Paper II — 2018 July (Supplementary) (2010 Scheme) — Q2

Paper II

2018 July (Supplementary) (2010 Scheme) · 40 marks · 120 min

Question

Ramu, a 35 years old male is suffering from end stage kidney disease. His brother has come forward to donate his kidney for Ramu. What immunosuppressant drugs are required to inhibit rejection of transplanted kidney. Explain the mechanism of action and side effects of cyclosporine. (2+2+2)

Q26 marksEssays★✓

Answer

Immunosuppressants required to prevent graft rejection

• Calcineurin inhibitors: Cyclosporine, Tacrolimus
• Antiproliferative agents: Mycophenolate mofetil, Azathioprine
• mTOR inhibitors: Sirolimus
• Corticosteroids: Prednisolone
• Induction therapy (antibody-based): Basiliximab, Antithymocyte globulin

(Typically a combination regimen is used — e.g., a calcineurin inhibitor + an antiproliferative agent + corticosteroid — to allow lower, less toxic doses of each while achieving effective immunosuppression)

Mechanism of action of cyclosporine

• Binds to cyclophilin (an intracellular immunophilin); this complex inhibits calcineurin
• Calcineurin normally activates the transcription factor NFAT, promoting IL-2 gene transcription
• By inhibiting calcineurin, cyclosporine suppresses IL-2 production, reducing T-lymphocyte activation and proliferation

Side effects of cyclosporine

• Nephrotoxicity (dose-limiting, especially relevant in a transplanted kidney)
• Hypertension
• Hepatotoxicity
• Gingival hyperplasia, hirsutism
• Increased susceptibility to infections and malignancy
• Tremor

Related Concepts

1. 1Immunosuppressants

Other Years Asked

1. 1(2023 July (Supplementary) (2019 Scheme)Short Essay · 8 marks
2. 2Monoclonal antibodies and their uses2022 July (Supplementary) (2019 Scheme)Short Answer · 4 marks
3. 3Cyclosporine2016 February (2010 Scheme)Short Note · 3 marks
4. 4Cyclosporine2021 December (Supplementary) (2010 Scheme)Short Note · 3 marks
5. 5Tacrolimus2019 July (Supplementary) (2010 Scheme)Short Note · 3 marks
6. 6Assertion (A): Cyclosporine is used as a part of induction regimen to prevent organ transplant rejection. Reason (R): Cyclosporine inhibits TNFα secreted by activated macrophages and other immune cells.2024 December (Supplementary) (2019 Scheme)MCQ · 1 mark
7. 7Immunosuppressive in organ transplantation2014 September (Supplementary) (2010 Scheme)Short Answer · 1 mark
8. 8Calcineurin inhibitors2014 March (2010 Scheme)Short Answer · 1 mark
9. 9Immunosuppressants2021 February (Supplementary) (2010 Scheme)Short Answer · 0.3 marks
10. 10Drugs for prevention of rejection of organ transplantation2022 October (Supplementary) (2010 Scheme)Short Answer · 0.3 marks
11. 11Cytokine inhibitors.2022 July (Supplementary) (2019 Scheme)Short Answer · 0.2 marks
12. 12 Sirolimus for graft rejection reaction in Renal failure patient. Name the following (Two examples for each): (8x1=8)2024 June (Supplementary) (2019 Scheme)Short Answer · 0.2 marks
13. 13Drugs to treat Irritable bowel disease2024 March (Supplementary) (2019 Scheme)Short Answer · 0.2 marks
14. 14Calcineurin inhibitors2024 March (Supplementary) (2019 Scheme)Short Answer · 0.2 marks