Immunosuppressants

Under certain conditions, immune mechanisms that play an important role in protecting the body from various harmful effects can cause unwanted reactions. Thus, the rejection of transplanted tissues and organs is associated with immunological incompatibility. With tissue incompatibility, the body produces antibodies to the antigens of foreign tissue, which together with lymphoid cells cause its damage and death. According to modern data, some diseases (systemic lupus erythematosus, thrombocytopenic purpura, periarteritis nodosa, autoimmune glomerulonephritis, ulcerative colitis, rheumatoid arthritis, etc.) can be considered as autoimmune processes resulting from the release of specific antigens contained in the body. Under normal conditions, these antigens are in a bound state and do not cause immunopathological reactions. In connection with these reasons, a new direction in the search for drugs that inhibit immunogenesis and suppress the production of antibodies has developed: since antibodies are produced by lymphocytes and plasma cells, chemical compounds that suppress proliferative processes in lymphoid (immunocompetent) tissues and inhibit the biosynthesis of nucleic acids should have immunosuppressive activity. As it turned out, many substances have an immunosuppressive effect.
They are classified as follows: suppressing the immune response in general (for example cytostatics), having a specific immunosuppressive effect (including anti-lymphocytic serum), eliminating reactions accompanying immune processes, having anti-inflammatory and only partially immunosuppressive effects (for example glucocorticoids).
Especially pronounced immunosuppressive activity is inherent in cytostatics – alkylating agents (cyclophosphamide, chlorambucil, thiotepa, prospidium chloride, etc.), antimetabolites (mercaptopurine, fluorouracil, etc.), some antibiotics (dactinomycin, etc.). Representatives of these groups are currently used as immunosuppressants. A specific immunosuppressant is azathioprine, which is similar in structure and action to 6-mercaptopurine. Immunosuppressive drugs can reduce tissue incompatibility and be very effective in treating autoimmune diseases. However, the currently existing drugs do not have sufficient selectivity of action, and their use may be accompanied by side effects. They suppress the production of interferon, inhibit hematopoiesis (leading to leukopenia, thrombocytopenia, anemia and even pancytopenia), a decrease in the general protective functions of the body, activation of a secondary infection, the development of septicemia, with prolonged use, they can contribute to the development of malignant neoplasms. Immunosuppressants (cytostatics, including azathioprine, etc.) should be used according to strict indications in compliance with the necessary precautions.
Below is a list of immunosuppressants:

  • Teriflunomide
  • Tacrolimus
  • Azathioprine
  • Tocilizumab
  • Immunoglobulin antithymocytic (Immunoglobulinum antithymocytarum)
  • Immunoglobulin antithymocytic (Immunoglobulinum antithymocytarum)
  • Leflunomide
  • Penicillamine
  • Immunoglobulin antithymocytic (Immunoglobulinum antithymocytarum)
  • Belimumab
  • Hydroxychloroquine
  • Fingolimod
  • Chloroquine
  • Daclizumab
  • Canakinumab
  • Pomalidomide
  • Cyclosporine
  • Omalizumab
  • Rituximab
  • Mycophenolate mofetil (Mycophenolatis Mofetilum)
  • Mycophenolic acid
  • Methotrexate
  • Belatacept
  • Abatacept
  • Sirolimus
  • Efalizumab
  • Infliximab
  • Everolimus
  • Certolizumab pegol
  • Golimumab
  • Basiliximab
  • Eculizumab
  • Ustekinumab
  • Sodium aurothiomalate
  • Natalizumab
  • Adalimumab
  • Etanercept
  • Tofacitinib