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Renal Immunosuppressive Drugs
Renal Immunosuppressive Drugs
24
Medical
Professional
10/09/2010

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Term
APCs
Definition
Monocytes, macrophages
DCs
Langerhans
B cells
Term
MHCI is found on...
Definition
All nucleated cells
Term
MHCII is found on...
Definition
APCs
Term
What happens if an APC encounters a foreign Ag?
Definition
Phagocytosis, process
APC MHCII presents the processed Ag to Th0
Th0 CD3 aids in intracellular signal transduction to activate the Th0 cell
Th0's TCR binds to this MHCII/Ag complex
Term
APCs secrete...
Definition
IL 1
IL 6
Term
IL 1's function is...
Definition
Activating Th0 cells
Term
IL 6's function is...
Definition
Activating Th2, B-cells, plasma cells
Term
Th0s secrete...
Definition
IL 2: T-cell proliferation and inc. production of IL 2
Term
Th1s secrete...
Definition
IL 2
IFN-gamma
TNF-beta
Term
IFN-gamma and TNF-beta's function is...
Definition
Activating macrophages, CTLs, and NK cells
Term
Macrophages, CTLs, and NK cells provide cellular immunity by directly...
Definition
Attacking and destroying bacteria, virus-infected cells, and tumor cells
Term
Th2s secrete...
Definition
IL 2
IL 4
IL 5
IL 6
IL 10
All stim. B-cell proliferation
Term
Th2 cells aid in which kind of immunity?
Definition
Humoral
Term
Describe the sequence of steps in allograft rejection
Definition
1. Interstitial DCs w/ foreign MHCII in transplanted tissue
2. Foreign MHCII directly stimulate recipient Th0s
3. Th1s secrete IFN-gamma and TNF-beta, which inc. expression of endothelium adhesion molecules = easier for leukocytes to invade the graft
4. IFN-gamma induces graft cells to express MHCII, which provides more Ab "targets" and inc. stimulation of recipient's immune system
5. Anti-donorMHCII-Ab activate complement, inflamm, plt activation, hemorrhage, thrombosis
Term
Prednisone and (active metabolite) prednisolone: leukocytopenia
Definition
1. Lymphocytopenia
2. Dec. monocytes
3. Dec. eosinophils and basophils
4. Inc. neutrophils b/c BM releases more and they marginate less
Term
Prednisone/prednisolone: general effects
Definition
1. Leukocytopenia
2. Interference w/ macrophage fxn
3. Interference w/ T-cell fxn
4. Interference w/ IL synthesis
Term
Prednisone/prednisolone: lymphoid tissue
Definition
Dec. in lymph nodes and spleen
Term
Prednisone/prednisolone: IL synthesis
Definition
Blocks:
IL 1,2,4,6
IFN-gamma
TNF-beta
Term
Prednisone/prednisolone: random other stuff it does
Definition
Dec. activation of Th1
Dec. the inc. MHCII and adhesion molecule expression on the graft
Term
Cyclosporine
Definition
Binds to cytoplasmic cyclophilin
Cyclosporine-philin complex inhibits calcineurin
Can't dephosphorylate nuclear factor of activated T cells (NFATC)
NFATC can't travel to nucleus and activate genes for IL 2, IL 2R, IFN-gamma, TNF-beta
Term
Cyclosporine: random other stuff it does
Definition
Prevents B-cell proliferation
Term
Tacrolimus
Definition
Binds to cytosolic protein FKBP in Th cells
Tacrolimus-FKBP complex inhibits calcineurin
Can't dephosphorylate nuclear factor of activated T cells (NFATC)
NFATC can't travel to nucleus and activate genes for IL 2, IL 2R, IFN-gamma, TNF-beta
Term
Mycophenolate
Definition
Inhibits inosine monophosphate dehydrogenase in lymphocytes
Can't synthesize guanine de novo
Lymphocytes don't have an alternative pathway (like HGRPT) to make guanine
Term
Muromonab CD3/OKT3
Definition
Anti-CD3-Ab
Blocks TCR binding to MHCII-Ag complex
Th, CTL fxns blocked
No production of ILs and TCR endocytoses
Anergy and removed from circulation by RE system
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