Active immunotherapy

Active immunotherapy is a type of immunotherapy that aims to stimulate the host's immune system or a specific immune response to a disease or pathogen and is most commonly used in cancer treatments.[1][2] Active immunotherapy is also used for treatment of neurodegenerative disorders, such as Alzheimer's disease, Parkinson's disease, prion disease, and multiple sclerosis.[3] Active immunotherapies induce an immune response through direct immune system stimulation, while immunotherapies that administer antibodies directly to the system are classified as passive immunotherapies.[4] Active immunotherapies can elicit generic and specific immune responses depending on the goal of the treatment.[5] The categories of active immunotherapy divide into:

  • Non-specific active immunotherapy: generating a general immune system response using cytokines and other cell signaling molecules.[6]
  • Specific active immunotherapy: the generation of cell-mediated and antibody immune responses focused on specific antigens expressed by the cancer cells, typically using a vaccine platform.[5]
Active immunotherapy
Specialtyimmunology

Active immunotherapies fall under the category of activation immunotherapies, which is a subset of immunotherapies that activate the immune system as opposed immunotherapies that suppress the immune system.

Non-specific active immunotherapy

Non-specific active immunotherapy is administered with the overall goal of generally eliminating malignant pathogens or cells from the host system.[5] This treatment stimulates the immune system in a general sense, rather than specifically targeting a cell type e.g. cancer cells. Non-specific approaches aim to create a robust immune response that would lead to the eventual killing of malignant cells through immunomodulators such as cytokines.[6]

Cytokines

Immunomodulating agents regulate the immune system's response and are produced by various immune cells. These agents include the following agents and markers:

Class Examples
Cytokines Ig, Interferons, TNF
Chemokines CXC, CC, CX3C, XC
Interleukins IL-2, IL-7, 1L-10, 1L-12

BCG Vaccine

The BCG vaccine has been used against tuberculosis, mycobacteria, and various cancers in the form of vaccination as an initial immune system stimulant.[7] In cancer, the anti-tumor immunological effects are elicited by the host's immune response and the BCG infection against the tumor cells, most commonly in bladder cancer.[7] The immune activation allows for further recognition and elimination of malignant tumor cells.[7]

Specific active immunotherapy

Specific active immunotherapy administers a specific antigen as the therapy. The therapy allows the host to create an antigen-specific response with the development of antibodies, proliferation of cytotoxic T lymphocyte responses, or both, directed at the desired pathogen or malignant tumor cell in the case of cancer therapy.[5]

Vaccine Therapies

Vaccine therapies are a type of specific active immunotherapy. Vaccine therapies deliver various agents that will lead to a specific immune response e.g. antibody development or CTL response.[5] Tumor antigens have been a main target in specific active immunotherapy by way of vaccination. Tumor antigens are antigens produced by tumor cells and can be common among patients with the same cancer-type, or unique to a particular patient. Their specificity to malignant tumor cells makes tumor antigens ideal candidates for vaccination.[2]

See also

References
  1. Yang, Isaac; Han, Seungu (2009). "Heat-shock protein vaccines as active immunotherapy against human gliomas". Expert Review of Anticancer Therapy. 9 (11): 1577–82. doi:10.1586/era.09.104. PMC 3836274. PMID 19895242.
  2. Davis, Ian D (2000-06-01). "An overview of cancer immunotherapy". Immunology and Cell Biology. 78 (3): 179–195. doi:10.1046/j.1440-1711.2000.00906.x. ISSN 1440-1711. PMID 10849106. S2CID 37602189.
  3. Brody, David L.; Holtzman, David M. (2008-06-17). "Active and Passive Immunotherapy for Neurodegenerative Disorders". Annual Review of Neuroscience. 31 (1): 175–193. doi:10.1146/annurev.neuro.31.060407.125529. ISSN 0147-006X. PMC 2561172. PMID 18352830.
  4. Winblad, Bengt; Graf, Ana; Riviere, Marie-Emmanuelle; Andreasen, Niels; Ryan, J. Michael (2014-01-30). "Active immunotherapy options for Alzheimer's disease". Alzheimer's Research & Therapy. 6 (1): 7. doi:10.1186/alzrt237. ISSN 1758-9193. PMC 3979042. PMID 24476230.
  5. Baxter, D (2014). "Active and passive immunization for cancer". Human Vaccines & Immunotherapeutics. 10 (7): 2123–9. doi:10.4161/hv.29604. PMC 4370360. PMID 25424829.
  6. "Non-specific cancer immunotherapies and adjuvants | American Cancer Society". www.cancer.org. Retrieved 2018-04-03.
  7. Green, James; Fuge, Oliver; Allchorne, Paula; Vasdev, Nikhil (2015-05-04). "Immunotherapy for bladder cancer". Research and Reports in Urology. 7: 65–79. doi:10.2147/rru.s63447. PMC 4427258. PMID 26000263.
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