodies
summarize the humoral immune response in a lymph node
1. activation and migration of T and B lymphocytes
2. T:B cell interaction
3. B-cell differentiation/Ig secretion/Isotype switching
4. Germinal center reaction/affinity maturation/memory B cells
True of False
In humoral immune responses the activation of B cell and helper T cells occurs in different anatomical compartments of peripheral lymphoid organs
True
Where do naive B cells recognize antigens?
naive B cells recognize antigens in follicles
where do helper T-cells recognize antigens?
helper T-cells recognize antigens in T-cell rich zones outside of follicles
Where do T-cells and B-cells interact?
T-cell and B-cell interact at the edges of the follicles in the humoral immune response.
Where does the differentiation of B-cells into antibody secreting cells occur?
mainly outside of lymphoid follicles
where does affinity maturation of the antibody secreting cell occur in the humoral immune response?
affinity maturation occurs in germinal centers and heavy chain class switching may occur outside follicles and in germinal centers
where do memory B-cells develop?
memory B-cells develop mainly in the germinal centers and enter the circulation
what can inhibit B-cell response?
when the antibody titer gets elevated, microbes covered with antibodies bind to B cell Fc receptors which inhibits the response of cross-linked Ig receptors
why is it important for the B-cell responses to be controlled?
presence of the Fc receptors binding tells the B-cell that this is not something that the B-cell should react too
describe the mechanisms by which microbes can escape antibody immunity
1. antigenic variation
2. inhibition of complement activation
3. resistance to phagocytosis
how are antibodies used in clinical testing and research?
1. monoclonal antibodies
2. flow cytometry
3. ELISA
4. Coombs Test
5. Western blotting
describe monoclonal antibodies
monoclonal antibodies to a given antigen can be generated indefinitely by fusing B-cell producing specific antibody to transformed cells to generate B cell hybidomas. These cells can be grown in culture an frozen back for future production of mAb. Large quantities of mAb are then produced and sold commercially.
-Monoclonal antibodies to thousands of antigens are available for clinical diagnosis and research purposes.
what is the Coombs test?
a test that relies on agglutination of particulate antigen or antigen on a cell surface and soluble antibody. Anti-human immunoglobulin is used to promote cross-linking of antibodies and antigens which causes agglutination.
Important clinical application includes:
1. typing of Rh determinates on RBCs, detection of anti-Rh antibody in the serum of Rh- women, and diagnosis of Autoimmune Hemolytic Anemia
-this is a qualitative test
drugs with the suffix zumab
humanized monoclonal antibodies
drugs with the suffix ximab
human/murine chimeric monoclonal antibodies
drugs with the suffix mumab
fully human monoclonal antibodies
drugs with the suffix omab or onab
murine monoclonal antibodies
what was the first FDA approved monoclonal antibody therapy
Muromonab
-prevention of graft rejection
Omalizumab
humanized monoclonal
allergy related asthma
rituximab
chimeric monoclonal
B cell lymphomas
natalizumab
humanized monoclonal
Crohn's Disease
MS
Infliximab
human monoclonal
autoimmune disease
adalimumab
human monoclonal
autoimmune disease
bevacizumab
humanized monoclonal
colorectal cancer
trastuzumab
humanized monoclonal
breast cancer
define inflammation
inflammation is a protection and repair response to tissue damage and/or infection. It is a process that protects an organism from further injury by clearing microbes or toxins. It also cleans up cellular debris and allows for would healing to progress. It is good when it is self limiting but can turn bad when it becomes chronic
what are the classical signs of inflammation
pain, swelling, heat and redness
these are the major events that occur during an inflammatory response
1. increase blood supply to the damaged area
2. retraction of endothelium near site which allows increased vascular permeability and exudation of serum proteins
3. migration of leukocytes out of the capillaries into the damaged area
4. Leukocytes follow a gradient of chemoattractants to the damaged site
________ inflammation is a self-limiting response that mostly results in accumulation of neutrophils, eosinophils, basophils, and macrophages at site of injury. Toxins and microbes are cleared by cellular and soluble mediators and the response is terminated upon clearance of microbe or healing of wound
ACUTE inflammatory response
__________ inflammatory response is a long-term response that is mediated by persistence of inflammatory cells, especially T-cells and macrophages. Can cause blood vessel proliferation, tissue damage, and excessive scarring. Cause of numerous inflammatory diseases such as RA, psoriasis, and asthma
CHRONIC inflammatory response
what cells are mediators of inflammation?
cellular mediators:
neutrophils
eosinophils
basophils
lymphocytes
monocytes
mast cells
-all of these cells are found in the blood stream except for mast cells which are found in tissue
name some soluble mediators of inflammation
chemokines
pro-inflammatory cytokines
vasoactive amines
arachidonic acid metabolites
what do the soluble chemokines function as with respect to inflammation
low molecular weight cytokines that stimulate leukocyte movement
Regulate the migration of leukocytes into and out of site of inflammation
Examples: IL-8. GRO IP-10 secreted by activated macrophages
What is the function of pro-inflammatory cytokines? examples:
Example: IL-1, IL-6, IL-12, IFN-gamma, and TNF-alpha
These cytokines promote inflammation in a variety of ways which include induction of adhesion molecules on the surface of leukocytes and endothelium activation of PMNs and other leukocytes and production of other cytokines
The function of __________ _______ in inflammation is to release histamine by mast cells which causes vasodilation, vascular permeability, and release of arachidonic acid
Vasoactive amines
What events facilitate migration of leukocytes into a site for inflammation
-Bacteria produce peptides that contain N-FMLP which is a powerful attractant for neutrophils and macrophages.
-Release of bacterial peptides, chemokines from endothelium and resident macrophages, and lipid mediators causes vasodilation, vascular permeability, and expression of adhesion molecules on nearby endothelium
Steps in Leukocyte Chemotaxis
1. Rolling
2. Integrin activation by chemokines
3. Stable adhesion
4. Migration through endothelium
what are the first leukocytes to the site of inflammation
neutrophils are the first leukocytes to migrate out of the vasculature into sites of acute inflammation
they are followed by mononuclear phagocytes and T-cells
What are Selectins?
adhesion molecules involved in leukocyte migration
Selectins: surface molecules found on leukocytes and endothelium that bind to carbohydrates.
-these molecules allow for loose biding that slows leukocytes and facilitates the initial rolling of lymphocytes along the cell walls of blood vessels
where are P-selectins found?
P-selectins are found on platelets and endothelium
where are E-selectins found?
E-selectins are found on endothelium and activated by T-cells
where are L-selectins found?
L-selectins are found on leukocytes
ICAM-1 and ICAM-2 function as what?
ICAM-1 and ICAM-2 are integrins. These are receptors present on the surface of leukocytes that enable firm adhesion to endothelium . ICAM-1 and ICAM-2 are found on surface of endothelium cells
What induces integrin expression?
cytokines such as IL-1 induce CAM-1 expression
Integrins are activated to a higher affinity state by cellular interaction with chemokines during initial rolling processes
Once a leukocytes is firmly bound to the endothelium what happens?
once the leukocytes has stopped rolling & is firmly bound via integrins to the endothelium it can interact with chemotatic factors that signal migration into the site of infection or damage
what integrins is present on lymphocytes that facilitates ICAM-1 binding
LFA-1 is on the surface of lymphocytes
it facilitates ICAM-1 binding and is critical for trafficking of these cells
what integrin is present on macrophages that facilitates binding with ICAM-1?
MAC-1 is present on macrophages and facilitates ICAM-1 binding anad is critical in trafficking these cells
which integrins are of the beta-2 type?
LFA-1: leukocytes
MAC-1: macrophages
what does the lack of beta-2 integrins result in?
Lack of beta-2 integrins results in a severe immunodeficiency known as LAD-1 (leukocyte adhesion deficiency)
What do LAD-1 patients exhibit
-Leukocyte Adhesion Deficiency
-Leukocyte transmigration defects and suffer repeated bacterial infections
What disease is caused by a deficiency in Sialyl-Lewis factor?
Sialyl-Lewis factor is a receptor for E-selecting and P-selectin
-LAD-II is caused by this deficiency
what rapidly induces TNF-alpha and IL-1 production?
LPS from bacteria
what do TNF and IL-1 stimulate by their actions on endothelial cells and leukocytes
ACUTE INFLAMMATION
What does IL-12 stimulate in inflammation?
IL-12 stimulates the production of IFN-gamma by NK cells or memory T-cells which activates macrophages
what are PAMPS?
Pathogen Associated Molecular Patterns
what is the function of PRRs?
PAMP recognition receptors
-activate innate immunity and are necessary for initiation of inflammation but overactivation can lead to endotoxic shock and be potentially fatal.
-found on the surface and inside a number of cells like macrophages, mast cells, and neutrophils
TLR2
bacterial cell walls and molecules
-binds to peptidoglycans of Gram+ bacteria
TLR4
bacterial cell walls and molecules
binds to LPS of Gram - bacteria
TLR5
bacterial cell walls and molecules
-binds to flagellin of various bacteria
TLR9
bacterial endosomal TLR
binds to bacterial unmethylated cpg DNA
TLR3
viral
bind to ds-RNA
TLR7 & TLR8
endosomal TLR
binds to SS viral RNA
TLR9
endosomal TLR
binds to unmethylated cpg viral DNA
cytoplasmic sensors for PAMP recognition
NOD1, NOD2, RIG1
NOD1
bacterial cytoplasmic sensor
binds to peptidoglycans from Gram - bacteria
NOD-2
cytoplasmic sensor
binds to peptidoglycans from gram + bacteria
RIG-1
viral cytoplasmic sensor
binds to HCA RNA
what is the cellular response to TLR receptors recognition of microbes?
1. TLR
2. production of cytokines, reactive oxygen species intermediates
3. killing of microbes
what is the cellular response of the mannose receptor to foreign invaders?
1. mannose receptor
2. phagocytosis of microbe into phagosome or production of cytokines, reactive oxygen intermediates
3. killing of microbes
why is inflammation an important part of wound healing?
activated macrophages are not only involved in killing microbes and the activation of chemoattraction of other cells but also secrete factors that are important in mediators of tissue remodeling and wound healing.
what are the effector functions of an activated macrophage?
1. killing of microbes
2. inflammation of enhanced adaptive immunity
3. tissue remodeling
4. enhanced antigen presentation
what occurs in the sensitization of a person in the first exposure?
IgE made to allergen that binds to Fc receptors on mast cells
what happens in the 2nd exposure to an allergen
2nd exposure the allergen crosslinks the IgE/Fc receptor complex and elicits allergic response
what does free arachidonic acid initiate?
Free arachidonic acid released from membrane phospholipids by enzymes PLA2, PLC, and PLD initiates a cascade that results in the production of several potent inflammatory mediators
what causes the release of arachidonic acid?
Exposure of many cell types to bacteria products (LPS) or cytokines IL-1, TNF-alpha, or other soluble factors such as histamine or bradykinin causes elevation of phospholipases (Phospholipase A2) and the release of free AA.
What does free Arachidonic acid metabolize?
Free AA is metabolized to produce leukotrienes, prostaglandins, thromboxanse and prostacylins which are potent inflammatory mediators
What is the effect of leukotrienes and prostaglandins in the allergic response?
Leukotrienes and prostglandins cause capillary endothelial leakiness and edema during inflammation. They are potent chemotactic factors for leukocytes
What are Thromboxanes and prostacylins function in the allergic response?
vasoconstrictors and vasodilators
What is the mechanism of action of NSAIDs?
Non-Steroidal Anti-Inflammatory Drugs
-inhibit cyclooxygenases (COX-1,2 or both) and therefore inhibit production of prostaglandins, thromboxanes, and prostacyclins
Examples of inhibitors of COX-1 and COX-2:
Aspirin, Ibuprofen, Naproxen
_______ is an example of a COX-1 inhibitor.
Indomethacin
____________ and ___________ are examples of COX-2 inhibitors
Celecoxib (Celebrex) and Rofacoxib (Vioxx)
a bronchoconstrictor is an example of __________.
Leukotriene Receptor Antagonist
-these block leukotrienes
________ is a LTRA (leukotriene Receptor Antagonist) which is used in asthma and allergic rhinitis.
Montelukast (Singulair)
Zafirlukast (accolate) is a __________ used in treatment of asthma.
Leukotriene Pathway Inhibitors (LTRA)
Zileuton is used in the treatment of asthma. What type of drug is it?
5-lipoxygenase antagonist: blocks leukotrienes production
Hydrocortisone, dexamethasone, and prednisone are examples of _______.
Corticosteriods
what is the function of corticosteroids
inhibit PLA2 and therefore inhibits AA metabolism. Also inhibits T-cell proliferation and causes T-cell apoptosis
________ targets histamine receptors and inhibit histamine binding.
Antihistamines
What is an example of an antihistamine that is found in the smooth muscle of intestines, bronchi, and blood vessels?
H1 receptors
Where are H2 receptors found? What type of receptor are they?
H2 receptors are in airway mucous, gastric parietal cells, and in the vascular and central nervous.
what is an example of an H2 receptor?
Cimetidine targets are H2 receptors
________, ____________, and ________ are examples of cytokine inhibitors.
Kineret
Etanercept (Enbrel)
Infliximab (Remicade)
What is the function of Kineret?
cytokine inhibitor
recombinant IL-1Ra
blocks IL-1 binding
used in RA treatment
what cytokine inhibitor is a fusion of protein that binds TNR receptors and blocks TNFa and TNFb and is used in RA treatment?
Etanercept (Enbrel)
__________ is an anti-TNFa antibody that blocks TNFa binding and is used in RA treatment.
Infliximab (Remicade)
Example of a Selective Adhesion-Molecule Inhibitors
Tysabri (Natalizumab)
-humanized monoclonal antibody against VLA-4 which is present on leukocytes and mediates binding to VCAM-1 on inflamed endothelium and other receptors necessary for leukocytes migration
-used in treatment of MS and Chrohn's
what is the function of Methotrexate?
general immunosuppressant: inhibits DNA synthesis and therefore inhibits cell growth