The Mode of Action of Immunosuppressive Agents

Preface to the second edition. List of abbreviations. General introduction. Chapter 1. I. Problems of definition. II. The problem of the anti-inflammatory effect. III. Therapeutic index. IV Immunosuppression-induced malignancies. V. Problems in drug evaluation. VI. The main experimental approaches. VII. The immune system conceived as a double network. VIII. Action on the various types of immune responses. IX. Actions on experimental immunological diseases. X. Immunosuppression in the human. References. Chapter 2. Corticosteroids. I. Structure. II. Pharmacokinetics. III. Species differences. IV. Toxicity. V. Biochemical impact. VI. Subcellular actions. VII. Cytological actions. VIII. Differential actions on lymphocyte subpopulations. IX. Action on humoral immunity. X. Action on cell-mediated immunity. XI. Other effects of steroids. XII. Immunosuppressive effects in man. XIII. General conclusions on the mechanisms of the immunosuppressive action of corticosteroids. Summary. References. Chapter 3. Thiopurines (6 mercaptopurine, azathioprine, thioguanine). I. Structure, 6-mercaptopurine versus azathioprine. II. Pharmacokinetics. III. Toxicity. IV. Biochemistry. V. Subcellular actions on lymphocytes. VI. Cytological actions. VII. Effects on lymphocyte traffic. VIII. Action on humoral immunity. IX. Action on cell-mediated immunity. X. The selective effect of azathioprine on T cells. XI. The effect of azathioprine on T cell subsets. XII. Thiopurines and immunopathological processes. XIII. Immunosupressive effects in man. XIV. General conclusions on the mechanism of the immunosuppressive action of thiopurines. Summary. References. Chapter 4. Alkylating agents. I. Structure. II. Pharmacokinetics. III. Toxicity. IV. Biochemistry. V. Cytological actions. VI. Differential effects on lymphocyte subpopulations. VII. Action on humoral immunity. VIII. Action on cell-mediated immunity. IX. Other effects of cyclophosphamide. X. Immunosuppressive effects in man. XI. General conclusions on the mechanism of the immunosuppressive action of alkylating agents. Summary. References. Chapter 5. Cyclosporine. I. Chemistry. II. Pharmacokinetics. III. Toxicity. IV. Mechanism of action. V. Experimental allograft models. VI. Experimental autoimmune diseases. VII. clinical experience. VIII. Conclusions. Summary. References. Chapter 6. Antilymphocyte antibodies. I. Definition. II. Historical survey. III. Methods of preparation of polyclonal ALS. IV. Toxicity. V. In vitro activities of polyclonal ALS. VI. In vivo ALS effects on lymphoid organs. VII. Action on humoral immunity. VIII. Action on cell-mediated immunity. IX. Other effects of ALS. X. The use of monoclonal anti T cell antibodies for immunosuppression. XI. Mechanism of action. XII. Immunosuppressive effect in man. Summary. References. Chapter 7. Total lymphoid irradiation. Clinical experience. References. Chapter 8. Concluding remarks: a few guide lines for the clinical use of immunosuppressive agents. I. What are the indications for immunosuppressive treatment? II. The choice of the immunosuppressive agent. III. The choice of the dosage. Appendix. Doses of immunosuppressive agents to be used in experimental studies. Subject index.