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~Immuno Therapy~
Dr. Arifa Akram
MD Student
Virology Department
Bangabandhu Sheikh Mujib Medical University, Dhaka
Immunotherapy
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
suppression immunotherapies.
`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
immunotherapy.Administering monoclonal
antibodies (mAbs) is a form of passive
immunotherapy.
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.
“Immunomodulators“
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
Agent Example
Interleukins IL-2, IL-7, IL-12
Cytokines
Interferons, G-CSF,
Imiquimod
Chemokines CCL3, CCL26, CXCL7
Other
cytosine phosphate-
guanosine,
oligodeoxynucleotides,
glucans
`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.
5)Vaccination /Immunization
Anti-microbial immunotherapy, which includes
vaccination, involves activating the immune
system to respond to an infectious agent.
Immunization may be active or passive.
`Suppression immunotherapies`
Immune suppression dampens an abnormal immune
response in autoimmune diseases or reduces a normal
immune response to prevent rejection of transplanted
organs or cells.
1)Immunosuppressive drugs
Immunosuppressive drugs are important tools in the
management of organ transplantation and autoimmune
disease. cytotoxic drugs are immunosuppressive.
2)Immune tolerance
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.
3)Allergies
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
therapy).
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.
Antibody
Brand
name
Approval
date
Type Target
Approved
treatment(s
)
Alemtuzum
ab
Campath 2001
humanize
d
CD52
Chronic
lymphocyti
c leukemia
Bevacizum
ab
Avastin 2004
humanize
d
vascular
endotheli
al growth
factor
colorectal
cancer
Brentuxim
ab vedotin
Adcetris 2011 chimeric CD30
Hodgkin
lymphoma,
Anaplastic
large-cell
lymphoma
Cetuximab Erbitux 2004 chimeric
epidermal
growth colorectal
EG:- Cancer immunotherapy:Monoclonal antibodies
Gemtuzu
mab
ozogamici
n
Mylotarg 2000
humanize
d
CD33
acute
myelogeno
us
leukemia
(with
calicheami
cin)
Ibritumom
ab
tiuxetan
Zevalin 2002 murine CD20
non-
Hodgkin
lymphoma
(with
yttrium-90
or indium-
111)
Panitumu
mab
Vectibix 2006 human
epiderma
l growth
factor
receptor
colorectal
cancer
4.Immune Therapies for Infertility.
5.In Allergic Rhinitis & Asthma .
6.Topical immunotherapy agents in skin cancer
7.Vaccination.
Conclusion:
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
effective .

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Immuno therapy~

  • 1. ~Immuno Therapy~ Dr. Arifa Akram MD Student Virology Department Bangabandhu Sheikh Mujib Medical University, Dhaka
  • 2. Immunotherapy 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 suppression immunotherapies.
  • 3. `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.
  • 4. 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 immunotherapy.Administering monoclonal antibodies (mAbs) is a form of passive immunotherapy.
  • 5. 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. “Immunomodulators“ 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
  • 6. Agent Example Interleukins IL-2, IL-7, IL-12 Cytokines Interferons, G-CSF, Imiquimod Chemokines CCL3, CCL26, CXCL7 Other cytosine phosphate- guanosine, oligodeoxynucleotides, glucans
  • 7. `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.
  • 8. 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.
  • 9. 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. 5)Vaccination /Immunization Anti-microbial immunotherapy, which includes vaccination, involves activating the immune system to respond to an infectious agent. Immunization may be active or passive.
  • 10. `Suppression immunotherapies` Immune suppression dampens an abnormal immune response in autoimmune diseases or reduces a normal immune response to prevent rejection of transplanted organs or cells. 1)Immunosuppressive drugs Immunosuppressive drugs are important tools in the management of organ transplantation and autoimmune disease. cytotoxic drugs are immunosuppressive. 2)Immune tolerance 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.
  • 11. 3)Allergies 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
  • 12. `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 therapy). 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.
  • 13. Antibody Brand name Approval date Type Target Approved treatment(s ) Alemtuzum ab Campath 2001 humanize d CD52 Chronic lymphocyti c leukemia Bevacizum ab Avastin 2004 humanize d vascular endotheli al growth factor colorectal cancer Brentuxim ab vedotin Adcetris 2011 chimeric CD30 Hodgkin lymphoma, Anaplastic large-cell lymphoma Cetuximab Erbitux 2004 chimeric epidermal growth colorectal EG:- Cancer immunotherapy:Monoclonal antibodies
  • 14. Gemtuzu mab ozogamici n Mylotarg 2000 humanize d CD33 acute myelogeno us leukemia (with calicheami cin) Ibritumom ab tiuxetan Zevalin 2002 murine CD20 non- Hodgkin lymphoma (with yttrium-90 or indium- 111) Panitumu mab Vectibix 2006 human epiderma l growth factor receptor colorectal cancer
  • 15. 4.Immune Therapies for Infertility. 5.In Allergic Rhinitis & Asthma . 6.Topical immunotherapy agents in skin cancer 7.Vaccination. Conclusion: 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 effective .