What is immunity and how does it work?
Immunity is the body’s defense system that destroys cells affected by various pathogens and the pathogens themselves. Immune cells live in every human organ and can fight various threats themselves or produce special molecules for this purpose.
“The immune response is always directed towards a specific target. These can be bacteria, protozoa, viruses or parasites. In order to respond correctly to the pathogen, immunity has a very clearly structured understanding of which infection has entered the body and how (for example, it may have entered the nasopharynx, through food or through the skin). “It requires an indicator,” he said. socialbites.ca Head of MIPT Genomic Engineering Laboratory, immunologist Pavel Volchkov.
There are protein and non-protein molecules to regulate the immune system. For example, these may be systemic glucocorticoids produced by the adrenal glands. They can have a suppressive effect on the immune system and are essentially natural immunomodulators, that is, substances that can affect the activity of the body’s defense system.
“Normally, the immune response is very specific. Let’s say a killer T cell destroys a particular cell that it recognizes as infected. Moreover, the mechanisms of such intercellular interaction are also quite specific, but they can be regulated with the help of other cells. In particular, T regulatory cells use different cells to influence the immune response.” It can create a microenvironment by activating proteins. These are two examples of the work of our internal immunomodulators,” Volchkov noted.
A number of similar immunomodulatory small molecules exist in nature. Their mechanism of action was taken as the basis for creating drugs that are actively used today to externally regulate the immune response.
What are immunotropic drugs?
As told to socialbites.ca by the candidate of medical sciences, head of the herpes center of Moscow State University. MV Lomonosova, Director of the Research Center for the Prevention and Treatment of Viral Infections, immunologist-allergist Georgy Vikulov, Immunotropics are drugs used to affect various immunopathological conditions (diseases and conditions based on dysfunction of the immune system).
Many drugs entering the human body affect the functioning of immune system cells. However, the difference between immunotropic drugs is that they deliberately act on various parts, cells of innate and adaptive immunity.
“There are many different classifications of immunotropic drugs, but we can separate them according to the way they affect the immune system. They can be divided into three large groups: immunostimulants, immunosuppressants, immunomodulators. The first is used for immunodeficiencies and the second for organ and tissue transplantation in oncology and autoimmune diseases. And immunomodulators are drugs that can cause a multifaceted response in the body itself, that is, they can increase low levels and reduce high levels of the immune state, normalize the function of impaired parts of the immune system or immune dysfunction,” explained Vikulov.
According to the expert, there are more than 440 nosological forms of primary (genetically determined) immunodeficiencies; Not all of these have regulated treatment, but replacement or immunosupportive therapy is available for most. For example, if a person does not produce immunoglobulin, then it will be administered to him for life.
“The mechanism of action of all immunotropic drugs is very diverse. For example, there are drugs that affect hematopoiesis or cytokines, which are receptors on immune system cells. A separate group of drugs that create an active immune response are vaccines. Immunoglobulins are used, which create a passive immune response. A separate group of drugs are monoclonal antibodies used in diagnosis, treatment of autoimmune diseases, oncological diseases (targeted therapy), allergopathology and severe cases of COVID-19.
There are a large number of immunotropic drugs, but a large number of drugs that are attributed to the properties of immunomodulators are not such. That is, some manufacturers have a postscript that the drug has immunomodulatory and immunostimulating properties, but this is often not proven in terms of the requirements of evidence-based medicine,” noted Vikulov.
Which medications work?
According to Vikulov today it is registered in Russia More than 120 immunomodulators. Some of these have proven effectiveness, while others may be homeopathic remedies with unproven effectiveness and possible health risks. Therefore, you should approach the choice of these drugs carefully.
For example, according to Vikulov, drugs based on interferon gamma antibodies are homeopathic drugs that do not have pharmacokinetic data, but they are also considered “releasing active molecules.”
“Accordingly, their distribution in the body cannot be measured precisely and their mechanism of action is not yet fully known. Then we cannot say exactly what changes this drug causes, which receptors it binds to, whether it affects the functioning of cytokines. These drugs have a questionable evidence base.
According to experts, there are more than a hundred such drugs that do not have a serious evidence base. Most often this is a homeopathic medicine, which is attributed immunomodulatory properties to create demand,” explained Vikulov.
Taking such drugs is associated with various health risks, precisely due to the serious lack of research. According to the expert, the use of a substance whose effectiveness and safety is unknown may lead to unpredictable reactions. In addition, there is a dose-dependent effect for many known substances and drugs; This is true for vitamins, for example. Vitamins A and D can have both immunomodulatory and immunosuppressive effects depending on the dose, the same is true for medications.
However, even medications that are based on good evidence can be hazardous to health if prescribed incorrectly. Interferons according to Volchkov (generic name for a set of proteins with similar properties secreted by body cells in response to virus invasion) They are designed in nature for a targeted effect on specific cells, but are often used systemically.
“If you administer interferons systemically, you cause general inflammation throughout the body, even in healthy cells. In fact, this can greatly interfere with the functioning of the immune system because we actually disorient it. You can compare it to a plane landing, instead of a single landing strip, we’ve lit up everything at once.” “Immune cells will not understand where to land, just like the pilot,” Volchkov gave an example.
As told to socialbites.ca by an immunologist at the European Medical Center, Candidate of Medical Sciences, pediatrician at the Department of Clinical Immunology of the Federal Scientific Center for Children and Pediatric Orthopedics. D. Rogacheva Alexandra Laberko, Buyers should be careful about drugs not used abroad.
“Most likely, data from large randomized and placebo-controlled studies are missing. These are the types of studies that need to be done to prove the effectiveness of any drug. Of course, to date there are no large studies confirming a direct relationship between taking immunomodulators and the risk of developing autoimmune diseases and cancer. However, this is more due to the lack of research to control the risk of developing complications of this treatment, especially in the long term, rather than their safety: such processes still take some time to develop.” .