Posted: April 15th, 2022

Immunosuppressants and their Effects on Health

Immunosuppressants and their Effects on Health
Immunosuppressive drugs play a crucial role in improving health outcomes for patients with autoimmune diseases, organ transplants, and certain cancers by suppressing the immune system (Kidney Health Initiative et al., 2020). However, long-term use of these medications can also negatively impact health through increased susceptibility to infection and other side effects. This article will explore how various classes of immunosuppressants affect the body and discuss recent research on balancing immunosuppression with patient well-being.
Corticosteroids such as prednisone are a first-line treatment for many conditions due to their potent anti-inflammatory properties but carry significant health risks with chronic use. By inhibiting immune cells, steroids increase vulnerability to bacterial, viral and fungal infections (Frontiers in Pharmacology, 2020). They have also been linked to adverse metabolic changes like new-onset diabetes, weight gain, and osteoporosis (National Center for Biotechnology Information, 2022). However, short-term “pulsed” steroids can provide clinical benefit with fewer side effects than long-term therapy.
Calcineurin inhibitors cyclosporine and tacrolimus are workhorses of transplant immunosuppression but impose toxicities like nephrotoxicity (kidney damage) and hypertension (American Academy of Pediatrics, 2019). Mycophenolate mofetil (MMF), commonly used in combination regimens, selectively targets lymphocyte proliferation and is generally better-tolerated than other drugs, though gastrointestinal upset is common (American Academy of Pediatrics, 2019). Newer biologic agents etanercept and rituximab supplement traditional therapies, but data on long-term safety is still emerging (Frontiers in Pharmacology, 2020).
In summary, while immunosuppressants enable treatment of previously fatal conditions, their use necessitates careful monitoring and management of infection risk, metabolic complications, and other potential adverse effects. Further research aims to develop targeted therapies that minimize harmful impacts on health while maintaining disease control (Kidney Health Initiative et al., 2020). Close collaboration between patients, clinicians, and researchers remains key to optimizing quality of life for individuals living with chronic immunosuppression.
American Academy of Pediatrics. (2019). Immunosuppressive drugs and pregnancy. NeoReviews, 20(11). https://doi.org/10.1542/neo.20-11-e578
Frontiers in Pharmacology. (2020). Gonadal effects of immunosuppressive drugs. Frontiers in Pharmacology, 11. https://doi.org/10.3389/fphar.2020.01333
Kidney Health Initiative, American Society of Nephrology, & American Society of Transplantation. (2020). Management of COVID-19 in kidney transplant and living donor candidates and recipients: Interim guidance. Clinical Journal of the American Society of Nephrology, 15(7). https://doi.org/10.2215/CJN.11501220
National Center for Biotechnology Information. (2022). Immunosuppressants. U.S. National Library of Medicine. https://www.ncbi.nlm.nih.gov/books/NBK557853/