-
Immediate (type 1) hypersensitivity
- Prototype Disorder: anaphylaxis; allergies; bronchial asthma (atopic forms)
- Immune Mechanisms: production of IgE antibody -> immediate release of vasoactive amines and other mediators from mast cells; recruitment of inflammatory cells (late phase reaction)
- Pathologic Lesions: vascular dilation, edema, smooth muscle contraction, mucus production, inflammation
-
Antibody-mediated (type 2) hypersensitivity
- activate complement
- Prototype Disorder: hemolytic anemia; Goodpasture syndrome
- Immune Mechanism: Production of IgG, IgM -> binds to antigen on target cell/tissue -> phagocytosis or lysis of target cell by activated complement or Fc receptors; recruitment of leukocytes
- Pathologic Lesions: cell lysis; inflammation
-
Immune complex-mediated (type 3) hypersensitivity
- circulating antibdoies binding to circulating antigens
- Prototype Disorder: systemic lupus erythematosus; some forms of glomerulonephritis; serum sickness; Arthus reaction
- Immune Mechanisms: Deposition of antigen-antibody complexes -> complement activation -> recruitment of leukocytes by complement products and Fc receptors -> release of enzymes and other toxic molecules
- Pathologic Lesions: necrotizing vasculitis (fibrinoid necorsis); inflammation
-
Cell-mediated (type 4) hypersensitivity
- TH1 cells
- Prototype Disorder: contact dermatitis; multiple sclerosis; type I, diabetes; translpant rejection; tuberculosis
- Immune Mechanism: Activated T lymphocytes -> release of cytokines and macrophage activation; T-cell mediated cytotoxicity
- Pathologic Lesions: Perivascular cellular infiltrates; edema; cell destruction; granuloma formation
-
suffix - mab
monoclonal antibody
-
infix immediately preceeding the suffix identifies ____ of the antibody
species source
-
-
-
-
-
xi
chimeric- mostly human, but some mouse
-
zu
humanized - ~95% human, remaining mouse
-
infix preceding the species infix designates the _____
target
-
-
-
-
-
-
muromonab - CD3
- Ligand/Target: CD3 on T-lymphocytes
- Indication: acute graft rejection
- IV bolus
-
abciximab
- Ligand/Taget: glycoprotein IIb/IIIa receptors on platelets, vitronectin receptor
- Indication: prevent reocclusion of coronary arteries following PTCA, unstable angina
- Fab fragment, IV bolus prior to PTCA
-
rituximab
- Ligand/Target: CD20 on B lymphocytes
- Indication: non-Hodkin's lymphoma
- chronic lymphotcyic leukemia
- rheumatoid arthritis
- Wegener's Granulomatosis (WG) and Microscopic Polyangiitis
- IV infusion, tumor lysis syndrome, severe mucocutaneous reaction
-
ibritumomab tiuxetan
- Ligand/Target: CD20 on B lymphocytes
- Indication: B-cell Non-Hodgkin's lymphoma
- radioimmunotherapy, In-111 - Y-90
- Sever cytopenias, Maximum dose: 32mCi
-
tositumomab
- Ligand: CD20 on B lymphocytes
- Indication: Non-Hodgkin's lymphoma
- Radioimmunotherapy, I-131
- Severe cytopenias, Category X, iodide pretreatment
-
ofatumumab
- Ligand: CD20 on B-lymphocytes
- Indication: chronic lympocytic leukemia
- cytopenias, PML, hepatities B reactivation, intestinal obstruction
- IV infusion
-
brentuximab vedotin
- CD30 on malignant lymphocytes
- Indications: Hodgkin lymphoma,
- anaplastic large cell lymphoma (ALCL)
- Use monomethyl aurostatin E (MMAE)
-
alemtuzumab
- Ligand: CD52 on leukocytes
- Indication: B-cell chronic lymphocytic leukemia
- Prophylactic antibiotics required
- immunosuppression, myelosuppression
- IV infusion
-
ipilimumab
- Ligand: CTLA-4 on T-lymphocytes
- Indication: unresectable or metastatic melanoma
-
trastuzumab
- Herceptin
- Ligand: Human Epidermal growth factor Receptor (HER2)
- Indication: metastatic breast cancer
- cardiomyopathy, IV infusion
-
cetuximab
- Erbitux
- Ligand: Epidermal Growth Factor Receptor (EGFR-1; HER-1; c-Erb-1)
- Indication: metastatic colorectal carcinoma
- head and neck squamous cell carcinoma
- cardiopulmonary arrest, IV infusion
-
panitumumab
- Ligand: Epidermal Growth Factor Receptor (EGFR-1; HER-1; c-Erb-1)
- Indication: colorectal carcinoma
- IV infusion, dermatologic toxicity
-
bevacizumab
- Ligand: VEGF
- Indication: metastatic colorectal carcinoma
- glioblastoma
- metastatic renal cell carcinoma
- nonsquamous non-small lung cancer
- GI perforation, wound dehiscence, hemorrhage, IV infusion
-
ranibizumab
- Ligand: VEGF-A
- Indication: neovascular ("wet") age related macular degeneration (AMD)
- fragment from E. coli, intravitreal
-
basiliximab
- Ligand: binds to alpha-subunit (CD25) of IL-2 receptors (IL-2R antagonist)
- Indication: immunosuppressant
- IV infusion
-
belimumab
- Ligand: binds to B-lymphocyte stimulator (BLyS)
- Indication: systemic lupus erythematosus
-
infliximab
- Ligand: TNF-alpha
- Indication: rheumatoid arthritis
- psoriatic arthritis
- plaque psoriasis
- ankylosing spondylitis
- ulcerative colitis
- Crohn's disease
- IV infusion, TB, Fungal, T-cell lymphoma, heart failure
-
adalimumab
- Ligand: TNF-alpha
- Indication: rheumatoid arthritis
- juvenile idiopathic arthritis
- psoriatic arthritis
- ankylosing spondylitis
- Crohn's Disease
- plaque psoriasis
- Sub-Q q2w, TB
-
golimumab
- Ligand: TNF-alpha
- Indication: rheumatoid arthritis
- psoriatic arthritis
- ankylosing spondylitis
- Sub-Q q1m, TB
-
certolizumab pegol
- Ligand: TNF-alpha
- Indication: Crohn's Disease, RA
- Fab, PEG, Sub-Q, infection
-
toclizumab
- Ligand: IL-6 receptor
- Indication: rheumatoid arthritis, juvenile ideiopathic arthritis
- serious infections, IV infusion q4w
-
ustekinumab
- Ligand: p40 protein subunit of IL-12 and IL-23
- Indication: plaque psoriasis
- Sub-Q, infections
-
omalizumab
- Ligand: IgE, Fc-epsilon receptor blocker
- Indication: asthmas
- Sub-Q
-
palivizumab
- Ligand: respiratory syncytical virus (RSV)
- Indication: prophylaxis against RSV infection in pediatric
- IM: November through April
-
natalizumab
- Ligand: alpha 4 subunit of alpha-4-beta-1 and alpha-4-beta-7 integrins expressed on the surface of leukocytes
- Indication: multiple sclerosis
- IV infusion, PML
-
eculizumab
- Ligand: complement protein C5
- Indication: paroxysmal nocturnal hemoglobinuria (PNH)
- IV infusion, meningococcal infections, encapsulated bacteria, rebound hemolysis
-
canakinumab
- Ligand: IL-1beta
- Indication: Cryopyrin-associated Periodic Syndromes (CAPS) - NLRP3 gene overexpression
- Sub-Q q8w, infections
-
denosumab
- Ligand: RANKL (receptor activator of nuclear factor kappa B Ligand)
- Indication: bone loss, osteoporosis
- prevention of skeletal-related events with bone metastases from solid tumors
- Sub-Q
-
etanercept
- Ligand: TNF-alpha
- Indication: rheumatoid arthritis
- polyarticular-course juevenile rheumatoid arthritis
- ankylosing spnodylitis
- plaque psoriasis
- psoriatic arthritis
- dimeric fusion protein: TNFR with Fc of IgG
- Sub-Q
-
abatacept
- Ligand: CD80 and CD86 (B7.1 and B7.2)
- Indication: rheumatoid arthritis
- selective co-stimulation modulator: fusion protein, CTLA-4 linked to modified Fc of IgG
- - decrease TNF, IFN, IL-2, TNF antagonist nor anakinra should not be used
-
belatacept
- Ligand: CD80 and CD86 (B7.1 and B7.2)
- Indication: renal transplantation
- extracellular domain of CTLA-4 with Fc blocks T-cell activation
- PTLD- do not use with EBV seronegative or with serostatus, infections, malignancies, do not use in liver transplant, PML
- IV infusion
-
alefacept
- Ligand: CD2 on T-lymphocytes
- Indication: plaque psoriasis
- CD2 binding portion of LFA-3 with Fc of IgG
- blocks LFA-3 binding, Fc (CD16) activates ADCC, opsonization of T-cell
- IM or IV, Not for HIV
-
rilonacept
- Ligand: IL-1beta
- Indication: Cryopyrin-Associated Periodic Syndromes (CAPS)
- orphan drug, IL-1RI, IL-1RAcP with Fc of IgG
- Sub-Q, q1w
-
aflibercept
- Ligand: VEGF
- Indication: neovascular ("wet") age-related macular degeneration (AMD)
- VEGF receptor 1, 2 with Fc of IgG, q8w
|
|