Biological agents cytokines

A small-molecule inhibitor of tumor necrosis factor a, a protein involved in inflammatory diseases such as rheumatoid arthritis, has been identified <2005SCI1022>. Direct inhibition by the commercial biological agents Enbrel and Remicade has produced major advances in rheumatoid arthritis treatment and validated extracellular inhibition of this proinflammatory cytokine as an effective therapy. The new inhibitor 35 is composed of trifluoromethylphenyl indole and dimethylchromone moieties linked by a dimethylethylenediamine spacer. 

In psoriasis, biologic agents typically act through one or more of the following mechanisms (1) elimination of activated T cells, (2) inhibition of T-cell activation, (3) interference with T-ceU trafficking to the skin, (4) neutrahzation of the effects of Thl-type cytokines, and (5) induction of immune deviation by introducing Th2-type cytokines. ... 

It has recently been discovered that immune modulating biologic agents can induce DIAI in a small percentage of patients (Pichler 2006 Weber 2004). Currently, there are no animal models to study the mechanism of these diseases, and, as a result, mechanistic insight into the role of cytokines has been derived from animal models of idiopathic SLE. 

Cytokines and biological response modifiers represent a broad class of therapeutic agents that modify the hosts response to cancer or cancer therapies. The enormous body information about their clinical uses and their side effects is beyond the scope of this essay that can only give illustrative examples. For an up-to-date information the reader can resort to reference [5]. As many as 33 different interleukins are known and the list continues to grow IL-2 used in the treatment of kidney cancer is one example. Interferon alpha is used for chronic myelogenous leukeia, hairy cell leukaemia and Kaposi s sarcoma. Interferons are also used in the treatment of chronic infections such as viral hepatitis. Tumor necrosis factor (alpha), G/GM/M-CSF, and several other cellular factors are used in treatment of various cancers. Many of these cytokines produce serious side effects that limit their use. 

Thalidomide (Thalomid) is a derivative of glutamic acid that is chemically related to glutethimide. It exerts a number of biological effects as an immunosuppressive, antiinflammatory, and antiangiogenic agent, yet its mechanisms of action have not been fuUy elucidated. Thalidomide potently inhibits production of tumor necrosis factor (TNF) a and interleukin (IL) 12, and its effect on these and other cytokines may account for some of its clinical effects. 

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