Medical Microbiology

Immunosuppression...................................

Variousmethodsareemployedtoinhibit,orsuppress,theimmuneresponse:

&Generalizedimmunosuppression;glucocorticoids(inhibitionofinflam-

matorycells),cytostaticdrugs(endoxan,DNAalkylatingagents,methotrex-

ate,antimetabolites),andmorespecificimmunosuppressants,e.g.,cyclospor-

ineA,FK506,rapamycin(inhibitionofsignaltransductioninTcells,seeFig.

2. 11 ,p. 7 3).
   &Immunosuppressionbyantibodies,solublecytokinereceptors,deletionof
   TcellsorT-cellsub-populations(anti-CD4,anti-CD8,anti-CD3,anti-Thy1,
   etc.).Administrationofmonoclonalantibodiesdirectedagainstadhesionmo-
   leculesandaccessorymoleculesorcytokinesandcytokinereceptors.Admin-
   istrationofsolublecytokinereceptors,orsolubleCTLA4,inordertoblockB7-
   1 andB7-2(importantcostimulators,seep. 7 1ff.).
   &Specifictoleranceinductionor“negativeimmunization.”Massiveandde-
   pletiveT-cellactivationbroughtaboutbysystemicadministrationoflarge
   amountsofpeptides,proteins(riskofimmunopathology),orcells(chimer-
   ism).
   &Completeneutralizationandeliminationoftheantigenwiththepurpose
   ofpreventinginductionofanantibodyresponse.Example;rhesusprophy-
   laxiswithhyperimmuneserum.

AdaptiveImmunotherapy.............................

Thisinvolvesin-vitroantigenstimulation,andconsequentproliferation,of

patientT-celleffectorclonesorpopulations(CD8+Tcellsorlessspecific

lymphokine-activatedkillercells,LAKcells),followedbytransfusionof

thesecellsbackintothepatient.Thismethodissometimesusedasameans

oflimitingcytomegalyorEpstein-Barrvirus infectionofbonemarrow

recipients.TheLAKcellsalsoincludelessspecificNK-likecells,whichcan

beexpandedwithIL-2intheabsenceofantigenstimulation.

Toxicantibodiesaremonoclonalantibodiestowhichtoxinshavebeen

coupled.Theseareusedasspecifictoxintransporters,administereddirectly,

orwithliposomesbearinganchoredantibodiesandcontainingatoxinor

cytostaticdrug.

120 2 BasicPrinciplesofImmunology

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Kayser, Medical Microbiology © 2005 Thieme

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