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🔹p53
→ Tumor suppressor gene
→ Stops cell division
→ Mutation = cancer
🔹BCL-2
→ Anti-apoptosis gene
→ Prevents cell death
→ ↑ BCL-2 = Follicular lymphoma
🔹AFP
→ Marker for liver cancer
→ Also ↑ in testicular & ovarian cancer
🔹CEA
→ Marker for colorectal cancer
→ Also ↑ in pancreatic cancer
🔹PSA
→ Marker for prostate cancer
⸻
🔹CTLA-4
→ Brake on T cells
→ Turns T cells OFF
🔹Ipilimumab
→ Anti-CTLA-4
→ Removes T-cell brake
🔹PD-1
→ Brake on T cells
🔹PD-L1
→ Found on tumor cells
→ Turns T cells OFF
🔹Nivolumab
→ Anti-PD-1
→ Reactivates T cells
⸻
🔹CD80/CD86 = B7
→ Co-stimulatory signal
→ Needed for T-cell activation
🔹MHC I
→ Presents to CD8 cells
🔹MHC II
→ Presents to CD4 cells
⸻
🔹Tc
→ Cytotoxic T cell
→ CD8
→ Main anti-tumor cell
🔹NK
→ Natural Killer cell
→ Kills without MHC restriction
🔹Tdth
→ CD4 helper cell
→ Kills indirectly by cytokines
⸻
🔹FcγR
→ Receptor for IgG Fc portion
→ Used in ADCC
🔹ADCC
→ Antibody-dependent cellular cytotoxicity
→ Antibody + NK/macrophage = tumor killing
⸻
🔹IFN-α / IFN-β
→ ↑ MHC I
🔹IFN-γ
→ ↑ MHC I & II
→ Activates macrophages, NK, CD8
🔹IL-2
→ Activates T cells & NK cells
🔹TNF-α / TNF-β
→ Direct anti-tumor activity
⸻
🔹BCG
→ Activates macrophages
🔹CAR-T
→ Genetically engineered T cell
🔹Cancer Vaccine
→ Teaches immune system tumor antigens
⸻
🔹GM-CSF
→ Stimulates immune cells
🔹IL-12
→ Activates NK & T cells
⸻
🔹FasL
→ Tumor kills T cells through Fas-FasL interaction
🔹PGE₂
→ Tumor suppresses immune response
⸻
🔹🔥 Absolute exam favorites:
▪ p53 → Tumor suppressor
▪ BCL-2 → Anti-apoptosis → Follicular lymphoma
▪ AFP → Liver cancer
▪ CEA → Colon cancer
▪ PSA → Prostate cancer
▪ CTLA-4 → Ipilimumab
▪ PD-1 → Nivolumab
▪ B7 = CD80/CD86
▪ Tc = CD8
▪ CAR-T = Engineered T cell
▪ BCG = Macrophage activator 👑
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🔹🦾 CAR-T(Chimeric Antigen Receptor)
→ Change the T cell
→ Genetically engineered T cells
→ Direct tumor killing
🔹🎯 Cancer Vaccine
→ Teach the T cell
→ Gives tumor antigens to immune system
→ Stimulates immune response against tumor
🔹🔥 Memory:
🪽 CAR-T = Modify the soldier
🪽 Cancer Vaccine = Train the soldier
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واحد راح تكسي بلي جان السايق يكتله
وواحد اشترى تلفون نوفا مال هواوي وطلع مال جهال pediatrics🫠
ipli—> CTLA4
Nivu—>PD
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🚨 MCQ ALERT
Monoclonal anti-CTLA-4 and anti-PD-1 antibodies are called immune checkpoint inhibitors.
Anti-CTLA-4 → Ipilimumab
Anti-PD-1 → Nivolumab
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🔹A patient receives an immune checkpoint inhibitor that blocks CTLA-4. What is the main effect?
🔹A) Increased apoptosis of T cells
🔹B) Increased activation of T cells
🔹C) Decreased MHC I expression
🔹D) Inhibition of NK cells
🔹✅ Answer: B
🔹CTLA-4 normally acts as a brake on activated T cells. Blocking CTLA-4 removes the brake and increases T-cell activity.
⸻
🔹👑 MCQ 2
🔹Which drug acts by blocking PD-1 on T lymphocytes?
🔹A) Ipilimumab
🔹B) BCG
🔹C) Nivolumab
🔹D) IL-2
🔹✅ Answer: C
🔹Nivolumab = anti-PD-1 antibody
⸻
🔹👑 MCQ 3
🔹The interaction that normally switches OFF T lymphocytes is:
🔹A) CD28–B7
🔹B) CTLA-4–CD80/86
🔹C) MHC I–CD8
🔹D) IL-2–IL-2 receptor
🔹✅ Answer: B
🔹CTLA-4 binding CD80/86 sends an inhibitory signal to T cells.
⸻
🔹👑 MCQ 4
🔹Which immunotherapy uses genetically engineered T cells carrying tumor-specific receptors?
🔹A) Cancer vaccine
🔹B) BCG therapy
🔹C) CAR-T therapy
🔹D) TNF-α therapy
🔹✅ Answer: C
🔹CAR-T = Chimeric Antigen Receptor T cell
⸻
🔹👑 MCQ 5
🔹PD-1 interaction with PD-L1 leads to:
🔹A) T-cell activation
🔹B) Increased NK activity
🔹C) T-cell suppression or apoptosis
🔹D) Increased IL-2 production
🔹✅ Answer: C
🔹PD-1 + PD-L1 = T cell OFF ❌
⸻
🔹👑 MCQ 6 (Sneaky)
🔹Which pair is correctly matched?
🔹A) Ipilimumab — anti-PD-1
🔹B) Nivolumab — anti-CTLA-4
🔹C) BCG — macrophage activator
🔹D) CAR-T — cancer vaccine
🔹✅ Answer: C
🔹BCG activates macrophages against tumors.
⸻
🔹👑 MCQ 7 (Exam Favorite)
🔹A tumor expresses PD-L1 on its surface. Which therapy would most directly restore CD8⁺ T-cell activity?
🔹A) Nivolumab
🔹B) TNF-α
🔹C) BCG
🔹D) GM-CSF
🔹✅ Answer: A
🔹Nivolumab blocks PD-1, preventing PD-L1-mediated suppression.
⸻
🔹👑 MCQ 8
🔹Monoclonal anti-CTLA-4 and anti-PD-1 antibodies are called:
🔹A) Tumor markers
🔹B) Immune checkpoint inhibitors
🔹C) Immunotoxins
🔹D) Cancer vaccines
🔹✅ Answer: B
🔹Why?
🔹CTLA-4 and PD-1 are inhibitory checkpoints on T cells. Blocking them removes the “brake” and increases anti-tumor immunity.
🔹🚨 MCQ ALERT
🔹CTLA-4 inhibitor → Ipilimumab
🔹PD-1 inhibitor → Nivolumab
🔹PD-1 + PD-L1 → T-cell OFF
🔹CTLA-4 + CD80/86 → T-cell OFF
🔹CAR-T = Genetically engineered T cells
🔹BCG = Macrophage activator
🔹CD8⁺ T cells = Main anti-tumor effector cells 🔥
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🚨 MCQ ALERT
CTLA-4 inhibitor → Ipilimumab
PD-1 inhibitor → Nivolumab
PD-1 + PD-L1 interaction suppresses T cells
CAR-T cells are genetically engineered T lymphocytes
Cancer vaccines expose the immune system to tumor antigens
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🚨 MCQ ALERT
BCG → macrophage activation
IFN-α IFN-β IFN-γ→ increase MHC I
IFN-γ → increase MHC II and activate macrophages
-Inhibits cell division & proliferation
-Increases activity of Natural Killer (NK) cells & Cytotoxic T cells (Tc = CD8⁺)
IL-2 → activates T cells and NK cells
TNF-α and TNF-β → direct anti-tumor activity
Immunotoxin = monoclonal antibody + toxin
Immunotoxin ( Magic bullet)
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Which immune cell is considered the fundamental element of anti-tumor immunity?
🔹A) B lymphocyte
🔹B) NK cell
🔹C) CD8⁺ cytotoxic T cell
🔹D) Macrophage
🔹✅ Answer: C
ممكن هيج شي :)
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ملخص
🔥 If tumor wants to escape CD8 T cells
→ ↓ MHC I expression OR lower sensitivity to IFN-y
🔥If tumor wants to prevent T-cell activation
→ ↓ B7 (CD80/CD86)
→ No co-stimulation (Signal 2)
🔥 If tumor wants to kill T cells
→ Express FasL
→ FasL + Fas = T-cell apoptosis
🔥 If tumor wants to switch off T cells
→ Express PD-L1
→ Binds PD-1 on T cells
→ T-cell suppression
🔥 If tumor wants immune tolerance
→ Antigen shedding
🔥 If tumor wants general immunosuppression
→ Secretes PGE₂
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CD8 DIRECT كبل
CD4 InDIRECT
و كل وحدة و الاشياء الي تستخدمها مطلوبة
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