Calcineurin Inhibitors Mechanism

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Questions and Answers

Which of the following best describes the role of calcineurin in T-cell activation?

  • It activates calmodulin, which then inhibits T-cell proliferation.
  • It directly binds to DNA, inducing the transcription of IL-2 and other cytokines.
  • It dephosphorylates NFAT, allowing it to enter the nucleus and promote cytokine production. (correct)
  • It phosphorylates NFAT, preventing its translocation into the nucleus.

How do cyclosporine and tacrolimus exert their immunosuppressive effects?

  • By forming complexes that inhibit calcineurin's phosphatase activity. (correct)
  • By binding directly to NFAT, preventing its activation.
  • By directly inhibiting the T-cell receptor (TCR).
  • By promoting the phosphorylation of NFAT, keeping it active in the cytoplasm.

What is the immediate consequence of calcineurin inhibition on NFAT?

  • NFAT remains phosphorylated and stays in the cytoplasm. (correct)
  • NFAT is dephosphorylated and translocates into the nucleus.
  • NFAT activates calmodulin, leading to further T-cell activation.
  • NFAT binds to DNA and starts the transcription of IL-2.

Which of the following events would directly follow the stimulation of the T-cell receptor (TCR) in a normal T-cell activation pathway?

<p>Activation of calmodulin by increased intracellular calcium (Ca²⁺). (D)</p> Signup and view all the answers

If a patient is taking tacrolimus, which of the following processes would be directly inhibited?

<p>The dephosphorylation of NFAT by calcineurin. (B)</p> Signup and view all the answers

What is the role of immunophilins like cyclophilin and FKBP-12 in the mechanism of action of calcineurin inhibitors?

<p>They bind to calcineurin inhibitors, forming a complex that inhibits calcineurin. (C)</p> Signup and view all the answers

In a T-cell treated with cyclosporine, what would be the expected state and location of NFAT?

<p>Phosphorylated and in the cytoplasm. (C)</p> Signup and view all the answers

Which cytokine's transcription is most directly affected by the inhibition of NFAT translocation into the nucleus?

<p>IL-2 (D)</p> Signup and view all the answers

A researcher is studying a new drug that also inhibits T-cell activation. If this drug works similarly to cyclosporine, which of the following mechanisms of action would be most likely?

<p>Inhibiting the translocation of NFAT into the nucleus. (A)</p> Signup and view all the answers

How does the function of calcineurin contribute to the adaptive immune response?

<p>It activates T-cells by enabling the production of cytokines needed for proliferation. (D)</p> Signup and view all the answers

Flashcards

Calcineurin

A calcium and calmodulin-dependent phosphatase crucial for T-cell activation. It dephosphorylates NFAT, allowing it to enter the nucleus and promote cytokine production.

Calcineurin Inhibitors (CNIs)

Drugs like cyclosporine and tacrolimus that prevent T-cell activation by inhibiting calcineurin's phosphatase activity.

Nuclear Factor of Activated T-cells (NFAT)

A protein that, when dephosphorylated by calcineurin, translocates to the nucleus to promote the transcription of IL-2 and other cytokines.

Cyclophilin

An intracellular protein that binds to cyclosporine.

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FKBP-12 (FK506-binding protein)

An intracellular protein that binds to tacrolimus (FK506).

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Phosphorylated NFAT (inactive)

In resting T-cells, NFAT is in this state, preventing its translocation to the nucleus.

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T-cell Receptor (TCR)

Stimulation of this receptor leads to increased intracellular calcium, activating calmodulin and subsequently calcineurin.

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Calmodulin

A protein activated by calcium, which then activates calcineurin.

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IL-2

A cytokine whose transcription is promoted by NFAT, leading to T-cell proliferation.

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Calcineurin Inhibition

Cyclosporine and tacrolimus form complexes with immunophilins. These complexes then bind to and inhibit this enzyme.

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Study Notes

  • Calcineurin is a calcium and calmodulin-dependent serine/threonine phosphatase critical for T-cell activation.
  • It dephosphorylates nuclear factor of activated T-cells (NFAT), enabling it to enter the nucleus.
  • Once in the nucleus NFAT promotes the transcription of IL-2 and other cytokines, which are essential for T-cell proliferation.

Mechanism of Action of Calcineurin Inhibitors in Immunosuppression

  • Calcineurin inhibitors (CNIs) like cyclosporine and tacrolimus prevent T-cell activation thus reducing the immune response.

Normal Calcineurin Function (Without Inhibitors)

  • In resting T-cells, NFAT is phosphorylated (inactive) and remains in the cytoplasm.
  • Immunophilins are freely found in the cytoplasm and have no effect on NFAT.
  • When the T-cell receptor (TCR) is stimulated by an antigen intracellular calcium levels rise, leading to activation of calmodulin.
  • Calmodulin activates calcineurin, a serine/threonine phosphatase.
  • Calcineurin dephosphorylates NFAT, activating it and enabling it to translocate into the nucleus.
  • Once in the nucleus, NFAT binds to DNA and induces the transcription of IL-2 and other cytokines, promoting T-cell proliferation.

Mechanism of Action of Calcineurin Inhibitors (Cyclosporine & Tacrolimus)

  • Cyclosporine binds to cyclophilin, and tacrolimus binds to FKBP-12 (FK506-binding protein).
  • The drug-immunophilin complexes bind to calcineurin, inhibiting its phosphatase activity.
  • By inhibiting calcineurin, the complexes prevent calcineurin from dephosphorylating NFAT.
  • Since NFAT remains phosphorylated, it cannot translocate into the nucleus.
  • Without NFAT in the nucleus, IL-2 transcription is blocked, leading to reduced T-cell activation and proliferation.

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