Immunosuppression is a reduction of the activation or
efficacy
Efficacy is the ability to perform a task to a satisfactory or expected degree. The word comes from the same roots as ''effectiveness'', and it has often been used synonymously, although in pharmacology a pragmatic clinical trial#Efficacy versu ...
of the
immune system. Some portions of the immune system itself have immunosuppressive effects on other parts of the immune system, and immunosuppression may occur as an adverse reaction to treatment of other conditions.
In general, deliberately induced immunosuppression is performed to prevent the body from
rejecting an
organ transplant.
Additionally, it is used for treating
graft-versus-host disease
Graft-versus-host disease (GvHD) is a syndrome, characterized by inflammation in different organs. GvHD is commonly associated with bone marrow transplants and stem cell transplants.
White blood cells of the donor's immune system which remain wit ...
after a
bone marrow transplant, or for the treatment of
auto-immune disease
An autoimmune disease is a condition arising from an abnormal immune response to a functioning body part. At least 80 types of autoimmune diseases have been identified, with some evidence suggesting that there may be more than 100 types. Nearly a ...
s such as
systemic lupus erythematosus
Lupus, technically known as systemic lupus erythematosus (SLE), is an autoimmune disease in which the body's immune system mistakenly attacks healthy tissue in many parts of the body. Symptoms vary among people and may be mild to severe. Comm ...
,
rheumatoid arthritis,
Sjögren's syndrome, or
Crohn's disease
Crohn's disease is a type of inflammatory bowel disease (IBD) that may affect any segment of the gastrointestinal tract. Symptoms often include abdominal pain, diarrhea (which may be bloody if inflammation is severe), fever, abdominal distension ...
. This is typically done using medications, but may involve surgery (
splenectomy),
plasmapheresis, or radiation. A person who is undergoing immunosuppression, or whose immune system is weak for some other reasons (such as
chemotherapy or
HIV), is said to be ''
immunocompromised''.
Deliberately induced

Administration of
immunosuppressive medications
Immunosuppressive drugs, also known as immunosuppressive agents, immunosuppressants and antirejection medications, are drugs that inhibit or prevent activity of the immune system.
Classification
Immunosuppressive drugs can be classified int ...
or immunosuppressants is the main method for deliberately inducing immunosuppression; in optimal circumstances, immunosuppressive drugs primarily target hyperactive components of the immune system. People in remission from cancer who require immunosuppression are not more likely to experience a recurrence. Throughout its history,
radiation therapy has been used to decrease the strength of the immune system. Dr. Joseph Murray of Brigham and Women's Hospital was given the
Nobel Prize in Physiology or Medicine in 1990 for work on immunosuppression.
Immunosuppressive drugs have the potential to cause
immunodeficiency
Immunodeficiency, also known as immunocompromisation, is a state in which the immune system's ability to fight infectious diseases and cancer is compromised or entirely absent. Most cases are acquired ("secondary") due to extrinsic factors that a ...
, which can increase susceptibility to
opportunistic infection
An opportunistic infection is an infection caused by pathogens (bacteria, fungi, parasites or viruses) that take advantage of an opportunity not normally available. These opportunities can stem from a variety of sources, such as a weakened immune ...
and decrease
cancer immunosurveillance
Cancer immunology is an interdisciplinary branch of biology that is concerned with understanding the role of the immune system in the progression and development of cancer; the most well known application is cancer immunotherapy, which utilises ...
. Immunosuppressants may be prescribed when a normal immune response is undesirable, such as in
autoimmune diseases
An autoimmune disease is a condition arising from an abnormal immune response to a functioning body part. At least 80 types of autoimmune diseases have been identified, with some evidence suggesting that there may be more than 100 types. Nearly a ...
.
Steroids were the first class of immunosuppressant drugs identified, though side-effects of early compounds limited their use. The more specific
azathioprine was identified in 1960, but it was the discovery of
ciclosporin in 1980 (together with azathioprine) that allowed significant expansion of
transplantation to less well-matched donor-recipient pairs as well as broad application to
lung transplantation
Lung transplantation, or pulmonary transplantation, is a surgical procedure in which one or both lungs are replaced by lungs from a donor. Donor lungs can be retrieved from a living or deceased donor. A living donor can only donate one lung lobe. ...
,
pancreas transplantation, and
heart transplantation.
[ After an organ transplantation, the body will nearly always reject the new organ(s) due to differences in human leukocyte antigen between the donor and recipient. As a result, the immune system detects the new tissue as "foreign", and attempts to remove it by attacking it with white blood cells, resulting in the death of the donated tissue. Immunosuppressants are administered in order to help prevent rejection; however, the body becomes more vulnerable to infections and malignancy during the course of such treatment.
]
Non-deliberate immunosuppression
Non-deliberate immunosuppression can occur in, for example, ataxia–telangiectasia, complement deficiencies, many types of cancer, and certain chronic infections such as human immunodeficiency virus (HIV). The unwanted effect in non-deliberate immunosuppression is immunodeficiency
Immunodeficiency, also known as immunocompromisation, is a state in which the immune system's ability to fight infectious diseases and cancer is compromised or entirely absent. Most cases are acquired ("secondary") due to extrinsic factors that a ...
that results in increased susceptibility to pathogens, such as bacteria and viruses.[
Immunodeficiency is also a potential adverse effect of many immunosuppressant drugs, in this sense, the scope of the term ''immunosuppression'' in general includes both beneficial and potential adverse effects of decreasing the function of the immune system.
]B cell
B cells, also known as B lymphocytes, are a type of white blood cell of the lymphocyte subtype. They function in the humoral immunity component of the adaptive immune system. B cells produce antibody molecules which may be either secreted or ...
deficiency and T cell deficiency are immune impairment that individuals are born with or are acquired, which in turn can lead to immunodeficiency problems. Nezelof syndrome
Nezelof syndrome is an autosomal recessive congenital immunodeficiency condition due to underdevelopment of the thymus. The defect is a type of purine nucleoside phosphorylase deficiency with inactive phosphorylase, this results in an accumulati ...
is an example of an immunodeficiency of T-cells.
See also
References
Further reading
* Retrieved 6 May 2017.
*
External links
PubMed
{{Medicine, state=collapsed
Immune system
Immunology
Medical treatments
it:Immunodepressione