Immune suppression diseases associated with

Immunotoxicology is the study of undesired effects resulting from the interactions of xenobiotics with the immune system (Figure 19.1). There is evidence that some xeno-biotics can cause immune suppression. Xenobiotics can also interact with the immune system to either cause or exacerbate allergic disease. Finally there is growing concern that xenobiotics could have some involvement in autoimmune disease. This chapter provides a brief overview of the immune system, chemicals associated with immune suppression and immune pathologies, and approaches to testing for these effects. 

Oropharyngeal candidiasis (OPC) is a common fungal infection, usually associated with immune suppression. If left untreated, it will progress to more serious oral disease. Esophageal candidiasis, representing a serious progression of oropharyngeal candidiasis, is associated with increased morbidity. 

Clinical Use. Sulfasalazine (Azulfidine, other names) has unique properties, with some antibacterial characteristics similar to sulfonamide drugs (see Chapter 33) and some of anti-inflammatory characteristics similar to the salicylates (see Chapter 15). This drug is primarily used to suppress the immune response associated with rheumatoid arthritis and inflammatory bowel disease.38,61... 

The most commonly used therapy to treat LSDs is heterologous bone marrow transplantation (BMT). This treatment provides both normal bone marrow and bone marrow-derived cells, which release enzyme continuously. Unfortunately, BMT is associated with several problems and risks including the availability of a suitable donor, poor response to therapy, and sustained immune suppression. BMT therapies for MPS I, MPS II, MPS III, metachromatic leukodystrophy, and non-neuronopathic forms of Gaucher disease have demonstrated promising results. In most successful cases, the pathology is reversed in the visceral organs with variable or unclear success in the CNS (Laine et al., 2004). 

With respect to HCMV causing disease in immune-suppressed individuals, reactivation from latency appears to be more important than primary infection. It is believed that cytokine-induced differentiation of latendy infected cells can lead to a cell type that supports productive infection (Hahn et al., 1998), and viral amplification results from reduced immune surveillance (Fiala et al., 1973). Like many perisistent/latent viral infections, the early events associated with reactivation from latency are poorly understood. 

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