2. Immunosuppressant(anti-rejection drugs)
These drugs are a class of drugs that suppress or reduce
the strength of the body's immune system.
One of the primary uses of these drugs is to lower the
body's ability to reject a transplanted organ, such as a liver,
heart or kidney
who receives an organ transplantation has almost to take
this drugs.
The body recognizes a transplanted organ as a foreign
mass and this drugs decrease the body's reaction to the
foreign organ.
The drugs allow the transplanted organ to remain healthy
and free from damage.
This drugs also are used to treat autoimmune diseases
such as lupus.
In general there are two types of immunosuppressants:
Induction drugs: Powerful antirejection medicine used at
3. Classification of Immunosuppresant
1. Selective inhibitors of cytokine production and
function:
Cyclosporine, tacrolimus , and sirolimus.
2. Immunosuppressive antimetabolites:
Azathioprine, mycophenolate mofetil mycophenolate
sodium
3. Antibodies:
Muromonab-CD3, Alemtuzumab, basiliximab,
daclizumabel
4. Adrenocorticoids:
Methylprednisolone, prednisone
4. Cyclosporine
Also called cyclosporin, is a calcineurin inhibitor, used as
an immunosuppressant medication. It is a natural product
Mechanism of Action
Inhibition of production and release of interleukin II and
inhibits interleukin II-induced activation of resting T-
lymphocytes.
Indication:
prevent rejection of organ transplantation
alternative to methotrexate for the treatment of severe,
active rheumatoid arthritis
Psoriasis
Crohn’s disease
Ulcerative colitis
5. Side-effect:
excess hair growth in certain areas - acne
high blood pressure - fatigue
tremors or shaking; - decreased
kidney function
stomach pain - muscle, bone,
or joint pain
increased gum size
Contraindication:
uncontrolled hypertension,
uncontrolled infections
Renal dysfunction
Dose:
Organ transplant: 5-7 mg/kg/dose BDS starting 12 hours
before transplant and continued for 1-2 weeks
6. Mycophenolate Mofetil (MMF)
is an antimetabolite immunosuppressant.
prodrug of mycophenolic acid (MPA), an inhibitor of
inosine-5'-monophosphate dehydrogenase.
Mechanism
It is an inhibitor of inosine -5’- monophosphate
dehydrogenase (IMPDH) which inhibits de novo pathway
of guanosine nucleotide synthesis. T and B lymphocytes
are dependent on this pathway for proliferation.
Indication
It is used for the prevention of renal, liver and cardiac
transplantation rejection
auto-immune disease (lupus nephritis).
7. Adverse effects:
Vomiting Diarrhoea
Anaemia Haematurea
BP change
Acne Alopecia
Rashes
Insomnia Dizziness, Headache
Contraindications
Hypersensitivity
Dose:
600 mg/m/dose 2 times daily First dose within 72 hours
after transplant Max 2 gm/day
8. Muromonab-CD3
It is an immunosuppressant drug
It is a monoclonal antibody targeted the CD3 receptor,
a membrane protein on the surface of T cells.
It was the first monoclonal antibody to be approved for
clinical use in humans.
Mechanism of action:
Muromonab binds to the T-cell surface glycoprotein CD3
epsilon chain. It appears to kill CD-3 positive cells by
inducing Fc mediated apoptosis, antibody mediated
cytotoxicity and complement-dependent cytotoxicity.
Indication:
used as immunosuppressive therapy in kidney, heart, and
liver transplant patients.
9. Side-effect:
dizziness or faintness
fever and chills
headache
muscle or joint pain
nausea and vomiting, Diarrhea
general feeling of discomfort or illness
Contraindication:
Sever bone marrow supression
Hypersensativity
Dose:
100mg/m2 per cycle, once every 4 weeks IV
10. Application of Gene Therapy
It is concept of the introduction of normal genes into cells
in place of missing or defective ones in order to correct
genetic disorders.
It the genetic modification of cells to produce a therapeutic
effect or the treatment of disease by repairing or
reconstructing defective genetic material.
1. CAR-Engineered Stem Cells that Treat HIV
2. Engineered Natural Killer Cells against Hodgkin’s
Lymphoma
A. Somatic Gene Therapy
This type usually occurs in the somatic cells of human
body.
In this method, therapeutic genes are transferred into the
somatic cells or the stem cells of the human body.
B. Germline Gene Therapy
It occurs in the germline cells of the human body.
11. Application
It is used in the replacement of genes that cause medical
ill-health
The method generally destroys the problem causing
genes
It helps the body to fight against diseases by adding
genes to the human body
This method is employed to treat diseases such as
cancer