Frey B M
Abteilung für Nephrologie, Inselspital, Bern.
Ther Umsch. 1993 Feb;50(2):71-6.
In addition to T and B cells, accessory cells such as macrophages are necessary for an immune response to occur. At present it is probably reasonable to regard collaborative immune response as a series of interrelated processes in which antigen-specific recognition is performed and in which various nonspecific mediators function as modifiers to regulate the intensity and quality of the response. According to this model, immunosuppressive drugs interfere at different stages and levels of the immune response. Glucocorticoids inhibit preferentially the activities of monocytes and T-helper cells as well as lymphokine production. Cyclosporin effectively inhibits the production of interleukin-2 and influences selectively the action of the T lymphocytes. Azathioprine, cyclophosphamide and methotrexate decrease the proliferative response of all the cells involved in the immune response. The immunosuppressive activity of chloroquine is still not well established, but the drug seems to have inhibitory effect on thromboxane and interleukin-2 production. Whole populations of lymphoid elements are destroyed by administering antibodies against surface determinants of these lymphoid elements. Antiidiotypic antibodies, present in intravenous immunoglobulin preparations from pools of donors, are capable of eliminating circulating (auto-)antibodies by binding to the idiotypic region of a specific disease-associated antibody.
除了T细胞和B细胞外，诸如巨噬细胞等辅助细胞对于免疫反应的发生也是必需的。目前，将协同免疫反应视为一系列相互关联的过程可能是合理的，在这些过程中进行抗原特异性识别，并且各种非特异性介质作为调节剂发挥作用，以调节反应的强度和质量。根据这个模型，免疫抑制药物在免疫反应的不同阶段和水平发挥作用。糖皮质激素优先抑制单核细胞和T辅助细胞的活性以及淋巴因子的产生。环孢素有效抑制白细胞介素-2的产生，并选择性地影响T淋巴细胞的作用。硫唑嘌呤、环磷酰胺和甲氨蝶呤降低参与免疫反应的所有细胞的增殖反应。氯喹的免疫抑制活性尚未完全明确，但该药物似乎对血栓素和白细胞介素-2的产生有抑制作用。通过给予针对这些淋巴细胞表面决定簇的抗体，可以破坏整个淋巴细胞群体。供体库来源的静脉注射免疫球蛋白制剂中存在的抗独特型抗体，能够通过与特定疾病相关抗体的独特型区域结合来消除循环（自身）抗体。
