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Immunosuppressive Drugs are types of medications that inhibit the activity of the immune system, or the immune response. They are most commonly used in autoimmune diseases and for treating inflammatory processes, but their most well-known purpose is preventing organ rejection in the case of transplantation.

Immunosuppressive drugs have been used in medicine for over half a century. There is a wide range of different immunosuppressive drugs with various mechanisms of action. The biggest drawback of these drugs throughout their use in medicine has been their potential and frequent negative effects or severe side effects.

Negative effects and consequences of immunosuppressive drugs can be very dangerous, such as severe poisoning. However, over the years, immunosuppressives have advanced significantly, with newer generations of drugs being much safer and more refined, reducing the likelihood of serious consequences compared to the oldest medications.

Particularly when it comes to immunosuppressive drugs, it is crucial to choose an appropriate therapy that will be the most effective while simultaneously having the fewest harmful effects on other parts of the body. In the following text, learn all about immunosuppressives, their use for preventing organ rejection, their benefits, and the potential dangers of the therapy.

Immunosuppressive Therapy – Immunosuppressive Drugs for Preventing Organ Rejection

As mentioned, immunosuppressives have a wide range of uses, particularly in treating autoimmune diseases, but also in organ transplantation. Organ transplantation mainly refers to the transplantation of kidneys, hearts, livers, and lungs, and the goal of immunosuppressives is to prevent the recipient's body from rejecting the new organ.

There are three main objectives or purposes of immunosuppressives during transplantation:

1. Prevention of organ rejection;
2. Reduction of the risk of drug toxicity and their unwanted side effects;
3. Reduction of the risk of infection.

The ideal case for immunosuppressive therapy would be to achieve all three mentioned goals using the smallest possible number of drugs, at the lowest doses, which effectively allow for successful patient treatment and transplantation.

Immunosuppressive Drugs for Preventing Organ Rejection in Three Phases

Organ rejection can occur in three phases – hyperacute, acute, and chronic, which are treated with different agents. Hyperacute rejection occurs instantly, or within a few minutes after transplantation, and careful donor selection prevents this type of rejection.

The second type of organ rejection is acute rejection, which occurs 1 to 3 months after transplantation, while chronic rejection refers to a slowly developing manifestation that gradually destroys the donated organ and its functions. Chronic rejection is often caused by chronic inflammation of the organ.

One of the primary goals of immunosuppressive therapy is to prevent acute phases of organ rejection, which occur within a few days of transplantation. Induction therapy is used during the transplantation procedure and continues for 7-10 days afterward.

Depending on numerous factors, with the phase of rejection being only one of them, the immunosuppressive therapy will vary, using drugs such as cyclosporine, tacrolimus, mycophenolic acid, daclizumab, basiliximab, sirolimus, etanercept, infliximab, leflunomide, everolimus, efalizumab, azathioprine, or methotrexate.

Immunosuppressive Therapy for Autoimmune Diseases

Another use of immunosuppressive drugs is in treating autoimmune diseases such as rheumatoid arthritis and inflammatory bowel diseases. Autoimmune diseases are characterized by a condition where the patient's immune system begins to attack and destroy cells and organs within its own body.

An autoimmune disease occurs and develops when the immune system mistakenly recognizes its own cells as foreign. Unlike immunosuppressive drugs for preventing organ rejection that act specifically on a particular organ or region, the treatment of autoimmune diseases typically involves broad immunosuppression.

Immunosuppressive therapy for treating rheumatoid arthritis has proven to be excellent not only for treating symptoms but also for slowing the progression of the disease. Immunosuppressive therapy is also used to treat some ophthalmological issues such as uveitis, which is inflammation of the eye.

Although useful in many cases, the use of immunosuppressive agents should not be taken lightly. For most patients with the aforementioned ophthalmological issues, treatment is usually done with corticosteroids. However, if the patient is allergic to corticosteroids or if the inflammation is severe, immunosuppressive therapy may be an option.

What Are the Potential Dangers of Immunosuppressive Drugs?

Nevertheless, many doctors, especially ophthalmologists, avoid immunosuppressive therapies due to their dangerous side effects. Since immunosuppressive drugs weaken the immune response, the body becomes more susceptible to almost all diseases, including malignant diseases or cancer.

The main problem with immunosuppressive therapy is that these drugs suppress the entire immune system, not just specific parts of it, thus significantly compromising or endangering the organism. Therefore, the first step before introducing immunosuppressive therapy requires a comprehensive analysis of the existing condition.

This includes a complete laboratory report, blood tests, medical history, chest X-ray and pulmonary examination, cardiological examination, Doppler ultrasound of blood vessels, stool and urine cultures, blood sugar levels, and numerous other tests, which based on the obtained parameters will determine if the patient is suitable for this type of therapy.

This is particularly true for treating other diseases, such as ophthalmological conditions, although it should be noted that in these cases, immunosuppressive therapy is advised only when no other options are available.

Although immunosuppressive therapy has significantly advanced with modern medical technology, it still carries numerous challenges, such as the balance between unwanted effects and potency in preventing organ rejection and treating diseases.

Patients on immunosuppressive therapy are also referred to as "immunocompromised patients" because their immune system is weakened and at constant risk of further complications. Although this therapy is sometimes a necessary treatment process, it carries potentially dangerous side effects, and patients should be aware that they may require special and additional care.

If you need additional care services, either at home or in a hospital setting, rely on Eliksir Medical and hire professionals with extensive experience and knowledge who will understand the specific needs of each patient's therapy and provide optimal, personalized care according to individual needs.

Sources:

1. Zdanowicz, Martin. (2009). The Pharmacology of Immunosuppression. American Journal of Pharmaceutical Education. 73.
2. Carnaham, M. C., & Goldstein, D. A. (1999). The Use of Immunosuppressive Drugs in Uveitis. Developments in Ophthalmology, 132–159.