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INTRODUCTION

Test Taking Tips

Topics related to transplant are usually memorization-based and make up a very small percentage.

Quickly review the mechanism of action and side effects of transplant medications and the types of rejection the night before the test.

INTERLEUKINS

Name the cells of origin and functions of the following interleukins:

Interleukin-1

  • Mononuclear phagocytes, T and B cells, NK cells, fibroblasts, neutrophils, smooth muscle cells

  • Proliferation of T and B cells; fever, inflammation; endothelial cell activation; increases liver protein synthesis

Interleukin-2

  • Activated T cells

  • T-cell growth factor, cytotoxic T-cell generation; B-cell proliferation/differentiation; growth/activation of NK cells

Interleukin-4

  • CD4+ T cells, mast cells

  • B-cell activation/differentiation, T- and mast-cell growth factor

Interleukin-5

  • T cells

  • Eosinophil proliferation/activation

Interleukin-6

  • Mononuclear phagocytes, T cells, endothelial cells

  • B-cell proliferation/differentiation; T-cell activation; increases liver acute-phase reactants; fever, inflammation

Interleukin-8

  • Lymphocytes, monocytes, multiple other cell types

  • Stimulates granulocyte activity, chemotactic activity; potent angiogenic factor

Interleukin-10

  • Mononuclear phagocyte, T cells

  • B-cell activation/differentiation, inhibition, mononuclear phagocytes

Interleukin-12

  • Mononuclear phagocytes, dendritic cells

  • IFN-γ synthesis, T-cell cytolytic function, CD4+ T-cell differentiation

INTERFERONS AND OTHER CHEMOKINES

What cells produce interferon-γ and what are its functions?

  • NK and T cells

  • Increases expression of class I and class II MHC, activates macrophages and endothelial cells, augments NK activity, antiviral

What cells produce interferon-α and β and what are their functions?

  • Mononuclear phagocyte-α; fibroblast-β

  • Mononuclear phagocyte increases class I MHC expression, antiviral, NK-cell activation

What cells produce tumor necrosis factor-α and β and what are their functions?

  • NK and T cells, mononuclear phagocyte

  • B-cell growth/differentiation, enhance T-cell function, macrophage activator, neutrophil activator

What cells produce transforming growth factor-β and what are its functions?

  • T cells, mononuclear phagocyte

  • T-cell inhibition

What cells produce lymphotoxin and what are its functions?

  • T cells

  • Neutrophil activator, endothelial activation

IMMUNOSUPPRESSANTS

What was the first effective clinical immunosuppressive maintenance regimen for the transplantation of solid organs? (It was introduced in 1962.)

  • Azathioprine and corticosteroids

What 2 commercially available polyclonal lymphocyte-depleting agents are used for induction therapy?

  • Horse anti-thymocyte globulin; rabbit anti-thymocyte globulin (most commonly used)

What is OKT3?

  • A very potent murine monoclonal antibody that binds to CD3, a site associated with the TCR, that blocks cell-mediated cytotoxicity by inhibiting the function of naive T cells ...

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