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Example research essay topic: Rheumatoid Arthritis Multiple Sclerosis - 2,060 words

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... f cells. However, recent research suggests that autoimmune diseases maybe due to the dys regulation of the immune system, and that poor thymus functioning results in T 4 Helper cells losing control of humoral immunity so that antibodies lose their specificity and attack host cells (Beardsley, 1997). Thus immuno modulation in this area could be highly effective. It must be stated that this is merely a theory and that extensive testing is still needed in this area before such drugs can be used safely to treat these disorders.

It would appear that immuno modulation is a new and exciting area to be explored with many potential benefits. A selection of these new drugs including levamisole, thymic peptides, roquinimex, and cyclophosphamide will be described in more detail. Levamisole Levamisole (eramisole) is an immuno modulating agent administered orally with the effect of increasing the number of T-cells. It has been shown to be effective in the treatment of Hodgkins disease, and is approved by the FDA for the treatment of colorectal cancer after surgery. Recently, levamisole has been tested in the treatment of rheumatoid arthritis with some efficacy.

The side effects involved include mild nausea, stomach pain, dizziness, headache and fatigue (Katzung, 1998). It would appear that there is insufficient research concerning this drug, thus the likelihood that it will be marketed for clinical use in the near future is markedly reduced. Thymosin & other thymic peptides Thymic activity is critical to T cell maturation, only mature cells can effectively combat cancer cells and infectious agents. Thymosin conveys specificity to immature lymphoid stem cells and therefore increases the number of active T-cells (Katzung, 1998).

However, it has not been yet approved by the FDA (Beardsley, 1997) despite its successes in trials in treatment of diseases of T-cell deficiency such as Di Georges syndrome (Katzung, 1998). Thymic protein A has proved beneficial in the treatment of hepatitis C, cancer and certain immune disorders via the stimulation of the cell mediated immune system (Beardsley, 1997). Thymopentin and Thymic humoral factor have also been used to treat AIDS as well as cancer and hepatitis. However, other trials suggest that thymosin may stimulate the pituitary-adrenal system, resulting in an increase of serum corticosteroids and the decrease of thymic hormone production. Therefore the impairment of the immune functioning will result from thymic treatments rather than the intended increase of the immune response (Bard et.

al. , 1990) Such new immuno modulators certainly need extensive research before a more suitable form can be identified. Cyclophosphamide Cyclophosphamide (cyton, near) is traditionally an immunosuppressant used to suppress a variety of humoral and cell-mediated immune functions (Dale et. al. , 1994). However, new developments have proved the immuno modulating function of the drug. Low doses given prior to immunisation with a tumour vaccine can augment the immune response (Katzung, 1998). As such, cyclophosphamide can be used to treat Hodgkins disease, lymphomas, leukemias and other tumours.

Rheumatoid arthritis can also be treated by the immuno modulating features of this drug which can be achieved at higher doses than are necessary for immunosuppression (Shorthouse, 1996). Recently, this drug has been used in trials to treat chronic -progressive multiple sclerosis. However, the benefits proved to be inadequate in balance with the side-effects which included hair loss, fever, oral ulcers (Panitch, 1996), nausea, vomiting, thrombocytopenia, leucopenia and anorexia (Shorthouse, 1996). Teratogenic effects make the drug unsuitable for pregnant or breast feeding women and long term toxicities include bladder cancer and acute non lymphocytic leukemia (Panitch, 1996). In conclusion it appears cyclophosphamide may have some benefit in short-term immuno modulation, particularly as a cytotoxic agent, but long term, high doses will produce a plethora of side effects. THC & marijuana Trials in the United States of America in 1995 have tested the use of marijuana in immuno modulation.

THC is the component of interest in marijuana which has been demonstrated to enhance the production and release of pro-inflammatory cytokines from macrophages. The study has also found impairment of immunological functions in persistent marijuana smokers. However, the conclusion is that THC is an excellent tool for studying the mechanisms of immuno modulation, especially altered susceptibility to microbial infection (Friedman et. al. , 1995) but further intensive study is needed. Roquinimex Roquinimex (linomide) is not an immunosuppressant, it activates lymphocyte and natural killer cells, therefore acting as an immuno modulator (Panitch, 1996). By stimulating a variety of B and T-cell functions it has been used to treat acute and chronic relapsing multiple sclerosis, with a marked reduction in relapses, disease activity and progression (Katzung, 1998).

Although the mechanisms of action themselves are not fully understood it is thought that via activating T-cells these drugs stimulates the production of regulatory cytokines that suppress inflammation and prevent myelin deterioration (Panitch, 1996). Trials in prostate tumour treatment have proved that roquinimex is the most effective drug with a sixty-nine percent inhibition of tumour growth (Joseph & Isaccs, 1998). Thus roquinimex is emerging as a promising new treatment for cancer and multiple sclerosis. CONCLUSION To conclude, recent literature suggests that research into immunosuppression is more wide spread than in the area of immuno modulation. This newer concept certainly needs further investigation but has many potential benefits especially in the treatment of AIDS. Many other agents such as new vaccines and alternatives to antibiotics are being developed, unfortunately due to certain constraints they are beyond the scope of this review.

As understanding of natural immune mechanisms is increased, further manipulation of the immune system will be possible. As the millennium begins it appears that the future of immunopharmacology is promising. REFERENCES Bard, D. R; Knight, C. G. & Page-Thomas, D. P. (1990) A Chelating Derivative of Alpha-Melanocyte Stimulating Hormone As A Potential Imaging Agent For Malignant Melanoma AT web > Barron, K. (1996) Mycophenalate Mofetil (Cell cept) A New Immunosuppressant Agent AT web > Beardsley, T.

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immune response, clinical pharmacology, hodgkins disease, rheumatoid arthritis, multiple sclerosis

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