Dr. Arifa Akram
Bangabandhu Sheikh Mujib Medical University, Dhaka
Immunotherapy is a medical term defined as the
"treatment of disease by inducing, enhancing, or
suppressing an immune response".
Immunotherapies designed to elicit or amplify an
immune response are classified as activation
immunotherapies, while immunotherapies that
reduce or suppress are classified as
`Types of Immunotherapy1. Active immunotherapy
The basic idea is to give the proper mission
objectives to the T helper cells of the immune system
so that they attack the cancer and continue to attack
it until it is completely destroyed. This is called active
immunotherapy, because the treatment given to the
patient has a direct interaction with the body's
immune system. Active immunotherapy can be
achieved by administering cytokines, such as
interferons (IFNs) and interleukins (IL-2), which
triggers non-specific stimulation of numerous
immune cells. It divides into:
Non-Specific Active Immunotherapy:
Specific Active Immunotherapy.
2. Passive immunotherapy
The other method of immunotherapy is to
develop new ways to "create" antibodies and
other types of cells that mimic the immune
system of the human body. These synthesized
cells are usually designed to attack cancer
cells directly through the use of toxins and
radioactive materials without interacting with
the body's natural immune system. Due to its
lack of interaction with the immune system,
this is referred to as passive
antibodies (mAbs) is a form of passive
3. Non-Specific ImmunotherapiesThere are other forms of immunotherapies that
do not attack a specific antigen or tumor cell.
Instead, a non-specific immunotherapy is
designed to boost the performance of the
immune system to make the cells that travel
throughout the body more powerful and efficient.
The active agents of immunotherapy are
collectively called immunomodulators. They are a
diverse array of recombinant, synthetic and
natural preparations, often cytokines.
Immunomodulatory regimens offer an attractive
approach as they often have fewer side effects
than existing drugs, including less potential for
`Activation immunotherapies`1)Cancer :
Cancer immunotherapy attempts to stimulate the
immune system to reject and destroy tumors. BCG
immunotherapy .Topical immunotherapy in skin
cancer & Injection immunotherapy uses mumps,
candida the HPV vaccine.
2)Autologous Immune Enhancement Therapy:
Autologous immune enhancement therapy (AIET)
is a treatment method in which immune cells are
taken out from the patient's body which are
cultured and processed to activate them until their
resistance to cancer is strengthened and then the
cells are put back in the body.
3)T-cell adoptive transfer
This can be achieved by taking T cells that are
found with the tumor of the patient, which are
trained to attack the cancerous cells. These T
cells are referred to as tumor-infiltrating
lymphocytes (TIL) are then encouraged to
multiply in vitro using high concentrations of IL-2,
anti-CD3 and allo-reactive feeder cells. These T
cells are then transferred back into the patient
along with exogenous administration of IL-2 to
further boost their anti-cancer activity.
4)Immune recoveryThe potential use of immunotherapy to restore
the immune system of patients with immune
deficiencies as result of infection or
chemotherapy. For example cytokines have
been tested in clinical trials interleukin-7 has
been in clinical trials for HIV and cancer
patients. In addition, interleukin-2 has also
been tested in HIV patients.
Anti-microbial immunotherapy, which includes
vaccination, involves activating the immune
system to respond to an infectious agent.
Immunization may be active or passive.
Immune suppression dampens an abnormal immune
response in autoimmune diseases or reduces a normal
immune response to prevent rejection of transplanted
organs or cells.
Immunosuppressive drugs are important tools in the
management of organ transplantation and autoimmune
disease. cytotoxic drugs are immunosuppressive.
Immune tolerance is the process by which the body
naturally does not launch an immune system attack on its
own tissues. Immune tolerance therapies seeks to reset
the immune system so that the body stops mistakenly
attacking its own organs or cells in autoimmune disease or
accepts foreign tissue in organ transplantation.
The Allergen immunotherapy is indicated for people who are
extremely allergic or who cannot avoid specific allergens. For
example, they may not be able to live a normal life and
completely avoid pollen, dust mites, mold spores, pet dander,
insect venom, and certain other common triggers of allergic
reactions. Immunotherapy is generally not indicated for food
or medicinal allergies. This therapy is particularly useful for
people with allergic rhinitis or asthma. Sublingual
immunotherapy involves putting drops or tablets of allergen
extracts under the tongue of a patient with allergic reactions
and then swallowing the extracts. It allows the organism to
become tolerant to the allergen by absorbing the allergen
through the stomach lining. Subcutaneous immunotherapy
is the historical route of administration and consists of
allergen extract injections. Subcutaneous immunotherapy
can only be performed with a medical observation. Although
efficacy of subcutaneous immunotherapy has been
demonstrated by several studies, subcutaneous
immunotherapy entails the risk of systemic anaphylactic
`Application of Immune Therapy`
1. Helminthic therapies in case of relapsing remitting
multiple sclerosis,Crohn’s, allergies and asthma.
2.Radioimmunotherapy in case of Lymphoma.
3. Immunotherapy to Attack Cancer( Monoclonal antibody
Advantages over ordinary monoclonal antibodies:
Cancer immunotherapy with ordinary monoclonal
antibodies does not activate T-lymphocytes because this
type of cell does not possess Fc receptors, so the Fc
region cannot bind to them, and the Fab regions are
already used for binding the tumour cells. Bispecific
antibodies have a higher cytotoxic potential.
Adcetris 2011 chimeric CD30
Cetuximab Erbitux 2004 chimeric
EG:- Cancer immunotherapy:Monoclonal antibodies
Zevalin 2002 murine CD20
Vectibix 2006 human
4.Immune Therapies for Infertility.
5.In Allergic Rhinitis & Asthma .
6.Topical immunotherapy agents in skin cancer
Immunotherapy is a type of biological therapy that
utilizes a person's natural immune defense system to
fight disease.Today scientists are discovering ways in
which immunotherapy can be used as a stand-alone
treatment for cancer and a adjuvant (supplemental)
treatment to make current cancer treatments more