Which medications in the drug class Immunomodulator are used in the treatment of Macrophage Activation Syndrome?

Updated: Nov 21, 2018
  • Author: Angelo Ravelli, MD; Chief Editor: Lawrence K Jung, MD  more...
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Calcineurin inhibitors (eg, cyclosporine) inhibit IL-2, which is essential for T-cell proliferation.

Cyclosporine (Neoral)

An 11-amino acid cyclic peptide and natural product of fungi. Acts on T-cell replication and activity. Specific modulator of T-cell function and an agent that depresses cell-mediated immune responses by inhibiting helper T-cell function. Preferential and reversible inhibition of T lymphocytes in G0 or G1 phase of cell cycle suggested.

Binds to cyclophilin, an intracellular protein, which, in turn, prevents formation of IL-2 and the subsequent recruitment of activated T cells. Has approximately 30% bioavailability, but widely varies on an individual level. Specifically inhibits T-lymphocyte function with minimal activity against B cells. Maximum suppression of T-lymphocyte proliferation requires that drug be present during first 24 h of antigenic exposure.

Suppresses some humoral immunity and, to a greater extent, cell-mediated immune reactions (eg, delayed hypersensitivity, allograft rejection, experimental allergic encephalomyelitis, and graft-vs-host disease) in various organs.

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