Immunosuppression

Jean F Borel, Transplantation Research, Novartis Pharma Inc., Basel, Switzerland

Copyright © 1998 Elsevier Ltd. All Rights Reserved.

Regulation of the immune response can be influenced in two ways. The enhancement of the immune response is called immunopotentiation and its down-regulation immunosuppression. The early history of medical immunology is dominated by deliberate attempts to induce resistance to infectious agents by means of eliciting an immune response and by enhancing the immunological defense mechanisms. Vaccination or immunization with an antigen preparation can specifically protect the body against microorganisms such as smallpox, rabies or poliomyelitis. More recently, increasing awareness that several pathological conditions are caused by undesirable reactions of the immune system has led to attempts to reduce the immune response. Thus, immunosuppression is needed in transplantation to prevent the rejection of a transplanted and histo-incompatible but life-saving organ as well as to induce remission and to prevent relapse in autoimmune diseases.

The advent, around 1900, of the feasibility of anastomosing vessels opened to the surgeons a wide vista into the field of transplantation surgery. The transplantation of organs such as kidneys was experimentally performed at that time by pioneers such as A. Carel in France and E. Ullman in Austria, but all attempts met with failure due to the invincible rejection phenomenon. It was Medawar who, in 1944, described the immunological basis for rejection of foreign tissues. Soon after, cell-mediated immunity and immunological tolerance were discovered by Billingham, Brent and Medawar. The investigation of the human leukocyte antigen (HLA) system since 1958, initially by Dausset and coworkers, has made a major contribution to improving organ transplantation. Finally, in the late 1950s, it was further realized that immunosuppressive methods were useful in controlling rejection.

If the immune response, as originally conceived, was to defend the individual against any foreign antigen, it should remain fully tolerant to self components. However, for various reasons, a breakdown in tolerance can occur and lead to more or less specific immune attacks directed against defined cells or organs of the host, thus inducing an autoimmune disease. The use of immunosuppressive agents has proven of therapeutic value in many such diseases, e.g. uveitis, myasthenia gravis, juvenile diabetes, psoriasis, primary biliary cirrhosis, ulcerative colitis, systemic lupus erythematosus, nephrotic syndrome and rheumatoid arthritis.

How To Bolster Your Immune System

How To Bolster Your Immune System

All Natural Immune Boosters Proven To Fight Infection, Disease And More. Discover A Natural, Safe Effective Way To Boost Your Immune System Using Ingredients From Your Kitchen Cupboard. The only common sense, no holds barred guide to hit the market today no gimmicks, no pills, just old fashioned common sense remedies to cure colds, influenza, viral infections and more.

Get My Free Audio Book


Post a comment