Immuno Therapyhhhhhh
Transcript of Immuno Therapyhhhhhh
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Immunotherapy
Prof Anura Weerasinghe
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Objectives What is immunotherapy? When is it used? Different strategies of immunomodulation
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Immunotherapy
Mode of therapy by which immune systemis mobilized or inhibited.
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When is it used? Immunization Allergic diseases Autoimmune diseases Cancers Immunodeficiency
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Immune response to immunization
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The aim of immunotherapy inallergy and autoimmunity is to
inhibit the immune response. Achieved by
- attempting to re-establish lymphocytenon-responsiveness (tolerance)- boosting suppressive mechanisms
eg; Regulatory T cells (T Reg cells)
- diverting the immune response to lessdamaging pathways
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Allergen desensitization Involves repeated injections of allergens Employed in
severe allergic rhinoconjunctivitis
Anaphylaxis to bee and wasp venom Allergic asthma
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Immunomodulatory therapy Corticosteroids Immunosuppressive drugs Cytokines
Monoclonal antibodies NSAIDs Antiallergic drugs
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Mechanisms of action ofcorticosteroids
Prevent the production of essentialcytokines and chemokines
Reduce lymphocyte activation andproliferation by preventing
Reduce inflammation through action onmacrophages and neutrophils
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Other immunosuppressive drugs Methotrexate Azathioprine Cyclosphorin Cyclophosphamide
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Cytokines Colony-stimulating factors
In Cytopenia associated with chemotherapyfor cancers
-interferon In viral hepatitis
IL-2 In renal cancers
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Monoclonal antibodies
Inhibit the effect of TNF- ( Eg; infliximab& etanercept) In Crohns and rheumatoid arthritis
Against B cell marker (CD20)(Eg; Rituximab)
In Lymphoma
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Anitinflammatory therapy
Corticosteroids Non-steroidal anti-inflammatory drugs
Side-effects of corticosteroids Alter fat and glucose metabolism Adrenal suppression
OsteoporosisHypertension
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NSAIDs Inhibit enzyme cyclo-oxygenase (COX)
and prevent synthesis of prostaglandins COX -1- gastric protection
COX -2 enzyme in macrophages Aspirin non-selective inhibitor Celecoxib Selective inhibitor of COX-2
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Other anti-inflammatory drugs Interfere with leukotrienes
Blocks production by the inhibition of lipo-oxygenase (Eg; Zileuton)
Leukotriene receptor blockers
(Eg; monteleukast and Zafirlukast)
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Antiallergic drugs Antihistamines
H1-histamine receptors on blood vessels andsmooth muscles
Sedative eg; Chlorphenaramine
Non-sedative eg; Cetrizine & fexofenadine H2-histamine receptors found mainly in
stomach (H2 blocker ranitidine)
Mast cell stabilizers Sodium chromoglycate
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