Biologics
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Immunosuppressants
- 1. Immunosuppressant Amornrat Prasertcharoensuk , MD. 15 Sep 2017
- 2. Abul K. Abbas,Cellular and Molecular Immunology ,Eight Edition
- 3. Abul K. Abbas,Cellular and Molecular Immunology ,Eight Edition
- 4. n engl j med 351;26 www.nejm.org december 23, 20
- 5. Abul K. Abbas,Cellular and Molecular Immunology ,Eight Edition
- 6. Abul K. Abbas,Cellular and Molecular Immunology ,Eight Edition
- 7. Abul K. Abbas,Cellular and Molecular Immunology ,Eight Edition
- 8. Abul K. Abbas,Cellular and Molecular Immunology ,Eight Edition
- 9. History Corticosteroid cortisone - RA 1949 Philip Hench Early 1960s AZA –kidney allograft rejection 1960s and 1970s Cyclophos phamide Antilymphocyte serum Alexander C .Wiseman,Clin J Am Soc Nephrol 11: 332–343, February,
- 10. History • Develop monoclonal antibodies (mAbs) use and the discovery of the immunosuppressive effects of cyclosporin A from fermentation extracts of the fungal species Tolypocladium inflatum . • Mammalian target of rapamycin (mTOR) pathways Alexander C .Wiseman,Clin J Am Soc Nephrol 11: 332–343, February, 2
- 11. International Journal of Pharmacy and Pharmaceutical Sciences Vol 4, Suppl 1, 2012
- 12. Corticosteroid therapy Annals of Internal Medicine 84:304-315 ,1976
- 13. Annals of Internal Medicine 84:304-315 ,1976
- 14. Annals of Internal Medicine 84:304-315 ,1976
- 15. Glucocorticoids Robert R.Rich,Clinical Immunology Principle and Practice,Third edition
- 16. International Journal of Pharmacy and Pharmaceutical Sciences Vol 4, Suppl 1, 2012
- 17. History Corticosteroid cortisone - RA 1949 Philip Hench Early 1960s AZA –kidney allograft rejection 1960s and 1970s Cyclophos phamide Antilymphocyte serum Alexander C .Wiseman,Clin J Am Soc Nephrol 11: 332–343, February, 2016
- 18. Azathioprine Gary L. C. Chan, Pharmacotherapy 1987;7(5):165-177
- 19. Azathioprine in renal transplantation, Chan et al,pharmacotherapy volume 7,number 5 ,1987
- 20. Mycophenolate mofeti
- 21. Burmester, Color Atlas of Immunology © 2003
- 22. Leflunomide Burmester, Color Atlas of Immunology © 2003
- 23. Burmester, Color Atlas of Immunology © 2003
- 24. History Corticosteroid cortisone - RA 1949 Philip Hench Early 1960s AZA –kidney allograft rejection 1960s and 1970s Cyclophos phamide Antilymphocyte serum Clin J Am Soc Nephrol 11: 332–343, February, 2016
- 25. History • Develop monoclonal antibodies (mAbs) use and the discovery of the immunosuppressive effects of cyclosporin A from fermentation extracts of the fungal species Tolypocladium inflatum . • Mammalian target of rapamycin (mTOR) pathways Alexander C .Wiseman,Clin J Am Soc Nephrol 11: 332–343, February
- 26. Alexander C .Wiseman,Clin J Am Soc Nephrol 11: 332–343, February, 2016 Monoclonal antibodies
- 27. Abul K. Abbas,Cellular and Molecular Immunology ,Eight Edition
- 28. n engl j med 351;26 www.nejm.org december 23, 2004
- 29. T Cell-Directed Therapy • Agents Targeting Signal 1 (the interaction of the TCR complex with an APC ) • Agents Targeting Signal 2 (the costimulatory signal provided by additional T cell/APC interaction that leads to full activation of the T cell) • Agents that inhibit further downstream activation and proliferation (typically driven by cytokine production) Alexander C .Wiseman,Clin J Am Soc Nephrol 11: 332–343, Februar
- 30. Alexander C .Wiseman,Clin J Am Soc Nephrol 11: 332–343, February, 20
- 31. Agents Targeting Signal 1 •Anti-TCR Agents. •Calcineurin Inhibitors (Cyclosporin and Tacrolimus).
- 32. Anti-TCR Agents Alexander C .Wiseman,Clin J Am Soc Nephrol 11: 332–343, February, 2016
- 33. Calcineurin Inhibitors (Cyclosporin and Tacrolimus) Clin J Am Soc Nephrol 11: 332–343, February, 2016 Alexander C .Wiseman,Clin J Am Soc Nephrol 11: 332–343, February, 2016
- 34. Burmester, Color Atlas of Immunology © 2003
- 35. Agents Targeting Signal 2 • Costimulation Blockade by CD80/86:CD28 Targeting (Abatacept and Belatacept). • Costimulation Blockade by CD154:CD40 Targeting (AntiCD40 mAb)
- 36. Alexander C .Wiseman,Clin J Am Soc Nephrol 11: 332–343, February, 2
- 37. Alexander C .Wiseman,Clin J Am Soc Nephrol 11: 332–343, February, 201
- 38. B Cell–Directed Therapy • B Cell Targeting - Anti-CD20 Targeting: Rituximab, Ocrelizumab, Ofatumumab, and Veltuzumab - Anti-CD22 Targeting: Epratuzumab • Targeting B Cell Differentiation : Belimumab and Atacicept
- 39. Alexander C .Wiseman,Clin J Am Soc Nephrol 11: 332–343, February, 2016
- 40. Alexander C .Wiseman,Clin J Am Soc Nephrol 11: 332–343, February, 2016
- 41. Anti- CD 20 : Rituximab • The first agent to target CD20, rituximab, is a chimeric anti- CD20 mAb (30% murine and 70% human) that leads to B cell depletion through a number of mechanisms, including complement-dependent cytotoxicity, growth arrest, and apoptosis .
- 42. Plasma Cell Targeting: Bortezomib • Bortezomib is a proteasome inhibitor
- 43. Alexander C .Wiseman,Clin J Am Soc Nephrol 11: 332–343, February, 2016
- 44. Complement Inhibition (Eculizumab) • Eculizumab is a humanized mAb to C5 that effectively inhibits its cleavage to C5a and C5b. • Because C5a is a neutrophil chemoattractant and required to form the C5b-9 membrane attack complex, inhibition of this enzymatic step results in blockade of proin flammatory, prothrombotic, and lytic functions of complement
- 45. Agents Targeting Cytokines Alexander C .Wiseman,Clin J Am Soc Nephrol 11: 332–343, February,
- 46. Agents Targeting Chemokines and Cell Adhesion • CCR5 receptor antagonist maraviroc used in the treatment of HIV. • CXCR4 antagonist plerixafor approved for hematopoietic stem cell mobilization. • CCR4 humanized mAb mogamulizumab approved for the treatment of T cell lymphoma. • Emapticap is an inhibitor to CCL2 (also known as monocyte chemotactic protein 1), which has been studied in phase 1 and 2 trials in diabetic nephropathy .
- 47. Pooled Polyclonal Antibodies as Immunosuppressive Agents • Immune Globulins mechanisms often cited include (1) direct binding to natural antibodies, immunomodulatory proteins (e.g., cytokines), or superantigens and pathogens (2) inhibition of complement fixation on target tissues by acting as a complement sink (3) Fc receptor (FcR) binding and subsequent inhibition of the FcR mediated recycling of native IgG (4) stimulation of FcR-induced anti-inflammatory pathways
- 48. Pooled Polyclonal Antibodies as Immunosuppressive Agents • Polyclonal Antithymocyte Globulin ATG products also have activity against B cells, monocytes, and neutrophils to lesser degrees. The primary mechanism of action of ATGs is lymphocyte depletion, predominantly by complement-dependent lysis and T cell activation– induced apoptosis
- 49. Burmester, Color Atlas of Immunology © 2003
- 50. Immunosuppressive Agents with Multiple Cellular Targets • Panlymphocyte Depleting Agents: Anti-CD52 (Alemtuzumab) • Antiproliferative Agents: mTOR Inhibitors (Sirolimus and Everolimus) • Antimetabolites: Inhibition of DNA Synthesis - AZA - Mycophenolate - Leflunomide
- 51. Panlymphocyte Depleting Agents: Anti-CD52 (Alemtuzumab)
- 52. Immunosuppressive Agents with Multiple Cellular Targets • Panlymphocyte Depleting Agents: Anti-CD52 (Alemtuzumab) • Antiproliferative Agents: mTOR Inhibitors (Sirolimus and Everolimus) • Antimetabolites: Inhibition of DNA Synthesis - AZA - Mycophenolate - Leflunomide
- 53. Antiproliferative Agents: mTOR Inhibitors (Sirolimus and Everolimus) Alexander C .Wiseman,Clin J Am Soc Nephrol 11: 332–343, February, 2016
- 54. Burmester, Color Atlas of Immunology © 2003
- 55. Int. J. Mol. Sci. 2016, 17, 975
- 56. Int. J. Mol. Sci. 2016, 17, 975
- 57. J Obstet Anaesth Crit Care ,2014
- 58. Panackel C, Ganjoo N, Saif R, Jacob M.,IMA Kerala Medical Journal. 2016 Mar 30;9(1):
- 59. n engl j med 351;26 www.nejm.org december 23, 2004
- 60. n engl j med 351;26 www.nejm.org december 23, 2004
