Immunology

What is an Immunologist?

An immunologist is a clinician or scientist who specializes in immunology and investigates the immune system and related processes. While many immunologists perform research in academic or private industry labs, some clinical immunologists focus on identifying and treating immune system disorders, including autoimmune disorders and allergies. Both research and clinical immunologists have an essential role in developing new treatments, conducting clinical trials, and providing excellent patient care through specialty pharmacies.

About the Immune System

The immune system is an intricate network of structures and processes that evolved to safeguard us from diseases. It is made up of various molecular and cellular components, each with unique functions that can be categorized into two types of mechanisms. The first type is nonspecific, as it is innate to the organism and provides a general defense against pathogens. The second type is responsive, as it adapts to specific pathogens and offers a more targeted defense. The study of these components is fundamental to understanding how the immune system works. Classical immunology explores the anatomy, physiology and biochemistry of both the innate and adaptive immune system.

Innate Immunity

Innate immunity constitutes the body's first line of defense against pathogens and is characterized by non-specific responses. Although these responses remain constant regardless of the type of invader, the physical barriers, such as skin and saliva and various cells including macrophages, neutrophils, basophils, and mast cells, can quickly and effectively protect the organism from external pathogens for several days after infection. In some cases, the initial response suffices to eradicate the pathogen, but in other instances, the first defense is overcome, and a second line of defense comes into play.

Adaptive Immunity

Adaptive immunity serves as our second line of defense against harmful pathogens and foreign substances. This defense mechanism works by building up a memory of previously encountered infections, allowing for a more efficient positive immune response. The adaptive immune system utilizes antibodies, targeting pathogens that circulate in the bloodstream, and T cells, which focus on pathogens that have established themselves inside cells. T cells actively fight infection by eliminating the source directly or helping regulate the antibody response.

Types of Immune Disorders

Allergies

Allergies are a type of hypersensitivity disorder that occurs when the body's immune system reacts against substances that are typically harmless, resulting in damage to the body's own tissues. These substances can be anything, but most commonly they come from certain types of food, like peanuts, or from airborne substances like pollen or dust. When an allergen enters the body, the immune system perceives it as dangerous and releases substances to attack it. This, in turn, causes cells of the immune system to release chemicals such as histamine, which triggers inflammation and the various symptoms associated with allergies. Immunology is a field of study that focuses on understanding what happens to the body during an allergic response, as well as the factors responsible for causing them. By carefully analyzing this process, researchers hope to improve methods for diagnosing, preventing, and controlling allergic diseases.

Asthma

Asthma is a severe respiratory disease that can be fatal if not managed properly. It primarily affects the airways and is triggered by the immune system's response to airborne particles. If left untreated, it can cause the airways to thicken over time, severely impairing breathing. The disease is pervasive and is a leading cause of illness, especially in children. While asthma may have an allergic component in some individuals, the exact cause remains elusive in most cases.

Autoimmune Disorders

Autoimmune disorders and diseases occur when the immune system mistakenly attacks the body's own cells as if they were foreign invaders. In individuals with autoimmune diseases, there is a defect in the immune system that causes it to lose the ability to distinguish 'self' from 'non-self' or 'foreign' molecules. These diseases can be classified as either 'primary' or 'secondary.' In the case of type-1 diabetes, for example, the disease may occur from birth or during early life and is considered a primary autoimmune disease. Secondary autoimmune diseases develop later in life due to various factors and include conditions such as rheumatoid arthritis and multiple sclerosis. 

The principles of immunology have led to the development of various laboratory tests to detect autoimmune diseases. In addition, autoimmune diseases can be localized, such as Crohn’s disease, which affects the gastrointestinal tract (GI immunology), or systemic, such as systemic lupus erythematosus (SLE), which can affect multiple organs and systems in the body.

Cancer

Cancer is a complex disease caused by abnormal and uncontrolled cell growth and proliferation. It is described by a set of hallmarks, one of which is the ability of cancer cells to evade immune destruction, like skin cancer, dermatologic cancer and urologic cancer. With the knowledge that evasion of the immune system can contribute to cancer, researchers have turned to manipulating the immune system to defeat cancer, a process known as immunotherapy. 

Immunotherapy has shown extraordinary promise as a new weapon in our arsenal against cancer, seeking to leverage the immune system's innate powers to fight cancerous tissue. The approach includes a range of techniques designed to boost the immune response, such as the use of monoclonal antibodies. These are proteins that seek and directly bind to a specific target protein called an antigen. 

One example of monoclonal antibodies used to treat cancer is Herceptin. It specifically targets the HER2 protein that is overexpressed in some breast and stomach cancers. In addition to monoclonal antibodies, a number of successful cancer vaccines have been developed, with the HPV vaccine being a notable example. 

With the continued advancement of cancer immunotherapy, researchers are optimistic about the future of cancer treatment. By further understanding the intricate relationship between the immune system and cancer, we can continue to improve our methods of cancer prevention and treatment.

Immunodeficiency

Immunodeficiency disorders, which involve a compromised immune system, greatly reduce the body's ability to mount an appropriate defense, leading to severe and recurring infections that can result in debilitating complications and even mortality. There are two types of immunodeficiency disorders: primary and secondary. Primary immunodeficiencies, which are usually hereditary and are present from birth, are relatively rare. Common variable immunodeficiency (CVID) is such an example. Secondary immunodeficiencies usually occur later in life and are often caused by imbalances following an infection, such as the case with AIDS following HIV infection. It is important to correctly identify these disorders to provide timely treatment to minimize the impact of such afflictions on those who are affected.

Transplants

Transplants entail transferring cells, tissues, or organs from a donor to a recipient. Despite the life-saving nature of this procedure, the immune system's tendency to identify and reject foreign objects poses a significant challenge to transplant success. A thorough comprehension of the mechanisms and clinical features of rejection plays a crucial role in diagnosing and recommending treatment, and in devising new strategies and medications to manage transplants and effectively mitigate the risk of rejection.

Vaccines

Vaccines are medicinal preparations that train the human body to identify and defend against infections caused by harmful pathogens, such as bacteria, viruses, and parasites. They achieve this by providing a "preview" of a specific pathogen, which activates the immune system in preparation for a possible future infection. The vaccine is composed of a harmless portion of the infectious agent which invigorates the immune system to produce an antibody response. This antibody production is facilitated by the proliferation of cells responsive to the vaccine, such as memory cells. Following the first encounter with the pathogen, these memory cells record the specific details of the previous immune response to the pathogen and are reactivated upon subsequent exposure. They quickly neutralize the threat by producing sufficient levels of targeted antibodies, leading to the destruction of the invading pathogen within the body and preventing further infection.

Due to the successful application of vaccines, many infectious diseases that were once a scourge on Europe no longer pose a threat. These diseases include smallpox, measles, mumps, rubella, diphtheria, tetanus, whooping cough, tuberculosis and polio.

Clinical Immunology

The immune system is a complex and finely-tuned regulatory network. When this balancing act is disrupted, it can lead to disease. Research in this field focuses on understanding how immune system dysfunction can precipitate illness. This understanding enables the development of new therapies, treatments and using specialty pharmacies, that modulate immune function. These interventions can not only treat disease, but also have the potential to prevent it in the first place. Vaccines, for example, are designed to prime the immune system, preparing it to generate a robust response to specific pathogens.

Immune System Conditions

Treatment for autoimmune diseases generally focuses on reducing immune system activity, including the below as well as others.

Please consult with your doctor for conditions for your specific disease state.

Lupus Nephritis

Lupus nephritis is a type of kidney disease caused by systemic lupus erythematosus (SLE or lupus). Kidney disease caused by lupus may get worse over time and lead to kidney failure. If your kidneys fail, you will need dialysis or a kidney transplant to maintain your health.

Guillain-Barre syndrome

The immune system attacks the nerves controlling muscles in the legs and sometimes the arms and upper body. Weakness results, which can sometimes be severe. Filtering the blood with a procedure called plasmapheresis is the main treatment for Guillain-Barre syndrome.

Infantile Spasms

These specific types of seizures are sudden, uncontrolled movements of a child’s neck, body, arms, and legs. They last only for a few seconds. Spasms are most common during the early morning or when a child wakes up from a nap.

Nephrotic Syndrome

A condition marked by very high levels of protein in the urine; low levels of protein in the blood; swelling, especially around the eyes, feet, and hands; and high cholesterol. Nephrotic syndrome results from damage to the kidneys’ glomeruli (the singular form is glomerulus). Glomeruli are a network of capillaries that filter waste and excess water from the blood and send them to the bladder as urine.

 

Medications

Benylsta

BENLYSTA (belimumab) is used to treat Systemic Lupus Erythematosus (SLE) and Lupus Nephritis (LN), in patients age 5 years and older who are receiving other lupus medicines. It works by binding to a protein (found in high levels in patients with active lupus) in the blood and limiting the activity of the protein. It helps decrease the symptoms of lupus.

Acthar Gel

Acthar Gel is a prescription medicine for the reduction of protein in the urine in people with nephrotic syndrome of unknown origin as well as other immune system disorders such as Infantile Spasms. Acthar is believed to work by helping your body produce its own natural steroid hormones. Natural steroid production helps your body regulate inflammation. Acthar is not a steroid. Acthar is a self-injectable medication that provides a prolonged release of the medication after it is injected.

 

Immunology Therapies

Dermatology

Dermatologic immunology therapy is the branch of medicine that deals with skin, mucous membranes, hair and nails. Although relatively straightforward to examine, the skin is the largest organ and has numerous potential abnormalities - there are about 1500 distinct skin diseases and many variants, including eczema and atopic dermatitis, Psoriasis and alopecia areata. We are relatively ignorant about the pathogenesis of the majority of these although knowledge is rapidly increasing especially in the fields of molecular medicine and genetics.

Learn more about Dermatologic Cancer.

Gastroenterology

Gastroenterology immunology therapy (GIT) refers to the field of medical practice that deals with the study and treatment of disorders affecting the gastrointestinal tract. Problems with digestion and nutrient absorption can be mechanical or function based. This means that issues in one part of the digestive tract can be affecting overall gut health, but that organ dysfunction or chronic illness may be impacting the symptoms that are expressed.

Learn more about Gastroenterology specialty pharmacy.

Rheumatology

Rheumatologic immunology therapy refers to the branch of medicine that deals with disorders involving your vital organs, including the lungs, heart, nervous system, kidneys, skin and eyes.

Rheumatologic diseases, such as rheumatologic arthritis, may result in conditions so severe that those who suffer from them cannot bathe or dress themselves. Additionally, a simple task such as walking can cause pain and be difficult or even impossible.

Learn more about rheumatologic disorders.