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Drugs to Treat Autoimmune Diseases PowerPoint Presentation

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Description : This medical presentation titled "Drugs to Treat Autoimmune Diseases" is about autoimmune diseases (Types, Symptoms, and Diagnosis), immunological tolerance (Clonal Deletion Theory, Clonal Anergy Theory, and Idiotype Network Theory), Pathogenesis of autoimmunity (Mechanisms), treatments (Immunosuppressive, Anti-inflammatory, and Disease modifying), and new research and future.

Tags : autoimmune diseases, Types, Symptoms, Diagnosis, immunological tolerance, Clonal Deletion Theory, Clonal Anergy Theory, Idiotype Network Theory, Pathogenesis of autoimmunity, Mechanisms, treatments, Immunosuppressive, Anti-inflammatory, Disease modifying, research, antibodies

Published on : Apr 24, 2021 | Views : 1747 | Downloads : 7

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Slide 1-

Drugs to Treat Autoimmune Diseases Chelsea Wells
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Outline Autoimmune diseases Types Symptoms Diagnosis Immunological tolerance Clonal Deletion Theory Clonal Anergy Theory Idiotype Network Theory Pathogenesis of autoimmunity Mechanisms Treatments Immunosuppressive Anti-inflammatory Disease modifying New research and Future
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The Basics Autoimmunity occurs when the body is unable to differentiate “self” from “non-self” Results in overactive immune response against own cells and tissues Affects 5%-8% of the population 78% affected are females Over 80 conditions linked to autoimmunity 15 diseases directly linked to autoimmune response Low level autoimmunity is normal
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More Basics Both antibodies and effector T cells can be involved in the damage in autoimmune diseases. Organ specific immune response is directed against antigen(s) associated with the target organ being damaged Non-organ specific antibody is directed against an antigen not associated with the target organ
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Common Autoimmune Diseases
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Symptoms Tiredness Depression Weight gain Weight loss Muscle weakness Cramps Irritability Sweating Shaky Swelling Rash Body pains Tremors Numbness Fatigue Loss of appetite Insomnia Coordination loss Many different symptoms make autoimmune diseases hard to diagnose Many times there are no symptoms!
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Diagnosis Based on symptoms and detection of antibodies Antibodies against cell/tissue associated antigens are detected by immunofluorescence Antibodies against soluble antigens are normally detected ELISA or radioimmunoassay Biological and biochemical assay also used
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Immunological Tolerance Three present theories to explain the loss of immunological tolerance Clonal Deletion Theory- self reactive lymphnoid cells destroyed during development of immune system Clonal Anergy Theory- self reactive T or B cells become inactivated Idiotype Network Theory- network of antibodies capable of neutralizing self reactive antibodies exist naturally within the body
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Pathogenesis of Autoimmunity Genetic predisposition and environmental factors relevant Immunoglobulins, T cell receptors, major histocompatibilty complex T Cell Bypass- The requirement of T cells to activate B cells in order to produce large amounts of antibodies is bypassed Molecular Mimicry- An exogenous antigen shares structural similarities with host antigen and when an antibody is produced, it can bind to host antigen Idiotype Cross Reaction- A cross reaction between the idiotype (molecule recognized by antigen) on an antiviral antibody and a host cell receptor for the virus in question Cytokine Dysregulation- Certain cytokines have a role in the prevention of the exaggeration of pro-inflammatory immune response Dendritic Cell Apoptosis- Defective dendritic cells can lead to inappropriate systemic lymphocyte activation and a decline in self tolerance
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Treatments- Immunosuppression Reduce the activation or efficacy of the immune system Leaves body very vulnerable to opportunistic infections Also used to prevent the body from rejecting an organ transplant
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Immunosuppression Cont. Cortisone 1st immunosuppressant identified Steroid hormone Discovered by Edward Calvin Kendall (1950) Administered intravenously Few side effects Pain at injection site Thinning of skin Weight gain
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Immunosuppression Cont. Azathioprine 2nd immunosuppressant identified Pro-drug Discovered by Sir Roy Calne (1959) Inhibits purine synthesis necessary for the proliferation of cells Site of action-DNA (false nucleotide incorporation Side effects Carcinogen Nausea Rash
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Immunosuppression Cont. Cyclosporine 3rd immunosuppressant identified Cyclic nonribosomal peptide Discovered by Hartmann F. Stahelin (1972) Site of action- calcineurin (inhibits phosphatase activity) Side effects Interacts with a wide variety of other drugs and substances hyperplasia, convulsions, peptic ulcers, fever, vomiting, diarrhea, confusion, breathing difficulties, numbness and tingling, high blood pressure, kidney and liver dysfunction
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Treatments- Anti-Inflammatory Remedy pain by reducing inflammation Steroidal Glucocorticoids- regulate gene transcription Bind to cortisol receptors Nonsteroidal Counteract cyclooxygenase enzyme Ibuprofen, aspirin, naproxen
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Anti-Inflammatory Cont. Prednisone Given orally, intravenously, intramuscularly Pro-drug Also an effective immunosuppressant Side effects Weight gain Increased blood pressure and blood sugar Insomnia
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Disease Modifying Drugs Improve symptoms Alter disease course Improve radiographic outcomes
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Disease Modifying Drugs Cont. Methotrexate Immunosuppressive effects due to inhibition of enzyme involved in the metabolism of folic acid Anti-inflammatory effects due to interruption of adenosine Relatively rapid onset of action (4-6 weeks) Side effects Stomatitis Oral ulcers GI upset
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Disease Modifying Drugs Cont. Etanercept (Enbrel) Recombinant DNA drug binds TNF (tumor necrosis factor) in the circulation and in the joint, preventing interaction with cell surface TNF receptors thereby reducing TNF activity Subcutaneous injection Side effects Susceptibility to opportunistic infection
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Disease Modifying Drugs Cont. Abatacept Inhibits costimulation of T cells Interferes with the process of turning T cells on which activate cells that cause inflammation and damage Delays progression of structural damage Side effects Back pain Cough Dizziness Headache Susceptibility Infection
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New Research Discovered role of protein Naturally occurring chemical interleukin 17 Plays role in autoimmune and inflammatory responses Has commonly known effects within immunity Future research will target unwanted actions and preserve benefits within the immune system
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New Research New pathways for autoimmune treatment identified Rare genetic defect can trigger diseases Mutation in Aire gene causes defect in iNKT cells-helps the immune system fight infections while suppressing T cells wanting to attack the body manipulating the iNKT cell population is one possible way to cure autoimmune disease
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Future Understanding the role of inflammation in the development of autoimmunity Determine whether the trigger of disease is an infection itself Discover the role of apoptosis in the origin and development of autoimmunity Future treatments based on modern understanding of the immune system (e.g., anti-idiotype antibodies, antigen peptides, anti-IL2 receptor antibodies, anti-CD4 antibodies, antiTCR antibodies,
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Sources www.wikipedia.com http://www.aarda.org www.pubmed.com http://pathmicro.med.sc.edu/ghaffar/tolerance2000.htm Goodman and Gillman