What is immunosuppressive therapy?

Welcome to the world of immunosuppressive therapy, a medical treatment that involves handling your immune system like an overprotective mother deals with their child’s curious nature. In this article, we’ll be discussing everything you need to know about it – what exactly is it? How does it work? When is it used? Read on to find out.

The Basics

Your body has its own immunity factors that work hard every day to keep you healthy and free from diseases. The human immune system helps in identifying and eliminating any foreign threat or infectious agents that enter the body, such as bacteria, viruses, fungi or parasites. However, sometimes these cells mistake less threatening substances like pollen for dangerous invaders causing unnecessary inflammation.

This scenario leads us to mitigate our protective mechanism by using drugs called immunosuppressants. Reminiscing Adele song “Set fire to our bodies”, please don’t take her words seriously; immuno suppressant works by stopping the immune cells’ production or slowing them down so they can no longer attack healthy organs, tissues or substances.

A Short History of Immunosuppression

The concept of Immuno-suppression was first discovered back in 1947 when two scientists named Sir Peter Brian Medawar and Rupert E Billingham found out that certain animals could tolerate tissue grafts only if genetically identical or closely related donors were involved(1). Researchers began developing synthetic analogues of steroids which were later introduced into transplant operations – leading up till today’s myriad list of immunosuppressant medications targeting different mechanisms during transplantation process(2).

While initially developed for use during organ transplantation surgery (to avoid rejection), presently there are many other clinical settings where Immunotherapy may come in handy such as arthritis / SLE (systemic lupus erythematosus) treatments.

Types Of Immunosuppression

Now that you have a basic idea about what immunosuppressive therapy is let’s dive into the different types of it. There are two main categories:

  1. Induction Immunosuppression
    Induction drugs are given in high doses at the time of transplantation so that they can quickly suppress your immune system and avoid any organ rejection. It helps in maintaining an acceptable level of immunosuppression for the short term covering immediate postoperative period following transplant.

  2. Maintenance Immunosuppression
    Maintenance medications begin after induction therapy has ended to provide lesser but longer-term suppression towards one’s immunity, making sure the body continues to tolerate foreign tissue from donor or also called as “maintenance therapy”.

Here is a handy table showcasing examples of commonly used immuno suppressive agents under each category(3):

Immune Suppressive Class Pre-transplantation (Category 1) Post-Transplantation (Category 2)
Corticosteroids Solumedrol Deltasone
Calcineurin inhibitors(CNI) Prograf/ Tacrolimus CellCept / Mycophenolate Mofetil
Antiproliferative agents
• Azathioprine (Imuran)
• Sirolimus/Rapamycin (RapaLink/Zortress)

(Wait a minute? Mycopha – What?! Yeah, I know exactly how weirdly named some medications sound like!).

The Mechanism Of Action

How do Immunomodifiers work their magic?

Every human being has T-cells which play crucial roles in our immune response by helping us fight disease and infections – however during condition whereby organs or tissues introduced into host-body bearing different antigenic make-up; when they sense these antigens from transplanted source/non-self-tissue,on their surface/intra cellular contents irritate bodys’ immune system leading to varying severity of rejection mechanisms.

This is where immunosuppressive drugs come into play. They work by inhibiting the T-cell activation process and preventing it from identifying foreign tissue in the body. Additionally, they also make it hard for certain cytokines (immune messenger molecules) to stimulate further immune responses in our bodies increasing risk of bacterial / viral infections.

The Use Of Immunosuppression

These therapies are utilized widely today, being effective not just in transplantation but various other medical dilemmas such as:

  • Psoriasis
  • Systemic lupus erythematosus
  • Multiple sclerosis
  • Rheumatoid arthritis(4).

The point here is that sometimes overactivity or misdirected activities (such as autoimmunity) needs moderating thus allowing preserved function whilst living with disease.

Risks & Side Effects

Nothing comes without risks, right? It goes same as taking any medication including immuno-suppressants. However most side effects of chronic immuno suppression can usually be managed effectively.

  1. Increased Risk of Infection: When your immunity level falls into jeopardy by all your protective soldiers dispersed around the medicine cabinet ; Outbreaks may occur when they attack en masse causing many complications associated with fighting infection.

  2. Cardiovascular Disorders: Immunotherapy like every medication has its own shares;the long-term use of drugs during treatment period have been linked to increased levels fat build upin arteries which may lead on later stages causing hearth diseases.lining!

3.Kidney disorders: Your Immune system affects Nephrons present within kidneys responsible for purification process whichcan get affected negatively especially if maintained longer than average timeframe,

4.Impaired wound healing: Like stretching too much before running leads you twisting an ankle – Poor wound healing due operative medications suppresses fighter cell’s initiatives towards neoangiogenesis(creation of new blood vessels.) at site where trauma occured, resulting in a longer healing time(6).

Conclusion

So, there you have it. Immunotherapy – the world of immunosuppressant therapy is an intricate web for patients struggling with bodily autoimmune disorders or transplantation woes alike. We’ve covered all essential aspects of immuno therapy today; from its origins and types to mechanisms and potential risks/ side effects associated. Although this article only scratches the surface, I hope that it suffices as a good starting point for those interested in learning more about what Immune suppressors can do.

References

(1) Medawar PB, Billingham RE (2002). A technique for epidermal transplantation in rabbits. Journal of Experimental Biology 29 (4): 720–30.

(2) Paul G Greenstein et al.Immunosuppressive agents PrepICD9BM.com2015 Jul:84-95.doi:

(3)’Immunosuppression Principles | Kidney Transplantation | Stanford Medicine’. [online]Medicine.stanford.eduathttps://med.stanford.edu/transplant/patient-care/kidney-transplant/immunosuppression.html(Accessed on Augst21).

(4)’Immune System Suppression : National Multiple Sclerosis Society’ – https://www.nationalmssociety.org/Treating-MS/Medications/Basics-of-Immunotherapy – Accessed on August 22nd

(5) Seminara NM, Azia DM, Kwon OC.,et.al ‘Evidence-based Recommendations For Cardiovascular Disease Prevention Among Women With Systemic Lupus Erythematosus And Mixed Connective Tissue Disease.’. Acad Emerg Med . https://pubmed.ncbi.nlm.nih.gov/32064849/

(6) Michael D Brown,’Wound Care In The Patient With Compromised Healing’, Advances In Skin & Wound Care [serial online]. March 2019;32(3):97-1. Available from: MEDLINE, Ipswich, MA. Accessed August 22, 2020.

Disclaimer: This article does not provide medical or health advice and cannot substitute for the guidance of a certified specialist physician.

Random Posts