IMMUNODEPRESSIVE SUBSTANCES (Latin immunis the free, saved from something + depressi about suppression, oppression) — the pharmaceuticals oppressing immune responsiveness of an organism.
Immune mechanisms in some cases can play a negative role and be the cause of undesirable reactions, napr, at organ transplantation and fabrics (see. Incompatibility immunological ), and also at autoimmune diseases (infectious nonspecific polyarthritis, a system lupus erythematosus, etc.). In this regard in clinic the drugs reducing proliferative processes in an adenoid tissue were widely adopted pharmakol. Treat them: the alkylating substances — Cyclophosphanum (see); antimetabolites of the purine and pirimidinovy bases — 6 Mercaptopurinum (see), imuran (see); antagonists folic to - you — methotrexate (see); drugs of glucocorticoid hormones — hydrocortisone (see), cortisone (see), Prednisolonum (see); metaphase poisons — vinblastine (see), Vincristinum (see); derivatives of quinoline — Chingaminum (see). In quality And. century also some antibiotics, napr, Actinomycinums of C and D are used (see. Actinomycinums ) and anti-lymphocytic serums (see. Anti-lymphocytic serum ). Practically all immunodepressants concern to group of cytostatic means, i.e. the means blocking cell division, however all of them more or less selectively slow down proliferation of lymphoid cells.
The alkylating substances have an immunodepressive effect due to alkylation of the phosphates which are a part nucleinic to - t. From them only Cyclophosphanum has satisfactory selectivity concerning an adenoid tissue. Connections of this group slow down cell fission preferential on a synthetic phase of a cellular cycle (see. Cell division ). Antimetabolites of the purine and pirimidinovy bases oppress immunol, reactivity by creation in the sharing lymphoid cells of deficit of nucleotides. Some substances of this group join in molecules DNA and RNA, causing their defect. They block cell division generally on a synthetic phase of a cellular cycle. Antagonists folic to - you cause lethal disturbances of amino-acid, protein and energy balance of a cell. Glucocorticoid hormones have limfolitichesky effect, molecular mechanisms to-rogo are not established yet. The cytostatic effect of these connections is based on general extension of all phases of a cellular cycle. Metaphase poisons block cell fission on a phase of a mitosis. The cytostatic and immunodepressive effect of Chingaminum is connected, apparently, with disturbance of metabolism nucleinic to - t.
I.v. affect unequally different types of immunity: they block products of antibodies more actively, than cellular immunity. The most optimum term of introduction of the majority And. century (Mercaptopurinum, a methotrexate, an imuran, Cyclophosphanum, etc.) — second day from the moment of antigenic influence (according to an experiment). Sensibilized lymphoid population passes into this period from equilibrium in exponential growing, more sensitive to cytostatic drugs. Glucocorticoid hormones are approximately equally effective at introduction both to, and after an antigenic incentive. The latent phase of an immune response several times is stronger oppressed by immunodepressants, than productive. The immune response on soluble antigens is braked by drugs of this row much easier, than on corpuscular antigens. Synthesis of IgM-antibodies is blocked by them more than antibody formation of the class IgG (see. Antibodies ).
In clinic immunodepressants use for the prevention of crisis of rejection at allogenic organ and tissue transplantation and treatments of autoimmune diseases. At organ and tissue transplantation widely apply glucocorticoid hormones and an imuran. The drugs begin to be administered to the recipient in high doses one week prior to operation. Then carry out a maintenance therapy in half doses. At emergence of symptoms of rejection dose I.v. increase.
Apply 6 Mercaptopurinum, drugs of glucocorticoid hormones, a methotrexate to treatment of autoimmune diseases (nonspecific ulcer colitis, infectious nonspecific polyarthritis, bronchial asthma, nephrites, a system lupus erythematosus, autoimmune hemolitic anemia). Treatment is carried out by courses.
And. can cause damage to quickly proliferating fabrics century (marrow, a mucous membrane went. - kish. a path), shown anemia, leucio-and a lymphopenia, decrease in coagulability of blood and an ulceration of mucous membranes went. - kish. path. Besides, under influence And. century body resistance to bacterial and viral infections decreases.
I.v. are contraindicated at diseases of a liver and a leukopenia.
Kliniko-pharmakol. characteristic of the main I.v., applied in medical practice, see in the tab.
the Table. The Kliniko-pharmakologichesky characteristic of the main immunodepressive substances applied in medical practice
Bibliography: Zaretskaya Yu. M., etc. Immunological aspects of allotransplantations, M., 1974, bibliogr.; Kinetics of cell populations at the immunological answer, under the editorship of V. A. Babichev, page 5, M., 1974, bibliogr.; Kovalyov I. E. and With ergeev P. V. Introduction to an immunopharmacology, Kazan, 1972; Nasonova V. A., etc. Pharmacotherapy in rheumatology, page 99, M., 1976; Petrov R. V. and Manko V. M. Immunodepressora, M., 1971, bibliogr.; Having consoled in B. S. and Babichev V. A. Inhibitors of biosynthesis of antibodies, M., 1974, bibliogr.; Antineoplastic and immunosuppressive agents, ed. by A. G. Sartorelli a. D. G. Johns, pt 1 — 2, V. a. o., 1974 — 1975; Bradley J. ElsonC.J. Suppression of the immune response, J. med. Genet., v. 8, p. 321, 1971, bibliogr.; Chalmers A. H., Burgoyne L. A. a. Murray A. W. Antineoplastic and immunosuppressive drugs, Drugs, v. 3, p. 227, 1972, bibliogr.; Makinodan T., Santo s G. W. a. Quinn R. P. Immunosuppressive drugs, Pharmacol. Rev., v. 22, p. 189, 1970, bibliogr.
V. A. Babichev.