Term
| What are the different types of transplants? |
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Definition
- Orthotopic - in a normal location
- Heterotopic - Different location
- Autologous - graft comes from yourself
- Syngeneic - graft comes from a genetically identical individual
- Allogeneic - Different individuals of the same species
- Xenogeneic - Different species
**Last 2 need rejection drugs. |
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Term
| Where does antigen recognition and T cell differentiation take place? |
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Definition
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Term
| What is the function of B cells in humoral immunity |
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Definition
Recognition of an antigen and secretion of antibodies
Antibodies then label for opsonization, activate complement, or attract NK cells. |
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Term
| What are the 3 signals for T cell activation? |
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Definition
1) Antigen + MHC - CD4 binds to MHC, CD3 is a drug target
2) Adhesion molecules - B7 + CD28. CTLA4 will block. LFA1/ICAM are also for adhesion
3) Release of IL-2 |
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Term
| What pathways for T cell activation have drug targets? |
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Definition
- IP3/Calcineurin pathway - NF-AT
- NFkB signalling pathway
**Both lead to formation of IL-2 |
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Term
| What reactions are involved in rejection? |
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Definition
- Hyperacute
- Humoral - antibodies
- Acute cellular
- Chronic |
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Term
| How do glucocorticoids help prevent rejection of transplants? |
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Definition
| Inhibition of the NFkB pathway by either upregulating the IkB inhibitor or preventing transcription directly on the DNA |
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Term
| What drugs are immunophilin-binding agents and how do they work? |
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Definition
- Tacrolimus/Prograf - inhibits Calcineurin
- Sirolimus/Rapamune - inhibits mTOR --> in IL-2 step. IL-2 cannot stimulate mTOR, a necessary step.
- Cyclosporin/Sandimmune or Neoral - also inhibits calcineurin --> NF-AT |
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Term
| What drugs are purine antagonists and how do they work for transplant rejection? |
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Definition
- Azathioprine/Imuran
- Mycophenolate/Cellcept
Inhibit the synthesis of purines and thus DNA and RNA |
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Term
| What polyclonal antibodies are used for transplant rejection, and how do they work?a |
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Definition
- ATGAM - LFA1, CD3, CD4, CD2
- Thymglobulin - IL2-R, CD44, MHC, CD2, CD45
**Bind to MULTIPLE surface antigens, depleting lymphocytes and blocking replications. TCR NOT INVOLVED! |
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Term
| What monoclonal antibodies are used for transplant rejection, and how do they work?a |
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Definition
- OKT3/Orthoclone - binds to CD3 during first step. T cells redistributed to bone marrow
- Daclizumab/Zenapax - binds to IL-2 receptors. Humanized
- Basiliximab/Simulect - binds to IL-2 receptors. Chimeric. Binds only to ALPHA subunit of ACTIVATED t-cells |
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Term
| How does Alemtuzumab/Campath work for transplant rejection? |
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Definition
| Binds to CD52 on B cells, Tcells neutralize B cells. |
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Term
| What drug for transplantation has affinity for B7? |
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Definition
-Belatacept/Nulojix
Soluble CTLA4 binds to B7, preventing 2nd signal |
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Term
| How does Bortezomid/Velcade work for transplant rejection? |
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Definition
NOT an antibody!!
Proteosome inhibitor - buildup of proteins induces apoptosis. Degrades ubiquinated proteins, preventing protein destruction |
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