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Immunotherapy refers to a treatment strategy aimed at modulating the immune system to achieve a prophylactic and/or therapeutic goal.
Reasons For Use
Vaccination is in fact anti-microbial immunotherapy, which involves activating the immune system to respond to an infectious agent.
Cancer immunotherapy attempts to stimulate the immune system to reject and destroy tumors. BCG immunotherapy for early stage (non-invasive) bladder cancer utilizes instillation of attenuated live bacteria into the bladder, and is effective in preventing recurrence in up to two-thirds of cases.
Topical immunotherapy utilizes an immune enhancement cream (imiquimod) which is an interferon producer causing the patients own killer T-cells to destroy warts, actinic keratoses, basal cell cancer, squamous cell cancer, cutaneous lymphoma, and superficial malignant melanoma.
Injection immunotherapy uses mumps, candida or trichophytin antigen injections to treat warts (HPV induced tumors).
Dendritic cell-based immunotherapy utilizes dendritic cells to activate a cytotoxic response towards an antigen. Dendritic cells, an antigen presenting cell, are harvested from a patient. These cells are then either pulsed with an antigen or transfected with a viral vector. The activated dendritic cells are then placed back into the patient; these cells then present the antigens to effector lymphocytes (CD4+ T-cells, CD8+ T-cells, and in specialized dendritic cells, B-cells also). This initiates a cytotoxic response to occur against these antigens and anything that may present these antigens. One use for this therapy is in cancer immunotherapy. Tumor Antigens are presented to dendritic cells, which cause the immune system to target these antigens, which are often expressed on cancerous cells.
T-cell based adoptive immunotherapy uses T-cell-based cytotoxic responses to attack cancer. In brief, T-cells that have a natural or genetically engineered reactivity to a patient's cancer are expanded in vitro using a variety of means and then adoptively transferred into a cancer patient. T-cells with a naturally-occurring reactivity to a patient's cancer can be found infiltrated in the patients own tumors. The tumor is harvested, and these tumor-infiltrating lymphocytes are expanded in vitro using high concentrations of interluekin-2 (IL-2), anti-CD3 and allo-reactive feeders. These T-cells are then transferred back into the patient along with exogenous administration of IL-2. Thus far, a 51% objective response rate has been observed; in some patients, tumors shrank to indetectable size.
In the case of engineered T-cells, T-cell receptors (TCR) that have been identified to have reactivity against tumor associated antigens are cloned into a replication incompetent virus that is capable of genomic integration. A patient's own lymphocytes are exposed to these viruses and then expanded non-specifically or stimulated using the engineered TCR. The cells are then transferred back into the patient. This therapy has been demonstrated to result in objective clinical responses in patients with refractory stage IV cancer.
Immune suppression dampens an abnormal immune response in autoimmune diseases or reduces a normal immune response to prevent rejection of transplanted organs or cells.
Immune tolerance is the process by which the body naturally does not launch an immune system attack on its own tissues. Immune tolerance therapies seeks to reset the immune system so that the body stops mistakenly attacking its own organs or cells in autoimmune disease or accepts foreign tissue in organ transplantation. A brief treatment should then reduce or eliminate the need for life-long immunosuppression and the chances of attendant side-effects, in the case of transplantation, or preserve the body's own function, at least in part, in cases of type 1 diabetes or other autoimmune disorders.
Allergy immunotherapy is used to treat allergies. While other allergy treatments (such as antihistamines or corticosteroids) treat only the symptoms of allergic disease, immunotherapy is the only available treatment that can modify the natural course of the allergic disease, by reducing sensitivity to allergens.
Immunotherapy is generally not indicated for food or medicinal allergies.
A 3-to-5-year individually-tailored regimen of injections may result in long-term benefits. Recent research suggests that patients who complete immunotherapy may continue to see benefits for years to come. Immunotherapy does not work for everyone and is only partly effective in some people, but it offers allergy sufferers the chance to eventually reduce or stop symptomatic/rescue medication.
The therapy is indicated for people who are extremely allergic or who cannot avoid specific allergens. For example, they may not be able to live a normal life and completely avoid pollen, dust mites, mold spores, pet dander, insect venom, and certain other common triggers of allergic reactions.
Immunotherapy is typically individually-tailored and administered by an allergist (allergologist). Injection schedules are available in some healthcare systems and can be prescribed by family physicians. This therapy is particularly useful for people with allergic rhinitis or asthma.
The therapy is particularly likely to be successful if it begins early in life or soon after the allergy develops for the first time. Immunotherapy involves a series of injections of 'allergy extract' given regularly for several years by a specialist in a hospital clinic. The first shots contain very tiny amounts of the allergen or antigen to which you are allergic. With progressively increasing dosages over time, the body will adjust to the allergen and become less sensitive to it. This process is called desensitization. A recently approved sublingual tablet (Grazax), containing a grass pollen extract, is similarly effective, with few side-effects, and can be self-administered at home, including by those patients who also suffer from allergic asthma, a condition which precludes the use of injection-based desensitization.
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Immunotherapy can help with the following:
KEY | | May do some good |
GLOSSARY
Actinic Keratoses
Actinic keratoses are common premalignant skin tumors that appear as small, raised, flaky lesions usually found on heavily sun-exposed skin in older people. They are mainly due to long-term exposure to the sun in susceptible persons and may progress to squamous cell carcinoma.
Allergen (Allergens)
A substance that is capable of producing an allergic response in the body.
Allergic Rhinitis (Hay Fever)
Inflammation of the nasal mucous membranes that is caused by specific allergen(s). It is an allergy characterized by sneezing, itchy and watery eyes, a runny or stuffy nose, coughing and a burning/scratchy sensation of the palate and throat.
Allergy (Allergies)
Hypersensitivity caused by exposure to a particular antigen (allergen), resulting in an increased reactivity to that antigen on subsequent exposure, sometimes with harmful immunologic consequences.
Antigen (Antigenic, Antigens)
A substance, usually protein or protein-sugar complex in nature, which, being foreign to the bloodstream or tissues of an animal, stimulates the formation of specific blood serum antibodies and white blood cell activity. Re-exposure to similar antigen will reactivate the white blood cells and antibody programmed against this specific antigen.
Asthma (Asthmatic)
A lung disorder marked by attacks of breathing difficulty, wheezing, coughing, and thick mucus coming from the lungs. The episodes may be triggered by breathing foreign substances (allergens) or pollutants, infection, vigorous exercise, or emotional stress. Extrinsic Asthma is triggered by pollen, chemicals or some other external agent; Intrinsic Asthma is triggered by boggy membranes, congested tissues, or other native causes… even adrenalin stress or exertion.
Autoimmune Disease (Autoimmune, Autoimmunity)
One of a large group of diseases in which the immune system turns against the body's own cells, tissues and organs, leading to chronic and often deadly conditions. Examples include multiple sclerosis, rheumatoid arthritis, systemic lupus, Bright's disease and diabetes.
Bacteria (Bacterial, Bacterium)
Microscopic germs. Some bacteria are "harmful" and can cause disease, while other "friendly" bacteria protect the body from harmful invading organisms.
Cancer
Refers to the various types of malignant neoplasms that contain cells growing out of control and invading adjacent tissues, which may metastasize to distant tissues.
Candidiasis (Candida)
Infection of the skin or mucous membrane with any species of candida, usually Candida albicans. The infection is usually localized to the skin, nails, mouth, vagina, bronchi, or lungs, but may invade the bloodstream. It is a common inhabitant of the GI tract, only becoming a problem when it multiplies excessively and invades local tissues. Growth is encouraged by a weakened immune system, as in AIDS, or with the prolonged administration of antibiotics. Vaginal symptoms include itching in the genital area, pain when urinating, and a thick odorless vaginal discharge. Candidiasis is also known as: Candida; Candida albicans; Candida Related Complex; Chronic Candida Syndrome; (Chronic) Systemic Candidiasis; Monilia; Candidiasis Hypersensitivity Syndrome; Candidosis; (Chronic) Mucocutaneous Candidosis; Thrush (oral or vaginal); Moniliasis; Polysystematic Candidiasis.
CD4
A symbol for glycoprotein expressed on the surface of some lymphocytes, including Helper T-cells. Human CD4 is the receptor that serves as a docking site for HIV viruses on certain lymphocyte cells. Binding of the viral glycoprotein gp120 to CD4 is the first step in viral entry, leading to the fusion of viral and cell membrane. White blood cells are composed primarily of neutrophils, monocytes and lymphocytes. Lymphocytes are either T-cells or B-cells. T-cells (CD3 cells) are divided into T-helper (CD4 cells) and T-suppressor/cytotoxic (CD8 cells) cells.
CD8
White blood cells are composed primarily of neutrophils, monocytes and lymphocytes. Lymphocytes are either T-cells or B-cells. T-cells (CD3 cells) are divided into T-helper (CD4 cells) and T-suppressor/cytotoxic (CD8 cells) cells.
Corticosteroid (Corticosteroids)
Steroid hormone produced by the adrenal cortex.
Cytotoxic
A compound that produces a toxic effect on cells.
Diabetes Mellitus (Diabetes, Diabetic, Diabetics)
A disease with increased blood glucose levels due to lack or ineffectiveness of insulin. Diabetes is found in two forms; insulin-dependent diabetes (juvenile-onset) and non-insulin-dependent (adult-onset). Symptoms include increased thirst; increased urination; weight loss in spite of increased appetite; fatigue; nausea; vomiting; frequent infections including bladder, vaginal, and skin; blurred vision; impotence in men; bad breath; cessation of menses; diminished skin fullness. Other symptoms include bleeding gums; ear noise/buzzing; diarrhea; depression; confusion.
Exogenous
Arising from the outside; the opposite of endogenous.
IL-2
Interleukin-2.
Immune System (Immune Response, Immunity)
A complex that protects the body from disease organisms and other foreign bodies. The system includes the humoral immune response and the cell-mediated response. The immune system also protects the body from invasion by making local barriers and inflammation. The process may involve acquired immunity (the ability to learn and remember a specific infectious agent), or innate immunity (the genetically programmed system of responses that attack, digest, remove, and initiate inflammation and tissue healing).
Immunotherapy
Techniques used to stimulate or strengthen a patient's own immune system.
Interferon
A protein formed by the cells of the immune system in the presence of a virus, etc. It prevents viral reproduction, and is capable of protecting noninfected cells from viral infection. Several kinds of interferon exist including alpha, beta, and gamma.
Intravenous Infusion (IV)
A small needle placed in the vein to assist in fluid replacement or the giving of medication.
Lymphoma (Lymphomas)
Any tumor of the lymphatic tissues.
Malignant (Cancerous)
Dangerous. Mainly used to describe a cancerous growth -- when used this way, it means the growth is cancerous and predisposed to spreading.
Melanoma
A life-threatening type of skin cancer that occurs in the cells (melanocytes) that produce melanin, the pigment found in skin, hair, and the iris of the eyes.
Mumps
An acute infectious disease, caused by a paramyxovirus, and most common in children. Although it usually infects the parotid glands, and is often only a mild condition, it can spread to the testes or ovaries and cause serious problems, particularly when contracted by unresistant adults. A mild child's infection that is not properly monitored holds the potential for pancreatic or meningeal complications.
Sublingual (Sublingually)
Situated or administered under the tongue, for example sublingual glands or sublingual tablets.
T-Cell (T-Cells)
T cells are lymphocytes that are produced in the bone marrow and mature in the thymus. T cells are responsible for mediating the second branch of the immune system called "cellular immune response." T cells can live for months to years. This lymphocyte population is defined by the presence of a rearranged T-cell receptor.
Topical
Most commonly 'topical application': Administration to the skin.
Tumor (Tumors, Tumour, Tumours)
An abnormal growth of tissue resulting from uncontrolled, progressive multiplication of cells and serving no physiological function; a neoplasm. Literally, a swelling; in the past the term has been used in reference to any swelling of the body, no matter what the cause. However, the word is now being used almost exclusively to refer to a neoplastic mass, and the more general usage is being discarded.
Virus (Viri, Viruses)
Any of a vast group of minute structures composed of a protein coat and a core of DNA and/or RNA that reproduces in the cells of the infected host. Capable of infecting all animals and plants, causing devastating disease in immunocompromised individuals. Viruses are not affected by antibiotics, and are completely dependent upon the cells of the infected host for the ability to reproduce.
Last updated: Apr 13, 2008
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