immunopharmakologi 2008 english

8/2/2019 Immunopharmakologi 2008 English

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IMMUNOPHARMACOLOGY

I Made JawiBagian Farmakologi

Fakultas Kedokteran Unud

2009


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Respons Imun

Ag

APC MHC-II

Th

IL-12

Th-2

Th.1

IL-1

TNF-, IFN-

IL-2, IFN-

LYM-B

IL-4

IL-5 SEL PLASMA

SEL MEMORI

IL-6

IL-10

CTL MHC-I

I L-2 IFN-

SEL-NK

SEL-NK AKTIF

FC-R

L

L

SEL ABNORMAL

SITOTOKSIN

SEL-LISIS

Sel Abnormal FAST


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Learning Objective

To Understand The Pharmacology 0fdrugs used in Immune SystemDisorders

To be Able to choose the appropriatedrugs for Immune System Disorders


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IMMUNOPHARMACOLOGY

LYMPHOCYTE

INCREASE

DECREASE


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T CELLS / ANTIBODY

INTERACTION ANTIGEN

Tissue Injury

ANTIGEN

RECOGNITION

PROLIFERATION

DIFFRENTIATION,

SYNTHESIS

D

R

U

GS


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INHIBIT

ANTIGEN RECOGNITION

1. LYMPHOCYTE IMMUNE GLOBULIN

BLOCKS SELLULAR IMMUNITY

CELL MEDIATED PROCESSSUPPRESS ORGAN GRAFT REJECTION

2. Rh0(D) IMMUNE GLOBULIN

3. MONOCLONAL ANTIBODIES

MUROMONAB- CD3, DACLIZUMAB,INFLIZIMAB


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INHIBIT PROLIFERATION1. CORTICOSTEROIDS

Action at multiple cellular sites, leading to broad

effects on inflammatory and immune process.

At biochemical level: gene expression; decrease synthesis

Prostaglandins, leukotriens, cytokins and others signalingMolecul. At cellular level: inhibit proliferations of T lym.

Cytotoxic to certain subsets of T cells, lower Ig G level

by increasing catabolism of Ig

2.ANTIBIOTIC: CYCLOSPORINE, TACROLIMUS,SIROLIMUS

3.CYTOTOXIC AGENTS: AZATHIOPRINE,CYCLOPHOSPHAMIDE, METHOTREXATE

4. ENZYM INHIBITOR. 5. ANTI-TNF ALFA.


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INHIBIT DIFRENTIATION

CYCLOSPORINE

TACROLIMUS


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Drugs that modulate immune function

Immunepotentiators

Immunesuppressants

Drugs AntibodiesBCG vaccineCytokines

(interleukin-2,

interferon's)

Thymosin

Glucocorticoids(prednisone) Immunophilin

ligands(cyclosporine)

Cytotoxic drugs(cyclosphamide)

Anti-TNF- agents(etanercept)

Enzyme Inhibitors(mycophenolate mofetil)

Antilymphocyte. G, RHO (D)

Monoclonal


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THANKS


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GLUCOCORTICOIDS

(CORTISOL,HYDROCORTISONE)PRODUCED BY ADRENAL CORTEX

NORMAL ADULT: 10-20MG DAILYREGULATED CNS AND FEEDBACK

EXERTS WIDE RANGE PHYSIOLOGIC

EFFECTREGULATION INTERMEDIARY MET.

CARDIOVESCULER FUNCTION

GROWTH AND IMMUNITY


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PHARMACOKINETIC

BOUND TO CORTICOS B GLOBULIN

FREE 5-10% EXERTS EFFECT

CBG INCREASE INPREGNANCY/ESTROGEN ADMINISTR

HALF LIFE 60-90 MENIT

ADMINISTRATION OF

HYDROCORTISON INCREASE HALFLIFE.


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PHARMACODYNAMIC

BERIKATAN DENGAN RESEPTORDALAM SITOPLASMA

MESUK KEDALAM INTIMEMPENGARUHI DNA

TERJADI PROTEIN BARU

TERJADILAH EFFFECT


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PHYSIOLOGIC EFFECTS

INFLUENCE MOST CELL IN THE BODY

METABOLIC EFFECTS

CATABOLIC EFFECTS ANTI-INFLAMMATORY EFFECTS

IMMUNOSUPPRESSIVE EFFECTS

OTHER EFFECTS.


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ANTI-INFLAMMATORY

REDUCED INFLAMATION

BY EFFECT ON LEUKOCYTECONCENTRATION,DISTRIBUTION

AND FUNCTION SUPPRESSIVE EFFECT ON

INFLAMATORY CYTOKINE AND

CHEMOKINES SUPPRESSIVE EFFECT ON OTHER

LIPID AND GLUCOLIPID MEDIATOROF INFLAMMATION.


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INFLAMMATORY and

IMMUNOSUPPRESSIVE effect

Inhibited of extravasation and infiltration ofleukocytes into tissue of inflammation

Single dose increase Neutrophils anddecrease Cell B,T,Monocytes,Eosinophils in

circulation max at 6 hours recovery in 24hours.

Neutrophils influx from Bone marrow and

decrease to migration Other cell movement from circulation to

lymphoid tissue


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Immunosuppressive

Inhibited Machrophages and APC

On Machrophages inhibitedphagocytose,produce TNF alfa,Interleukin1

Interleukin 12, Interferon gama, by

machrophages and lymphocyte decrease soinhibited of cellular immunity.

Large dose reduced antibody production, noin moderate dose.

Reduced antigen expression from the graftedtissue.


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Anti-inflammatory Glucocorticoid Reduced synthesis of

prostaglandins, leukotriene, platelet-activating factor.

Reduced expression of

cyclooxygenase II

Cause vasoconstriction when applieddirectly to the skin by suppressing must

cell degranulation. Decrease capillary permiability by

reducing the histamin released by

basophils and mast cell

immunopharmakologi 2008 english

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