This document discusses the effects of immunosuppression on various body systems and endocrine function. It begins by classifying different types of immunosuppressants and describing their mechanisms of action. The document then examines how immunosuppression can lead to hyperglycemia, reproductive dysfunction, decreased bone density, muscle weakness, kidney damage, gastrointestinal issues, increased risk of infection and cancer, adrenal gland effects, neurological and psychiatric side effects, eye problems, heart issues, and liver toxicity. In conclusion, the widespread effects of immunosuppression throughout the body are summarized.
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immunosupressant and endocrine dysfunction.pptx
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P. E. Society’s Modern College of Pharmacy, Moshi Pune - 44
Presented by:
Pallavi kakade
Assistant Professor
Pharmacology
Immunosuppression and
Endocrine Dysfunction
3. General Principle of Immunosuppression
Primary immune responses are more easily repressed
than secondary (memory)
Suppression is more likely to be achieved if therapy is
begun before exposure to the immunogen
Different immunosuppressants have different effects
on different immune reactions and mediators
Immunosuppression involves an act that reduces the
activation or efficacy of the immune system
4. Aim and objectives
Advances in transplant immunosuppression
Have contributed to the-
Decrease in the frequency of acute rejection.
Increase in graft survival .
longevity for renal allograft recipients.
Longevity for renal allograft recipients
For the treatment of auto-immune diseases such
as rheumatoid arthritis or crohn’s disease.
8. Immunosuppression and Hyperglycemia
Decreased insulin secretion and insulin sensitivity.
Decreased glucokinase activity and reduced insulin
gene expression .
Decreases Akt (also known as protein kinase B)
phosphorylation in the liver, which is a key step in
insulin signal transduction.
Proliferation of beta cells .
Apoptosis human islets.
Hypertriglyceridemia.
9. Immunosuppression and Hyperglycemia
To characterize this complication, including random
blood glucose ≥ 200 mg/dl, fasting blood glucose ≥
140 mg/dl.
Which leads to increase blood glucose level and cause
diabetic mellitus.
It is major effect of immunosuppressant.
13. Bone disorders
Multiple causes of poor bone density
Weak
bones
Hypogonadism
Low Vitamin
D &
parathyroid
gland failure
Iron overload
? Low Growth hormone Diabetes mellitus
Glucocorticoids
14. Immunosuppression and Muscle
Decreases muscle function.
Decreases co-ordination between different types of
muscle fibres to contract and relax .
Decreases adaptability of fibres.
Tingling of the hands and feet, hand tremors.
Decrease muscle protein production and decrease the
ability of the muscle to produce muscle energy in an
effective manner.
Muscle weakness.
15. Immunosuppression and Kidney
Causes nephrotoxicity .
Causes small arteries branches to constrict or smaller
causing high blood pressure .
Causes high levels of potassium and low levels of
magnesium in the blood.
Renal failure.
17. Immunosuppression and GIT
Enhances the secretion of gastric acid and pepsin.
Due to that GIT disturbances occurs.
Increases enzyme level in GIT and it disturb
metabolic process.
Causes various symptoms like -----
20. Immunosuppression and Infection
Weaken the immune system
Less body resistance to infection
Difficult to treat infection
Decreases platelet count
Decreases red and white blood count
21. Immunosuppression and Cancer
Immunosuppressant drugs are also associated with a
slightly increased risk of cancer.
Bladder cancer, also thought to be due to
accumulation in bladder
The immune system also plays a role in protecting the
body against some forms of cancer.
For example, long-term use of immunosuppressant
drugs carries an increased risk of developing skin
cancer as a result of the combination of the drugs and
exposure to sunlight.
22. Immunosuppression and Adrenal gland
Long term administration immunosuppressant
causes-
Cushing’s syndrom(excessive levels of cortisol in
the blood) symptom -moon face, buffalo hump,
thinning of skin.
23. Immunosuppression and CNS
It cross links DNA, interferes with RNA synthesis and
inhibits the enzyme topoisomerase II.
Ii is used for reducing neurologic disability.
Interferes in purine nucleotide synthesis and
metabolism
Inhibits the enzyme inosine monophosphate
dehydrogenase, and as a consequence, it decreases de
novo guanosine nucleotide synthesis.
25. Immunosuppression and CNS
Difficulty controlling emotion.
Difficulty in maintaining train of thought psychosis,
or other psychiatric symptoms.
Unusual fatigue or weakness.
Mental confusion/ indecisiveness
28. Immunosuppression and Heart
Reduce capillary permeability thereby reducing fluid
exudation causes positive inotropic effect prolong use
causes hypertension.
Change tone of arterioles causes artrities.
They interact with s1p3 receptor results in slowing of
the sinoatrial node and reactivation of g-protein-
activated potassium channels 1 and 4.
It has similar effects on the atrioventricular (AV)
node bradycardia and results AV block.
Causes heart failure.
29. Immunosuppression and liver
Direct damage to hepatocytes.
Enhance infection of hepatitis b and hepatitis c virus .
Hepatotoxicity due to elevation of -------
Serum alkaline phosphatase
Bilirubin
Serum transaminases .
30. Summary
Immunosupressant are drugs which inhibit immunity.
It is necessary to suppress immune reaction in organ
transplantation.
It is necessary to suppress immune reaction
autoimmune disorders.
Effect of immunosupresent on endocrine and other
organ of body.
31. Conclusion
Immunosuppressant causes hyperglycemia .
It causes hypertension ,nephrotoxicity, bone density.
It causes endocrine disturbance.
Study of effect on CNS ,reproductive dysfunction ,
susceptibility to infection .
Risk of causes cancer.
32. References –
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al. (2007) results of an international, randomized trial
comparing glucose metabolism disorders and outcome with
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2. Hjelmesaeth j, hartmann a, leivestad t, holdaas h, sagedal s, et
al. (2006) the impact of early-diagnosed new-onset post-
transplantation diabetes mellitus on survival and major
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3. Kasiske bl, snyder jj, gilbertson d, matas aj (2003) diabetes
mellitus after kidney transplantation in the united states. Am J
transplant 3: 178-185.
4. 3. John PR, Thuluvath PJ (2002) Outcome of patients with
new-onset diabetes mellitus after liver transplantation
compared with those without diabetes mellitus.
33. References
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SJ (2011) New- Onset Diabetes After Kidney
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34. References
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sirolimus: mechanisms of action and applications in
dermatology Clin exp dermatol 27: 555-561.
10 Halloran pf (2001) mechanism of action of the calcineurin
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11 Bierer be, mattila ps, standaert rf, herzenberg la, burakoff sj,
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