What are the effects of  immunosuppressants on the human body and how can they benefit  or harm our immune system?

 

   Objective

The purpose of this research is to understand what immunosuppressants are and how they can affect the human body, both negatively and positively. Immunosuppressants can  benefit a weak human immune system by boosting the human body's immune system for various things. However,  immunosuppressants can also aggravate the immune system  resulting in infections, organ dysfunction and more. By using statistical data and information from medical expertise, this research concludes the consumption of immunosuppressants by comparing its different factors. 

 

Research Question

 

What are the effects of immunosuppressants on the human body and how can they benefit or harm our immune system?

 

Objective

The purpose of this research is to understand what immunosuppressants are and how they can affect the human body, both negatively and positively. Immunosuppressants can benefit a weak human immune system by boosting the human body's immune system for various things. However,  immunosuppressants can also aggravate the immune system resulting in infections, organ dysfunction and more. By using statistical data and information from medical expertise, this research concludes the consumption of immunosuppressants by comparing its different factors.  

What is the immune system?

The immune system is a complex apparatus containing structures of several organs and cells, defending the human body against contamination. By keeping records of previous infections, this system can recognize and break microbes swiftly. 

The immune system is broken down into two parts, there is the innate immune system which is considered the nonspecific immune system (does not attack specific pathogens) and there is the adaptive immune system which is considered the specific immune system as it attacks specific pathogens. These subsystems work together when an immune response is triggered due to viruses/diseases.

 

Key definitions

 

• Antigen: an antigen is a foreign substance which causes the body to elicit an immune response 
• Pathogen: a pathogen is a disease-causing organism 
• Antibodies: antibodies bind to antigens to remove the foreign antigen through various mechanisms, and can also activate complement proteins which help kill pathogens 
• B cells: b cells bind to antigens which produce antibodies 
• T cells: recognize processed antigens, they attack targets by releasing chemicals. There are two types of t cells, helper t cells and cytotoxic t cells. Helper t cells are activated by the antigen-presenting cells, they activate B cells and cytotoxic T cells to kill infected host cells. Cytotoxic T cells are known as killer cells, they kill cells by releasing chemicals (granzymes and perforins) which cause cell apoptosis (cell suicide) 
• Antigen Presenting Cells: cells that present the antigen surface to other immune cells for them to elicit an immune response (allows other cells to recognize that there is an antigen which needs to be acted on) 

 

What are immunosuppressants?

 

Immunosuppressant is a class of medicines used to limit the amount of immune response given in the body. These drugs are used to prevent the body from unintentionally attacking healthy cells and tissues. By doing so, they treat certain autoimmune diseases and allow the body to be less likely to resist organ transplantation. By disabling certain parts of the immune system, immunosuppressants can decelerate the attack on healthy tissues and cells. 

 

How do immunosuppressants work?

 

• Essentially, Immunosuppressants work by suppressing the immune system and decreasing its reaction to the body. However, it is a case-to-case matter and based on different bodies, the symptoms and effects will vary. These effects are usually negative as people rely so much on this drug that they are unable to discontinue it since it is the only way they keep their immune system intact. 
• They do this by blocking the activity of T cells (the killer cells) which attack pathogens and kill pathogens in the body. 
• Calcineurin is an enzyme that activates the T cells and causes them to start attacking the disease-causing cells, immunosuppressants prevent this enzyme from being released, hence, the T cells cannot be activated and the immune response is suppressed  

 

When and Where were immunosuppressants discovered?

 

The discovery of immunosuppressants dates back to the 1960s by the experiments of Sir Roy Calne. However, the most common immunosuppressant, Cyclosporine, had been discovered in 1972 in the lab of Sandoz in Switzerland. By 1983 it gained more recognition as a higher-ranking immunosuppressive drug.

 

Types of Immunosuppressants

• Corticosteroids are the most common type of immunosuppressant, they are a type of anti-inflammatory drug
• Calcineurin inhibitors: inhibit calcineurin, are proteins that prevent the activation of t cells, hence suppressing the immune system 
• Inosine monophosphate dehydrogenase (IMDH) inhibitors and Mechanistic target of rapamycin (mTOR) inhibitors: suppress cell growth and cell multiplication (ex cancer) 
• Monoclonal antibodies: are used in cases of organ transplants 
• Janus kinase inhibitors: prevent the activation of certain enzymes which reduce inflammation caused by the immune system

 

The need for immunosuppressants

• Immunosuppressants are used for patients with autoimmune diseases, cell damage, and inflammation as well as to perform organ transplantations. Patients with conditions such as Inflammatory Bowel Disease, Lupus, and Rheumatoid arthritis (RA), may need immunosuppressants. Organ transplantations such as bone marrow, lung or heart transplantations also require immunosuppressants.  With conditions like these, the drug may be used to increase the healthy being of the body. 
• Immunosuppressive therapy is a therapy that requires prescribed immunosuppressant drugs to treat conditions (autoimmune diseases, post-organ transplantation, inflammation, etc). This treatment is used to lower the activity of the body’s immune system. This treatment may be used to prevent the rejection of an organ, as well as disease protection. . 

 

Benefits

• Helps the immune system by combating cell damage, and inflammation, and reduces the risk of organ transplantation and autoimmune diseases
• In the past, the main objective of immunosuppressant drugs was to help reduce the risk of rejecting organ transplants which continues up 
• For individuals who have an autoimmune disease, immunosuppressants can then inhibit the enzyme called calcineurin (which activates T cells), preventing the activation of T cells which stops the immune system from damaging healthy cells and inflammation 
• Individuals who get a stem cell transplant due to having blood cancer start to build a new immune system (due to the new stem cells which produce blood cells), this new immune system is in a new body and believes the new body is foreign (considers it an antigen) and may start attacking the body, hence immunosuppressants are required to suppress the immune system 
• In cases of organ transplants, your body is not familiar with the new organ and believes it is an antigen, hence an immunosuppressant may be needed so that your body does not attack the cells of the new organ 

 

Harms

• Immunosuppressants suppress the immune system, sometimes more than intended. With too much weakening, the body may not be able to protect itself from pathogens and infectious microorganisms. If this were to happen, the body would become vulnerable to other diseases, increasing the risk of viral, bacterial and fungal infections. Long-term toxicities associated with immunosuppressants (specifically Azathioprine) also include hematological deficiencies, GI disturbances, and hypersensitivity reactions. 
• Another major risk of immunosuppressants is the development of skin cancer, which is developed through the body’s inability to kill cancer cells. More than 50% of transplant patients develop skin cancer 20 years post-transplantation. Although immunosuppressants can offer lifesaving benefits, the side effects and health complications could potentially become life-threatening. Symptoms and side effects of this drug include birth defects, otitis media, sinusitis, bronchitis, pneumonia, diarrhea, meningitis and bacterial sepsis.

 

Professional Opinion on Immunosuppressants 

• A study done by the Stanford University highlighted some of the key risks associated with immunosuppressants, they  identified a genetic profile present in about 20% of the population that may cause fatal reactions to immunosuppressants 
• These risks included severe reactions such as life threatening lung problems, liver dysfunction, and cytokine storm
• According to the researchers at Stanford University, it is important to raise public awareness regarding the risks and usage of immunosuppressants in order to prevent severe negative reactions due to them 
• The researchers advocate for prescreening of patients prior to being prescribed for immunosuppressants 

 

The graph below represents the statistics of the global Organ Transplant Immunosuppressant Drugs Market Share(%) from 2023 to 2030. North America is predicted to hold a greater position in the global organ transplant immunosuppressant drugs market by 2030. This forecast period can resemble the future healthcare of North America as it is not only an investment for ill patients but it will also increase its production and distribution activity among pharmaceutical companies and biotech firms. Companies such as Sanofi in September 2021 invested in safer drugs and merged with RezurockTM to expand their core General Medicines assets. COVID-19 can also be another reason for the demand for immunosuppressant drugs. As the population of COVID-19 patients increased, they put medical procedures on hold for transplant patients. This resulted in a 16% decrease in transplant procedures in 2020 which soon became a great demand once the pandemic was on the border and controlled.

 

https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.mskcc.org%2Fnews%2Ft-cell-science-behind-immunotherapy&psig=AOvVaw02vfnV3Y4xPj2N5-ZVzXx2&ust=1708649553681000&source=images&cd=vfe&opi=89978449&ved=0CBMQjRxqFwoTCODo29_dvYQDFQAAAAAdAAAAABAD

 

 

Improvements from School Science Fair to CYSF. 

•  Research 3 most common immunosuppressants in depth
• Emailing a professional immunosuppressant expert before hand
• Create an original graph
• Extend further knowledge about the immune system 

 

The graph below represents the statistics of the global Organ Transplant Immunosuppressant Drugs Market Share(%) from 2023 to 2030. North America is predicted to hold a greater position in the global organ transplant immunosuppressant drugs market by 2030. This forecast period can resemble the future healthcare of North America as it is not only an investment for ill patients but it will also increase its production and distribution activity among pharmaceutical companies and biotech firms. Companies such as Sanofi in September 2021 invested in safer drugs and merged with RezurockTM to expand their core General Medicines assets. COVID-19 can also be another reason for the demand for immunosuppressant drugs. As the population of COVID-19 patients increased, they put medical procedures on hold for transplant patients. This resulted in a 16% decrease in transplant procedures in 2020 which soon became a great demand once the pandemic was on the border and controlled.

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Global Organ Transplant Immunosuppressant Drugs Market Share (%) 2023-2030

X axis: Continents

Y axis: Rate of Market Share(%)

 

In response to our question; “What are the effects of immunosuppressants on the human body and how can they benefit or harm our immune system,” immunosuppressants can cause both negative and positive effects on the body. The two subsystems in the immune system, the innate and adaptive, work together when a virus/disease enters the body and an immune response is triggered. When this occurs, the body may experience harmful or beneficial symptoms. Immunosuppressants may be required with certain health implications including autoimmune diseases and transplantations. Doctors also say that these medications should be used with caution, research and correct dosage. Otherwise, results may include a decrease in health, and even fatal conditions. Therefore, while immunosuppressants can be beneficial, they can also weaken the immune system if they are relied on frequently, causing additional risks.

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We would like to acknowledge and thank the following people for providing support while completing this project.

Thank you to:

• Ms Bretner (science fair director and organizer at school)
• Parents (Prisha and Kasturi's parents)
• Srisha S ( Kasturi's sister)
• Partners (Prisha and Kasturi for supporting eachother and helping eachother out)
• CYSF coordinators (for providing the opportunity to compete)