immunological agents

immunological agents - DM SEMINAR JULY 21, 2006...

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Immunological agents in Pulmonary Medicine R.SRINIVAS Department of Pulmonary Medicine DM SEMINAR JULY 21, 2006
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Classification of Immunological agents in Pulmonary Medicine 1. Traditional agents : Corticosteroids Cyclophosphamide, Azathioprine, Methotrexate 2. Newer agents: b. Infectious diseases: Tuberculosis/ Fungal/ CAP c. Carcinoma lung ( SCLC/ NSCLC), Mesothelioma. d. Pulmonary vasculitis: e. D P LD ‟s: IP F / C T -ILD/ LAM/ Eosinophilic diseases/ PAP f. Sarcoidosis g. Hypersensitivity pneumonitis.
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Nomenclature of monoclonal antibodies The following letters were approved as product source identifiers : u = human o = mouse a = rat e = hamster i =primate xi = chimera Disease or target class Viral -vir- Bacterial -bac- Immune -lim- Infectious lesions -les- Cardiovascular -cir- Tumors Colon -col- Melanoma -mel- Mammary -mar- Testis -got- Ovary -gov- Prostate -pr(o)- Miscellaneous -tum-
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Newer Immunological agents In Asthma : 1. Non-traditional multi-step agents : M ethotrexate/ T roleandom ycin /G old/ H C Q ‟S / A zathioprine/ cyclosporine/ IVIG/ Inhaled heparin/ Inhaled Furosemide/ Dapsone. 2. Immune down-regulation (Immunotherapy) dust mite rx newer tech ( peptide based / CpG motifs/ Plasmid DNA vaccine/ anti-inflamm cytokines). Probiotics Sublingual immunotherapy. 3. Inhibit Eosinophils : IL-5 antagonists. 4. Inhaled Allergen-Eosinophil / Basophil interactions: a. block cell surface adhesion : Cytokines ( Th1 agonists/ Th2 antag)/ anti- sense oligonucleotides/ Chalcone derivatives. b. block f.n : linear/ cyclic peptides/ polym. Lipid particles/ Glycomimetics. c. Low MW Antagonists : VLA-4 antag/ LDV-antag/ N-acetyl phenylalanine based antag. d. M onoclonal Ig‟s :
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5. Chemokine Antagonists . CCR3 CCR4 6. Activation Pathway inhibition (FcγR11b) 7. Down-stream Pathway Inhibition . a. MAP Kinases/ P38/ Janus kinases b. Transcription Factors : GATA3/ STAT 6/ NF-κB 8. Anti-IgE therapy : Omalizumab.
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Cytokines in asthma therapy: Cytokines ( Th1 agonists) IL-12 IFNγ IL-18 Th2 antagonists IL-4 IgG (Pascolizumab) soluble IL-4 receptor (Altrakincept) IL-5 IL-13 IL-9 T N F ∞ antagonists. T Regulatory cells
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Omalizumab: Humanized monoclonal antibody that binds human IgE and prevents it from attaching to mast cells and basophils Indications: Moderate or severe persistent asthma that has not responded well to inhaled corticosteroids and long-acting beta agonists Side effects: Urticaria in 2%–3% of patients; anaphylaxis in 0.01%–0.1% Route and frequency: Subcutaneous, monthly or every 2 weeks depending on the dose Dose: 0.016 mg *body weight (kg)*IgE level (IU/mL) Cost: Varies on the basis of dose needed, but will average about $12,000/yr Who are Candidates For Omalizumab? • M oderate or severe persistent allergic asthm a
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This note was uploaded on 12/03/2011 for the course MEDICINE 350 taught by Professor Dr.aslam during the Winter '07 term at Medical College.

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immunological agents - DM SEMINAR JULY 21, 2006...

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