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Cancer Biology and Genetics for Non-Biologists
Published in Trevor F. Cox, Medical Statistics for Cancer Studies, 2022
Immunotherapy is a more recent treatment for cancer, not widely used yet. It helps the immune system to recognise cancer cells and then kill them. There are various types of immunotherapy, for instance, drugs called immune checkpoint inhibitors block immune checkpoints, which stop the immune system from being too aggressive and T-cell transfer therapy where immune cells are taken from the tumour and modified, and then injected back into the body, where they become more effective. Other treatments include monoclonal antibody therapy drugs, called immune system modulators, and treatment by vaccines that strengthen the immune system.
Immunosuppressants, rheumatic and gastrointestinal topics
Published in Evelyne Jacqz-Aigrain, Imti Choonara, Paediatric Clinical Pharmacology, 2021
Evelyne Jacqz-Aigrain, Imti Choonara
Initially, ciclosporin (CsA), the cornerstone of immunosuppressive treatment, was given in association with azathioprine and corticosteroids to prevent acute and chronic rejection. Tacrolimus (Tac) is more potent and somewhat less toxic than CsA, and may replace CsA as the first-line drug in paediatric transplantation. Mycophenolate mofetil (MMF) is increasingly used in paediatric organ (both liver and kidney) transplantation, in association with CsA or Tac in patients with deteriorating renal function, or to provide additional immunosuppression in patients resistant to conventional medication. Monoclonal antibody therapy in combination with standard immunosuppressive therapy has given promising preliminary data in children.
Biologic Therapies for Rheumatoid Arthritis
Published in Thomas F. Kresina, Monoclonal Antibodies, Cytokines, and Arthritis, 2020
Ian R. Mackay, Merrill J. Rowley, Claude C. A. Bernard
We excluded any reference to technical aspects of monoclonal antibody therapy. However, there must be awareness of the self-limiting nature of therapy with intact murine MAb, in terms of “antimouse” responses to the antibody or anti-idiotypic responses to the active site of the antibody. These limitations can be overcome by the use of hybrid human-mouse MAbs or by linkage to the MAb of toxins, which can thereby be directed to sites of relevance (104). A particular limitation for rheumatoid arthritis, referred to throughout this review, is the unknown nature of the rheumatogenic antigen. We draw attention to the “conformational equivalence” hypothesis, which reviews the new knowledge on disease susceptibility sites on DR molecules; this is presented in the context of the rheumatogenic “antigen X” that currently eludes characterization (21).
Development of a method of nasal secretions sampling for local nasal inflammation studies
Published in Expert Review of Clinical Immunology, 2023
Xu Xu, Xu Zhang, Dong Liu, Kunpeng Wang, Yang Wang, Chengshuo Wang, Yuan Zhang, Jingyun Li, Luo Zhang
CRS and AR are inflammatory diseases of the lining of the nasal and paranasal cavities, and the diagnosis is based on history, clinical examination, rhinoscopy, allergy testing, imaging, functional testing, and nasal cytology. However, the biochemical and immunological analyses of nasal secretions can provide additional information on mucosal innate and adaptive immunities [23]. Type 2 cytokines activate inflammatory cells involved in pathogenic mechanisms, and novel biologic drugs that block the production or action of these factors are emerging as new therapeutic modalities. Eosinophils are central to the pathogenesis and severity of chronic inflammatory diseases of the airways. Since IL-5 is essential for eosinophil growth, differentiation and migration into the airways, it is a suitable therapeutic target. Mepolizumab and reslizumab bind directly to IL-5 and reduce the production and survival of eosinophils by inhibiting IL-5 signaling through blockade of its receptor [28]. IL-4 and IL-13 function upstream of IL-5 and affect more cell types beyond eosinophils, including airway smooth muscle cells, fibroblasts, macrophages, mast cells, and basophils [29]. Dupilumab binds to the IL-4 Rα subunit, inhibiting IL-13 and IL-4 signaling and decreasing IgE production by about 40% [30]. Nasal secretions reflect the local inflammatory state of the nasal cavity. The analysis of biomarkers in nasal secretions provides important information for the study of biological targets. Its noninvasive characteristics make it feasible as a screening method for monoclonal antibody therapy.
COVID-19 scenario and recommendations on the continuity of immunobiological therapy in patients with atopic asthma in Brazil and Latin America
Published in Expert Review of Respiratory Medicine, 2022
Rafael de Oliveira Resende, Vinícius José de Oliveira, Alessandro Sousa Correa, Pedro Trica de Araújo, Ernesto Akio Taketomi
Thus, in the absence of robust data indicating potential damage for COVID-19, it is reasonable to continue the administration of immunobiological agents during the COVID-19 pandemic, as recommended by the main societies and organizations of Allergy and Clinical Immunology as it has been expected that COVID-19 may involve different biological pathways. However, physicians should individually evaluate each case based on the health condition of the patient as well as the inhibitory characteristics of the immunobiologics. Besides, if those are not effective, patients may require treatment with systemic corticosteroids and/or immunosuppressants with a potentially negative impact on immune response against SARS-CoV-2. Noteworthy, the use of immunobiologics associated with corticosteroids/immunosuppressants is likely to have an additional potentially negative impact on the immune response against SARS-CoV-2, so they might be used with caution. Monoclonal antibody therapy aims to inhibit molecules in the immune system that trigger an allergic response and when associated with immunosuppressive effects, the impacts on the health of patients may be immeasurable.
Pharmacologic agents directed at the treatment of pain associated with maladaptive neuronal plasticity
Published in Expert Opinion on Pharmacotherapy, 2022
Joseph V. Pergolizzi, Giustino Varrassi, Peter Magnusson, Frank Breve, Robert B. Raffa, Paul J. Christo, Maninder Chopra, Antonella Paladini, Jo Ann LeQuang, Kailyn Mitchell, Flaminia Coluzzi
Monoclonal antibodies have high affinity for specific ligands associated with pain signaling, allowing them to be developed as potential analgesic agents [42]. Although not yet proven, it may be that such high specific affinities will result in fewer deleterious side effects which are treatment limiting for many other analgesics. Should monoclonal antibodies be cleared for market release to treat chronic non-migraine pain, they possess the advantage of long elimination half-lives and relatively infrequent dosing, which often improves patient acceptance and regimen adherence [42]. Monoclonal antibodies have limited ability to cross the blood–brain barrier; however, administration of these agents must be parenteral (intravenous, intramuscular, or subcutaneous) as the large hydrophilic molecules are subject to gastric degradation [42]. Furthermore, monoclonal antibody therapy may be expensive and broad application of these treatments may be financially prohibitive. Large molecules may be challenged by the blood–brain barrier.