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73 Cards in this Set
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Anti-thromocyte antibody (ATG)
Atgam Thymoglobulin |
Polyclonal Ab specific for T cell antigens.
Depletes T cells thru complement dependent cytolysis and opsonization Actively kills T cells |
For in vivo T cell depletion in preventing GVHD
an Ab used in solid organ transplant therapy |
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Alemtuzumab
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IgG Ab for lymphocyte CD52 antigen
Causes lysis of lymphocytes by binding to CD52 antigen (B, T, monocytes, thymocytes and macrophages) Actively kills T cells |
In vivo T cell depletion agent for preventing GVHD
Ab in solid organ transplant |
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Methotrexate
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inhibits dihydrofolate reductase which inhibits purine biosynthesis and DNA biosynthesis which inhibits T cell proliferation
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Immunosuppression for preventing GVHD
Rheumatoid arthritis anti-cancer |
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Cyclosporin A
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cyclic decapeptide
Binds to cyclophilin which inhibits calcineurin which disrupts the transduction cascade of T cell receptors. Inhibits IL-2 synthesis |
Inhibits T cell proliferation, preventing GVHD
Rheumatoid arthritis |
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Tacrolimus
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Binds to FK-binding protein (FKBP-12) which inhibits calcineurin which disrupts signal cascade of T cell receptors
Inhibits IL-2 synthesis |
Inhibits T cell proliferation, preventing GVHD
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Sirolimus
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Binds to FKBP12 and complexes to mTOR.
Inhibits DNA transcription, protein synthesis and cell cycle leading to T cell immunosuppression. Also dendritic cell activity reduced, antifungal, antiviral activity |
Immunosuppressant inhibits T cell proliferation, dendritic cell activity
for prevention of GVHD |
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Mycophenolate mofetil
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Prodrug form of mycophenolic acid
Uncompetitive reversible inhibitor of inosine monophosphate dehydrogenase Decrease synthesis of GMP and inhibits RNA/DNA synthesis Anti-proliferative agent |
Is especially active on B and T cells and inhibits their proliferation
prevents GVHD Antiproliferative agent in solid organ transplant |
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Cyclophosphamide
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Nitrogen mustard DNA alkylating agent.
Inhibits DNA synthesis Selective to T cells (less on stem cells b/c have high aldehyde dehydrogenase which inactiviates drug) |
Inhibits DNA synthesis
Immunosuppression for preventing GVHD |
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Prednisone/ Methylprednisone
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Corticosteroids
Systemic anti-inflammatory. Decreases activity of IL1,3,4,5, adhesion molecules, phopholipase A, COX 2 |
1st line treatment for GVHD
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OKT3
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mouse Ab against CD3 (a co-receptor w/ T cell receptor). Causes apoptosis of activated T cells
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GVHD treatment
- stimulates cytokine release= edema, hypotension |
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Visilizumab
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Anti-CD3 antibody
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GVHD treatment
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Daclizumab
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human Anti-CD25 (IL-2 receptor) antibody
Blocks IL-2 receptor preventing T cell activation and proliferation |
GVHD treatment
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Inolimomab
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mouse anti-CD25 (IL-2 receptor) antibody
Blocks IL-2 receptor preventing T cell activation and proliferation |
GVHD treatment
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Basiliximab
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chimeric anti-CD25 (IL-2 receptor) antibody
Blocks IL-2 receptor preventing T cell activation and proliferation |
GVHD treatment
IBD relapse |
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Denileukin diftitox
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Ontak. Fusion protein of IL-2 and diptheria toxin
Binds to IL-2 receptor, releases toxin and kills T cell by inhibiting protein synthesis |
Cutaneous T cell Lymphoma
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Alemtuzumab
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Anti-CD52 antibody
Causes lysis of lymphocytes by binding to CD52 antigen |
For treatment of B cell chronic lymphocytic leukemia
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Etanercept (Enbrel)
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Genetically engineered molecule made of extracellular domains of human TNF-alpha receptor.
Inhibits TNF-alpha by binding TNF and blocking its action. Mimics soluble TNF receptors |
Rheumatoid arthritis
GVHD treatment |
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Infliximab (Remicade)
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chimeric anti-TNF alpha antibody
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Croh's Disease
Ulcerative Colitis GVHD treatment Rheumatoid arthritis |
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Pentostatin
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natural product that inhibits adenosine deaminase= inhibition of ribonucleotide reductase= inhibition of DNA and RNA synthesis
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Nonspecific cytotoxic agent
GVHD treatment |
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FTY720
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PO4ed by sphingosine kinase then binds to sphingosine phosphate receptors
Stimulation of receptor inhibits lymphocytes from leaving lymph node |
Immunomodulatory drug
Solid organ transplant |
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Belatacept
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recombinant immunoglobulin fusion protein (Fc IG1 portion and CTLA4)
Competitively inhibits CD80 & 86(B-7) from interacting with CD28 (a necessary costimulation for T cell activation) |
Solid organ transplant
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JAK3 kinase inhibitor
CP-690, 550 |
Inhibits JAK3 (a tyrosine kinase) which inhibits IL2 signal transduction and inhibits T cell proliferation
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Solid organ transplant
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Sulfasalazine
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anti-inflammatory
inhibits COX 1 &2 |
Rheumatoid arthritis
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Hydroxychloroquine
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Blocks Toll like receptors of dendritic cells, preventing them from maturing and presenting antigen to T cells
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rheumatoid arthritis
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Leflunomide
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anti-metabolite that inhibits mitochondrial dihydroorotate dehydrogenase (DHODH) inhibiting rUMP and RNA synthesis.
Prevents lymphocyte activation |
rheumatoid arthritis
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Gold salt
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Enters mitochondria and disrupts cellular respiration causing apoptosis
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High affinity for immune cells
Rheumatoid arthritis |
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Anakinra
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Anti- IL1 receptor antibody
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Rheumatoid arthritis
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Adalimumab
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anti-TNF alpha antibody
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Rheumatoid arthritis
IBD relapse |
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Certolizumab
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anti-TNF alpha antibody
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Rheumatoid arthritis
IBD relapse |
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Golimumab
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anti-TNF alpha antibody
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Rheumatoid arthritis
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Abatacept
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Same as Belatacept
inhibits B7:CD28 interaction |
Rheumatoid arthritis
IBD relapse |
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Rituximab
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Anti-CD20 chimeric antibody
Target CD20 on B cells causes B cell death |
Rheumatoid arthritis
B cell lymphoma |
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Toclizumab
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Anti-IL6 receptor antibody.
Blocks receptor |
Rheumatoid arthritis
Relapse IBD |
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Mesalamine
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COX inhibitor works in GI tract
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IBD first line therapy
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Natalizumab
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anti-adhesion molecule
humanized AB for alpha 4 integrin Inhibits binding of leukocyte integrin to endothelial cell MADCAM1 |
IBD
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Cetuximab
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Anti-EGFR antibody
inhibits signal transduction, causes ADCC |
colorectal cancer, head and neck cancer
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Panitumumab
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human anti-EGFR antibody inhibits signal transduction
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colorectal cancer
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Bevacizumab
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humanized anti-VEGF antibody, binds VEGF preventing it from binding with receptor prevents tumor vascularization and tumor growth
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colorectal cancer
lung cancer breast cancer |
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Trastuzumab
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humanized anti-HER2 receptor antibody
causes ADCC and inhibits signal transduction |
breast cancer
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Ibritumomab tiuxetan
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Binds to CD20 causes ADCC
Also has radioactive attachment which kills cells or allows for diagnostic tests |
B cell Non-Hodgkins lymphoma treatment and diagnosis
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Tositumomab
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Binds CD20: ADCC
Carries radioactive atom to kill or diagnose cancer cells |
Non-Hodgkin's lymphoma
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Capromab pendetide
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Binds to prostate specific antigen (PSA), lablled with radioactive indium
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Diagnosis for prostate cancer
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Interferon alpha 2a/2b
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Induce non-specific resistance to viral infection
NK cell expansion Increased cytotoxic T cell activity enhanced macrophage activity Increased ADCC |
Treats hairy cell leukemia, Kaposi's sarcoma, chronic myelogenous leukemia, melanoma
Increases immune system |
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Aldesleukin
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Enhances cytotoxic T cell activity and NK activity
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Metastatic renal cell cancer
melanoma Increases immune system |
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Interleukin 11
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a thrombopoietic growth factor increasing platelet production
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Treatment following myelosuppressive chemotherapy
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Filgrastim
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Granulocyte colony-stimulating factor increasing neutrophil production
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Neutropenia following myelosuppressive chemotherapy
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Sargramostim
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Granulocyte colony-stimulating factor increasing neutrophil production
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Neutropenia following myelosuppressive chemotherapy
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Epoetin Alpha
Darbepoetin Alpha |
glycoproteins that stimulate erythrocyte production
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For anemia following myelosuppressive chemotherapy
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Primary cells involved in the INNATE immune system (4)
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macrophage
neutrophil natural killer cells mast cells |
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Phagocytic cells (2)
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macrophage
neutrophil |
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Difference between macrophage and neutrophil?
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Neutrophil undergoes apoptosis
Macrophage diplays antigen and relases cytokines |
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NK cells kill what type of cells?
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bodies own cells: virus//bacteria/fugal infected cells, tumor cells by causing ADCC (coat the cell with Abs)
No antigen required |
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Imiquimod
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for warts
ligand for TLR 7 and 8 |
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What is a collectin?
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Soluble pattern recognition receptor that recognizes bacterial carbohydrate structures
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Which cytokine(s) mediate acute inflammatory responses?
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IL-1 and
TNF-alpha |
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What are the 3 parts of innate immunity?
(primary, secondary and tertiary) |
Physical/chemical barriers: skin, mucus, tears etc
Cellular and chemical surveillance: macrophage, neutrophils, cytokines, interferons etc Inflammation |
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The humoral immune response primarily involves what cells?
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B lymphocytes
produce antibodies which attach to antigen |
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The cell-mediated immune response primarily involves what cells?
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T lymphocytes
Recognize foreign material on surface receptors and attack |
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Activated B cells develop into ____ and serve what 3 functions?
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Plasma cells;
produce antibodies antigen presenting cells memory B cells |
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B cell activation involves 3 steps:
1. Cell encounters antigen and binds it to surface receptor 2. Bound antigen is expressed on MHC ____ 3. ? |
2. 2
3. B cell interacts with TH2 cell which signals B cell to divide |
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T cells are divided into what 2 types?
Which T cell marker do each express? |
CD8: Cytotoxic T cell. bind MHC I
CD4: Helper T cell. bind MHC II |
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CD4 T cells are divided into what 2 types with what funtion?
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TH1: inflammation. produce cytokines
TH2: helps B cell Ab production |
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Which cell type is essential for both humoral AND cell mediated immunity?
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CD4 T helper cells
Activate B cells to produce Ab (TH2). Produce IL-2 to promote CD8 CTL proliferation (TH1). |
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Vaccines made of whole killed or inactivated antigenic pathogen
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Diptheria/tetanus/aacellular pertussis/ polio/ H influenza
Influenza Rabies Menigncoccus Pneumococcus HPV Hepatitis A & B |
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Vaccines made of live attenuated pathogen
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influenze
measles mumps rubella zoster rotavirus varicella yellow fever |
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IgG
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monomer
80% of Ab half life: 20 days activates complement crosses placenta enhances phagocytosis, neutralizes toxins Work horse antibody |
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IgM
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Pentamer
half life 5 days NOT cross placenta Activates complement First Ab made during infection. High capacity but low affinity |
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IgA
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Dimer
Half life 6 days In secretions, tears, saliva, mucus membranes Localized protection of mucosal surfaces |
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IgE
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monomer
half life 2 days bound to mast cells and basophils thru out body Allergic reactions |
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Type 1 allergy
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Anaphylaxis
involves IgE mast cells degranulate= histamine edema, shock, asphyxiation Give Epi, O2, albuterol, FLUIDs antihistamine, corticosteroids |
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Type 2 allergy
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IgG bind to blood cells and are killed.
Low blood cell counts, fever, chills Usually occurs more than 7 days after high dose therapy DC drug and reduce dose usually good treatment Splenectomy for chronic |
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Type 3 allergy
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Ab/antigen form soluble immune complexes that go to organs, joints and activate complement causing inflammation.
Fever, hives/skin reactions, arthalgia/myalgia Often caused by metabolite ex: rheumatic fever |
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Type 4 allergy
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Cutaneous reactions: Delayed hypersensitivity. T cell mediated.
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