Immunomodulators

1. Introduction

2. Types of immunomodulators

3. How they function ?

4. Therapeutic Applications

5. Examples

6. Side Effects

7. Monographs

Introduction

Immunomodulators are a class of drugs that regulate and modify the immune system. They can enhance, suppress, or modulate specific components of the immune response to achieve therapeutic effects. These agents play a crucial role in managing various immune-mediated diseases.

Types of Immunomodulators

Immunostimulants

These agents enhance the immune system's ability to recognize and eliminate pathogens or cancer cells.

Immunosuppressants

These drugs suppress or downregulate the immune system to prevent or treat autoimmune diseases and organ rejection.

Biological Response Modifiers

These are natural or synthetic substances that modify the body's biological response to disease or injury.

How they function ?

Immunosuppression:
Immunomodulators can suppress the immune system, which is useful in conditions where the immune system is overactive or attacking the body's own tissues (autoimmune diseases) or in situations where the immune system needs to be dampened, such as in organ transplant recipients to prevent rejection. This suppression can be achieved through various mechanisms:

- Inhibition of T cells:
  T cells are a type of white blood cell that play a central role in orchestrating the immune response. Some immunosuppressants work by inhibiting the activation or function of T cells, preventing them from attacking healthy tissues.
- Interference with cytokines:
  Cytokines are signaling molecules that regulate immune responses. Certain immunosuppressants can block the production or activity of pro-inflammatory cytokines, which helps reduce inflammation and immune activity.
- Disruption of immune cell proliferation:
  Immunosuppressants may also interfere with the proliferation or replication of immune cells, particularly lymphocytes, which are key players in the immune system's response.
- Induction of cell death (apoptosis):
  Some immunosuppressants induce programmed cell death in activated immune cells, helping to reduce their numbers and overall immune response.

Immunosuppressants

Immunostimulation:
Conversely, immunomodulators can also stimulate the immune system, which is beneficial in situations where the immune response is weak or needs to be bolstered, such as in immunodeficiency disorders or in fighting off infections. Mechanisms of immunostimulation include:

- Enhancement of antigen presentation: Immunostimulants can promote the presentation of antigens (foreign substances) to immune cells, particularly antigen-presenting cells such as dendritic cells, which helps activate the immune response.
- Activation of immune cells: Immunostimulants can directly activate various immune cells, including T cells, B cells, and natural killer cells, enhancing their ability to recognize and eliminate pathogens.
- Augmentation of cytokine production: Some immunostimulants can increase the production of cytokines, particularly those involved in promoting immune responses, such as interleukins and interferons.
- Promotion of antibody production: Immunostimulants may also stimulate B cells to produce antibodies, which are essential for targeting and neutralizing pathogens.