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Drug Interactions in Infectious Diseases: Mechanisms and Models of Drug Interactions pp 163–204Cite as

Drug-Cytokine Interactions

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Part of the book series: Infectious Disease ((ID))

Abstract

There are many documented examples of altered drug disposition in human conditions that stimulate host cytokine responses. These include viral, bacterial, or parasitic infections, tissue injury, surgery, cancer, and autoimmune conditions. Interferons, interleukins 1 and 6, and tumor necrosis factor are the central mediators. These cytokines have been traditionally viewed with respect to their ability to suppress hepatic cytochrome P450 (CYP)-mediated drug detoxification. The potential result is a temporary conversion from a rapid or normal metabolizer to a poor metabolizer phenotype. Such aberrant drug handling has placed patients at risk for adverse drug responses to low therapeutic index, CYP-metabolized drugs like theophylline. It is now evident that drug-cytokine interactions are broader than once appreciated. They impact CYPs and drug transporter proteins ABCB1 (P-glycoprotein) in the liver, intestine, kidney, blood-brain barrier, placenta, and immune cells. Furthermore, the possibility that anti-cytokine biological therapies may precipitate drug-cytokine interactions is gaining increasing recognition. The consequences of drug-cytokine interactions are altered absorption, elimination, and/or cellular and tissue distribution of drugs. The outcomes can be negative or positive depending on the drug, the anatomical site of the interaction, and the therapeutic objectives. This chapter provides a historical overview of drug-cytokine interactions, discusses recent advances, and examines the clinical scenarios in which infections or inflammation might lead to abnormal drug handling and drug responses.

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Authors and Affiliations

  1. Department of Pharmacology, Dalhousie University, Halifax, NS, Canada

    Kerry B. Goralski

  2. College of Pharmacy, Faculty of Health Professions, Dalhousie University, Halifax, NS, Canada

    Kerry B. Goralski & Matthew A. Ladda

  3. Department of Family Medicine, Dalhousie University, Halifax, NS, Canada

    Jenna O. McNeil

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Correspondence to Kerry B. Goralski .

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Editors and Affiliations

  1. College of Pharmacy, University of Michigan, Ann Arbor, Michigan, USA

    Manjunath P. Pai

  2. Department of Pharmaceutical Sciences, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Aurora, Colorado, USA

    Jennifer J. Kiser

  3. Division of Pharmacy Practice and Administration, UMKC School of Pharmacy at MSU, Springfield, Missouri, USA

    Paul O. Gubbins

  4. College of Pharmacy and Medicine, University of Illinois at Chicago, Chicago, Illinois, USA

    Keith A. Rodvold

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Goralski, K.B., Ladda, M.A., McNeil, J.O. (2018). Drug-Cytokine Interactions. In: Pai, M., Kiser, J., Gubbins, P., Rodvold, K. (eds) Drug Interactions in Infectious Diseases: Mechanisms and Models of Drug Interactions. Infectious Disease. Humana Press, Cham. https://doi.org/10.1007/978-3-319-72422-5_5

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