What are immunosuppressants? These substances are also called immunosuppressants, they suppress the immune response. Their action is aimed at slowing down the functioning and reproduction of cells of the immune system. They are used in cases when it is necessary to suppress immune reactions: during organ and tissue transplantation, autoimmune pathologies, various hypersensitive reactions (bacterial allergies, contact dermatitis), as well as other serious illnesses.
Some features
The use of immunosuppressive drugs is recommended only when the possibilities of another treatment are exhausted, and the chances of success exceed the risks from their use. From the list of immunosuppressive drugs, almost all of them exhibit immunosuppressive activity, have a wide spectrum of action. They inhibit both immunocompetent and other proliferating cells. Their use reduces antitumor and antimicrobial immunity, increases the risk of oncopathology and infectious complications. Due to the fact that immune ailments often have an unfavorable prognosis, the contraindications for conducting immunosuppressant therapy are relative.
In recent years, scientists have been working to create human antibodies using genetic engineering to give them a narrow spectrum of action, that is, only one cell population, T-cell antigen receptors, etc. As a result, the use of such medications will help to target only to the necessary link in the immune system.
General information
What are immunosuppressants? These are drugs that inhibit the production of nucleic acids, protein substances, as well as cell division processes. For such medications, withdrawal syndrome and a depressing effect on the functions of other rapidly growing cells are characteristic. Many substances have an immunosuppressive effect. For example, cytostatics generally suppress the immune response. "Daclizumab", "Hydroxychloroquine", "Cyclosporin" are specific agents, but do not have sufficient selectivity. Therefore, their intake reduces the protective functions of the body of an individual, inhibits hematopoiesis and provokes other undesirable reactions. “Plaquenil”, “Delagil” exhibit weak immunosuppressive activity, and unwanted effects are rare.
Classification of immunosuppressants
Several generations are distinguished in the systematization:
- The first is Methotrexate, Azathioprine, Cyclophosphamide.
- The second - glucocorticoids, alpha-asparaginase, antilymphocytic serum.
- The third is Cyclosporin.
- Fourth - Mycophenolate Mofetil, Daclizumab.
Depending on the effect on the immune system of the individual, the drugs are divided into several groups:
- completely overwhelming;
- selective action, or they are also called "selective immunosuppressants";
- possessing anti-inflammatory effect - are indicated for malfunctions of the brain;
- symptomatic - used to alleviate symptoms in autoimmune pathology.
According to another classification, immunosuppressants are divided:
- on large - antitumor drugs;
- medium - steroidal anti-inflammatory drugs;
- small ones - NSAIDs, gold preparations, Kuprenil.
Operating principle
Consider the mechanism of action of immunosuppressants with specific examples:
- Cyclosporin has a selective and reversible effect on the cellular immune response. It does not affect the function of phagocytes and does not inhibit hematopoiesis. Increases the lifetime of allogeneic transplants of various organs.
- Cytostatics - "Methotrexate", "Azathioprine" block cell division, inhibit the production of protein substances. The effect develops slowly and after the start of administration appears after six months. Both drugs have antitumor activity. "Methotrexate" in small doses has an anti-inflammatory effect, disrupts the formation of antibodies. "Azathioprine" suppresses T-lymphocytes more, less toxic.
- Glucocorticoids are endowed with a pronounced immunosuppressive effect. They are able to suppress macrophage function, proliferation of B- and T-lymphocytes, and also prevent their penetration into the blood. In large doses, they can reduce the production of immunoglobulin. They have a strong and rapid anti-inflammatory effect.
- "Mycophenolate mofetil" is a powerful selective and reversible immunosuppressant that has a more pronounced cytostatic effect on lymphocytes, unlike other cells.
- Gold preparations, deposited in the affected tissues of the joints, reduce the phagocytic function of macrophages, reduce the amount of immunoglobulin in the plasma, thereby reducing its destructive effect on the joints. The effect is visible after six months.
Clinical and pharmacological principles of cytostatics
To achieve an immunosuppressive or antitumor effect, cytostatics are used in accordance with certain clinical and pharmacological principles:
- high doses - low doses;
- slight anti-inflammatory effect - significant anti-inflammatory effect;
- short-term therapy - long-term therapy;
- different duration of the development of the effect - after a few days, weeks or months;
- cytostatic effect - immunosuppressive effect;
- inhibition of DNA production - inhibition of RNA synthesis.
The most common group of cytostatics are drugs from the list of immunosuppressants that are most sensitive to alkylating nucleic acid compounds - Cyclophosphamide, Mielosan, Chlorbutin.
The use of immunosuppressants
Particular caution when using these funds should be shown during pregnancy, failure of the liver and kidneys, the presence of infectious processes, inadequate bone marrow function, oncopathology. Due to the large number of adverse events, these agents are not used in the first stages of treatment. Immunosuppressants are prescribed:
- with rheumatoid arthritis;
- multiple sclerosis;
- psoriasis
- collagenoses;
- cirrhosis of the liver;
- transplantation of tissues and organs;
- autoimmune ailments;
- myocarditis in the chronic stage and other conditions.
Among the immunosuppressive drugs that prevent the formation of the main cells of the immune system (lymphocytes), the most famous are the medicines with the INN “Azathioprine” and “Cyclosporin”. They are indicated for the treatment of malignant tumors, as well as after transplantation of tissues and organs in order to avoid their rejection.
Preparations with selective action do not prevent the appearance of protective cells in infectious or viral pathologies, and also almost do not suppress antitumor immunity:
- "Tacrolimus";
- "Timodepressin."
The manifestations of an allergic nature, the clinic of autoimmune failures are removed and the following agents have an anti-inflammatory effect:
- "Hydrocortisone";
- "Methylprednisolone";
- "Fluocinonide" and others.
List of immunosuppressants
The following is a list of immunosuppressive drugs that are widely used by practicing doctors to treat various conditions:
- Sandimmune;
- "Copaxon-Teva";
- "Remicade";
- "Prograf";
- Cyclosporin;
- "Ecoral";
- Mayfortic;
- “Arava”;
- Sellsept;
- "Humira";
- Azathioprine
- "Actemra";
- Leflunomide;
- "Timoglobulin";
- Mycophenolate Mofetil.
The listed medicines belong to different groups. However, their main action is aimed at suppressing the response of the body through indirect inhibition of the function of cells of the immune system. These drugs are recommended for the treatment of severe pathologies, removal of inflammatory processes of unclear etiology, to exclude transplant rejection.
Immunostimulants and immunosuppressants: differences
The immune system of the individual in some cases requires correction, and then special medications come to the rescue - immunostimulants, as well as immunosuppressants. Consider their differences:
- With a rather long course of a chronic ailment, the body's defense system malfunctions and autoimmune disorders appear, i.e., the cells attack themselves. In this case, correction by immunosuppressants is required. They are indicated for allergic reactions, increased activity of lymphocyte cells, after organ or tissue transplantation.
- When viruses or bacteria attack, the body begins to produce special cells, and if they are not produced enough, the individual is often sick. To increase the synthesis of protective cells, immunostimulants are indicated. Basically, they are recommended in the following conditions: chronic sluggish pathologies with constant relapses caused by a bacterial, viral or fungal infection; malignant neoplasms; primary immunodeficiency.
Thus, both of these substances are aimed at correcting the immune system.
Conclusion
After reading the article, you now know what immunosuppressants are. These are drugs of various pharmacological groups that inhibit the immune system reactions. Medicines in this group have different activities. For example, NSAIDs and glucocorticoids have a mild effect, and cytostatics have a powerful effect: Mercaptopurin, Mielosan, Azathioprine; antibiotics - Actinomycin. In addition, there are drugs that affect humoral or cellular immunity.
What are immunosuppressants? These are means to achieve satisfactory results of immunosuppression after transplantation of organs and tissues. At the same time, avoid side effects that threaten the life of the individual, as well as reduce anti-infective immunity.