iMMUNOSUPPRESSION

1. IMMUNOSUPRESSION

2. SHORT TERM IMMUNOSUPRESSION
 STEROIDS
Classical immunosuppressant
Revolutionary drug

3. Mechanism of action of steroids
1. Lysis and redistribution of lymphocytes
2. Dampening antigen presentation by APC
3. Blocking of T cell activation
4. Enhances Apoptosis of activated T cells
5. Down-regulation of IL-1, IL-6 genes
6. Decreased IL-2 production (indirectly)

4. LONG TERM IMMUNOSUPRESSION
 ANTIPROLIFERATIVE DRUGS
Azathioprine, Mycophenolate Mofetil
 CALCINEURIN INHIBITORS
Cyclosporine, Tacrolimus

5. Azathioprine
 Inhibit purine biosynthesis
 Prevent Mitosis
 Prevent proliferation of T cells, B cells

6. Mycophenolate Mofetil
 Prevents proliferation of activated T lymphocytes
 Inhibits purine synthesis
 Non competitive inhibition of Inosine Monophosphate Dehydrogenase

7. Cyclosporine
 Target- Intracellular signalling pathway (induced by Activated T cells)
 Binds to Immunophilin, inhibit calcineurin catylysed dephosphorylation
 Translocation of nuclear factor of Activated T cells (NFAT)

8. SIROLIMUS
Prevents phosphorylation of p70 kinase
Others-
1. Antilymphocyte Globulin
2. IL-2 receptor antibody – Daclizumab, Basiliximab
3. Antibodies to CD40 ligand

9. THANKS….