Cytokines
Cytokines are a group of proteins or glycoproteins primarily produced by white blood cells, playing a crucial role in the immune system by facilitating communication between cells. These molecules can stimulate or inhibit the activity of immune cells, contributing to both the innate and adaptive immune responses. Cytokines are categorized into various subclasses, including interleukins, interferons, and tumor necrosis factors, each with specific functions in immune regulation. They can be produced naturally within the body or synthesized in laboratories for therapeutic use, particularly in cancer treatment.
Cytokines are administered through subcutaneous or intravenous injection and have shown potential in activating the immune system to target cancer cells, while minimizing harm to normal cells. Interferons and interleukins are the primary types used for conditions such as metastatic melanoma and renal cell carcinoma. Despite their therapeutic benefits, cytokine treatments can lead to side effects like nausea, fever, and in severe cases, cytokine storm, which can result in critical health complications. Ongoing research is focused on enhancing the efficacy of cytokines in immunotherapy, aiming to improve treatment outcomes for cancer patients.
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Cytokines
ATC CODE: LO3-LO3AX
ALSO KNOWN AS: Lymphokines, monokines, interleukins and interferons, hematopoietic growth factors, tumor necrosis factors, chemokines, granulocyte colony-stimulating factor
DEFINITION: Cytokines are a class of (mainly water-soluble) proteins or glycoproteins produced by white blood cells (immune system cells; leukocytes). Cytokines carry chemical messages between cells and are particularly important in the innate and adaptive immune response. Immune cell activity can be stimulated or inhibited or can stimulate or inhibit other cells’ activities. There are many cytokine subclasses. Cytokines are produced naturally by immune cells in the body and can also be produced in the laboratory.
Cancers treated:Renal cell carcinoma, metastatic melanoma, Kaposi sarcoma, chronic myelogenous leukemia, hairy cell leukemia, follicular non-Hodgkin lymphoma, cutaneous (skin) T-cell lymphoma
Delivery route: Subcutaneous or intravenous (IV) injection
How these agents work: Cytokines are unique in that they bind to individual cell receptors. They can regulate several parts of the immune system by stimulating the production of cellular molecules that can attach themselves to the surface of tumor cells, where they have an antitumor effect. Other cytokines suppress the activity of cells and thus inhibit their action.
Cytokines have more than one mechanism of action, and many aspects of their cellular signaling are being actively researched. They are being investigated for their ability to kill tumor cells and for their potential to act as vaccines or adjuvant stimulants against the development of cancer cells by presensitizing the immune system to kill cancer cells if they develop.
Immunotherapy is still being aggressively studied for mechanisms of action, stimulation, and suppression, and it is believed that it will work in conjunction with other therapies rather than alone. The attractiveness of immunotherapy is the specificity of attacking only cancer cells and not harming normal cells, finding small numbers of cancer cells not identified through other treatment modalities, and using the existing immune system to treat cancer.
The main types of cytokines used to treat cancer are interferons and interleukins. Interferon alfa (IFN-alfa), which enhances the immune response to cancerous cells and may also inhibit their growth or survival, has been approved by the US Food and Drug Administration (FDA) for the treatment of melanoma, Kaposi sarcoma, hairy cell leukemia, kidney cancer, Cutaneous (skin) T-cell lymphoma, chronic myelogenous leukemia (CML), and follicular non-Hodgkin lymphoma. Interferon beta (IFN-beta) and interferon-gamma (IFN-gamma) treat diseases other than cancer.
Interleukin-2 (IL-2), also known as T-cell growth factor, promotes the production of white blood cells and certain antibodies. The synthetic version, known as aldesleukin, has been approved to treat metastatic kidney cancer and metastatic melanoma. In addition, certain hematopoietic growth factors, including erythropoietin, interleukin-11, and granulocyte colony-stimulating factors, are sometimes used to alleviate the side effects of some chemotherapies. The interleukins IL-7, IL-12, and IL-21 are also being investigated for applications in cancer treatment.
Side effects: Common side effects of cytokine treatment include nausea and vomiting, acute toxicity, capillary leak syndrome, low blood pressure, high cardiac output, liver toxicity, renal toxicity, pulmonary edema, fever, chills, gastric acidity, hair loss, confusion, skin rash, and infection. Most of the toxic side effects can be reversed. Fever and chills are treated with acetaminophen, and antibiotics are used for infection. Cytokine storm is a syndrome that can occur with the overstimulation of cytokines and can result in severe adverse effects, including death.
Bibliography
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