General characteristics and indications
Immunostimulating agents represent a vast group of medicinal products. Their main pharmacological task is the activation of the body's defense mechanisms. It is important to note that the specific target of these drugs is precisely the immune system, rather than the hypothalamic-pituitary system, the reticuloendothelial system, or the complement system in isolation.
In clinical practice, there are three main groups of indications for prescribing immunostimulants:
- Immunodeficiency states of various genesis.
- Chronic sluggish infections, in which the patient's body is unable to cope with the infectious agent on its own.
- Certain oncological diseases (drugs are used as part of combination therapy to support the immune response).
Colony-stimulating factors and interleukins
A significant portion of immunostimulants consists of cytokine preparations. They are actively used for the targeted regulation of immune processes.
The group of colony-stimulating factors includes the following drugs:
- Molgramostim (trade name — Leukomax).
- Filgrastim (Neupogen) and the related pegfilgrastim.
- Lenograstim (Granocyte).
- Sargramostim.
Another important subgroup of cytokines is interleukin preparations. This category includes medicinal products such as aldesleukin, betaleukin, and oprelvekin.
Interferon preparations
Interferons are classified into three major groups depending on the type of active substance (alpha, beta, or gamma).
- Interferons alpha: include interferon alfa (Alphaferon), interferon alfa-2a (Roferon-A), interferon alfa-2b (Intron-A), and interferon alfa-n1 (Wellferon).
- Interferons beta: represented by interferon beta-1a (Rebif) and interferon beta-1b (Betaferon).
- Interferons gamma: the main representative of this group in the classification is ingaron.
Classification of other preparations by origin
The group "Other immunostimulants" is divided into several subcategories depending on the source of the active substance:
- Polypeptides of endogenous origin (and their analogues). These include thymalin and immunofan.
- Synthetic preparations. Prominent representatives of the group are levamisole and azoximer bromide (widely known as Polyoxidonium).
- Preparations of microbial origin (and their analogues). Include drugs created on the basis of bacterial components: Broncho-Vaxom, Ribomunyl, and prodigiosan.
- Interferon inducers. Unlike ready-made interferon preparations, these agents stimulate the production of own interferon in the patient's body. These include tilorone and meglumine acridonacetate (Cycloferon).
- Other immunostimulants. This mixed group includes preparations of herbal and other origins, such as Immunal, Galavit, Erbisol, and Estifan.
Briefly: answers to topical questions
Which immunostimulants are of herbal origin?
Herbal immunostimulants include echinacea preparations and potato shoot polysaccharides.
- Immunal — belongs to other immunostimulants, including herbal ones.
- Estifan — represents a dry extract of Echinacea purpurea.
- Potato shoot polysaccharide sum — used as an antiviral agent of herbal origin in combination therapy.
What are the existing contraindications to prescribing immunostimulants?
Contraindications to prescribing immunostimulants depend on the specific drug. Echinacea preparations (e.g., Estifan) are characterized by the following restrictions:
- Tuberculosis.
- Leukemias.
- Collagenoses.
- Multiple sclerosis.
For the synthetic drug azoximer bromide, other contraindications are distinguished:
- Hypersensitivity to the components of the drug.
- Pregnancy.
- Breastfeeding period.
What is the mechanism of action of azoximer bromide?
The mechanism of action of azoximer bromide consists in the activation of natural resistance factors and pronounced immunomodulating activity. The drug increases the functional activity of cells predominantly when their baseline indicators are reduced. Main effects:
- Activation of cells of the monocyte-macrophage system, neutrophils, and natural killers.
- Enhancement of T-cell proliferation and dendritic cell maturation.
- Increased antibody production.
- Activation of cytokine production (interleukins, interferon-alpha).
- Nonspecific protective action against a wide range of pathogens.
What side effects are characteristic of interferon preparations?
Interferon preparations are characterized by a wide range of adverse reactions affecting various body systems. Influenza-like syndrome develops most frequently, including fever, myalgia, arthralgia, and headache. Other side effects:
- CNS — dizziness, depression, insomnia, tremor, confusion.
- GI tract — nausea, vomiting, diarrhea, loss of appetite.
- Hematopoiesis — thrombocytopenia, neutropenia, transient leukopenia.
- Kidneys — proteinuria, possible development of nephritis.
- Cardiovascular system — symptoms of heart failure.
- Other — hepatotoxic effect, pneumonia, skin rash, alopecia.
For quick memorization of immunostimulant groups by origin, use the phrase "SEMI Herbs": Synthetic (levamisole), Endogenous (thymalin), Microbial (ribomunyl), Interferon inducers (tilorone), Herbal and others (immunal).
Class and exam questions
What is the fundamental difference between interferons and interferon inducers?
Interferon preparations (e.g., interferon alfa-2a or beta-1b) contain ready-made proteins that are introduced into the body from the outside. Interferon inducers (such as tilorone or cycloferon) do not contain these proteins themselves, but their mechanism of action is aimed at stimulating the production of own interferon by the body's cells.
In what types of infections is the prescription of immunostimulants indicated?
According to general indications, immunostimulants are used for chronic, sluggish infections. In such cases, the immune system is depleted or functioning insufficiently, and requires pharmacological support.
Which drugs belong to the group of colony-stimulating factors?
This group includes molgramostim (Leukomax), filgrastim (Neupogen), pegfilgrastim, lenograstim (Granocyte), and sargramostim. They belong to the class of cytokines.
What else to study on this topic
- Pharmacodynamics of colony-stimulating factors: mechanisms of action of filgrastim and molgramostim.
- Comparative characteristics of interferon preparations: alpha, beta, and gamma.
- Synthetic immunostimulants: features of the use of levamisole and azoximer bromide.
- Drugs of microbial origin (Broncho-Vaxom, Ribomunyl): mechanism of action and indications.
- Interferon inducers: how tilorone and cycloferon stimulate the immune response.
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