Skip to main content

Actions of novel immunoregulants useful in the treatment of arthritis as may be relevant to their toxicity

  • Chapter
Side-Effects of Anti-Inflammatory Drugs

Part of the book series: Inflammation and Drug Therapy Series ((IDTH,volume 2))

  • 124 Accesses

Abstract

The term “immunoregulant” (also referred to as “immunomodulator”) is an appropriate description for most drugs that effect the immune system since they usually possess condition-dependent immunostimulant and immunosuppressant activities1,2. Chemical classification of immunoregulants is extremely difficult in view of the plethora of agents with immunoregulating activity1–3. Functional classification is also a difficult task since immunoregulants act at different locations on the immune system and the exact target cell(s) for many agents has proven elusive4. In this chapter we will review immunoregulatory/immunomodulatory agents Which may have therapeutic usefulness in the treatment of rheumatoid arthritis (RA)5. We intend to concentrate on novel immunoregulatory agents (Table 1) that are currently under evaluation as potential antirheumatic drugs, and in particular discuss potential toxicity problems which may be encountered with such compounds.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Gilman, SC and Lewis, AJ (1986). Immunopharmacological approaches to drug develoment. In: Drug Discovery and Development ( Williams, M and Malick, J, eds.) ( New Jersey: Human Press) (In press )

    Google Scholar 

  2. Masek, K (1983). Current status of drugs which modulate the immune response. Trends Pharmacol. Sci., 4, 318

    Article  CAS  Google Scholar 

  3. Hadden, JW (1983). Characterization of in¢nunotherapeutic agents: an over- view. In: Advances in Immunopharmacology, Vol. 2 ( Hadden, JW, Chedid, L, Dukor, P, Spreafico, F and Willoughby, D, eds.). ( Oxford: Pergamon Press ), p. 691

    Google Scholar 

  4. Florentin, IM, Bruley-Rossett, M, Schulz, J, Davigny, M, Kiger, N and Mathe G (1981). Attempt at functional classification of chemically-defined immunomodulators. In: Advances in Inununopharmacology ( Hadden JW, Chedid, K, Mullen, P and Spreafico, F eds), ( Oxford: Pergamon Press ), p. 311

    Google Scholar 

  5. Gilman, SC and Lewis, AJ (1985). Immunomodulatory drugs in the treatment of rheumatoid arthritis. In: Anti-inflammatory and Antirheumatic Drugs, Vol. 3 ( Rainsford, KD, ed), ( Boca Raton, FL: CRC Press ) p. 127

    Google Scholar 

  6. Zvaifler, NJ (1973). The immunopathology of joint inflammation in rheumatoid arthritis. Adv Immunol, 16, 265

    Article  PubMed  CAS  Google Scholar 

  7. Hammerman, D (1975). Evidence for an infectious etiology of rheumatoid arthritis. Ann NY Acad Sci USA, 256, 25

    Article  Google Scholar 

  8. Jasin, HE (1983). Factors controlling articular cartilage degradation by activation of chondrocytes. Adv Inflamm Res, 5, 87

    CAS  Google Scholar 

  9. Ziff, M (1982). Rheumatoid disease: immunological aspects. Adv Inflamm Res, 3, 123

    Google Scholar 

  10. Pope, RM and Talal, N (1985). Autoimmunity in rheumatoid arthritis. Concepts Immunopathol, 1, 219

    PubMed  CAS  Google Scholar 

  11. Rawson, AJ and Huang, TC (1974). Lymphocytes in rheumatoid arthritis. I. Responses to allogenic cells and to phytomitogens. Clin Exp Immunol, 16, 41

    Google Scholar 

  12. Smith, J and DeHoratius, R (1982). Deficient autologous mixed lymphocyte reactions correlate with disease activity in systemic lupus erythematosus and rheumatoid arthritis. Clin Exp Immunol, 48, 155

    PubMed  CAS  Google Scholar 

  13. Miyasaka, N, Nakamura, T, Russell, IJ and Talal, N (1984). Interleukin 2 deficiencies in rheumatoid arthritis and systemic lupus erythematosus. Clin Immunol Immunopathol, 31, 109

    Article  PubMed  CAS  Google Scholar 

  14. Hassler, F Bluestein, H, Zvaifler, NJ and Epstein, LB (1983). Analysis of the defects responsible for the impaired regulation of Epstein-Barr virus-induced B cell proliferation by rheumatoid arthritis lymphocytes. I. Diminished gamma interferon production in response to autologous stimulation. J Exp Med, 157, 173

    Article  Google Scholar 

  15. Veys, EM, Hermanns, Ph, Goldstein G, Kung PC, Schindler, J, Symoens, J and Van Wauwe, J (1982). T cell subpopulations defined by monoclonal antibodies in RA- influence of immunomodulating agents. Adv Inflamm Res, 3, 155

    Google Scholar 

  16. Zatz, MM, Oliver, J, Goldstein, AL, Novak, C and Jacobs, RP (1984). Suppressor cell responses in patients with rheumatoid arthritis: the effect of thymosin. Thymus, 6, 205

    PubMed  CAS  Google Scholar 

  17. Sakane, T, Takada, S, Murakawa, Y, Kotani, H, Honda, M and Ueda, Y (1982). Analysis of suppressor T cell function in patients with rheumatoid arthritis: defects in production of and responsiveness to concanavalin A - induced suppressor T cells. J Immunol, 129, 1972

    PubMed  CAS  Google Scholar 

  18. Williams, BO, Lockwood, CM, Pussell, BA and Cotton, C (1979). Defective reticuloendothelial system function in rheumatoid arthritis. Lancet, 2, 1311

    Article  Google Scholar 

  19. Attia, WM, Shams, AH, Ali, MKH, Clark, HW, Brown, TM and Bellanti, JA (1982). Studies on phagocytic cells function in rheumatoid arthritis. I. Phagocytic and metabolic activities of neutrophils. Ann Allergy, 48, 279

    Google Scholar 

  20. Neighbor, PA, Brayzell, AI and Miller, AE (1982) Endogenous and interferon- augmented natural killer cell activity of human peripheral blood mononuclear cells in vitro. Studies of patients with multiple sclerosis, systemic lupus erythematosus or rheumatoid arthritis. Clin Exp Immunol, 49, 11

    Google Scholar 

  21. Rosenbert, JN and Currey, HLF (1979). Antibody-dependent and PHA-induced cellular cytotoxicity in rheumatoid arthritis. Ann Rheum Dis, 38, 347

    Article  Google Scholar 

  22. Silverman, HA, Johnson, JS, Vaughn, JH and McGlamory, JC (1976). Altered lymphocyte reactivity in rheumatoid arthritis. Arthritis Rheum, 19, 509

    Article  PubMed  CAS  Google Scholar 

  23. Johnson, PM and Faulk, WP (1976). Rheumatoid factor: its nature, specificity and production in rheumatoid arthritis. Clin Immunol Immunopathol, 6, 414

    Article  PubMed  CAS  Google Scholar 

  24. Klareskog, L, Forsum, U, Scheynius, A, Kabelitz, D and Wigzell, H (1982). Evidence in support of a self-perpetuating HLA-DR-dependent delayed type cell reaction in rheumatoid arthritis. Proc Natl Acad Sci USA, 79, 3632

    Article  PubMed  CAS  Google Scholar 

  25. Janossy, G, Panayi, G, Duke, 0, Bofill, M, Poulter, LW and Goldstein, G (1981). Rheumatoid arthritis: a disease of T-lymphocyte/macrophage immunoregulation. Lancet, 1, 839

    Google Scholar 

  26. Duke, 0, Panayi, GS, Janossy, G and Poulter, LW (1982). An immunohistochemical analysis of lymphocyte subpopulations and their microenvironment in the synovial membranes of patients with rheumatoid arthritis using monoclonal antibodies. Clin Exp Immunol, 49, 22

    PubMed  CAS  Google Scholar 

  27. Klareskog, L, Forsum, U, Wigren, A and Wigzell, H (1982). Relationship between HLA-DR-expressing cells and T lymphocytes of different subsets in rheumatoid synovial tissue. Scand J Immunol, 15, 501

    Article  Google Scholar 

  28. Cecere, F, Lessard, J, McDuffy, S and Pope, RM (1982). Evidence for local production and utilization of immune reactants in rheumatoid arthritis. Arthritis Rheum, 25, 1307

    Article  PubMed  CAS  Google Scholar 

  29. Wood, DD, Ihrie, EJ and Hamerman, D (1985). Release of interleukin-1 from human synovial tissue in vitro. Arthritis Rheum, 28, 853

    Article  PubMed  CAS  Google Scholar 

  30. Stasney, P, Rosenthal, M, Andreis, M and Ziff, M (1975). Lymphokines in the rheumatoid joint. Arthritis Rheum, 18, 237

    Article  Google Scholar 

  31. Dayer, JM, Krane, SM, Russell, RGG and Robinson, DR (1976). Production of collagenase and prostaglandin by isolated adherent rheumatoid synovial cells. Proc Natl Acad Sci USA, 73, 945

    Article  PubMed  CAS  Google Scholar 

  32. Davies, P, Bailey, PJ, Goldberg, MM and Ford-Hutchinson, AW (1984). The role of arachidonic acid oxygenation products in pain and inflammation. Ann Rev Immunol, 2, 335

    Article  CAS  Google Scholar 

  33. Oyanagui, Y (1982) Macrophage-generated superoxide radicals: inflammation and tumor cell growth, In: Pathology of Oxygen ( Autor, AP, ed.). ( New York: Academic Press ), p. 99

    Google Scholar 

  34. Robertson, RP (1981). Prostaglandins and hypercalcemia of cancer. Med Clin N Am, 65, 845

    PubMed  CAS  Google Scholar 

  35. Autor, AP (1982). Pathology of Oxygen. ( New York: Academic Press )

    Google Scholar 

  36. Dinarello, CA (1984). Interleukin 1. Rev Infect Dis, 6, 51

    Article  CAS  Google Scholar 

  37. Gilman, SC and Kimball, ES (1985). The role of cytokines in joint destruc- tion. Agents Actions, 16, 468

    Article  Google Scholar 

  38. Nuki, G and Duff, G (1985). Interleukin 1. Br J Rheumatol, 23 (Suppl. 1), 1

    Google Scholar 

  39. Wood, DD, Ihrie, EJ, Dinarello, CA and Cohen, PL (1983). Isolation of an interleukin-1-like factor from human joint effusions. Arthritis Rheum, 26, 975

    Article  PubMed  CAS  Google Scholar 

  40. McGuire, MB, Meats, JE, Wood, DD, Ihrie, EJ, Ebsworth, NM and Russell, RGG (1984). In vitro activation of human chondrocytes and synoviocytes by a human interleukin-1-like factor. Arthritis Rheum, 27, 654

    Article  Google Scholar 

  41. Postlethwaite, AE and Kang, AH (1983). Induction of fibroblast proliferation by human mononuclear leukocyte-derived proteins. Arthritis Rheum, 26, 22

    Article  PubMed  CAS  Google Scholar 

  42. Gowen, M, Wood, DD, Ihrie, EJ, McGuire, MKB and Russell, RGG (1983). An interleukin-1-like factor stimulates bone resorption in vitro. Nature, 306, 378

    Article  PubMed  CAS  Google Scholar 

  43. Husby, G and Williams, Jr, RC (1985). Immunohistochemical studies of interleukin-2 and gamma-interferon in rheumatoid arthritis. Arthritis Rheum, 28, 174

    Article  PubMed  CAS  Google Scholar 

  44. Degre, M, Mellbye, OJ and Clark-Jenssen, 0 (1983). Immune interferon in serum and synovial fluid in rheumatoid arthritis and related disorders. Ann Rheum Dis, 42, 672

    Article  PubMed  CAS  Google Scholar 

  45. Trinchieri, G and Perussia, B (1985). Immune interferon: a pleiotropic lym- phokine with multiple effects. Immunol Today, 6, 131

    Article  CAS  Google Scholar 

  46. Rosa, F and Fellous, M (1984). The effect of gamma-interferon on MHC antigens. Immunol Today, 5, 261

    Article  Google Scholar 

  47. Brinckerhoff, CE and Guyre, PM (1985). Increased proliferation of human synovial fibroblasts treated with recombinant immune interferon. J Immunol, 134, 3142

    PubMed  CAS  Google Scholar 

  48. Serrou, B and Rosenfeld, C (eds) (1982). New immunomodulating agents and biological response modifiers. Human Cancer Immunol, 3, 1

    Google Scholar 

  49. Davies, GE (1983). Immunotoxicology: a viewpoint from industry. In: Im- munotoxicology ( Gibson, GG, Hubbard, R and Parke, DV, eds). ( New York: Academic Press ), p. 413

    Google Scholar 

  50. Shevach, EM (1985). The effects of cyclosporin A on the immune system. Ann Rev Immunol, 3, 397

    Article  CAS  Google Scholar 

  51. Thomson, AW, Whiting, PH and Simpson, JG (1984). Cyclosporine: immunology, toxicity and pharmacology in experimental animals Agents Actions, 15, 306

    CAS  Google Scholar 

  52. White, DJG (1982). Cyclosporin A ( New York: Elsevier Biomedical )

    Google Scholar 

  53. Editorial (1985). Cyclosporin in autoimmune disease. Lancet, 1, 909

    Google Scholar 

  54. Hiestand, PC, Gunn, HC, Gale, JM, Ryffel, B and Borel, JF (1985). Comparison of the pharmacological profiles of cyclosporine, (Nva2)- cyclosporine and (Va12)dihydrocyclosporine. Immunology, 55, 249

    PubMed  CAS  Google Scholar 

  55. Myers, BD, Ross, J, Newton, L, Leutscher, J and Perlroth, M (1984). Cyclosporine-associated chronic nephropathy. N Engl J Med, 311, 699

    Article  PubMed  CAS  Google Scholar 

  56. Bendtzen, K (1984). Ciclosporin (Cyclosporin A): prototype of a new gener- ation of immunosuppressive drugs. Allergy, 39, 565

    Article  PubMed  CAS  Google Scholar 

  57. Bunjes, D, Hardt, C, Solbach, W, Beusch, K, Rollinghoff, M and Wagner, H (1982). Studies on the mechanism of action of cyclosporin A in the murine and human T-cell response in vitro. In: Cyclosporin A, ( White, DJG, ed.). ( New York: Elsevier Biomedical ), p. 261

    Google Scholar 

  58. Reem, GH, Cook, LA and Palladino, MA (1983). Cyclosporine A inhibits interleukin-2 and interferon gamma synthesis by human thymocytes. Transplant Proc, 15, 2387

    Google Scholar 

  59. Hess, AD, Tutschka, PJ and Santos, GW (1983). Effect of cyclosporin A on in- duction of cytotoxic T lymphocytes: role of interleukin-1 and interleukin-2. Transplant Proc, 15, 2248

    CAS  Google Scholar 

  60. Reem, GH, Cook, LA and Vilcek, J (1983). Gamma interferon synthesis by human thymocytes and T lymphocytes inhibited by cyclosporin A. Science, 221

    Google Scholar 

  61. Kahan, BD, Kerman, RH, Agostino, G, Friedman, A and Legrue, SJ (1982). The action of cyclosporin A on human lymphocytes. In: Cyclosporin A ( White, DJG, ed.). ( New York: Elsevier Biomedical ), p. 281

    Google Scholar 

  62. Handschumacher, RE, Harding, MW, Rice, J, Drugge, RJ and Speiches, DW (1984). Cyclophilin: a specific cytosolic binding protein for cyclosporin A. Science, 226, 544

    Article  PubMed  CAS  Google Scholar 

  63. Colombani, PM, Robb, A and Hess, AD (1985). Cyclosporin A binding to calmodulin: a possible site of action on T lymphocytes. Science, 228, 337

    Article  PubMed  CAS  Google Scholar 

  64. Russell, DH, Kibler, R, Matrisi, AN, Larson, DF, Poulos, B and Magun, BE (1985). Prolactin receptors on human T and B lymphocytes: antagonism of prolactin binding by cyclosporine. J Immunol, 134, 3027

    PubMed  CAS  Google Scholar 

  65. Russell, D, Larson, DF, Cardon, SB and Copeland, JG (1984). Cyclosporine inhibits prolactin induction of ornithine decarboxylase in rat tissues. Mol Cell Endocrinol, 35, 159

    Article  PubMed  CAS  Google Scholar 

  66. Murad, F and Haynes, RC Jr. (1980). Adenohypophyseal hormones and related substances. In: The Pharmacology Basis of Therapeutics. ( Goodman, LS and Gilman, A, eds.). ( New York: Macmillan ), p. 1369

    Google Scholar 

  67. Jaffe, IA (1980). Thiol compounds with penicillamine-like activity and pos- sible mode of action in rheumatoid arthritis. Clin Rheum Dis, 6, 633

    Google Scholar 

  68. Gleichmann Pals, ST, Rolink, AG, Radaszkiewicz, T and Gleichman, H (1984). Graft-versus-host reactions: clues to the etiopathology of a spectrum of immunological diseases. Immunol Today, 5, 324

    Article  Google Scholar 

  69. Janssen, FW, Young, EM, Kirkman, SK, Sharma, R N and Ruelius, H W (1981). Biotransformation of the immunomodulator, 3-(p-chlorophenyl)-2,3-dihydro-3hydroxythiazolo[3,2a]benzimidazole-2-acetic acid, and its relationship to thyroid toxicity. Toxicol Appl Pharmacol, 59, 355

    Article  PubMed  CAS  Google Scholar 

  70. Janssen, FW, Kirkman, SK, Fenselau, C, Strogniew, M, Hofmann, BR, Young, EM and Ruelius, HW (1982). Metabolic formation of N- and 0-glucuronides of 3(p-chlorophenyl)thiazolo[3,2a]benzimidazole-2-acetic acid. Drug Metab Dispos, 10, 599

    PubMed  CAS  Google Scholar 

  71. Robb, RJ (1984). Interleukin 2: the molecule and its function. Immunol Today, 5, 203

    Article  CAS  Google Scholar 

  72. Smith, KA (1984). Interleukin 2. Ann Rev Immunol, 2, 319

    Article  CAS  Google Scholar 

  73. Dosch, H-M and Shore, A (1982). Hypothesis: the role of interleukins in lymphopoesis-important in autoimmune disease? J Rheumatol, 9, 353

    PubMed  CAS  Google Scholar 

  74. Gilman, SC (1984). Lymphokines in immunological aging. Lymphokine Res, 3, 119

    PubMed  CAS  Google Scholar 

  75. Durum, SK, Schmidt, JA and Oppenheim, JJ (1985). Interleukin-1: an immunological perspective. Ann Rev Immunol, 3, 263

    Article  CAS  Google Scholar 

  76. Baker, PE, Fahey, JF and Munck, A (1981). Prostaglandin inhibition of T-cell proliferation is mediated at two levels. Cell Immunol, 61, 52

    Article  PubMed  CAS  Google Scholar 

  77. Arend, WP, Joslin, FG and Massoni, RJ (1985). Stimulation of production of interleukin 1 and an interleukin 1 inhibitor in human monocytes. Br J Rheumatol, 24 (Suppl. 1), 175

    Google Scholar 

  78. Honda, M, Chan, C and Schevach, EM (1985). Characterization and partial purification of a specific interleukin 2 inhibitor. J Immunol, 135, 1834

    PubMed  CAS  Google Scholar 

  79. Krakauer, T (1985). A macrophage-derived factor that inhibits the production and action of interleukin 2. J Leukocyte Biol, 38, 429

    PubMed  CAS  Google Scholar 

  80. Symmons, DPM, (1985). Neoplasms of the immune system in rheumatoid arthritis. Am J Med, 78 (Suppl lA), 22

    Article  PubMed  CAS  Google Scholar 

  81. Hazleman, B (1985). Incidence of neoplasms in patients with rheumatoid arthritis exposed to different treatment regimens. Am J Med, 78 (Suppl. lA), 39

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1987 MTP Press Limited

About this chapter

Cite this chapter

Lewis, A.J., Gilman, S.C. (1987). Actions of novel immunoregulants useful in the treatment of arthritis as may be relevant to their toxicity. In: Rainsford, K.D., Velo, G.P. (eds) Side-Effects of Anti-Inflammatory Drugs. Inflammation and Drug Therapy Series, vol 2. Springer, Dordrecht. https://doi.org/10.1007/978-94-010-9775-8_27

Download citation

  • DOI: https://doi.org/10.1007/978-94-010-9775-8_27

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-010-9777-2

  • Online ISBN: 978-94-010-9775-8

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics