Cytokines are proteins produced by cells of the immune system and act like hormones, which control and modulate other immune system cells and body’s response to disease in infections. Cytokines also regulate growth of new blood cells in the bone marrow.
Following are the cytokines that are naturally produced in the body:
- Interferons
- Interleukins
- Tumor Necrosis Factors
- Colony Stimulating Factor
- Erythropoietin
- Thymopoietin
Artificial cytokines (Therapeutic cytokines) produced by recombinant DNA technique are available for disease modification.
Interferon: They are the 1st line of defense against a viral infection. There are 3 types of interferon (IFN) available – IFN-alpha, IFN-beta and IFN-gamma. Interferon alpha is currently used in treatment of chronic Hepatitis B & C. Interferon-gamma is used to treat diseases in which macrophage activation may occur such as lepromatous leprosy, leishmaniasis and toxoplasmosis.
Erythropoietin: Erythropoietin stimulates the bone marrow to make red blood cells. It is naturally produced in kidney in response to hypoxia and stimulates erythrocyte burst cells and colony forming units. Recombinant erythropoietin is used in the treatment of anemia associated with chronic renal failure.
Granulocyte-Colony Stimulating Factor (G-CSF): It is a hematopoietic growth factor and is naturally produced in lymphocytes and monocytes & stimulates progenitor cells of different hematopoietic cell lines to form mature blood cells. It is especially useful in cancer patients with chemotherapy-induced neutropenia to reduce the incidence of infection.
Etanercept: It is an anti-Tumor Necrosis Factor (TNF) receptor and used to retard the progression of disease in patients with Rheumatoid arthritis, Juvenile Rheumatoid Arthritis, and Psoriatic arthritis. Etanercept binds TNF, one of the dominant inflammatory cytokine resulting in significant reduction in inflammatory activity.
Interleukin 1 inhibitor: It is used in adult patients with Rheumatoid Arthritis who have inadequate response to disease modifying agents. It selectively blocks IL-1, a protein present in excess in these patients that causes joint inflammation and damage.
RECOMBINANT ENZYMES Dornase alfa: It is a recombinant deoxyribonuclease 1 (DNAse 1) available in aerosol form that breaks down intracellular DNA in the excessive mucous secretions of lung making them less adhesive to airways and thus decreases excessive mucus accumulation in lungs. It is used in patients with cystic fibrosis.
Glucocerebrosidase enzyme: Recombinant enzyme is available for patients with Gaucher’s disease.
Recombinant Tissue-type plasminogen activator: This dissolves blood clots by activating conversion of protein plasminogen to proteolytic enzyme plasmin and is used in the treatment of myocardial infarcts, strokes and pulmonary emboli. It has a predominant local action as compared to streptokinase and urokinase and thus theoretically would cause less bleeding.
MONOCLONAL ANTIBODIES (MoAbs) They are antigen specific antibodies. Theoretically a MoAb designed for a particular antigen on cancer cells can initiate an immune response that would destroy cancer cells without harming normal cells.
Muromonab-CD3 is used for treatment of immune-system rejection of transplanted heart, kidney and liver without causing immune suppression.
Daclizimab: It is an immunosuppressant used to prevent kidney transplant rejection.
Infliximab: It is effective against Crohn’s disease and reports have indicated usefulness in Kawasaki’s disease.
Abciximab: It is used to prevent blood clotting as an adjunct to angioplasty.
Last updated on 1-03-2005
