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a drug that lowers the bodys normal immune response (同)immunosuppressor, immunosuppressive_drug, immunosuppressive, immune suppressant drug

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/10/31 14:05:46」(JST)

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Immunosuppression is a reduction of the activation or efficacy of the immune system. Some portions of the immune system itself have immunosuppressive effects on other parts of the immune system, and immunosuppression may occur as an adverse reaction to treatment of other conditions.

In general, deliberately induced immunosuppression is performed to prevent the body from rejecting an organ transplant, treating graft-versus-host disease after a bone marrow transplant, or for the treatment of auto-immune diseases such as systemic lupus erythematosus, rheumatoid arthritis or Crohn's disease. This is typically done using medications, but may involve surgery (spleen removal), plasmapharesis, or radiation.

A person who is undergoing immunosuppression, or whose immune system is weak for other reasons (for example, chemotherapy or HIV), is said to be immunocompromised. An immunosuppressant is any agent that weakens the immune system, including immunosuppressive drugs and some environmental toxins.

Deliberately induced

Administration of immunosuppressive medications or immunosuppressants is the main method of deliberately induced immunosuppression. In optimal circumstances, immunosuppressive drugs are targeted only at any hyperactive component of the immune system, and in ideal circumstances would not cause any significant immunodeficiency. However, in essence, all immunosuppressive drugs have the potential to cause immunodeficiency. Immunodeficiency may manifest as increased susceptibility to opportunistic infections and decreased cancer immunosurveillance. The term immunotoxin is also sometimes used (incorrectly) to label undesirable immunosuppressants, such as various pollutants. Immunosuppressants may be prescribed when a normal immune response is undesirable, such as in autoimmune diseases.

Cortisone was the first immunosuppressant identified, but its wide range of side-effects limited its use. The more specific azathioprine was identified in 1959, but it was the discovery of cyclosporine in 1970 that allowed for significant expansion of kidney transplantation to less well-matched donor-recipient pairs as well as broad application of liver transplantation, lung transplantation, pancreas transplantation, and heart transplantation. After an organ transplantation, the body will nearly always reject the new organ(s) due to differences in human leukocyte antigen haplotypes between the donor and recipient. As a result, the immune system detects the new tissue as "foreign", and attempts to remove it by attacking it with recipient white blood cells, resulting in the death of the donated tissue. Immunosuppressants are given as an attempt to prevent this rejection; the side-effect is that the body becomes more vulnerable to infections and malignancy, much like in an advanced HIV infection.

Throughout its history, radiation therapy has been used to decrease the strength of the immune system. Dr. Joseph Murray of Harvard Medical School and chief plastic surgeon at Children's Hospital Boston from 1972-1985 was awarded the Nobel Prize in Physiology or Medicine in 1990 for his work on immunosuppression.

Non-deliberate immunosuppression

Non-deliberate immunosuppression can occur in, for example, malnutrition, aging, many types of cancer (such as leukemia, lymphoma, multiple myeloma), and certain chronic infections such as Human Immunodeficiency virus (HIV).^[1] The unwanted effect in non-deliberate immunosuppression is immunodeficiency that results in increased susceptibility to pathogens such as bacteria, viruses, or fungi.

Immunodeficiency is also a potential adverse effects of many immunosuppressant drugs. In this sense, the scope of the term immunosuppression in general includes both beneficial and potential adverse effects of decreasing the function of the immune system, whereas the term immunodeficiency in general refers solely to the adverse effect of increased risk for infection.

References

^ Abbas, Abul K.; Lichtman, Andrew H. (29 January 2010). Basic Immunology: Functions and Disorders of the Immune System. Saunders/Elsevier. ISBN 978-1-4160-5569-3.

UpToDate Contents

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1. 移植片対宿主病の予防および治療に使用される免疫抑制剤の概要 overview of immunosuppressive agents used for prevention and treatment of graft versus host disease
2. Overview of immunosuppressive and conventional (non-biologic) disease-modifying drugs in the rheumatic diseases
3. 成人の腎移植における免疫抑制維持療法 maintenance immunosuppressive therapy in renal transplantation in adults
4. 免疫抑制療法に関連したB型肝炎ウイルス再活性化 hepatitis b virus reactivation associated with immunosuppressive therapy
5. 成人の腎移植における免疫抑制誘導療法 induction immunosuppressive therapy in renal transplantation in adults

English Journal

Cytomegalovirus Pneumonia in Patients with Rheumatic Diseases After Immunosuppressive Therapy: A Single Center Study in China.

Xue Y, Jiang L, Wan WG, Chen YM, Zhang J, Zhang ZC1.
Chinese medical journal.Chin Med J (Engl).2016 5th Feb;129(3):267-273. doi: 10.4103/0366-6999.174490.
BACKGROUND: Rheumatic diseases involve multiple organs that are affected by immunological mechanisms. Treatment with corticosteroids and immunosuppressive agents may also increase the frequency of infection. Cytomegalovirus (CMV) is a widespread herpes virus and a well-recognized pathogen, which cau
PMID 26831226

Neurologic Complications of Commonly Used Drugs in the Hospital Setting.

Dawson ET1, Hocker SE2,3.
Current neurology and neuroscience reports.Curr Neurol Neurosci Rep.2016 Apr;16(4):35. doi: 10.1007/s11910-016-0636-7.
This chapter reviews the neurologic complications of medications administered in the hospital setting, by class, introducing both common and less common side effects. Detail is devoted to the interaction between pain, analgesia, sedation, and their residual consequences. Antimicrobials are given in
PMID 26905071

Japanese Journal

縦隔リンパ節腫脹から気管内浸潤と心嚢水貯留をきたした肺クリプトコッカス症の1例

沼田岳士,児玉孝秀,山田英恵,佐藤信也,小川良子,本間晋介,栗島浩一,坂本透,酒井光昭,佐藤幸夫,南優子,檜澤伸之
気管支学 : 日本気管支研究会雑誌 34(5), 456-461, 2012-09-25
背景.免疫不全宿主に生じる肺クリプトコッカス症では,肺野結節影に加え浸潤影や胸水貯留など様々な臨床所見を呈することがある.症例. 71歳女性.肺腺癌の手術歴があり,重症筋無力症のため胸腺摘出術後に免疫抑制剤の投与を受けていた.慢性咳嗽のため近医受診し,胸部CTにて左肺上葉結節影,縦隔リンパ節腫脹,心嚢水,両側胸水が認められたため,肺癌の再発を疑われ紹介受診となった.気管支鏡検査では気管前壁にポリー …
NAID 110009518310

視神経脊髄炎(NMO)の治療をめぐって

藤原一男
日本臨床免疫学会会誌 = Japanese journal of clinical immunology 35(2), 129-135, 2012-04-28
視神経脊髄炎（Neuromyelitis Optica, NMO）は重度の視神経炎と横断性脊髄炎を特徴とする免疫性中枢神経疾患でありDevic病とも呼ばれてきた．NMOは女性に多く，重度の機能障害を遺し，脊髄病変は3椎体以上の長い病変を呈する．脳病変もまれではない．NMOと多発性硬化症（MS）の関係は長い間議論されてきたが，NMO患者の血中には疾患特異的な自己抗体（抗aqu …
NAID 10030573799

Related Pictures

immunosuppressants, which can be available prevention of rejectionafter organ Immunosuppressants are administered under here: Home > Pharmacy > Immunosuppressants Immunosuppressants for organ transplants Immunosuppressants Used in Kidney Failure

★リンクテーブル★

リンク元	「超急性拒絶反応」「慢性拒絶反応」「急性拒絶反応」

「超急性拒絶反応」

Immunosuppression
	Intervention
	Micrograph showing an opportunistic infection due to immunosuppression - large (blue) cell below-center-left infected with a polyomavirus. Urine cytology specimen.
MeSH	D007165

　　[★]

英: hyperacute rejection
関: 移植免疫、拒絶反応

移植直後から24時間以内に起こる激しい拒絶反応。
腎移植の時は、ドナーの血清とレシピエントのT細胞を使って抗体抗原反応が起きないか調べる。抗原はHLA class Iである。(HIM.1777)
移植腎で超急性拒絶反応が起こったときは次の病理像が見られる：neutrophils, immunoglobulin, and complement in vessel walls

反応機序：液性免疫。レシピエントの抗HLA抗体の存在による
治療法：臓器摘出

hyperacute rejection	Antibody mediated due to the presence of preformed antidonor antibodies in the transplant recipient. Occurs within minutes after transplantation.
acute rejection	Cell mediated due to cytotoxic T lymphocytes reacting against foreign MHCs. Occurs weeks after transplantation. Reversible with immunosuppressants such as cyclosporin and OKT3.
chronic rejection	Antibody-mediated vascular damage (fibrinoid necrosis); Occurs months to years after transplantation. Irreversible.

「慢性拒絶反応」

　　[★]

英: chronic rejection
同: 慢性拒否反応
関: 拒絶反応

hyperacute rejection	Antibody mediated due to the presence of preformed antidonor antibodies in the transplant recipient. Occurs within minutes after transplantation.
acute rejection	Cell mediated due to cytotoxic T lymphocytes reacting against foreign MHCs. Occurs weeks after transplantation. Reversible with immunosuppressants such as cyclosporin and OKT3.
chronic rejection	Antibody-mediated vascular damage (fibrinoid necrosis); Occurs months to years after transplantation. Irreversible.

「急性拒絶反応」

　　[★]

英: acute rejection

hyperacute rejection	Antibody mediated due to the presence of preformed antidonor antibodies in the transplant recipient. Occurs within minutes after transplantation.
acute rejection	Cell mediated due to cytotoxic T lymphocytes reacting against foreign MHCs. Occurs weeks after transplantation. Reversible with immunosuppressants such as cyclosporin and OKT3.
chronic rejection	Antibody-mediated vascular damage (fibrinoid necrosis); Occurs months to years after transplantation. Irreversible.

[AbbasLichtman2010-1] Abbas, Abul K.; Lichtman, Andrew H. (29 January 2010). Basic Immunology: Functions and Disorders of the Immune System. Saunders/Elsevier. ISBN 978-1-4160-5569-3.

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immunosuppressants