Immune system modifiers / Immunosuppressives / Glucocorticoids
1. Glucocorticoids: DEXAMETHASONE, PREDNISONE
Mechanism of action (immune system)
-
naturally occurring compound is cortisol - interfere with the concentration, distribution and function of leukocytes
- increases the concentration of neutrophils; decreases T & B lymphocytes, monocytes, eosinophils and basophils
- end result is decrease in cytokine release, including decreases in IL-2 and TNF α
- decreases size of lymph nodes and spleen
- most steroid-sensitive cancers have specific receptors for corticosteroids (e.g., prednisone-sensitive lymphomas)
- PREDNISONE is used in the MOPP treatment for Hodgkin's disease
The glucocorticoids DEXAMETHASONE and PREDNISONE, are used as immunosuppressants in the treatment of many types of cancers --- specifically those that express the requisite receptors (e.g., prednisone-sensitive lymphomas). When used in cancer chemotherapy, these agents are given in higher doses, using a “pulse” regimen, compared to their use in treating inflammatory diseases (asthma, arthritis, lupus, etc.). |
 |
- due to differences in the nature of cell division between cancer cells and normal immune system cells, the dosing regimens are different when these drugs are used as antineoplastics vs. conventional immunosuppression
Cancer cells |
Normal immune system |
|
Trigger for cell division |
Unstimulated |
Specific antigen |
Cell division |
Random |
Synchronized |
Chemotherapy |
Immunosuppression |
|
Drug administration |
High dose, "pulse" |
Low dose, continuous |