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Immunodeficiencies and possibilities of their modulation
1Department of Immunology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
Immunodeficiencies (IDs) have been a very attractive and fruitful topic immunology for a number of years. In the early years of studies attention is given to these conditions focused on clinical and theoretical aspects, while recently, the expanding area of immunomodulation has opened the door to possible application of this form of therapy also to IDs. IDs are nonphysiological, mostly clinical pictures and disease states that stem from disorders or defects of immunity. Either the genetic basis may be involved - inherited or primary IDs, or ID may be a consequence of an event affecting the organism - secondary or acquired ID. Among these events predominate viral infections, tumors, metabolic diseases, life threatening conditions, and environmental and other factors. Some selected primary IDs have been described where analysis at the molecular level resulted in a much deeper understanding of their underlying mechanisms. Secondary IDs are very important in terms of their frequent incidence and complex nature, but their investigation is still very incomplete with the exception of AIDS. The importance of secondary IDs is illustrated by data from the Institute for Clinical and Experimental Medicine in Prague. Immunomodulation in broad terms seems to be very promising in many IDs. Not only substitutive therapy, e.g. by Ig, or treatment of infections in immunodeficient patients with antibiotics, but a total spectrum of immunomodulating procedures should be in the focus of immunologists in the near future when IDs will be considered: modern approaches including application of new thymic hormones, monoclonal antibodies, bone marrow or stem cell transplantation, and gene therapy will be used.
Immunodeficiencies (IDs) have been a very attractive and fruitful topic immunology for a number of years. In the early years of studies attention is given to these conditions focused on clinical and theoretical aspects, while recently, the expanding area of immunomodulation has opened the door to possible application of this form of therapy also to IDs. IDs are nonphysiological, mostly clinical pictures and disease states that stem from disorders or defects of immunity. Either the genetic basis may be involved - inherited or primary IDs, or ID may be a consequence of an event affecting the organism - secondary or acquired ID. Among these events predominate viral infections, tumors, metabolic diseases, life threatening conditions, and environmental and other factors. Some selected primary IDs have been described where analysis at the molecular level resulted in a much deeper understanding of their underlying mechanisms. Secondary IDs are very important in terms of their frequent incidence and complex nature, but their investigation is still very incomplete with the exception of AIDS. The importance of secondary IDs is illustrated by data from the Institute for Clinical and Experimental Medicine in Prague. Immunomodulation in broad terms seems to be very promising in many IDs. Not only substitutive therapy, e.g. by Ig, or treatment of infections in immunodeficient patients with antibiotics, but a total spectrum of immunomodulating procedures should be in the focus of immunologists in the near future when IDs will be considered: modern approaches including application of new thymic hormones, monoclonal antibodies, bone marrow or stem cell transplantation, and gene therapy will be used.