Immunopharmacology : Defination, components of immunity, classification of immunity and its explanation. Drugs used in immune disorder : Immunosuppressants and Immunostimulants.

1. PRESENTED BY –
R.ARUNA
170117887007
PRESENTED ON –
20’July’2018.

2. DEFINITION:
A branch of pharmacology concerned with the application
of immunological techniques and theory to the study of the effects of
drugs especially on the immune system.
Immune system : Is an organization of organs, tissues, cells and
molecules with specialized roles in defending against
microorganisms, viruses and cancer cells.
The cells of immune system are present throughout the host’s body.

3. Components of immune system

5. IMMUNITY:
Immunity is a general ability of the host to resist damage from
foreign substances such as microorganisms and harmful chemicals
such as toxins released by microorganisms.
The immune response that results is a specific and complex series of
defensive reactions widely distributed throughout the human or
animal body.
The ability to ward off disease through our defenses is called
resistance.

6. CLASSIFICATION OF IMMUNITY:

7. INNATE IMMUNITY:
Native immunity.
It is the resistance which an individual possess by virtue of his/her
genetic & body constitution. Thus, it is inborn.
In this type of immunity, the body is born with the ability to
recognize and destroy certain foreign substances, but the ability to
destroy them doesn’t improve each time when body is exposed to
them due to lack of immunological memory.
It can act against many microorganisms (in absence of specificity),
hence, also called as non-specific immunity.

8. TYPES OF INNATE IMMUNITY:
• Resistance to infection varies with species.
• Eg: Humans are susceptible to measles
infection, whereas dogs are resistant.
Species
immunity
• Within a species, different races exhibit
differences in their resistance, due to genetic
factors.
• Eg: Africans are resistant to malarial
infections.
Racial
immunity
• Different individuals in a race exhibit
differences in innate immunity.
• Combination of nonspecific and specific
resistance. Eg: cold attacks in winter.
Individual
immunity

9. ACQUIRED IMMUNITY:
The resistance that an individual acquires during his/her life time is
known as acquired immunity.
Also called as specific immunity.

10. TYPES OF ACQUIRED IMMUNITY:
• When an individual is exposed to
infections or antigens 
stimulation of immune response
• Long lasting,.
• Induces immunological memory.
Actively acquired
immunity
(adaptive immunity)
• There are certain individuals
whose immune system does not
respond and produce antibodies
to foreign antigens.
• So such individuals are
immunized.
Passively acquired
immunity

11. TYPES OF
ACTIVELY
ACQUIRED
IMMUNITY
ACTIVE
NATURAL
IMMUNITY
ACTIVE
ARTIFICAL
IMMUNITY
TYPES OF
PASSIVELY
ACQUIRED
IMMUNITY
PASSIVELY
ACQUIRED
NATURAL
IMMUNITY
PASSIVELY
ACQUIRED
ARTIFICAL
IMMUNITY
FUTHER TYPES:

12. OTHER TYPES OF IMMUNITY:
LOCAL
IMMUNITY
HERD
IMMUNITY
INFECTION
IMMUNITY
HUMORAL
IMMUNITY
CELL MEDIATED
IMMUNITY

13. Immunomodulators are the drugs
which stimulate the immune system
 called “Immunostimulant’s”
(Or) suppress the immune system 
called “immunosuppressant's”
IMMUNOMODULATORS:

14. IMMUNOSUPPRESSANT DRUGS
Calcineurin
inhibitors
(Specific T-cell
inhibitors)
Eg:-
Cyclosporine,
Tacrolimus
Anti-
proliferative
drugs
(Cytotoxic
drugs)
Eg:-
Azathioprine,
Cyclophospha
mide,
Methotrexate,
Glucocorticoids
Eg:-
Prednisolone,
Antibodies
Eg:-
Muromonab
CD3,
Antithymocyte
–globulin,
Rho(D)
immunoglobuli
n

15. Calcineurin inhibitors (Specific T-cell inhibitors)
1. CYCLOSPORINE :
Cyclic polypeptide with 11 amino acids, obtained from fungus.
Introduced in 1977 as highly-selective immunosuppressant.
Successful drug in organ transplantation.
It inhibits T lymphocyte proliferation, IL-2 and other cytokine
production.
Contd…,

16. Contd…,

17. ADVERSE EFFECTS:
Sustained rise in BP
Precipitation of diabetes
Anorexia (lack of appetite for food)
Lethargy (lack of energy)
Opportunistic infections
Hirsutism (abnormal growth of hairs)
PHARMACOKINETICS:
Oral bioavailability is low.
Metabolized in liver by CYP3A4.
Excreted in bile
Plasma t1/2 is 4-6hr and 12-18hr.
Dose: 10-15mg/kg/day

18. Calcineurin inhibitors (Specific T-cell inhibitors)
2. TACROLIMUS :
It’s a new molecule chemically differ from Cyclosporine but having
the same mechanism of action and is 100 times more potent.
Pharmacokinetics :-
 Administered orally as well as i.v. infusion.
 Oral absorption is variable and decreases with food.
 Metabolized by CPY3A4.
 Excreted in bile.
Dose :- 0.05-0.1mg/kg BD oral

19. Anti- proliferative drugs (Cytotoxic drugs)
1. AZATHIOPRINE :
Pure antimetabolite.
More selective as immunosuppressant's than antitumor action.
(May be due to its more selective uptake to immune cells)
Less effective than cyclosporine.
Used in patients developing cyclosporine toxicity.

20. Glucocorticoids
Glucocorticoids have potent immunosuppressant action.
It inhibits several components of immune response, particularly
MHC expression and proliferation of T lymphocytes.
PREDNISOLONE:
Fluid retention (edema)occurs with high doses.
Dose:- 5-60mg/day orally.
10-40mg i.m.

21. Immunosuppressant Antibodies:
1. Muromonab CD3
It is a murine monoclonal antibody.
It is developed against CD3 glycoprotein located on T cell receptor.
Binding of muromanab CD3 to the antigen obstructs the binding of
MHC II antigen complex.
Hence, precipitation of T cells occur.

22. Immunosuppressant Antibodies:
2. ANTITHYMOCYTE GLOBULIN:
It is a polyclonal antibody purified from horse or rabbit immunized
with human thymic lymphocytes which binds to T lymphocytes and
depletes them.
Dose: Thymoglobulin (rabbit) 25mg/vial inj.

24. INDUCTION
REGIMEN
Given in
perioperative
period.
Cyclosporine+
Predisolone+
Azathioprine
MAINTENANC
-E
REGIMEN
Given for
prolonged
period.
Cyclosporine+
Predisolone+
Azathioprine
ANTI-
REJECTION
REGIMEN
Given to
suppress an
episode of
acute rejection.
Methylprednis
olone 0.5-1g
i.v. daily for 3-
5 days.
IMMUNOSUPPRESSION IN ORAGN TRANSPLANTATION

25. CLASSIFICATION OF IMMUNOSTIMULANTS:
provide antigenic
specificity in
immune
response, such
as vaccines or
any antigen
Specific
Immuno
stimulan
t
act irrespective of
antigenic
specificity to
augment immune
response of other
antigen or stimulate
components of the
immune system
without antigenic
specificity, such
as adjuvant.
Non-
Specific
immunos
timulant

26. REFERENCES :
Essentials of MEDICAL PHARMACOLOGY 6th EDITION
JAYPEE “KD Tripathi”.
RANG AND DALE’S PHARMACOLOGY 6th EDITION.
REVIEW OF MEDICINAL MICROBIOLOGY AND
IMMUNOLOGY.
https://www.merriam-webster.com/medical/immunopharmacology
https://en.wikipedia.org/wiki/Immunocompetence
https://www.aboutkidshealth.ca/Article?contentid=1511&language=
English
https://www.dreamstime.com/illustrated-vector-human-immune-
system-flat-medical-science-full-body-organs-image105059099

27. REFERENCES :
https://en.wikipedia.org/wiki/CD4
https://www.google.co.in/search?q=generation+of+humoral+and+cel
l+mediated+immune+response+and+sites+of+action+of+immunosu
ppressants+drugs+image+from+tripathi+text+book&rlz=1C1CHZL_
enIN768IN768&source=lnms&tbm=isch&sa=X&ved=0ahUKEwjW
_tqox6zcAhVGLo8KHcNPCWsQ_AUICigB&biw=1034&bih=576#
imgrc=zaOJwVBJFRgAMM:
https://en.wikipedia.org/wiki/Immunostimulant