Shared Flashcard Set

Details

Immunotherapy
4th packet
31
Pharmacology
Graduate
12/09/2012

Additional Pharmacology Flashcards

 


 

Cards

Term
Immunomodulating Agents
Definition
• Immunomodulators or biological response
modifiers
– Recombinant interferon and cytokines
• Enhance antitumor immunity
Monoclonal antibodies
Can be immunostimulants or
immunodepressants
Term
Immunosuppressive Drugs
Definition

-Glucocorticoids:

    -Prednisone, dexamethasone, hydrocortisone

-Immunophilin ligands:

     -Cyclosoprine, Tacrolimus (FK506), Sicrolimus (rapamycin)

-Cytotoxic agents:

    -Cyclophosphamide, cisplatin, etc.

Term
Immunophilin ligands
Definition
Cyclosoprine, Tacrolimus (FK506),
Sicrolimus (rapamycin)
– They are microbial derivatives
– They may not share a common mechanism(s)
Term
Immunophilin ligands
Definition

– Cyclosporin A and Tacrilimus
    • inhibit T-cell receptor activation and induction of
cytokines
– Cyclosporin A
    • inhibit IgE-stimulated mast cell degranulation and
stimulate TGF-β expression
– Sirolimus
    • inhibit lymphocyte response to cytokines
    • sensitize cancer cells to chemotherapeutic reagent

Term

Cyclosporin A

• Mechanisms

Definition

• inhibit T-cell receptor activation and induction of
cytokines
• inhibit IgE-stimulated mast cell degranulation and
stimulate TGF-β expression
• READ page 676 on effect on CD4+ Cells

Term
Cyclosporin A

• Clinical uses
Definition
• Anti-rejection in organ transplants
• Autoimmune diseases: RA, bullous pemphigoid,
pemphigus, etc
• Topical agent for oral lichen plannus
Term

• Cyclosporin A, Trcrolimus & Sirolimus

Adverse effects

Definition
• Renal toxicity (dose related); hypertension
• CNS (headache, seizures); hirsutism,
Gingival overgrowth
Term
Immunostimulants
Definition

Cytokines
    – Interferon Alfa-2a; Interferon Alfa-2b
    – Interleukin-2 (Aidesleukin)
    – Colony-stimuating factors
Levamisole (Ergamisol)
• BCG Vaccine
• Imidazoquinolinamines
    – Imiquimod

Term
Interferons (IFNs)
Definition
• Cytokines secreted by virally infected
________ & macrophages
• Signals non-infected cells to synthesize and/
or secrete antiviral proteins
• Slow infection and enhance activity of
leukocytes
• Have antiviral, anticancer, and antiinflammatory
properties
Term
Interferons (IFNs)
Definition
• Have antiviral, anticancer, and antiinflammatory
properties.
• They modulate immune functions
– Increasing phagocytosis
– Enhance cytotoxic activity of T cells
Term
Alpha- IFN
Definition
• Several formulations
– IFN alfa-2a; pegIFN alfa-2a ; IFN alfa-2b;
pegIFN alfa-2b; IFN alfa-n3; IFN alfa-n1
– peg is polyethylene glycol
• Increases half-life, allows q24h dosing

Term
Alpha- IFN
Definition
• Clinical uses
– Hairy cell leukemia, AIDs-related Kaposi’s
sarcoma, chronic myelogenous leukemia,
chronic hepatitis B & C
Term
• Beta1a-IFN & Beta-1bIFN
– Clinical uses
Definition
• Multiple sclerosis
Term
IFN gamma-1b
– Clinical uses
Definition
• Chronic granulomatous disease; severe osteopetrosis
(a rare congenital disorder)
Term
Interleukins (ILs)
Definition
• Cytokines synthesized by lymphocytes,
monocytes and macrophages
• Several types (> 20 types)
– IL-1 …… IL21 etc
• Wide spread effects on immune functions
– Stimulation of T cell activity against tumor cells
– Increase B cell & plasma cell production
– Promotes inflammation
Term
• IL-1 Receptors (IL-1R)
Definition
Two subtypes: IL-1RI & IL-1RII
– Exist as transmembrane receptor or a soluble form.

Term
• IL-1RI

Definition
– preferentially binding with IL-1α
– T cells, endothelial cells, keratinocytes, hepatocytes, fibroblasts
– More sensitive to IL-1Ra (than IL-1RII)

Term
• IL-1RII

Definition
– preferentially binding with IL-1β
– is expressed by neutrophils, monocytes, B cells and bone marrow
cells.
– Has a short cytoplasmic domain .. “decoy receptor”
Term
• IL-1Ra
Definition

– a protein with structural homology to IL-1α and IL-1β.
– Secreted by monocytes
– Competes with IL-1α and IL-1β for the IL-1 receptor.
– Blocks the IL-1 receptor events, a means of blocking excessive
IL-1 inflammatory events
    » Shock, arthritis, osteoporosis, colitis, leukemia, diabetes,
wasting, atherosclerosis

Term
– Interleukin-1RI (IL-1RI)- (Anakinra) [Kineret®]
Definition

• Category: Interleukin-1 receptor antagonist
• Recombinant form of IL-1R1
• Tx of rheumatoid arthritis not responding to DMARDs.
     – Subcu injections, daily
• ADRx
    – Cutaneous reactions; lichenoid reactions’ neutropenia
• Drug InterX
    – No significant interaction reported

Term
– Interleukin-2 (Aidesleukin; Proleukin)
Definition
• Aka T cell growth factor
• Promotes proliferations of T lymphocytes and
activated B lymphocytes
• Metastatic renal carcinoma

Term
– Interleukin-11 (Oprelvekin, Neumega)

Definition
• growth factor with multiple hematopoietic
(hemopoiesis) effects
• Stimulates platelet production in immunosuppressed
patients
Term
Other cytokines
Definition
• Granulocyte colony stimulating factors
– G-CSF (filgrastin, Neupogen)
• Granulocyte-macrophage colony stimulating
factors
– GM-CSF-leukine (Leucomax)
Term
Levamisole (Ergamisole)
Definition

• An antihelmintic agent
• Acts on multiple cell types, restoring
fucntions
    – Neutrophils, macrophages, T cells
    – Thymomimetic agent,
       • stimulates cell-mediated immunity

Term

Levamisole (Ergamisole)

• Clinical uses

Definition

– Cancers;
– Autoimmune diseases: Rheumatoid arthritis;
Crohn’s Diseases
– Dental: Aphthous tomatitis

Term
BCG Vaccine (Tice, TheraCys)
Definition
• Is an attenuated strain of Mycobacterium bovis
• Once in the bladder,
– the organisms are taken up by macrophages,
– Initiate an immunologic reaction as in tuberculosis.
– BCG vaccine also targets bladder cancer cells,
• This induces a cytokine and direct cell-to-cell
cytotoxicity response, which targets these cells for
destruction.
Term
Imidazoquinolinamines
Definition
– Imiquimod (Zyclara , Aldara): Topical
– Resiquimod : Topical & Oral

Term
Imidazoquinolinamines

Clinical Uses:

Definition
Basal Cell carcinoma, Actinic Keratoses, anogenital
and non-genital warts and other skin lesions
Term
Imiquimod (Zyclara , Aldara)
Definition
• Nucleoside analog
• First developed as an antiviral agent …. but
found to have no direct antiviral properties
• Have antiviral properties via an indirect
mechanism
Term
Imiquimod (Zyclara , Aldara)
• Mechanism: stimulating the Innate immunity
Definition

• Mechanism: stimulating the Innate immunity
    – Macrophages, neutrophils; basophils, mast cells,
eosinophils and NK cells
           • Release cytokines such as TNF-α; IL (1,6,10, 12, 15,18); IFN-α and chemokines
   – Imiquimod binds to cell-surface Toll-like receptors (TLR) leading the the activation of NFkB signaling, and subsequent gene expression of proinflammatory cytokines {IL (1, 6 and 8); TNF-α; IFN-α ; etc]

Term
Imiquimod (Zyclara , Aldara)
• Mechanism:stimulating the Adaptive immunity (B and T lymphocyte, APC)
Definition

• Mechanism:stimulating the Adaptive immunity (B and T lymphocyte, APC)
   – No direct evidence showing imiquimod directly
stimulated lymphocyte proliferation or cytokines
release
   – Some evidence that imiquimod may activate
Th1(activate cellular responses to pathogens –
macrophages, cytotoxic T cells) and Th2 cells
(activate humoral response by stimulating B
cells)

Supporting users have an ad free experience!