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IMMUNE SYST E M MODULATION

IMMUNE SYST E M MODULATION. i mmunomodulation: therapeutic manipulation with the immune system immunopotentiation: enhancement (optimalisation) of the immune response immunisation: passive active to prevent infection

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IMMUNE SYST E M MODULATION

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  1. IMMUNE SYSTEM MODULATION

  2. immunomodulation: therapeutic manipulation with the immune system immunopotentiation: enhancement (optimalisation) of the immune response immunisation: passive active to prevent infection therapeutic administration of immunomodulators IMMUNE SYSTEM MODULATION

  3. IMMUNE SYSTEM MODULATION immunopotentiation: local systemic mucosal immunosubstitution: administration of intravenous immunoglobulins (IVIGs) agammaglobulinemia, hypogammaglobulinemia immunorestauration: bone marrow transplantation

  4. IMMUNOPOTENTIATING AGENTS: nutrition elements immunomodulators of microbial origin: whole bacterial cells (BCG) immunotherapy of adenoca of urine vesicle bacterial lysates: mixture of undefined (or semidefined) bacterial compounds treatment of chronic respiratory and urinary infections (bronchovaxom, etc.) mechanisms of action: activation of macrophages active immunisation

  5. chemical immunomodulators: stimulation of T cell immunity antiviral and anticancer activity levamisol, isoprinosine thymic hormons: stimulation of T cell immunity thymosin recombinant cytokines: produced by biotechnology in recombinant form rCSF: stimulation of myeloid cells differentiation (leukopenic patients) recombinant interferons: antiviral and antitumor effects recombinant interleukins: rIL-2 (antitumor effect)

  6. CONCLUSIONS: laboratory evidence of defect is recommended immediate risk of administration is low risk of late autoimmune immunopathological diseases could be acknownledged

  7. IMMUNOSUPPRESSION - to downmodulate inappropriate immune reactions - to downmodulate autoimmune immunopathological reactivity - numerous side effects of immunosuppression - development of more selective drugs

  8. non-steroidal antiinflammatory drugs • inhibition of cyclooxigenase (COX) catalysing metabolism • of arachidonic acide • - decreased production of prostaglandins and leukotriens • - acetylosalic acid, numerous other drugs • - COX2: inducible enzyme • inflammatory response • new inhibitors without side effect

  9. 2) glucocorticoids • - the most useful antiinflammatory and immunosuppressive drugs • - lipophilic compounds difusion into the cell • - cytoplasmic receptor • - translocation into nucleus • - serves as transcription factors (GRE: glucocorticoid response elements) • inhibition of transcription of proinflammatory cytokines genes • (IL-1, TNF, IL-6) • - induction of lipocortins which inhibit phospholipase A2 • - induction of apoptosis of lymphocytes • - inhibition of T cell functions • - downmodulation of proinflammatory cytokines • - inhibition of granulocyte functions

  10. 3) chemotherapeutics • - action on the level of DNA • - antiproliferative effect • - cytotoxic effect • antimetabolits: • metothrexate, asathioprine • b) mitotic drugs: • colchicine • c) alkylating drugs: • cyclophosphamide: • inhibition of autoantibodies production

  11. 4) selective immunosupresive drugs of biological origin a) ciclosporin A, FK-506: lipophilic compounds, diffusion through cell membrane intracellular receptors (immunophilins) inhibition of NF-AT transcription factor inhibition of IL-2 transcription selective inhibition of CD4+ T cells immunosuppression after transplantation modulation of immunopathological inflammatory response b) rapamycin: inhibition of signalling from receptors for cytokines c) antilymphocyte immunoglobulins: polyclonal antiserum raised in animals directed against T cells treatment of acute rejection

  12. d) monoclonal antibodies: directed against functionally important molecules on leukocytes originally of mouse origin (development of xenoantibodies) chimeric antibodies (Fc fragment is of human origin) humanized antibodies (only antigen-binding sites are of mouse origin) antibodies against CD3, CD4, IL-2R, others immunosuppression after transplantation selective treatment of autoimmune immunopathological inflammation antibodies against cytokines: inhibition of cytokine action (TNF)

  13. Conclusion: • numerous drugs with antiinflammatory • and immunosuppressive activities are in development • very promising target is chemokine network • the need for more selective and potent • antiinflammatory drugs

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