Miller E
Colorado State University, College of Veterinary Medicine and Biomedical Sciences, Department of Clinical Sciences, Fort Collins, USA.
Semin Vet Med Surg Small Anim. 1997 Aug;12(3):144-9. doi: 10.1016/s1096-2867(97)80025-4.
The therapy of immune-mediated diseases in dogs and cats requires effective immunosuppressive therapy. The ideal therapy would suppress the abnormal (anti-self) immune responses while leaving the normal (anti-pathogen) immune responses intact. Unfortunately, such a therapy is not readily available. Current therapeutic strategies designed to suppress aberrant immune responses include combinations of glucocorticoids, cytotoxic drugs, and other immunomodulating agents such as cyclosporine and androgens. Glucocorticoids have a multitude of effects on the immune response at several levels and are both antiinflammatory and immunosuppressive. Cytotoxic drugs such as cyclophosphamide and azathioprine suppress the immune response by inhibiting protein (ie, antibody) synthesis, DNA replication, and cell division. Some cytotoxic drugs cause lysis of immunocompetent cells. Cyclosporine A suppresses production of interleukin-2, a cytokine necessary for the amplification stages of the immune response and critical for the activation of both T and B lymphocytes. Androgens modulate the immune system by as yet poorly defined mechanisms involving alterations in lymphocyte numbers and function as well as mononuclear-phagocytic cell function. Newer immunosuppressive agents are being studied in laboratory animals and human transplant patients that either inhibit do novo synthesis of nucleotides or signal transduction in lymphocytes, thereby reducing the number or function of immunocompetent cells. These newer agents can be combined with more traditional therapies for enhanced immunosuppressive effects.
犬猫免疫介导性疾病的治疗需要有效的免疫抑制疗法。理想的疗法应能抑制异常的（抗自身）免疫反应，同时保持正常的（抗病原体）免疫反应完好无损。不幸的是，目前尚无这样的疗法。当前旨在抑制异常免疫反应的治疗策略包括糖皮质激素、细胞毒性药物以及其他免疫调节药物（如环孢素和雄激素）的联合使用。糖皮质激素在多个层面上对免疫反应有多种作用，具有抗炎和免疫抑制双重特性。细胞毒性药物如环磷酰胺和硫唑嘌呤通过抑制蛋白质（即抗体）合成、DNA复制和细胞分裂来抑制免疫反应。一些细胞毒性药物可导致免疫活性细胞溶解。环孢素A抑制白细胞介素-2的产生，白细胞介素-2是免疫反应扩增阶段所必需的细胞因子，对T淋巴细胞和B淋巴细胞的激活至关重要。雄激素通过涉及淋巴细胞数量和功能以及单核吞噬细胞功能改变的尚不明确的机制来调节免疫系统。新型免疫抑制药物正在实验动物和人类移植患者中进行研究，这些药物要么抑制核苷酸的从头合成，要么抑制淋巴细胞中的信号转导，从而减少免疫活性细胞的数量或功能。这些新型药物可与更传统的疗法联合使用，以增强免疫抑制效果。
