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Modulation of a complex immune system
Author(s) -
Steinberg Alfred D.
Publication year - 1981
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/ana.410090717
Subject(s) - immune system , antigen , context (archaeology) , immunology , priming (agriculture) , biology , suppressor , lymphokine , macrophage , antibody , cell type , t cell , microbiology and biotechnology , cell , in vitro , genetics , gene , paleontology , botany , germination
The immune system consists of multiple cells that interact in a manner analogous to interlocking feedback loops Antigenic stimulation leads to collaboration between an antigen presenting cell, a macrophage or related cell, and several types of lymphocytes, including helper T cells and various B cells. The result of this interaction is an immune response that encompasses antibody production, cell‐mediated immunity, and priming for subsequent respones. In addition, a variety of regulatory cells and substances are produced which may tend to limit the response. These include suppressor cells, suppressor substances produced by those cells, additional suppressor substances (including macrophage products), antibody itself, and antiantibody. These suppressor mechanisms may directly suppress the immune response to the antigen or may operate through other cells in the various feedback loops. Any attempt to interfere with an ongoing immune response requires respect for the various cells that regulate the immune response as well as their feedback loops. Mere administration of an immunosuppressive drug in an attempt to suppress a specific immune response may yield the desired effect or its opposite, depending upon the details of administration. Thus, the immunosuppressive drug cyclophosphamide may actually enhance immune responses by selectively inactivating suppressor functions before interfering with other cells and functions. The treatment of Guillain‐Barré syndrome presents a unique opportunity and challenge. We are now in a position to consider a variety of antigen nonspecific therapies and look forward to the introduction of specific ones. However, the world medical community will be best served if new treatments are assessed in the context of randomized trials. Controlled clinical evaluation will allow accurate determination of the relative advantages and disadvantages of a new therapy, providing the basis for continued search for increasingly better methods of helpful intervention.