Chapter 20. Therapeutic Modulation of Cellular Mediated Immunity

Abstract

Cell mediated immunity (CMI) is thought to play a crucial role in chronic infection from fungi, bacteria, viruses, and parasites in immunity to soluble proteins, in reactions against tumors and transplants, in contact sensitivity, and in some autoimmune diseases. There has been a considerable recent interest in immunotherapy that, unlike chemotherapy, attempts to modify the immune mechanism of the host. The immuno-regulatory mediators of CMI— namely lymphokines (including interferon)and monokines —have been classified into factors that influence cell proliferation, cell motility, and cell activation research on these soluble products has been discussed extensively in this chapter. The chapter describes the specificity of such agents for the development of new immuno-modulators. The immunopharmacologic evaluation of these agents is fraught with problems and is dependent on a multitude of factors, such as the species, age, sex, strain (genetics), biorhythm, nutritional status, environmental conditions, and concurrent infection of the animal used, as well as the dose, route, duration, and time of administration of the agent. Where tumor, pathogen, or antigen is involved in response, the immunonenicity, dose and site of administration are also important. New data and reviews have been reported on the peptidoglycans and the β-1,3 polysaccharides, including lentinan, glucan, krestin (PSK), schizophyllan (SPG), mannan, mannosyn, and the β-2,6 fructan, levan. Detailed discussion is made on peptides, neuroendocrine agents, H 2 -antagonists, antimicrobial agents, sex hormones, retinoids, modulators of arachidonic acid metabolism, polymers, levamisole and related compounds, isoprinosine and related compounds, monoclonal antibodies (McAbs) and metals, and their structures and uses in immunotimulatory effects. Miscellaneous agents CCA, IG-10, and azimexon have also been discussed in the chapter.