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The Characterization of Immunotherapeutic Agents

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Abstract

Two relatively recent scientific evolutions have raised therapeutic immunopharmacology to its present position of interest. The first concerns the progressive elucidation of primary and secondary immunodeficiency diseases over the last 25 years, and the second is the attempt to mobilize host resistance mechanism in the treatment of cancer over the last 15 years. Twenty-five years ago, immunodeficiencies were considered to be relatively rare clinical problems involving mainly patients who lacked the capacity to make antibody (Bruton agammaglobulinemia and acquired agammaglobulinemia) and patients with ataxia telangiectasia, Wiskott-Aldrich syndrome, or humoral immunodeficiency secondary to lymphoid malignancy. With the development of the current concepts of the role of the thymus-dependent system of immunity and the cooperative roles of macrophages and natural killer cells with T lymphocytes in the expression of cellular immune response, there ensued an extensive analysis of the prevalence of cellular immune deficiencies in various human populations. Somewhat unexpectedly, it was found that cellular immune deficiencies are not rare and that they occur to a degree in large percentages of the world’s populations. In addition to a number of rare congenital deficiencies (such as the DiGeorge and Nezeloff syndromes), transient deficiencies were observed in neonates and in children with viral infections. As expected, cellular immune deficiency was found to be common in cancer patients and increased in severity with more widespread disease. It was compounded by intensive cytoreductive therapy with chemotherapy and irradiation. Similar deficiencies were seen following inmiunosuppressive drug therapy and exposure to immunotoxic chemicals. Impressive in terms of the numbers of people involved was the discovery of pronounced immune deficiencies associated with parasitosis, malnutrition, and aging. The general impression that was derived from these observations is that cellular immune deficiencies are a common precursor to a large variety of clinical diseases ranging from infection to cancer and autoimmunity. The degree of association is such as to indicate that the treatment of cellular immune deficiency is a clinical goal in itself to prevent these disease sequelae. Such an immunoprophylactic approach seems reasonable in the same context as we now treat coronary artery disease to prevent acute myocardial infarction or hypertension to prevent cerebral vascular accidents.

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© 1990 Plenum Press, New York

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Hadden, J.W., Renoux, G., Chirigos, M. (1990). The Characterization of Immunotherapeutic Agents. In: Hadden, J.W., Szentivanyi, A. (eds) Immunopharmacology Reviews. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-7252-7_1

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