Learning unit: Principles of immunotherapy


Impact of the learning unit:

Immunologic mechanisms of action are used therapeutically in different indications. For instance,
immune suppression in rheumatology or transplantology, and immune stimulation in infectious
diseases and oncology.  Physicians need to know how to pharmacologically influence immune functions
and which drugs are used for it.


Relevant terms

immunosuppressants

immune suppression as adverse effect

glucocorticoids

                               iatrogenic Cushing syndrome

                               hydrocortisone

                               prednisone

                               prednisolone

                               methylprednisone

                               triamcinolone

                               dexamethasone

                               betamethasone

                calcineurin inhibitors

                               ciclosporin A

                               tacrolimus

mTOR inhibitors

sirolimus

antimetabolites

methotrexate

azathioprine

mycophenolate mofetil

                biological drugs

                               etanercept

                               adalimumab

                               rituximab

                               basiliximab

immunostimulants

autoimmune adverse effects

cytokines

                interferon alpha

                interferon beta

                interferon gamma

                normal human immunoglobulin

immune checkpoints inhibitors

                ipilimumab

                nivolumab

dendritic cell therapy as an example of somatic cell immunotherapy


Learning outcomes

Student explains the mechanism of effect of selected immunosuppressants and immunostimulants and
derives their adverse effects.

Student is oriented in general indications of immunosuppressant and immunostimulants and gives
examples of drugs and their clinical use.

Student knows basic pharmacological profile (mode of action, unwanted effects, indications and
contraindications) of immunostimulants and suppressants.

Student knows synthetic glucocorticoids, their potency, and duration of effect.

Student chooses appropriate dosage form according to the indication of glucocorticoid. Student
describes the adverse effects of long-term glucocorticoid therapy and how to manage them.

Student knows basic pharmacological profile (mode of action, unwanted effects, indications and
contraindications) of glucocorticoids.

Study materials

Lecture

Rang & Dale's Pharmacology, 8th edition, 2016, chapter 26 (Anti-inflammatory and immunosuppressant
drugs: subchapter Antirheumatoid drugs, Anticytokine drugs and other biopharmaceuticals), and
chapter 33 (The pituitary and the adrenal cortex)

Study materials for courses aVLFA0721p and aVLFA0721c.

Exam questions

Special pharmacology: 6. Glucocorticoids, 7. Immunostimulants + immunosuppressants (except
glucocorticoids)

Essential drugs: 18. dexamethasone, 19. prednisone, 20. cyclosporine, 21. interferons, 22.
methotrexate