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Immunomodulation Jardine Jade Albert C. Valdez, RMT

Lecturer/Clinical Instructor

Our Lady of Fatia !ni"ersity

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Overview:

#u$$ression or en%anceent of t%e iune resto select anti&en is soeties desirable. T%e iodulation ac%ie"es t%is.

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Objectives:

Furt%er understand t%e iune res$onse t%rou&% t%e $iune re&ulation.

'($lain t%e conce$t of iunosu$$ression andiuno$otentation.

)no* t%e di+erent iunosu$$ressi"e a&ents and t%ei

e a*are of ot%er factors and conditions t%at can lead tsu$$ression of t%e iune res$onse.

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Lesson:

-. Aller&ic conditions in"ol"in& bot% iediate and dela%y$ersensiti"ities.

. Autoiune disease, in *%ic% t%e body destroys its o*ay destroy noral tissue "ia an iune ec%anis.

0. 1rolon&ation of &raft sur"i"al can be en%anced by su$$t%e $atients iune res$onse, because t%e re2ection oftissues and or&ans %as an iunolo&ic basis.

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'n%anceent of iune res$onse is ad"anta&eous in tana&eent of t%e iunode3cient $atients.

Res$onsi"eness is t%e 4ey to iune re&ulation.

!nres$onsi"eness is t%e absence of an iune res$onssubstance t%at *ould be iuno&enic under ordinaryconditions5 e"en t%ou&% t%e substance %as all t%e featunecessary for anti&enicity, it elicits no iune res$ons

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Classifcation

-. Iunosu$$ression refers to a reduction in a lar&e $ot%e %ost6s iune res$onsi"eness. T%e reduced res$onay be caused by5

a. A con&enital defect

b. An ac7uired iunoco$roisin& condition.. Tolerance is ore restricti"e8 it i$lies t%e absence o

selected iune res$onse and t%us a state of s$eci3cunres$onsi"eness 9i.e, an iunotolerant state:

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Enhancement o responsivenes

-.Iuno$otentation, t%e en%anceent ofres$onsi"eness, can be s$eci3c or non s$eci3c.

.Ad2u"ants are aterials t%at $ossess t%e abiliten%ance or au&ent an iune res$onse.

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Natural processes control theimmune response:

-.#u$$ressor T 9Ts: cells control t%e $roliferationaturation of iunoco$etent T and cells

.M;C restriction0.<euroendocrine control

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physical means oimmunosuppression

-.#ur&ical ani$ulation can %a"e a a2or ion iune res$onsi"eness.

.Ionizin& radiation daa&es t%e ly$%oid and bone arro*.

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Chemical and biologic means oimmunosuppression

-.In trans$lantation $rocedures to su$$ress &raft=re2ection reaction.

.In autoiune disease as t%era$eutic a&ents.0.In cancer as c%eot%era$eutic a&ents.

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ypes o immunosuppressiveagents and their actions

-.Ly$%atic a&ents can bloc4 t%e e($ression of iune res$onse 9t%rou&% cell lysis: but are oe+ecti"e in disru$tin& t%e initiation of t%e iures$onse.

a. Ionizin& a&ent

b. Antibodies.Ly$%ocytoto(ic a&ents a&ents are ost e>c

interru$tin& t%e induction of an iune res$on

-.Antietabolites

.Al4ylatin& a&ents

0.cyclos$orine

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0.Corticosteroids are bot% iunosu$$ressi"e ain?aatory. In addition to actin& as an anti=in?aatory a&ent, cortisone %as se"eral &enefunctions5

a. @ecrease ly$%ocyte e($osure to anti&ens.

b. In%ibits neutro$%il ii&ration into areas of in?ac. #tabilizes lysosoal ebranes so t%at e(ocytosis o

de&radati"e lysosoes is lessened.

d. In?uences T and cell cyclin&, reducin& in?aator$resent.

.Antibodies

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Immunosuppression associatedwith diseases and other condit

-.Con&enital iunode3cienciesa. In ruton6s %y$o&aa&lobulineia, cell iunit

de"elo$. 1atients for antibodies "ery $oorly and sure$eated bacterial infections.

b. In @iBeor&e syndroe, T cell iunity is de3cient b

t%e t%ird and fourt% $%ar&yn&eal $ouc%es fail to de"durin& ebryo&enesis. 1atients are sub2ect to recurrdiseases.

c. In c%ronic &ranuloatous disease, $%a&ocytes are un4ill in&ested icroor&aniss. 1atients %a"e recurrenbacterial infections.

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.Mali&nancies t%ese are $otentiallyiunosu$$ressi"e, $articularly if t%ey in"ol"ely$%oid tissues. Ly$%oas ay disru$t norly$%ocyte functions directly or ay cro*d ou

noral ly$%ocyte fro bone arro* and $eri$ly$%oid tissues.

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0.Infections

a. Measles and certain ot%er "iral diseases causes a transde$ression in cell=ediated iune res$onses.

b. Viral infections also %a"e a ne&ati"e e+ect on "arious

acro$%a&e functions.

c. ;IV infection causes a $rofound iunosu$$ression.

d. #$eci3c aner&y is seen in le$roatous le$rosy and t%e sa&es of tuberculosis. In t%is conditions, delayed %y$ersis i$aired because aounts of anti&en are e(cessi"e.

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. Malnutrition ade7uate nutrition is essential for $ro$erfunctionin& of t%e iune syste.

E. C%eicals "arious c%eical can induce iunosu$$r

For e(a$le anest%etics and cannabinoids are co$ounin2ure di"idin& cells and interfere *it% in?aatory $ro

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olerance

 Tolerance is t%e absence of s$eci3c iunity rein an ot%er*ise fully iunoco$etent $erson.ty$e of unres$onsi"eness can be eit%er naturall

ac7uired 9autolerance: or s$eci3cally induced 9aor iune tolerance:.

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Clinical i$ortance. Tolerance is of i$ortance clinical edicine in se"eral *ays5

-. Failure or autotolerance ay result in autoiune d

. #$eci3cally induced tolerance could re$resent an a"et%e t%era$y of autoiune diseases, aller&ic conditiallo&raft re2ection.

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!utolerance and ac"uired toler

-. Autolerance 9neonatal, natural or self=tolerance: autots a tolerance to one6s o*n anti&ens t%at is ac7uired ear$robably in utero. Clonal deletion t%eory it is $robable t%at clones of cells ca$ab

res$ondin& to a $erson6s o*n tissue de"elo$ent t%rou&%out li

clones, called forbidden clones, are iediately deleted by enc*it% o"er*%elin& nubers of self anti&ens or by t%e acti"ity os$eci3c su$$ressor cells. T%e cell t%at is ost susce$tible to de

 T% cell, functional cells t%at are $otentially reacti"e a&ainst se

$robably e(ist.

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.Ac7uired 9iune: tolerance

a. #iulation autotelerance can be siulated by a sie($erient. !nres$onsi"eness can be induced in a fanial by t%e in2ection of a forei&n substance.

b. Induction= ac7uired tolerance usually is induced by eaounts of anti&en. Tolerance in"ol"es eac% e$ito$eanti&en. T%e antibody $roducin& cells or t%e T cellsof ountin& a res$onse are o"er*%eled and delete

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Immunopotentation

 T%e iune res$onse can be en%anced by incret%e rate at *%ic% t%e res$onse occurs, ele"atin&a&nitude, or increasin& t%e duration of t%e resIn soe instances, one $articular res$onse can

en%anced *it% no c%an&e in ot%er res$onses. Foe(a$le, t%e $resence of certain ycobacterial*all co$onents fa"or t%e de"elo$ent of cell=ediated iunity.

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!djuvants

Ad2u"ants are nons$eci3c $otentiators of iures$onse. T%ey are substances t%at en%ance t%e

iuno&enicity of olecules *it%out alterin& t%c%eical co$osition.

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#echanisms o potentiators

-.Increasin& t%e e>ciency of acro$%a&es $rocesanti&en.

.1rolon&in& t%e $eriod of e($osure to t%e anti&en

0.A$lifyin& t%e $roliferation of iunolo&icallycoitted ly$%ocytes by en%ancin& ly$%o4acti"ity