Immunosuppressants & Steroids

Question 1

Azathioprine (Azmido)

Answer 1

Mechanism of action: not entirely understood but it’s thought that it inhibits amidophosphoribosyltranferase therefore reducing purine synthesis and affecting B & T cell function. Azathioprine also affects modulation of rac1 to induce T cell apoptosis

Question 2

Prednisolone (Prednipress)

Answer 2

Mechanism of action: decreases inflammation via suppression of the migration of polymorphonuclear leukocytes and reversing increased capillary permeability. It also suppresses the immune system by reducing its activity and volume.

Question 3

Dexamethasone

Answer 3

Mechanism of action: type of corticosteroid medication, specifically glucocorticoid. It works by mimicking the action of cortisol which is a hormone naturally produced by the body in the adrenal glands that has anti-inflammatory and immunosuppressive properties. It binds to glucocorticoid receptor found in cytoplasm and the drug-receptor complex moves into cell nucleus where is binds to specific parts of the DNA leading to changes in gene transcription. This leads to decrease in proteins that promote inflammation and an increase in proteins that inhibit inflammation. It decreases vasodilation, permeability of capillaries, and leukocyte migration to sites of inflammation.

Question 4

Hydrocortisone

Answer 4

Mechanism of action: binds to glucocorticoid receptor leading to downstream effects such as inhibition of phospholipase A2, NF kappa B and other inflammatory transcription factors. Once it binds to promotor region, it induces the expression of anti-inflammatory genes by reducing prostaglandin production, inhibiting NK kappa B, reducing cytokine & chemokine production, and phagocytosis