Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
12 Cards in this Set
- Front
- Back
|
Transplant Rejection Mech. |
1. Direct Pathway: 수여자의 T cell이 공여자의 APC의 표면에 있는 allogenic MHC 인지. 2. Indirect pathway: 공여자의 MHC를 수여자의 APC가 가공처리하여 수여자의 T cell이 인지. |
|
|
Immunosuppressants |
a. Glucocorticoids b. Selective inhibitors of cytokine production an d function c. Anti-metabolic & anti-prolif. drug: azathioprine, methotrexate (MTX) d. Biologicals |
|
|
Glucocorticoids |
a. Bind to receptors inside cells and regulate the transcription of proinflammatory cytokines (such as IL-1 and IL-6). b. T cells are inhibited from making IL-2. c. The activation of cytotoxic T cells is inhibited. d. Neutrophils and monocytes display poor chemotaxis. e. IL1 생성 억제/ NFkB, AP1에 의한 작용 억제.
|
|
|
Prednisolone |
-이것도 스테로이드 -감염 증가/고혈압 및 고혈당증 유발. |
|
|
Selective Inhibitor |
1. Calcineurin Inhibitors: -cyclosporine, tacrolimus (FK506). -blocks calcineurin's phosphatase activity.
2. mTOR Inhibitors: -sirolimus, everolimus. -blocks mTOR kinase activity. |
|
|
Cyclosporine |
-Inhibits T-cell activation by inhibiting calcineurin -Forms a complex with cyclophilin. This complex binds to calcineurin, inhibiting Ca stimulated dephosphorylation of NFAT. -Prevents the nuclear translocation of NFAT and inhibits T-cell activation -Also increases expression of TGF-beta, a potent inhibitor of IL-2-stimulated T-cell proliferation.
Toxicity: -Nephrotoxicity -Hypertension -Elevates LDL cholesterol lv
피해야될 음식: 자몽 주스. |
|
|
Tacrolimus (FK506) |
-binds to an intracellular ptn FK506-BP12 (FKBP-12) -calcineurin phosphatase activity is inhibited.
Toxocity: -Neurotoxicty: 구분되는 부작용. 두통, 경련, 손이나 발의 감각이상. |
|
|
Sirolimus |
-복용방법: cyclosporine 먼저 복용 후 다음으로 sirolimus 복용.
-forms complex with FKBP12, but the complex does not affect calcineurin activity. -binds and inhibits a protein kinase mTOR (이를 통해 CDK2 activity inhibition)
-usually used in combination with a reduced dose of calcineurin inhibitor & glucocorticoids.
Toxicities: Increase in serum cholesterol and TG/ not recommended in lung transplants |
|
|
Anti-metabolic drugs: Azathioprine |
-Cleaved to 6 mercaptopurine (6MP) -inhibits de novo purine synthesis. -made allogenic kidney transplantation possible
toxicity: BM suppression (leukopenia) -CBC (Complete blood count) & liver function should be monitored (부작용: 백혈구 감소증)
-HGPRT 에 의해 TIMP -TIMP -> 6TGN (incorporated into DNA) -TIMP-> 6MeMPN (inhibition of de novo purine synthesis: TPMT에 의해 이 과정 촉진) |
|
|
Mycophenolate Mofetil (MMF) |
-hydrolyzed to the active form MPA -inhibits IMPDH (inosine monophosphate DH) -inhibits de novo pathway of guanine nucleotide synthesis
Therapeutic Use: Typically used in combination with glucocorticoids and a calcineurin inhibitor but not with azathioprien
Toxicity: 위장장애
|
|
|
Biologicals |
제1세대: Polyclonal antisera (ATG, ALG) 제2세대: OKT3 (monoclonal reagents): TCR complex block. 제 3세대: Daclizumab, Basiliximab :binds to IL2R on the surface of activated T cell. used in the prophylaxis of acute organ rejection in adults. |
|
|
Drug/Site of Action |
|
