2. The Immune Response - why and
how ?
• Discriminate: Self / Non self
• Destroy:
–Infectious invaders
–Dysregulated self (cancers)
• Immunity:
–Innate, Natural
–Adaptive, Learned
3. • Innate immune response
– first line of defense against an antigenic insult.
Includes
•defenses like physical (skin),
• Biochemical (complement, lysozyme, interferons)
•cellular components (neutrophils, monocytes,
macrophages).
• Adaptive immune response
a) Humoral immunity - Antibody production –
killing extracellular organisms.
b) Cell mediated immunity – cytotoxic / killer T
cells – killing virus and tumour cells.
4. ABNORMAL IMMUNE
RESPONSE
• Hypersensitivity reactions
Type 1 – Anaphylactic shock
Type 2 – mismatched blood transfusion
Type 3 – Serum Sickness, glomerulonephritis
and arthritis.
Type 4 – TB
5. Autoimmunity
– Autoimmune diseases arise
when the body mounts an immune response
against itself as a result of failure to distinguish
self tissues and cells from foreign antigens.
Rheumatoid Arthritis, Type 1 Diabetes Mellitus,
Multiple Sclerosis etc….
• Immunodeficiency Diseases
Extrinsic – HIV causing AIDS.
19. • Mycophenolate Mofetil – mycophenolic acid
– Inhibits inosine monophosphate
dehydrogenase which is a key enzyme in
guanine nucleotide synthesis.
– Used in steroid refractory diseases, RA.
Leflunomide – it inhibits pyrimidine synthesis.
Used in RA.
• Cyclophosphamide – alkylating agent which
destroys proliferating lymphoid cells. Used in
autoimmune haemolytic anaemia, multiple
sclerosis.
20. • Muromonab CD3 – T cell receptor
complex
( blocks Ag recognition ).
– Used in steroid resistant rejection.
• Daclizumab, Basiliximab – IL-2
receptor (blocks IL-2 mediated T cell
activation ).
– Used in acute organ rejection in
renal transplant patients.
25. Levamisole
• Antihelminthic
• Restores depressed immune function of B, T
cells, Monocytes, Macrophages
USES:
• Adjuvant therapy in colon cancer
• Used to treat immunodeficiency associated with
Hodgkins disease.
Toxicity
• Agranulocytosis
26. Thalidomide
• Birth defect
• Contraindicated in women with childbearing
potential
• Enhanced T-cell production of cytokines – IL-
2
• Cell-mediated cytotoxicity against tumor cells
USE:
• Multiple myeloma
27. Bacillus Calmette-Guerin
• Live, attenuated culture of BCG strain of
Mycobacterium Bovis
• It causes activation of macrophages to make them
more effective killer cells.
• used as intravesical therapy for superficial bladder
cancer.
Adverse Effects
– Hypersensitivity
– Shock
– Chills
31. Capillary leak syndrome
• (systemic capillary leak syndrome or Clarkson
syndrome)
• A rare medical condition where the number
and size of the pores in the capillaries are
increased which leads to a leakage of fluid
from the blood to the interstitial fluid,
resulting in dangerously low blood pressure
(hypotension), edema and multiple organ
failure due to limited perfusion.
34. Active immunization
Vaccines
• Administration of antigen as a whole, killed
organism, or a specific protein or peptide
constituent of an organism
• Booster doses
• Anticancer vaccines:
Vaccinating patients with autologous antigen
presenting cells (APC) expressing tumor-
associated antigens (TAA)
35. Immune Globulin
Indications
• Individual is deficient in antibodies –
immunodeficiency
• Individual is exposed to an agent, inadequate time
for active immunization
– Rabies
– Hepatitis B