Immune-mediated

Interferons (lENs) (52,53), a family of species-specific vertebrate proteins, confer nonspecific resistance to a broad range of viral infections, affect cell proliferation, and modulate immune responses. AH three principal interferons, a-interferon (lEN-a) produced by blood leucocytes, P-interferon (lEN-P) by fibroblasts, and y-interferon (lEN-y) by lymphocytes, also have antiviral activity. The abiUty of interferons to inhibit growth of transplantable and carcinogen-induced tumor led to research showing the direct antiproliferative and indirect immune-mediated antitumor activities (see Chemotherapeutics, anticancer). IENs have been found to be efficacious in certain malignancies and viral infections, eg, hairy cell leukemia (85% response) and basal cell carcinoma (86% response). However, the interferons do have adverse side effects (54). 

Multifunctional cytokines/immune mediators Multifunctional cytokines/immune mediators... 

The first mouse monoclonal antibody specific for human CD3 was produced in 1979 and named orthoclone OKT3. Aside from its use in the laboratory, OKT3 became the first anti-CD3 antibody to be utilized in transplantation medicine, but its wider application was hampered by its immunogenic and mitogenic properties (reviewed in [6]). Consequently, humanized and engineered anti-CD3 antibodies were developed to circumvent these limitations (Table 1). Since T cells and the TCR are involved in many immunological diseases, it is not surprising that the application of CD3 antibodies is not restricted to the field of transplantation. For example, CD3 antibodies are tested in clinical studies of diseases such as autoimmune diabetes (type 1 diabetes), immune-mediated inflammatory arthritis and inflammatory bowel disease [7]. 

Hypnotics. Common hypnotics are thiopental, propofol, midazolam, etomidate, ketamine and inhaled anesthetics. The incidence of hypersensitivity reactions with thiopental is rare. Recently, thiopental was involved in less than 1% of allergic reactions in France [9]. Ever since Cremophor EL, used as a solvent for some non-barbiturate hypnotics, has been avoided, many previously reported hypersensitivity reactions have disappeared. In the last French surveys, reactions to propofol accounted for less than 2.5% of allergic reactions, and reactions to midazolam, etomidate or ketamine appear to be really rare [9]. Finally, no immune-mediated immediate hypersensitivity reaction involving isoflurane, desflurane or sevoflurane has been reported despite their wide use. 

Opioids. Reactions to morphine, codeine phosphate, meperidine, fentanyl and its derivatives are uncommon. Because of their direct histamine-releasing properties, especially regarding morphine and codeine, distinction between anaphylaxis and non-immune-mediated histamine release is not always easy. Only 12 cases were recorded in the last 2 years epidemiologic survey in France, 9 of them being related to morphine administration [9]. 

NMBAs Immune-Mediated Hypersensitivity Reactions Are Predominant... 

Immune reconstitution inflammatory syndrome AIDS on HAART Acute or subacute Worsening or new neurological symptoms in the setting of immune reconstitution Immune mediated... 

Motor neuron disease AIDS Subacute Motor dysfunction, muscle wasting with upper motor neuron signs bulbar dysfunction Possible immune mediated... 

Albee, W.E., Jacobs, J., Phillips, M., Fisher, L., Panetta, J.A. and Gidda, J.S. (1992). The healing and protective effects of LY213829 in a model of formalin-immune mediated rabbit colitis. Gastroenterology 102, A589. 

Primary biliary cirrhosis is characterized by progressive inflammatory destruction of the bile ducts. Immune-mediated inflammation of intrahepatic bile ducts results in remodeling and scarring, causing retention of bile within the liver and subsequent hepatocellular damage and cirrhosis. The number of patients affected with primary biliary cirrhosis is difficult to estimate because many people are asymptomatic and incidental diagnosis during routine health care visits is common. 

Describe the immune-mediated mechanism of allergic rhinitis. 

Interferon-a2b has diverse mechanisms of action, including antiviral activity, impact on cellular metabolism and differentiation, and antitumor activity.42 The antitumor activity is due to a combination of direct antiproliferative effect on tumor cells and indirect immune-mediated effects.42 Interferon-a2b is currently approved by the Food and Drug Administration (FDA) as adjuvant therapy for patients who are free of disease after curative surgical resection but are at high risk of MM recurrence. This includes patients with bulky disease or regional lymph node involvement such as stage IIB, IIC, or III disease.43 It is controversial if interferon-a2b (IFN) should be offered as adjuvant therapy for every high-risk MM patient. The reason is because clinical trials with different doses of IFN have not proved definitively that IFN improves overall patient survival. 

Acute GVHD usually is not evident until the time of engraft -ment, when donor lymphoid elements begin to proliferate. The primary targets of immune-mediated destruction of host tissue by donor lymphocytes in acute GVHD are the skin, liver, and GI tract.44 A diffuse maculopapular rash on the face, truck, face, extremities, palms, soles, and ears is the usual sign of acute GVHD of the skin. In more severe cases, it can... 

Hageman, GS, Luthert, PJ, Chong, NHV, Johnson, LV, Anderson, DH, and Mullins, RF, 2001. An integrated hypothesis that considers drusen as biomarkers of immune-mediated processes at the RPE-Bruch s membrane interface in aging and age-related macular degeneration. Prog Retin Eye Res 20, 705-732. 

For much of its life cycle a parasite s environment is its host. A principal, and potentially lethal, feature of this environment is the host immune response. Diversity in parasites interactions with this aspect of their environment may therefore be expected. The host immune response varies between different hosts and so, if this is considered as a selection pressure, it may produce the ideal conditions for the generation of diversity in immune-mediated parasite-host interactions. 

Appleton, J.A. and McGregor, D.D. (1987) Characterization of the immune mediator of rapid expulsion of Trichinella spiralis in suckling rats. Immunology 62, 477-484. 

Ishikawa, N., Horii, Y. and Nawa, Y. (1993) Immune mediated alteration of the terminal sugars of goblet cell mucins in the small intestine of Nippostrongylus brasiliensis infected rats. Immunology 78, 303-307. 

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