Manish Kumar
M.Pharm (Pharmacology)
Web- www.manishpharma.webs.com
INTRODUCTION
  Immunopharmacology is the study of the effects of the
  drugs modifying immune mechanism in body.

  It includes not only inoculation but also autoimmune
  disorders, allergic reactions, and cancer.

  A significant development has new approach to control
  the immunological mechanism by drugs.
   Eg. Immunosuppressant.
THE IMMUNO SYSTEM
IMMUNITY :

 It is the ability of the living body or the process to resist
  various types of organisms or toxins that tend to damage
  the tissue and organs.
CELLS INVOLVED IN IMMUNOSYSTEM
 Lymphocytes
 Neutrophils
 Basophils
 Eosinophils
 Monocytes
 Plasma cells
 Kupffer cells
Components of immune system
Antigens
 A substance that when introduced into the body,
  stimulates the production of an antibody.
 An antigen is an organic compound - protein,
  polysaccharide or glycolipid. It has 2 parts
o Hapten
o Carrier

 Antigens include:
Toxins
Bacteria
Foreign blood cells
Microorganisms
Allergens
Viruses Etc.
Antibodies
 They are gamma globulins or immunoglobulin's produced
  in the serum on exposure to antigen.
 Chemically they are glycoprotein's containing
   two heavy chains and two light chains joined together by
  disulfide bonds.
 It has 2 parts
     1) Fab
     2) Fc
The entire antibody structure can be cleaved by papain(a
  proteolytic enzyme)
TYPES OF ANTIBODIES
There are 5 types :
   1.IgG
   2.IgM
   3.IgA
   4.IgE
   5.IgD
CHARACTERISTICS OF ANTIBODIES
TYPES   MOL. WT.   CONC. IN SERUM   SPECIAL
                   (mg/ml)          CHARACTERSTICS
Ig G    150,000    1200             Can produce anaphylaxis

Ig M    900,000    100              Seen in vascular system
                                    most effective as
                                    agglutinin
Ig A    160,000    400              Found in serum, saliva,
                                    tears, G.I Secretions
Ig E    200,000    <0.01            Causes release of
                                    histamine from mast cells


Ig D    185,000    NOT CLEAR        Present on surphase
Immunopharmacology
   Mainly include :
         1.Autoimmune disorders.
         2.Allergy
AUTO-IMMUNE DISORDERS
 It is occur due to the immunity can not distinguish body
  own cells and organism cells and by mistake kill the body
  own cells.
MECHANISAM:
 In auto immunity ,by activation of self reactive T& B
  lymphocytes that produce cell-mediated response directly
  against self-antigen and it may lead to killing of body own
  cells
Eg. Rheumatoid arthritis
     Myasthenia gravis
     Ulcerative anemia etc.
 The development of autoimmune disease depends on a
  combination of genetic and environmental factors like
  hormones, diet, toxins, drugs and infections.
 Genetic predisposition accounts for only about one-third
  of the risk of developing an autoimmune disease.
 while non- inherited environmental factors account for
  the remaining 70% risk.


                        Environmental
       Gene                                      Auto
                            factors
                           (70%)                immune
       (30%)                                    disease
Allergy
 Definition:
  Allergy is one of the consequences of immunological
   response involving antigen-antibody reaction and in
   it mainly increased reactivity to foreign material
   above normal. Hence it is also called hypersensitivity.
Types of allergy
It has mainly 2 types:
 1.Humoral
     a)type I or anaphylaxis
     b)type II or cytotoxic type
     c)Type III or toxic complex reaction
2.cell mediated allergy
3.miscellaneous types( atopy )
Humoral allergy
 In the humoral allergy the reaction of antigen occurs
   with humoral antibodies.
1. Type I (anaphylaxis) :
 It follows immediately after the administration of the
   drug. Eg. it occurs in the sensitized patient when given
   a penicillin inj. because the liberation of histamine
   leading to unwanted results.
 Gastrointestinal allergy are also comes under the
   immediate anaphylaxis type reaction
Treatment of anaphylaxis
  anti-histamines
  corticosteroid
  calcium(I.V)
2. Type II (cytotoxic type):
In this type, antigen is localized on the surface of
 target cell and the antibody present in the blood
 combines with antigen to cause the lysis of the target
 cell.
Eg. Haemolytic anaemia
    Thrombocytopenia
3. Type III (toxic complex reaction):
    This occurs due to the presence of elevated levels of
     antigen-antibody complexes that deposit on
     basement membrane in tissue and vessels and
     produce anaphylatoxic activities that increasing
     vascular permeability and recruit Neutrophils to
     site of complex deposition ,it may lead toxic
     reactions.
   Eg. Skin rashes
         Arthritis.
Cell mediated allergy
 In it, antigen reacts directly with lymphoid cells so it
  produce inflammatory response that cause cells
  damage and it is also characterized by the influx of
  antigen into the cells which activates macrophages and
  this macrophages are responsible for tissue damage.
Eg. 1.bone-marrow lesions
    2.lupus erythematous
Miscellaneous types (atopy)
 Atopic allergy may arise out of a single
 contact or ingestion of common articles
 of food or drugs in daily routine life.
Eg. Fever
     Asthma
     Eeosinophilia
Therapy in Immunopharmacology:

   Immunosuppressant's
   Immunomodulators
   Immunoenhancers
Immunosuppressant's
 They are the agents that suppress the immune system. Most of
  the immunosuppressant act in the induction phase of the
  immunological response
Classification
 1.alkylating agents
  Eg. cyclophosphamide, chlorambucil
 2.antibiotics
  Eg. cyclosporine-A, rapamycin
 3.corticosteroids
  Eg.prednisolon,hydrocortisone,dexamethasone etc.
 4.antimetabolities
  Eg.azathipurine,mizorbine,mercaptopurine,methotrexate.
 5.antibody reagents
   Eg.vaccines ,muromonab
 6.miscellaneous
   Eg.thalidomide,zileatin,lipoxygenase inhibitors
Clinical applications
 Organ transplantation
 Treatment of auto immune disorders
 Treatment of haemolytic disease
immunomodulators
 These are the substances that modulate the
  intensity of immune response by inducing
  maturation     of    potentially   immune
  competent cells, expression of epitopes on
  the cell membranes.
 Various immunomodulators are
      1.thymic hormones Eg.thymopentin
      2.reserpine
      3.indomethacin
      4.antihistamines
Immunoenhancers
 These are the agent that increase the immunity.
 The agents are:

1.BCG vaccine
 It is not only used for tuberculosis but also in
  leukaemia
 Stimulates macrophages and this macrophages
  produce cytotoxicity against neoplastic cells and also
  increase phagocytic activity
2.lipopolysaccharides
 This agents increase antibody production and
  produce the characteristic biological activities of
  endotoxin from gram-positive bacteria
3.levamisole
 It is anthelmintic agent known to stimulate the
  immune system
 It increases the breakdown of c-AMP and
  decreases the breakdown of c-GMP so produce
  the cytotoxicity and phagocytosis
Immunopharmacology

Immunopharmacology

  • 1.
  • 2.
    INTRODUCTION  Immunopharmacologyis the study of the effects of the drugs modifying immune mechanism in body.  It includes not only inoculation but also autoimmune disorders, allergic reactions, and cancer.  A significant development has new approach to control the immunological mechanism by drugs. Eg. Immunosuppressant.
  • 3.
    THE IMMUNO SYSTEM IMMUNITY:  It is the ability of the living body or the process to resist various types of organisms or toxins that tend to damage the tissue and organs.
  • 4.
    CELLS INVOLVED INIMMUNOSYSTEM  Lymphocytes  Neutrophils  Basophils  Eosinophils  Monocytes  Plasma cells  Kupffer cells
  • 5.
    Components of immunesystem Antigens  A substance that when introduced into the body, stimulates the production of an antibody.  An antigen is an organic compound - protein, polysaccharide or glycolipid. It has 2 parts o Hapten o Carrier  Antigens include: Toxins Bacteria Foreign blood cells Microorganisms Allergens Viruses Etc.
  • 6.
    Antibodies  They aregamma globulins or immunoglobulin's produced in the serum on exposure to antigen.  Chemically they are glycoprotein's containing two heavy chains and two light chains joined together by disulfide bonds.  It has 2 parts 1) Fab 2) Fc The entire antibody structure can be cleaved by papain(a proteolytic enzyme)
  • 8.
    TYPES OF ANTIBODIES Thereare 5 types : 1.IgG 2.IgM 3.IgA 4.IgE 5.IgD
  • 9.
    CHARACTERISTICS OF ANTIBODIES TYPES MOL. WT. CONC. IN SERUM SPECIAL (mg/ml) CHARACTERSTICS Ig G 150,000 1200 Can produce anaphylaxis Ig M 900,000 100 Seen in vascular system most effective as agglutinin Ig A 160,000 400 Found in serum, saliva, tears, G.I Secretions Ig E 200,000 <0.01 Causes release of histamine from mast cells Ig D 185,000 NOT CLEAR Present on surphase
  • 10.
    Immunopharmacology Mainly include : 1.Autoimmune disorders. 2.Allergy
  • 11.
    AUTO-IMMUNE DISORDERS  Itis occur due to the immunity can not distinguish body own cells and organism cells and by mistake kill the body own cells. MECHANISAM:  In auto immunity ,by activation of self reactive T& B lymphocytes that produce cell-mediated response directly against self-antigen and it may lead to killing of body own cells Eg. Rheumatoid arthritis Myasthenia gravis Ulcerative anemia etc.
  • 12.
     The developmentof autoimmune disease depends on a combination of genetic and environmental factors like hormones, diet, toxins, drugs and infections.  Genetic predisposition accounts for only about one-third of the risk of developing an autoimmune disease.  while non- inherited environmental factors account for the remaining 70% risk. Environmental Gene Auto factors (70%) immune (30%) disease
  • 13.
    Allergy Definition: Allergy is one of the consequences of immunological response involving antigen-antibody reaction and in it mainly increased reactivity to foreign material above normal. Hence it is also called hypersensitivity.
  • 14.
    Types of allergy Ithas mainly 2 types: 1.Humoral a)type I or anaphylaxis b)type II or cytotoxic type c)Type III or toxic complex reaction 2.cell mediated allergy 3.miscellaneous types( atopy )
  • 15.
    Humoral allergy  Inthe humoral allergy the reaction of antigen occurs with humoral antibodies. 1. Type I (anaphylaxis) :  It follows immediately after the administration of the drug. Eg. it occurs in the sensitized patient when given a penicillin inj. because the liberation of histamine leading to unwanted results.  Gastrointestinal allergy are also comes under the immediate anaphylaxis type reaction
  • 16.
    Treatment of anaphylaxis anti-histamines corticosteroid calcium(I.V)
  • 17.
    2. Type II(cytotoxic type): In this type, antigen is localized on the surface of target cell and the antibody present in the blood combines with antigen to cause the lysis of the target cell. Eg. Haemolytic anaemia Thrombocytopenia
  • 18.
    3. Type III(toxic complex reaction):  This occurs due to the presence of elevated levels of antigen-antibody complexes that deposit on basement membrane in tissue and vessels and produce anaphylatoxic activities that increasing vascular permeability and recruit Neutrophils to site of complex deposition ,it may lead toxic reactions. Eg. Skin rashes Arthritis.
  • 19.
    Cell mediated allergy In it, antigen reacts directly with lymphoid cells so it produce inflammatory response that cause cells damage and it is also characterized by the influx of antigen into the cells which activates macrophages and this macrophages are responsible for tissue damage. Eg. 1.bone-marrow lesions 2.lupus erythematous
  • 20.
    Miscellaneous types (atopy) Atopic allergy may arise out of a single contact or ingestion of common articles of food or drugs in daily routine life. Eg. Fever Asthma Eeosinophilia
  • 21.
    Therapy in Immunopharmacology: Immunosuppressant's Immunomodulators Immunoenhancers
  • 22.
    Immunosuppressant's  They arethe agents that suppress the immune system. Most of the immunosuppressant act in the induction phase of the immunological response Classification  1.alkylating agents Eg. cyclophosphamide, chlorambucil  2.antibiotics Eg. cyclosporine-A, rapamycin  3.corticosteroids Eg.prednisolon,hydrocortisone,dexamethasone etc.  4.antimetabolities Eg.azathipurine,mizorbine,mercaptopurine,methotrexate.  5.antibody reagents Eg.vaccines ,muromonab  6.miscellaneous Eg.thalidomide,zileatin,lipoxygenase inhibitors
  • 23.
    Clinical applications  Organtransplantation  Treatment of auto immune disorders  Treatment of haemolytic disease
  • 24.
    immunomodulators  These arethe substances that modulate the intensity of immune response by inducing maturation of potentially immune competent cells, expression of epitopes on the cell membranes.  Various immunomodulators are 1.thymic hormones Eg.thymopentin 2.reserpine 3.indomethacin 4.antihistamines
  • 25.
    Immunoenhancers  These arethe agent that increase the immunity.  The agents are: 1.BCG vaccine  It is not only used for tuberculosis but also in leukaemia  Stimulates macrophages and this macrophages produce cytotoxicity against neoplastic cells and also increase phagocytic activity
  • 26.
    2.lipopolysaccharides  This agentsincrease antibody production and produce the characteristic biological activities of endotoxin from gram-positive bacteria 3.levamisole  It is anthelmintic agent known to stimulate the immune system  It increases the breakdown of c-AMP and decreases the breakdown of c-GMP so produce the cytotoxicity and phagocytosis